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Guest Post: The Midwife as a Storyteller and Teacher by Patricia Harman

The use of old-fashioned narrative to influence, and inform patients about health practices

As an author of memoirs, historical fiction and children’s literature, I am a storyteller, but I’m also a nurse-midwife, and I use storytelling as one of my primary teaching tools.

Storytelling is uniquely human.  Anthropologists have argued that storytelling is pre-verbal, that pictographs on the inside of caves are in fact stories.  Form the earliest days humankind has used narrative to record history, to entertain, to convey experience and to transfer information.

To convey information in narrative form is something no other species can do.  It’s an evolutionary advantage and allows each individual to harbor  more information than personal experience would allow.

Using stories to teach patients is not unique to midwives.  All good providers use stories to illustrate May 2016 004how individuals can make better health choices.

We all know that many patients are non-traditional learners  and even those in higher education love a good story.  Research and statistics are boring for most people and easy to forget .  Many patients, even if given a handout drop it in the trash as they leave our office. They don’t have time to read it or are non-readers.

On the other hand, if I tell a tale, in an amusing way, about a young woman who refused to take her birth control pills because she was worried they would make her fat…and now she’s pregnant…that’s a cautionary tale and brings a smile and a knowing nod from the fifteen-year-old here to discuss birth control: That’s not going to happen to her!  

Using self-disclosure about your own life can humanize a professional relationship and help patients be more honest with you about their lives.  For example, I might say with a smile, that I’ve gone to Weight Watchers for so long I could teach the class, even though I’ve never reached goal weight.  The patient and I share a good laugh and now she feels comfortable telling me she can’t stand to look in the mirror, has tried four different TV diets and is terribly discouraged.  A door for real communication has opened.  She no longer feels alone and she knows she has me as a non-judgmental advocate.

Stories can accomplish what no other form of communication can do; they can get through to hearts with a message.  I might tell a very stressed-out college student, sitting on the end of the exam table, about a patient of mine who had two jobs and was studying nursing full time.  Last year she started getting a series of illnesses.  Next thing she knew, she flunked two courses, lost her boyfriend and had a motor vehicle accident.  The moral is clear: don’t take on more than is humanly possible.  And the tale is more likely to induce lifestyle change than a lecture.

All health care providers, surgeons, nurses, physical therapists, family doctors or midwives must be teachers.  If you missed that part in school, it’s not too late.  With humor and love we can become part of the human story that will bring health and hope to our patients.

For the past twenty years, Patricia Harman has been a nurse-midwife on the faculty of The Ohio harman-2008-by_bob_kosturko-330State University, Case Western Reserve University and most recently West Virginia University. In 1998 she went into private practice with her husband, Tom, an OB/Gyn, in Morgantown, West Virginia. Here they devoted their lives to caring for women and bringing babies into the world in a gentle way. Patricia Harman still lives with her husband, Thomas Harman, in Morgantown, West Virginia. She recently retired from her thirty-five years of midwifery so she could write more books for people like you!

My past reviews of Patsy’s books:

Past blog posts on the subject of story power: october-2016-240

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Guest Post: Holiday Coping: Dealing With Infertility or Adoption Process During The Festive Season

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I distinctly remember sitting through Thanksgiving and Christmas after the loss of my third baby. The sense of hollowness. The sense of having to put on a happy face. Guilt for laughing. Guilt for not laughing. Going through the motions. Pretending to be okay. When I received this short guest post on coping with infertility during the holidays, it brought back those memories of tension, strain, and grief.

Executive Director of The Adoption Consultancy and BeyondInfertility.com Nicole Witt–remembers a personal story of “holiday coping” years ago during the festive holidays:

Early on in Nicole’s marriage, before anyone knew that she and her husband were having fertility struggles, Nicole was at a family holiday gathering.  A family member started showing her pictures of a recent get-together she had had with her college girlfriends.  As she showed Nicole each picture, the only information she gave to her about each woman was what children she had.  Such as, “Here’s Susie. She has a 6 year old boy and a 4 year old girl.”  “And here’s Jodie who’s a stay-at-home mom to her 5 year old twin girls….”  It seemed to be how she defined each woman and it left Nicole wondering how this family member would define her to others.  Was Nicole nothing without kids?  This is just one scenario that someone may have to cope with this holiday season.

We all have that crazy cousin, drunk uncle, overly-concerned parent or blunt friend who might say or do something this holiday that will make us cringe, but here are some tips on how to cope from Nicole Witt:

  1. Think Ahead: Make a plan ahead of time.  This can include practicing responses to probing questions that you know you’ll be asked.  Or it can be a signal to your partner that it’s time to fake a sickness and leave.  It can also be recruiting and educating trusted family members on how & when to redirect inappropriate dinner table conversations so that you don’t have to.
  2. Take “Me” Time: Step away.  This was the most effective tip for me.  I would just take a few minutes in the bathroom to myself for some deep breaths and refocusing.  Once I had gathered myself, I would have the strength to rejoin the group, at least for a little while.
  3. It is OK to Say “No!”: Say ‘no’ to invitations that will be too difficult for you.  It’s OK to not accept every invitation you get.  Even if it’s for your family’s traditional Thanksgiving dinner.  Maybe create an urgent trip that you need to go on that week.  Although it may be difficult to do, if it’s easier than attending the event, don’t hesitate.

During the holiday season this year, The Adoption Consultancy and BeyondInfertilty.com along with Nicole are inviting others to share their holiday coping stories via @AdoptConsultant and @BeyondIF with the hashtag #holidaycoping.  We would love to hear from your readers this holiday season to share their stories, whether they are funny, sad, frustrating or heartwarming.  Everybody needs a place to vent to an audience that truly understands.

Happy “Coping” Holidays.

Closing the Bones…

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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

IMG_9800My own post about my postpartum sealing ceremony can be found here:

Ceremonial Bath and Sealing Ceremony | Talk Birth

Guest Post: Postnatal Mental Health

11998990_1661958487349700_7935437715757927025_nI received notice of a new article published in the Journal of Psychosomatic Obstetrics & Gynecology looking at the types of distress experienced by postpartum women and the type of support available. It indicates that current classification of “postpartum depression” and other postpartum mood disorders are inadequate to convey the range of women’s experiences, nor do they properly account for the role of support in their lives.

Before I share the article, I wanted to note something I’ve done recently to support postpartum health. I donated to the fundraising effort to buy a permanent location for WomanSpace, the local community center devoted to supporting women. It is spearheaded by Summer Birth Services, an organization offering birth, postpartum, and breastfeeding support to Rolla area mothers. We can’t undervalue the importance of organizations like this! WomanSpace offers meeting space for groups, classes, and workshops for a wide range of purposes for all ages, stages, and phases of a woman’s life.

For women in any community, you might want to check out a free virtual retreat for women (unaffiliated with any of the above): Nurturing You.

Postnatal mental health: Are women getting the support they need?

“I really did not feel like I fitted the box.” New research indicates the need for postnatal support that encompasses all mental health issues, not only postnatal depression.

The study, published in Journal of Psychosomatic Obstetrics & Gynecology, examines the postnatal symptoms of distress experienced by women, and the support options they were offered. Rose Coates et al. argue that “Current classification and assessment of postnatal mental health problems may not adequately address the range or combination of emotional distress experienced by mothers.” To understand women’s own experiences, the team interviewed 17 women, all of whom had a child under one and had experienced a postnatal mental health problem.

Through the interviews, the women reported a number of different postnatal mental health symptoms, with tearfulness and anxiousness the most frequently mentioned. In addition a number of women each reported feeling: stressed, isolated, lonely, angry, low, panicky, frustrated, worried, scared and overthinking. Despite these symptoms of postnatal distress, the women found that they didn’t identify with postnatal depression, and many of them were left “bereft of information, advice and support” about other types of distress. The paper notes that “there was a perception that health professionals were focussed on postnatal depression and once it had been ruled out there was no further investigation.”

At the time of their distress some of the women had been assessed for postnatal depression by health care professionals through answering a questionnaire. This paper questions whether this alone is really sufficient to identify distress, and suggests that alternative methods of assessment would be conducive to identifying and supporting women with a number of different postnatal mental health issues. The authors conclude that “Identification and recognition of symptoms and disorders beyond postnatal depression needs to be improved, through evaluating different approaches to assessment and their acceptability to women.”

Post provided by Taylor and Francis Group.

Talk Books: Q & A with Jenny Kitzinger

cropAugust 2015 048“These hands are big enough to save the world, and small enough to rock a child to sleep.”

–Zelda Brown

Childbirth education pioneer and feminist icon, Sheila Kitzinger has five daughters. After reading and reviewing Sheila’s passionate, beautiful, inspiring memoir: A Passion for Birth, published shortly before her death this spring, I did a short interview with her daughter, Jenny Kitzinger…

  1. How has your own work been influenced by your mother?

I grew up knowing that the ‘personal was political’ – including issues such as birth, marriage and death – and believing that nothing was taboo or closed off for discussion.

My early work on AIDS, and then on child sexual abuse, as well as my most recent work on the treatment of patients in long-term coma, has all been fundamentally influenced by my mother’s approach to life and work.

  1. What was it like to grow up with a birth activism “celebrity”?

To me my mother was just normal – so I took for granted her passion, determination and impact on the world, and the privilege we had as children of meeting lots of interesting people from the world of women’s rights, politics, and the arts.

  1. I was struck by the focus on humanitarian work in Kitzinger’s memoir. Do you have any childhood memories of these experiences and their influence? Are you still involved in cause-oriented work as an adult?

We often had people staying who needed support – it was lovely to meet the different people who came into our home – and to see the practical support and nurture my mother offered them. Sheila was also clear that the personal was political and that alongside supporting individuals it was necessary to learn from them and work alongside them to tackle root causes of problems.

My sister Tess was centrally involved in support for refugees – a cause also close to my father’s heart (he came over to England as a refugee in 1939). I was involved in setting up one of the first incest survivors refuges. Polly was also active in disability rights, advocating for people with mental illness. Our oldest sister, Celia, is a leading campaigner for sexual equality and equal marriage.

Since my sister, Polly’s car crash in 2009, Celia and I have worked together to examine the treatment of people with catastrophic brain injuries, including rights at the end-of-life. Although we are both full professor, and publish academically, we are committed to making work accessible to families, health care practitioners and policy makers. That is why we designed an online support and information resource about the vegetative and minimally conscious state.

  1. How many times did you hear birth stories around the dinner table?

We are a loud and talkative family. We would often discuss childbirth issues around the dinner table – alongside topics such as sex. This was fine at home, but I think when we went out to eat in restaurants I am not sure next door tables always enjoyed either the content of our lively debates, or the volume of the conversation as we became engrossed in family debate and everyone spoke at once!

  1. What do you feel like is your mother’s most enduring legacy?

The transformation of assumptions about childbirth – alongside a broader contribution to respecting women’s experience and supporting their rights to have choice and control over their own healthcare decisions.

Sheila

A Passion for Birth, My Life: anthropology, family and feminism by Sheila Kitzinger

(Pinter & Martin)

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Talk Books: Maternity Leave Excerpt, 19 Days Old…

This is an excerpt from the new novel, Maternity Leave, by Julie Halpern, released today and previously reviewed here.

19 Days Old

Two days and counting before Zach goes back to work as an IT specialist at a local bank. “What are you so worried about?” My mom holds Sam as I drag a pen along the seams of an envelope. Two half-finished thank you notes jeer at me. “I raised you kids without your dad around, and you turned out decent.”

“I’m not worried about Sam being decent. He barely has a sporting chance, what with being your grandson.” I smirk. “I’m worried about generally sucking as a mom,” I explain.

“Let me let you in on a little secret: all moms suck much of the time. The beauty about being a stay-at-home mom is that there is no one to watch you fail. It’s not like Sam is going to tell anyone. You’ll be back at work before he learns to talk anyway.”

“Mom, you’re wigging me out a little. And yet, you are very wise. You sure you don’t want to move in for a few months?”

“Oh, you’d love that. We couldn’t spend two days in Lake Geneva without the battle of the air conditioner. No, I’ll just be around for support when you need me. At least until I go to San Francisco next month.”

“I can’t believe you’re still going. You have a grandchild now!” I’m worried more about me not having her to help than my mom not seeing Sam, but it sounds better when the baby is the one being the baby.

“He won’t remember. And you’ll make it without me. What if I were dead? You’d have to do it without me anyway. In fact, pretend I’m dead. It’ll be easier.”

“Ma! Why do you always have to go to the dark side?” I ask.

“It’s part of my charm, I guess.”

Doogan looks at me, and I swear I detect a shrug. “She’s your mother,” he says.

I have managed to take care of Doogan for seventeen years. I’ll take that as a good sign. Then Doogan bites me, and I shove him off the couch.

I’m screwed.

20 Days Old

Zach goes back to work tomorrow. I am terrified, scared shitless, and entrenched with fear. I have to be alone with this baby all day, every day, and I don’t know if I can do it.

“You’re going to be fine. You’ve been doing it already for three weeks,” Zach tries to comfort me as we watch “Supernatural” on the couch. Sam sleeps peacefully on Zach’s chest. I give him the stinkeye, just in case he can sense I’m not happy with him.

“I haven’t been doing it for three weeks by myself. At first I was in the hospital, and you’ve been here the whole time, playing a supporting role, as has my mom in her morbid kind of way. Plus– fine? I don’t want to be fine. I want to be the best, most kick-ass mother on the planet. And beyond. I want to nurse him lovingly whilst I bake cakes and keep the house so clean you can hear little chimes of sparkle ringing from the countertops. I want Sam to learn sign language and ten other languages and to fit all the right shapes into that ball with the shapes cut out that five different people bought for him. Fine wasn’t good enough for me before I had this baby, so it certainly should not be good enough when we’re talking about the health and happiness of our first born son!” This would be the start of many a sleep-deprived diatribe on the subject of mama failure. But Zach will soon be lucky enough to get away from it all for ten hours a day, five days a week. Son of a bitch.

Middle of the Night

Full-on panic that Zach goes back to work tomorrow. Thank god for QVC. I don’t know what I’d do without the hypnotic beauty of twenty-four hours of gemstones.

21 Days Old

First Day Without Zach Goals

  • Feed, clothe, change, etc. Sam
  • cut fingernails
  • paint toenails
  • bake chocolate chip cookies
  • take nap
  • master Moby Wrap

Zach is gone, and so far so good. Nothing out of the ordinary, and I did manage to write three more thank you notes. Perhaps I will send them before Sam’s first birthday.

I spent much of the day practicing intricate wrappings of the Moby Wrap so I can wear Sam around when I go places. Working with at least twenty feet of fabric to somehow transform it into a safe nest in which Sam will lay seems semi-impossible, but I’ve made it my quest for the day. Or maybe the week. Why rush these things.

First Day without Zach Accomplishments

  • Blah blah blah Sam
  • Managed to knot my Moby Wrap and watched it fall on the floor
  • Fell asleep while on toilet (nap?)
  • Ate half a roll of refrigerated cookie dough (baked in my stomach?)

When Zach arrives home, the house is the same mess it was before he left. My face is still the same mess it was before he left. Zach looks like he just returned from a three week trip to a spa. I pray for a gigantic, dribbly poo to slither into Sam’s diaper so I can hand it off to Zach, but for once Sam’s baby buns have clammed up. Not that Zach would care. “I missed you so much!” he proclaims to Sam as he swings him around the room. I should take my act on the road. How much does an Invisible Woman make?

Copyright © 2015 by St. Martin’s Press LLC.

Maternity Leave by Julie HalpernMATERNITY LEAVE by Julie Halpern
Published by Thomas Dunne Books
On-sale September 1, 2015
ISBN-13: 9781250065025 | $24.99 | Hardcover

Guest Post: Five Common Surrogacy Myths

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Special request still in progress for a friend whose family was birthed via a beautiful surrogacy experience.

North America’s leading surrogacy agency, Family Source Consultants, highlights five of the biggest misconceptions about surrogacy

Chicago – June 4th, 2015 – If you’re thinking about becoming or using a surrogate, you may feel inundated with information and unsure where to start. There can often initially be a lack of understanding about the process involved and a lot of misinformation out there, too.

Staci Swiderski, Co-Founder of Family Source Consultants, says: “If you’re in a position where you’re contemplating an alternative path to family creation, you might be overwhelmed and possibly apprehensive when looking at the many choices you have before you.  It is our mission to alleviate the pressures all parties are facing and to help make this experience positive and fulfilling for everyone involved.”

Here are five common misconceptions about the surrogacy process: 

  1. The child is genetically-related to the surrogate. Although this can be true if the arrangement is considered to be a traditional surrogacy, with a gestational surrogacy arrangement, the embryos are created with either the intended mother’s eggs or an egg donor – never those of the surrogate.
  2. Building a family via surrogacy is only for the wealthy. Based on Family Source Consultants’ experience, many intended parents have an average income. Additionally, there are financing options available from lenders who specialize in reproductive arrangements, as well as cash discounts and payment plans.
  3. The surrogate may not give up the child. Surrogates have to already have their own children and completely understand that they are helping another family to have this child. Of course, the surrogate will care for the child and have an emotional bond, however, she is fully aware that the child is not her’s to keep. Surrogacy agencies should always work with attorneys who specialize in reproductive law and, with the correct legal procedures in place, intended parents are the legal parents of the baby. In addition, a surrogate (and her partner if applicable) must undergo a psychological evaluation prior to entering into a legal agreement with the intended parents.
  4. The surrogate needs the compensation or is poor. Many surrogates who are enrolled in Family Source Consultants’ surrogacy programs have a full-time career, are financially stable and often have a partner who has a secure, well-paid job, too.  Family Source Consultants have actually worked with many surrogates who are considered to be the breadwinners of their marriage or partnership. A surrogate should never fully depend on the compensation that she receives in order to live a stable lifestyle. Financial problems or any indication that a surrogate candidate is motivated by money can be reason for disqualification.
  5. Intended parents who live in a less surrogate ‘friendly’ state cannot utilize surrogacy as a family building option. Family Source Consultants’ intended parent clients come from all 50 states and internationally. The important factor is that the surrogate must deliver in a state where her legal rights as a parent are protected. Some of the best states for surrogacy law include Illinois, Florida, California, Nevada, Arkansas and Connecticut and some of the less-friendly states include New York, Michigan, Washington and Nebraska.

About Family Source Consultants

Family Source Consultants is one of North America’s leading surrogacy agencies, with offices in Illinois (Hinsdale and River North in Chicago) and Florida (Cape Coral).

When matching and facilitating Gestational Surrogacy and Egg Donation arrangements, Family Source Consultants work with traditional, gay or lesbian couples and individuals of all races, religious and ethnic backgrounds. They provide personalized support throughout the entire process and work with the very best reproductive law attorneys and doctors.

What’s unique, is that 75% of its employees have been a surrogate/egg donor/intended parent, including Founders, Staci Swiderski who completed her family through surrogacy and has been an egg donor twice; and Zara Griswold, who built her family via surrogacy using the assistance of an Egg Donor.