31 March 2011
Happy birthday (not April Fools!)
...'cause I need to do some major juggling. Such is the life of a doula who happens to be the mom of three (or the other way around, I suppose)...who is also hosting a playdate and has to pickup from afterschool activities. And make sure the dog goes out. And there is some food to eat. Feels a bit like a game of poker...depending on which card is dealt next, everything could go perfectly smoothly (and I'm not even talking about the labor) or not...ah, adrenaline....guess I won't have that second cup of coffee!
*hey - is that a birth ball on which the circus performer is standing? ;-)
30 March 2011
29 March 2011
A reader comment from yesterday's post made me realize that I wanted to cover a bit more about birth plans and hospital birth in general.
I think that this whole "birth plan" era has also unfortunately ushered in a huge amount of antagonism between patients & nurses, which is just SO upsetting to me (as a nurse). Believe it or not, we WANT you to have the birth that you want, but sometimes things just don't go the way they are "planned." Welcome to parenthood, that's your first lesson that kids never stick to the plan!
Sometimes people have the impression that giving or receiving a birth plan is an opportunity for scorn and eye rolling. It certainly can be...I have clients ask me all the time if they will be annoying the staff with a birth plan. I've also heard care providers jokingly speculate that the people with the longest birth plans are the ones who get cesareans...and the implication is that it's all their own fault. I hate to hear this...the people saying it just have not met the right kind of birth plans (and the mindset that goes with them)! Just as I think birthing women should not be dogmatic, I would love it if care providers also took responsibility for not mentally penalizing people for their earnestness.
A big part of the equation that usually can't be planned for is the luck of the draw with the assigned nurse. Sure, some nurses can be invested in women having as few needs as possible, in them being quiet or not "suffering". However, I find that most nurses (and everyone really) can get on board with a just about any birth plan if they are approached from a place of respect and acknowledgment that they are there to help. Find your inner Dale Carngie: "We prefer that you don't offer us medication, but we sure would love some ice chips and another pillow!" or consider saying, "Here's what we would prefer/what is important to us...can you help us with that?". Most people are decent human beings.
When there is an adversarial approach, it is likely caused, in part, when people are not well matched with the care providers/birth place (you know what they say about not going to a fast food restaurant if it's fine dining you are after). But also when people are coming from a place of fundamental distrust. There is this fine balance, I think, between being prepared to advocate for yourself (as well you should) and going in looking for a fight. 'Cause if you look for a fight, you are more likely to find one. Hostility is not going to help anyone, including the birthing woman, who will surely need to be able to trust and surrender. An atmosphere of distrust or upset can actually stop labor from progressing...those stress hormones are like kryptonite to the hormones that progress labor.
Instead, iron out as many details before you go into labor and make sure you are comfortable with the answers you are getting from all your care providers. Ask what is typical, where there is wiggle room, under what sorts of circumstances interventions might be typical. Consider hiring a doula. Labor at home for a good long time if you can. And, as I have written before, picture your care provider telling you you need an intervention you really don't want...in your gut, do you trust them? If the answer is no, if you are finding that you are still anticipating an uphill battle, make peace with the fact that you may be with the wrong practice or planning to birth at the wrong place for you and then do something about it.
Again, I'm not suggesting you jump on a conveyor belt of unwanted interventions...I'm suggesting you find out whether the conveyor belt is there at all before you get there and then respectfully pick you battles.
Note to pregnant mommas: the darker Buckwheat honey is delicious (a bit more like molasses) and has higher amounts of iron than lighter colored honey!
28 March 2011
I do (remember)…that was a big scientific breakthrough moment for us (both of us). For one thing it created the understanding of how our solar system functions, but it also taught me the value of creating simple training aids to enhance the learning/understanding process of a person trying to grasp a concept, thereby making the teaching process easier and more valuable. That principle stood me in good stead later when I was instructing skydiving and computer training.
I spent last night and then again this morning reviewing an incredibly lovely client's birth plan. Um - it shouldn't take that long. And it should fit on one page. No one else (in a hospital birth at least, which is who this post mostly concerns) is going to really read it if it's way too long or complicated. They don't want or need a preamble. Make it easy for them - think bullet points. And know that they can't really sign off on incredibly specific requirements...sure, you'd like a heplock (if medically necessary) in your left hand if you are right handed, but what if they can't find a vein there? See where I'm going with this? Not for nothin', but I think sometimes some childbirth educators or resources out there can get hung up on dogma and end up doing a disservice to people who might expect that all they have to do is show up with the plan. It's not that simple...birth happens within the culture of our society and of individual institutions (unless you are having a home birth) and practices. So it behooves you to approach that micro-culture in a way it can understand most easily. And do your homework before you go into labor to make sure you are with the right care provider and birth place for the type of birth you want.
Don't get me wrong - I think the exercise is very valuable for the woman/couple. I consider it part of my job as a doula and childbirth educator to make sure people understand their options and know what will typically happen if they do not express a preference. The process is important (for those who want it) even if "the plan" never sees the light of day. It's also a great jumping off point from which to have a discussion with your care provider.
But a potential downside is that sometimes women and couples think that it is somehow a binding document or that it can be the end of the discussion with their care provider. I know that's what I thought when I was pregnant with my first. For some wacky reason, my care provider (an OB) actually signed my birth plan, complete with preamble. I was an attorney at the time - I thought we were set (and as it turns out, we were - everything cooperated). But what about the others in the practice? What if my birth hadn't gone the way it did? I think I would have been upset - we had a deal, right? And yet plans have to be flexible...if I am taking a trip and plan to take the very scenic and lovely Road X, but Road X is under construction, I need to find a way around it. I'm not talking about caving to every intervention thrown at you - not at all! I'm simply saying that you need to have an understanding of what you are getting or giving up with your choices and when trading in one preference might, in the big picture, keep you more on track with where you want to go and how, generally, you want to get there. I'm talking about avoiding bigger interventions.
I prefer the idea of "Birth Preferences" because that's what they are. And I suggest that instead of just one big talk, there be a continued mentioning of preferences at all subsequent appointments, just to keep reminding them who you are and what's important to you (there are a lot more "yous" than there are of "them", as in other patients). I also suggest that you consider making the receptionist aware that extra time is needed at the appointment where you intend to have the initial birth plan talk. Nothing like trying to be heard and having your care provider looking at the clock or having her hand on the door handle (though if that's the case, it might be time to consider a new practice!).
So when I am faced with an incredibly detailed birth plan, I know it's time for a talk about big picture. It may be that every item can be adhered to with no issue. But what if someone is dead set against an IV and then vomits for hours and labor stalls due to dehydration? Sometimes a little intervention can save a bigger intervention. That's why they are preferences. It's good, I think, to always consider what the next best thing is too...
"OK everybody," (it was really only me there)
"Be quiet - I have a call to make. (takes a deep breath)...OK - let's do this thing!"
Does my baby like a girl??
27 March 2011
Do you remember teaching me this? I remember like yesterday...you put an orange on a pencil (tilted on it's axis, naturally) & then rotated it around the hanging hotel light fixture (that looked a bit like Saturn, actually)...and I got it.
I just did the same for E...only it was a cherry tomato on a chop stick around a seltzer bottle. The moon was played by a smaller bottle. He completely understands now.
Apologies for not posting sooner, baby Kara Grace. Outside the three walls of glass on your birthday (March 13, NYC) morning, the whole city woke up to greet you. Welcome, beautiful girl - the world is out there waiting for you! Congratulations to you momma and poppa.
So the boy came through his surgery with flying colors. The recovery was actually a bit trickier than I imagined (not sure why that is - every mom who had btdt warned me!) but was also sort of nice. Firstly, my dad flew in to help (which we all loved), so I was able to get out to the gym and make daily runs for new ice cream flavors and foods that might be ok to grind up...though we discovered during the second week that soft scrambled eggs were like manna from the gods...a bit tough to say goodbye to egg friends though.
Mostly we stuck close to home and I was needed as a mom in a way I had not been needed in a long time. We actually had a middle-of-the-night cuddle sitting in the steamy bathroom with the shower running in order to sooth his throat. Either my lap has gotten smaller (not freaking likely) or the boy has gotten WAY bigger since last we did that.
Since his voice was so tiny and it hurt to talk, I gave him a bell to ring when he needed something. It was the very same bell I had used as a sick kid - I think my mom had gotten it at the mission in Carmel, CA where she grew up (I might be making up a more romantic heritage of this bell, but it makes me feel good to think that - and I think my dad liked the idea too). The kid enjoyed using the bell a little too much, if you know what I mean. I considered using rollerskates for a few days there.
So fast-forward to yesterday - the post-op doctor appointment at which he got the all-clear. On the way to the car, he said,
"Mom, it doesn't have to be over...we could just pretend that I'm still getting better. I can keep using the bell at least, right?"
18 March 2011
17 March 2011
In a fantastic blog post by a CA midwife about Japan, there is this bit of interesting/useful information for those who are concerned for themselves and their families on the west coast of the US (in particular):
....the general scientific consensus is that we on the West Coast will be "safe" from radioactive contamination. HOWEVER, since the jet stream is carrying everything toward us from Japan, it might be wise to feed your family superfoods that are radiation-protective. Especially if you are pregnant, or have young children, please check out the following links, and add miso, kelp, nettle tea, and the other mentioned plants and superfoods to your diets for the next several weeks, as things "fall out". Here is Susan Weed http://www.wisewomantradition.com/wisewomanweb/2010/11/surviving-radiation-the-wise-woman-way.html
and here is another excellent one from Christian Bates http://christianbates.com/?p=748
11 March 2011
Gonna be a long day.
10 March 2011
By the way, beautiful boy...I don't expect you'll remember, but we had a moment, you and I. You looked right into my eyes and held them for a bit and it made me cry...I don't cry at every birth and I didn't even cry when you were born - this was after. The enormity of being there and staring into the eyes of a baby who is only a few minutes old but looking so very wise reminded me how lucky I am to do what I do, so thank you for that.
ps: tell your momma to start playing the oboe again...she got lots of practice showing us how it's done! ;-)
06 March 2011
One of the biggest opportunities for reducing health care costs is improving the quality of maternity care. For most businesses, childbirth and newborn care is the largest or second largest (after heart care) category of hospital expenditures, and it's by far the largest category of hospital expenditures for state Medicaid programs. So even small improvements can result in large savings.
The place to start is with the most common hospital procedure in America -- the cesarean section. A C-section is a surgical delivery of a baby, rather than a normal, vaginal delivery. Not only does a C-section typically cost twice as much as a vaginal delivery, it is more likely to result in infections, injuries and other complications for both mothers and babies.
As for the rest of us, mental illness is not funny to watch...I get that it's hard to look away from the train wreck, but that's what I have been doing for the most part on this whole thing...it's just disturbing and there are worthier topics that should be dominating the news and captivating our country...like Wisconsin. Or Georgia.
And I'm not being holier-than-thou...I watch plenty of bad TV. But I don't wish to contribute life energy to watching a man implode on camera, preserving it forever for his children to watch for the rest of their lives. Sad.