Birth, Life, Love, Breastmilk...

I know, I know, that title does not have a ring to it. Cut me some slack, I am recovering from pneumonia.

I had to come up with something to say as I find myself in a new profession. It's hard to admit to hanging up the doula hat. Even if I never take another client or go to another birth (which is unlikely) being a doula is not just what I did. It's who I am. Which is so strange to say, really, as I always considered myself someone who would float from thing to thing forever. But after five years of tending to moms and babies, I can honestly say that the profession has intermingled with the personal. I mean really, no one does doula work for the money or the glory. It's just not that kind of job.
All the months of ignoring this blog were because I was uber focused on finding a new job, and I had no idea what it was to be. I leave my old life not for lack of love for it, but for money, honestly, and professional advancement. If I want to take over the world I have to get going! I am almost 34! In any case, I accepted a great position at a local hospital doing lactation support on the mother-baby unit. I will have the opportunity to help lots and lots of families and hopefully, after a year, will have enough hours to sit for the IBCLC exam. Pretty exciting stuff.

Note to self: do not trust "feelings"

I though it was going to be good. I really did. When I got in the car Bob Dylan and Coldplay came on the radio back to back, and I thought, gee, this is a good sign. I was feeling happy.

When we got to the hospital, mom, a young primip was already at 8! We were all elated, and I was thinking how great this was for her, that that was what the universe had in mind for her.

2 hours later she had an anterior lip. 6 hours after that she had an anterior lip. A little pit, an awesome midwife (or 2) and 4 more hours of pushing later, she had a baby girl. No epidural, lots of joy. A happy family.

Then the doc, as he was stitching up her tears, says, what's that going on with your uterus? She ended up having a uterine inversion, which for those of you that are lucky enough not to know, is a rare emergency where after delivery your uterus ends up inside out trying to come out of your vagina. It is very serious. I would love feedback from any of my midwife and doula readers who have any experience with this. So mom is rushed to the or, lost lots of blood, will be in the ICU for three days unable to see baby, nurse, bond. It's all just very maddening and sad.

This is exactly why I went to work for BOLD. The little picture of birth is just too emotionally draining.

Off to Bend to see the BOLD performance. Let me know if you'll be there too.

A new season for all

Well, tomorrow is the first day of kindergarten for the big one, and the first day of preschool for the small one. I myself am off to a birth, the first after the summer off. Looks like it's time for change for us all.

This birth feels like it's going to be good.

If you give a woman an epidural...

A doula from Minnesota wrote this hilarious spoof on "If you give a mouse a cookie." I love it!

If you give a Woman an Epidural...


If you give a woman an epidural, she'll need a big bag of lactated ringers to go with it, the lactated ringers will keep her blood pressure from plummeting when she gets her epidural, but it will also swell her tissue with excess fluid so her legs and breasts will swell and she'll be shedding water weight for days if not weeks. The fluid in her breasts will make it hard for the baby to latch on at first, so the nurses will think the baby's not able to nurse and they'll recommend some formula, just until the nursing goes better, this will probably make mom feel insecure and crappy about her mothering skills and it could interfere with bonding.

After the epidural's in, she'll probably need a catheter because she won't be moving around much anymore, and hey! she can't feel anything below her belly button anyway! If she gets the catheter, she might get a urinary tract infection to go with it.

Once she gets the epidural and the catheter, even with the extra fluid, her blood pressure might drop anyway in response to the medication she's getting, she might get some epinephrine which has the following common side effects:

Anxiety; difficulty sleeping; dizziness; fearfulness; headache; nausea; nervousness; paleness; sweating; tremors; vomiting; weakness.

If she's unlucky she might even experience these side effects:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fast heartbeat; irregular heartbeat; wheezing.

If she gets the fluid, the epidural, the catheter, and the epinephrine, the baby might not respond very well, so the doctor will want to know what the baby's heart rate looks like all the time, and the doctor will also want to see whether mom's contractions are strong enough to dilate her cervix, so an electronic fetal scalp electrode will be screwed into the baby's head, and another special catheter, one that measures the strength of the contractions, will be pushed up inside mom's uterus. Of course, to do this, the bag of waters would have to be broken, so that the catheter can go in. Once the bag of waters is broken, the doctor will be paying close attention to the time, because doctors don't like women to walk around with a ruptured amniotic sack for much longer than a day, even if the mom and baby need longer to birth.

When she gets her fetal scalp electrode and the intrauterine pressure catheter is in place, the contractions might not look very strong on paper, so the nurse or doctor will do some cervical exams, to see how things are going. Lots of people, from the nurse, to the doctor, to the resident, to the medical student might put their fingers up inside of mom's vagina, so they can get a better idea of what's going on. But it's no big deal how many people put their hands up there, because remember, mom can't feel it! If they put their fingers up there over and over again, mom might get sick. She might get a fever, she might even get a fever in response to the epidural! But the doctors won't know exactly what's causing it, so they'll just give her a full spectrum anti-biotic to cover everything.

And if they give her a bunch of anti-biotics over the course of labor, she might get a yeast infection to go with it! If she gets a yeast infection she might give the infection to her baby too, then the baby would have thrush, which could cause more breastfeeding problems.

Once she's got the fluid, epidural, iupc, fse, the catheter, the cervical exams, and the anti-biotics, her contractions might poop out altogether, so she'll get some pitocin. The pitocin will blast her body into labor, making her contract harder and harder, faster and faster, but it won't cross the blood-brain barrier like natural oxytocin does, which is what triggers our bodies to create nature's pain killers: endorphins, so the contractions will be excruciating and very difficult to work with.

And if the contractions are very difficult to work with....

chances are.....


She'll want an epidural!

Study Links Pitocin to Negative Birth Memories, Reduced breastfeeding rates and more

A while back I participated in a research study about 3 year olds. I was unaware of what she was researching at the time, but I found the results to be fascinating. The author, Claire Winstone, allowed me to publish it as long as I attached her email if anyone had any further questions. Feel free to pass it on.

The study found that women who had pitocin in their births had more negative recollections of their births, spent less time with their babies in the immediate postpartum period, were less likely to exclusively breastfeed. There were also ramifications for baby; babies born in pitocin births were more likely as three year olds to have trouble communicating their needs effectively and had more experiences of discomfort and insecurity. It's a fascinating read. Click here to read the findings in their entirety.

The brain giveth, the body taketh

I have no idea what that title means. What i do know is this: I am leaving for the DONA conference in 15 days and I completely forgot to submit my passport application. Thank you, US government, by the way, for requiring a damn passport to go to Canada. What happened to NAFTA? Are we really scared of Canadians? Have you met any of our northern neighbors? They are more likely to buy you a beer than attack you I am sure.

In any case, I probably would have remembered to take care of this were it not for the ligaments in my ankle that are, to use a scientific term, extremely messed up. I have been hobbling around on crutches for 6 days. Probably 3-4 more before I get to be really hot in a walking cast. At least the surgeon gave me "loose ligaments" to blame for my constant state of "falling down-ness" rather than what my husband thinks of as general spazzy-ness with complete disregard for the physical world.

This trip to BC is supposed to tell me if I want to continue to be a doula or not. I sure hope I get the passport:)

Who has time to be tired?

Or blog, for that matter? I would write extensively about how I had 4 clients deliver in 3.5 days, including one emergency section, one baby transported to a different hospital NICU than mom, 4 different hospitals and about 13 hours of sleep.....but I can't. We're having 24 people over for a Passover Seder tonight. Send caffeinated thoughts! And at least there's this: I am free to have the obligatory 4 cups of Passover wine since I am no longer on call:)

Don't I know better?

So I get a call at 3:30 this morning from B, telling me wife J (who is 42 weeks) is having contractions that are 3 minutes apart and lasting for a minute. They say they are getting ready to leave but will call when they are out the door. I immediately hop out of bed, make coffee wash crust out of sleepy eyes. 

It's now 4:49. I could be sleeping. I am typing instead. 

Like burnt toast that fell on the floor and has cat hair all over it

That's what I feel like this morning. Icky, crappy, dirty old toast. I am such a drama queen. Thank god for good coffee and itunes.

Another birth gone by way of the operating room. I have gotten so swept up in my own feelings about seeing so many cesareans that I am no longer able to say if I think it was necessary or not. All I know this morning is that the look in the eyes of a woman who has labored for a long time and is now being rolled down the hall for surgery is almost too much for me to bear. She will recover physically and mentally...but will i?

We are in the finals!!!!!

We have made it to the showcase showdown, my friends! I am sorry that I don't have anything else to say; this ideablob thing has been all consuming.

We are in the finals. We need you more than ever.

Go.Vote.Now.Immediately.Pronto.

Just do it.

Be BOLD!

Now you know I do not ask for much, faithful (or unfaithful) reader. Today I am asking for 2 minutes of your time that I know can make a huge difference!

Thanks to initial and very exciting enthusiasm, BOLD has quickly risen to become one of the top contenders for this week's finalist spots on ideablob's $10,000 contest! However, the last 36 hours will be the most intense. It isn't too late to log on to ideablob.com Registration is easy. It will take a minute. Don't tell me you don't have a minute. I am not the annoying guy on the corner asking if you have a minute for our earth, oh, and by the way, did you bring your checkbook? We just want your vote to support BOLD's quest for the March ideablob award!

As you may know BOLD is an organization that uses the arts to inspire social action, including supporting local communities for the last 2 years without asking for any financial contributions from our participants. I am the Performance and Talkback Coordinator for this fine, fine organization which has about 5 cents to it's name. With your vote that can change!

So, here are two simple things you can do to help:

The ideablob.com contest is very democratic. The 2 ideas with the most votes by midnight on Friday, March 14 will become finalists in this month's contest, which will have it's final sprint from March 22-31.

Thank you! You rock!

What a long, strange trip it's been

The last three weeks have been a total blur. Between dealing with a friends horrific loss and my own family being sick for 3 weeks, I feel like I have lost many days of my own life. Oh, and yeah, I was away visiting family for 5 days, too.

Part of this trip involved meeting up with all of my siblings and driving to middle-of-nowhere-but-up-a-scary-mountain, California to see my dad's place and meet his girlfriend.



She was very nice, fine, whatever. Then I found out she had a home birth and all of a sudden I started to like her a little more:) Though interestingly enough, that birth was her fifth and she said if given the chance (not likely, as she is 60) she wouldn't do it again. She didn't want the drugs, just the safety she felt the hospital assured her. It made me think about what I feel the most strongly about is not how any one woman in particular births, but that it is her right to have access to whatever type of care she desires. I wish the feminist movement would take birth on as a choice issue. If we deserve the right to choose to have a baby, shouldn't we also have the right to have it on our own terms?

While we were in the aforementioned small town, my dad wanted to take us to see the zoo that his "spiritual community" owns. Lots of animals that I am not sure belong in a zoo, like emus and 2 manecoon cats with their own personal shrine to their leader, which I do not understand personally as I think my cat is the least conscious being in my house, but that is neither here nor there. After we visited the "regular" zoo, we were to go see the "camel" zoo. Apparently there is some concern that the camels would be either killed or stolen, so they keep them at this hidden space way the fuck up this already isolated mountain. This drive in my rented Hyundai Elantra caused me a severe panic attack. As we were leaving I realized I could not operate the vehicle without a valium, so I gave the keys to my sister. Then she drove the car into a ditch. Over a big rock. Then we had to be towed. Lots of fun. Luckily the folks at enterprise didn't care about their cars because their inspection showed no scratches.

The small highlight of the zoo experience was that two of the camels, mother and daughter, were pregnant. The mother was due to give birth any day. The camel guy told me they birth standing up and the baby drops onto the ground. Ouch! I was tempted to camp out up there to see if I could camel-doula, but I decided sitting on the couch and drinking wine from Napa was a far better idea.

A Tragic Loss

Good god, it is every parents worst nightmare.

One of my doula sisters, partner, friend has had an unimaginable loss. Her beautiful son, Bryant, died Monday after a rapidly deteriorating lung infection. He was 6.

This is a total shock for this family- Bryant was a normal, healthy happy boy just days ago.
This is a total shock for our birth community, who thrives on life, not death.
This is a total shock for all mothers and fathers everywhere, who could just never imagine.

There is a memorial fund at Key Bank sent up for this wonderful family in the name of their son, Bryant Tennant. If you can, please do.

There is nothing to say, only thoughts of love and the hope of peace.

Made in May, Born in February

I cannot believe it's February. In three days I will be 33, which is not nearly as exciting as the fact that Dr. Oz says my "real age" is 31.8. Hooray for young cells! Too bad I have about as much hair and cellulite as my 84 year old grandmother. At least I'm young on the inside. February is also my younger daughter's birthday, the anniversary of my successful and redemptive home birth. Whenever I think about her birth story, I always remember my sister telling me I hummed throughout the whole thing. I don't have a body memory of doing so, but really, why would she lie about that?

Whenever I think about having more children it seems like a ridiculous idea: I have a great husband and two great kids, a really, really busy personal and professional life and what feels like not a single second to spare. What I long for is not another child but another birth, another moment of personal greatness, a miracle I helped create.

Maybe I'll just run another marathon.

A Picture is Worth a Thousand Surgical Births

The Cure is Happiness and Visa Versa

A while ago I was speculating that my bad attitude was costing me jobs. I was feeling really cranky about the whole birth thing, after a year of seeing a whole host of things that left me feeling disenfranchised, to say the least. I have always had a really good interview/hire rate, but towards the end of the year I lost a few jobs to what I am sure was my inability to remain neutral.

Now it's 2008 and I have gotten the green light from all four of the families I have interviewed with. It's not the income that makes me happy but the realization that I am coming across as potentially really good labor support, which I know I am;-) Two of those interviews I was accompanied by one of my partners, M, who is totally different from me but amazing and wonderful just the same. She is what you would think of as a doula: long, flowy hair, no makeup but naturally so pretty, always a hugger and a source of positivity. I am more the doula anti-christ: mascara, lip liner, blond highlights, acerbic and honest. True, I am a home-birther on the inside; I just don't look like it on the outside. But believe you me, I love what I do and I feel strongly that it is what I was meant to do.
There is a mom at my kidlets preschool who is about 100x fancier than me. I like nice clothes but I am usually parading my sweaty ass around town in workout gear. She always looks perfect. Always full makeup, always a complete outfit (including high heels) and a matching handbag. One day her and I and another mom were sitting in the schmoozing area after drop-off (come on, it's a Jewish preschool!) and the subject of vaccinations came up. I am always hesitant to talk about these things with people I don't know very well, especially in a school setting. All of a sudden fancy mom started telling me about her 2 home births and how her mom is a home birth midwife! See, see, you never know. Lesson learned.

I digress, I know. When I was in high school I had an English teacher who told me I was smart but I had too many ideas and my writing wasn't focused. He was right. But then again, he taught a class where our "big" assignment was to interpret the lyrics to our favorite song. Wanna guess what I chose? Think black eyeliner and hair in the 80's.
At least it wasn't "Pour Some Sugar on Me."
The moral of the story is I feel really happy right not and it is being reflected back to me by the clients I am working with. So there!

Who needs an epidural when you can eat chocolate?

For starters, here's something wonderful: cheap red table wine and chocolate covered blueberries. Seriously good. I have very little interest in a wine and cheese tasting, but I sure wish someone would do a wine and chocolate tasting. Now there's something I would pay money for.
I now return you to our previously scheduled conversation.
As I mentioned last time we spoke, I have gotten involved with BOLD, an acronym for Birth on Labor Day. It's a fantastic organization whose goal is to make maternity care more mother-friendly. BOLD is a grassroots movement that uses the arts to empower communities to educate themselves, speak their truth about birth and finally to take action in regards to maternity care issues.
The foundation of BOLD is Birth, an amazing and inspiring play written by Karen Brody. Now for the third year, many cities around the world will stage performances of this play as fundraisers for their own grassroots organizations. After the play, they would also have a talkback, essentially a panel discussion about the current state of birth with members of that community, such as OB's, midwives, doulas, etc. My job is Performance and Talkback Coordinator. I am the behind the scenes person that will help all these communities ( hopefully many this year!) make this happen.
One of the things I have to do is filter through this email account and do alot of sending and receiving and lots of other techy-type stuff that is, let me tell you, way different than cooling a mom's head in labor and reminding her what a great job she is doing! Though maybe, as I sit here and write this, I will end up "doula-ing" these groups through their birth of Birth. Hmmm. Anyway, so yesterday I was sitting at my desk going through this inbox (which is very vast) and i see an email from Ina. Ina! Ina May! Holy shit! I could email Ina May! This thought sent shivers of joy down my spine and I was truly excited for the rest of the day. By the way, if you are reading this and you don't know who Ina May is, please, please, run to your nearest bookstore and grab Spiritual Midwifery. Please. Tell them the crazy doula sent you.

So here I am, at the beginning of this great new journey with BOLD, with a binder full of clients having babies and births, and for the first time in a while feeling fully optimistic. Of course, it could be the wine and chocolate. I'll let you know.

Are you hip with HIPPA?

Ok, seriously, that title is the absolute most ridiculous thing I have ever written. If my husband ever read my blog (which I assure you, he does not) he would laugh at my cliche-ness. Anyway.

It's kind of a strange thing to blog about being a doula and yet keep all the intimate details of my clients private. I can never say: "So I was at this birth last week and all these lame things happened" because what if my client read it? Do I really want her to know that working with her was excruciating? That it made me consider never attending a birth again? (Ok, part of me does. But don't tell her.) No really, all of my clients sign a confidentiality form letting them know how seriously I take their trust in me. So I am left to talk about how I see doula-ing and birth in general, but not in reference to this or that.

My oldest and dearest friend was here in Portland visiting this weekend. She is a blogger that has some serious readership. Like thousands. Many thousands. She said I should have 2 blogs; this one and a private one. One where my identity is hidden so I can rant about whatever I want without having to worry. Great idea, but seriously, there are already too many things to do in an already way too short day.

She did teach me how to add pictures and all that stuff that my left-brainedness can't come up with on it's own. So lookie here:
I have recently gotten involved with this fabulous organization. More details to follow. I promise.

I Repeat: Always Press Save

Did you hear me? Did I hear myself? Why do I not learn?

On New Year's Day I spent all this time writing what I considered to be a beautifully crafted essay on my work in 2007.

Then someone made it all go away. It was an accident and I am not mad, but truthfully, it kinda sucks.

The gist of what I said was this: I attended 13 births in 2007, the first and last of which were c-sections, as well as 4 others in between. Seriously, that is really depressing. Here we are, thinking we actually make a difference, and in the end, not so much.

I was having a conversation with another doula today and we were talking about how part of our job is to "frame" these events for our clients. We help them process the events to they walk away feeling like the outcome was justified or that at least they did what they could. But how can I frame an almost 50% surgical birth rate in 1 year? My first year, not only was my c-section rate 0% ( out of 14 births) but I had 100% natural births! What has changed?

I think part of it is that the average person hiring a doula has changed. It used to that most everyone who hired labor support did so because they wanted help having an unmedicated birth in a hospital setting. Now that doulas are so much more a part of the general consciousness surrounding birth, more people are hiring doulas who have very little expectation of "natural" for their births. What's better? Good for the mother, good for doulas overall, bad for individual doulas who have to bear witness.

I feel thankful that I get to make a difference. I just look forward to making a bigger one, I guess.