Tuesday, October 12, 2021

Birth and the Fourth Trimester

With all the fuss and bother these days about where women are going to give birth and what will happen to them when they get there, or if they stay home if they will have competent support, or if they're giving birth on their own if they've prepared enough spiritually to accept whatever may or may not unfold ... with all the conflict and controversy about who is vaccinated and who isn't, and what restrictions have  or haven't been put in place been put in place ... with the removal of the woman from the center of the birth experience and the forgetting of this vital fact ... most importantly, we have forgotten that after the pregnancy and birth, there is usually a baby! 

Many, many women find themselves at home after their baby has been born, without much idea of what to do, what they should do, or how to do it. Personally, I was lucky. I came home after fairly difficult experiences with my hospital births, and the breastfeeding went exceptionally well, and my maternal instincts led the way. But over the years, I've seen that my experience isn't common, and I'm moved now to do as much as I can to teach birth companions and doulas about how to provide care during those important hours, days and weeks after the baby is born.

I'm teaching a course on this important time that will be starting on October 26. That's a Tuesday, and we'll be meeting online every Tuesday evening from five to eight pm EDT for eight weeks. The course covers what we will usually see during these days and weeks; how we can use all six of our senses to care for a new family; we will explore elemental ways of nourishing; we will be taking a good look at the family, the motherbaby dyad, and the newborn mother to truly understand how best to increase pleasure and strength during this seminal time.

Breastfeeding is a big part of many women's experience, so we will learn about that. But it isn't everyone's, so we'll look at other options. We need to learn about how to do proper housewifery: cleaning, cooking, tidying, calming. We will be exploring some uses of herbs and food. I am hoping that the members of our class will bring their own talents to share with us.

Please let me know if you would like to join us!

Tuesday, September 14, 2021

Home Can Be A Tower

I'm thinking a lot about home, and what home means to us. We moved our family to a medieval tower in 1988: it was the beginning of a long series of adventures, some cool and exciting, others devastating and dangerous. I pulled the Tower card this morning for my reading, which can mean change in a fundamental way. It can mean the destruction of one home and the creation of another. It can signal the breaking down of old habits and patterns to make way for new: an eruption, a revolution.

I work alongside women who are thinking deeply about how they want to give birth. Most of them want to birth at home, and many of them do. Last week, one of the women I have been working with over the summer gave birth at home, peacefully, in her place, with her partner alongside her. She came back to the city from abroad because she felt the need to give birth "at home". She didn't just mean in her own apartment, on her own bed. She meant "in her home". She missed the smells of her city; the bicycles; the streets and trees of the place she knew - she knows - as her own home.

When I am invited to accompany a woman during her reproductive experience, whether that is pregnancy, birth, miscarriage, abortion, infertility experiences, or the decision whether or not to have children, I try to facilitate a way that she can work her way back to her "home". We all have a centre place, a home, that we need to be able to return to. When we can't return, we get lost. We get lost in other peoples' needs and desires. We get lost in addictions. We get lost in our jobs. We get lost in cleaning up. We get lost in the search for money or new things. We get lost and then the Hungry Ghost finds us and we feel empty all the time, and hungry, and we don't even know what we are hungry for. But the answer is, we're missing our Home.

I've never felt I had a geographic home. I moved from one continent to the next all my life: Africa, North America, Europe. I love the Canadian Rockies. I feel at home when I'm on a trail. I love the desert. Give me temperatures at body temp or higher, and I'm happy. Then again, I love the challenge of a 20 k run in 20 below zero. 
But I wouldn't say I have a home, like, I don't feel "at home" anywhere. I am at home when I'm with any number of my five children and their spouses. I'm at home when I'm running a long distance. I'm at home ... when I'm on a plane, looking down at my planet.

I listen with awe to people who speak of missing their home, how they miss the taste of a place, or the feeling of the wind on their faces in their home place. My journey is different: because I've never felt the geographic pull of home, I seek to find my centre, and I accompany others on their own journeys to their centres. When a woman is birthing in her centre, she is birthing at home. When she gives birth in her power, at the centre of the event, she has found her home. My job is to navigate with her so she can find the path home. Sometimes there are huge prickly trees in front of the entranceway. Sometimes her home is very small, so small she can trip on it at night. Sometimes she needs to lose something in order to find her home. Sometimes she needs to let go of one place to journey to the other.


Sunday, June 27, 2021

Makeup for an Old Tomboy

You all probably know by now that I am a new grandma!!! I can't believe I am actually allowed to say that, but yes. It's true. I feel like it's a gigantic rite of passage, and an honour, and more joy than I thought I would be allowed.. but yes, the wheel is turning as it should. And I am growing older and my children are now having children. As it happens, as it should. So be it.
My moon cycle ended when I turned fifty, or rather, the bleeding part of it, because of course I am still led by the moon and she still affects my body. But the miracle of bleeding every month has passed, and it passed with a dramatic few months when every 23 days or so I would lose what seemed like a bathtub full of deep rich blood.
I gained a lot of extra weight after I had my fifth child at 44. I was miserable, and I was eating too much and badly. I was lonely and out of my element. I felt trapped and disgusted with myself. The younger smarter woman would have left the trap she found herself in, but the older and slower one didn't.
But it was fine, because then I started to run, and run, and run until in 2018, on Mother's Day, I ran 26.2 miles. I felt great! I have always been the type of person who wants a physical challenge: back when I had a farm and four little boys I would always be physically busy. Even being a birth companion is physical. But running long distances is the best! So I just kept running. Every day.

But then Covid happened, and although I kept on running, I entered into a new phase of my relationship with my body.

Maybe because I was always running alone. Maybe because I hurt my foot so I had to take a break. Maybe because my Covid stress came out this way, but I started going through the same kinds of feelings many of us go through as girls when we start to reach adolescence. I remember being so terribly shy; so embarrassed about myself; so uncomfortable with my new breasts.
And suddenly, at 64, my infernal mask started giving me a rash on my face that looked suspiciously like my teenage acne. I started feeling self-conscious when I was out running, sure that people were looking at me and wondering why the plump older lady was lumbering down the street with a running watch on. The nightmare of adolescent self-consciousness started to mix and match itself around in my head, until I realized that I had the answer.

I've never worn a lot of makeup. My mother wore it, but she never passed on any tips. I went through a heavy black eyeliner look when I was a hippie, and then when I flirted with punk. But mostly I love lipstick. I've always worn it - every different color from the lightest pink through deep red to almost purple, and a lighter orange for the summer. 
Covid meant that my lipsticks all disappeared into a drawer. I was wearing it for a while at the beginning until I realized that lipstick plus mask makes a mess. I've been going out every day into the world feeling somehow... naked? 

That's what Covid has done to us. We're all feeling naked, or something close to it. Threatened, maybe. Either by the virus itself or by peoples' reactions to it. People are acting wonderfully and awfully. The best of us has come out, and the worst. Our reality has been jolted, as it is when we go through a life change like puberty, pregnancy or menopause. We've been pushed out of our daily routines, our habits, the familiar ways we used to interact with people.
So I feel self-conscious and weird. So does my friend and my neighbour, and even the young woman at the gas station. We're wearing our masks, and no lipstick, and many of us have gained some weight especially around the belly because of our extra high cortisol levels.

But I think I am seeing a little pinprick of light at the end of the tunnel. I see people interacting in different ways, and trying to create a new, better place for us to live. Of course, I could equally go the darker way and note how much more oppression and repression and basic bullshit there is, which is undeniable. The social media have made us worse as a species, not better. But let's say things are getting better. Let's say every "smile with the eyes", every kind act, every time someone went out of their way in the tiniest way, let's say those little things did add up to a mountain of change, and let's say we are moving to a new er and better "normal". 

Most birth journeys include pain, or at least a few moments of .... to call it discomfort is to minimize it ... ok, let's call it intensity. Most of the birth journeys I have witnessed have had several of these moments: before, during and after the child is born. Maybe this is a time of birthing change. Maybe we are birthing a new world, and the intensity and transition that we all feel is part of it.

But lipstick helps. 


Wednesday, June 16, 2021

The Language of Loss

The word "miscarriage" implies that somehow the carrier fucked up. The woman's body wasn't effective in "carrying" the fetus to a healthy end: a live birth. "They" say early miscarriage, that is, before about 10 weeks, happens in around 15% of all pregnancies, but I don't know how you could really tell since many very early pregnancy losses would be interpreted as a heavy period.

Anyway, this word "miscarriage" started to be used in the context of pregnancy loss in the 1500s. A more useful word is abortion: "ab" is a prefix that indicates that something didn't happen; "-ortion" comes from "oriri": I rise, get up. I appear, become visible. I am born, come to exist, originate. So, an abortion doesn't place blame on the carrier, it just names what happened, that the baby didn't come to exist.

Many women who suffer pregnancy loss keep it to themselves. They don't tell their stories, either because they feel ashamed that they lost the baby, or because they're worried about what other people will say, or because they don't know how to express the grief they feel. Women who decide to have therapeutic abortions, also, keep their decisions private, don't know how people will react, and don't know how to express the real emotional fact that although they decided to end the pregnancy, they still feel grief.

The reasons for early pregnancy loss are mostly unknown. Some causes could be a lack of progesterone, an embryo with chromosomal malformations,  an ectopic or abdominal pregnancy, and other reasons that remain a mystery to us. Later pregnancy loss is even more of an unknown and usually the result of an abnormality that would be incompatible with life. Unfortunately, intimate partner abuse is a recognized cause of pregnancy loss up to and including the late third trimester, as are other forms of trauma.

There are studies and statistics that talk about all of these things, but basically when it happens to you, your statistic boils down to 100%. If you've never had a pregnancy loss, it shoots down to 0%. Most women during a normal reproductive life will be pregnant a few times, have a live baby or two, and lose a couple of pregnancies, either on purpose or not. 

But the reality of losing a pregnancy, especially a later one, is something that women don't talk about much, and that means that when it does happen to you, you feel like you have nowhere to turn. People don't know how to react: they'll suggest that you should've taken certain vitamins, seen a different care provider, or done yoga. They won't know how to deal with your grief. As a whole, this society is awful at coping with any kind of pain, whether it be physical or emotional. So losing a baby is just one of those things it's best not to talk about.

Baby Magic, the podcast, is a place where women tell their stories. This week I spoke to Laura about her son's birth during her second trimester, and about how she and her family coped with the loss, learned from his birth, and what she believes women need during this difficult unfolding of the childbearing year.

Baby Magic Podcast

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.


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


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.