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 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. 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.

Book Launch!!

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.

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

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.

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)