The Future

Jul26

I enjoyed reading an article called “The Future of Midwifery” by Judith Rooks and Kitty Ernst in the December 1999 edition of the IJCE (another find from the previously referenced big binder of back issues). The conclusion of the article was as follows:

It is said that the best way to predict the future is to create it. Creative forces come from our souls, our beliefs, our values, our moral and spiritual strength, and from the scientific evidence available to us at any given time. If we are to meet the challenges ahead, each of us must weigh authoritative pronouncements and popular opinions against the available scientific evidence, temper it with our own beliefs and values, and chart a course drawing on our collective moral and spiritual strengths. Change is often shaped not only by what we do but by what we do not do. The future of midwifery and our children’s care in childbirth is in our hands today. To be silent is to speak. To do nothing is to take action. (emphasis mine)

Sometimes it seems as if I am saying the same things over and over and trying to reach people who may or may not want to be reached. I found the above quote a good reminder that continuing to pursue change in birth practices is a worthwhile endeavor.

Balanced Living and Saying ‘No’

Jul10

I fairly regularly experience what I term a “crisis of abundance.” There are SO many great things to do in the world: SO many great causes, so many wonderful organizations, so many beautiful books, and just so many good things to do with my time. I prefer this state to having a crisis of scarcity or lack, but abundance brings its own challenges and saying “no” or “enough” to the requests for my time is one of those. I feel fortunate that I am humming with life purpose (most of the time), but I also have to be mindful that this hum of energy does not lead me to overcommit and to stretch myself too thin.

This past week, I said “no” to two birthwork-related opportunities that were very appealing, but that I know in my heart that I don’t have the time, space, or energy for right now. It was very empowering and actually semi-thrilling to say,”no” and to mean it. I felt smart and that in these situations saying no was taking care of myself (saying no to someone else = saying “yes” to myself” sometimes!). Perhaps not coincidentally, after my “No” experiences, I received an article to share from life-balance expert Renée Trudeau. I really like her “Nine Creative Ways to Say No.” Enjoy!

Four Key Strategies for Balanced Living by Renée Peterson Trudeau, life balance expert/speaker

~Know your top priorities & effectively manage your energy: What in life is most important to you? How good are you at managing your energy? What is draining you? What is fueling you? Are you comfortable saying “no” and not over committing? “Things which matter most should never be at the mercy of things which matter least.” Goethe

~Make your self-renewal a priority: By filling your cup first, you’ll have more to give to clients/family/friends, you’re able to function at your optimum and you’ll be setting an example for healthy, balanced living for those around you. Self-care (on all levels physical/mental/emotional/spiritual) should be part of your every day life. “Self-care is not about self-indulgence, it is about self-preservation.” A. Lorde

~Build a personal support system: What type of and how much professional & personal support do you need to feel emotionally healthy and stress-free? Learn to ask for and receive help. Re-evaluate your support needs every three months; these change based on your current life stage.

~Be more present in all that you do: Stress and overwhelm are often brought on by dwelling on the past or living in the future. By spending more time living in the present and focusing on what is most important in the here and now, the calmer, more effective we become.

Nine Creative Ways to Say “No”

Below you’ll find specific language to support you in saying “no.” Most people find that the more they say “no,” the easier it becomes say “yes” to those things that really matter.

(1) Just No: “Thanks, I’ll have to pass on that.” (Say it, then shut up.)

(2) The Gracious No: “I really appreciate you asking me, but my time is already committed.”

(3) The “I’m Sorry” No: “I wish I could, but it’s just not going to work right now.”

(4) The “It’s Someone Else’s Decision” No: “I promised my coach (therapist, husband, etc.) I wouldn’t take on any more projects right now. I’m working on creating more balance in my life.”

(5) The “My Family is the Reason” No: “Thanks so much for the invite, that’s the day of my son’s soccer game, and I never miss those.”

(6) The “I Know Someone Else” No: “I just don’t have time right now. Let me recommend someone who may be able to help you.”

(7) The “I’m Already Booked” No: “I appreciate you thinking of me, but I’m afraid I’m already booked that day.”

(8) The “Setting Boundaries” No: “Let me tell you what I can do …” Then limit the commitment to what will be comfortable for you.

(9) The “Not No, But Not Yes” No: “Let me think about it, and I’ll get back to you.”

(This list is adapted in part from Work Less, Make More—Stop Working So Hard and Create the Life You Really Want, by Jennifer White.)

Trudeau is a nationally-recognized career/life balance coach, president of Austin-based Career Strategists and the author of The Mother’s Guide to Self-Renewal: How to Reclaim, Rejuvenate and Re-Balance Your Life. Sign up to receive monthly life balance tips, order the book, find out about upcoming retreats/events and learn more about Trudeau’s coaching groups at www.ReneeTrudeau.com or www.CareerStrategists.net.

One Woman Awake

Jun12

Several years ago, I received a card from the National Association of Mothers’ Centers with the following poem printed on the front:

One Woman Awake
Awakens another,
The second awakens her next door neighbor.
And three awake can rouse the town,
And turn the whole place upside down.
And many awake
Can raise such a fuss
That it finally awakens the rest of us.
One woman up,
With dawn in her eyes,
Multiplies.

——

It has been hanging on the wall behind my computer since 2007 and it still gives me chills to read it. Of course, it can be applied to many elements of women’s lives, but I look at it through the lens of birth advocacy. I always say that what I want to do with my life is simply to transform the birth culture in the U.S. A lofty goal maybe, but if many awakened women raise enough of a fuss, it could happen!

WomanSpace

Jun2

Yesterday, a friend/colleague and I toured a possible studio space to rent in Rolla. We do not have a particularly clear idea of what we’d like to do exactly, but we have both long felt the desire to create a “women’s resource center” as well as to have a dedicated “birth studio” for our birthwork (she is a doula and I’m a birth educator and soon to be prenatal yoga teacher). The space felt perfect and was in our exact price range. I left feeling tremendously excited and inspired about the possibilities. Later that evening, the doubts, realities, and fears started to crowd in—I do not want to live a fear-based life, but I also want to be “practical” (which can be a handicap as well as an asset). I have too much to do already, etc., etc. In February, after my miscarriages, I took a personal renewal retreat in which I kept my computer off for 5 days and spent the time nurturing myself and doing those many things I always say I “really want to do.” During that time, I spontaneously wrote a description in my notebook of the women’s center I envision. So, this morning I opened up my notebook and re-read my “vision” there. I want to share it now and continue to explore the possibilities angle of the studio opportunity, rather than get bogged down in fears and self-doubts:

I visualize a center. A place where women can come together to learn, to talk, to develop, to grow. A safe place. A nurturing place. A supportive place. Hostess to LLL meetings, book clubs, birth circle, birth info nights, prenatal yoga classes, birth classes, birth art workshops, pregnancy retreats, journaling workshops, craft classes, crafty mamas meetings, a miscarriage support group, postpartum mamas support group, birth counseling/consultation sessions, dancing for birth, prenatal bellydance, drop-in support chats, blessingways, red tent events, meet the doulas night, Mother’s Guide to Self-Renewal groups, women’s spirituality circles, playgroups, baby massage classes, baby/tot yoga, girls’ coming of age classes, an ICAN chapter, Friends of Missouri Midwives meetings. A gathering place. A woman’s place.

It will have a large, open meeting room, access to a bathroom and another, smaller room that could be an office, consult room, or playroom. We will have counter space to plug in some minimal cooking implements (like a microwave). There will be comfy couches, chairs, toys, a lending library of books and films as well as perhaps toys/games/puzzles. There will be big pillows on the floor and beautiful art all over the walls. Other women wishing to have groups/classes for women, could also use the space for their groups/events.

Think we can do it? (And, if so, what can I not do to make space in my life for it? 😉 )

In a way, my vision is that this will be that classic “room of one’s one” that every woman needs access to. WomanSpace.

In-Utero Practice Breathing

May15

During my pregnancy with my first baby I had a somewhat unique experience in that I was able to feel him practice breathing in the womb. Babies practice breathing movements with increasing frequency towards the end of pregnancy, but usually this is only seen via ultrasound and the mother can’t feel OR see it happening.

A mysterious sensation

38 weeks pregnant with baby #1

I was about 32 weeks pregnant when we had a prenatal visit (and I was up to a whopping 140 pounds—looking back, that seems very thin, but at the time I felt like I had gained a lot of weight!) . Since 30 weeks I’d been feeling what I thought was the baby practicing breathing. My husband was able to feel it too, as well as occasionally physically see it—a rhythmic sort of pulsing sensation located where the baby’s back was and feeling like a rising/falling breath type sensation (like a cat under a blanket). I noticed it once or twice daily. Very different than the hiccups, which I also felt often. I wanted to mention it to the doctor to see if that was really what I was feeling, because lots of books and things say you won’t be able to feel those movements, but I didn’t want to be wrong and be embarrassed for having a kooky idea about feeling him breathe. (When we mentioned the feeling to my mom, she looked at us like we were quite nutty to think we could feel it!)

A prenatal appointment and a doctor’s surprise

At the prenatal appointment, I laid down to have my fundal height measured (32) and the baby’s heartbeat checked and he was conveniently doing the breathing thing at that exact moment! My husband asked the doctor about it and told her we thought it was breathing. She quickly disregarded the breathing hypothesis, saying it was unlikely we’d be able to feel that, but she was fascinated by the movements and listened with the Doppler trying to figure it out etc. She thought for a minute that it had something to do with my pulse and checked that, but it didn’t match, plus was just on one side of my belly where his back is. She also felt with her hands, etc. It was particularly strong that day—usually I felt a sort of pulsing and could also feel it with my hand. On this occasion, it was like the left side of my belly was rising and falling rhythmically in a very noticeable way. She said she’d never felt or seen anything like it before.

Then (this was the weird part), she said that maybe I should have an ultrasound to see what the baby was doing in there. This doctor was a crunchy-mild-mannered-has-you-call-her-by-her-first-name-homebirth-attending -birth-center-low-intervention-doesn’t-break-your-water-unless-the-baby-is-born-in-the-sac sort of doctor, so I was really shocked by that. I said I really didn’t think that was necessary, because I wasn’t worried about it we just thought it was breathing (again, we get a look that vaguely implies that we are nutty). She kept saying she’d never seen it before and said she was going to call one of her consulting doctor friends, “just because I’m curious,” to see what he thought about maybe needing an ultrasound.

After she left to call him, I started to feel nervous that something might actually be wrong. I knew how this doctor was and she did not seem like the type at all who would be calling other doctors unless she was a little worried about something. My husband kept saying that, “no, she is just curious about what it is,” but the “curious” wording felt to me like a don’t-want-alarm-the-mother-but-I-think-something-is-up type of doctor speak. Also, I knew her well enough to know that running off to call other people in the middle of an appointment wasn’t in character for her, especially since the mom (me) was saying it didn’t seem necessary. So, I briefly became petrified that the baby was having seizures or something.

Trust the mother!

She came back in a bit and had consulted with her ultrasound doctor friend who had said, “let me guess. This mom is thin and very healthy” and then confirmed that it was just the baby’s breathing movements we were seeing. He told her that you usually don’t see them on the outside, just via ultrasound, but it is still normal and just means that the baby is healthy and he is getting good practice. When she came back, the doctor also brought the practice’s midwife in to see, since the midwife had never seen anything like it either, but it had mostly stopped by then. This doctor has been in practice since 1992 and has had four kids of her own and the midwife has six kids and a 20-year practice. The doctor explained that she’d seen the breathing movements on ultrasound before, but they were always more like occasional gasp-type things, not steady and pulsing like that and not visible externally. She thanked me for teaching her something new 🙂

I liked being right about what was going on (trust the mother! She usually knows what’s up!) and I liked that my pregnancy had something “new” or special to it to show to someone for whom pregnancy is quite routine. Being able to feel my baby breathe in the womb was one of the special things about this first pregnancy.

(Side note: the doctor then said, “I’ll bet he comes out screaming” and as a matter of fact this baby did begin to cry when only his head was sticking out of my body!)

Note (added 3/2/2013):

A lot of mothers come to this post because of concerns similar to my own…what if my baby is having seizures in the uterus? Of course I am not able to tell you with 100% certainty that your baby is not having seizures, but here are two things to pay attention to that may set your mind at ease and allow you to enjoy this special connection with your baby:

One way to help you feel confident that it is practice breathing is to pay attention to whether it happens at the same time(s) each day. There’s usually a pattern to it.
Another way to tell with almost total accuracy is to notice if the baby gets hiccups shortly after and “episode.” A lot of babies will practice breathe and then get hiccups from their practice.

—

This post is modified from a message board posting that I made shortly after the events described above.

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Consumer Blame

Mar31

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…

Thoughts About “Let”

Mar28

“The effort to separate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women.” –Mary Rucklos Hampton

Related to my recent birth consumer post, I wanted to write a little bit more about the word “let.” One of my strongest birth-related pet peeves is the use of the word “let” when applied to birthing women. Women and providers and even doulas and CBEs often use terminology like “well, they let me get up for a while and walk around” or “my doctor is going to let me go to 41 weeks” or “the nurse let her get off the monitor for about 30 minutes” or “my husband won’t let me have a homebirth.” I do not like this phrase because of the “victim” mentality I feel like it conveys—-that women are passive and things are being “done to” them and they have no power of their own. I feel like it removes autonomy and empowerment and women’s control over their own bodies and births.

I often remind people that birth is not a time in a woman’s life when she should have to fight for anything. I also like to gently remind clients that no one can “let” them do anything. With colleagues, I occasionally have to clarify or explain my perception of the term as disempowering. Though in the end, sometimes I need to let (!) it go and realize that some people are perfectly satisfied with the term. And, I also have to acknowledge that the word DOES accurately describe many women’s experiences-—they are “let” or “not let” to do things even if I think it should be different and think they should have more power and control during their own births!

Becoming an Informed Birth Consumer

Mar26

Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labor and birth, it is very common to hear women say, “they won’t let you do that here” (such as regarding active birth–moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a “boss.” If you went to a grocery store and were told at the entrance that you couldn’t bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are “paid consultants,” not experts whose opinions, ideas, and preferences override your own.

There are several helpful ways to become an informed birth consumer:

Read great books such as Henci Goer’s The Thinking Woman’s Guide to a Better Birth or Pushed by Jennifer Block.
Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Bradley, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National.
Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different.
Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:

Remember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

Conclusions About Listening

Mar2

“What would happen if one woman told the truth about her life? The world would split open.” —Muriel Rukeyser

I continue to think about the ideas in the post I made a couple of days ago about birth choices and listening to women’s stories. Though my thoughts are by no means fully “concluded,” I wanted to add a postscript of sorts based on comments some people have left as well as to share some new apropos quotes that keep popping out at me from all kinds of places. I guess my basic conclusion is that as “birth advocates” we definitely should NOT stop sharing our stories–-perhaps what most needs to change is how we listen to stories—how they are received and accepted and heard, rather than analyzed or dissected. And, perhaps also our approach at story-telling itself needs to change-–to being about our experiences and not trying to “convert” anyone. Bottom line for me is that if I was forced to choose, I value WOMEN the most–-not birth or giving birth the “right way.”

I just finished reading a book called Soul Sisters and came across this quote: “I have learned that…in listening you become an opening for that other person.” Perhaps this is how changes are born. And later this treasure, “Indeed, nothing comes close to an evening spent spellbound by the stories of women’s inner lives.”

And, I think the KuKd author made a good point–-most women are “capable” of seeking out the information they wish, without having it handed to them (that supports the blog theory-–the value of sharing our stories via blogs and letting people find them as they wish!). Though, then my recent experience with my brother’s girlfriend shows me that maybe some people really don’t even know that they’d like to seek out the information and I’m back to the beginning again…

Another blogger commented that my post raised many conflicting feelings for her and expressed that she does not believe in a “live and let live approach,” that some choices in life truly are “wrong.” I have many conflicting feelings about my post too…and I wrote it! However, the basic conclusion I reached with my wanderings was that I think we (okay, I) need to do some serious thinking about HOW it is (and WHY it is) that I share information about alternative choices or tell stories. Because, as the KuKd post I quoted shared, sharing in a specific type of “zealous” way, closes doors rather than opens eyes.

Small Stone Birth Activism

Oct9

Edited to say that I’ve now added the 2009 version of the article here: Small Stone Birth Activism

—

In 2008, I wrote an article called Small Stone Birth Activism for Citizens for Midwifery News. I revised the article in 2009 and it was published in the Fall 2009 edition of the International Journal of Childbirth Education (ICEA’s publication). It begins on page 8. I also have an older version uploaded here. This version is also slightly edited from the original version that appeared in CfM News.