Archive | 2010

Book Review: Pregnant on Prozac

Book Review: Pregnant on Prozac: The Essential Guide to Making the Best Decision for You & Your Baby

By Shoshanna Bennett, Ph.D.
GPP Life, 2009
ISBN 978-0-7627-4940-9

248 pages, softcover, $16.95
http://www.clearsky-inc.com

Reviewed by Molly Remer, MSW, CCCE

Written by a clinical psychologist and mother of two, Pregnant on Prozac is a comprehensive look at the benefits and risks of antidepressant use during pregnancy or postpartum. The focus on depression during pregnancy is what makes this book stand out—this is a subject that has received very little attention and it is important for doula and childbirth educators to learn more about the issues involved.

The book includes sections on “natural and emerging treatments” including homeopathy and acupuncture as well as a section on nutrition, though the overall emphasis is on pharmacological treatment methods.

The information presented is very comprehensive, though I was disturbed by the suggestion not to read the package inserts coming with medications, but to trust your doctor to know “what is safest for you and your baby.” This is not the type of informed decision-making I promote in my work with pregnant and new mothers!

Pregnant on Prozac briefly addresses midwives and doulas in a section about “helping professionals who may be of use to you.”

I have three significant critiques of the book. During one section the author waxes eloquent about the non-specific benefits of an unnamed “exercise system” and then later an unnamed “nutritional system.” She glowingly recommends these unidentified systems and refers readers to her website for more information about the nutritional system and to another website for the exercise system. I suddenly felt like I was reading a commercial and the tone called into question for me the validity and reliability of the entire rest of the book.

My third critique is that the segment addressing medication use while breastfeeding is woefully incomplete, falling back on the trite platitude “a calm, happy mother is more important to a child’s healthy development than breast milk.” Though I do not quibble with the truth of this statement in an “ultimate” sense, my concern is that it summarily dismisses the fact that many women can take medication AND breastfeed—it is not an either or situation! The very brief section on breastfeeding also included the questionable and disappointing statement, “you can even get better eye contact with your baby with a bottle in its mouth instead of being squished face-first into your breast.”

Each of these sections is small, but my concerns about them are large. Despite these critiques however, I would still recommend Pregnant on Prozac to birth professionals and parents seeking information about treatment options for depression during pregnancy with the caution not to rely on it as your only resource and certainly not to count on it for advice on exercise, nutrition, or breastfeeding.

Disclosure: I received a complimentary copy of this book for review purposes.

Thoughts About Birth Thoughts

When I check my blog stats, I’m interested to see which search terms bring people to this blog. Recently, a search term used was “birth thoughts.” I use “birth thoughts” as my default category for posts that don’t fit in a specific other category and I have a lot of posts in that category. So, I searched for the term myself and was very surprised to see that of 52 million google hits for “birth thoughts,” Talk Birth was the FIRST site to come up on a search using that term. Isn’t that cool? Since, I’ve been somewhat obsessed with searching for “birth thoughts” to see where I continue to stand and I guess it depends on page updates (?), because sometimes it drops off the top 10 (though then it is usually of 32 million or 27 million sites, not 52 million—not sure what is up with that either). Either way, I think it is interesting 🙂

I do think a lot of birth thoughts. Sometimes I wonder why birth remains such a consuming subject of interest to me. I have been considering this a lot lately, actually, and still working to put my finger on WHY. I think it is because birth, for me, is one of the fullest experiences of standing in my “personal power” that I’ve ever had. A “peak experience,” a “flow experience,” almost a “religious experience.” Last year I led a series of classes on women’s spirituality and one of the questions we addressed was, “how do you feel when you are standing in your personal power? When do you feel like you are standing in your personal power.” While it is great that I experienced such powerful births, I was saddened slightly to discover when answering this question myself, that essentially the only personal power moments I could come up with were in giving birth. What about the rest of my life?! (On my m/c blog I have written that apparently I need to get into extreme sports!) So, one of the birth thoughts on my mind lately is how do you pull that “birth power” feeling into the rest of your life? Make no mistake, my life is full and vibrant and full of good things, but that birth power feeling comes only in giving birth—maybe there is no other way to experience it?!

New Training!

This year, I completed several new trainings that I am very excited about.

Prenatal Yoga Training

This weekend I fulfilled a 7 year old dream and attended a prenatal yoga teacher training in St. Louis. I have wanted to teach prenatal yoga since I was pregnant with my first baby, but a training opportunity just never opened up for me until now. I felt like this was perfect timing. The training was through YogaFit and was pretty basic, but it was just what I needed to feel like I can move forward with this dream. YogaFit is a very “fitness” oriented type of program vs. any kind of holistic-mind/body connection stuff, but I can add those elements in myself. I think I will be able to offer something fairly unique—not just yoga and not just childbirth education but yoga-childbirth-education. There are several other programs like that, of course, but none in the local area! At the training, I also learned some really cool partner yoga stuff that I didn’t know how to do before.

Birth Art Training

In February, I completed something else that I’ve been dreaming about for some time—I took Birthing from Within‘s online course, “How to Lead the Birth Art Process.” Aside from a few minor complaints about the sometimes-frustrating “Zen” underlay and occasional contradictions within the course, I really LOVED this class. I found the online course format to be an ideal format for me—real-person interaction through message board, chat, phone call, and email; written information; writing journals/essay responses; hands-on personal practice with the assignments; and real-life application with other people/clients in birth art sessions. I felt like I got more out of actual use out of this workshop than most of the other classes and workshops I’ve attended—I think this was because the course was spread out over 5 weeks, not just a weekend, which allowed plenty of time to really assimilate and USE the information. It was very affordable too and I was able to attend right from the comfort of my own chair! The class is marketed as suitable for beginners, but personally I found my past background in childbirth education to be very important and I cannot imagine having taken the class with no prior birth class teaching experience—I think the people who had little experience were kind of disadvantaged in this course. Birthing from Within is my all-time favorite birth preparation book/resource and it was so exciting for me to have a little taste of direct training with them. Hopefully at some point in the not-too-distant future, I will take further training with BfW.

Childbirth Educator Certification

In March of this year, I was pleased to earn my childbirth educator certification with CAPPA. Since I am already certified with other organizations, I enrolled in the dual certification program option. I am very excited to be “throwing my hat in” with CAPPA. The organization is very friendly and stable and I really connect with the CAPPA Vision. The program information itself was pretty basic and I didn’t really learn anything new from it, but that makes sense because it isn’t specifically designed for people who already have CBE teaching experience—I think it is a great program for someone starting out in this field.

Comparing CBE Programs:

I get a lot of inquiries from people seeking information about different childbirth education programs and thought I would provide a super-quick mention of the things I enjoyed most about each of my certification programs/organizations. Keep in mind that I certified with ALACE first, hence, I had the most direct experience with their full training program, vs. the other organization’s “accelerated” options (which I SO deeply value and I am SO grateful that ICEA and CAPPA make that option available to people—I’m very, very grateful!). In sequential order:

ALACE (now IBWP)—phenomenally in-depth training program with a wonderful woman-oriented, holistic, midwifery-model. Very homebirth friendly. When I finished this program, I felt like I’d earned another master’s degree—this time in birth. At the present time, however, I do not get a “stable” or professional feeling from the organization and that is very disappointing 😦

ICEA—very professional. Lots of really good information on how to teach and on the principles of adult education in general. I learned the most about the “how” from ICEA (and the “how” is very, very important). They also have several great teaching manuals that are super-affordable. I enjoy the International Journal of Childbirth Education as well. Very professional. The training information assumes educators will be teaching a “mainstream” population, probably in a hospital, but their position papers are very sound and I can really get behind their mission as well. Their certification exam was the most difficult of the three programs and I feel like I really earned my certificate!

CAPPA—I am really pleased with my association with CAPPA. As I noted, they are very friendly and I feel like they will be around for a long time to come. I just get a lovely, warm feeling of “sisterhood” from CAPPA and that is very important to me. I feel connected to the organization and the people and it is a very supportive atmosphere. I recommend them for training, especially for people who are just starting out. I’m excited about the free conferences CAPPA offers as well and I’m going to my first one this July! I also enjoy the CAPPA Quarterly and and I am proud to write the book/film reviews column.

Cesarean Awareness Month

April is Cesarean Awareness Month! My favorite resources about cesareans are the International Cesarean Awareness Network (ICAN) and The Unnecesarean.

In honor of the month (and in recognition that the national cesarean rate has risen again–to 32.3%), I went back through some of my posts and pulled out some of the things I’ve written about cesareans:

One of my “pet” subjects centers around the question of, “why would someone be upset over a cesarean, at least she has a healthy baby?” and this post partially addresses that: Birth and Apples.

I believe that a cesarean is often an act of personal courage and wrote about this here.

I also wrote about the same in this post on when birth doesn’t go as planned.

And, finally, here is a post I wrote about cesarean trivia.

Book Review: She Births

Book Review: She Births: A Modern Woman’s Guidebook for an Ancient Rite of Passage By Marcie Macari
Infinity Publishing, 2006
ISBN 0-7414-3390-7
255 pages, softcover, $23.95
http://www.shebirths.com

Reviewed by Molly Remer, MSW, ICCE

She Births is a book that “goes beyond” the average birth book. It is a particularly good read for mothers having subsequent children—perhaps for a woman who is well read in the physiology and stages of labor and who wants to dig deeper into the emotional and spiritual meaning of giving birth. It is also helpful for first-time mothers, though I felt that there was a lot of content that seemed to assume the reader had already given birth (and was perhaps reading this book to reflect, process, and prepare for future births).

The emphasis of She Births is on childbirth as a rite of passage and as an opportunity for spiritual growth and personal transformation. There is a lot of content that has a very “New Age” flavor. While I personally do not mind—and actually enjoy—this framework, other readers may consider some of the sections to be offputting.

Each chapter ends with a short chapter-topic meditation and several pages of related journaling exercises.

The book contains a higher than average number of minor typographical errors, as well as odd mid-sentence capitalizations, and too-short dashes between ideas. Persistent capitalization of words such as Birth and Spirit were a bit distracting. The book contains a variety of empowering birth stories, but none of them have attribution, making it difficult to identify who was giving birth. (The author? The woman in the previous story?) It was hard to grasp who was the “I” reflecting and sharing in each story.

She Births has several particularly wonderful passages that are well worth quoting and it also has a lovely cover. It is a passionately written book that is very dynamic and “alive” to read. The book is strongly written—the author does not mince words nor attempt to “balance” her perspective and this can be a refreshing approach. She Births also raises thought-provoking questions such as, “The way a society views a pregnant and birthing woman, reflects how that society views women as a whole. If women are considered weak in their most powerful moments, what does that mean?”

Disclosure: I received a complimentary copy of this book for review purposes.

Two Birth Poems

I shared these on my Facebook page recently too and as long as I was updating my birth quotes, I thought I’d post the poems as well. They could be good for a mother blessing or blessingway ceremony or just to print up for a mother preparing to give birth, to to one who has just given birth, or to a birthworker (another favorite birthing poem is posted here):

Being Born

by Carl Sandburg

Being born is important
You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her.

You who have seen the new wet child
dried behind the ears,
swaddled in soft fresh garments,
pursing its lips and sending a groping mouth
toward nipples where white milk is ready.

You who have seen this love’s payday
of wild toiling and sweet agonizing.

You know being born is important.
You know that nothing else was ever so important to you.
You understand that the payday of love is so old,
So involved, so traced with circles of the moon,
So cunning with the secrets of the salts of the blood.
It must be older than the moon, older than salt.

—-

Ordinary Miracle

by Barbara Kingsolver

I have mourned lost days
When I accomplished nothing of importance.
But not lately.
Lately under the lunar tide
Of a woman’s ocean, I work
My own sea-change:
Turning grains of sand to human eyes.
I daydream after breakfast
While the spirit of egg and toast
Knits together a length of bone
As fine as a wheatstalk.
Later, as I postpone weeding the garden
I will make two hands
That may tend a hundred gardens.

I need ten full moons exactly
For keeping the animal promise.
I offer myself up: unsaintly, but
Transmuted anyway
By the most ordinary miracle.
I am nothing in this world beyond the things one woman does.
But here are eyes that once were pearls.
And here is a second chance where there was none.

—-

(hat tip to Birth True for posting the Kingsolver poem—Barbara Kingsolver is one of my favorite authors, but I had never read the poem before seeing it on the Birth True blog.)

Birth Quotes and More Birth Quotes

Time for my semi-regular birth quotes update post!

“Birth is the doorway for integration of body and mind.” –Gayle Peterson

“Good timber does not grow with ease; the stronger the wind, the stronger the trees.” – J. Willard Marriott

“Most mothers are instinctive philosophers.” – Harriet Beecher Stowe

“Sometime in your life you will go on a journey. It will be the longest journey you have ever taken. It is the journey to find yourself.” – Katherine Sharp

“Sometimes when you think you are done, it is just the edge of beginning. Probably that’s why we decide we’re done. It’s getting too scary. We are touching down onto something real. It is beyond the point when you think you are done that often something strong comes out.” ~ Natalie Goldberg

(This is something I try to convey in my birth classes–that when it seems “too much” and you manage to “dig deeper,” you find so much strength that you didn’t know you had and that knowledge of strength can continue to inform the rest of your LIFE!)

“When a woman has a child, it is equivalent to taking life vows.” –Stephanie Demetrakopoulos

“You do not know how a pregnant woman comes to have a body and living spirit in her womb.” –Ecclesiastes 11:5

(I guess tecnnically we “know,” but I think this is talking about the mystery of how we get from no where to now here…)

“Childbirth is a rite of passage so intense physically, psychologically, emotionally, spiritually, that most other events in a woman’s life pale next to it. In our modern lives, there are few remaining rituals of initiation, few events that challenge a person’s mettle down to the very core. Childbirth remains a primary… initiatory event for a woman.” –Maren Hansen

“Birth is an active, completely engaging process and requires that a woman be actively engaged, not only physically and emotionally but also in the decision-making process (before and during the birth).” –Awaken Your Birth Power e-newsletter

“Although women have been giving birth since time began, the lack of cumulative female knowledge and sharing in our society has led us to seek information about birth in books and classes rather than from the native wisdom of community experience.” –Elizabeth Noble

“…many women see the experience of birth as mystical, something they turn over and refocus on all their lives.” –Stephanie Demetrakopoulos

“Confront the dark parts of yourself, and work to banish them with illumination and forgiveness. Your willingness to wrestle with your demons will cause your angels to sing. Use the pain as fuel, as a reminder of your strength.” ~August Wilson

“You know being born is important to you. You know nothing else was ever so important to you.” –Carl Sandburg

“Spring has returned. The earth like a child that knows poems.” –Rainer Maria Rilke

“Hope is like a bird that senses the dawn and carefully starts to sing while it is still dark.” ~Anonymous

“Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.” –Harriette Hartigan

“Giving birth is a transformation and it doesn’t matter whether you’ve had eight babies before. It’s still a transformation the next time you have another baby, because you are no longer the same woman you were before you had that baby.” –Penny Handford

“When a woman births without drugs…she learns that she is strong and powerful…She learns to trust herself, even in the face of powerful authority figures. Once she realizes her own strength and power, she will have a different attitude for the rest of her life, about pain, illness, disease, fatigue, and difficult situations.” –Polly Perez

“It is certainly true that for an increasing number of women, the birth experience is ecstatic. But it’s very important to keep in mind that, from a global perspective, the birth experience is still not a positive one for millions of women.” –Judy Chicago

“Woman is the first environment. In pregnancy our bodies sustain life. At the breast of women, the generations are nourished. From the bodies of women flows the relationsiop of those generations both to society and the natural world. In this way the earth is our mother, the old people said in this way we as women are earth.” –Katsi Cook Mohawk midwife

“When we let our light shine, we unconsciously give others permission to do the same.” –Marianne Williamson

“Awe enables us to perceive in the world intimations of the divine, to sense in small things the beginning of infinite significance, to sense the ultimate in the common and the simple; to feel in the rush of passing the stillness of the eternal.” –Abraham Joshua Heschel

“Loss makes artists of us all as we weave new patterns in the fabric of our lives.” –Greta W. Crosby

“Pregnant woman, at once universal and individual, lives the compelling force of creation within her whole being.” –Harriette Hartigan

“Childbirth is a rite of passage so intense physically, psychologically, emotionally, spiritually, that most other events in a woman’s life pale next to it. In our modern lives, there are few remaining rituals of initiation, few events that challenge a person’s mettle down to the very core. Childbirth remains a primary initiatory event for a woman.” –Maren Hansen

“Male science disregards female experiences because it can never share them.” –Grantly Dick-Read

“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” –Michel Odent

(Personally, I LOVE books–of all sorts–and reading is THE top way for me to learn about anything. I think the best prep I did before having my first baby was to read and I always give a recommended reading list to my clients. However, I also “hear” what he is saying here and wanted to share the quote. My personal opinion is that in our current birth culture it is nearly impossible to go into birth just planning to “go with the flow” and let labor unfold without expectation [if you are birthing in the hospital that is—because the hospital is FULL of expectations and those will often run right over your flow]).

“No matter what your size, shape, percentage of body fat, or BMI, you and I…can start right this minute to express gratitude to our bodies for being home to our souls and allowing us to express our uniqueness on the earth at this time.” – Dr. Christiane Northrup, The Wisdom of Menopause

“In pregnancy’s sculptured beauty, one body grows within another. Energy becomes human in the alchemy of the womb.” –Harriette Hartigan

“The experience of birth is vast. It is a diverse tapestry woven by cultural customs, shaped in personal choices, affected by biological factors, marked by political circumstances. Yet the nature of birth itself prevails in elegant design of simple complexity.” –Harriette Hartigan

“Stress hormones are contagious–if someone in your birthing space is stressed, you will feel it and become stressed.” (Awaken Your Birth Power)

DVD Review: Dance of the Womb

DVD Review: Dance of the Womb: Belly Dance for Pregnancy and Birth
By Maha Al Musa, 2009
Red Polar Pictures
164 minute DVD, $49.95 (AUS)
http://www.bellydanceforbirth.com

Maha Al Musa has created a remarkable treasure for the birth world—an easy-to-follow, beautifully presented, step-by-step instructional bellydancing DVD called Dance of the Womb. Maha’s interest in Middle Eastern Dance was sparked by her Palestinian/Lebanese roots and she brings a lot of love and authenticity to her presentation of the dance techniques. Maha has also published a gorgeous companion book, Dance of the Womb (see previous review).

Dance of the Womb contains a 45-minute dance stretch warm-up. The exercises are comprehensive, gentle, and easy to follow. There are also six instructional dance technique chapters that cover specific beginning bellydance movements.

One of the special treats of this DVD is the included 50 minute video about Maha’s own homebirth journey with her third child (at age 46!). It also contains interviews with several homebirth midwives. The still photographs and birth footage are beautiful and brought a tear to my eye several times! Another bonus feature is a seven minute guided relaxation exercise.

Dance of the Womb is a great introduction to the basic physical elements of prenatal belly dance and also to some the spiritual and rhythmic aspects of giving birth. The DVD is a gentle and nurturing experience for both pregnant women and the women who serve them.


Disclosure: I received a complimentary copy of this DVD for review purposes.

Following Your Body’s Urges to Push…

Sense and Sensibility is having a blog carnival around Healthy Birth Practice #5: Avoid giving birth on your back and follow your body’s urges to push.

For this blog carnival, I feel like sharing my own personal experiences with following my body’s urges to push. I gave birth to my first son over six years ago in what was the only freestanding birth center in the state (related side note: when I told my landlord that my new baby was born in a freestanding birth center, she said, “oh, so does everyone there have them standing up?”;-D). When I arrived at the birth center, I was surprised to be ten centimeters dilated already. Fortunately, the midwife on duty said, “go ahead and push when you feel the urge,” and went about her business, rather than encouraging me to push simply because I was at ten or exhorting me to push with loud counting and the near-aggression as is so frequently depicted in the media. After some time, I decided to experiment with the “pressure” feeling I’d been feeling for several hours—as soon as I gave a couple of small, experimental pushes like that, my water broke. I stayed on my knees on the floor for some time—head and arms on the bed—and eventually the doctor suggested that I get up on the bed, where I ended up giving birth to my son in a semi-sitting position.

During this birth, I was very sensitive to suggestion and to “being good,” and so when the bed was mentioned, I felt I had no choices even in such a gentle birth setting. I feel if left to my own urges, I would have stayed kneeling on the floor.

With my second son, who was born at home, I was alone with my husband for nearly the entire labor. As I got closer to giving birth, I felt “driven” to my hands and knees where I began to push spontaneously (and again my water broke with the onset of pushiness). It was a very wild and rapid birth and I barely had conscious thought of whether or not I felt like pushing—it just happened! After several pushes on hands and knees, my son eased out where he was received by my midwife after her arrival five minutes prior.

My third son (second trimester m/c), was born at home with just my husband present.  My labor was again extremely rapid and I found myself kneeling on the floor in child’s pose. This position felt safe and protective to me, but I finally coached myself into awareness that the baby wasn’t going to come out with me crouched on the floor in that manner. I told myself that just like with any other birth, gravity would help. So, I pushed myself up into a kneeling position and my water broke right away. I crouched forward again—feeling fearful—and then told myself to move upright again. As soon as I was back on my knees, some blood clots emerged. I stood then, with knees slightly bent, and my baby was born.

For me, being nearly alone is the best way to follow my body’s own promptings. I feel it can be difficult to heed our bodies’ own wisdom when other people in the room are encouraging directed pushing or are “cheerleading” loudly. Freedom to move as desired and to push spontaneously according to the body’s own urges is a mother and baby friendly approach to birth.

Some of my other posts about second stage labor include: pushing the issue of pushing; waiting before pushing; and thoughts about pushing.

For more information about spontaneous pushing check out this video from Mother’s Advocate.

And, don’t forget my handout: helpful ways to use a hospital bed without lying down.

Consumer Blame

Two things came to my attention today that made me think about how ironic it is that the medical system “lets” or doesn’t “let” women do so many things with regard to pregnancy and birth care and yet if something goes wrong, the locus of control shifts suddenly and it is now her fault for the situation. I see this often with things like “failure to progress”—“she’s just not dilating”—and even with fetal heart decelerations (“the baby just isn’t cooperating”). With induction—“her body just isn’t going to go into labor on its own”—and with pain relief—“she’s just not able to cope anymore” (yes, but is she also restrained on her back and denied food and drink?!). There are other ugly terms associated with women’s health that blame the “victim” as well such as “incompetent cervix” and “irritable uterus” and even “miscarriage” (and its even uglier associate, “spontaneous abortion.” And then for women with recurrent pregnancy losses we have the lovely, woman honoring term, “habitual aborter.” EXCUSE me?!). And then today, via The Unnecesarean, I read about a doctor inducing “labor” and then performing a cesarean on a non-pregnant woman.

Okay wow. So much could be said about that, but the kicker for me is that the woman was blamed—“The bottom line is the woman convinced everybody she was pregnant.” Huh?! So random surgery is totally acceptable if the person is “convincing” enough? What happened to diagnosing something first? Or, for taking responsibility for an inaccurate diagnosis?

The final thing that happened is that I got a completely unexpected refund check for over $400 today from my own local medical care system. While I’m not complaining about $400 that I thought I’d seen the last of, I had to shake my head in disbelief at the reason for the refund—“you overpaid”—excuse me, but I think the real reason is, “you overcharged me.” I checked back through my bills and I paid what I was billed (which, now that I think about, did seem like a heck of a lot for services NOT-rendered. If I had been in less of a state of grief and shock perhaps I would have questioned it more!), but now it has become “my fault” (in a sense) by switching the language to my overpaying vs. them overcharging.

What interesting dynamics these are…