TIME Parenting

How I Explained Caitlyn Jenner’s Transition to My 7-Year-Old Daughter

“A man can become a woman?”

Last evening after dinner, my husband and I were comparing notes from our social-media news streams while our 7-year-old daughter was doodling. My husband was reading aloud from a statement that a personality (who shall remain nameless) we follow had posted on Facebook about Caitlyn Jenner. A conservative with deeply rooted religious beliefs — very different from our own — this person expressed that in his mind it would never be acceptable for a man to choose to become a woman.

Suddenly, our daughter’s ears perked up. “A man can become a woman?” “Yes,” I replied, “if he wants to.” My husband’s eyes widen and he lightly shook head his to signal “let’s not go there.”

“How can a person do that?” she asked, clearly intrigued. I looked at my husband, gave him my “we’re going there” smile and continued.

“Sometimes, when people are born, they may look like boys and girls on the outside, but on the inside, they know something is not right. For example, there are people who may look like boys, but know that they are really girls, and would be much happier if they could look like the way they feel on the inside. And, there are people who look like girls, but feel like they are boys on the inside. They would be much happier if the world saw them as boys. We are lucky enough to live at time where doctors and science can help people like that be who they are really meant to be.”

She got up from her seat and walked over to me and crawled onto my lap. She knew this was something serious. My husband, watching the exchange, laughed as if to say, “I warned you.”

“Mom,” she asked softly in my ear, “do the boys that become girls still have, you know, their things?” She nodded her head toward her own lap. “If they want to keep them, yes,” I replied. “They can decide.”

She gave me a kiss, walked back to her seat, picked up her colored pencil, and started doodling again. That was enough … for now.

Our girl has not yet encountered the Vanity Fair images of Caitlyn Jenner that were released last week. If she did, we’d have talked a bit about Caitlyn’s journey, and also about ideas of beauty and how magazine cover images get made. Luckily, she’s still in a childhood phase that is not affected by pop culture and media. I am hoping we can stay there a bit longer.

Want to know more about talking to your children about transgender issues? Here are a few sources you may find useful.

Angela Matusik is the executive digital editor at InStyle, and she is not afraid to talk to kids about the tough stuff. You can follow her on Twitter @angelamatusik

Read next: Watch Kids Share Eloquent, Empathetic Reactions to Caitlyn Jenner

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TIME Family

Meet the Father of Paternity Leave

Gary Ackerman
Bassem Tellawi—AP Congressman Gary Ackerman, D-NY, on Nov. 9, 2004.

Before Richard Branson, there was Gary Ackerman

Correction appended, June 11, 2015

This week, the man most celebrated for his impact on paternity leave policies is Richard Branson: the Virgin founder made news by announcing that some employees at Virgin Management would be eligible for a full year of paid new-dad time off.

Almost exactly 45 years ago, a very different man—a teacher, not an executive—was the one making strides for paternity leave. His name was Gary Ackerman, and he was a teacher in New York City who had a daughter in late 1969. When his daughter was about 10 months old, he applied for a leave (without pay) for childcare purposes. As a resulting lawsuit laid out, the principal did not recommend to the district that Ackerman’s application be approved; unsurprisingly, the superintendent followed suit by not approving the leave. Ackerman tried to appeal the decision several ways, and was told by many people that the childcare leave policies of the Board of Education only applied to female teachers.

As TIME later reported, “[t]urned down, he went AWOL from his job, [and] with his wife Rita filed a complaint of discrimination with the Federal Equal Employment Opportunity Commission and sued the board in U.S. district court. Their argument: granting child-care leaves only to women is an invasion of privacy because it forces mothers to be housekeepers and child rearers and prevents husbands and wives from dividing up family responsibilities as they see fit.”

In 1973, the EEOC, TIME continued, “found that the mothers-only rule ‘discriminates against male teachers as a class.’ As a result, the board says it will reword its bylaws to ensure equal rights for fathers.” That autumn, the relevant section of the Board of Ed bylaws was amended so that it no longer referred to an affected teacher as “her” or relied on the timing of the teacher’s pregnancy, thus expanding its relevancy to fathers and to adoptive parents. The determination is widely regarded as the groundbreaking first step toward paternity leave’s existence.

Just how groundbreaking was it? Ackerman’s motion to have a lawsuit he filed against the Board of Ed (separate from the EEOC case) considered as a class-action suit was denied because, though 40% of the Board of Ed’s teachers were men, he was the first male teacher ever—and one of two in total—to apply for childcare leave before that 1973 change. According to a New York Times article about the EEOC’s decision, at the time about 2,000 to 3,000 female teachers took a maternity leave in the city each year.

Ackerman was eventually denied compensation in his suit, because he had already stopped teaching and the relevant bylaw had already been changed, but that doesn’t mean his story came to an end. Though his first job after leaving teaching was at a local newspaper, he soon transitioned to a life in politics. Elected to the state senate in 1979, he went on to serve in Congress for three decades, until January of 2013.

Correction: The original version of this article misstated how long Gary Ackerman served in Congress. He served for three decades.

TIME Family

This 92-Year-Old Just Adopted a 76-Year-Old Daughter

"I have worked jigsaw puzzles, and my life had been a beautiful picture. But one piece was missing"

A 92-year-old Dallas woman adopted her 76-year-old cousin after a relationship that has spanned more than six decades, WFAA in Dallas reported.

Muriel Clayton began to care for Mary Smith, her younger cousin, after Smith’s father died decades ago. Smith’s mother was still living, but illness prevented her from caring for her daughter. Though Clayton wanted to ask Smith to formalize their relationship earlier, she waited until her biological mother had died.

On Tuesday, the pair went to Dallas County Court and legally became mother and daughter.

“I have worked jigsaw puzzles, and my life had been a beautiful picture. But one piece was missing, and that was Mary,” Clayton said. “And now I’ve got that piece in place. Officially!”


Read next: What I Learned About Family from Organizing the World’s Biggest Family Reunion

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TIME women

Why I Don’t Want to Have Children

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I’ve spent years carefully crafting the most amazing life I can

What I want is to be happy.

I’m often told that I’d make a good mother. Depending on my relationship with the person making this wildly incorrect statement, I have one of two reactions: either a small, insincere smile and a “mmmm” response that does not invite further discussion or a hearty laugh followed by a firm “No.”

Don’t get me wrong: I love kids. They’re hilarious, they’re adorable, and I (mostly) enjoy spending time with them. But without a doubt, I do not want them. And here’s why.

I don’t want to worry about diaper rash and “tummy time” and I don’t want to know what colic is.

I don’t want to put a kid on a kindergarten waiting list and I don’t want to decide between public and private education. I don’t want to coordinate basketball practice drop-off with ballet lessons pick-up, I don’t want to help with trigonometry and darling, I will not deal with your teenage angst because you best believe I invented that. I’d rather have bamboo shoots shoved under my fingernails than try to figure out how to pay for my child’s college while I still owe roughly twelve kajillion dollars for my own degree. I’ve more than once done something “just to tell the grandkids about it,” but I never actually planned on there being any grandkids.

It amuses me to tell people I don’t want children because no one ever quite knows how to respond. I’ve gotten “Well, when you meet the right guy, you’ll change your mind,” which is basically suggesting I’m incapable of making decisions regarding my own life without consulting a nameless, faceless FutureMan and is, by the way, astonishingly offensive. Others immediately ask what I do for a living, as though my employer holds the key to my womb and has locked it up until I retire. I don’t really consider myself a career-minded kind of girl; I’ve always worked to live, not lived to work.

Two mothers have actually said to me, “I didn’t know what love was before having a baby. You should reconsider.” I’m happy they’re happy now but “not knowing love before kids” is one of the most acutely sad things I’ve ever heard. Occasionally, I get a hearty “yeah!” from like-minded women, some of whom will eventually become mothers and some of whom will not. I appreciate the support.

But at this point, it doesn’t matter how much anyone tries to change my mind because the decision’s been made — permanently.

Last October, I spent a wonderful morning with my doctor, during which he performed a tubal ligation on me.

Yep, I got my tubes tied at 28.

I admit that once my doctor agreed to perform the surgery, I had a moment of panic. It immediately crossed my mind that maybe everyone was right and I was wrong and I would wake up at 30 and want a baby more than anything in the world or that maybe my “hard pass” on kids was a rebellion against expectations simply for the sake of a rebellion.

Maybe I would love the complete upheaval of my priorities and schedule and life in general. Shortly after these hysterical thoughts raced through my mind, though, I regained my sanity. I picked a date for the surgery. Done. Tubes tied.

Here’s the thing: I’ve spent years carefully crafting the most amazing life I can.

I’m surrounded by people I love very much, who love me in return. I’m well-educated and well-traveled. I have endless time to learn about things that interest me and to see wonderful things and to meet the greatest people on earth. I leave piles of library books all over my bedroom and plan fabulous trips all over the world. I stay up until 6 a.m. watching Sons of Anarchy because I know no small person is relying on me to feed them in a few short hours. I occasionally eat chips and salsa for breakfast and drink beer for dinner and feel no guilt that I’m teaching anyone horrific eating habits. I spend my days finding my bliss, like all the inspirational posters beg of me.

All this being said, I can’t wait to be an auntie. Whenever my friends start popping out kids, I’ll be there with inappropriately loud and expensive presents. I’ll be the aunt who slips them a vodka martini on their 16th birthday and I’ll rant and rail with the best of them whenever they feel slighted by other kids.

And when I’m off for six months teaching scuba in Venezuela, I promise to send lovely postcards.

I get the reasons people want kids. I do. I’m not such a heartless, selfish monster that I’m incapable of understanding the appeal of a small person who loves you unconditionally and relies on you to guide them safely through a scary world. Parents are brave and strong and incredible people. But so are astronauts and brain surgeons and I don’t want to be those things, either.

What I want is to be happy.

And I’m doing that. I’m there, I’m living that dream. I’m happiest not being a mom, but hey… Call me if you need a babysitter. I’m great in a pinch.

This article originally appeared on YourTango.

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TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

MONEY Sports

5 Sports Struggling to Reach Kids

It goes without saying, but if you ever have to launch a campaign to convince people that something is cool, it's probably not.

Kids today! They’re overscheduled with activities, and they’ve got no attention spans thanks to social media, video games, smartphones, and assorted other screens. That’s the gist of how today’s younger generations have been routinely portrayed. And these factors are among the reasons cited for waning interest and participation in sports that once captured the attention—and dollars—of the masses, but are now considered too old-fashioned, too time-consuming, too unexciting, or just too uncool by kids today.

These struggling sports aren’t simply conceding defeat, however. They’re introducing marketing initiatives and new business models to win over younger consumers as if the future of these sports depends on them—which is pretty much the case.

  • Bowling

    Bowling alley with neon lights

    The number of bowling alleys in America has been on a steady decline for years, dropping roughly 25% from 1998 (5,400 alleys) to 2013 (just under 4,000). Bowling alleys once thrived thanks to active bowling leagues around the country, but participation has dwindled, perhaps as part of the broader trend of Americans detaching from society and their local communities, as explained in the groundbreaking 2000 book Bowling Alone.

    That might not be the only reason interest in bowling has faded. “People’s social tastes change, too,” Wayne State University assistant sociology professor David Merolla told the Detroit Free Press. “It’s also possible bowling isn’t what people do anymore.”

    In recent years, emerging entertainment brands like Pinstack and Latitude 360 have aimed to reinvent the faded old bowling alley concept and attract more young people by adding all sorts of bells and whistles—or rather, ropes courses, laser tag, rock climbing walls, bumper cars, restaurants, and concert and comedy venues, all under one roof. Latitude 360, which plans on opening a location in lower Manhattan in late 2015, bills itself as a “cruise ship on land.” An ongoing Kids Bowl Free summertime promotion encourages children (and their families) to bowl too.

  • Golf

    Jordan Spieth of the U.S. grins as he wears his Champion's green jacket on the putting green after winning the Masters golf tournament at the Augusta National Golf Course in Augusta, Georgia April 12, 2015.
    Brian Snyder—Reuters Jordan Spieth of the U.S. grins as he wears his Champion's green jacket on the putting green after winning the Masters golf tournament at the Augusta National Golf Course in Augusta, Georgia April 12, 2015.

    Jordan Speith and Rory McIlroy are among the young golf champions who have been heralded as the sport’s potential saviors. And why might the sport need saving? The reasons include that it’s too snobby, too hard, too expensive, or just not cool or too time-consuming for our fast-moving culture.

    Perhaps the most obvious sign of golf’s struggles is that the number of courses in America is expected to plummet for years to come. To boost participation and interest in the sport, golf associations and country clubs have tried everything from pushing the idea of playing nine holes rather than the full 18, to using oversized holes on courses to make the game less frustrating—and perhaps even fun.

  • Boxing

    Boxing: Mayweather vs Pacquiao
    Mark J. Rebilas—USA TODAY Sports/Reuters Floyd Mayweather and Manny Pacquiao box during their world welterweight championship bout at MGM Grand Garden Arena, May 2, 2015.

    The big Floyd Mayweather-Manny Pacquiao match in Las Vegas was a huge money maker, but it didn’t help endear the sport to casual fans. Dozens of lawsuits have been filed by spectators who want their money back because the match was so boring (and because Pacquiao didn’t disclose an injury to prior to the fight).

    The heightened attention given to boxing with the “Fight of the Century” was also an anomaly. Interest in boxing among fans has been described as struggling, dead, or “undead” at least since the rise of mixed martial arts into the mainstream. Prior to the most recent “Fight of the Century,” many boxing pay-per-view events have drawn disappointing viewer numbers, and some have argued that PPV format is to blame as the reason so many casual fans stopped keeping up with the sport.

    “What’s hurting boxing is they’re not putting it on free television,” boxing great Evander Holyfield theorized in 2011. In March, boxing returned to prime time network television for the first time in three decades, with Saturday broadcasts of Premier Boxing Champions on NBC. Thus far, boxing on network TV has proved to be the equal of UFC in terms of viewer numbers.

    Interestingly, while the consensus is that fan interest in boxing has dwindled, participation in boxing has been on the upswing over the past decade, as it’s become a trendy fitness activity among men and women alike. Still, the American Association of Pediatricians vigorously opposes youths being involved in amateur boxing because of the serious risk of brain injury. On a related note, fewer kids are playing football across the U.S., though the trend may come as a result of children increasingly specializing in one sport for most of the year, rather than just concerns about head injuries.

  • Fishing

    Alex Wong—Getty Images Local students of Septima Clark Public Charter School participate during a fishing event at the Constitution Gardens Pond of the National Mall in Washington, DC.

    According to a 2014 report, there was a net loss of 1.2 million fishing participants in the previous year: Overall, 9.9 million people gave up fishing, while only 8.7 participants picked up the sport, representing a decrease of 21%. The poll shows that households with kids are more likely to fish: 17.5%, versus 12% of households without young children. But teenagers are the group least likely to be interested in fishing: Only 6.6% of people ages 13 to 17 who don’t fish said they were considering taking up the sport, compared to 43% of those 45 or over.

    Unsurprisingly, the outdoors seems to be deemed less cool the older a child gets. Among kids ages 6 to 12, 44% say outdoor recreation is “cool,” compared to 34% of 13- to 17-year-olds. Nearly half (47%) of first-time adult fishing participants said they perceived the sport as “exciting,” but significant numbers also described the sport as “time consuming” (25%), uninteresting (16.5%), and “not for someone like me” (12%). The poll doesn’t reveal such perceptions with regard to children or teenagers specifically, but presumably an above-average portion of easily distracted, smartphone-addicted teens think fishing is too boring.

    The insights of an outdoors recreation analyst quoted in 2007—when a study showed the number of fishing participants had dropped 16% over the previous 10 years—seems to hold up well: “Thirty years ago, people would get up and go fishing,” he said. “Now you get up and you have a soccer game at 9, a baseball game at 11, a team picnic at 1 — it’s much more structured time. Video games also are part of it.”

    It’s understandable why the fishing industry is so eager to encourage kids to give the sport a try: 84% of adult participants say they were introduced to fishing by the time they turned 12. Of course, it helps if you actually catch a fish: 40% of men said the most enjoyable thing about fishing was (what else?) catching a fish, and 37% said the worse thing about fishing was (what else?) not catching a fish. Yet 19% of survey participants who fish said they caught nothing on their most recent fishing trip.

    National Fishing & Boating Week, held the first week of June each year (June 6-14 in 2015), provides families a good excuse to give fishing a try. On one or more days during this week, most states allow fishing on public bodies of water without the requirement (or fee) of a permit.

  • Baseball

    As part of a season-long program titled "Calling All Kids", the players of the Boston Red Sox were accompanied by children during pre-game introductions.
    Jim Davis—Boston Globe via Getty Images As part of a season-long program titled "Calling All Kids", the players of the Boston Red Sox were accompanied by children during pre-game introductions.

    Studies have shown participation and interest in baseball has fallen year after year among children. Between 2002 and 2013, the number of children who played baseball dropped 41%. Polls indicate that teens identifying themselves as “avid” baseball fans are on the decline, while the fan base in professional soccer and basketball have been rising. (The NFL has the highest percentage of avid teen fans, overall.)

    Major League Baseball Commissioner Rob Manfred has been on a mission to win over younger fans, which seems like an essential move because the future of baseball as a business relies on it. “Our research shows the two biggest determinants of fan avidity are did you play as a kid? And how old were you when your parents took you to the ballpark for the first time?” Manfred said at the start of this season.

    Hence the proliferation of family ticket deals and kids clubs offered by virtually every MLB team. The promotions include free tickets and team swag, with the hope that playing up to kids now pays off down the road.

TIME People

Family Members Charged for Loud Cheering at Mississippi Graduation

They were charged with "disturbing the peace"

Four people could face jail time for cheering too loudly at a Mississippi high school graduation.

Authorities have charged them with disturbing the peace, punishable by up to six months in jail and a $500 fine, for disrupting commencement exercises at Senatobia High School on May 21.

One of them, Henry Walker, cheered, “You did it, baby!” when his sister’s name was called and was promptly whisked outside, his mother said.

“I don’t think it was right for what they did to him,” Linda Walker told NBC affiliate WMC in Memphis.

The superintendent, Jay Foster, who pressed the charges, told WMC that…

Read the rest of the story from our partners at NBC News

TIME Parenting

Harvard Obstetrician Speaks on Safety of Giving Birth at Hospitals

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Much of the developed world offers only one pragmatic alternative: the hospital

There is a good chance that your grandparents were born at home. I am going to go ahead and assume they turned out fine, or at least fine enough, since you were eventually born too and are now reading this.

But since the late 1960s, very few babies in the United Kingdom or the United States have been born outside of hospitals. As a result, you may find the new guidelines from the U.K.’s National Institutes for Health and Care Excellence (NICE) just as surprising as I did. For many healthy women, the NICE guidelines authors believe, there may be significant benefits to going back to the way things were.

Shortly after the NICE guidelines were issued, the New England Journal of Medicine invited me to write a response. The idea that any pregnant patient might be safer giving birth outside the hospital seemed heretical, at least to an American obstetrician like me. Knowing that no study or guideline is foolproof, I began my task by looking for holes to form a rebuttal.

I soon realized that this rebuttal largely hinged on flaws in the American system, not the British one. While we take excellent care of sick patients, we do less well for healthy patients with routine pregnancies – largely in the form of turning to medical interventions more than strictly necessary.

As the guidelines suggest, some women in the U.K. with low-risk pregnancies may be better off staying out of the hospital. Why? Because the significant risks of over-intervention in hospitals, such as unnecessary C-sections, may be far more likely (and therefore more dangerous) for patients than the risks of under-intervention at home or in birth centers. But women in the U.K. have access to greater range of settings where they can give birth. For women in much of the U.S., the choice is often the hospital or nothing.

Are hospitals always the best option? The view from the U.K.

The British Birthplace Study, upon which the NICE guidelines are based, reviewed 64,000 low-risk births to compare the relative safety of giving birth in one of four settings: a hospital obstetric unit led by physicians, an “alongside” midwifery-led birth center (on the same site as a hospital obstetric unit), a freestanding midwifery-led birth center, and at home. The study included only women with low-risk pregnancies. Women with obesity, diabetes, hypertension or other medical conditions were excluded from the study.

For low-risk women who had never given birth before, home birth led to bad outcomes (such as encephalopathy or stillbirth) slightly less than 1% of the time. That’s rare, but still twice as risky as the other options. Birth centers were no riskier than hospitals for first-time moms, and all options (including home) appeared equally safe for women who had given birth before.

By contrast, this same group of low-risk women was between four and eight times more likely to get a C-section if they started off getting their care in the hospital compared to other settings. Rather than being driven by patient risk or preference, this tendency toward C-sections appeared to be driven by proximity to the operating room.

While the NICE guidelines make it clear that women should be free to choose the birth setting they are most comfortable with, they point out that the risks of over-intervention in the hospital may outweigh the risks of under-intervention at a birth center or at home for the majority of expecting mothers.

The situation is different for women in the U.S. Last year 90% of births were attended by physicians, while just 9% were attended by midwives. Fewer than 1% of U.S. women have their babies at birth centers. While access to care is guaranteed in the U.K., nearly half of U.S. counties have no midwife, obstetrician or other maternity care professional.

C-sections are routine, but not without complications

Today, newborn babies in the U.S. have a one-in-three chance of entering the world through an abdominal incision. In the U.K., the odds are lower – more like one in four, but everyone on both sides of the Atlantic agrees this still represents too much help.

Part of the challenge may be a feature of the species. Homo sapiens have always required some form of extra help being born. Narrow pelvises are required for walking upright, and large frontal lobes are required for nuanced thought. Neither works in our favor when it comes to navigating the birth canal. The unresolved question is how much help is truly necessary – and how much help is too much.

Cesareans are designed to be a lifesaving surgery, but they are now so routine that C-sections have become the most common major surgery performed on human beings, period. It hasn’t been until recently that we started to fully consider the downsides of cesarean deliveries.

For starters, caring for a newborn while dealing with a 12-centimeter skin incision in your own abdomen is the pits, especially when compared to caring for a newborn without having a 12-centimeter skin incision.

Though common, let’s not forget that C-sections are a major abdominal surgery that can lead to threefold higher rates of serious complications for mothers compared to vaginal delivery (2.7% vs 0.9%). These complications can include severe infection, organ injury and hemorrhage.

I should also point out that the first C-section a woman has is an easy surgery – I can train an intern to do one safely in just a few weeks. But most women have more than one child, and most women who have a C-section the first time will have a C-section the next time. Obstetricians are among a small group of surgeons who regularly operate on the same part of the same patient over and over again, dissecting thicker layers of old scar tissue with each surgery.

By the second, third, or fourth C-section on the same patient, the anatomy becomes distorted and the surgery becomes increasingly technical. I recently did a cesarean where the woman’s abdominal muscles, bladder and uterus were fused together like a melted box of crayons.

In the most dreaded cases, a woman’s placenta (a large bag of blood vessels that nourishes the fetus) can get stuck in this mess of tissue and fail to detach normally. In these cases, pints of blood may be lost within minutes, and the only way to stop the bleeding is often to do a hysterectomy.

Why do hospitals mean more interventions? It comes down to risk perception

Since 1970, the number of C-sections performed in the U.S. has gone up by 500%. Some of this increase is because mothers have become older and less healthy, conferring greater risks in pregnancy. But having a baby in this decade is not 500% riskier than having a baby in the 1970s. We know this because C-sections rates in just the women who are young and perfectly healthy have gone up just as quickly. And contrary to popular belief, this has little to do with maternal preferences. First-time mothers who request C-sections with no medical reason make up fewer than 1% of the total.

What’s driving the increase in C-sections in the U.S. is unclear, but much of the drive to do more comes from our perception of risk. Although my professional contribution to childbirth is often just to catch, my responsibility as a scalpel-trained, general obstetrician in the United States is to mitigate risk.

I am acutely aware that even women with healthy pregnancies can develop life-threatening hemorrhage, fetal distress or other unanticipated emergencies during labor that require surgical intervention.

My job is to get the baby delivered before it is too late, and often I’m working with ambiguous information. I know how long labor should take on average, but don’t have a precise estimate of how long labor should take for the patient in front of me. What if the baby is too big or the pelvis is too narrow? C-sections often come down to a game-time decision.

Fortunately, I can make sure this decision is never wrong. If the baby looks a little blue and lackluster right after I do a C-section, I’m convinced I did it just in time. But if the baby is pink and vigorous after I do a C-section, I’m still convinced I did it just in time. Without evidence to the contrary, it is easy for me and many of my colleagues to believe that operating is always the right course of action.

When it comes to the safety of mothers and newborns, most would agree that it is better to overshoot than undershoot. The problem is that we are overshooting by a lot, in ways that lead to more insidious harm. Nearly half of the cesareans we do in the U.S. currently appear to be unnecessary, and come at a cost of 20,000 avoidable surgical complications and US$5 billion of budget-busting spending in the US annually.

C-sections may have consequences for babies as well, in ways that we are just beginning to understand. Exposure to normal bacteria in the birth canal may play a role in the development of a baby’s immune system. A Danish study of two million children born at full term found that those born by cesarean were significantly more likely to develop chronic immune disorders. Others have suggested that going from the womb to an artificial warmer can have an impact on immediate bonding, and even success with breastfeeding.

In parts of the world where women do not have access to skilled birth attendants, large numbers of mothers and babies die from preventable causes. Even for the healthiest among us, walking into the woods to have your baby would be unwise. Still, much of the developed world offers only one pragmatic alternative: the hospital. For more than a half-century, we have believed that spending many hours, if not days, in a hospital bed with a smattering of ultrasound gel, clips, wires, heart tones, random beeps and routine alarms is the safest way to have a baby.

Many of the patients I care for benefit from my surgical training. I get to save lives while also sharing in one of the most profoundly joyous moments that families experience. But obstetricians like me may be hardwired to operate, and too many operations are harmful to patients. One strategy to fix this might be to change our wiring. Another may be the British way: for patients to stay away from obstetricians altogether – at least until you need one.

This article originally appeared on The Conversation.

The Conversation

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Parenting

What I Learned About Family from Organizing the World’s Biggest Family Reunion

AJ Jacobs

Sometimes taking on too much can bring you all together

You guys busy the first weekend in June? Because I’m having a party, and you’re invited. After all, you’re family. Really.

I’m holding what I’m calling The Global Family Reunion—a gathering for the entire human family. I got the idea because I learned about the mind-boggling advances in genealogy that are showing just how interrelated all of us homo sapiens are.

People can now use online services and DNA testing companies to join mega-massive family trees. I’m on one family tree that has 92 million people. That’s 92 million humans all connected by blood or marriage spanning 160 countries. Not all are close relatives. For instance, I’m related to Barack Obama—he’s my aunt’s fifth great aunt’s husband’s father’s wife’s 7th great nephew. See you at Passover next year, Mr. President!

For a roundup of the week’s best stories about family, sign up here for TIME’s weekly parenting newsletter.

I fell in love with this idea and decided to make it the topic of my next book. And also to throw a party to celebrate our massive family. The event is Saturday, June 6, in New York City, and there will be more than 50 performers and speakers, 400 activities – and Sister Sledge singing the wildly appropriate “We Are Family.”

As I’ve been working on this for more than a year, I’ve learned several lessons. Here are four…

We can choose whom we consider family

AJ Jacobs

Here’s the paradox of modern families: Thanks to DNA testing, we can know more accurately than ever who is closest to us biologically. And yet, society is going the opposite direction. DNA is becoming less and less important in whom we consider family.

We are in the age of gay marriage, sperm and egg donors and open adoption. I have a friend who considers her ex-husband’s parents to be very close relatives. “I divorced my husband,” she says, “not his parents.” My kids consider their “cousins” in Providence, Rhode Island to be super-close family. In reality, they are the kids of my sister-in-law’s cousin. So quite a few branches apart.

Some traditionalists feel threatened by this. Not me. The more expansive our families, the more potential caregivers we have. And as my aunt’s 8th cousin twice removed’s wife Hillary Clinton once said, it takes a village.

My family is far more diverse than I imagined


The 190 million members on my family tree are of every hue on earth. My family is diverse. Like if the Village People mated with current and former members of The View (I’m guessing it’d probably be via sperm donorship)?

This is because many of us had ancestors who interbred more back then than we tend to think (sometimes by choice, sometimes by force). And thanks to jet travel and the breakdown of some taboos, the current rate of intermarriage is unprecedented. My immediate family is a good example: My sister married a man from Peru, my first cousin a man from India, my other first cousin a Korean-American.

For this project, I got to interview hip hop star Ludacris. I was able to tell him that he is 1/16th Jewish. He was surprised, but intrigued. (My friend suggested that his Hebrew name could be Mishpucha).

The melting pot used to be quite chunky, with lots of bits that stood out. But it’s slowly turning into a puree. This has its advantages and disadvantages. Some fear the mixing might erode each group’s cultural heritage. I can’t predict the consequences. But I’m hopeful that we can continue to keep cultural traditions even while mixing DNA.

You can teach compassion…at least a little


One of my motivations for working on what I call a Global Family Tree is positively Woodstock-ian. I believe that once we see how closely we’re related, we’ll treat each other with more kindness.

Yes, I sometimes have doubts when I watch how my three sons wrestle. But still, I believe that we tend to treat family members with more kindness than strangers. (See how happy that nice bearded man is to have his photo taken with me? )

Legal scholar Cass Sunstein—who is my first cousin once removed—gave me some intellectual backup on this. He recently wrote an article about the Family Heuristic, the bias to be kinder to known family. The Global Family Tree tricks humans into applying the Family Heuristic to all people.

I’ve seen this happen with myself, and with my kids. When we read about the Nepal earthquake, my kids said that we needed to help our “cousins” in Nepal.

It’s not a perfect solution. A couple of months ago, I went to Chipotle with one of my eight-year-old sons and his friend. The friend dropped a napkin on the floor. I suggested he pick it up.
“Well, someone’s going to pick it up, and the people here are overworked, so it’s a nice thing to do.”
“But they’re my cousins. They won’t mind.”

Ridiculously overambitious projects are a great way to bring a family together

AJ Jacobs

I won’t say that planning a reunion for thousands of people has replaced Mario Party 8 in my kids’ hearts. But it has energized them.

I told my kids earnestly that I am overwhelmed and needed their help. That’s the key: They felt needed.

My 8-year-old volunteered to be head of security at the party. He weighs about 40-lbs., so maybe not the best fit for him. But they have helped me scan family photos for the tree, and manage the Twitter account about the reunion. If I ever run for President, I know they’ve got my back.

And they love coming up with ideas. This morning’s involved robot cousins. I love it. I’m just not sure if our family tree is that quite that diverse.

TIME Family

What Sheryl Sandberg Learned About Motherhood Through Grief

Grief sends some people scurrying into isolation and silence; the pain makes them want to shut out any light or human connection. Sheryl Sandberg is not one of those people.

In a heartrending post on Facebook, under a photo of her late husband Dave Goldberg and her in a particularly, now gutwrenchingly, carefree moment she talks in depth about grief and how it feels. “I have lived thirty years in these thirty days. I am thirty years sadder. I feel like I am thirty years wiser,” she writes.

It’s a very Sandbergian post, full of things she’s learned and hopes to pass along. But it’s also quite unSandbergian: raw and much less levelheaded than the cool, reasonable tone of Lean In. “I still hate every car that did not move to the side, every person who cared more about arriving at their destination a few minutes earlier than making room for us to pass,” she writes of her ambulance ride to the hospital with Goldberg.

One of the things Sandberg addresses first is what she has learned about motherhood. “I have gained a more profound understanding of what it is to be a mother,” she writes, “both through the depth of the agony I feel when my children scream and cry and from the connection my mother has to my pain.” To be a mother, she suggests, is to double down on the pain. But to be a mother is also to have a potential source of joy. “As heartbroken as I am, I look at my children each day and rejoice that they are alive,” she writes. “I appreciate every smile, every hug.”

The Sandberg family has always been tight knit. Her sister lives close by and her parents, who reside in Florida, are very frequent visitors to the Bay Area. Spend any time with Sandberg’s parents and you’ll realize that her father is the calm, steady brainy one and her mom, while also whipsmart, is the passionate, activist one. And she’s the one Sandberg thanks first.

“She has fought to hold back her own tears to make room for mine,” Sandberg writes. “She has explained to me that the anguish I am feeling is both my own and my children’s, and I understood that she was right as I saw the pain in her own eyes.” She goes on to say that her mother has been lying in bed with her at night, “holding me each night until I cry myself to sleep.”

While expressing grief so openly and vulnerably on Facebook may seem a strange thing to do—has any other COO of a huge multinational media concern ever used their own company’s product for such purposes?— it’s not at all uncommon. Since the disappearance of most of our public mourning rituals, such as wearing black armbands or veils or wailing in the public square, social media has become one natural replacement.

Facebook is already used for checking in with folks, displaying evocative photos of a loved one, reminding the world at large of the amazingness of a certain person. So while experts do not agree about whether public expressions of bereavement are always healthy, for those for whom it’s helpful, social media would seem to be a boon. Especially since farflung friends of the bereaved can be regularly expressing condolence and support without being intrusive.

Grief is a nasty, wily changeling, and can overcome people without much warning. Sandberg acknowledges she can’t always been the rejoicing, expressive, I’ll-make-everyone-feel-comfortable mom. “I went to Portfolio Night at school where kids show their parents around the classroom to look at their work hung on the walls,” she writes. “I looked down the entire time so no one could catch my eye for fear of breaking down. I hope they understood.”

Not every mother’s mourning will be as widely noted as Sandberg’s (within two hours, it had been shared more than 18,000 times), but at least her public declaration of vulnerability and loss might make less connected widows feel less alone.

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TIME Marriage

Why Remarrying Isn’t What it Used To Be

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Fewer people are retying the knot, especially women.

If you’re wondering whether you should get married again, you’re not alone. About 40% of all the two million odd marriages that took place in 2013 were remarriages either for the bride or the groom. About 20% of them were remarriages for both.

Divorce remains a deeply unpleasant process, but not as hard to do as it was. And marriage—for all its flaws—is still a very popular institution. So it makes sense that a lot of people figure they’ll give it another go. The triumph of hope over experience and all that.

But second (and third and so on) marriages are not what they were. According to a new brief written by Wendy Manning for the Council on Contemporary Families, here are some ways retying the knot is changing.

*Remarriage rates are falling. In 1990, 50 out of every 1,000 previously-married men and women got married again. In 2013, it was 28, a 40% drop.

*Much of that drop has been among women. In 1995, 54% of women who divorced before age 45 had remarried within five years. In 2005, only 38% had.

*Men are more likely to remarry. The rate is almost twice as high for men as for women (40 per 1,000 vs. 21 per 1,000)

*There aren’t always just two. Among remarrying couples, 46% already have a child under 18 living in the home. (Then again, 38% of couples who marry for the first time already have a child in the home)

*If there are kids, they’re usually hers. Only 9% of remarried stepmoms are living with their stepkids, while 46% of remarried stepdads have their wife’s kids in the home. The good news is that more people with stepkids report a happier marriage than those who don’t, a switch from prior years.

*Remarriages, which have always had a higher implosion rate than first marriages, have become even less stable over the past 20 years. By 2010, almost a third of remarriages (31%) of women under 45 ended in divorce within five years. In 1995, that figure was 23%. (About 20% of first marriages don’t make it to their fifth anniversary.)

*Finding a new spouse takes a little longer. Half of the folks who remarry do so within four years. In 2002 it was three years.

Some of this is slightly disheartening for those who wish to marry again, but never fear, the decision can pay off. “Remarriages confer at least some of the same health benefits as first marriages,” says the report. And in any case, studies have shown that about 100% of every newly married couple thinks their love is going to last forever.

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