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DVD Review: The Big Stretch

Sep13

DVD Review: The Big Stretch

By Alieta Belle & Jenny Blyth

60 Minutes, includes 20 page booklet

www.birthwork.com

Reviewed by Molly Remer, Talk Birth

Jenny Blyth the author of the book Birthwork, is also a filmmaker who co-created the film The Big Stretch with another mother. The particularly special thing about this film is that it is all about women sharing their own experiences and feelings–unlike many current birth movies there are no “experts” present in the film (other than the true experts–women themselves!), the focus is on the families preparing for birth or reflecting on their past birth experiences. The many topics addressed are insightful.

The film’s emphasis is on, “Women in different stages of pregnancy and preparing for a natural birth reflect on how they and ‘stretched’ in everyway – emotionally, physically and spiritually” and I enjoyed this “stretch” theme that ran throughout.

Introducing new scenes/topic is neat artwork and the images in this film in general are particularly gorgeous. In one exception, I was taken aback by footage at the close of the film of a totally naked man riding a bicycle and feel I should warn other viewers to be prepared for that!

The DVD is accompanied by a 20 page booklet full of questions that carries the themes from the film into personal questions to increase self-awareness during pregnancy.

The Big Stretch is a unique and beautiful film in which women’s voices are clearly represented. There are no titles, no degrees, no qualifications listed. This film is a perceptive “motherful” look at the many stretches of birthing: physical, emotional, mental, and cultural.

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

Review previously published at Citizens for Midwifery.

Becoming an Informed Birth Consumer (updated edition)

Sep3

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“Birth is life’s central mystery. No one can predict how a birth may manifest…Our dominant culture is anything but ‘natural’ so it is no surprise that childbirth, even with the most natural lifestyle lived by an individual family, sometimes needs intervention and medical assistance. This is not to say that any one mother’s efforts to have a natural childbirth are futile. Just that birth is bigger than one’s personal desires.” –Jeannine Parvati Baker (in The Goddess Celebrates: An Anthology of Women’s Rituals, p. 215)

It’s Labor Day and it is also the start of Empowered Birth Awareness Week! A blog carnival is in full swing at The Guggie Daily and I’ve been having some thoughts about birth as a consumer issue. Very often, it appears to me that responsibility for birth outcomes is placed on the mother—if only she’d “gotten educated” she would have made “better choices.” Many people have a tendency or overlook or minimize the impact of the context in which she makes her choices. In that way, I appreciate Baker’s observation about that birth is bigger than one’s personal desires. That doesn’t mean that we can’t take vital steps to alter the larger culture of birth in which we make our choices, however, and one of those ways is to remember to think about birth as a consumer issue.

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

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

  • Read great books such as Henci Goer and Amy Romano’s new book Optimal Care in Childbirth or Pushed by Jennifer Block.
  • Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
  • Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
  • Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National or International Cesarean Awareness Network.
  • Check to see if you have a local birth network in your own community or even start your own (I recently co-founded one in my town!)
  • Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different. Pay attention to their experiences and how they feel about their births. If they are dissatisfied, scarred, unhappy, and disappointed, don’t do what they did.
  • Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
  • Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:
  1. Let labor begin on its own
  2. Walk, move around and change positions throughout labor
  3. Bring a loved one, friend or doula for continuous support
  4. Avoid interventions that are not medically necessary
  5. Avoid giving birth on your back and follow your body’s urges to push
  6. Keep mother and baby together – It’s best for mother, baby and breastfeeding

These care practices are evidence-based and form an excellent backbone for a solid, mother and baby friendly birth plan.

Why “evidence-based care” though?

Because maternity care that is based on research and evidence for best practice is not just a nice idea or a bonus. It isn’t just about having a “good birth.” Evidence-based care is what mothers and babies deserve and what all birthing mothers should be able to expect! Here is a great summary of pregnancy and birthing practices that the evidence backs up:

20120903-142510.jpgRemember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

“As long as birth- metaphorically or literally-remains an experience of passively handing over our minds and our bodies to male authority and technology, other kinds of social change can only minimally change our relationship to ourselves, to power, and to the world outside our bodies” – Adrienne Rich (Of Woman Born p185)
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Related posts:

Birth class handouts

Can I really expect to have a great birth? (updated edition)

What to Expect When You Go to the Hospital for a Natural Birth

Active Birth in the Hospital

The Illusion of Choice

Musings on Story, Experience, & Choice…

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This post is updated from a previous edition.

Book Review: Pushing for Midwives

Aug29


Book Review: Pushing for Midwives: Homebirth Mothers and the Reproductive Rights Movement
by Christa Craven
Paperback: 232 pages
Publisher: Temple University Press; 1 edition (October 28, 2010)
ISBN-13: 978-1439902202

Reviewed by Molly Remer, Talk Birth

Mainstream feminist groups have been slow to recognize the right to reproduce along with the right to be free from reproducing. A focus of the second-wave women’s movement was shaking off motherhood as what solely defined womanhood. So perhaps there has been a reluctance to watch over the process that makes women mothers. –Jennifer Block quoted in Pushing for Midwives

Framed as a health policy concern, Pushing for Midwives assesses the homebirth movement and midwifery activism in the context of the reproductive rights movement. The focus of the book is on legislation in Virginia, but is still of relevance and interest to activists from other states. Craven also tackles complicated topics that are often ignored in homebirth and midwifery texts, addressing issues of race, privilege, and socioeconomic status and the impact on access to care. She also takes a solid look at issues of political and religious diversity within the homebirth activist community.

Written in a densely academic style evocative of a dissertation, Pushing for Midwives, became tedious and dry in places and took a long time to finish reading. The very narrow focus on Virginia, while still applicable to other states, became tiresome by the final chapters.

I particularly enjoyed Craven’s exploration of the history of consumer activism in midwifery as well as the consideration of homebirth in the larger context of women’s health activism. I appreciated her exploration of the feminist movement and how it has historically neglected issues of birth advocacy and reform, while also looking the current relationship between feminism and midwifery activism, particularly how birth advocates choose to self-identify. Women’s health activists and midwifery advocates will likely find a lot of food for thought in the pages of Pushing for Midwives.

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

Amazon affiliate links included in book title and image.

Can I really expect to have a great birth? (updated edition)

Aug22

“Given my limited situation, can I really expect to have a great birth today?” For the woman who asked me this question a homebirth, a birth center, a midwife, and a doula were all not remotely feasible options. My answer to her question is a qualified “yes!” and it really got me thinking about ways to help yourself have a great birth when your overall choices are limited. In fact, there is a long list of ideas of things that may help contribute to a great birth!

  • Choose your doctor carefully—don’t wait for “the next birth” to find a compatible caregiver. Don’t dismiss uneasiness with your present care provider. As Pam England says, “ask questions before your chile is roasted.” A key point is to pick a provider whose words and actions match (i.e. You ask, “how often do you do episiotomies?” The response, “only when necessary”—if “necessary” actually means 90% of the time, it is time to find a different doctor!). Also, if you don’t want surgery, don’t go to a surgeon (that perhaps means finding a family physician who attends births, rather than an OB, or, an OB with a low cesarean rate).
  • If there are multiple hospitals in your area, choose the one with the lowest cesarean rate (not the one with the nicest wallpaper or nicest postpartum meal). Hospitals—even those in the same town—vary widely on their policies and the things they “allow” (i.e. amount of separation of mother and baby following birth, guidelines on eating during labor, etc.) Try checking with Cesareanrates.com for local information!
  • When you get the hospital, ask to have a nurse who likes natural birth couples. My experience is that there are some nurses like this in every hospital—she’ll want you for a patient and you’ll want her, ask who she is! If possible, ask your doctor, hospital staff, or office staff who the nurses are who like natural birth—then you’ll have names to ask for in advance.
  • Put a sign at eye level on the outside of your door that reads, “I would like a natural birth. Please do not offer pain medications.” (It is much easier to get on with your birth if you don’t have someone popping in to ask when you’re “ready for your epidural!” every 20 minutes.)
  • You might want to check out either or both of these two books: Homebirth in the Hospital and/or Natural Hospital Birth
  • Work on clear and assertive communication with your doctor and reinforce your preferences often—don’t just mention something once and assume s/he will remember. If you create a birth plan, have the doctor sign it and put it in your chart (then it is more like “doctor’s orders” than “wishes”). Do be aware that needing to do this indicates a certain lack of trust that may mean you are birthing in the wrong setting for you! Birth is not a time in a woman’s life when she should have to fight for anything! You deserve quality care that is based on your unique needs, your unique birthing, and your unique baby! Do not let a birth plan be a substitute for good communication.
  • Two resources I particularly enjoy that shake up the notion of a birth plan are, 1. the birth as a labyrinth metaphor from Birthing from Within and 2. this article about how does one really PLAN for birth.
  • When making a birth plan, use the Six Healthy Birth Practices as a good, solid foundation.
  • Cultivate a climate of confidence in your life.
  • Once in labor, stay home for a long time. Do not go to the hospital too early—the more labor you work through at home, the less interference you are likely to run into. When I say “a long time,” I mean that you’ve been having contractions for several hours, that they require your full attention, that you are no longer talking and laughing in between them, that you are using “coping measures” to work with them (like rocking, or swaying, or moaning, or humming), and that you feel like “it’s time” to go in. If you’re worried about knowing when you’re really in labor, check out this post: how do I know if I’m really in labor?
  • Ask for the blanket consent forms in advance and modify/initial them as needed—this way you are truly giving “informed consent,” not hurriedly signing anything and everything that is put in front of you because you are focused on birthing instead of signing.
  • Have your partner read a book like The Birth Partner, or Fathers at Birth, and practice the things in the book together. I frequently remind couples in my classes that “coping skills work best when they are integrated into your daily lives, not ‘dusted off’ for use during labor.”
  • Practice prenatal yoga—I love the Lamaze “Yoga for Your Pregnancy” DVD—specifically the short, 5-minute, “Birthing Room Yoga” segment. I teach it to all of my birth class participants.
  • Use the hospital bed as a tool, not as a place to lie down (see my How to Use a Hospital Bed without Lying Down handout)
  • If you feel like you “need a break” in the hospital, retreat to the bathroom. People tend to leave us alone in the bathroom and if you feel like you need some time to focus and regroup, you may find it there. Also, we know how to relax our muscles when sitting on the toilet, so spending some time there can actually help baby descend.
  • Use the “broken record” technique—if asked to lie down for monitoring, say “I prefer to remain sitting” and continue to reinforce that preference without elaborating or “arguing.”
  • During monitoring DO NOT lie down! Sit on the edge of the bed, sit on a birth ball near the bed, sit in a rocking chair or regular chair near the bed, kneel on the bed and rotate your hip during the monitoring—you can still be monitored while in an upright position (as long as you are located very close to the bed). Check out the post Active Birth in the Hospital for some additional ideas.
  • Bring a birth ball with you and use it—sit near the bed if you need to (can have an IV, be monitored, etc. while still sitting upright on the ball). Birth balls have many great uses for an active, comfortable birth!
  • Learn relaxation techniques that you can use no matter what. I have a preference for active birth and movement based coping strategies, but relaxation and breath-based strategies cannot be taken away from you no matters what happens. The book Birthing from Within has lots of great breath-awareness strategies. I also have several good relaxation handouts and practice exercises that I am happy to email to people who would like them. One of my favorites is: Centering for Birth.
  • Use affirmations to help cultivate a positive, joyful, welcoming attitude.
  • Read good books and cultivate confidence and trust in your body, your baby, your inherent birth wisdom.
  • Take a good independent birth class (not a hospital based class).
  • Before birth, research and ask questions when things are suggested to you (an example, having an NST [non-stress test] or gestational diabetes testing). A good place to review the evidence behind common forms of care during pregnancy, labor, and birth is at Childbirth Connection, where they have the full text of the book A Guide to Effective Care in Pregnancy and Childbirth available for free download (this contains a summary of all the research behind common forms of care during pregnancy, labor, and birth and whether the evidence supports or does not support those forms of care).
  • When any type of routine intervention is suggested (or assumed) during pregnancy or labor, remember to use your “BRAIN”—ask about the Benefits, the Risks, the Alternatives, check in with your Intuition, what would happen if you did Nothing/or Now Decide.
  • Along those same lines, if an intervention is aggressively promoted while in the birth room, but it is not an emergency (let’s say a “long labor” and augmentation with Pitocin is suggested, you and baby are fine and you feel okay with labor proceeding as it is, knowing that use of Pitocin raises your chances of having further interventions, more painful contractions, or a cesarean), you can ask “Can you guarantee that this will not harm my baby? Can I have in writing that this intervention will not hurt my baby? Please show me the evidence behind this recommendation.”
  • If all your friends have to share is horror stories about how terrible birth was, don’t do what they did.
  • Look at ways in which you might be sabotaging yourself—ask yourself hard and honest questions (i.e. if you greatest fear is having a cesarean, why are you going to a doctor with a 50% cesarean rate? “Can’t switch doctors, etc.” are often excuses or easy ways out if you start to dig below the surface of your own beliefs. A great book to help you explore these kinds of beliefs and questions is Mother’s Intention: How Belief Shapes Birth by Kim Wildner. You might not always want to hear the answers, but it is a good idea to ask yourself difficult questions!
  • Believe you can do it and believe that you and your baby both deserve a beautiful, empowering, positive birth!

I realize that some of these strategies may seem unnecessarily defensive and even possibly antagonistic—I wanted to offer a “buffet” of possibilities. Take what works for you and leave the rest!

I posted on my Facebook page asking for additional thoughts and suggestions and I appreciated this one from doula and educator, Rebecca:

“I think I’d tell people to stop closing doors on themselves you know? Stop making assumptions about what is possible and be open to creating new possibilities – maybe not perfect and exact but inviting in opportunity. No money doesn’t mean no doula in most cases.”

She’s right! A lot of doulas-in-training will offer free birth services, many doulas and midwives do barter arrangements or other trades, and many non-traditional birth professionals also have sliding scale rates.

Great births are definitely possible, in any setting, and there are lots of things you can do to help make a great birth a reality!

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This post was revised (from this one) to participate in… And the Empowered Birth Awareness Blog Carnival!

Woman Centered Pregnancy and Birth

Aug18

“Woman-centered childbirth recognizes the primary role of the mother, and allows labor to progress according to the mother’s natural rhythms.” —ALACE CBE training manual

Several years ago I wrote a popular and somewhat controversial post called What to Expect When You Go to the Hospital for a Natural Childbirth. The article took a look at what women can realistically expect from a “standard” hospital birth and included some thoughts on what they deserve, my conclusion being that what women can expect and what they deserve are often, sadly, very different things. The article was one of my widest-reaching pieces and it was republished on both the Unncesarean and on Navelgazing Midwife. I also converted it into an article that was published in Pathways magazine, laid out so beautifully and professionally I practically cried.

However, my idea for the post didn’t come from me alone, it was sparked by reading a similar list in the 1970’s book Woman-Centered Pregnancy and Birth, co-authored by Carol Downer. So, imagine my delight when I was contacted last month by her assistant, letting me know that they’d read and enjoyed my post and telling me this awesome news:

“We recently published the book in its entirety online at: www.womenshealthinwomenshands.org/BirthingOurBabies.html.“

That’s right, free online! Check it out!

For my conservative readers, do be aware that the book and website both come from a solidly feminist and pro-choice perspective!

“The whole point of woman-centered birth is the knowledge that a woman is the birth power source. She may need, and deserve, help, but in essence, she always had, currently has, and will have the power.” –Heather McCue

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Previous thoughts on Why “Woman-Centered” Childbirth?

Birth Customs

Aug14

“Pay attention to the pregnant woman! There is no one as important as she!”

(Chagga saying, Uganda)

The book Mamatoto is a look at birth in a variety of cultures (including the US) that was published by The Body Shop in 1991. Even though it is “old” it isn’t really dated since it is a brief overview of different customs and rituals and so forth and not a lot of statistics. There are a lot of absolutely fabulous (and fascinating) pictures and illustrations and these are the highlight of the book. Each chapter is followed by a “black page” of “facts you don’t want to know” about such things are reproductive health care policies in Romania and things like that.

One of the things that struck me about this book was that there is little distinction made between the customs of other cultures and the customs of the US. For example:

“People in Tibet believe that whether or not labour is due, a child won’t come out into the world unless the star under which it’s destined to be born is shining. Western medicine has developed a way of starting labour artificially, by injecting into a woman’s blood a simulation of the hormone oxytocin, which triggers contractions. For several years during this century, an unusual number of women laboured between the convenient hours of nine and five on weekdays…As the Malaysians say, a baby is like a fruit; it will be born when it’s ripe.”

I absolutely love seeing Western culture put into the proper context like this. Too often we see our way as THE way and forget that much of what the dominant culture views as normal for birth is not necessarily truly normal, but is instead an artifact of, or custom of, our culture. Viewed from a distance, the routines of birth in America are just interesting customs—in Tibet, born when the proper star is out, in the US, born when artificial hormones are injected…

(Since first reading this, I use the baby is like a fruit quote regularly.)

I may not be explaining myself clearly, but I find this distance in perspective refreshing and interesting. It reminds me of the work of anthropologist Robbie Davis Floyd whose book Birth as an American Rite of Passage explores the “ritual” elements of hospital birth in America and compares and contrasts the “technocratic” model of care with a holistic, woman-centered model of care (an example of which would be the midwives model of care). She asserts that there are many elements of hospital births that serve as rituals to reinforce the technocratic model (rather than to serve actual purposes, but instead to send cultural messages as well as to initiate the baby into the technocratic model). Examples of ritual elements include putting on a hospital gown, riding in a wheelchair, and having a routine IV. These elements serve to enculturate the woman and baby into a particular model–a ritual function–rather than an individually appropriate method of care.

Another example from Mamatoto that I enjoyed is as follows:

“‘Home birth’ can mean different things to different people. It can mean a bedroom, dimly lit and scented with myrr; a sweatbath perched on a Guatemalan hillside, or a birthing pool in an English flat; a warm fireside in a Himalayan kitchen; the packed-snow sleeping platform of an Inuit igloos; or a one-room shack in Jamaica, with a washing line dividing the family bed and the children waiting on the other side for a first glance at the baby who will be held up for them to see. When a woman gives birth at home, she and her family have a degree of control over the event; it’s their domain.”

In short, at home the family is in their own personal culture rather than having to adapt to the customs, culture, and “ritual elements” of an out-of-home environment.

When I think about American birth customs and culture, the first thing that comes to mind is this potent illustration from Mothering Magazine’s powerful article Cesarean Birth in a Culture of Fear, which was then published in booklet form by Childbirth Connection:

20120813-083208.jpgIn this image we see a woman immersed in the hospital birth culture found in many hospitals in the US.* She is hooked up to a potential of 16 different attachments. When I see this image, I instantly see why women might not want to “be martyrs” and thus go ahead and have any medications offered to them. It can be very difficult to stand in her personal power and embrace her own body’s rhythms and rituals when she is literally strapped down in this manner. I also think of this quote:

“Since beliefs affect physiologic functions, how women and men discuss the process of pregnancy and birth can have a negative or positive effect on the women that are involved in the discussion. Our words are powerful and either reinforce or undermine the power of women and their bodies.”–Debra Bingham

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*Note: I am fully aware that this may not be what birth looked like in your hospital, but I’m speaking generically about many hospitals in the nation.

Modified from a post originally posted at Citizens for Midwifery

Amazon affiliate links included in book titles.

A Bias Toward Breastfeeding?

Aug9

During World Breastfeeding Week, Lamaze’s Science and Sensibility blog published an interesting and thought-provoking guest post called “Instructor Has A Clear Bias Toward Breastfeeding!” The post explores a birth educator’s experience with teaching breastfeeding classes and receiving the title phrase on one of her evaluations. She is very disturbed by the evaluation and offers this profound and potent reminder: “We must not leave mothers less than whole.”

While I very much appreciate this observation and reminder, we also absolutely need to remember that biased means to exhibit “unfair prejudice”–it simply IS NOT “biased” to support breastfeeding as the biological norm and most appropriate food for babies. I was very concerned to read the comments on the post from other educators talking about their own “biases” toward physiologic birth or breastfeeding and how carefully they guard against exhibiting any such bias in their classes. Hold on! Remember that the burden of proof rests on those who promote an intervention—birth educators and breastfeeding educators should not be in a position of having to “prove” or “justify” the biological norm of unmedicated births or breastfed babies. I hate to see birth instructors being cautioned to avoid being “biased” in teaching about breastfeeding or birth, because in avoiding the appearance of bias they’d be lying to mothers. You can’t “balance” two things that are NOT equal and it is irresponsible to try out of a misplaced intention not to appeared biased. So, while I appreciate some of this educator’s points, I do think she’s off the mark in her fear/guilt and her acceptance of the word “bias.” The very fact that making a statement that someone has a bias toward breastfeeding can be accepted as a reasonable critique is indicative of how very deeply the problem goes and how systemic of an issue it is. If I say that drinking plenty of water is a good idea and is healthier for your body than drinking other liquids, no one ever accuses me of having a “bias towards water.” Breastfeeding should be no different. But, as we all know, breastfeeding occurs in a social, cultural, political, and economic context, one that all too often does not value, support, or understand the process.

This reminds me of an excellent section in the book Mother’s Intention: How Belief Shapes Birth about judgment and bias. The author also address how the word “balanced” is misused in childbirth education–as in, “I’m taking a class at the hospital because it will be more balanced.” Balance means “to make two parts equal”–-what if the two parts aren’t equal though? What is the value of information that appears balanced, but is not factually accurate? Pointing out inequalities and giving evidence-based information does not make an educator “biased” or judgmental-–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s own opinions or experiences).  (formerly quoted in this post. And, see this post for some thoughts about pleonasms.)

I do value the reminder that pregnant and postpartum mothers are vulnerable and how we speak to them really matters. I know that. I also worry that too much “tender” speech regarding breastfeeding as a “choice,” a “personal decision” and “we support you no matter what”—leaves the door wide open for continued systemic support of a bottle feeding culture that treats formula feeding and breastfeeding as similar or interchangeable. I’m not sure what the answer is. Maternal wholeness matters, so does breastfeeding!

World Breastfeeding Week Post Round Up

Aug8

I ended up writing a lot of breastfeeding posts during WBW this year and decided to gather them all together in one post, plus extras, so that no one manages to miss out!

Other favorite posts about breastfeeding:

  • Breastfeeding as a Spiritual Practice: Reflections on the intimate, spiritual connection and meditative quality of being a breastfeeding mother as well as thoughts about parenting as a (rigorous) spiritual practice of its own.
  • Breastfeeding as an Ecofeminist Issue: Why does breastfeeding threaten both feminists and the patriarchy? Why is breastfeeding a core women’s issue? And, why aren’t we more concerned about systemic barriers?
  • The Birth-Breastfeeding Continuum: From a biological perspective birth and breastfeeding are not discreet events, but are inextricably linked. Healthy breastfeeding begins with healthy birth!
  • Ode to my nursling: What it is like to nurse my baby.
  • Nursing Johnny Depp: My “classic” essay on what it is like to nurse things other than my baby…
  • Listening Well Enough: What I learned from a dream about listening to breastfeeding mothers.
  • Listening to my baby…even when we disagreed! Personal story about how I learned to listen to my baby about what he needed with regard to breastfeeding even when I didn’t like what he was telling me.
  • Inseparable: Personal thoughts about being “in dependence” with our babies.

Other great resources:

Infographic for parents (and heck, providers too!) about the first few days of breastfeeding–newborn stomach sizes, number of diapers, etc.

Ban the Bags toolkit: Great rebuttals to common arguments about the assumed neutrality of distributing formula marketing materials via medical care settings/providers as well as evidence about the link between “free” formula distribution and reduced rates of successful breastfeeding.

Resources from the Breastfeeding Taskforce of Greater Los Angeles including:

Also, you can check Baby Friendly USA to see if your birthing facility is Baby Friendly.

CIMS sent out some good WBW information about how Birth Practices Affect Breastfeeding:

CIMS is proud that the WHO/UNICEF included recommendations in the Ten Steps of the Mother-Friendly Childbirth Initiative in the WHO/UNICEF’s Infant and young child feeding: A tool for assessing national practices, policies and programmes (2003).

The WHO and UNICEF recommend that to maximize the establishment of successful breastfeeding women in labor, regardless of birth setting, should have access to the following practices recommended in the MFCI:

  • Care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s culture, ethnicity and religion;
  • Birth companions of her choice who provide emotional and physical support throughout labor and delivery;
  • The freedom to walk, move about, and assume the positions of her choice during labor;
  • Care by staff trained in non-drug methods of pain relief and who do not promote the use of analgesic or anesthetic drugs unless required by a medical condition;
  • Care that minimizes routine practices and procedures that are not supported by scientific evidence including withholding nourishment, early rupture of  membranes, use of IVs,  routine electronic fetal monitoring, episiotomy and instrumental delivery;
  • Care that minimizes invasive procedures such as unnecessary acceleration or induction of labor and medically unnecessary cesarean sections.

And, so did Lamaze:

Valuable resources and information for expecting parents, like Lamaze’s Push for Your Baby, are aimed at giving expecting parents the tools to push for the best care practices for moms and babies, including those that support breastfeeding education and awareness.

Lamaze calls out the following top five breastfeeding barriers within the first 24 hours of birth to help expecting moms prepare for the best breastfeeding experience:

  1. Unnecessary birth interventions
  2. Separating mom and baby
  3. Use of pacifiers or other artificial nipples before breastfeeding is well established
  4. Supplementing breastmilk with formula
  5. Lack of postpartum breastfeeding support

Note: on August 15, Lamaze is hosting a free webinar called Moms, Babies, Milk and the Law: Legal and Ethical Issues When Teaching Breastfeeding

And, some other interesting posts not by me:

World Breastfeeding Week Sucks According to this Lactation Consultant

While I don’t really care for the title because I think it may cause people to not even read the article, I really appreciated this IBCLC’s thoughts about the correlation between the occurrence of WBW each year and the strategic release “breaking” news about some kind of breastfeeding related controversy. Call me a conspiracy theorist, but this does in fact happen every. single. year. During World Breastfeeding Week, something comes out that causes doubt about breastfeeding or breastfeeding advocates. Maybe it is about vitamin D and how “deficient” breastmilk is, or maybe it is a trumped up “mommy wars” tale or hyperbolic call to action about not letting those mean “breastfeeding Nazis” try to tell us how to raise our babies, or, like this year, a bizarre spin on the idea that formula should not be readily distributed in large “gift packs” via our medical care system, but should instead be reserved for cases in which it is actually needed (see above mentioned notion of those mythical, control-freak breastfeeding Nazis who are out to get us all). Anyway, the LC points out this:

I really hate World Breastfeeding Week because much of the media takes it as an opportunity to attack those who wish to support mothers who breastfeed rather than celebrate their efforts to improve infant feeding. Every year I hope I will not have to read more faux feminist manifestos that denigrate the value of women who enjoy their care-giving roles. I hope I won’t have to read more junk science fishing expeditions by journalists who deliberately exclude the wide body of solid research that does show that what infants are fed does matter. This year sets a new low with the addition of outrageously false claims that New York’s City’s Mayor has imposed a ban on formula that is going to deprive mothers of their rights. –Susan Burger

And, speaking of the bizarre spin of this year’s anti-WBW backlash conspiracy, Moxie wrote a great post exploring this issue: The illusion of choice, the free market, and your boobs

If you truly care about a woman’s right to choose what’s best for her and her baby, you will take the financial pressure out of the equation, and eliminate any actions that impede free choice. Putting formula samples right next to the baby’s head impedes free choice. Having to ask for formula (just like you have to ask for tylenol, or an extra chucks pad, or another container of orange juice) doesn’t impede free choice. It doesn’t change anything for women who cannot breastfeed–they can still get those formula samples easily by asking. It doesn’t change anything for women who don’t want to breastfeed–they can still get those formula samples easily by asking. It could change everything for women who want to breasfeed but don’t have correct information or are experiencing problems they can overcome if they’re given help, because they will be given EQUAL ACCESS to information that can help them breastfeed and formula samples. They ask for help or they ask for formula. Equal access. No privilege for formula.

I don’t want the decisions I make about how to parent my children made by the highest bidder. Especially since the highest bidder doesn’t care about me and only wants my money. (Let’s not forget that those formula samples are worth about $1.50. A woman who chooses to feed formula based on those samples has just been signed on to spend hundreds or thousands of dollars on formula once she leaves the hospital. She is never informed of that. Is THAT free choice?)

I don’t care how you feed your baby. But I want you to make a decision about it with all the information, all the support, and all the help you can get. Free choice. I do not want your choices narrowed by the huge financial incentives formula manufacturers pour into hospitals. [emphasis mine]

And, as I’ve already referenced in some of the posts linked to above, Dr. Newman has a helpful article about How to Know a Health Professional is not Supportive of Breastfeeding that directly connects to the issue of formula distribution by medical care professionals. One way to know right away is if the provider distributes material provided by a formula company—even if that material is labeled “breastfeeding information.”

The lifelong impact of breastfeeding support

Aug5

I’m on a roll with breastfeeding-related posts during World Breastfeeding Week. Why stop now? This essay is an older story that was previously published in Leaven, LLL’s publication for Leaders.

Nursing Zander at our 2006 WBW picnic.

In 2006 I was in the post office — 24 weeks pregnant and holding my sleepy two-year-old, three packages, and my purse. An older woman in front of me offered to hold my packages so that I could hold Lann better. We chatted for a minute about how crowded the post office was. She glanced at my necklace then and said, “I like your necklace. Is that La Leche League?” (I was wearing my logo pendant.) I told her it was, and she said, “LLL saved me about 32 years ago.” She proceeded to tell me her story.

Her baby had weighed seven pounds, 13 ounces at birth. At his two-week checkup, he weighed seven pounds, three ounces. The doctor watched her nurse, weighed the baby, and then decreed that she wasn’t making enough milk for him. He “ordered” her to give the baby formula. She said she is someone who always follows orders. He had previously ordered that she feed the baby only every four hours and never wake him when he was sleeping. Wanting to nurse before it was “time,” her baby had been crying himself to sleep; she wouldn’t wake him to nurse when the prescribed four hours had passed because she had been ordered not to wake him. So, he was “starving to death.” She went to the store, got all she needed for formula feeding, and went home crying.

When her husband came home, the woman was still crying. He had seen a poster for La Leche League and told her, “Before you give him that stuff, call that La Leche person.” She called, and the Leader encouraged her to nurse the baby as often and long as he wanted; so she did. The baby started to perk up and gain weight, and they had no more problems. When she went back to the doctor, he said it looked like his plan was working. She said, “No, I know what really works!” and told him that she was nursing the baby anytime he wanted and that everything was going great. (The doctor then told her that his office could no longer help her and she would need to find a new doctor.) “He never did have a drop of formula!” she reported with obvious happiness. Then she told me that her daughter-in-law is expecting a baby and is going to breastfeed and that she had told her about LLL.

One of the things that stood out to me about this story is that the woman had never gone to any LLL meetings, met the Leader she talked to, nor had any further contact with LLL…and yet she still recognized the logo and felt so positively about her experience that she wanted to tell me about it 32 years later. These seemingly little contacts we make with mothers matter. They have a lifelong impact. As birth advocates and breastfeeding helpers, we may never know the potent impact of our words on a woman’s life, but someday, perhaps 32 years in the future, someone may be sharing the legacy of our own words to another stranger in the post office. Choose carefully, choose consciously, and make a difference!

Building Birth Bridges: Communication

Aug2

This post is part 5 of my CAPPA re-cap series.

The final day of the CAPPA conference I heard Polly Perez speak about Building Bridges with an emphasis on communication and fear. She described four basic communication and emphasized that communication is a two-way street.

The four styles are:

  • Expressive
  • Sympathetic
  • Direct
  • Systematic

Each style has its strengths and also ways in which it is perceived by others. You should give information in the simplest way to the person you are talking to and adjust your style of communication depending on who you’re talking to, changing communication behavior in order to improve communication. Communication is the lifeblood of all relationships.

She shared this quote:

Luke: I don’t believe it. Yoda: that is why you fail.

And she explained that listening is active, not a passive activity. Listen with empathy, openness, and awareness:“Use language that lets you share your heart openly.”

She also asserted that we must stop letting our practices be fear-based, quoting Connie Pike in saying, “We must give people the opportunity to challenge their fears. Not only will this change each person, it will change the political and medical climate in which they make these choices.”

In communicating within in the medical system, Polly pointed out that a fundamental issue is with the power hierarchy and that we must develop strategies that enhance problem solving, but still retain and support the person in power. (**I’m a little too radical, I guess, for this tip, which is perhaps why I’ve not found a niche working within a medical system and instead work outside of it.) She suggested asking yourself: What does this person you are talking to fear? She also quoted Bethany Hayes “Working in Circle” who said with regard to working in hospital climates, “we found a system that was as sick as the people it was treating.” Changing sick systems is not about subterfuge but bringing light to situations that need to be altered.

Polly then made an observation that I found very powerful and very telling:

We have taken the hearts and minds out of much of our work because we’re frightened of getting too close. But, close is where we need to be.

Yes.

During a different session, but closely related to this topic of communication, I laughed out loud watching this video clip of twin babies communicating with each other. I’m going to use this in future classes.