Monday, May 30, 2011

Doula Breakdown

Last week was a week full of difficulties and ruptures - it wasn't a rapture, silly, to quote my dear friend Syd...

All sorts of very difficult things happened to a lot of people I know, and by the end of the week I was just wondering what was going to happen next. And then, after a rather difficult labor and birth, a proud new grandmother hugged me and said, "This is the happiest day of my life"!

It was the same day a very gentle and wonderful woman in our family passed away, so it was especially poignant to me to see the paradox of being alive with such clarity.

A couple of months ago I called one of my apprentices to let her know that our client was in early labor. She said she just couldn't come with me - literally that minute she had broken up with her boyfriend. I let her know that this is something that happens - the doula's life goes on, and even if something disturbing is taking place in your life, you can still put that something in a box and go to take part in another woman's joy without reserve, clean, fresh, and open.

How do we do this? I have spent many taxi rides doing just that - letting go of my worries about one of my sons, or the fact that my husband and I had planned a much-needed evening together, or what that strange phone call was about from my dear friend. I let it go, and I try to concentrate on the woman I will be attending, and her needs.

Sometimes the doula does have to take a break from doula work in order to concentrate on sorting out her personal issues. I remember several years ago when a doula called me in tears because her husband was not happy with her being away at nights. She chose to move to a different area of maternity care and is happy doing childbirth education and staying home nights. I personally take a break every summer and turn my energies to creating a different sort of life in a very different environment. That life may include birth one day, I don't know right now, but I do know that I am happy without my pager when I am working the cement mixer up on our mountain.

Just fixing everything up here with a little love, some words, and a dab of cement!

Wednesday, May 18, 2011

Michel Odent in Montreal

Michel Odent came to town the other day, and I was very interested in finally hearing him speak. I first heard about him when I started learning about natural birth, twenty five years ago. His accounts of natural birth and his respect for the birthing woman seemed legendary among some circles, so I was eager for a first-hand impression.

The talk took place in a huge imposing building, on a cold, windy, and rainy night. The hall was a good size, though, so the audience was packed in and everything seemed cozy. I saw three or four men in a huge sea of women, and there were enough babies there to make a considerable noise at odd moments during the talk.

As a radical old feminist, I was uncomfortable with the dynamic of the evening. Here were over one hundred women, of all shapes and sizes and ages. One lady wore a head covering; a couple of ladies were different colors. And here is a man, old enough to be our father, or even our grandfather, telling us about what our bodies could and couldn’t do! And we were all lapping it up, eager to ask questions, eager to be spoken to by the expert.

I appreciated one point that M.Odent made. He said that the traditional midwife not only is witness to the births of generations of babies, but she is also the transmitter of information from generation to generation. We tell the younger women we attend what we know about birth, about babies, about children, about how to treat your man, about herbs and healing, about grief and dying. I feel the weight of that responsibility every time a woman calls me to ask a question. We are the keepers of woman knowledge. We keep knowledge in our breasts, in our uteruses, in our scars and in our hearts.

M. Odent spoke of the nature of natural birth, and the difficulties women in our culture have with the process of natural birth. “Natural Birth” has become a buzz word, a goal, and through and because of this popularity, it is becoming more and more misunderstood.
I agree so far. I agree with M. Odent that a truly natural birth is a birth during which a woman is simply giving birth. A birth during which her body takes over, when she has no more control over it than when she is digesting her food. The body takes care of itself. The baby wants and needs to be born; the uterus obliges by making contractions, the cervix opens, e violĂ ! We have all witnessed births like this, and we do well to identify these births as normal and natural. A first time mother usually takes about 6 to 8 hours to birth, and multiparas take much less time.
I agree as well with M. Odent’s suggestion that the presence of the woman’s husband (does that include lesbian women’s partners?) can actually have a negative effect on labor. About one third of all the births I have attended have been with women whose husbands stay out of the birthing area. These women tend to give birth effectively and easily, but there are other factors involved.

So what is the problem? Why do we have women laboring for days in the hospital? Why do the babies not come out? How can all these babies get stuck? Why is our surgery rate so high? Why does everyone else end up with a second-degree tear?
M. Odent says that a woman needs to be able to labor within a protected environment, where her neo-cortex is not activated with silly questions, and she feels free to do what she needs to do. Every doula knows that this is part of what we try to provide for the mother when she is laboring. If we are at home with her, we like to rest in the armchair as she labors. If we are in the hospital, however, the dynamic changes and we do need to become protective of the birthing space. For this reason, we like women in labor to go to the hospital as late as possible in their labor, which gives her body a better chance to get into the birthing mode, with full-on oxytocin and triple shots of the birthing cocktail.

M. Odent stated that “oxytocin is timid”. I disagree. I believe that characterizing oxytocin, which is thought of as primarily a female hormone, in this way, is to do women yet another disservice. Oxytocin isn’t timid! I have watched so many women birth their way right through all sorts of ridiculous situations, with their oxytocin going strong. I have seen women answering questions and filling out forms while their oxytocin gets the baby ready to be born. I’ve seen women pushing in the elevator, with people asking them if they need a wheelchair.
No, oxytocin is not timid. There’s something else happening here.
Let us remember that in this world, as soon as you observe something, it changes. So whatever you are witnessing at a birth has been changed by your act of observing. The less we observe, the better off the birthing mother will be. If I am there with a woman, as her friend, sister, or mother, I can mitigate that difficulty by entering into the birthing woman’s world.

M. Odent went on to decry the masculinization of childbirth, and suggested that our culture’s obsession with a dysfunctional sexuality is at the root of the de-naturing of childbirth. Again, I take exception to this interpretation.
Let me propose another explanation:
We live in a hypersexualized society, where young people are expected to have their first sexual encounter before they turn sixteen; where Viagra is advertised on prime time TV; where any seven-year old can access movies of sexual acts on a cell phone; where marriage is temporary and our private sex life is grist for the public mill.
At the same time, though, real sexuality, the vibrant, living, and intimate communication with one another, is shunned and feared. Pictures of breastfeeding mothers are banned from Facebook, and regularly purged. A long and fertile marriage is caricatured on national radio (“Who wouldn’t need Viagra when their wife is old and wrinkly?”). Women in labor are silenced with epidurals or breathing techniques.
Our culture is afraid of childbirth. Men have always been afraid of birth – remember, only the woman knows who the father of the baby really is. The miracle of birth - bizarre, shocking, and extraordinary – is difficult for men to accept. They are shaken by it. It moves them in ways they do not appreciate.
But how can I say what men feel? Who am I to theorize about how a man feels when he sees a baby come out of his wife’s vagina? How can I, as a woman, presume to imagine what a man feels at this elemental time of his life?

We are a culture full of fear. We are afraid of terrorists, of viruses, of weight gain, financial ruin, cancer, mold, in fact, we are afraid of our own shadows. We have been “rimbambolito”, reduced to doll-like proportions, by our media, by the conclusions we have drawn, by the absence of real mothers and fathers. Women in particular need to grow up, and we need to take back our own voices and our own bodies. If a man feels the need to take Viagra, so be it. If he tries to tell you that your own body is “timid”, shout him down.
Birth is powerful, duh.
Women are strong. Life is good.

Monday, May 9, 2011

Mother's Day?

Well, yesterday was Mother's Day and what a week it was! It started out with a birthday party - last Sunday was my youngest son's tenth, so we took a crew of little boys out and about and then home for cake and fun. Monday was his actual Birth Day so that was busy too. I always get a little sad on the birth days but I didn't have a chance.
I spent every other waking minute working on a very exciting project proposal that involves mothers and babies in Africa. Keep tuned and I will definitely let you know what happens. So I was working like crazy on the proposal when, Thursday morning, two out of my 6 clients for May called to say they were in early labor. Of course - couldn't do it next week, on separate days. By Thursday night they were both having good contractions, so I went to my first-time mother's absolutely beautiful natural birth - just a wonderful birth, a wonderful family, and all...the only thing that rang a slightly jarring tone was my pager that kept beeping and muttering. I snuck into the bathroom every so often to call for backup but I really wanted to make the next lady's birth. Baby was born, and they new parents said "Go! Go on, we're behind you! Go give that other mother some love!" So I rushed out, got a cab, and Baby #2 was born soon after. A triumphant VBAC after two cesareans. Yay!!!
Back to work on my project. Very excited at the possibility that I may be able to give back to Africa what Africa gave me (life, the spirit of adventure, a sense of rhythm, love of heat...). Then my best friend, husband and partner found out he had to go out of town. Now I know most modern people spend lots of time apart but we don't. We are usually together. So for him to go away for two days is a BIG DEAL. And he left on Mother's Day, at 7am.
But what a wonderful day - all sorts of giving and loving from my five sons. A sunny day, a bike ride, the kids messing around with the mechanical stuff in the driveway. A postnatal visit to a happy mother. Homemade brunch including pancakes, pasta salad, apple tart, salad.... all made by the chef (22 y.o.) and his ten-year-old assistant. Then a barbecue at night.
Mother's Day is for loving - and mothers are for loving - and let us try to open the doors to all that love and leave not one mother behind.

Monday, May 2, 2011

La Mamma!

I was lucky when I had four little ones, because I lived in Italy, a country world-renowned for its art and culture. What? You are imagining I took my four rambunctious boys to the museums? No! The museums came to us ...
There was one image that was always around, and that was the image of a mother and child. Everywhere I looked, when I first arrived in Florence with my oldest, who was then a babe-in-arms, was an image of a beautiful woman with a baby on her lap. The religious details didn't mean anything to me - but the beauty of that image moved deep into my soul and colored much of what I believe about mothering.
I was honored back then. It was a generation that wasn't too reproductive, and we made up for it by having four boys each two years apart. Everyone looked at me with admiration, though they thought I was a happy fool. A peasant once drew me aside to ask me if I knew about "the pillola" - the little pill. I was happy in my ignorance and enjoyed the fertility of that life.

I look at my clients here in a city that is under snow much of the time, where children are considered a nuisance, and the best times are when mom and dad get to go out on their own, and I admire those women I meet who devote their immense energies to being with their young ones. I work with women to achieve their optimum birthing experience, but often I find I am giving support after the baby is born and named - when the mother wants assurance that she is doing the right thing by holding her baby when he cries, or she wants her baby to sleep with her, or she keeps her two year old home from daycare. It is hard enough being a mother without having to cope with everyone else's ideas about what you should or shouldn't be doing. If only we could honor mothers just for being mothers! I felt I received that honor, when my boys were small - no one knew who I was or where I was from, but when they saw me with my children, they congratulated me. I was fulfilling the honorable task of raising babies.

To the mothers having and raising babies! To the women who support them!