Category: family

Mom’s health matters too

Eamon sleep“Breast is best!” is akin to “Back to sleep!” as the most overused phrase for a healthy baby.

My son eats about 82% breast milk (I’ve done the math)…and I hate that it’s not 100%. I pump at work, I breastfeed at home, I try to make ‘enough.’ It is stressful. Since he is a preemie, there’s even more pressure to give him the ‘perfect’ food to make up for his early arrival.

I actually LIKE breast feeding, but it’s time-consuming, energy-depleting and sleep-depriving. I don’t have a solution to the guilt, but articles like this one from The Washington Post help:

Doctor says: When it comes to breastfeeding, your health and happiness matter as much as your baby’s – By Vivien K. Burt, Sonya Rasminsky and Robin Berman

Whoever said, “Don’t cry over spilled milk” couldn’t possibly have been talking about breast milk. As reproductive psychiatrists who specialize in treating women who suffer from depression and anxiety during pregnancy and the postpartum, we see far too many tearful new mothers for whom breastfeeding is a source of self-recrimination.

Doggedly determined to provide breast milk exclusively for their babies, these moms endure breast and nipple pain, around the clock pumping, sleep deprivation, anxiety, and chronic feelings of inadequacy—all for the sake of doing what’s “best” for their babies. As physicians, we think we know better, but as mothers, we too bought into the dogma that breast is best at all costs. We would never have taken our own advice: when it comes to breastfeeding, your health and happiness matter as much as your baby’s.

Sheepishly we recently shared our secret stories of shame with one another:

“I proudly accumulated a freezerful of stored breast milk by routinely pumping immediately after nursing. I was happy that my baby never had to have formula, and I was devastated when I had to throw away gallons of expired milk. To this day, I have deep regret about my choices. I wish that I had never bought the pump; my time would have been better spent bonding with my baby.”

“When I went back to work when my baby was five months old, I was so ashamed that I had switched to formula, I lied to all my friends and coworkers.”

“For me, nursing was harder than medical school. My milk was slow to come in and my baby howled whenever I put him to the breast. It hurt so much that I cried. I was so determined to feed him breast milk that I didn’t realize that he was getting dehydrated. Even when he was hospitalized with an IV, I felt that my most important task was to try to pump milk for him. In retrospect, I wish that I had transitioned to formula—we both would have been happier.”

Sharing these stories, we wished that we had put less pressure on ourselves. Despite our knowledge about the importance of maternal mental well-being to healthy mother-baby bonding, we let shame and guilt eclipse our good sense.

Read the full article

Labor-Inducing Spinach Artichoke Dip

Just kidding. Sort of.

While there’s no scientific evidence that a particular food can jump-start labor, my water broke within one hour of eating this dip.

Adapted from Slate’s “You’re Doing it Wrong,” I threw this together for Thanksgiving. At 33 weeks pregnant, my husband and I made the short drive to Houston for the holiday. My 94-year-old grandmother lives there, and some other family drove in from Arkansas.

We left Austin with the uncooked dip in tow, compression stockings squeezed onto my swollen legs. I napped most of the way (Aside: I have a superhuman ability to fall asleep anywhere, anytime, within moments. It’s great for me; not so great for whomever I’m roadtripping with).

We exchanged hugs and a few jokes about whether my grandmother’s or my ankles were more swollen, and then the seven of us sat down with paper plates of dip, veggies, pita chips and Panettone bread. We’re not the kind of people to postpone eating for decorum’s sake.

I sat on a scratchy old, yellow chair with my legs stretched out in the living room, talking with my big sister. Something must have registered on my face, as she suddenly asked if I was okay. I nodded, and excused myself. I can only describe the feeling as unexpected dampness.

Surprise! I’ll leave out the details, but suffice it to say my water broke on that ragged yellow chair while my husband was jogging and my dad was sleeping. A few phone calls and we headed to a Houston ER.

742
Happy Thanksgiving from the Houston hospital! This is about four hours after eating dip. If I’d known it would be the last I could eat for 20 hours, I’d have consumed the entire pan.

My big sister graciously blotted up the poor chair, and grandmother is still none the wiser. Our son was born at 6:30 a.m. the Friday after Thanksgiving. No word yet on whether he likes spinach.

So if you’re pregnant and feeling ready to pop, why not give this recipe a whirl? Or just make it to enjoy; it’s easy and delicious.

Ingredients
8 ounces reduced-fat cream cheese, softened
2 cups grated Parmesan cheese
1 cup mozzarella cheese
¼ cup extra-virgin olive oil
Juice of 3 lemons
3 garlic cloves, minced
½ teaspoon crushed red pepper – to taste
Salt and black pepper
2, 15-oz cans marinated artichoke hearts, roughly chopped
10 ounces frozen chopped spinach, thawed and squeezed dry

Directions
Heat the oven to 450°F. Put the cream cheese, Parmesan, olive oil, lemon juice, garlic, and crushed red pepper in a large bowl. Season with salt and black pepper, and stir to combine. Stir in the artichoke hearts, spinach and mozzarella. Transfer to an 9×13 pan or a gratin dish and bake until golden brown, about 20 minutes. Serve warm with crisp crackers and crunchy veggies.

 

Eating as a New Mom

933I’m a mom! My son arrived 7 weeks early and spent a month in the NICU. We brought him home a few days before Christmas and are riding the rollercoaster of parenthood.

The little man loves to eat and isn’t a fan of sleeping – or at least, sleeping without being held. This particular trait is endearing – snuggle bug! But it also makes it challenging to accomplish anything, say, like, prepping or eating food.

My husband is awesome about making ‘real’ meals for dinner, but during the day and after late night feedings, I’m purely snack ‘n grab. This means my eats have included:

  • spoons of peanut butter and hummus
  • bananas
  • cans of green beans and baked beans
  • string cheese
  • Triscuits
  • Cheerios

My mother visited and showed her concern about my lack of balanced diet by adding slices of of butter and extra mayonnaise to everything she prepared for me. It was sweet in that mom way, and also served as a reminder that I need to do a better job of managing healthful eating – for myself, for baby and for successful breastfeeding.

Since her visit, I’ve made a more conscious effort to store leftovers in containers easy to pop in the microwave, stock lunch meats for meat-and-cheese roll-ups, and keep quick proteins like cottage cheese and yogurt on hand. Less butter and mayo necessary.

What other quick, easy and one-handed foods should a new mom consider?

Unpacking the Invisible Knapsack

I’m feeling miffed this morning at the lack of awareness for health equity. I first read this piece during ‘Sociology of the Family’ my freshman year at college, and it profoundly impacted my worldview. The full list of 50 ways white privilege is hidden is available online.


White Privilege: Unpacking the Invisible Knapsack
by Peggy McIntosh

“I was taught to see racism only in individual acts of meanness,
not in invisible systems conferring dominance on my group”

DAILY EFFECTS OF WHITE PRIVILEGE

I decided to try to work on myself at least by identifying some of the daily effects of white privilege in my life. I have chosen those conditions that I think in my case attach somewhat more to skin-color privilege than to class, religion, ethnic status, or geographic location, though of course all these other factors are intricately intertwined. As far as I can tell, my African American coworkers, friends, and acquaintances with whom I come into daily or frequent contact in this particular time, place and time of work cannot count on most of these conditions.

1. I can if I wish arrange to be in the company of people of my race most of the time.
2. I can avoid spending time with people whom I was trained to mistrust and who have learned to mistrust my kind or me.
3. If I should need to move, I can be pretty sure of renting or purchasing housing in an area which I can afford and in which I would want to live.
4. I can be pretty sure that my neighbors in such a location will be neutral or pleasant to me.
5. I can go shopping alone most of the time, pretty well assured that I will not be followed or harassed.
6. I can turn on the television or open to the front page of the paper and see people of my race widely represented.
7. When I am told about our national heritage or about “civilization,” I am shown that people of my color made it what it is.
8. I can be sure that my children will be given curricular materials that testify to the existence of their race.
9. If I want to, I can be pretty sure of finding a publisher for this piece on white privilege.
10. I can be pretty sure of having my voice heard in a group in which I am the only member of my race.
11. I can be casual about whether or not to listen to another person’s voice in a group in which s/he is the only member of his/her race.
12. I can go into a music shop and count on finding the music of my race represented, into a supermarket and find the staple foods which fit with my cultural traditions, into a hairdresser’s shop and find someone who can cut my hair. 
13. Whether I use checks, credit cards or cash, I can count on my skin color not to work against the appearance of financial reliability.
14. I can arrange to protect my children most of the time from people who might not like them.
15. I do not have to educate my children to be aware of systemic racism for their own daily physical protection.
16. I can be pretty sure that my children’s teachers and employers will tolerate them if they fit school and workplace norms; my chief worries about them do not concern others’ attitudes toward their race.
17. I can talk with my mouth full and not have people put this down to my color.
18. I can swear, or dress in second hand clothes, or not answer letters, without having people attribute these choices to the bad morals, the poverty or the illiteracy of my race.
19. I can speak in public to a powerful male group without putting my race on trial.
20. I can do well in a challenging situation without being called a credit to my race.
21. I am never asked to speak for all the people of my racial group.22. I can remain oblivious of the language and customs
of persons of color who constitute the world’s majority without feeling in my culture any penalty for such oblivion.
23. I can criticize our government and talk about how much I fear its policies and behavior without being seen as a cultural outsider.
24. I can be pretty sure that if I ask to talk to the “person in charge”, I will be facing a person of my race.
25. If a traffic cop pulls me over or if the IRS audits my tax return, I can be sure I haven’t been singled out because of my race.
26. I can easily buy posters, post-cards, picture books, greeting cards, dolls, toys and children’s magazines featuring people of my race.
27. I can go home from most meetings of organizations I belong to feeling somewhat tied in, rather than isolated, out-of-place, outnumbered, unheard, held at a distance or feared.
28. I can be pretty sure that an argument with a colleague of another race is more likely to jeopardize her/his chances for advancement than to jeopardize mine.
29. I can be pretty sure that if I argue for the promotion of a person of another race, or a program centering on race, this is not likely to cost me heavily within my present setting, even if my colleagues disagree with me.

Peggy McIntosh is associate director of the Wellesley Collage Center for Research on Women. This essay is excerpted from Working Paper 189. “White Privilege and Male Privilege: A Personal Account of Coming To See Correspondences through Work in Women’s Studies” (1988), by Peggy McIntosh; available for $4.00 from the Wellesley College Center for Research on Women, Wellesley MA 02181. The working paper contains a longer list of privileges.

Miracle Work on 38th Street: Connecting a Family at Life’s End

In my work at Seton Healthcare Family, I had the privilege of interviewing this family about their experience in one of our hospitals. All they wanted was time for the father to say goodbye. They got a great deal more.  

“We expected to visit the hospital, get him stabilized and then take him back home. Suddenly, everything changed.”


Eduardo’s sister, Cecilia, holds a photo of him at school.

On a humid Sunday morning, a young man with Down syndrome entered the emergency room at Seton Medical Center Austin (SMCA), part of the Seton Healthcare Family, Austin, Texas. Accompanied by his mother and sister, he struggled to breathe. Thirty-two-year-old Eduardo Martinez had recently been diagnosed with kidney disease and was told he had six months to a year left. Within the hour, the prognosis changed dramatically. Eduardo was given less than two days to live.

“We were floored when the doctor told us the news,” said Cecilia Martinez, Eduardo’s sister. “We expected to visit the hospital, get him stabilized and then take him back home. Suddenly, everything changed. I started calling family to come to the hospital.”

Though Eduardo’s mother is local, his father lives in Mexico and had not seen Eduardo in 16 years. The family asked Seton to help the father cross the border and say goodbye.

Enter Dr. Truly Hall and Eileen West. Dr. Hall is the director of the Seton Adult Inpatient Medical Services (SAIMS) program at SMCA, which is on 38th Street in Austin. She is board certified in internal medicine, with seven years at Seton under her belt. Eileen West is a medical social worker at SMCA, spending every other Monday through Friday in the 4-North unit. On the weekends her role expands to “the whole house,” meaning she covers all cases that are not in the Emergency Department or labor and delivery.

Around 2 p.m. that Sunday, West received a call from Dr. Hall about a family standing vigil in the ICU for their terminally ill son. The request for border crossing assistance was not a surprise. “Maybe once a year we have a case like this, and I’ve written to the Mexican Embassy for an emergency visa,” said Dr. Hall. “But never on a Sunday.”

Given the political upheaval at the Texas/Mexico border, West was concerned. “I said I’d get right on it, but then realized the Mexican Embassy was closed,” she said. West spoke with Cecelia and decided to contact the U.S. Customs and Border Protection, since the family knew which one of the 26 crossing stations the father was going to enter.

How did she know where to start? “I just Googled it,” she said nonchalantly. “I got a phone number, then was transferred and passed around a bit, but I ended up on the phone with a humanitarian care unit.”

To cross the border on such short notice, Eduardo’s father required detailed paperwork. Dr. Hall and West compiled six pages of materials outlining the situation. West provided Border Patrol agents with her personal cell phone, work phone and home phone. Then she hit a snag.

“The Border Patrol told me that I needed to give the paperwork to the family, and that the family should deliver the documents to the father at the border,” said West. “But I told them,  ‘No. This young man is dying and the family is not leaving his side.’” Several faxes later, the paperwork was approved.

The U.S. Citizenship and Immigration Services allows foreign residents to apply for humanitarian parole for emergency situations. Handled on a case-by-case basis, approval generally takes between 60 and 120 days. With West’s tenacious prodding, it took mere hours. West attributes her success to “A bit of luck – and someone must have taken pity on us!”

Meanwhile, Eduardo continued receiving comfort care. “Every single doctor, nurse, all the people we met – they are great people,” recalled Cecelia. “We moved Eduardo to the third floor, and the nurses brought us pillows, blankets and a folding bed. Someone from the ICU made sure that we got a bigger room so we could all be near Eduardo. Even though it was a tough situation, the doctors and nurses never treated us or Eduardo dismissively. They knew it was hard.”

A fitful night passed as the family waited. At 9 a.m. the next day, Eduardo’s face split into a grin when his father walked into the room. As Cecilia described it, “I kept saying, ‘Wow.’ We didn’t expect him to cross the border at all, especially on a Sunday. I am so impressed by Eileen. She was an angel for us.”

Cecilia isn’t the only one impressed by West’s actions. “A lot of social workers — especially on a Sunday — they wouldn’t even have tried to help the family, and no one would have batted an eye, considering she was also covering the whole house,” said Dr. Hall. “The chaotic border situation didn’t deter her; Eileen took care of everything. I don’t know how she did it!”

Garry Olney, vice president and chief operating officer at SMCA concurred, adding, “This is amazing! It is what Humancare is all about. Eileen did a great job.”

Lifted spirits were short-lived, however. Over the next few days, Eduardo’s condition deteriorated. In his final hours a nurse noticed the family focused on the plummeting numbers and screeching beeps of the monitors surrounding him. She disconnected the monitors and encouraged the family to focus on Eduardo, adding, “He is more important than any numbers.”

Thanks to West’s thorough initial work, Eduardo’s father was able to stay in town long enough to attend the burial. When asked why she went to such great lengths for this family, Eileen’s answer was simple: “The most important thing I could do for the family was to get the father here.”

She downplayed the significance of her actions, adding, “Every social worker does this; it’s not out of the ordinary in our department. In fact, this is what many social workers accomplish before their first cup of coffee or morning rounds!” Caffeinated or not, West exemplifies Humancare, going above and beyond her required duties to impact lives.

Cecilia has a message for the staff at SMCA: “We are very thankful for Seton. From the ER to the final day in the hospital, everybody treated us like family. A lot of people discriminate against people with disabilities, but Seton showed great love and care for my brother. There are several hospitals we could have gone to and we ended up at the right one. We received so much support. I don’t have the words to describe the experience. Please tell all the Seton staff thank you.”

About Humancare

Humancare challenges the status quo of healthcare. By adding humanity back into a system that seems to have lost its human touch, we’re moving closer to being able to provide person-centered care. This recommitment to the people we serve modernizes our mission to care for and improve the health everyone in Central Texas, and beyond. Humancare is how we bring our mission to life, everyday. On this page you’ll find resources to help you understand, experience and share Humancare. setonhumancare.org

10 Lessons for Your 30’s

I liked this piece from Mark Manson, “10 Life Lessons to Excel In Your 30’s” — even if the title doesn’t roll off the tongue. I’ve captured the 10 points below, and encourage you to read the full piece.

1. Start Saving for Retirement Now, Not Later

2. Start Taking Care of Your Health Now, Not Later

3. Don’t Spend Time with People Who Don’t Treat You Well

4. Be Good to the People You Care About

5. You Can’t Have Everything; Focus On Doing a Few Things Really Well

6. Don’t Be Afraid of Taking Risks, You Can Still Change

7. You Must Continue to Grow and Develop Yourself

8. Nobody (Still) Knows What They’re Doing, Get Used to It

9. Invest in Your Family; It’s Worth It

10. Be Kind to Yourself, Respect Yourself

 

Tattoo Parlors > Mall Kiosks for Piercings

I read this great piece in TIME on why tattoo parlors are better for piercings. My first piercing was the ears. Like many

Ear Piercing Gun

girls my age, I was absolutely dying to be deemed grown up enough to pierce my ears. My dreams came true on my 7th birthday: I remember sitting in the lavender chair in a Claire’s at the mall, the odor of rubbing alcohol heavy and my ear lobes cold, trying not to squirm while a woman put a dot on each ear and shot an earring through a piercing gun. I clenched my eyes tight and hoped that the dots would be parallel and centered, or ‘straight’ in 7-year old speak.

I admit a bias towards tattoo and piercing parlors: my undergraduate honors thesis was on the gender differences in piercing preferences, and involved a number of interviews at local businesses. I found shop owners and artists to be respectful, honest and scrupulous about sanitation — which I can’t say for any mall kiosk on the planet. When I got a nose piercing and entered the world of body jewelry purchasing, I found businesses ready to offer advice and suggestions, often with simple instructions and easy DIY recommendations.

In sum: save time and headache and likely money – go to a tattoo parlor for all your piercings. 

Why I Took My 7-Year-Old to a Tattoo Parlor

By Bonnie Rochman
“Last month, following a long period of girlish cajoling, my daughter finally got her ears pierced in celebration of her 7th birthday. The setting was not the traditional mall kiosk staffed by some bored and minimally trained 16-year-old. Instead I took my daughter to a tattoo parlor.

Surprised they even allow 7-year-olds in those kinds of places? Think again. A growing number of parents are apparently turning to tattoo parlors to bejewel their children’s little lobes. I didn’t come up with this crazy idea out of the blue; I’m a reporter, after all: I researched where to take Shira and weighed the pros and cons. I found that tattoo parlors — despite the blaring heavy metal music — were mom-approved by a local parenting email list. When even a nurse cast her vote in favor of the tattoo parlor, I deliberated no longer.

“There is a stigma attached to tattoo parlors that they’re dirty and will be bombarded by foul-mouthed people,” says Sarah LaRoe, a mom with multiple facial piercings and tattoos creeping up her neck, who pierced my little girl’s ears so tenderly that she left her not in tears but with a big, happy smile on her face.

Contrary to what you might think, tattoo parlors — at least the one I went to — are actually bastions of cleanliness. Some states regulate them, and reputable ones use disposable needles and sterilize all their equipment in an autoclave. In contrast, mall piercers and many jewelry stores use piercing guns that have been associated with complications and can’t be completely sterilized. Armed with that knowledge, which would you choose?

While some parents might be freaked out by the idea of taking their kid to a tattoo parlor, I looked upon the outing as an adventure, joking with my daughter about getting a Hello Kitty tattoo for mom. What I didn’t expect was that the experience would evolve into a lesson in tolerance. In that unnerving way little kids have of speaking their mind, Shira took an initial look at LaRoe and stage-whispered: “I think she looks ugly like that.”

I immediately flashed her my scary mom eyes to signal her to clam up. But later, after we’d left the store, her comment served as an opportunity to point out that just because someone looks different, it doesn’t mean she’s not a good person. LaRoe, regardless of her unconventional piercings, was super-professional and extremely kind.

For professional piercers like LaRoe, who stick needles through noses, eyebrows, tongues and nether regions, ears are the most mundane of piercing locations. But that doesn’t mean they don’t take it seriously. LaRoe spent nearly an hour with us, versus the quick in-and-out that I remember from getting my ears pierced at the mall as a girl. Before leading us into the piercing room — which looked just like a doctor’s office — LaRoe handed the birthday girl a bag with a lollipop, which expertly distracted Shira from being overly nervous about what was going on.

The bag also contained non-iodized sea salt and instructions for mom on how to mix a saline solution to clean newly pierced ears. Unlike the alcohol that mall kiosks recommend for cleaning, salty water doesn’t burn.

Now for the gory details: at tattoo parlors, piercers use hypodermic needles to core out a sliver of skin, making room for an earring — a relatively painless procedure. In contrast, at the mall, the piercer uses a gun that painfully jams a blunt-tipped earring stud into the ear lobe; the process does not remove skin, but effectively pushes it aside.

LaRoe is so convinced of the superiority of needles over piercing guns that she’s signed petitions to ban the guns; one such petition makes the case that “only cowboys use guns.” In her quest to reform the ear-piercing industry, LaRoe leaves her business card at schools and pediatricians’ offices. When she takes her own son to the doctor, she’ll frequently get questions about her multiple piercings; sometimes she gets customers that way too.

Ultimately, though, change starts parent by parent, through word of mouth. “It kind of acts like a trendsetter,” says LaRoe. “All it takes is one little girl who goes to school and says it didn’t hurt.”

It didn’t hurt? Well, maybe a little. But so little that Shira didn’t even blink when LaRoe pierced her first ear. During the procedure, LaRoe had her do some deep, yoga-like breathing, which Shira is familiar with from her weekly yoga class. In and out, in — pierce! Of course, the lollipop helped too.”

Facebook in a Time of Divorce

I found out I was getting divorced through Facebook. Well, kinda. This is what I learned about online etiquette for really big life events.

Monday started like any other: snag coffee, check work email, putz around online. I signed into Facebook and stopped breathing. There, in the center of my news feed, broadcast to absolutely everyone: “He has changed his status. He is no longer married.” My heart thudded, my stomach dropped, my eyebrows shot up. I mean, yes, we’d had the conversation but this felt like a kick in the gut; it was so public, so final, so soon.

I swallowed a small hysterical snort of realization that I was now married to someone not married to me. Is that even possible? I clearly needed to fix it, pronto. Frantically I sought out our barely 21 year-old colleague and explained in a rush of words, “Hi I need your help I’m getting divorced and he just unmarried me now I need to change my status but not broadcast it and I don’t really want any status posted at all but do you know how and can you show me?” A nervous laugh, the briefest of apologies and in 15 seconds we were done. I feebly thanked him and promised to buy the next round of coffees.

Like the wave of an unwelcome fairy wand, I went from married to unmarried with a deft stroke. I mean, we knew each other for over 10 years, were married for 5-plus years, our families lived 45 minutes apart for crying out loud! Isn’t there some decorum, some etiquette, a precedent on how to publicly dissolve your joint lives? Apparently not. Somehow surprise un-marrying your spouse with a global announcement hardly seems the ticket.

Advice in five online spaces:

1. Emails to Socialize – as a Couple. Our former friends and housemates sent us an email announcing their engagement and asking us to come out for a drink to celebrate. I stared at the email and in a very toddler tantrum way, internally declared that I would NOT be the one to reply because I didn’t create this situation, why should I have to craft some benign excuse? He put his degree in English literature to use and wrote a brief, poised email explaining that we were no longer together, but wished them the very best. I laughed at the kindness in his words which for so long had been absent from our conversations. But really, it was fine. I just wish we’d made a game plan, but then again, I didn’t know that I needed one….

Read the other tips on The Huffington Post Divorce Blog

What’s In A Name: Boyfriend/ Partner/ Fiancé?

My Mom is getting married.

Again.

For the fourth time.

Without going into reams of details, suffice it to say her relationship philosophies are skewed. Which means I have the pleasure of sorting my own thoughts, ideas and expectations of love and commitment while dissecting out the ‘truths’ she espouses.  Also, I’m a sociologist at heart, intrigued by dissonance in social structure and systems — you know, like marriage in America.

Here’s a great piece from Slate that touches on the complexities of language and tradition in defining relationships, and the gray areas that I — and many of my peers — inhabit. My mom would not understand.

What Do You Call the Person You Are Probably Never Going to Marry?

By

In certain parts of America, the word fiancé does not mean what it used to. I first became aware of this when I was reporting a story in a small town in Wisconsin a couple of years ago and “Bug” Smith, a 50-year-old man who worked as a machinist introduced me to his “fiancée.” I was about to say “Congratulations!” but something stopped me. Their union did not have the air of expectant change about it. From their domestic surroundings, it looked like they lived basically as a married couple already, his boots next to hers by the front door, pictures of kids above the mantel. I later found out they’d been living together for 15 years and had two children.

Since then I have come across this phenomenon dozens of times. Someone will introduce me to his or her fiancé. But what they mean is more like my “steady lady” or my “steady man.” It could mean the person they are living with, or the father or mother of their child. It could also just mean the person they’ve been dating for a long time. It could be that they only use that title in the presence of outsiders (i.e., me) because it gives an official, respectable status to a relationship that’s otherwise amorphous. It could mean that someone has actually proposed, or bought a ring, but usually not. But what it definitively does not mean is that they are choosing a wedding date or checking out venues or pricing caterers or otherwise making any kind of concrete plans for marriage. In many parts of America, fiancé has become a permanent relationship status (permanent, that is, until it’s not).

The aspiration for marriage won’t die in America, even though fewer people are getting married or think they can afford to get married. People no longer think of a wedding as a milestone that happens somewhere between high school and having children. They think of marriage as what sociologists call a “capstone”—that is, something they earn after many other things are in place in their lives, like a good job or a nice house. But they might never get the good job or the nice house. “We intended to get hitched,” Bug Smith told me. “But we just kept finding other things to do with the money. Fixed the porch, got a new engine.”  Smith and many others get lost in a free-floating longing for marriage that never gets fulfilled but finds temporary home in the liberal use of the term fiancé.

In the meantime, while fiancés are waiting for marriage, life goes on. People live together for longer periods. They have kids: Among Americans without a college degree, 58 percent of first time births happen outside marriage. People share huge life events with each other even though they’re not married, and yet the culture hasn’t adjusted by producing any new terms to describe these novel attachments or arrangements. Describing someone as “the guy I’m living with” or “the mother of my child” might be accurate but it’s not all that efficient, and a little clinical. Girlfriend or boyfriend belittles the relationship, and partner feels like something people in New York and San Francisco say, so fiancé fills in the gap. It conveys at least the correct level of emotional attachment, which is: something like spouse but not quite.

Mostly this is a class phenomenon. College-educated women flirt with not getting married, provide fodder for lots of movies about the glories of single life, but eventually they get married (even in the movies); among college graduates, only 12 percent of first time births happen outside marriage. But there’s a trickle-down effect. Everyone watches the same movies, so everyone has inherited the idea that marriage should be really special, maybe lavish, definitely worth waiting for, as Kathryn Edin and Maria Kefalas argue in Promises I Can Keep: Why Poor Women Put Motherhood Before Marriage. But since many can’t afford that fancy wedding and don’t want to go “downtown”—a term women in the book use to describe a marriage on the cheap—they just stay engaged.

“I’ve seen it among poorer couples,” says Edin. “They’re willing to get engaged but not sure they are ‘ready’ for marriage. Engagement is not a promise to marry, but rather an indication that they are thinking about it. Perhaps an indication of the high bar for marriage across classes, plus a way of gaining some ‘official’ status without the confines and expectations of marriage.” In her new book, Doing the Best I Can, co-written with Timothy Nelson, Edin tells a story about Lavelle and Big Toya (the mother of Lavelle’s child). Big Toya asks Lavelle to marry him, but she turns him down flat, because she doesn’t want to lose “her freedom, her food stamps or her subsidized apartment.” But he persuades her to let him call her his fiancée anyway. She knows she will never marry him, but that title cements the relationship enough that she will now travel to Camden so he can visit with his daughter.

Sociologists Wendy Manning and Pamela Smock, who study changing family demographics, told me that they, too, made the mistake of assuming couples who said they were engaged were making plans to get married. But when they asked follow-up questions for a large qualitative study they recently conducted with young adults on “Cohabitation and Marriage in America,” they realized that wasn’t true. Instead the term engaged, for couples of all races, seemed to be a kind of placeholder, “a way to keep the relationship going without actually making the move to marry,” says Manning. Smock says she noticed that couples use the term fiancé or engaged in a “flexible” way, that is, when dealing with authorities on the phone, or in a social setting where they might want to “own” the person more or seem like more of an “official couple.”

If anything, the liberal use of fiancé is devaluing the old term girlfriend. In the ’60s, being a girlfriend was an official status, like getting promoted to two-star general. You would get pinned, or get the letter jacket, or some other visible mark of distinction when a guy “decided” you were his girlfriend. But now being a girlfriend or boyfriend can mean anything or nothing. So if you’re really truly the girlfriend or boyfriend, you’re the fiancé.

In The Marriage Go-Round, sociologist Andrew Cherlin describes our dysfunctional relationship with marriage. Americans have unusually high marriage and divorce rates, because we are culturally attached to both old-fashioned commitment and to individual freedom. Other countries have solved this dilemma by letting go of the marriage ideal, allowing people, for example, to live together and still be considered a family, by the state and by their neighbors. Even by the guy at the car dealership, who doesn’t trust them any less for not having a signed marriage license. With 10 more years of fake fiancés, maybe we’ll get there, too.