Archives

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

Save

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

cropOctober 2015 055

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…

IMG_9515

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)

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

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

April 2015 076

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.

 

 

Author Interview: Sally Hepworth

At the end of last year, I reviewed a preview copy of an awesome new novel about midwives: The Secrets of Midwives.

Secrets of Midwives, the

The Secrets of Midwives is released for sale today and I’m excited to share an interview with the author, Sally Hepworth.

A Conversation with Sally Hepworth…

Q 1. How did you come to write the book?

Sally Hepworth and Family

Sally Hepworth and Family

There is a saying among writers “Write the book you want to read.” That’s what I did. Being the mother of young children (and pregnant while I wrote book), I was finding myself drawn to novels such as The Birth House by Ami McKay and Midwives by Chris Bohjalian. I have always thought there was a certain magic to midwifery—for a while, after I left high school, I even considered becoming a midwife. So, when it came time to start a novel, there was no choice to make.

I researched for months before I wrote a word. While I knew I was going to write about midwives, I had no idea what the actual story would be. I had a suspicion it would involve a mother and a daughter—particularly when I found out I was carrying a daughter—but it wasn’t until I read some fascinating stories about midwifery in the 1940s and 50s that Floss’s character (a grandmother) was born.

For me, the best plots start with a question, and the question I landed on for this book was: “Why would a woman hide the identity of her baby’s father?” I like books that have a big upheaval really early on—a “call to action” for the readers—so I knew that by the end of the first chapter, the reader would find out that Neva was pregnant, and that she wouldn’t reveal the identity of the father. At first, I didn’t know why she was hiding it, and I didn’t know who the father was, but as I wrote, I started to figure it out.

But when all is said and done, THE SECRETS OF MIDWIVES is a book about family. What makes a mother, what binds family together, and the role of biology.

In writing this book, I found answers to a whole lot of questions I never knew I had. And I suspect it is no coincidence that this book took me nine months to write.

In effect, in 2012, I gave birth to two babies.

Q 2. In the novel there are many differing opinions about the “right” way to give birth, even among the midwives. Why did you choose to include this in the book?

In my experience, there still exists a lot of debate over the “right” way to give birth so I thought it was important for December 2014 119authenticity to include this in the book. Also, the idea of “right” and “wrong” tied in with the novel’s theme: family. Unfortunately, there is still a commonly held belief that there is a “right” and “wrong” kind of family. Or at least a “good” and a “better” type. But these days, there are so many different kinds of families—blended, adoptive, single-parent, same-sex parents, communities of singles. Of course, there are a lot of (strong) opinions on this too! To me, this was all rich fodder for a novel.

As I started researching for this book, I read a lovely line in a book that said childbirth was a woman’s first battle as a mother, and it was this battle that made her a warrior, capable of protecting her child. I found this fascinating, but also troubling. If birth makes a mother a warrior, where did it leave adoptive parents? Step parents? Fathers?

It was also troubling on a personal level. My son had been born naturally and my daughter was due to be born by scheduled C-section. I had a sense that it didn’t matter how the baby was born, that the birth had no continued bearing on the relationship between mother and child, but the more I read about the transformative quality of natural birth, the more I wondered.

In writing this book, and in giving birth to my daughter by C-section, I was able to find answers to my questions. I have more respect for natural birth and midwifery now than I ever did, and I think a woman’s ability to provide everything her child needs through pregnancy and birth (and beyond!) is astonishing—even magical. And the idea of a home birth, I’ll admit, holds a certain appeal for me now that it hadn’t before. But I finally determined that there is no “right” way to give birth, because there is no “wrong” way. You don’t become a warrior because of the way you give birth. You become a warrior because of the depth of the love you feel for your child.

And while labor may be the first battle you’ll fight for your child, compared to the battles that still lie ahead? Even the most arduous birth is a walk in the park.

Q 3. What research did you do?

As I prepared to write this novel, I read everything I could get my hands on about midwifery—novels, memoirs, non-fiction books—and I watched every piece of footage that showed high-risk deliveries that YouTube had available. I subscribed to online communities and forums where I was able to ask questions about midwifery and birth and I touched base with several home-birth midwives and midwives alliance groups. I also have an aunt who is a midwife who was able to make suggestions and verify things for me.

Being pregnant, I also had easy access to my obstetrician for questions. It became common for my prenatal check-ups to consist of a quick blood pressure check, followed by twenty minutes of question time about my novel. In the hospital after having my daughter, I had a fantastic midwife who shared many stories with me about unusual or memorable births. I was stunned by the level of skill and expertise that was required, and the host of things to be prepared for during labor. But what I remember most about our conversations is her awe and respect for mothers in labor, and I attempted to weave this awe into all three of my POV characters, particularly Neva.

Q 4. What are some of the weird and wonderful facts you’ve learned about midwifery and birth during your research?

  • In the past, midwives were known to secretly harbor unwed mothers, perform abortions, baptize babies, and serve as pediatricians for the first year of the baby’s birth.
  • May Babies Are The Heaviest: Babies born in May are, on average, 200 grams heavier than any other month.
  • Centuries ago the midwife would catch the baby in her apron!
  • In the US, midwifery is only licensed or regulated in 21 states. In most states licensed midwives are not required to have any practice agreement with a doctor.

Q 5. One of your protagonists has issues with her mother. Did you draw on personal experience for this?

 Actually, my mother and I have a very close—verging on boring—relationship. Though we are quite different (she is private and conservative like Neva, and I am like Grace—pushy and talkative and loud) conflict between us is rare. So I wasn’t able to draw on that relationship from a dysfunctional perspective. That said, I was able to identify with loving someone who is very different (not just my mother, but also my husband and my son), and learning how to love them the way they need you to. Above all, the key is respecting the person for who they are, and always looking for the good they can offer.

Q 6. How can readers get in touch with you and support your work?

I am very active on Facebook, Instagram and Twitter. I have also started spending more time on Goodreads. My website www.sallyhepworthauthor.com is the place to go for book information, upcoming events and my bio.

Thanks for listening (reading)!

Sally x

October 2014 023

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

 

Guest Post: Pelvic Exams Need Rethinking

June 2014 045I almost never reprint any of the random articles, press releases, and news tidbits that find their way to my email address. However, this one was too interested to skim past. Conclusion: The pelvic exam has been a standard part of a woman’s annual checkup for decades — yet it serves no clear purpose and may do more harm than good.

Considering that I’ve written about Pelvic Exams I Have Known (watch for my eventual stand-up routine, 😉 ), I found this very interesting…

UC SAN FRANCISCO
Jennifer O’Brien, Assistant Vice Chancellor/Public Affairs
Source: Elizabeth Fernandez (415) 502-6397 (NEWS)
Web: www.ucsf.edu
Twitter: @EFernandezUCSF

TO COINCIDE WITH PUBLICATION IN ANNALS OF INTERNAL MEDICINE

UCSF Commentary: Pelvic Exams Need Rethinking

The pelvic exam has been a standard part of a woman’s annual checkup for decades — yet it serves no clear purpose and may do more harm than good.

That’s the conclusion of a new guideline by the American College of Physicians (ACP) based on a review of scientific literature spanning more than 60 years. In an article to be published July 1, 2014 in the ACP’s flagship journal, Annals of Internal Medicine, the national organization of internists strongly recommends against pelvic examinations for adult women who are not pregnant and show no signs of disease.

In issuing the new guideline, the nation’s largest medical-specialty organization contends that pelvic exams rarely detect “important disease” or reduce mortality. Under the new guideline, the ACP advises that pelvic exams are appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems, or sexual dysfunction.

The recommendation is expected to be controversial, according to an accompanying editorial by George F. Sawaya, MD, a UC San Francisco professor of obstetrics, gynecology and reproductive sciences, and epidemiology and biostatistics; and Vanessa Jacoby, MD, a UCSF assistant professor of obstetrics, gynecology and reproductive sciences.

“The recommendation is based on a systematic review that found no data in support of the examination but did find evidence of harms ranging from distress to unnecessary surgery,” they wrote in the commentary.

Sawaya and Jacoby point out that tens of millions of pelvic exams are performed annually at well-woman checkups in the United States but whether the exams actually benefit asymptomatic women has largely been unstudied. To help fill the void, surveys recently have sought to establish the goal of clinicians in performing the exams: some physicians contend the exams help detect benign uterine and ovarian lesions while others mistakenly say they effectively screen for ovarian cancer, noted Sawaya and Jacoby.

The editorial called into question the nature of the medical literature review by the ACP because some of the research analyzed focused on older women and failed to evaluate “the most important goal of the pelvic examination cited by obstetrician-gynecologists – detecting noncancerous masses.”

“Thus, it is reasonable to disagree with using these findings to recommend a major change in clinical practice for women of all ages attending well-woman visits,” Sawaya and Jacoby wrote in their editorial. “Many will ask ‘Have all of the pertinent clinical questions been addressed?’”

“Deciding when evidence is sufficient to conclude that an intervention should be promoted, discontinued, or submitted to further study is challenging,” they continued. “The determination relies largely on judgment about evidence quality and the likelihood that more evidence will tip the balance in making either a favorable or an unfavorable recommendation.”

Numerous routine screenings, including mammograms and prostate tests, are being reevaluated for their medical and financial value.

In their commentary, the UCSF authors stress that whether or not the new guideline actually changes current practice, it could lead to a better evaluation of the benefits and harms of pelvic exams.

“The pelvic examination has held a prominent place in women’s health for many decades and has become more of a ritual than an evidence-based practice,” said the authors.  “With the current state of evidence, clinicians who continue to offer the examination should at least be cognizant of the uncertainty of benefit and the potential to cause harm through a positive test result and the cascade of events that follow.”

UCSF is the nation’s leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and two top-tier hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco. Please visit www.ucsf.edu.

###

Follow UCSF

ucsf.edu | Facebook.com/ucsf | Twitter.com/ucsf | YouTube.com/ucsf

Rise for Justice

1497514_10153552346400442_1148387720_nOkay, so I knew I would enjoy The Vagina Monologues. How could I not, right?! Well, I did not expect to be SO blown away by the power, presence, and passion of my magnificent friends. They were incredible. Seriously incredible. It was an amazing show!  There were many powerful moments–some very funny, some sad, some horrifying. My friend, doula, and colleague did the piece on birth at the end and brought me to tears with her vibrance and passion. There was a moment in the middle where the teenage girl member of the cast read out some statistics on the One Billion women who are raped, abused, or assaulted. Each member of the cast began to rise in turn and as they did, their friends in the audience rose with them, until the whole theater was standing. We rose for justice.

I’ve mentioned several times that I came to birth work with a core foundation in feminism and social justice work, primarily in domestic violence. I remain firmly convinced that the way we treat women in the birthplace reflects an overall cultural attitude towards women in general. I believe that peace on earth begins with birth. I believe that we can change the world with the way we greet new babies and celebrate new mothers and see the deep, never-ending work of parenting our children. I believe in rising for justice and I keep vigil in my heart every day for women around the world.

In a stroke of coincidence that gave me chills, my independent study student who is working on a Breastfeeding and Ecofeminism course submitted her weekly reflections and in it she mentioned Eve Ensler, The Vagina Monologues, and One Billion Rising with no idea that I was going to the show this week. As I read her reflections, the connection between the personal and political was so tangible that I asked her if I could use her assignment as a guest post for my blog. Part of the reason I assigned the book Reweaving the World for this course was because of how it contextualizes the issues facing women so broadly and makes this undeniable connection between exploitation of the planet and exploitation of women’s bodies. While it might sometimes trigger a sense of hopelessness and distress, I think ultimately, the contextualization is empowering. The Vagina Monologues are based on the courage of women telling their stories and sharing their truths. Likewise, I appreciate Alea’s generosity and courage in sharing her reflections with my readers…

November 2013 061

Dancing for Change: A look inside a personal exploration of ecofeminism, sexuality, and social justice.

Guest post by Alea Scarff

I began reading The Politics of Breastfeeding which sparked a series of “hell, yes’s!” It also left me feeling inspired, excited and validated that I’m not the only one with these feelings and notions about women, breastfeeding, and the injustice I witness within this issue. Her kick-ass presentation of the truth among this profound cultural issue left me enlivened and ready for action sentence after sentence.

Then I read several pages of Reweaving the World: The Emergence of Ecofeminism. Yikes. This was heavy. I suddenly found myself caught between two worlds of inherent optimism excited for positive social change, and the deep dark issues of ecology and the longstanding reality of suffering and inequality of women on this planet. I felt my body overcome with anger. A feeling of helplessness ensued. I felt those women in third world countries starving and overheated, overworked and just trying to sustain the lives of their children on top of enduring mental, emotional, physical, and sexual abuse. I felt all the children who suffer because of this. I felt all of the gender imposing rules children in the western world are conditioned by, thus tainting our hearts and souls with limitation and sharp edges surrounding who we are allowed to be in this society. All of the emotionally repressed men; all of the objectified, degraded women who have never known what it feels like to feel good in their bodies.

I began to feel my grandmother’s oppression she suffered from my grandfather in the 60s. The abandonment, the sexual abuse, the use and re-use of her as a resource and service for himself. I felt my mother’s experience of an emotionally abusive relationship, and finally my experience of sexual molestation as a child. Where was all of this coming from? A deep sadness came over me as I desperately tried to figure out my own issues with sexuality and my relationship to the world as I sat amongst strangers in this warm coffee shop. Was I angry about what happened to me? Was I angry at my partner? Past partners? Was I angry at the world? I really couldn’t identify where the anger came from, or where it was directed. I had to stop, refresh, and start over. Maybe this shit is too intense for me. Maybe I need to change my course of study.

No, no. You can’t run away. I realized I had been running from this issue my whole life and it’s finally time to recognize it. I stopped, took some deep breaths, did some yoga asanas to release the sticky tensions of injustice lurking in my joints throughout my body. Ok. Begin again.

So I went back to my childhood, with my deepest memories of the frequent encounters of gender inequality. My mother, to this day, credits me for bringing to light her own femininity and capturing her attention to the inequalities of men and women. Something that went unnoticed until I came along, however she still was not interested in changing the ways of the world to the extent I was. She had her own social change she was working on. It was entrenched in art and consciousness. Luckily, I picked up on this, and found my own desire for changing the world through consciousness. Consciousness through equality for women. How could anyone else NOT be outraged by the fact that 8 out of 10 songs on the radio were sung by men? As a twelve year old, I began writing letters to radio stations. I couldn’t understand how no one seemed to care about this absurd injustice constantly happening on the radio. Something so simple yet so powerful as radio permeated our culture – and no one seemed to notice. There were a plethora of female musicians that I favored at this age. How could I not hear them on the radio? On top of an array of social issues such as this, I always HATED those older men who would make random, confusing, degrading comments to me for others’ and their own amusement. What the hell was up with that?

I began reading an interview with Eve Ensler, the creator of The Vagina Monologues and the global women’s campaign, One Billion Rising. The figures quoted from the UN in this interview left me in a deeper outrage. One billion women on the planet today are beaten or sexually assaulted. I reflected on an article I had read earlier that week, as well about how to talk with your children about their private parts and to help prevent them from being sexually abused. The article stated that one in five girls are sexually molested and one in six boys are. I never identified with the label “sexually molested” nor did I want to admit I was affected by this, but just in the last few years when I looked at the definition, I realized, even my few small inappropriate experiences are considered just that, and they have, in fact, affected me.

I had to take a few days off. This all needed to settle inside and I had to figure out what to do with it. I spent days pondering, how do I continue to explore this crucial subject and maintain a positive outlook? How do I channel this anger into solutions for helping others? How can I continue researching and hold my strength and goddess energy as a female role model, an inspiration for my two little boys, my partner, men and women, and the planet?

This is a tall aspiration I set for myself, I realize. I suppose this is simply what I aspire to be.

I began speaking with my mother about my sexuality from a young age and my exploration of it now. It was both comforting and disheartening to discover my mother had similar inappropriate sexual experiences as a child that I endured, as well as finding she’s still on her journey of understanding this taboo topic herself, female sexuality. Perhaps a running thread in my family of women? Or is this prevalent everywhere? Why is no one talking about it? Even after being so close with my mother, and being able to talk about anything for as long as I can remember, it took some courage to bring up this subject with her. Regardless, I am so glad I did.

I began to read again. I decided I had to begin with an open heart and mind, as I swim right through the obstacles of understanding the depths and spaces of the world of women and the planet. There is a lot to be grateful for, and a lot that needs changing. Positive reflection throughout this journey can only bring more light. Letting go and forgiving my past experiences, and the oppression the women I know and love have endured, I take a step into a new beginning. I can move forward continuing to understand my path of my sexuality growing up, and what this means for me now. I feel I’ve got a long way to go, and I can sense a gap of mystery and unknown feelings sitting somewhere inside. But I’m ready to embrace and heal whatever decides to reveal itself.

I am now in the process of releasing fear and letting go. Letting go of being afraid to speak up and stand up for what’s right; of being viewed as a bitch, uptight, or simply being exposed. We as women need to start somewhere within this realm in order to ignite change. Rather than accepting these old cultural paradigms and letting them continue to thrive within this patriarchal society, it’s time to change this tired, destructive trend. As Ensler quotes in a recent interview with Deccan Aitkenhead for The Guardian, “We have one in three women on the planet being raped or beaten…We’ve all learned to be so well behaved and polite. We should be hysterical.”

Ensler launched One Billion Rising which, on Valentine’s Day in 2013 brought close to one billion women out on the streets to protest against violence towards women. Ensler’s goal is to have one billion gather on February 14th outside buildings that represent justice – police stations, courthouses, and government offices – and dance. That’s it. Where and how they dance is up to them; each is organized at a local level. In this, I found tremendous uplifting relief.

Through this personal revelation, I’ve decided to remain free – and not restrained by anger or resentment of injustice. I simply cannot move forward or flourish from that space. We must find liberation through the endurance, triumph and the celebration of womanhood. Simply. This is the only way to encourage and create change. I must release the tensions that like to creep up and burrow inside my joints and muscles. I no longer will walk around carrying this stuff – I’d rather be dancing than dwelling. This is the only way I will find my way to living up to my goddess vibration of inspiration for social change for my two little boys, my partner, women and men, and the planet collectively.

Next year on Valentine’s Day, I think I will be dancing.

“But when you suddenly understand that violence against women is the methodology that sustains patriarchy, then you suddenly get that we’re in this together. Women across the world are in this together.” –Eve Ensler