Birth, Life, Love.

Hand to Mouth Disease

2009-09-10T00:14:00.000-07:00

I just ate too many cookies.

What is up with nurses? Why is eating a national pasttime? One of my favorite staff members (i.e. pro-breastfeeding and family centered care) is relocating to Boston next week. Every single night there has been a potluck in her honor. We have a potluck for just about any reason; birthdays, births, deaths, retirements, new hairdos, you name it. We eat.

Shouldn't health care workers be healthy?

I think I gained a baby on my ass this week.

Gratitude

2009-08-23T12:00:00.000-07:00

So there is no more hope. There are only memories, memories of teal and beauty, of wide eyes and laughter, of a path meant to be walked together and now not, of instantaneous friendship and connection, of hand holding and massaging, of tears and of tears. And now more tears.

Tomorrow is my wedding anniversary. Seven years, not always easy, better for what was hard, thankful for all.

Gratitude for all our time and blessings from the universe.

Hope

2009-08-06T01:22:00.001-07:00

Now that I work at the hospital, I see life on a daily basis. I don't get to witness birth anymore, per se, but I am a part of the melding of individuals into a family. I feel really thankful to have a job I love, one that fills my cup and reminds me that there is good to be done and sometimes I get to be a part of doing it.

These last two weeks I have been even happier to come here, and it's not just because of the air conditioning, though that doesn't hurt. In January I blogged about a friend getting cancer. Now it's August, and we are waiting for her to die.

It's kind of like being in purgatory. We can't really live joyously, freely, because we know her moment is moments away. And yet you never wish someone to die, but I think sometimes I feel like I am so ready to rid myself of the knot in my stomach and start mourning. I want to cry, sob, heave for myself and my loss of a friend, for her beautiful husband and child, for her mother and father and sister and brothers and for all the people she has touched with her grace in her life who will now have to know a world without her.

When I last saw her I very much had the sense that she had one foot in this world and one foot in the next, whatever that looks like. She said she was not scared, that she was ready to leave the pain behind and see what the next life has to offer. I wouldn't feel ready if she didn't.

Back in April my friend blogged about Hawaii, I think, and she made mention of palliative care. A mutual friend of ours who is a med student was so distraut because she new palliative care was the beginning of the end. After I talked to her I spent days in a depression about the idea of losing my friend.

I went to the beach for the weekend and I came back decided that if Julie had hope, who was I to say she was wrong? And I held out hope until the end, really I did. And now I have a new hope, a hope for an easy transition, a hope for peace, and hope that I can keep doing what I do so I can get life along with death.

Still Sweaty After All These Years

2009-08-03T16:41:00.000-07:00

The irony of it all.

The last time I blogged was in January where i wrote about sweaty gym guy. Have not looked at the blog since then. Today the guy on the mat behind me moaned, and finally farted, all the way through a pilates class.

At least I go to the gym.

Sweat equity?

2009-01-20T12:06:00.001-08:00

In keeping with my gym going yesterday, after I lovingly devoured the inauguration coverage this morning I went to the gym. I told myself I was going to get in 3 miles on the treadmill, with no stringency as to whether they were walked or ran. I made it to 1.75 and then someone got on the treadmill next to me. And then he started sweating. And then said sweat was flying all over the place. I could see little beads of nastiness all over the bottom of my machine.

And then some got on my face. And then I threw up in my mouth. And then I ran home and took the hottest shower of my life.

eeeew.

Yoga Soup

2009-01-19T15:15:00.000-08:00

I went to yoga today. Going to this particular class is kind of like going to Spain. You took all those years of Spanish and yet you have no idea what a single person in the whole country is saying. I have been practicing yoga on and off for 10 years and when I go to Willow-with-the-ridiculously-amazing-body's class I feel like I can hardly even get into downward dog.

But I do it and it feels good. I try not to stare at my stomach in the mirror. I swear they tell you to close your eyes so you don't obsess about yourself. I did pretty good today. And I ran my first mile since I hurt my ankle back in June. At the end of the class they throw this magic dust around that makes you able to pass out on a cold floor after your class. I have chronic insomnia but I can always zen out after a yoga class. Queer.

When I was at the height of my relaxation I awoke to the loudspeaker. "The kids club is now closed. Please come pick up your children." Oops.

I walked in pissy and I left happy. I ate soup. Today is alright.

The Storm Before the Calm

2009-01-17T09:01:00.000-08:00

Another one of my friends has cancer. It pisses me off that at 34 I am watching my third friend under 40 go through this. This newest trooper is just lovely, too. She has a daughter in my daughter's class. She does yoga and drinks tea. She's nice and pretty and kind and deserves something else. Cancer is one of those bastard things that messes with your feelings of comfort in the world. It's easy to say "everything happens for a reason" with the mild crappy things that happen, like losing a job or a boyfriend. It's hard to see the future now, but something better will come along that will make this all make sense.

Nothing makes cancer make sense.

In Judaism you are relieved of your religious obligations during the period of mourning between death and burial. It's almost like God realizes he's kind of screwed you over, so you are given an opt-out so you don't desert your belief systems all together. It's called Aninut-the storm before the calm. The storm is all the anger and sadness, and the calm is acceptance of a greater good. I don't look for calm, really, just a way to understand why these things happen. Because really, there's no reason. There's no justice in cancer or in Huntington's disease or car accidents or losing your parents or your children. It just plain old sucks.

Two years ago a different friend with a daughter in my daughter's class had a double mastectomy and bunches of chemo after a breast cancer diagnosis. I saw her last week with a full head of hair and lipstick and fancy earrings. I hope two years from now I see new friend with a full head of hair and a smile but probably not big earrings and red lipstick. It's just not her way.

Birth, Life, Love, Breastmilk...

2008-12-23T08:43:00.001-08:00

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"

2008-09-05T08:53:00.001-07:00

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

2008-09-03T23:53:00.000-07:00

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...

2008-09-02T08:47:00.000-07:00

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

2008-08-28T08:36:00.000-07:00

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

2008-07-02T09:00:00.001-07:00

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?

2008-04-25T09:15:00.000-07:00

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?

2008-04-23T04:46:00.000-07:00

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

2008-04-22T08:35:00.000-07:00

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!!!!!

2008-03-24T21:21:00.000-07:00

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!

2008-03-13T14:50:00.000-07:00

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

2008-02-21T15:29:00.000-08:00

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

2008-02-13T16:00:00.000-08:00

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

2008-02-01T15:21:00.000-08:00

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

2008-01-24T20:52:00.001-08:00

The Cure is Happiness and Visa Versa

2008-01-23T20:31:00.000-08:00

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?

2008-01-18T19:41:00.000-08:00

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?

2008-01-15T17:17:00.000-08:00

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

2008-01-10T13:14:00.000-08:00

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.

Birth Stories

2007-12-29T09:46:00.000-08:00

So I recently read about the following workshop. Normally the idea of such a thing might make me roll my eyes, but today, it sounds good.

BIRTH STORY WORKSHOP FOR BIRTH DOULAS ONLY - FEBRUARY 8
Expectant parents and babies aren’t the only ones who have powerful
experiences in the birth place. As doulas we are deeply affected by
the things we witness. Occasionally, it is time to examine our
experiences and seek resolution. Often what we really need is a safe
place, the opportunity to tell our story in a structured way and have
it be heard, really heard. We will use art exploration, facilitated
dialog and powerful ritual to promote self-awareness, stimulate
healing and celebrate ourselves as amazing women who lovingly and
bravely hold the space for others during a time of great power and
vulnerability. For more information about this workshop and other
Birth Story Workshops especially for home birth midwives and also for
women who have given birth: http://www.carolgray.com/carolgray/Workshops_for_Women.html

I was never one for "art exploration," though truthfully, I can't say I have any experience. I have had a number of clients use the "birthing from within" philosophy which uses art as one of it's tools, but really, it all sounds a little hokey to me. I think the reason I like Lamaze is that I am much more pragmatic than hippy by nature. In any case, right now I think I could use some doula therapy.

Being a doula is a very emotionally taxing job. One of the reasons I do it is because I know the birth story matters. I know that how you experience your birth can frame much of your life and how you see yourself as a woman. Ask anyone who has had an unwanted cesarean and she will tell you how the event effected her concept of her own womanhood. The problem, at least for me lately, is that a number of the births I have attended are shaping how I see myself. I have been to at least two births this year where I felt helpless, unable to support the family in the way that they wanted, in one case, and in the way they needed, in the other one. One of them truly hurt me on the inside, deep in my core, and I am sure I have not began to process the events and my reactions to them.

Ask any doula and she will tell you how difficult a really long labor can be for her. We are not blessed with the hormones and endorphins that keep mom and dad going, but yet we have to be present in the face of exhaustion and fear. People count on us to be strong and steady. Sometimes it is easier than others.

I have doula-d stillbirths, failed VBACS, long labors ending in surgery, abusive relationships and a host of other wonderful and trying situations. But none so sad for me as when I worked so hard and left feeling unappreciated.

Birth at St. V's

2007-12-18T17:24:00.000-08:00

I am still too tired and confused to have totally processed the very, very long birth I just attended, but I do have to give props to Dr. Sally Wentross and the many nurses at St. Vincents who handled an extremely difficult situation with grace and generosity. Often doulas are hesitant to work there as is can be a hostile environment but this was not the case today.

New "Section" For Men

2007-12-14T16:04:00.000-08:00

December 14, 2007
For Immediate Release

NEW SURGERY SAVES MEN

Portland, OR- In a truly groundbreaking turn of events, the AMA has developed a procedure to save all the men of the world! No more discomfort, unnecessary pain....have a fecalectomy!

This exciting new medical development will rescue men from thousands of years of suffering. A simple incision in the intestine will make the concept of the "bowel movement" obsolete. No need to move anything! No more pushing! Your doctor can suction in out for you.

Long gone are the days of wondering "will today be the day?" "Will I be at work and have to go? What if I am in the middle of an important meeting? Do I have childcare?" Now you can schedule all of your pooping in advance! And best of all, you don't have to feel anything; after all, there is no glory in natural excretion. A simple epidural and it is all taken care of for you.

Risks include death, post-traumatic stress disorder, infection at the sight, greater need for re-hospitalization, blood loss and long hospital stays. Also, due to malpractice rates, you will be forbidden to sit on the toilet ever again without constant monitoring, and in some cases, never at all.

A Perfect Ten

2007-12-14T05:46:00.000-08:00

I may not be perfect but these are the things that are perfect to me.

Hot, strong coffee in the early morning hours while my children are still snoring away.

The smell of Mrs. Meyers Lavender hand soap (or any other of her lavender products.)

The feeling of crossing the finish line, no matter how long it took.

My husband nicknaming me "almost," him being totally right, and both of us being able to laugh at me. I'll finish something I start soon, I swear...

My daughter Violet, who at 4 1/2 has the most amazing memory and is clearly one of the smartest people I know. You cannot fool this one. She has ruined my ability to sneak clothing purchases past my husband, as every time I wear something new she'll say, " That's a nice new sweater, mommy. When did you get it?"

My daughter Edie, almost 3 and still goofy and sweet as ever. Before she turned 2 she made up her own dance entitled "Wiggle Your Body as Fast as You Can. And Turn. And Turn."

The truffle pizza at Apizza Scholls. I ate it once many months ago and can still conger up the taste and smell. Yum. Let's go. Now. Yes, I know it's 5am.

A brand new baby with a perfect latch. One of natures true wondrous miracles. Form, function, beauty, love, all rolled into one.

Climbing into my big, comfy bed after a long exhausting birth, knowing I did good and happy to be home.

Knowing, deep, deep knowing that you love and are loved in the most perfect way possible.

I Know Where I Am...But Where Am I Going?

2007-12-13T19:28:00.000-08:00

So you know you are doing a good thing when an old client calls you and asks to meet up for a few minutes just to give you a hug.

This woman didn't have the greatest birth imaginable in terms of outcome. However, she was well supported by her OB, her husband and me, her doula, and I know that made all the difference for her. I talk about this all the time with expectant mamas. It's not only what happens but how it happens. If you are an active participant, if your voice is heard, if you really, truly understand informed consent, then I guarantee you will walk away feeling proud.

I have been toiling/toying for the last few months with the idea of going back to school, yet again. And yes, I realize I am in many, many thousands of dollars in debt from by undergrad and my almost-finished-but-not-quite MA in English Literature. Please do not rub it in. Sallie Mae and my mother do a fine enough job, thank you. I have been looking into Berkley, among other places, for the Masters in Public Health (MPH) program with a focus on Maternal-child health. The main obstacle is: will there be a job on the other side? I want to be able to work to create change that will positively impact the state of childbirth in America. The people with money are on the other side of the coin. So unless I want to fund raise and create my own foundation, I am not sure if it is worth it. I have been really wanting to get involved on more of an activist level, but I am not really sure what the next step is. I see myself as having the capacity to be a public voice for childbirthing rights. I am just not sure how to get there.

In the meantime, I will just continue on, supporting women and families and promoting normal birth wherever and whenever I can.

Life and Death

2007-11-30T15:41:00.000-08:00

After a busy November ushering babies into the world, I bid farewell to a family member. My uncle, Jack Wieder, died unexpectedly on Sunday after a life that was too short, too hard and too lonely. He was 54.

The world was not against my uncle but he thought it was. In the end, what you believe to be true is your truth.

He is survived my his mother, Celia, his sisters Leona and Sandy and brother-in law Michael, and his wife of three years, Kathy. If the depth of her grief was a measure of her love for Jack, he was very well loved indeed. He was preceded in death by his father, Soloman Wieder in 2005, whom he lived for but could never live up to.

Jack was troubled but bright, always wanting to do good by his family and the world. I learned alot about him at his funeral. I am sorry it didn't happen when I could tell him how much I respected him.

Why isn't sheepskin waterproof?

2007-11-18T22:15:00.000-08:00

I mean really, do sheep stain if gotten wet?

Reasons to Have a Home Birth

2007-11-14T16:21:00.000-08:00

1. No unnecessary fetal monitoring that leads to unnecessary pitocin that leads to unnecessary instruments pulling your baby from your body.

2. You will never be coerced into having a speculum exam to prove your water actually broke, even though fluid has been pouring out of your body for 6 hours.

3. You will not contract a staph infection at home, nor will you be told your baby has meningitis by mistake because of a "contaminated draw."

4. Your doctor or midwife won't be able to convince you that they need to manually stretch out your vagina because home birth midwives know they don't need to.

5. You will feel safer and you will be right.

6. You will not be woken up every two hours for various ridiculous reasons.

7. You will be able to eat and drink in labor.

8. You will be treated as if you are walking through a rite of passage, not as if you have a potentially life threatening disease.

9. No one will ever say to you "aren't you ready for that epidural yet?"

You should not need to have a home birth to have your rights as a laboring women upheld. But sometimes, you do.

Two for the road

2007-11-11T02:03:00.000-08:00

After a 5 month lapse (I cannot believe that it really was that long) I attended 2 births in 48 hours. One was amazing, the other frustrating though ultimately positive, both keen reminders of why I do what I do.

I am way too tired to say another word.

What I don't know

2007-11-07T08:14:00.000-08:00

It's been really hard for me to write because it's been a really hard time for me professionally. I used to think of myself as really impartial, a doula who could happily support any woman's birth choices regardless of whether that is what I would choose. I am finding that harder and harder to do. In my years of doing this work I have maintained an 85% hire rate; most of the families I met with hired me. Lately it's been more like 50%. I don't think it's because there are so many great doulas to choose from, though that is definitely true. I think I am having a harder and harder time presenting myself as neutral. I don't think it doesn't really matter what happens in your birth as long as everyone is healthy. I know that many other things matter. I know that an empowering birth is an opportunity of a lifetime, an experience that gives a woman confidence for all of her future undertakings. I don't think that when a woman in labor enters the hospital her chances of having a normal birth are good. I know that 35% of the time the baby will be surgically removed, and if that doesn't happen, she will likely have a host of plugs and cords and devices attached to her that even if she still manages to eke out a "natural" birth, she will never really know what a normal birth is.

More and more as I try to envision what my place is in this life, I think I have to be an advocate for normal birth. I am not sure where that starts. I used to think it started with my doula clients, but now I am not so sure.

"I'll take Potpurri for $200, Alex."

2007-08-14T17:43:00.000-07:00

A few unrelated thoughts.

Taking the advice of a good doula friend, when I got my tattoo I totally "doulad" myself through the whole thing. It was very Penny Simkin-esque. I was awash in rhythm, ritual and to whatever extent I could, rocking. It was very interesting, actually. I was tapping my foot the whole time to the beat of my breath, in two three four, out two three four. I was a big foot tapper in my births as well. When I do prenatals with my clients we always talk about reactions to stress and coping mechanisms. I guess however you are in life is how you are in birth. Or vise versa.

I need a life doula for tomorrow. I have a root canal. Childbirth, no problem. Dental work, whole different ball game.

I have met with some really amazing women lately. I always feel so honored when I get hired, so grateful to be able to share in this amazing time in a family's life.

Listen to WFUV online, Fordam U's really cool radio station.

Welcome Back, Crazy Person

2007-08-08T10:42:00.000-07:00

The problem with taking the summer off from work is that it's really hard to get back into the swing of things. Just last night I booked two appointments at the same time because I have fallen back into my old traps of deep, debilitating disorganization. For me to stay on top of my universe I have to force myself to write everything down (not on random bank receipts and gum wrappers) so I can keep it all together. It's not natural to me, but it's necessary for survival.

Earlier today I was tagged, which I don't really understand but apparently it's blogger speak for "you must do this."

Here goes.

The Rules:

1. We have to post these rules before we give you the facts.

2. Players start with eight random facts/habits about themselves.

3. People who are tagged write their own blog post about their eight things and include these rules.

4. At the end of your blog, you need to choose eight people to get tagged and list their names. Don’t forget to leave them a comment telling them they’re tagged and that they should read your blog.

Here are some things.

1. I never step on the grates on the sidewalk. Total unexplainable phobia.

2. If given the opportunity (and a dark closet) I will crush Chips Ahoy cookies atop a bowl of Cheerios and soy milk.

3. I always eat some form of chocolate at a birth. Sometimes three forms.

4. Our second daughter was almost named Beasley and I am VERY GLAD SHE WASN'T.

5. My name is spelled Randi on my birth certificate. I added the "e" on the end in 7th grade. That's odd, isn't it? Aside from my family, there are probably only 3 people in my life who knew that before now.

6. As soon as I found out I was pregnant with my second, I went to see the midwife I had with my first. During the visit she told me she was no longer catching babies. I was so crushed; I cried on and off for days. As it turns out, it was the best thing that ever happened to me. I was carrying so much baggage from my first labor around with me that I believe I would not have had a successful home birth if the cast of characters was the same the second time around.

7. When I was in high school I had a friend down the street who lived with her grandmother. We used to smoke cigarettes out her bedroom window. One time we dropped one, but her grandmother was downstairs so we didn't think we could go get it. We attached a wad of chewing gum to a shoe, tied many shoelaces together and successfully hoisted it up to safety.

8. Aside from my youngest sister, I have the worst sense of direction on earth.

KW, KR, EV, JH...consider yourself tagged.

My Doula, My friend?

2007-06-29T09:19:00.000-07:00

Oh my god, I have been so out of all birth loops. When I get stressed, I get crazy. But when I turn it off, i am really off. I scheduled the latter half of June and the first half of July off so I could go on vacation (what a concept!) and visit with my brother and his family when they roll into town.

It's nice to have time off to think about the last year, the births I've seen, how I might do things differently in the future. I don't know how many women and men I interviewed with exactly this year, but I know I only did not get hired twice. Both times it was the exact same situation: immediate connection between mom and me. Similar personality, sense of humor, approach to life. Feeling that we were meant to be friends.

Women do not want to hire their best friend to be their doula. The want someone to fill the space of the person they are not, to calm them when they need calming and to rev them up when the energy feels like it is dwindling. Why would they hire someone just like themselves? It makes me think that if I sense that happening in an interview in the future, i will need to navigate the conversation to a more warm, professional place. At least I will be aware of it, I suppose.

In a move in stark opposition to natural birth and all it encompasses, I will be in Las Vegas next week, sinning up a storm:)

The Sherpa

2007-06-09T08:29:00.001-07:00

I know a lot about a lot of things, but mountain climbing is not one of them. So when a client and her husband revealed to me that they were secretly refering to me as "the sherpa," I had no idea that it was a really great compliment! Of course, he was not saying it to be nice, he just couldn't remember the word doula:)

I can only assume (read:hope) I am not the only one who thought a sherpa was a fleece-lined coat or blanket. Then I realize it's a mountain guide, and I think, how freaking perfect! I always compare labor to running the marathon, because I have done that so I understand the challenge, both physical and mental. But I have never climbed the Himalayas, thank God, so I really didn't make the immediate connection. If you have never climbed a mountain, it'd be a great idea to have a guide to lead you through the process. Heck, it'd probably be a necessity. The sherpas help you pace yourself, drink enough water, keep you focused, remind you to keep your body in the right positions and keep your mind positive.

That is exactly what we as doulas do. We can't do the work of labor for you, but we can help make it easier and more positive. Doulas guide women (and their partners) through a challenging yet ultimately rewarding time. The best compliment I can get is not that someone feels they couldn't have done it without me, but that they wouldn't have wanted to.

The Blahs and the Aahs

2007-06-07T06:16:00.000-07:00

I haven't written anything lately because I haven't known what to say. As much as I love what I do, overall I have been feeling pretty jaded lately. I was on the phone with my mother the other day ranting about the state of birth in our country, how it is nearly impossible to have a normal birth with all the routine interventions, but mostly in the culture of fear and weakness surrounding childbirth in the United States. When I realized I was ranting like a lunatic and that instead of listening to me she was thinking about what to make for dinner, it occurred to me that I am in desperate need of a vacation.

I define myself largely by what I do, and if I don't feel good about that, I don't feel good about me.

My clients rely on me to be a positive force. My job is to protect their birth space from all negative energy, to make them feel like they are doing the best job they can with the tools they were given and the hand they were dealt. It's hard to do that when you are feeling shitty. Luckily I scheduled myself off for the month of June so I can get a little time to reassess.

By the way, in the midst of all this funk, I saw something really beautiful last week. This mom had an ordeal of a labor that ended in surgery. She had been awake forever and was feeling pretty poor overall. But when they put that baby in her arms, it was a miracle in the making. Everything else faded away and what was left was two new people, in love at first sight, being perfect together. In all the births I have seen, this was the most immediate, instinctual, natural mothering. Her birth may not have been perfect but her connection with her baby definitely was. Welcome to your world, D.

A Sea of C's

2007-05-29T06:04:00.000-07:00

For the 4th time in 3+ years, one of my clients ended up in the operating room.

I have supported clients before where I felt like they got steamrolled into a cesarean. Earlier this year I watched as a doctor (with all of his students watching) told a woman (primip, after 1 hour of pushing) that she could push some more if she wanted to, but she was going to end up in surgery so they might as well cut their losses. It was going to be a really big baby, after all.

It was 7lbs, 9 oz.

This was not like that.
This mom was an awesome laborer. She was totally able to get into the zone, that one that is so hard to describe but we all know it when we see it. She tuned out the world, tuned into her body and her baby. But in the end, her baby was in a bad position and she did not want to move. When the time came to call it quits, everyone in the room (and there were alot of us) felt good about the decision, including mom.

I cannot say enough about her midwife, Kathleen and her group, Pacific Midwifery. They are the only midwifery group completely staffed by CNMs in the area that do hospital births. And after what was no doubt an enormous amount of work, Legacy Salmon Creek is now the only facility in SW Washington doing water birth.

This, my friends, needs to be the wave of the future. Respectful, passionate, informed childbirth that takes place wherever you are comfortable. Although I believe strongly in home birth, I also feel women should be able to birth their babies in a hospital without fear. And although this birth ended in cesarean section, countless others in Kathleen's care have had normal, natural births without routine intervention. All women deserve that.

In 1965 4.5% of births were via c-section. In 2005 30.2% were. We cannot allow this trend to continue. The World Health Organization recommends a rate no higher than 15%. To find out what's being done and what you can do, visit www.motherfriendly.org

On a personal note, my wonderful doula who tended to my every need at the birth of my second daughter, is moving back east. Her compassion, support, humor and sisterhood will be missed by many, including myself. Everyone should be lucky enough to have a doula like her.

Hold Please...

2007-05-24T20:08:00.000-07:00

The hardest part of a doula's life is not the work. It's the waiting for the work. Not waiting to get clients (though that used to be a concern) but waiting for the clients to have their babies. When I am on call, which is probably about 75% of the year, I am constantly thinking about Plan B. Who will pick Violet up from school, do we have a spare car seat in the car, did I take a shower, who will watch the kids if my husband is at a game and cannot be reached, can I have a glass of wine tonight...you get the picture. When I am on call I plan the morning out before I go to sleep and then do it all over again in the morning when I wake up still in my bed, birth bag still in the closet.

It's very stressful.

Right now I have one client who is a week past her due date, and one due tomorrow. Tomorrow is Violet's last day of preschool, tomorrow night a wedding, Saturday a bartending shift and Sunday a barbecue? How many of these things will I miss?

Here is a perfect example: My phone just rang. Client A called, due tomorrow. Her water just broke, the midwives told her to go to sleep and wait for some contractions (I love midwives!). But...Client B called earlier, already plenty dilated, 41+ weeks, went to have an acupressure massage tonight. What happens if they both go? I have my back-up on standby, but after many months of getting to know these woman and their partners, I would feel AWFUL if I had to miss either of their births. I know it happens, but I really didn't want it to happen to me.

See what I mean? It's very stressful.

To Dream The Impossible Dream

2007-05-21T11:43:00.000-07:00

Last night I dreamt I cursed out an anesthesiologist.

In my dream he was saying he didn't understand why any woman would want to deliver vaginally when it is sooooo much easier to have a surgical birth. I could not restrain myself, and I asked him if he ever tried to recover from abdominal surgery and breastfeed a baby. He replied with "And another thing, why would anyone breastfeed anyway. We have formula, why not use it?"

This was only a dream.

For starters, I would never have an altercation in a hospital, especially in front of a client. It's always important to maintain the birth space for a laboring mama. She needs her support people to protect her from any stress, to make her feel like the universe is aligned and that wherever she is birthing her baby is the perfect place to be. There is no room for egos in a birthing room.
In addition, one of my colleagues and I are always talking about building bridges. Even though doulas are beginning to become more and more mainstream, there are still misconceptions about us floating around the obstetrical world. Every time I interact with medical professionals I consider it an opportunity to represent not just myself, but every doula everywhere. OB's are busy people. They may not remember me personally, but I hope they will remember that respectful doula who acted with sincerity and compassion without being combative.

I am more peacenik than weathermen.

Now of course the sad reality is that there are many people floating around out there that don't see the value in the things I value most. All but one of the Portland-area hospitals sends moms home with free* formula samples. There are many doctors out there that are doing elective cesarean section, even if it goes against WHO and many other guidelines. But every time we are our there in the world, nursing our babies, talking about normal birth, we make one step forward.
We need not dream, we need do.

*Free, meaning without monetary cost, not without consequence.

Childbirth and the Magic Pebble

2007-05-18T14:30:00.000-07:00

What is it about east-coasters that make us find one another wherever we are?

Two weeks ago I took this childbirth educator workshop up at OHSU in Portland. One of the trainers is originally from New Jersey, which is really Brooklyn only with more malls and trees. Wouldn't you know it, we hit it off right away. I ended up missing a day of the training because I was at a birth, so this trainer graciously offered to give me a private class to fill me in on all that I missed.

What I walked away from the meeting with is this: I should probably teach in a hospital.

I always envisioned myself teaching out of my house, and truthfully, I probably will. But that's not where my greatest impact can or will be. Most of the people who would take my out-of-hospital class will probably have out-of-hospital births, which means that many of the things about intervention and so on will most likely not apply. The majority of women in the united states are having their babies in hospitals. They deserve a great education by great teachers who are passionate about birth. Educators who believe in their hearts and bodies that birth is normal. Educators that know that women were designed to birth their babies and that they innately possess the knowledge and power to do so.

Do I wish that more babies in the US were delivered by midwives? Absolutely.
Do I think home birth is a safe, wonderful option and should be more widely accepted by the medical community? You betcha.

But like with any other social change, the scales tip one pebble at a time. If I can impact one woman by equipping her with the tools she needs to have a safe, powerful, ecstatic birth, no matter where it will take place, it's a good day.

What happens if people realize I'm not perfect?

2007-05-17T08:40:00.000-07:00

A few weeks ago I sent an email to an old client I had been trying to get in touch with. She had a really amazing birth- one of those that make doulas feel like they really make a difference. The mom and her husband were both overjoyed and extraordinarily grateful, and I went home with a smile on my face.

Four days later my father-in-law died of cancer.

Him and I were particularly close, and his passing fell on me like a ton of bricks. He was living with our family for the last part of his life, so everywhere I turned was a reminder of his life and death. I was in no shape to counsel anyone, least of all someone in the most exciting time of their life.

When I talked to the dad a couple of days after the birth, he mentioned that mom was having some nipple pain with breastfeeding. Since I was not up to a visit, I asked a Lactation Consultant friend to do a postpartum home visit for me so this family did not get deserted in this sacred time. She did, and they were thankful for the support.

A few weeks later I finally called this family. I left a few messages, sent a few emails. Mom had her own familial illness in California to contend with, so after a number of tries with little response, I let it go, assuming that was what they wanted.

When I heard back from this mom recently, she told be she felt dissapointed by my level of care after the birth of their baby. That I had not been there in the way they imagined.
I was totally shocked, extremely upset, and realistically, a little ego shattered. That's the first time anyone ever gave me that feedback, and it especially stung since I genuinely like this couple and thought we had a great experience together.

After much time spent mulling this over, I realize that how I feel or what I think I did or did not do does not matter at all. Who is right is immaterial. A new mom felt abandoned, one that was in my care, and regardless of what happened, I have to respect that feeling. Not because it's right, just because she feels it. New moms need support, love, attention and protection. As labor doulas we need to make sure that after the birth, even if it is not in our scope of practice, that these moms are getting the care they need. As hard as it sometimes is, people hire us to put ourselves aside and be fully present in our clients' lives. She needed me, and although she didn't tell me verbally, had I been there physically I probably would've known.