Angela Garbes was a professional food writer when she found herself in a new position after the birth of her first child.
“I was the one who was thinking about food all the time and eating food all the time and writing about food all the time and suddenly I was producing food all the time,” Garbes, of Seattle, said of breastfeeding her now 3-year-old daughter.
Garbes’ bewilderment at being told over and over that breastfeeding is the best thing moms can do – even if it’s painful and time consuming in ways most new moms don’t expect – but never learning why led her to tackle her most personal reporting subject ever: motherhood.
Garbes, who had her second daughter just a few months ago, went from reporting on food to digging into medical journals and speaking with experts on the subjects she knew women wanted real answers on -- from breastfeeding to hip pain to miscarriages.
The result is her new book, “Like a Mother: A Feminist Journey Through the Science and Culture of Pregnancy,” which gives women straight talk on pregnancy, their bodies and life after giving birth.
"I see it as a book that I wanted when I was pregnant and it's the book that my friends wanted, based on all the texts that we were exchanging," she said.
Just under four million women give birth every year, according to the U.S. Centers for Disease Control and Prevention (CDC).
"I think that there's some urgency to this," Garbes added. "Millions of women are missing out on this information which could help them be healthier, which would help them feel more supported and just more informed [about] one of the biggest transitions of their lives where so many things are unknown and so much of it leads to a lot of anxiety."
Garbes opened up to "GMA" about the five most surprising things she learned during her months-long journey researching the book.
Garbes was 10 months into breastfeeding her first daughter when she began her research. She discovered what she calls a "hugely motivating factor" to continue breastfeeding at a time she said she really needed it.
“I thought if you're telling women that breast is best and women are going to feel pressured to breastfeed, we should know more about it,” she said.
“People would say, ‘It's immunologically better for a baby,’ and when I asked ‘how does that work,’ no one had an answer.
“I found an evolutionary biologist and I asked her all of my questions,” she said. “The early research suggests that the way breast milk works is that it adjusts itself every single day.”
“How it helps the baby immunologically is that when a baby sucks at a mom’s breast, some of that saliva is sucked into the nipple and the mom’s nipple has receptors that read that saliva, and if they detect an infection or pathogens, it can trigger the body to produce antibodies specific to that infection.”
“I just thought, ‘Why don’t we all know this?’ It’s a hugely motivating factor to continue breastfeeding.”
One topic in Garbes' book that is sure to generate conversation is her case for allowing women to have the occasional glass of wine if they choose during pregnancy. The CDC advises that, "Women who are pregnant or who may be pregnant should not drink alcohol."
The CDC exercises extreme caution in its recommendation because drinking alcohol while pregnant has been proven to cause irreversible, lifetime effects on the physical, mental, and neurobehavioral outcome of the infant. It is more dangerous for a pregnant mother to binge drink (more than approximately four drinks at one time for women) but that does not rule out less amounts as dangerous, research shows.
“We're capable of having more nuanced and complex conversation around pregnancy and motherhood,” Garbes said.
“One example, I would say, is that in the United States we say, ‘no woman who's thinking about getting pregnant or who's pregnant should touch alcohol at all,’ and that's a very extreme position.”
“The truth is -- we don't know what the safe amount of alcohol is that could lead to things like fetal alcohol syndrome, which was only named in 1971,” she continued. “Up until that point no one was that worried about it, and they actually used to give women alcohol intravenously to slow preterm labor.”
“I think instead of just telling women, ‘You can't do this,’ I think you can ask them, ‘What level of risk are you comfortable with?’ Assuming, again, that people want to take care of themselves and their babies.”
“There's a real pressure because the minute you become pregnant, you basically have to kind of stop being the person that you were for decades before,” she said.
“I've been drinking coffee since I was like, 18-years-old, but suddenly I'm like ‘I can't drink coffee or wine or tea or have sushi or have deli meat.’ There are all these things that we basically say you know like the person that you were up until this point has to take a back seat to the baby. Yes the baby is important, but again, so is the mom.”
“So can you can talk through these things and a lot of the science shows that there's more leeway instead of having these rules that just set women up to feel bad,” Garbes said.
“We joke all the time about being a ‘bad mom.’ I think we should just abandon that term. I think everybody is doing the best they can with what they know. I think part of it is just the way that we present the information.”
“Before I had my oldest daughter I had two miscarriages,” she said. “I grieved for a long time. I had a really wonderful doctor -- whom I love -- but I didn't feel like anyone wanted to talk about it. I didn't feel like anyone had the answer for me about why this happened.”
Why do some pregnancies make it to term and why do we lose some?
“What I found out was that actually 20 to 25 percent of known pregnancies end in miscarriage. And for how common it is, why aren’t we talking about it?”
“Women go through this feeling really alone, feeling really sad and oftentimes ... many women felt guilty. Many women felt like maybe something they did... maybe had caused it and that’s not true.”
“When you’re not talking about it, that void is filled with a lot of self-doubt and a lot of guilt that women shouldn't have to carry, because the truth is that most miscarriages are just caused by genetic abnormalities that we have no control over.”
“You can see it as your body being really wise and recognizing that this is not a pregnancy that can be carried to term.”
“You start producing around 50 percent more blood” during pregnancy, Garbes said. “Some people say that's the pregnancy glow perhaps, but it also leads to [other] things. My gums bled when I brushed my teeth, or sometimes would just spontaneously bleed."
[Experts note that although there is more blood volume in a woman's system during pregnancy, her body is actually working to increase its ability to clot blood to prepare for the loss of blood volume that naturally occurs during delivery. It’s a safe practice to check with a doctor about any bleeding concerns.]
“What that blood is for is to nourish the baby -- which happens through the placenta -- which is an entirely new organ that women grow from scratch, along with an entirely new person, inside their body.”
“It’s not really talked about in pregnancy books. No one talks about it really even in childbirth.”
“When I was pregnant one of my best friends was like, ‘Just so you know, after you give birth you're going to have to keep having contractions and you're going to have to push out this whole other thing that's really big.’"
“That’s the placenta and the placenta is really important,” she said. “Before a baby develops lungs and liver and kidneys, the placenta acts as all of those things.”
“They’re saying this is the least understood and arguably the most important organ because you wouldn’t exist without it.”
“I think it just shows it’s not just how we don’t value mothers as much as we should, but we haven’t valued female reproductive health that much. We haven’t valued it enough to study it.”
Garbes' interest in post-delivery care for moms stemmed from hip pain she suffered after giving birth.
“If you have an ACL [anterior cruciate ligament] injury and you have surgery, the standard treatment is you have four to six weeks of physical therapy.”
“The standard for maternity care in America for new mothers is one appointment [usually six weeks post-delivery], and if you don't ask all of your questions and immediately get answers, then you're kind of on your own.”
“Meanwhile, your baby gets a one-month, a two-month, a six-month, and nine-months and a one-year checkup.”
“I would say moms are equally important, and I think it really indicates where our priorities are as a society,” she said.
During labor “women pull muscles, break their tailbones, their organs move around and women can get organ prolapse, which leads to incontinence.”
“They are also really embarrassing injuries to have and it affects your life,” Garbes said.
“Women are having these conversations among ourselves but we're not having them publicly and we're not having them necessarily with our providers which is whom we should be having them,” she said.
“If all of us, every single person, had a better understanding of what happened in pregnancy and childbirth and afterwards, then we’d have a society that was able to talk about it more and, therefore, be better able to support women.”
[The American College of Obstetricians and Gynecologists recently launched an initiative to address the issue of postpartum care for new moms called “the fourth trimester.” Click here to read more.]