Monday, October 31, 2011

Seven Billion!!

I heard today, as many of us did, that the world's population is estimated to have reached 7 billion people!

Let's not speak of low resources, climate change, and gloom and doom, but let's celebrate this 7 billionth baby's birth with a cheer and a toast, to good health, happiness, and longevity for us humans. I'm sure we can find a way to make it all work.

More interesting to me is the likely fact that this baby was probably born at home, with the attendance of a traditionally trained midwife. I do not advocate going back in time to the days when women died in childbirth, but I do believe that home is the best place to conceive and the best place to give birth. I offer a vision of birthing the future from my book:

My vision is one of most women giving birth at home, with full medical back-up available to them if needed. Midwives would provide prenatal care and accompany the laboring women through labor and birth. They would assist with the postpartum period and help the new mother adjust to life with a new baby. If there were problems, the midwives would refer the woman to a doctor, who may in turn refer her to a specialist, an obstetrician. Full emergency support would be in place for the rare occasion that it is needed, so that the midwife would know that she is covered in the case of an emergency. 
The women who chose to give birth in the hospital, in my dream world, would be there because of clear medical or social need. The hospital birthing centers would provide specialized medical care for the few women who need it. Occasionally, there would be a woman who needs the extra emotional support of a doula, but the doula would be well-integrated into the hospital system and would be on call in these situations. Sometimes a woman would want to give birth away from home, and she could go to an independent birthing center which, again, would be fully supported in case of a medical emergency. 
I do not believe that this vision is so far off in the future, or that it is out of our reach. For now, however, our reality is that most women in the developed world are giving birth in hospitals, and many of these hospitals have different philosophies about birth than many of the patients they are there to serve. In Canada, the philosophy of any hospital must be to provide the best care for the greatest number of people. This may translate into an epidural for every woman, especially if there are not enough nurses to support each woman individually. In the USA, hospitals are run as profit-making enterprises, so the word philosophy may not apply. We do know, however, that cesarean section rates are skyrocketing, and that the general consensus is that a national rate of about 15% may be optimum. Personally, I believe that the rate for emergency cesarean sections can be held to 5% without putting the mothers or babies at risk.

The doula is the interface between the birthing community and the medical establishment. This puts us in a difficult position. I have spoken to  women who thought that I would leave them to give birth alone if they decided to take an epidural (this is beyond cruel). I have been yelled at by a physician who thought I had removed an intravenous drip (the nurse hadn’t had time to put it in). I have been looked upon as a knight in shining armor (I don’t even like horseback riding) by women who had not yet understood that the birth work is done by the birthing woman.
     I have also been thanked and cherished by hundreds of women who have been happy to have me by their side as they go through the experience of giving birth. My task, our task as doulas, and in a bigger sense, our task as human beings in the 21st century, is to “humanize” birth. To me, that means affirming that all of us are different, and that we all have needs, desires, and histories that cannot and should not be judged. My job as a doula is to create a space in which a woman can reclaim her knowledge of birth and give birth according to her own birthright.

Seven Billion!!

I heard today, as many of us did, that the world's population is estimated to have reached 7 billion people!

Let's not speak of low resources, climate change, and gloom and doom, but let's celebrate this 7 billionth baby's birth with a cheer and a toast, to good health, happiness, and longevity for us humans. I'm sure we can find a way to make it all work.

More interesting to me is the likely fact that this baby was probably born at home, with the attendance of a traditionally trained midwife. I do not advocate going back in time to the days when women died in childbirth, but I do believe that home is the best place to conceive and the best place to give birth. I offer a vision of birthing the future from my book:

My vision is one of most women giving birth at home, with full medical back-up available to them if needed. Midwives would provide prenatal care and accompany the laboring women through labor and birth. They would assist with the postpartum period and help the new mother adjust to life with a new baby. If there were problems, the midwives would refer the woman to a doctor, who may in turn refer her to a specialist, an obstetrician. Full emergency support would be in place for the rare occasion that it is needed, so that the midwife would know that she is covered in the case of an emergency. 
The women who chose to give birth in the hospital, in my dream world, would be there because of clear medical or social need. The hospital birthing centers would provide specialized medical care for the few women who need it. Occasionally, there would be a woman who needs the extra emotional support of a doula, but the doula would be well-integrated into the hospital system and would be on call in these situations. Sometimes a woman would want to give birth away from home, and she could go to an independent birthing center which, again, would be fully supported in case of a medical emergency. 
I do not believe that this vision is so far off in the future, or that it is out of our reach. For now, however, our reality is that most women in the developed world are giving birth in hospitals, and many of these hospitals have different philosophies about birth than many of the patients they are there to serve. In Canada, the philosophy of any hospital must be to provide the best care for the greatest number of people. This may translate into an epidural for every woman, especially if there are not enough nurses to support each woman individually. In the USA, hospitals are run as profit-making enterprises, so the word philosophy may not apply. We do know, however, that cesarean section rates are skyrocketing, and that the general consensus is that a national rate of about 15% may be optimum. Personally, I believe that the rate for emergency cesarean sections can be held to 5% without putting the mothers or babies at risk.

The doula is the interface between the birthing community and the medical establishment. This puts us in a difficult position. I have spoken to  women who thought that I would leave them to give birth alone if they decided to take an epidural (this is beyond cruel). I have been yelled at by a physician who thought I had removed an intravenous drip (the nurse hadn’t had time to put it in). I have been looked upon as a knight in shining armor (I don’t even like horseback riding) by women who had not yet understood that the birth work is done by the birthing woman.
     I have also been thanked and cherished by hundreds of women who have been happy to have me by their side as they go through the experience of giving birth. My task, our task as doulas, and in a bigger sense, our task as human beings in the 21st century, is to “humanize” birth. To me, that means affirming that all of us are different, and that we all have needs, desires, and histories that cannot and should not be judged. My job as a doula is to create a space in which a woman can reclaim her knowledge of birth and give birth according to her own birthright.

Tuesday, October 18, 2011

Clean and Sparkling

It has been a bit of a difficult time for me recently. It's not smooth sailing once you get grownup - the old questions still haunt you and as your children grow, you see that they are haunted as well, and life goes on. Was I ever going to make peace with myself? See the truth? Figure out what it is all about?
When I am troubled, I turn to housework - at least the house can be sparkling and all the material things in their places, and a brightness to the air, a fresh smell, even if your soul is in turmoil. The other day I was hanging out the laundry.
There's the laundry line - and there are most of the people I love.
But they had gone back to their respective tasks, and I was alone on the hill, stretching the clothes and cloths tight so as to maximize the sun and wind's potential to dry and brighten the material. And the smell of the laundry soap, the smell of the wind, the feeling of the sun on my face; the feel of my son's anima in his work jeans that he left - the memory of the day on the beach in that Sponge Bob towel (who on earth left that here?); and then I remembered that, of course, we have been hanging out our mens' clothes for decades, centuries, dare I say millennia? And the love, peace, and longing that is there in our hearts as we birth them, raise them, and love them, is there for me in the simple act of hanging out the stuff they wear, the material they lie and dream in, the T-shirt my son wears when he wants to look good, when he wants to attract and maybe take part in the next generation of love and longing.

Laundry hung, I went in to prepare lunch. And I chose to cook some of the potatoes that "Mountain Lady" brought us from her garden. When I say garden, I mean that in the loosest term. A patch of forest, dug and planted, stolen from the wild boar, badger, and deer. And of course, as I peeled those mountain tubers, I felt again that sense of stretching back. It wasn't just me, who finished lunch and went to check my emails. It was also the beauty who was hiding in a cellar, the sailor, the old lady preparing a potato for her husband, the new bride who could only boil.

Giving birth is that way. I met a couple yesterday who were looking at my book, and they started telling me their birth stories - aggressive and rude midwives, cervix closing up, the man feeling impotent....

Giving birth, doing laundry, peeling potatoes, these are our tasks, and they are begging to be done with attention, with presence. Do not give these tasks away to others! Peel a potato! Fold the laundry! Take back your own birth and do not allow rudeness, aggression, or ego in your birthing room! All of the women through history will accompany you as you labor.

Clean and Sparkling

It has been a bit of a difficult time for me recently. It's not smooth sailing once you get grownup - the old questions still haunt you and as your children grow, you see that they are haunted as well, and life goes on. Was I ever going to make peace with myself? See the truth? Figure out what it is all about?
When I am troubled, I turn to housework - at least the house can be sparkling and all the material things in their places, and a brightness to the air, a fresh smell, even if your soul is in turmoil. The other day I was hanging out the laundry.
There's the laundry line - and there are most of the people I love.
But they had gone back to their respective tasks, and I was alone on the hill, stretching the clothes and cloths tight so as to maximize the sun and wind's potential to dry and brighten the material. And the smell of the laundry soap, the smell of the wind, the feeling of the sun on my face; the feel of my son's anima in his work jeans that he left - the memory of the day on the beach in that Sponge Bob towel (who on earth left that here?); and then I remembered that, of course, we have been hanging out our mens' clothes for decades, centuries, dare I say millennia? And the love, peace, and longing that is there in our hearts as we birth them, raise them, and love them, is there for me in the simple act of hanging out the stuff they wear, the material they lie and dream in, the T-shirt my son wears when he wants to look good, when he wants to attract and maybe take part in the next generation of love and longing.

Laundry hung, I went in to prepare lunch. And I chose to cook some of the potatoes that "Mountain Lady" brought us from her garden. When I say garden, I mean that in the loosest term. A patch of forest, dug and planted, stolen from the wild boar, badger, and deer. And of course, as I peeled those mountain tubers, I felt again that sense of stretching back. It wasn't just me, who finished lunch and went to check my emails. It was also the beauty who was hiding in a cellar, the sailor, the old lady preparing a potato for her husband, the new bride who could only boil.

Giving birth is that way. I met a couple yesterday who were looking at my book, and they started telling me their birth stories - aggressive and rude midwives, cervix closing up, the man feeling impotent....

Giving birth, doing laundry, peeling potatoes, these are our tasks, and they are begging to be done with attention, with presence. Do not give these tasks away to others! Peel a potato! Fold the laundry! Take back your own birth and do not allow rudeness, aggression, or ego in your birthing room! All of the women through history will accompany you as you labor.

Thursday, October 6, 2011

Illegal Midwives part 2


 The bureaucracy in Quebec has decided to remove another hurdle for women who choose to give birth at home without the support of a registered midwife. There aren't enough birthing centers or registered midwives to go 'round, so more and more women are giving birth "unassisted" or with the attendance of an unregistered midwife.

The women who choose to have their babies at home with  "illegal" midwives pay a price: registered midwives are free, paid for by provincial medical insurance. The other midwives charge around two thousand dollars for their services, which is a great deal as it includes sometimes months of prenatal care, personalized and attentive labor and birth attendance, and comprehensive postnatal support.

They also pay with hours of bureaucratic nonsense, when it comes to getting their new baby a birth certificate.
It may be that raggedy old hippies or sneaky foreigners on tourist visas come to mind when you are imagining the women who choose this route. But they are more often highly educated, professional women who are used to doing things "their way" and do not want to go outside their own home to give birth.

I have heard stories of women being threatened with the police and child protective services if they did not present themselves and their hour-old baby at the hospital to do their paperwork.  This new directive is a small fairy step in the right direction:
Quebec bureacracy

Monday, October 3, 2011

Killer Mama

The other day, yesterday in fact, we lit the woodstove for the first time and stayed inside like the two children in the Cat in the Hat and watched the rain. Of course there was laundry and cooking and homework and computer tasks and all that, but when it's pouring outside you do feel like you are just sitting looking. And it did pour, great grey poodles of it.

So when the ten year-old suggested a movie, we adults jumped to it and we all set off to see Spy Kids, even though on one site it had a dismal rating of three. Movies are great! Especially when it's wet and cold, and it's a matinee so you know you aren't spending thirty dollars, if you include a drink (what am I saying - a drink for two people for four dollars?). The warm smell of popcorn, everyone running in without their raingear on yet because it's still October, kids yelling, a young man with his older parents laughing and joking with the cashier. To the movies!

Spykids is about a step-mom who is actually a spy. The step-kids are having trouble with the blended family and ... don't want to spoil it for you. But the most hilarious scenes are at the very beginning, when spy-mom is beating the bad guys, seriously beating them - don't mess with the spy-mom. The thing is, though, that she's about to give birth to the blended baby - product of the new marriage.

This is a bizarre scene presents a beautiful sexy yummy-mummy, dressed in tight leather with belts and things, pregnant and actually in labor, beating off the bad guys with high-powered karate kicks. She says things like "I still have time"   kick, whirl ... "my contractions are still only three minutes apart"... jump, punch, kick, ..."was that my water breaking"?

She leaves the bad guys lying on the ground (kids' movie - they just fall down, no muss, no fuss) and hops into a conveniently waiting ambulance. Next scene, she is rushed into the hospital where she disappears into a room and all you can hear are terrible screams of absolute deathly pain, then whaaaa! A baby!

Oh, dear. I can't begin to unravel the cultural tangle that I observed yesterday in that movie house.I don't know why we are so interested in the image of beautiful women acting aggressively and why we try so hard to silence them in labor. Why don't most women say "My contractions are still only three minutes apart?" 

I do know, though, that I was laughing the loudest when I saw that lovely woman being physical, upright and downright active in labor.