Forget everything you think you know about infant sleep. What if the secret to better rest for the whole family isn't about training your baby, but about tuning into their needs? And what if science shows that breastfeeding, often blamed for maternal exhaustion, is actually a key to more sleep and lower depression risk?
In this groundbreaking follow-up episode of The Science Chick Report, Dr. Kathleen Kendall-Tackett moves beyond the critique of "cry it out" to present the powerful, evidence-based alternative. She dismantles the simplistic sleep-training model by exploring the complex web of factors that truly influence infant sleep from prenatal stress and parental mental health to attachment security and feeding methods.
Dr. Kendall-Tackett reveals stunning research that turns conventional wisdom on its head: exclusively breastfeeding mothers report more total sleep and better mental health than those who mix-feed or formula feed. She explains how responsive, attachment-based care creates a positive feedback loop of security and regulation, leading to better sleep outcomes for everyone.
If you are a new parent lost in the fog of exhaustion, or a healthcare provider looking for compassionate, science-backed guidance, this episode offers a revolutionary and empowering guide. It’s time to stop fighting biology and start working with it.
In This Episode:
(00:00) Introduction and limitations of sleep training models
(01:15) Domains influencing infant and child sleep
(02:25) Prenatal maternal depression and infant sleep
(04:37) Longitudinal evidence of prenatal depression effects
(05:46) Attachment theory and relational interventions
(06:48) Pilot study: parental education on infant crying
(09:48) Maternal sensitivity at bedtime
(10:58) Maternal responsivity and bedtime routines
(12:01) Feeding method and infant sleep
(13:04) Exclusive breastfeeding and maternal sleep
(14:09) Large-scale study: sleep predictors and feeding
(15:05) Contradictory findings on formula feeding
(20:37) Exclusive breastfeeding and bed sharing
(21:44) Does breastfeeding cause fragmented sleep
(22:45) Ecological perspective on infant sleep
(23:52) Attachment and ecological models vs sleep training
(24:53) Methodological issues in sleep training research
(25:50) Conclusion and resources
Notable Quotes:
(01:52) “Insecure attachment were linked to shorter sleep duration and more nighttime awakenings. And they said this was actually the most robust factor.” — Dr. Kathleen Kendall-Tackett
(03:24) “Higher prenatal depression scores were associated with shorter nighttime infant sleep duration, but interestingly only for babies born vaginally.” — Dr. Kathleen Kendall-Tackett
(07:51) “The maternal psychological stress can perpetuate infant regulatory difficulties in a negative feedback loop.” — Dr. Kathleen Kendall-Tackett
(09:55) “Secure attachment mitigates the effects of parental emotional dysregulation. And a secure attachment regulates infant sleep.” — Dr. Kathleen Kendall-Tackett
(13:39) “Exclusively breastfeeding mothers slept 40 minutes longer than the mixed or formula feeding mothers.” — Dr. Kathleen Kendall-Tackett
Resource and Links
The Science Chick Report
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Mentioned
Dao & Liu (China) – Five domains influencing infant sleep
CHiLD Study (Canada) – Prenatal depression and infant sleep
Tiffany Field (2007) – Stress hormones and infant sleep patterns
ALSPAC Study (U.K.) – Longitudinal maternal depression findings
Montessori (2018) – Treating maternal anxiety to reduce infant crying
Emotional availability and attachment studies (2019)
Chinese and Canadian breastfeeding/sleep trajectory studies
James McKenna & Helen Ball – Anthropological perspectives on infant sleep
What if everything you’ve been told about infant sleep is rooted in a century-old theory that dismissed love as unscientific? Are “cry-it-out” techniques really helping families, or just fueling a billion-dollar parenting industry built on exhaustion and guilt?
In this eye-opening episode of The Science Chick Report, the first of a special two-part series, Dr. Kathleen Kendall-Tackett takes a clear, evidence-based look at the world of sleep training, challenging both the parenting industry and the pediatric establishment. She traces its origins to the behaviorist movement of the 1920s, which urged parents not to comfort or emotionally engage with their babies in the name of “science.”
Dr. Kendall-Tackett contrasts this outdated view with attachment theory and evolutionary biology, showing that responsive caregiving is not spoiling—it is essential for survival and healthy development. Through a critical review of multiple studies, she asks whether sleep training truly helps babies sleep better or simply teaches them to stop signaling distress.
If you are a new parent, healthcare provider, or anyone who has ever been told to let a baby “cry it out,” this episode will empower you to question conventional wisdom and make informed, compassionate choices for your family.
In This Episode:
(00:00) Introduction: why sleep training needs a second look
(01:06) The business of baby sleep and the modern parenting dilemma
(02:13) Pediatricians and the promotion of cry it out
(03:23) Historical and theoretical foundations: Behaviorism
(05:30) Parenting without emotion: lessons from John B. Watson
(06:32) The rise of attachment theory after World War II
(08:31) Why infant crying is evolutionary, not manipulative
(10:37) What the latest research really says about cry it out
(12:55) Do babies really sleep better or just cry less?
(15:34) When cry it out backfires: findings from Canada and beyond
(18:20) Why ignoring babies raises cortisol and risks brain development
(21:10) The hidden costs of “successful” sleep training
(23:02) What studies from China and Australia reveal about sleep and maternal mood
(26:17) The two-way relationship between maternal depression and infant sleep
(28:22) Final reflections: toward a more responsive approach
Notable Quotes:
(01:17) “Infants crying at night is probably one of the hardest things to deal with when you're dealing with a newborn.” – Dr. Kathleen Kendall-Tackett
(11:38) “Excessive crying is associated with maternal depression, anxiety, and parental exhaustion, but it also can possibly disrupt attachment and increase the risk of abuse.” – Dr. Kathleen Kendall-Tackett
(22:31) “These poor little mute babies, still distressed, but they've learned not to signal.” – Dr. Kathleen Kendall-Tackett
Resource and Links
The Science Chick Report
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Mentioned
Breaking the Silence" by Mariette Hartley
Bathory & Thomas Paulus (2017) – Pediatric Sleep Recommendations
Wolke (2017) – Infant Crying and Parental Sensitivity
Build & Invoke (2020) – Cry It Out in First-Time Mothers
Davis & Kramer (2021) – Ecological Critique of Cry It Out
Middlemiss et al. (New Zealand Study) – Cortisol Synchrony in Sleep Training
Sapolsky (1996, Science) – Cortisol and Brain Health
Chinese Meta-Analysis (2020) – Infant Sleep Interventions
Australian Cohort Study – Maternal Depression and Infant Sleep
What happens when the healers become the wounded? When doctors and nurses are forced to make choices that violate their deepest ethical vows? In this compelling episode of The Science Chick Report, Dr. Kathleen Kendall-Tackett explores the concept of moral injury, a term once reserved for military contexts but now emerging as a crucial framework for understanding the psychological and ethical toll of the COVID-19 pandemic on healthcare providers.
Drawing from 46 empirical studies, Dr. Kendall-Tackett breaks down how physicians, nurses, and frontline workers faced impossible ethical choices, from resource shortages to patient isolation policies. She explains how these experiences overlapped with post-traumatic stress disorder (PTSD) yet carried a distinct moral and spiritual dimension.
Through striking quotes from clinicians and international studies, she unpacks seven defining themes of moral injury: ethics, high-stakes decisions, moral transgressions, betrayal, psychological wounds, spiritual wounds, and reconciliation, revealing the deep emotional cost of caregiving in crisis. The episode also highlights promising therapeutic pathways for recovery, including Acceptance and Commitment Therapy and Trauma-Informed Guilt Reduction Therapy.
If you care about the mental and moral well-being of those who care for others, this episode is essential listening.
In This Episode:
(00:00) Introduction and research update
(00:59) Definition and context of moral injury
(02:17) COVID-19’s impact on healthcare providers
(03:12) Differentiating moral injury from PTSD
(04:16) PTSD criterion A and trauma exposure
(06:16) Healthcare providers’ fears and experiences
(07:30) Key elements of moral injury
(09:35) Ethics and moral transgressions
(11:49) High-stress environments
(12:50) Orientation: immoral acts and guilt
(13:51) Betrayal by authorities
(15:51) Psycho-behavioral wounds
(17:01) Spiritual and existential wounds
(18:05) Burnout and functional impairment
(20:06) Suicide risk and hopelessness
(21:05) Reconciliation and resilience
(23:27) Summary and research implications
(24:28) Closing remarks
Notable Quotes:
(02:06) "The COVID-19 pandemic was a different kind of crisis because it put an enormous, unprecedented strain on all healthcare systems worldwide." – Dr. Kathleen Kendall-Tackett
(07:08) "As with soldiers in war, we know that as soon as we stop doing, we will start feeling the deterred processing of grief and trauma and betrayal for the patients we've lost." – Dr. Kathleen Kendall-Tackett
(13:37) "I almost wanted to tell people if they knew what had gone on and if they knew how bad things were, you wouldn't be clapping, you'd be writing petitions and storming Parliament." – Dr. Kathleen Kendall-Tackett
(14:59) "If I die, they don't care. They'll just get someone else in my shoes tomorrow." – Dr. Kathleen Kendall-Tackett
(17:01) "I didn't feel like I was a doctor. I felt like I was just letting people die." – Dr. Kathleen Kendall-Tackett
(19:56) "The last 20 months have been the most stressful, exhausting, and depressing time in my 30-year medical career." – Dr. Kathleen Kendall-Tackett
Resource & Links
Podcast
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Mentioned
Journal Traumatology – Upcoming article on Moral Injury in Healthcare
National Center for PTSD – Moral Injury Treatment Guidelines
Acceptance and Commitment Therapy (ACT) for Moral Injury
Trauma-Informed Guilt Reduction Therapy
Western Sydney University Moral Injury Studies
What are the real barriers to VBAC, and are they evidence-based or built on fear and bias? In Part 2 of this powerful two-part series, Dr. Kathleen Kendall-Tackett continues her conversation with Australian midwife, researcher, and author Dr. Hazel Keedle. They dive deeper into the systemic, emotional, and clinical roadblocks that women face when planning a vaginal birth after cesarean (VBAC).
From BMI bias to short interpregnancy intervals, big babies to special scars, Dr. Keedle unpacks the often-coercive medical narratives and exposes the power imbalances that still plague maternity care. She shares groundbreaking insights from her research and emphasizes how control, trust, and informed choice are key to transforming birth trauma into empowered birth experiences, whether or not a VBAC is achieved.
If you care about evidence-based, respectful, trauma-informed maternity care, this episode isa must listen.
In This Episode:
(00:00) Introduction to The Science Chick Report
(00:29) Concerns about inductions and VBAC barriers
(01:01) Body mass index and VBAC calculators
(01:28) Fat shaming in maternity care
(06:07) Impact of birth experience on mothers
(06:52) Challenges with big babies and VBAC
(09:16) Interpregnancy interval and VBAC
(12:07) Multiple cesareans and VBAC support
(16:30) Breech birth and ECV options
(18:07) Hospital policy changes and breech births
(19:28) Understanding special scars
(22:45) Birthplace choices: hospital, birth center, or home
(27:15) The importance of control during birth
(29:39) Positive birth experiences: beyond the outcome
(35:58) Final thoughts and resources
Notable Quotes:
(01:45) "A higher score was more chance of a VBAC the thinner you were. And it really went to quite a ridiculous weight." – Dr. Hazel Keedle
(04:24) "What annoys me is that this is about the baby and not the woman. We want to get the baby out of this woman who's larger and, you know, if she has complications afterwards, whatever, that's her fault." – Dr. Hazel Keedle
(05:31) "A live mother may well have a pulse. However, she can be traumatized." – Dr. Hazel Keedle
(12:15) "The data is very supportive for two. One or two cesareans…potentially the more caesareans you've had, the higher chance you've got of a uterine rupture." – Dr. Hazel Keedle
(22:58) "Sometimes being in a hospital doesn't feel safe for women, especially when they've had previous birth trauma." – Dr. Hazel Keedle
(25:58) "We're treating them like terrorists and they just wanted to have a natural birth.” – Dr. Hazel Keedle
(31:56) "You can have a cesarean and feel amazing. You can have a cesarean and feel bad, you can have a VBAC and feel amazing. You can have a VBAC and feel bad." – Dr. Hazel Keedle
(35:37) “There were women who had cesareans that felt okay about them, women who had vaginal births that described them as rapes.”– Dr. Hazel Keedle
Our Guest
Dr. Hazel Keedle is a Senior Lecturer of Midwifery at the School of Nursing and Midwifery, Western Sydney University. With over 25 years of midwifery experience, she completed her PhD in 2021, focusing on vaginal birth after cesarean (VBAC). Hazel is the author of Birth After Caesarean and The VBAC Clinician’s Guide. Her work blends research and lived experience to promote trauma-informed, evidence-based maternity care.
Resource and Links
Podcast
The Science Chick Report
Dr. Hazel Keedle
Dr. Kathleen Kendall-Tackett
Mentioned
INOSS Study – Largest European data on uterine rupture (0.22% rate)
Sarah Wickham – Plus Size Pregnancy
Interpregnancy Interval Study (Australia)
Special Scar Research Project (Qualitative study on uterine rupture)
Ever wondered what drives women to choose vaginal birth after cesarean (VBAC)? In this powerful first part of a two-part series of The Science Chick Report, Dr. Kathleen Kendall-Tackett sits down with Australian midwife, researcher, and author Dr. Hazel Keedle for an honest, eye-opening conversation about the challenges surrounding birth after cesarean, also known as VBAC. Drawing from her own experience, groundbreaking research, and two widely acclaimed books, Dr. Keedle explains why VBAC isn’t just a medical choice; it is a deeply personal and often political journey toward reclaiming power and autonomy.
Together, they dive into the complex mix of triumph and trauma that many people face in maternity care. They talk candidly about birth trauma, debunk some of the most stubborn myths about VBAC, and call out coercive practices that still get in the way of informed choice. This episode is a must-listen for anyone passionate about respectful, trauma-informed maternity care and making sure women’s voices are truly heard, especially in a system that too often tries to quiet them.
Be sure to tune in to Part 2, where Dr. Kendall-Tackett and Dr. Keedle continue this vital conversation and explore practical ways to support women on their VBAC journeys.
In This Episode:
(00:02) Introduction and guest background
(02:08) Dr. Keedle’s personal VBAC story and research motivation
(05:06) Book cover imagery and symbolism
(06:57) Stories of triumph and community
(08:28) Defining VBAC and its importance
(11:21) Women’s motivations for VBAC
(12:31) Birth trauma: prevalence and impact
(13:18) Factors contributing to birth trauma
(16:32) Obstetric violence and blame
(19:22) Comparing models of care
(20:13) Fear tactics and coercion in VBAC counseling
(22:00) Actual risks of uterine rupture
(23:59) Conclusion and closing remarks
Notable Quotes:
(03:37) "When I pushed my baby out, I felt amazing. I felt like I had just, I don't know, I'd won Olympic gold." – Dr. Hazel Keedle
(06:16) "I felt like it was a bit of a secret language that was going on in the VBAC world." – Dr. Hazel Keedle
(11:56) "The biggest reason was to experience birth, to go through that experience and have that experience." – Dr. Hazel Keedle
(16:58) "What's the high expectation is that you get treated with respect. The high expectation is that you make an informed decision." – Dr. Hazel Keedle
(22:31) "If your wife plans a VBAC, you will end up with a dead baby, a dead wife, and a toddler to raise on your own." – Dr. Hazel Keedle
Our Guest
Dr. Hazel Keedle is a Senior Lecturer of Midwifery at the School of Nursing and Midwifery, Western Sydney University. With over 25 years of midwifery experience, she completed her PhD in 2021, focusing on vaginal birth after cesarean (VBAC). Hazel is the author of Birth After Caesarean and The VBAC Clinician’s Guide. Her work blends research and lived experience to promote trauma-informed, evidence-based maternity care.
Resource and Links
Podcast
The Science Chick Report
Dr. Hazel Keedle
Dr. Kathleen Kendall-Tackett
Mentioned
INOSS Study – Largest European data on uterine rupture (0.22% rate)
Birth Trauma Inquiry – New South Wales, Australia
Did you know that during the peak of COVID-19 in New York City, 67% of frontline healthcare workers reported moderate to high levels of moral injury-related guilt?
In this debut episode of The Science Chick Report, Dr. Kathleen Kendall-Tackett takes a closer look at something we haven’t talked enough about: how the COVID-19 pandemic impacted the emotional well-being of healthcare providers. Specifically, she focuses on moral injury—a term originally used in military settings—that helps explain what many frontline workers experienced during the crisis.
Through a review of 36 studies from around the world, Dr. Kathleen Kendall-Tacket shares how nurses, physicians, and other care providers felt deep distress when they couldn’t give the care they knew their patients needed. Many described feeling helpless, unsupported, and in some cases, betrayed by their institutions. These aren’t just signs of stress or burnout—they point to something more complex and lasting.
But it’s not all bad news. Dr. Kendall-Tackett also highlights what helped: strong team support, open communication from leadership, and practical resources that made people feel valued. She wraps up the episode by encouraging organizations to reflect on what went wrong, take meaningful action, and commit to supporting their teams—not just in a crisis, but every single day.
This episode is a powerful reminder that behind every hospital badge is a human being—and that caring for healthcare providers is just as essential as caring for the patients they serve.
In This Episode:
[00:00] Introduction
[01:16] Defining moral injury and its origins
[02:21] Applying moral injury to healthcare providers
[03:22] COVID-19 policies and institutional collapse
[04:30] Moral injury in healthcare vs. military
[05:29] Frontline experiences during COVID-19
[06:47] Emotional impact and patient isolation
[07:56] Moral injury in maternity care
[09:07] Prevalence and effects of moral injury
[10:23] Institutional betrayal and burnout
[11:37] International perspectives on betrayal
[12:44] Burnout as a unique outcome in healthcare
[15:10] Resilience and protective factors
[16:17] Organizational lessons and recommendations
[17:32] Individual and organizational healing
[18:33] Conclusion and resources
Notable Quotes:
[01:45] "Moral injury is not a diagnosis yet, but it recognizes that people in combat experience symptoms beyond PTSD, dealing with issues of right and wrong." – Dr. Kathleen Kendall-Tackett
[02:51] "They felt that patient care was severely compromised, and they were witness to it but couldn't do anything to stop it.." – Dr. Kathleen Kendall-Tackett
[08:12] "In extreme cases, staff can feel that they have become instruments of inhumane treatment of women and babies, active perpetrators of psychological and physical harm." – Dr. Kathleen Kendall-Tackett
[11:25] "We got a lot of lip service and no actual action. It was demoralizing and disheartening.s." – Dr. Kathleen Kendall-Tackett
[12:39] “If I die, they don't care. They'll just get somebody else in my shoes tomorrow.”– Dr. Kathleen Kendall-Tackett
[18:44] "Apologize for what happened. That really goes a long way toward repairing relationships and re-establishing trust with your staff and your team." – Dr. Kathleen Kendall-Tackett
Resource and Links
Podcast
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Referenced Studies
Fisher et al. (2022) – NYC frontline moral injury and guilt
Hors et al. – Swiss maternity providers and ethical trauma
Nieuwsma et al. (2022) – Comparison of veterans and healthcare workers
U.S. & Netherlands ICU provider studies
NHS (UK) nurse experiences with systemic betrayal
Hosted by Dr. Kathleen Kendall-Tackett, The Science Chick Report brings women’s health research you can trust to the people holding it all together: birth workers, lactation consultants, doulas, midwives, mental health providers, and nurses. Every episode turns the latest science into practical tools, helping you advocate, recover, and stay grounded in the work you love, even when it feels like you’re doing it alone.