Talk Books: Pregnancy, Childbirth, and the Newborn

Mar29

Several months ago, I received an email from one of my former college students. His wife was newly pregnant and they had several specific questions. They asked for my help and recommendations with where to go for answers and without hesitation, I suggested a book: Pregnancy, Childbirth, and the Newborn. I was confident that not only would they find the answers they sought in the book, but also reliable, practical, helpful answers to questions they haven’t even thought to ask yet.

Co-authored by a foremost authority in childbirth and doula education, Penny Simkin, Pregnancy, Childbirth, and the Newborn was one of the first books I bought as a new childbirth educator in 2005. Now, newly revised and updated, the book has a companion website packed with resources to help you have a healthy pregnancy, a rewarding birth, and a nurturing postpartum.

One of the things I’ve always enjoyed about this book as a wonderful resource for childbirth educators are the line March 2016 119 drawings illustrating a variety of positions and concepts. This new fifth edition has lots of black and white photos as well. The fact that the book is co-authored by a world-renowned doula, a nurse/lactation consultant, a nurse/childbirth educator, a social worker, and a physical therapist, means it is an interdisciplinary resource benefiting from the skills and professional experience of each co-author. Childbirth educators and doulas as well as pregnant couples will want to check out the companion website which has a plethora of pdf handouts available on numerous topics including comfort techniques, nutrition, and parental leave.

Evidence-based, comprehensive, and encouraging, Pregnancy, Childbirth, and the Newborn is an ideal companion for both childbirth professionals and expectant parents.

—

Pregnancy, Childbirth, and Newborn is published by Meadowbrook Press, an award-winning publisher specializing in pregnancy & childbirth, baby names, parenting & childcare, and children’s books & poetry: Meadowbrook Press. Pregnancy, Childbirth, and the Newborn

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

Guest Post: Widespread Insurance Coverage of Doula Care Would Reduce Costs, Improve Maternal and Infant Health

Jan5

Leading Maternity Care Experts Release Issue Brief Encouraging Medicaid and Private Insurers to Cover Doula Care

WASHINGTON, D.C. – January 5, 2016 – At this time when most experts agree that not nearly enough women in this country receive high-quality maternity care, federal and state government agencies and health insurers should make doula care an option for more women by covering doula services. An issue brief released today by two leading maternity care advocates makes a powerful case for the health benefits of doula care for women and babies and the significant cost reductions that would result if more women used doulas – trained professionals who provide non-clinical emotional, physical and informational support before, during and after childbirth. The brief, Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health, is co-authored by Choices in Childbirth and Childbirth Connection, a program of the National Partnership for Women & Families.

In the brief, the authors summarize research showing that doula care reduces the likelihood of interventions such as cesarean birth and epidural while supporting shorter labor, spontaneous vaginal birth and other benefits to mom and baby. As the use of interventions decreases, so do associated costs, making coverage of doula care a cost-effective strategy for public and private insurers alike. The authors estimate that the reduction in cesarean births from the use of doula care could save Medicaid at least $646 million per year, and private insurers around $1.73 billion annually.

“Widespread coverage of doula care is overdue,” said Michele Giordano, executive director of Choices in Childbirth. “Overwhelming evidence shows that giving women access to doula care improves their health, their infants’ health, and their satisfaction with and experience of care. Women of color and low-income women stand to benefit even more from access to doula care because they are at increased risk for poor maternal and infant outcomes. Now is the time to take concrete steps to ensure that all women can experience the benefits of doula care.”

“Doula care is exactly the kind of value-based, patient-centered care we need to support as we transform our health care system into one that delivers better care and better outcomes at lower cost,” said Debra L. Ness, president of the National Partnership. “By expanding coverage for doula care, decision-makers at all levels and across sectors – federal and state, public and private – have an opportunity to improve maternal and infant health while reducing health care costs.”

The brief provides key recommendations to expand insurance coverage for doula care across the country:

Congress should designate birth doula services as a mandated Medicaid benefit for pregnant women based on evidence that doula support is a cost-effective strategy to improve birth outcomes for women and babies and reduce health disparities, with no known harms.
The Centers for Medicare & Medicaid Services (CMS) should develop a clear, standardized pathway for establishing reimbursement for doula services, including prenatal and postpartum visits and continuous labor support, in all state Medicaid agencies and Medicaid managed care plans. CMS should provide guidance and technical assistance to states to facilitate this coverage.
State Medicaid agencies should take advantage of the recent revision of the Preventive Services Rule, 42 CFR §440.130(c), to amend their state plans to cover doula support. States should also include access to doula support in new and existing Delivery System Reform Incentive Payment (DSRIP) waiver programs.
The U.S. Preventive Services Task Force should determine whether continuous labor support by a trained doula falls within the scope of its work and, if so, should determine whether labor support by a trained doula meets its criteria for recommended preventive services.
Managed care organizations and other private insurance plans as well as relevant innovative payment and delivery systems with options for enhanced benefits should include support by a trained doula as a covered service.
State legislatures should mandate private insurance coverage of doula services.

The issue brief and a new infographic illustrating the importance of coverage for doula care are available at http://Transform.ChildbirthConnection.org/Reports/Doula and www.choicesinchildbirth.org/our-work/advocacy-policy/doulacoverage.

# # # #

About Choices in Childbirth

Choices in Childbirth is a non-profit organization that works to ensure access to maternity care that is safe, healthy, equitable, and empowering. Our mission is to promote evidence-based, mother-friendly childbirth options through public education, advocacy, and innovative policy reform. Learn more at www.ChoicesinChildbirth.org.

About the National Partnership for Women & Families

The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and policies that help women and men meet the dual demands of work and family. Founded in 1918, Childbirth Connection became a core program of the National Partnership in 2014. Childbirth Connection programs serve as a voice for the needs and interests of childbearing women and families, and work to improve the quality and value of maternity care through consumer engagement and health system transformation. Learn more at http://Transform.ChildbirthConnection.org and www.NationalPartnership.org.

Closing the Bones…

Oct7

After my own postpartum sealing ceremony, November 2014.

I’m thrilled to have a guest post from Awen Clement on the Brigid’s Grove blog this month. She writes about Closing the Bones, a ceremony for postpartum women…

“After the birth of my son, I felt broken open”

Did you feel this way after the births of your children? Did you feel as though you had opened yourself body, mind and spirit to bring that new life into the world? Did it surprise you to feel this way?

We give so much when we birth our children, on every level, and then we keep on giving as we move on in our mothering. We feel exhausted, but that exhaustion somehow doesn’t seem to lift no matter how well we rest. We may feel as though something is missing, some part of ourselves that we were sure was there before. It probably isn’t something you would ever mention to anyone and even if you did many would simply point out that you’re a mother now, of course your tired and of course you feel different…

Read more here: Guest Post: Honouring the Bones of my Sisters – Brigid’s Grove

My own post about my postpartum sealing ceremony can be found here:

Ceremonial Bath and Sealing Ceremony | Talk Birth

Tuesday Tidbits: How to Make Life Easier as a New Parent

Aug11

In all my years as a birthworker, I still find that one of the most overlooked topics in childbirth preparation is adequate preparation for postpartum—those early weeks, or months, with a new baby. In my personal life, I experienced a difficult postpartum adjustment with my first baby, an easier one with my second baby, and two delightful, nurturing babymoons with my last two babies. Years after training as a postpartum doula, good postpartum care remains one of my passions, so I really enjoyed this post from a mother of five. Her feelings of rushing to get back to “normal” feel very familiar even though almost twelve years have passed since my first, tender, postpartum adjustment:

“I remember coming home from going out for the afternoon with Hero at 7 days postpartum. After we got back to our tiny apartment I came down with a fever. I was probably wearing the cutest non-comfortable outfit I could squeeze into. I probably didn’t think that 7 days after giving birth required anything of me other than “getting back to normal.” Life went on, and I urged it faster. In fact, that’s the way I parented, too. Smile, laugh, roll over, sit, crawl, walk, run, milestone, milestone, grow, grow, grow…

When I think back on my postpartum times (for the most part) I remember being exhausted, being emotional, being upset at Kirby for not doing enough, feeling fragile, feeling sad, and feeling weak. And then I got pregnant with Peter… And by the time I had him, I had interacted with enough wise mothers who had screwed up enough to know better and they told me what to do and I listened. After five babies I could finally say I did it right. I’m not saying you have to do it like me. Maybe you’ve already got your postpartum flow down and you need no such advice. In that case, a w e s o m e…”

Now I realize that some moms can just go, and they are happier that way! I get that. But it took me too long to realize that that’s not me. And I don’t want you to spend too much time thinking that should be you if it isn’t. Don’t spend four days, don’t spend four weeks, and certainly don’t spend 4 entire babies feeling like a shell of a person trying to figure it out…

The Fike Life: How to postpartum like a boss.

Unlike my early memories of my first son’s life, rather than looking back with sense of regret and fatigue, I look back on the weeks postpartum with Tanner (fourth and final full-term baby) with a tinge of wistfulness for the sweet, delicate, care-full time we spent together, nestled in bed in milky, marveling wonder. The author of the post above describes it as a “little sacred space,” and that is exactly how I feel. It also needs to be fiercely protected.

I look at that one week postpartum as a little sacred space that I will never get back. It’s a space where, for the most part, it’s just that brand new baby and me. And I’m selfish about it. And not sorry. Life will keep plummeting forward rapidly and I won’t ever stop it. But I can have a week with a floppy new baby on my chest in my bed and I’ll take it. And I’ll protect it.

AND IF THAT DOESNT TUG AT YOU MOTHERLY HEARTSTRINGS KNOW THIS… (super practical advice I got from my midwife with Peter)

When you have a baby you are recovering from an injury that is deeply internal. Your blood needs to stay concentrated there to bring essential nutrients to heal your organs and make you strong again. When you get up and walk around, your blood abandons your core and flows into your extremities, which can massively prolong your recovery. Stay rested and keep yourself down as much as you can. Just think of your organs! They need you!

via The Fike Life: How to postpartum like a boss.

It isn’t just the weeks following a new baby’s birth that matter, the first hour matters too and can set the tone for the rest of the postpartum journey:

…The way your baby is cared for and nurtured immediately after birth significantly impacts their transition from the womb to life outside.

In a culture that commonly separates mothers and babies for routine procedures such as cleaning, weighing and measuring, most babies are missing that critical time of being skin to skin with their mothers, which has short and long term consequences for all.

As these procedures are not necessary to maintain or enhance the wellbeing of either mother or baby, there is no reason why they cannot be delayed beyond the first critical hour.

via 7 Huge Benefits of An Undisturbed First Hour After Birth | BellyBelly.

Why doesn’t this uninterrupted hour and subsequent caring postpartum support happen for all new families? One reason is related to the “treatment intensity” of the US birth culture:

The questions you post in your article are good ones: Are midwives safer than doctors? How can homes be safer than hospitals and what implications does this study have for the US?

It’s a super knotty issue and it shouldn’t be about the superiority of midwives over doctors or homes over hospitals. The debate we should be having is over “treatment intensity” in childbirth and when enough is enough. The concern is that patients can be harmed by doing too much and by doing too little–in the US I worry that we cause avoidable harm by always erring on the side of too much.

via An Unexpected Opinion on Home Birth | Every Mother Counts.

Another is related to routine hospital practices that are not evidence based:

1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.

2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn…

via 6 Point Recipe for Making New Parenthood as Difficult as Possible | Wise Woman Way of Birth | by Gloria Lemay.

On a related note, we find that breastfeeding gets off to a better start when birth is undisturbed. We also find that decisions about breastfeeding may be made months before the baby is actually born:

…Recently, a nurse contacted me asking for ideas for teaching an early pregnancy breastfeeding class. I think this is a great idea, since mothers’ decisions about breastfeeding are often made before the baby is conceived and if not then, during the first trimester.

via Breastfeeding Class Resources | Talk Birth.

It isn’t just postpartum during which we need these reminders about the “cycle of care.” The cycle of care of young children can be largely invisible, both to those around us and to ourselves. I’ve taken some time this week to appreciate my investment in my baby and cut myself a little slack on the other things I always want to “get done.” Brain-building is important work too!

Speaking of said baby, who has been taking his first steps this week at nine months old, I was amused this week to come across one of my older posts on family size decisions, in which I decreed my doneness with my childbearing years. Instead of embarrassing, I find the post oddly affirming or reinforcing that at some level I really did know that we weren’t quite “done,” there was still space in our family (and our hearts!) and there really was one more baby “out there” for us.

We decided we’d make the final, ultimate decision after she turned two, because too much longer after that point would make more of an age gap than we’d want. I posted on Facebook asking how do people know they’re “done.” I had an expectation of having some kind of blinding epiphany and a deep knowing that our family is complete, as I’ve had so many other people describe: “I just knew, our family was complete.” I didn’t have that knowing though—I vacillated day to day. What if I never know for sure, I fretted. Perhaps this sense of wistfulness and possibility with continue forever—maybe it is simply normal. One more. No, finished. But…ONE more?! And, I have a space in my heart that knows with great confidence that four (living) children would be the ultimate maximum for us. I definitely do not want more than four…so, does that mean there still is one more “out there” for us?

via Driveway Revelations (on Family Size) | Talk Birth.

However, I also find it to be true that four is most definitely the ultimate maximum. We laughed earlier this week remembering that a couple of weeks after Tanner was born I kept saying that I thought maybe we’d picked the wrong name for him. Mark asked me what I thought it should be and I said I kept thinking that maybe it should have been “Max.” While we joked at the time that this was because he is Maximus Babius, I only now caught on to the unintended double joke that he has definitely pushed our family size to our “max”!

Other tidbits:

I got this book about midwives in Mexico to review and have been zooming through it. It is SO good!

We’ve been working on new sculptures!

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We’ve added some new Moon Wisdom/First Moon bundles to our shop:

And, our new blessing cards came in. We were printing these on regular printer paper and are excited to have nice, professional cards instead!

We also still have five spaces left in the Red Tent Initiation program beginning at the end of the month:

Sign up for the Brigid’s Grove Newsletter for resources, monthly freebies, + art and workshop announcements.

And, as is our tradition, in honor of World Breastfeeding Week and National Breastfeeding Month, you can get 10% off items in our shop throughout August: WBW10OFF.

Tuesday Tidbits: Does Giving Birth Have to Be Terrible?

Jul14

“To nurture life is to . . . embody the intelligent Love that is the ground of all being.”

— Carol Christ

Does giving birth have to be a terrible experience involving screaming, swearing, and pooping on the sterile “delivery” table? Anyone who has followed my blog for a while, already knows what my answer to this question is (no!), but here are some additional resources that caught my eye this week. First, erase the idea of maternal-fetal conflict, reinforced insidiously all across the internet and the media, and keep your expectations high:

Birth doesn’t have to suck. Keep your expectations high and do the work to have those expectations met. Don’t let anybody convince you that you need to step aside for your baby. You need to step up for your baby.

via Dear Friend, Birth Doesn’t Have to Suck | ImprovingBirth.

Next, choose your care provider very carefully. Remember, this baby only gets to be born once! Don’t wait for “next time,” to find a respectful provider and the birth setting your heart desires.

But, I have a doula, surely she’ll protect me from my less-than-ideal doctor!

No, again. Protection from other care providers is not a doula’s job. This is a multilayered issue, but here is a good post with some reasons why:

“My own doula and I have had more than one conversation about why she didn’t warn me about my own provider—someone who I now know has a reputation for not following through on promises to patients. “But I asked you!” I’ve said to her. “Why didn’t you tell me?” She has explained patiently, each time, that she gave me the information I needed to make my own decision. What I wanted from her—to say, “Oh, Cristen, you need to switch providers right now!”—is not something she would ever say to a client. Instead, she gave me specific questions to ask. She encouraged me to talk to my provider about my wishes and pay attention to the conversation, to trust my instincts, and to be honest with myself about whether or not I thought my provider was really going to follow through with what she’d promised.”

via Birth Monopoly | Three Things Your Doula Can’t Tell You.

I know you want your doula or childbirth educator to be able to tell you these things straightforwardly. I wish they could. I’ve had birth class clients ask me the, “why didn’t you tell me” question too and it is a very fine balance for birth professionals. I often longed for the freedom to take the Dr. Pig-Face approach, described by Nancy Wainer Cohen in her class birth activism book from the 1980’s, Open Season:

“If childbirth classes really ‘worked,’ more women would be having babies without interference. More women would be recognizing the complete naturalness of birth and would remain at home, delivering their infants with feelings of confidence and trust. More and more, midwives would be demanded. The names of those hospitals and doctors who treated women and babies with anything less than absolute respect would be public knowledge, and childbirth classes would be the first place these names would be discussed. ‘You’re seeing What’s-His-Face? He’s a pig! In my opinion, of course,’ I tell people who come to my classes. I then proceed to give them the names of people who have used Pig-face. They can always ask Dr. P. for the names of people who have used him and been satisfied with their births, for balance.”

–Nancy Wainer Cohen, Open Season

via Honesty in Birth Preparation | Talk Birth.

In addition to high expectations and careful assembly of the birth team, you may also want to keep secret the sensations of early labor. I followed this advice with all of my babies and have no regrets.

When you begin to have sensations, do your best to ignore them as long as you possibly can. You may want to consider keeping these feelings to yourself and having a “secret sensation time” with your unborn baby. Get in as dark a space as you can. Minimize what is happening with your husband, family and the birth attendants. You have control over your body and a say in your hormone activity. Help your pituitary gland secrete oxytocin to open your cervix by staying relax in a dark, quiet room with your eyes closed.”

via Words of Wisdom: Keep the “Sensations” of Early Labor a “Secret” | NüRoo.

Another way to prepare for a wonderful birth is through connecting with your body. One way to do this is through prenatal yoga. The movements and sensations of prenatal yoga sink into you and become a part of your body memory, guiding you through birthing:

“…Anyone involved with educating adult learners (in any context) is likely to be familiar with the concept that people are most likely to retain information that they have actually practiced (versus reading about, hearing about or seeing demonstrated). I have found that incorporating a few simple yoga poses into each class session is a beautiful way of illustrating and applying many important elements of childbirth preparation. In approximately 10 minutes of movement, important points can be underscored without having to actually say anything or “lecture” to clients. The hope is that as we move together through a carefully chosen series of poses, subtle emotional development and trust in birth occurs—again, in a more effective manner than by the childbirth educator saying during class: ‘Trust birth!'”

via Incorporating Prenatal Yoga into Childbirth Education Classes | Talk Birth.

Also, prepare yourself for a nurturing postpartum. Your baby will arrive primed for connection rather than separation. The more you are cared for by those around you during this vulnerable and magical time, the more embracing you can be of the delicate, fierce, and encompassing neediness of your dependent newborn:

“The cutting of the umbilical cord tends to herald the arrival of a new and unique life. Though this tiny being began its existence many months before, growing nestled and protected within the womb, the just-born infant is seen as an individual apart from his or her mother. There is, however, a significant error in this thinking, for baby and mother are one, so to speak, and severing this unit denies an empirical truth. Birth should not be a celebration of separation, but rather a reuniting of mother and baby, who joins her for an external connection.”

–Barbara Latterner, in the book New Lives

via Inseparable | Talk Birth.

I’ve spent a lot of time exclaiming: I JUST want to transform the birth culture in the U.S.! Now, you have a chance to share your opinions and experiences in this new survey: Transforming Birth Culture in the United States Survey.

Other tidbits this week:

Lann has a new YouTube channel for his Minecraft and other gaming videos. You can check out Zall Craft here.
I finally took the leap and signed up for Leonie Dawson’s Shining Year Academy. I’ve been buying her annual workbooks for four years, but it is time to grow! We’ve been working through the Double Your Biz Intensive and it has already been worth the price! (*links are affiliate links)
I updated the links/print layout for my three e-booklets. These were all written prior to my birth work. Hope you might find them helpful! Free e-Booklets | Talk Birth

Ceremonial Bath and Sealing Ceremony

Nov24

At three days postpartum, my mom and my doula, Summer, came over to do a sealing ceremony for me based on what I’d learned during my Sacred Pregnancy and Sacred Postpartum certification trainings. A sealing ceremony is based on the idea of “closing” the birth process. Pregnancy and birth are all about opening. We open up our bodies, minds, spirits, and hearts for our new babies. After birth, the body remains “open” and the idea with sealing the birth experience is to psychologically and physically “close” the body and help the mother integrate her birth experience into the wholeness of who she is. It is part of her “return” to the non-pregnant state and it is transition commonly overlooked by modern culture and sometimes by women themselves. We chose three days postpartum because that is a classic day for the “baby blues” to hit and it seemed like an important day to acknowledge, but it can be done at any point, preferably within the first 40 days. We started with the ceremonial bath. I had a very powerful experience with pre-birth ceremonial bath I did and this postpartum bath experience was very profound as well. My doula ran the bath and added milk and honey and I set up a small altar by the tub. I chose items for the altar that I felt had a connection to the birth altar I set up before birth, but that were now connected to postpartum and mothering another baby. So, I used things that were mother-baby centered primarily, but of course also included the birth goddess sculpture that I held all through my labor as well. Continuity.

Summer brought me a small glass of strawberry wine and then Mark came in with some rose petals and scattered them in and then left me to rest in my bath. I started my Sacred Pregnancy playlist and the first song to play was the Standing at the Edge song that I’d hummed during labor. Continuity.

It took me a little while to settle into it, but then I did. I reviewed his birth in my mind and sipped my wine. After I finished the wine, I used the glass to pour water over each part of my body as I spoke a blessing of gratitude for each part and what it did for us. I cried a little bit over some parts. I spoke aloud some words of closure about my births and my childbearing years. I felt grateful. I also felt a sense of being restored to wholeness, complete unto myself. As I finally stood to leave the tub…the Standing at the Edge song began to play again.

I’ve written before that I use jewelry to tell my story or to communicate or share something. I wore one of our baby spiral pendants through most of my pregnancy because it helped me feel connected to the baby. I wore it all through labor and birth too. The baby spiral pendant was one of the things I put on the little altar by the tub as a point of continuity between his birth and now. When I got out of the bath, I was going to put the spiral back on, but suddenly it didn’t feel like the one I wanted to wear anymore. I went to my room and there it was–my nursing mama goddess pendant. Putting down the baby spiral and putting on the nursing mama felt like a powerful symbolic indicator of my transition between states.

I put on the same purple tank top I’d worn in my pregnancy pictures and nursed Tanner. I had a sarong nearby for the “tuck in” part of the ceremony and I put it over my shoulder and asked my mom to take a picture. After we took the pictures, I realized the sarong was also the same one I wore in my pregnancy pictures. Continuity, again!

With Mark then holding the baby, Summer and my mom “tucked” me in using heated up flax seed pillows and some large scarves/sarongs. This tucking in symbolically pulls your body back together after the birth (sometimes called “closing the bones”) and also re-warms the body, which according to Chinese medicine and Ayurvedic understanding, is left in a “cold” state following the birth. I felt a little strange and “shroud-ish” while being tucked up and then especially when they put my mother blessing sheet on top of me and left the room.

As I laid there though, I reflected that the shroud feeling was not so creepy after all. In fact, it was pretty symbolic itself—the ending of something and the emergence of something, someone, new. I felt a sense of wholeness and integration and coming back into myself. I had a sensation of unity and, yes, of my body coming back together into one piece.

When I felt done, I called them to come back in and Summer put a “belly firming paste” of turmeric, ginger, and coconut oil that I’d made in my class on my belly and then she and my mom wrapped me up in the belly bind I’d bought for this purpose. I don’t have time to write a lot about bellybinding right now, but you can read more about it here. It is anatomically functional, not just symbolic or pretty. When I first learned about it, I was sold on the concept, distinctly remember how weak and hunched over I felt after previous births.

I am again reminded of a quote from Sheila Kitzinger that I use when talking about postpartum: “In any society, the way a woman gives birth and the kind of care given to her and the baby points as sharply as an arrowhead to the key values of the culture.” Another quote I use is an Asian proverb paraphrased in the book Fathers at Birth: “The way a woman cares for herself postpartum determines how long she will live.” Every mother deserves excellent care postpartum, however, the “arrowhead” of American postpartum care does not show us a culture that values mothers, babies, or life transitions. I am fortunate to have had the kind of excellent care that every woman deserves and that few women receive. Part of this was because I actively and consciously worked towards building the kind of care I wanted following birth, but part of it is because I am lucky enough to belong to a “tribe” that does value pregnancy, birth, postpartum, and mothering.

Tuesday Tidbits: Science, Mother Blame, & Postpartum Psychosis

Sep2

“There is nobody, out the other side of that sort of strong birth, who is not better prepared to meet the absolutely remarkable challenges of parenthood. When the power and trust is transferred to the mother, when she delivers her child, rather than ‘is delivered’ when she chooses, rather than ‘is allowed’, no matter what sort of technical birth she has, she is stronger, fiercer, and better…”

–Stephanie Pearl McPhee (The Yarn Harlot)

Just a short Tidbits post for today…

Over the weekend, I appreciated reading this article about an unusual topic: postpartum psychosis.

Two weeks previously, Jessica was in perfect health, enjoying a career as an actress, comedian and writer and at the end of a straightforward pregnancy with her actor husband Matthew Bannister.

“I describe Albert’s first weeks as ‘peace and war’,” she says. “The birth was gentle; I delivered Albert myself in a pool in our dining room. I remember looking down as he was born, seeing this baby blinking up at me under the water, and feeling such love. Then came a tidal wave of terror.”

The first days of parenthood were the blur of joy and shock common to most. “It was a time of epic contradictions: you’ve lost so much of yourself and you’ve never been more whole,” Jessica explains. Yet by day three she began to display symptoms of a rare illness affecting one to two in every 1,000 UK mothers…

via Postpartum psychosis: How Jessica Pidsley was driven to the edge by the rare illness – Features – Health & Families – The Independent.

I also read a significant article about epigenetic research and motherblame:

So why is it that the complex science of human development, in particular, is so readily distilled into this single, unhelpful message: “It’s all about mom”?

Of course, science is influenced by values in all sorts of ways: in the questions we address, the conclusions we prioritize, and the applications we pursue. But when dealing with complex causal processes and the assignment of causal responsibility “it’s the mother!”, values can affect the conclusions we draw from science in an especially pernicious way. That’s because we think of causal claims as simple descriptive facts about the world — as value-free. But a growing body of empirical work shows they’re not. In fact, the way we make causal claims depends a lot on how things normally happen and on how we think they should happen.

via Using Science To Blame Mothers : 13.7: Cosmos And Culture : NPR.

This in turn reminded me of my own past post about asking the right questions, which I shared on a friend’s Facebook page in response to all of the recent media attention being paid to newly developed date rape drug detecting nail polish.

We MUST look at the larger system when we ask our questions. The fact that we even have to teach birth classes and to help women learn how to navigate the hospital system and to assert their rights to evidence-based care, indicates serious issues that go way beyond the individual. When we say things about women making informed choices or make statements like, “well, it’s her birth” or “it’s not my birth, it’s not my birth,” or wonder why she went to “that doctor” or “that hospital,” we are becoming blind to the sociocultural context in which those birth “choices” are embedded. When we teach women to ask their doctors about maintaining freedom of movement in labor or when we tell them to stay home as long as possible, we are, in a very real sense, endorsing, or at least acquiescing to these conditions in the first place. This isn’t changing the world for women, it is only softening the impact of a broken and oftentimes abusive system…”

Asking the right questions… | Talk Birth.

And, while not completely related to the topics at hand in today’s post, but absolutely relating to quality mother care, I wanted to share a link to a fundraising project from my doula, Summer:

“…Smyth comments that ‘the role of mother is not immediately intelligible to those who find themselves inhabiting it’ p. 4. This is certainly borne out in the confessional writing and memoirs of young feminist women, who try to make sense of their experiences as a new mother. They write of a crisis of selfhood, feeling undifferentiated in ‘a primordial soup of femaleness’ Wolf 2001 and of experiencing a gendered, embodied and relational self for the first time Stephens 2012…”

via Tuesday Tidbits: Story Power | Talk Birth.

Wednesday Tidbits: Pregnancy and the Sacred

Feb26

“I see the beautiful curve of a pregnant belly shaped by the soul within.” –Hafiz
(quoted in The Art of Pregnancy)

Today we’re heading over to my parents’ house to see my brother and his wife for the big “gender reveal” of their baby! They had an ultrasound last week and had the sex of the baby sealed in an envelope (and then baked into cake pops) and are traveling here to share the surprise with their family. While permission has been given for me to talk about their pregnancy in my blog posts, I find myself hesitant somehow—this is their journey and their experience! However, let me just say that I had no idea how excited I’d feel about their baby. I really look forward to having a niece or nephew! My brother is nine years younger than me. I also have two sisters. My brother and I had a conflictual relationship in childhood and our personalities always clashed a lot. I occasionally worried about who he’d end up marrying, because I was pretty certain that he’d choose someone “clashy” and we’d gradually drift apart and rarely see him. However, my brother grew up to be an awesome man (he was actually an awesome kid too, he was just high impact—much like my second child is—and it was hard for me to cope with that energy as a pre-teen/teen/young adult woman) and now he has an awesome wife who is not clashy at all. In fact she pretty much feels just like a sister and I love and appreciate her. They are planning a homebirth with a midwife and I can’t wait to keep talking birth together! On New Year’s Eve I helped them listen to their baby’s heartbeat for the first time and it was one of the best experiences of my life 🙂 There is a lot of “everyday sacred” to pay attention to pregnancy as well as in parenting (and life!) and several topics caught my eye this week. The first was this short post on First the Egg:

The person leading the service asked the congregation to think about and support, among other groups, “parents and all those whose primary spiritual practice is caring for children.” And I’m so tired–so tired–because we never get decent sleep and we’re always ‘on,’ and I have so little self left over for creativity or meditation beyond the practice that is parenting (one act of care and then the next and then the next) and the practice that is writing (one word and then the next and then the next). And it felt goofy even at the time, but a wave of gratitude washed through me. I felt recognized in a way that I never, ever do outside my household. I felt like I was sitting amongst a community that could see what parenting is and what children are. Articulating that parenting is an intellectual, emotional, spiritual discipline and practice is both powerful and rare…

via parenting as a spiritual practice.

Reading Molly’s post brought back to mind my own post on breastfeeding and parenting as spiritual practices:

I calculated that so far in my life I’ve put a baby to my breast more than 12,000 times. Even if I only experienced a single moment of mindful awareness or contemplation or transcendence or sacredness during each of those occasions, that is one heck of a potent, dedicated, and holy practice. In the unique symbiosis of the nursing relationship, I recall a quote from the book The Blue Jay’s Dance (1996) by Louise Erdrich about male writers from the nineteenth century and their longing for an experience of oneness and seeking the mystery of an epiphany. She says: “Perhaps we owe some of our most moving literature to men who didn’t understand that they wanted to be women nursing babies.” (p. 148)

via Breastfeeding as a Spiritual Practice | Talk Birth.

I also absolutely loved this blog post on bringing the sacred into a hospital birth:

As a doula, one of the largest roles we take on is the job of environmental modification. In simple terms? Atmosphere.

Many times, we are the weavers of the “bubble”, so to speak, that mother will labor in – be it the physical atmosphere (furniture, objects, beloved items), the sensory atmosphere (sounds, smells, textures), or the emotional atmosphere (tension, ease and calm, excitement, and love).

All of the amazing doulas I have come across use elements of the above principles. Time and time again, I hear stories of “my awesome doula who used a soft voice when I felt frantic” (setting the emotional atmosphere), or “the soothing sound of piano that really grounded me in early labor” (setting the sensory atmosphere). We can be the key builders, setting the tone for the overall experience, utilizing whatever mom has discussed early on as her needs, wants, and wishes…

via How to Bring Sacred to the Hospital Setting — Lauren A. Condron, MOT, OTR/L.

Wednesday Tidbits: Activism!

Feb5

Rolla Birth Network is pleased to be one of the co-sponsors of the upcoming production of The Vagina Monlogues, Eve Ensler’s classic feminist empowerment play.

The local production of The Vagina Monologues will benefit the Russell House, a shelter for battered women and their children. The event is specifically planned as part of V-Day:

“V-Day is a global activist movement to end violence against women and girls. V-Day is a catalyst that promotes creative events to increase awareness, raise money, and revitalize the spirit of existing anti-violence organizations. V-Day generates broader attention for the fight to stop violence against women and girls, including rape, battery, incest, female genital mutilation (FGM), and sex slavery.”

Last year we had a candlelight vigil on Valentine’s Day in honor of One Billion Rising. While that was a wonderful project too, this play production is much more ambitious and is very exciting! Here are some more details:

Local cast members (including my very own talented and awesome doula! 🙂 )

Rolla Area Citizens for Women 2014
Presents a Benefit Production of

Eve Ensler’s
THE VAGINA MONOLOGUES

FEBRUARY 21, 2014 at 7:00 PM

Venue:
Cedar Street Playhouse
701 North Cedar Street
Rolla, Missouri 65401

$5.00 Minimum Donation per person CASH ONLY
Benefits The Russell House

I’m really looking forward to going!

Another Missouri-local opportunity specific to birth advocacy and midwifery activism is the annual Friends of Missouri Midwives Cookie Day at the Capitol coming up next week:

Yes, it is true, Barbara Harper will be there! Isn’t that cool?! I heard her speak at the CAPPA conference in 2010 and very much enjoyed her presence and devotion. I hope the weather cooperates so I can see her grace our Capitol building with her poise and information!

“Let us initiate our daughters into the beauty and mystery of being strong and confident women who claim their right to give birth and raise their children with dignity, power, love, and joy.” –Barbara Harper

One of the opportunities that is also going on this month that is not local, but virtual instead, is DeAnna L’am’s Red Tent Summit. It is free to register and participate. I have not yet carved out the space I need to actually tune in, but the lineup of speakers and wealth of topics is amazing!

Also, while all of these particular events are offered with a wonderfully upbeat spirit of intent and energy, I also feel like sharing an activism-related quote that I’ve had saved in my drafts folder for a long time that acknowledges the important role of anger and activism:

I’m not afraid to say it. Hell, isn’t anger kind of a prerequisite for activism work? As a birth worker I get to watch abuse after abuse, injustice after injustice – over and over again. I mean, really, what spurs the need for activism work if not injustice? And injustice stirs up indignant anger.

We have this huge deficit with the word, “anger.” Somehow, whenever it is said, we cling to this connotation that it – the word, the feeling – is inherently BAD. It took me a lot of years to come to the understanding that there are no “bad” or “good” feelings – that emotions just are. They are states of being which reflect either met or unmet needs.

Anger is usually a catalyst emotion…

via I am an Angry Activist.

I’ve self-identified as an activist since at least 1996 (when I first began working at the same battered women’s shelter for which the Vagina Monologues production is benefiting, actually!) I do find that some anger (or sheer disbelief!) at injustice is part of the fuel that drives my present-day activism. In fact, social justice was at the heart of my response several years ago when asked why I became a childbirth educator:

…the question was posed, “why did you become a childbirth educator?” I responded with the following: because I care deeply about women’s issues, social justice and social change and I feel like women’s choices in childbirth are intimately entwined with this. Because I believe peace on earth begins with birth. Because the births of my own sons were the most powerful and transformative events of my life. And, because I believe every woman should have the opportunity to feel and know her own power and to blossom into motherhood with strength, confidence, and joy. ♥

…On a discussion board once, someone asked the question “what’s at the root of your love of birth?” I was still for a moment and let my intuitive, heart-felt, gut level response come to me and it was this:

Women.

Women’s health, women’s issues, women’s empowerment, women’s rights.

Social justice….

via Why, indeed? | Talk Birth.

I’m currently finishing a book about women’s rituals and this paragraph caught my eye last night in relationship to my own experience of birth activism (and other activist work):

“One of the other problems in areas of small population is the relationship between local and regional leadership. Often, people who are competent local leaders are recruited to work regionally or nationally in their organizations. This policy frequently leaves a vacuum at the local level because leadership is not broadly enough based in those communities.”

I’ve seen this happen with myself, noticing that as I became involved with birth activism on a national level, my time for local birth activism was necessarily reduced. (And, then as my interests and commitments broadened beyond birth, the time for birth activism of any kind reduced.) I also see it happening with digital commitments—basically, the more I do for people on a virtual level over the internet, the less I have to give on a face-to-face local level. I’m still sitting with this realization and wondering what to do with it. The organizers of the One Billion Rising event in Denver this year recently contacted me to ask permission to read one of my poems aloud during their event. I was thrilled to say yes, but then I also thought about my local community and how most people here would not be familiar with my poem at all. So, Denver hears it, but my own local area does not. Interesting. I also found out this week that one of my essays about my grandma was translated into French and published in a French magazine. Cool, yes, but again gave me pause…

Related past posts:

Birth Violence

Tuesday Tidbits: Domestic Violence

Domestic Violence During Pregnancy

Guest Post: Abuse of pregnant women in the medical setting

Business of Being Born: Classroom Edition

Tuesday Tidbits: The Role of Doulas…

Community Organizing

Birth Matters!

Taking it to the Body, Part 4: Women’s Bodies and Self-Authority

Good Birth Books to Gift to Others

Dec23

I’ve recently had several requests from friends asking about the best birth books to give as gifts to pregnant relatives. After sending my third response, I realized that there’s a blog post in here somewhere!

Here are my current recommendations:

Sacred Pregnancy—this book is simply beautiful. My past review is here.

Giving Birth with Confidence—this is the well-known childbirth education organization Lamaze International’s guide to pregnancy and birth and it is one of my favorites. My review of a past edition is here.

The Birth Partner—this guide by Penny Simkin is a classic for helping fathers or other birth partners serve during labor

The Greatest Pregnancy Ever—focused on positive mental attitude during pregnancy and cultivating a mother-baby bond prenatally (caveat: I’ve not actually finished reading this one, so I’m not sure if I have any reservations about it or not. I bought it at the last CAPPA conference)

Birthing from Within—the original birth art resource and a fabulous “out-of-the-box” handbook for preparing for birth. It is not attached to a particular outcome and can help mothers dig deep whether experiencing a home birth or a cesarean. This book is my all-time favorite, but my recommendation comes with a caveat that the short breastfeeding section is terrible.

The Baby Book—-a comprehensive, reassuring look at baby’s first year by Dr. and Martha Sears.

For birth stories, I love and adore Simply Give Birth (past mini-review is here). I also like Journey Into Motherhood (available as a free digital copy here) and Adventures in Natural Childbirth.

I used to recommend The Thinking Woman’s Guide to a Better Birth, but is has been replaced by an updated version called Optimal Care in Childbirth and I’ve not yet read that one. My educated guess is that it is still an excellent recommendation! 🙂 I also used to recommend The Birth Book by Dr. Sears. It is still a good suggestion, but it is now an “older” book and so I don’t put it at the top of my list any longer.

Also, make sure you grab a copy of the free Guide to a Healthy Birth from Choices in Childbirth. I love this little booklet so much! It is my top favorite resource for tabling at community events. Another free educational resource that I recommend (particularly for women planning natural births in hospital settings) is Mother’s Advocate. There is a free booklet and a series of videos that explore Lamaze’s Six Healthy Birth Practices (which all mothers deserve as part of evidence-based care during birth, regardless of birth location).

Past book lists and related suggestions:

What To Do When Newly Pregnant and Wanting a Natural Birth…

Postpartum Reading List

Book list: Preparing Children for Homebirth

Non-Advice Books for Mothers

2012 Book List (all kinds of stuff, not just birth)

In addition, all the books I’ve reviewed in the past are available on my website from this link, so make sure to browse and see if anything else jumps out at you as a good match.

“Everyone who interacts with a pregnant woman is, in some way, her ‘teacher.’ Telling birth stories, sharing resources, imparting obstetrical information, giving advice or warnings—these are all direct or indirect ways of teaching about birth and parenting. Whether you currently identify yourself as a ‘childbirth teacher,’ or you are a midwife, doctor, doula, yoga teacher, nurse, therapist, breastfeeding counselor, or you are simply a woman or man who cares about the power of the childbearing year, you already hold the power of mentoring within you.”

–Pam England