Conspiracy

Conspiracies abound: are we are being controlled  by giant lizards? No, most of us would agree that we are not. Is the exhaust from planes flying above the Italian skies affecting the Italians, making them doll-like and unable to oust Berlusconi? A surprising number of seemingly rational people I have met actually believe this. Did man reach the moon? What evil was behind 9/11? Is Big Pharma out to drug us all, whilst stealing our life savings?

Of course not! We are rational, sensible human beings. Then why do we believe that the simplest task needs a multitude of experts? From conception to birth to early childhood education and beyond, we are confused and abused by lowly-qualified experts telling us which way is the right way.

The Birth Conspiracy is this: an understanding, created by all of us, that we cannot function without experts. We cannot give birth without birth experts. We cannot labor without assistance, without classes and checklists. We cannot make our own decisions, or accept consequences for our own actions. It is a way we can avoid responsibility for our lives. Those of us who are experts want and need to control the process. It is very hard to sit on your hands and wait while a woman labors. It is much easier to interfere, to preach, to suggest, and to control.

The doula sits uncomfortably on something between a fencepost and a pillar here, protecting the birthing woman from well-meaning experts who do not understand the truth about birth. She is in great danger of becoming an expert herself, and there is only one way for her to prevent this from happening. She should gain as much knowledge as she can about the birth process and how it unfolds in different environments. She should take this knowledge with her to every birth, to every meeting, to every workshop. With all of her knowledge and experience, she needs to remember only one golden rule, that is, that the woman she is accompanying is going through HER experience. The doula can hold her hand, literally or figuratively, but she needn't teach, judge, or convince. Then she is overstepping the bounds of the Birth Companion and becoming just another expert.

Just Visiting

I have always traveled a lot. From the time I was born I have traversed oceans, flown in small rickety planes over the desert, walked through Africa, hitchhiked countless times back and forth across the country I found myself growing up in. I love to see how we humans live our lives. Do you know, at this very minute, there is an old lady walking through a chestnut forest, on her own, looking for mushrooms that she will dry for the winter? And there is another woman, cooking a small pot of corn meal over a fire made from waste crude oil she collected from the stream near her home. She is waiting for her husband to return, annoyed with him for keeping her waiting but full of love for her man. On a train, there is a family from Belgium, staring at the immensely beautiful scene that is spread before them.

The life of a tourist is a hard one. There you are. You have saved for this small chunk of time for a while - perhaps all year. You are in a place where you probably don't speak the language. You don't know the customs. The food is different. You suspect you are getting cheated most of the time. You miss your own bed. The place smells funny. Your spouse has decided that it is NOW that you have to figure out your problems. The children are either sick or adolescents.

But the place is beautiful! You don't have to get up early! You are really in love with your spouse, especially when you get some time alone to walk on the beach in the moonlight. You imagine selling everything and moving here. You would wear comfortable clothes every day. Your wife would wear those sexy sandals and that little dress. Your kids would be all tanned and happy.

It doesn't usually work out that way though.

I live in two places these days. Most of the time I am in a big city, and for three months I am on top of a mountain far away from everyone. I always imagine I will spend those three months really sorting everything out. I will come back all transcendent-looking and calm. But, like the midwives say, meconium happens, and life does tend to keep going. The vacation, the holiday, the three-week all inclusive, ... it's all just life, and why should it be otherwise?

And so it is in life, it is in birth. It is one of the most important days of a mother's or father's life - and of course the most important day of a baby's. But at the same time, life does continue, before, during, and after. So, as in life, it is not the hugely transcendent, mind-blowing experience that it is the important thing. It's not the orgasm, the blinding flash of out-of-body-ness, that is important. It's the quiet, day-to-day, pleasant (yes, even when you're in labor!), humdrum traveling that is important. Let us turn to Cavafy for some wisdom:

Ithaka

As you set out for Ithaka hope the voyage is a long one, full of adventure, full of discovery. Laistrygonians and Cyclops, angry Poseidon—don’t be afraid of them: you’ll never find things like that on your way as long as you keep your thoughts raised high, as long as a rare excitement stirs your spirit and your body. Laistrygonians and Cyclops, wild Poseidon—you won’t encounter them unless you bring them along inside your soul, unless your soul sets them up in front of you.   Hope the voyage is a long one. May there be many a summer morning when, with what pleasure, what joy, you come into harbors seen for the first time; may you stop at Phoenician trading stations to buy fine things, mother of pearl and coral, amber and ebony, sensual perfume of every kind— as many sensual perfumes as you can; and may you visit many Egyptian cities to gather stores of knowledge from their scholars.   Keep Ithaka always in your mind. Arriving there is what you are destined for. But do not hurry the journey at all. Better if it lasts for years, so you are old by the time you reach the island, wealthy with all you have gained on the way, not expecting Ithaka to make you rich.   Ithaka gave you the marvelous journey. Without her you would not have set out. She has nothing left to give you now.   And if you find her poor, Ithaka won’t have fooled you. Wise as you will have become, so full of experience, you will have understood by then what these Ithakas mean.

Translated by Edmund Keeley/Philip Sherrard. (C.P. Cavafy, Collected Poems. Translated by Edmund Keeley and Philip Sherrard. Edited by George Savidis. Revised Edition. Princeton University Press, 1992)

Passing of a Wonderful Lady

My aunt was a wife, a mother, an aunt, a grandmother, and she loved to have fun, to entertain, to laugh.
She liked to have happy people around her so, to that end, she was happy and always had a smile waiting.

She didn't have it easy. She was widowed suddenly and too early. She had health problems from when she was in her forties. But she always had a positive attitude, and wasn't kept down for long.

A few weeks ago, she spent the day with her lifelong best friend. They did what old friends do, talking and traversing their time together. In the afternoon they came home and got themselves ready for dinner. They got dressed up, and gave each other pedicures.

They went out for dinner with a group of friends. After drinks and the first course, my aunt put her head down on the table and left us.

She is gone but remembered with joy. All of us should hope to go out like she did, not with a bang, not with a moan, but with a gentle sigh.

Birth Companion Doula Course

Birth Companion Doula Course

A knowledge-based, hands-off approach to accompanying woman during the birthing experience.

I am very excited to propose a new series of courses designed to assist women to attend births as companions, as friends, as knowledgeable and respectful assistants.

I will not be training or offering anything novel or out of the ordinary. We will be developing our innate skills as women - patience, kindness, strength, care - and these skills will lead to confident, non-judgmental companionship.

The courses are thirty hours and of varying schedules, and they are priced reasonably. The participants will receive lessons and interactions on theory, practice, and healing during the childbirthing year.

The first of these will take place in Montreal in mid-October 2011 and several are upcoming internationally throughout 2012.

Places will be filling up fast so if you are interested in attending please let me know as soon as possible.

Illegal Midwives?

"Illegal" is a word that brings to mind outlaws, bandits, drug runners, hoaxters and jails. I prefer to use the word "underground" when I am talking about the midwives I know who are working outside the (extremely limited) system of registration, colleges,and paperwork that is in place in most of Canada. I joke that they are underground - they'll only assist a woman in an underground parking lot or a basement. Ha ha.

In fact, the women working outside the system are not allowed to assume the title of midwife or sage-femme, which is why many of them describe themselves as birth attendants or even as birth activists. The Montreal Gazette's story about this phenomenon presents some bare facts and portrays a sympathetic, sensible woman who has chosen to assist women who would otherwise be giving birth in a hospital with a doula, or alone at home. Not so say that giving birth with a doula isn't the choice that most women ultimately make. The doula's job is often a difficult one, because of this. She has to straddle compromises that are often unbearable to watch.

"Brave" and "courage" are often words I hear about the women who choose to give birth at home with a qualified, if "illegal", attendant (or "stupid" and "selfish"). But I think a woman is much braver who knows exactly the kind of treatment she may receive in a hospital, after she has already had an unnecessary cesarean section, and chooses to go back into that environment with a doula at her side, in the hopes that she will be able to give birth with dignity and autonomy.

The sad thing is, birth shouldn't have to be about bravery, about ego, about choices, the law, surgery, or drugs.Here is an excerpt from my upcoming book:

The other day I was at a birth. My client was a third-time mother and she didn’t want to be in the hospital for too long, but her previous two births had not been that short. So as she kept in touch during the day I agreed that she didn’t have to rush to the hospital. It was mid-morning when she decided to go, after having a bath and making sure her kids were settled. When the doctor examined her, she was almost ready to give birth. The birth proceeded very quickly, and afterwards, the obstetrician said “Oh, ladies like you will put me out of business!”

I would like to be put out of business. I would like the system to change so much that the privately hired doula is a thing of the past. Certainly, there will always be women who do not have anyone to accompany them at their birth, and for these situations we will have the volunteer doula associations that already exist today. 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 women 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 21^st 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. 

I fully support those women who choose to give birth at home, who choose to assist others at home, and who choose to follow a different path. My only condition, however, is that birth attendants keep their egos, their pride, and their ambitions out of the birthing room, and indeed, out of the process. That way, knowledge of the craft can be the highest priority, assessments can be made honestly, and difficult decisions are not clouded by personal needs.

Two of the most famous midwives, Shifra and Puah, were "illegal"; they disobeyed the Pharoah of Egypt to assist women at home ... power to the women who follow in their footsteps! May we merit to be midwives to a better way of giving birth.

WWOOF Italia

I got a call from Ninni the other day. She was the first Italian Wwoofer we had years ago on our farm. Her and her boyfriend drove up from Sicily, held hands while they picked stones from the wheat, which I then ground and made our bread and pasta, and were generally a lot of fun to have around. Even though I could hardly understand a word of what Ninni said when she got excited and slipped into full Sicilian.
Talking to Ninni got me reminiscing about WWOOF Italia, and thinking about volunteers and the difference they can make to people’s lives.
We bought a crumbling stone farmhouse and seven acres of land, part vineyard, part wooded, with a pond and a spring, when I was expecting my fourth child. What a time those boys had! When we were in the fields or up on top of the roof, they were fighting battles, rafting in the goose-ridden pond, and making wooden schooners next to the chicken coop.
We had many helpers over the years. Our youngest was a seventeen year-old from England who came, took one look, and asked to be taken back to the station. Our oldest was a lovely woman who had done with family and children, and wanted to explore the world. They helped weeding the garden, picking grapes, building stone walls, cutting hay, … in return for a place to stay and three good meals a day.
Wwoof has changed over the years. In 1991 there were two or three hosts, now there are hundreds. The typical host was like us: lots of children, a small mixed farm, no money, and lots of energy and determination. There are still many hosts like we were, but there are also large “agriturismos”, which use volunteers to change beds and set tables.
And the volunteers have changed too. Back in the day, they were mostly travelers, or people in search of a different lifestyle, or curious about farming, or wanting to get away from their city-based life. Now, especially in the summer, we are inundated with young tourists, who are looking for a cheap place to stay, and consider a little farm work to be a good way to get some exercise. Winter is generally better, when tourism is down.
Still, it is a good way to get experience, and a wonderful way to meet people, and learn or practice languages. The hosts still benefit from a helping hand, and tolerance and generosity are generally the order of the day.

Rites of Passage

Today is my birthday - I am 55 years old. I am finally a grown up. It didn't happen when I was fifteen and I left home. It didn't happen when I was twenty-five and met my true love. Neither did it happen when I had my first child at twenty-seven. Nor when I had my fifth at forty-four. It just suddenly happened on the long stroll up to fifty-five. It feels good!

L'chaim! To life - I hope you all have a wonderful birthday day.