Wednesday, June 9, 2021

Knife's Edge - Life is Suffering

Today, I am grateful for the Edge. My gratitude alphabet is moving slowly, and I got stuck at E for Edge.

I like to live on that knife edge, where you never really know what's going on, but where you're so keenly aware of the Mysteries that life is always interesting. I get really, really sad sometimes, along with being really, really joyful, and what often keeps me balanced is the thought that "life is suffering". This means that whatever happens, if it's good, is a gift, and if it's not good, well, life is suffering. So you never really expect that things will be excellent, and then when they are, you're pleasantly surprised. 

So, how can we keep the joy in our hearts? And how can we keep our feet from being cut as we dance on the knife's edge?

  1. Open your mind. Maybe you're wrong. Maybe you're right. Whatever the case, it's not worth building fences.
  2. Keep on loving.
  3. Remember, you're always at a crossroads. There is no easy chair you're gonna sink down into.
  4. Keep on moving.
  5. Be attentive! With all six of your senses. Open up as much as you can, and say yes when it's time.














Stay loving. Keep dancing. Play on the edge. 

Sunday, May 30, 2021

Grateful for Dogs?


Even though I have a punk-rocker scar on my head where no hair grows from being bit by Skippy when I was a year and a half and I though it was my ball but clearly he thought it was his - and he paid dearly for his mistake! But anyway, even though that, and a huge scar my mother always had on her elbow from a badly trained guard dog in Uganda, even though these bad dogs bit us, I am now very grateful for dogs and in particular for Stella pictured above. She has taught me about unconditional love, playing, guilt, and determination.

Ok, there we go. So I'm grateful for D for Dogs.

But what I really wanted to talk about was D for Dreams. How we are molded and folded and ultimately completely remade by our dreams. How our dreams make us what we are and in turn we remake our dreams to fit the new person that arises whenever a dream turns sour or gets different, as dreams do.

My first dream: I wanted to dance forever on the sand, wearing little clothing and having the constant presence of my Ayah who loved me (but of course now I realize that she must have had a whole other life and that her caring for me and loving me was only part of the colonial myth that my parents were living).

My second dream: After getting yanked from Uganda to Calgary where it snowed and people wore a lot of clothes, I had a dream. My dream was to be an astronaut. I studied the planets and the stars, bought a telescope, kept a journal where I marked the positions of the stars, built model rockets, and made a small spaceship in my closet where I would head off to space every so often.

My third dream: Adolescence is a bitch. I realized life was hard and no one really knew the truth. I decided it would be a good idea to change the world. I thought I would like to be a doctor.

Then, things went crazy, life intervened, I travelled, had babies, married, and decided I wanted to accompany women in childbirth.

My Birth Dream: 

I studied midwifery and obtained my Certified Professional Midwife qualification. I started studying in 1988, when I was pregnant with my third son. I continued my distance studies for ten years, and then started working as a doula. In 2004 I started the CPM program, and in 2014 just after my mother died, I passed my final exam and became a professional midwife.

Yay!

Except ... except that I had miscalculated and I hadn't really grasped the reality of having a CPM qualification in Canada, where legislation requires midwives to be university trained in order to be licensed in order to work legally.

And now here's the big question: who wants to work illegally as a midwife? If midwifery is actually illegal, you can hone your skills and use your technologies such. as they are (Pinard horn, fetoscope, doppler, palpation, suturing skills, episiotomy if necessary, cord cutting and the like), and then if you really need to, there's always the hospital where you can pretend to be the birthing woman's friend.

But in a situation where midwifery actually is legal but restricted, that makes it much harder for anyone to actually monitor a mother and baby when things start to move outside of the norm. And, despite all sorts of people's convictions, I believe there is a norm that birth usually happens within. There's a certain time span when the woman feels certain things, when baby descends and then emerges. Within that norm, there's a ton of variation, and within that norm there's no need for intervention at all. But when things stretch outside of the normal, that's when the restrictions become dangerous and that's when our hands are tied. Because there are always women, and even more so now that Covid restrictions have made homebirth even harder, there are always women who want to birth their way, in their own home, with whomever they want present. And they call me to ask if I will be their "fly on the wall" in case something happens.

What? How can I fly do anything if the shit's hitting the fan? Granted, shit doesn't tend to unfold at a normal birth.... well of course meconium happens sometimes and mamas poop... but that's not what women are asking me to do.

Let's just use logic here: 

  1. First, let's remember that the original "concept" of the modern doula was the result of a flawed study on maternal-infant bonding. One of the researchers had provided verbal support to the mothers she was observing, and those mothers had quicker and easier labours. So I guess if a mother is planning a "fly on the wall" kind of birth and she wants someone present to encourage and reassure, then she might want to hire a doula
  2. What shit might hit the fan? What are women afraid of? I've asked women and they tell me they're afraid of hemorrhage, of the cord being around the baby's neck, and of something happening with the placenta. Partners are afraid the mother and baby will die. But if a woman is actually worried about these things, why would she place her trust in someone who is actually not allowed to do anything about it? Or does she think that her perfect birth is worth that other woman's livelihood, marriage, and possibly her home?
  3. The unassisted births I've heard about either before or afterwards are those where the mother and her partners decided to give birth either on their own or with select family or with a doula present. NOT with a trained by handcuffed birth attendant. 
There are tough choices to be made, all the time, in the land of the living. I myself always seem to be figuring out exactly how to live on a knife's edge. Yes, I provide prenatal guidance and support. Yes, I have been a "fly on the wall". Yes, I train doulas to accompany mothers to the hospital. Yes, I will tell you that I believe you should call your doctor, or get to a hospital, if I think that is right. No, I don't believe that nature is particularly gentle. No, I don't trust women's bodies. Not after millenia of patriarchy have inflicted deep, deep wounds on our abilities to recognize when it's right and when it's wrong. 

Would I risk everything for a birthing woman? I have and I will. But not for random shit that's hitting a fan that we ourselves turned on. 

Today, I am grateful for Dogs.

Saturday, May 29, 2021

Chaos

Today I am grateful for Chaos. My gratitude alphabet is moving slowly this time around because ... well, because of chaos. 


But actually what I really wanted to talk about here was this:


Ok, let's pretend we don't see the grammatical errors. Sorry to sound like an uptight bitch but I am so upset. Ok, here we go.

Sentence 1: I'm just going to ignore the first question, because that is a huge question and one that I'm trying to answer in a thoughtful and mindful way. So, if anyone actually wants to talk about that, and it's certainly worth talking about, then I respectfully invite you to enter into dialogue with me, but on my terms. Those would be no anonymity, no name-calling, no threats of violence, no libellous claims.

Sentence 2: I do respect people's chosen names and their pronouns. If someone came to me asking for my birth services and wanted to be called whatever, and whichever pronouns, I would absolutely respect their wishes and call them whatever they wanted. "when you go by an alias". Honestly, this phrase fills me with anger, shame, and dread. Anger, because I chose to use my "alias" to write and publish the original post, precisely because no one knows me by my former name and I didn't want to hide behind it.
Shame because Rivka Cymbalist, the name, has roots in a very dark time in my life. Toni Morrison actually had the same problem with her name. She had already divorced Morrison when her first book was going to press, "...I called the publisher and said, oh, by the way, I don't want Toni Morrison to be on the book. And they said, it's too late. They've already sent it to the Library of Congress. But I really would have preferred Toni Wofford." https://www.npr.org/2016/01/22/463901896/i-regret-everything-toni-morrison-looks-back-on-her-personal-life

Dread, because of sentence 3 below. 
Sentence 3: This really gets me because, actually, very few people who know me know that Rivka Cymbalist is not my birth name. Rivka was a name that a rabbi dreamed up for me twenty years ago when I was part of an ultra-orthodox cult. Ok, Cymbalist is my married name which ok, I get that we take our husband's names. But only people who knew me before 1997, or people who were actually part of that cult.... know that Rivka Cymbalist is my pen name. Why did I keep it? Because it's the name everyone knew me by in the birth world, where I have made a difference to very many women and their babies and their lives, by supporting them through birth. So I keep it, like a pet you never really liked but don't want to put down.

Sentence 4: Holy shit! I preach? Nope. 
Respectful maternity care? Yep.
"left a mother with unresolved retained placenta for four hours" This is Libel.
"went to your room to pray" Another clue that the (anonymous and cowardly) writer of this critique might be part of a religious cult, otherwise why would they think I would pray?

Be very clear, whoever you are. This is libel. You have just accused me of doing something that I never did.

Sentence 5: Let's just not bother with this. Ok, I will just mention that in fact the only time I ever used blue and black cohosh tincture was in a hospital with a patient under an OBGYN care who had asked me to try to induce "naturally". The patient had her BP checked every half hour and was under careful supervision. Those herbs are powerful!

Sentence 6: Well, there's so much wrapped up in this question.... let's just say that neither I nor the obstetricians I used to work with are in the habit of leaving a woman to die of infection or hemorrhage.

Chaos is in our blood. It's part of our mystery. It makes us human. As a mother, a wife, a friend, a human .... as a birth companion, a healer ... I try to embrace chaos as much and as often as I can. I try to live on the knife's edge because I've found that if you don't, you get bitter, and you get cut. 

Criticizing others is part of the way that we grow as humans and as cultures. But anonymous, hateful criticism, full of lies and darkness, scares me and although I know that this too is part of the chaos we live within, I'm sad.

So, today I am grateful for chaos.



Saturday, May 15, 2021

Birth Portals

 Today I am on the second letter ... and that would be B, and B stands for Birth Portals.


This was posted on Instagram by @catearth76 and it is so true! But, and I am so full of "but..." and "wait a minute..." and "sorry what?..." these days, but what about those women who don't use that portal to birth their babies?

No, I'm not talking about how wonderful gentle cesarean is and how it's so great that we can lie on the surgical table and do skin-to-skin. Neither am I talking about women whose babies might have died if they hadn't been intervened with.

I'm talking about women who are pushed, coerced, bullied, lied to, manipulated, scared, threatened into agreeing to surgical birth for their babies when there really wasn't any good medical reason for it. This is a fact, it's real, and it's happening in a hospital near you. Especially now that Covid restrictions have made it impossible for a woman to bring the support she needs into the hospital or birth center, and it's made medical workers much more jumpy and afraid.

What is the actual spiritual damage that is done to that miraculous portal when a baby is yanked out through a surgical cut nowhere near the portal? How can we repair that damage? How can we repair that damage to babies, to women, and to the world? 

This is a question I've been struggling with for decades. I started working as a doula in 1997, and I truly thought that accompanying women to the hospital and providing doula support was a valid option. And, yes, I did have a pretty decently low c-section rate (around 10 %, compared to 25% at the hospitals I attended births at). But watching these births wore me down. Watching intelligent, adult women being lied to and treated like children (actually, since when was it fine to manipulate and bully little children?) hurt my soul.

I quit attending births for a while, for various reasons. And now I've started again, and I'm very clear that I only will accompany women who want to KNOW that they hold a sacred portal between their legs, and they WILL NOT be bullied into messing with it. This is my own bias speaking, partly because I wasn't strong enough to do that - I let every Tom, Dick and Harry and their female counterparts bully their obstetric, know-it-all, fear-mongering way into my obstetric activities. And the reasons behind that are many and unsolvable and complex. But I believe that the way I work now is the way to open up that sacred power, so that women can come back to the recognition of their own selves and their own bodies.

Women contact me at various places in their pregnancy journeys. Since I have been back in the practice, I have spoken with women who want me to walk with them throughout their pregnancies, and others who have called me during pregnancy, during labour, or after giving birth. 

When I walk with a woman through pregnancy, we meet online every week and speak for an hour. Sometimes we could talk about books, or what seeds they're planting. Other times we talk about how the pregnancy is progressing, or where they've decided to give birth, and whom they want around them when they're birthing. We talk about their fears, dreams, desires. We try to plan the kinds of support they will have after the baby is born, and they try to imagine what life will be like when they're responsible for feeding and providing for their new baby.

Sometimes we talk about stuff that's happening in their lives, either in the present or in the past, and how that will affect their birthing. Serious abuse in the past affects how we live in the present, and it can definitely affect our ability to reach deep within to find the power it takes to open that sacred portal. Fighting and anger in the present can sometimes mean that a woman no longer has a home where she can feel safe to give birth in, so that is another hurdle for her to jump over. Physical challenges and illness can also affect our body's ability to give birth, but these are rare. Often women worry too much about the physical aspects of pregnancy and birth, and they don't consider the emotional and spiritual weight of their pregnancy, birth, and parenting.

So, I try to walk with a woman and her family through this important time in their lives while maintaining an open spirit and an open heart. My open heart reflects with theirs and together we can find a place where that shy but powerful portal will open. Women are being cut open for no reason. Placentas are being pulled out with no reason. Women are not listened to when they say they have a pain, for no reason. Women are being ignored when they say they are scared, for no reason.

Or, wait, is there a reason? Who could want to keep that portal scarred and closed? Who could want to stop that power from being unleashed in the world? Who could want a world where we all remembered that we are all birthed through a sacred, fiery, spiritual, creative, awe-inspiring portal? Who might be afraid of a world that was held together by witch power and magic? 


Oh, so I forgot - this is a gratitude note! So I am grateful for Birth Portals. I'm grateful for witches, for womanhood, for love. I'm grateful for the circle of women who surround me and protect me. I'm grateful for the moon and the stars.

Monday, May 10, 2021

A Cautionary Tale

I'm starting another Gratitude Alphabet. I first did one back in 2014, after my mother died. I think now is the time for another one: this past year has been foggy and strange for everyone, and sometimes we need to remind ourselves we are grateful.

I'm starting this alphabet with A for A Cautionary Tale.

In January 2020, I decided to start a run streak. That means that I would run at least a mile every single day. I ended up running a total of 1,111 miles during that year, and it was good. It helped me get out of the house; it gave me my much-needed solitude - living with a houseful of related males was fun and sometimes too much; it kept me fit.

In January 2021, I realized that my foot hurt pretty badly. And my muscles were cramping all the time: something was up! I am lucky - I have a family doctor, so I called her up and she sent me for an x-ray of my foot.

The day after the x-ray, I got a scary call. Severe Osteoporosis! No running, huge amounts of calcium and vitamin D, and a bone scan. I also added in some magnesium as I knew that the balance of calcium and magnesium needed to be maintained. My muscle cramps disappeared. My foot continued to hurt. I spent February sitting on the couch in the evenings having a drink (never more than one). Exercise wasn't happening. Oh, yea, I did the Plank Challenge. I can plank for two minutes. 

Bone scan happened. Three weeks passed! That's several different cocktail recipes. I wondered if I would ever be able to run again. Foot hurt. I got a fancy gizmo to wear on my toes. I was still on my feet every day working at my cafe.

March. My doctor calls me and says Oooops, weird. No osteoporosis, in fact my risk level is very very very low. I didn't bother asking why they said at first that I had the severe osteoporosis. Maybe because I'm 64, or who knows. Anyway, I don't have it so that's great! I started running again, short runs. I still want to do a 50k for my 65th birthday. But ... I am running very, very slowly. I feel weird when I run. Sluggish. I wonder if I have Covid. I can't seem to make my muscles move properly, but I'm not tired. Just "sluggish".

I kept running and decided it's the price you have to pay for taking an injury break. My running group leader said that it's the price I have to pay for doing a running streak. I'm just not convinced. Everyone's telling me different things, but none of it really adds up to how I'm actually feeling.

I teach a doula course. One of the main values that guides my practice, as a birth companion and as a teacher, is that we really only have our senses to guide us in this practice. One of our most valuable senses is the sense of intuition. I was chatting with one of my students about her main project, and she randomly mentioned that she takes magnesium at night after a stressful day: it helps her muscles relax and helps her sleep.

The next day, I stopped taking magnesium. A few days after that, I went for a run. I felt so different! I was back to my normal self! Yes, I'm not a fast runner, but I'm surely not a tortoise. I was literally poisoning myself with magnesium because of a suggestion that my doctor had made, on the basis of a false diagnosis!

My advice to you: 

  • Know your body. If it feels weird, then it is weird. Something's wrong. If someone tells you something is happening in your body that just doesn't seem right, then try and figure out what's going on. 
  • Be careful! Don't take supplements, herbs or anything unless you are very sure that it is safe and useful.
  • Trust other people, but not 100%! Even a doctor can be wrong sometimes.
  • If you're an older woman, perhaps a run streak isn't for you. Since my streak, I have been intrigued by how much of our advice in the sports and athletic world (and nutrition, and medication, and medicine...) is based on the adult male body. Women, especially older women, need to train differently from men. They have more stamina, but they burn energy differently, and most importantly, they recover differently. I was doing myself a disservice by emulating my heroes' run streaks, as I wasn't actually listening to what MY body needs. My body needs a day every week to recover and rest. 
I am grateful today for my healthy body, for the time I have to spend, for my lovely doula students.... oh, I am going way beyond A... tomorrow will be B.

Sunday, April 11, 2021

Cesarean Awareness Month

It's funny they would have a month for a surgical operation. I have the same feeling about Black History Month. Like, if it's important, shouldn't we learn about black history every day we learn about history? Like, shouldn't the history books be rewritten? They're certainly biased....

I digress. Let's deconstruct history another way:

Pithiviers, France, is remembered by some French Jews as the place where their relatives or friends of the family were sent after the Nazis occupied France. There was an internment camp there where families were separated and the adults were sent to Auschwitz to be killed.

We also remember Pithiviers as the place where Michel Odent was head of the maternity ward from 1962 to 1985. Here, he fashioned his notions of natural birth, by creating an environment where women could give birth in an undisturbed way. He provided singing sessions during the prenatal period, birthing pools, and skin-to-skin contact after birth.

Years ago, I was part of a group of birth workers who brought Dr Odent to Montreal to speak. I remember being so shocked when he suggested that there was a causal relationship between the murder and violent crimes rates in some cities in the world, and the cesarean rates. Effectively, he was suggesting that if you have your baby by cesarean, then they are more likely to become a violent criminal. I immediately took a dislike to him and his silly ideas, and, more importantly, I asked myself why there was a whole room of healthy, young women absolutely worshipping his words? There he was, a shrunken old white guy, talking about how babies needed to go through the vagina and arrogantly proclaiming that women who have cesareans are going down the path to hell, and dragging their newborns along with them.

Fast forward a few years and I was up on the stage. We were doing a little panel about VBACs. A woman stood up from the audience and said that she was newly pregnant with her second, hoping for a vaginal birth after a brutal c-section with her first. She wanted advice from a midwife on the panel. This is what she got: "If you want to give birth vaginally, you have to put your big girl panties on and fight for what you want."

And I remember teaching a class to a group of doula students, and the woman teaching with me said that, generally, women who have repeat cesareans have a lot of unprocessed resentment to deal with, and if they dealt with it their chances of VBAC increases. 

So, in a nutshell, three birth professionals said: women who birth their babies by c-section are driving up the crime rates because their children are more likely to be criminals (also, in an article he wrote in 2008, Odent suggested that cesarean birth may produce more male homosexuals); that women who want a vaginal birth after a previous c-section should somehow grow up so that they can achieve this; and that women who have c-sections may be dealing with repressed feelings, and that repression or other negative feelings such as resentment could be the reason for the surgeries.

If we look at these criticisms from a feminist perspective, they seem very similar to the rape dilemma - don't wear provocative clothing, don't go out at night alone, don't drink, or you will become a victim.

There's a feeling amongst the "natural" birth movement that a woman can have a "natural" birth if she wants it hard enough. We can read of powerful, transcendent, wild, free births where a woman moves through portals to meet her child. These are lovely, indeed, but not everyone can have or would want to have that experience.

In my opinion, giving birth is a very private act. It is so varied, the ways in which we birth, almost as varied as, for example, the shapes of our noses, or the leafiness of our labia. Some women want to birth alone, or just with their partner present. Others want their children there too. Some want a doula or two, and a midwife. Other women prefer a physician, and they want to be in a hospital. Some want to have a midwife follow them, and they want a water birth in the birthing centre.

All of these possibilities should be respected as valid, informed choices. So why are they not? Because, often, if a woman chooses to be followed by a medically trained midwife or a doctor, she ends up giving up her right to informed choice and she gets put on a conveyor belt where she is no longer the central person in this sacred, primal event, and she gets things done to her. The birth process gets put on a schedule; the body is examined time and time again; this or that intervention is done until finally all the options have been exhausted and she is wheeled into the operating room.

Yes, having a doula present will decrease your chances of c-section by a decent percentage, especially if you are a mid- to high-income woman living in an affluent country (https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003766.pub6/full

Women choose to go the hospital to have their babies for many different reasons, and none of these reasons are an excuse for an unwanted and unnecessary c-section. What could these reasons be? 

  • they want the security of being in a hospital
  • they wanted to have a midwife follow them but couldn't find one
  • they don't have health insurance and/or can't afford a midwife
  • they don't have a home that is suitable for a home birth (think abuse, living with a lot of other people who aren't supportive, and those kinds of things)
  • they don't know their options
  • they are forced to because no one will attend them at home because they're carrying twins, or have had several c-sections, or they're obese, or are substance abusers
  • they are followed by a midwife but get transferred to the hospital because of government regulations (labour too long, pregnancy too long, suspected this or that)
  • covid-related issues reduce their choices
Any number of these women could end up being part of the 25-30% of women who give birth in the hospital who end up with a c-section. The WHO suggests that 15% is a reasonable rate. I insist that here in our affluent country, a c-section rate of 5% would adequately save the lives that have to be saved by obstetric surgery.

How can you avoid an unwanted c-section? Ask questions. Hire a doula, or find one for free. Contact me and I will do my very best to connect you to the people you need. Find a midwife. Get a doctor who hears what you're saying. Say no. Don't do anything that seems wrong. 

Let's work together to put the Cesarean section back where it belongs - in the realm of emergency surgery!


Monday, April 5, 2021

Blast from the Past


You know when you decide to do some spring cleaning and before you know it you're deep in yesteryear, smiling over some things, scowling at others (how did I ever think that colour suited me?!?) ... well, that happens to me all the time with my writing and I've been doing a cleanup, getting my Doula Program running better (now that it's virtual I have more to play with but less at the same time...).
Anyway one of my most amazing yesteryear memories was the 13 years (2003-2016) that I was honoured to lead the Montreal Birth Companions. If you read StarHawk's Truth or Dare, you will realize why an anarchist such as myself made structural errors in designing an organization, so that when a seismic event like a sexual assault or even a power struggle hit the structure, it crumbled. People don't do well with anarchy in action, and so my beloved MBC died a natural death. BUT when she was alive, she was powerful, strong, and the MBC doulas literally changed so many women's lives with their kindness, skill, love, and caring.
So, here's a trip down memory lane. 

And if you're in the mood, give me a shout and we can start her up again! There are always, always women in need who cannot afford to pay for a doula. This blog post is from 2013:

provides free doula services, prenatal and postpartum support, and resources for refugee, non-status, and other marginalized women in Montreal.

We are in need of birth companions ... please contact me if you are willing and able to devote some time to our worthy cause.
If you are a doula and you can donate one birth every six months to MBC, we would be happy to have you on board!
We are looking especially for birth companions who are fluent in different languages. We would love to have more doulas from our diverse Montreal communities. We welcome everyone who has an open heart and is willing to donate their time and energy.

The women we serve appreciate the companionship, support and kindness that her doula provides. Women come from many backgrounds, walks of life, stories and histories. But the birthing year is the same: we want to give birth to a healthy baby, and we would like to have that experience to be filled with joy. This is not always possible if it is a sad time in the mother's life, but the presence of a birth companion can help spread the love.

We have clients from all around the world. Right now we are serving women from: Algeria, Haiti, St. Vincent, Germany, India, Nigeria, Philippines, Mali, Senegal, Guinee, and Quebec. Next month, we could receive requests from China, Cameroon, Mexico, the US, or Russia ... we never know where our clients will come from or when they will find us. We have had calls from women in their first trimester, and from women in labor!

Many midwifery students try to gain experience as interns in other countries. Volunteering for MBC is a way that doulas and aspiring midwives can gain experience working with women whose cultural attitudes and lives are very different from their own. It is a way that these doulas and aspiring midwives can really understand that the birth experience is universal, and that accompanying a woman in labor transcends language and reaches across boundaries.

photo used with permission