sat nam

sat nam...say it with me now...

"The words themselves have a soothing and centering quality due to their monosyllabic nature, similar to sounds made by babies."

if your're in IL

please consider lending your support to midwifery legislation in IL: they need supporters on Tuesday, March 3rd at the State Capitol regarding the Home Birth Safety Act. A lot of support is mobilizing against CPM (Certified Practical Midwives) licensure...for info, go here: http://homebirthishealthy.blogspot.com/ and consider calling your legislators

science factoid

Through getting a cast, my son learned about exothermic reactions ...so although he missed science today, he still learned something scientific....it's how the fiberglass casts get hard.

history

last Google search on my computer:

"how to make your cast look awesome"

in a flash

That's how long it seems since my oldest, 11, was little and needed my help getting dressed. He needed my help again this morning.

Last night I got one of those calls moms hate to get. He was snowboarding and had a minor accident. Minor, but could have been major. A broken arm is all. He FELL, 10 feet, from the lift because he and his friend were horsing around, without the safety bar down. And he wasn't wearing his helmet. Good God - he could have had a traumatic brain injury, a broken neck...it sort of freaks me out to go there, so I mostly don't.

I count myself lucky that with three very active, risk-craving boys, this is the first broken limb among them...and sort of a rite of passage as well. I'm happy there was no concussion (he has had one of those). No blood. Just bad, bad judgment that he will be working off in equally bad karma by missing a few awesome activities and a screeching end to his ski season. I hope he learned his lesson about the safety bar and helmet and maybe got just a small hint that he's not indestructible. Please, please let that be true. Because there is so much about their lives, even at 11, that is out of our control.

He says he will hang the official X-Ray films in his room (the doctor suggested using them as window shades - crafty!) & is planning how to decorate his red cast.

On the way home from the ER he announced that he and the friend he was with on the lift had a plan for their shared 18th birthday: sky diving!

OY.

you can read with one hand

The Daily Show With Jon StewartM - Th 11p / 10c

Jeff Bezos

Daily Show Full Episodes
Important Things With Demetri Martin

Funny Political News
Joke of the Day

new toy

My new Kindle reader is here! To open the box I had to pull a tab that read, "Once upon a time..." - cute, no? I'm quite excited in spite of feeling a little odd...no more books? I mean, of course I'll still buy some things in hard copy; this electronic gadget can't replace a kid story book or a design book. But I have to say I love the idea of going on vacation or heading off to a birth (or anyplace where there is the possibility of having time on my hands) with several books (& links to almost anything) taking up the space of a small note pad. There are even kid chapter books so if you finish one & your family is dying for the next one you can download it in seconds.

This extravagant gift from my husband feels a bit like when my MIL gifted me with a Bugaboo stroller when they first came out...I sort of felt like I was driving a Hummer - conspicuous consumption. But I loved that stroller & think I will also love this - it's cool & I like gadgets.

And to sooth my consumption concerns, I will donate the new hard copies of some duplicate books (book club favs) to my local library.

art overload

a sad momma moment for me last week...

My 4yo is a prolific artist and is quite attached to keeping his masterpieces...including every last coloring page from story time at the library or the doodles he does while the others do homework. Any mom can do the math: 3 kids X all the pieces of paper, art included, that they bring home...unless there is some culling, pretty soon you are living a nutty hoarder lifestyle with toenail clippings in jars and stacks of newspapers lining the hall.

Said 4yo is on to me and has begun checking the recycle bin to make sure nothing of his has made its way there. I try to hide his stuff (not the cool stuff, just the junk) on the bottom or take it to the big bin outside...but one day last week I forgot & tossed it on top of the bin. Well, he found it and came to me in almost-tears and said, "Do you hate it or do you love it?! Because you said you loved it and then you threw it away! Why do you throw my art away? Which is it - hate or love?"

Ugh. Knife in my heart. I suppose I contribute to the issue by being overly enthusiastic about everything...so I'll try to work on that. I've also made a small pile of really great stuff to frame & display rather than just taping on the door.

Birth on film

For those in the DC area (or close enough to make it to the area!), check out the Baby! International Film Festival on March 21, 2009.

Parenting Magazine

according to a reader comment (hi Elizabeth!), Parenting Magazine is dissing the film Orgasmic Birth...

Elizabeth writes:
The headline is "O,h Please!" and the pronouncement at the end is "Get real." How closed-minded! Can't wait to write a letter to the editor!

Here here! Thanks for the heads up.

got milk?

In the current (March, p. 197) issue of Oprah's O Magazine is an article on breast milk & milk banking. Entitled, "The Gift", the article is about a woman who has preemie triplets and begins pumping, ultimately donating over 7,000 ounces of breastmilk to a milk bank.  It also talks a lot about why breastmilk is best for babies nutritionally and for all the other reasons beyond nutrition.   This article follows last month's  "Books That Made A Difference" section, (where a celeb tells about what they are reading and why), in which Isla Fisher (Confessions of a Shopaholic) talked about birth and Ina May Gaskin's Guide... 

Why does this matter?  Because Oprah is incredibly influential and is sort of the holy grail in terms of PR...and because she has seemed to avoid birth-related topics much to the consternation of the birth community.  Hopefully this is a trend in the right direction!  

repeat cesareans

Check out a Time Magazine piece on Cesareans:

The Trouble With Repeat Cesareans
By PAMELA PAUL
Thursday, Feb. 19, 2009

For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car."

Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them. (Read "The Year in Medicine 2008: From A to Z.")

Why the VBAC-lash? Not so long ago, doctors were actually encouraging women to have VBACs, which cost less than cesareans and allow mothers to heal more quickly. The risk of uterine rupture during VBAC is real--and can be fatal to both mom and baby--but rupture occurs in just 0.7% of cases. That's not an insignificant statistic, but the number of catastrophic cases is low; only 1 in 2,000 babies die or suffer brain damage as a result of oxygen deprivation.

After 1980, when the National Institutes of Health (NIH) held a conference on skyrocketing cesarean rates, more women began having VBACs. By 1996, they accounted for 28% of births among C-section veterans, and in 2000, the Federal Government issued its Healthy People 2010 report proposing a target VBAC rate of 37%. Yet as of 2006, only about 8% of births were VBACs, and the numbers continue to fall--even though 73% of women who go this route successfully deliver without needing an emergency cesarean.

So what happened? In 1999, after several high-profile cases in which women undergoing VBAC ruptured their uterus, the American College of Obstetricians and Gynecologists (ACOG) changed its guidelines from stipulating that surgeons and anesthesiologists should be "readily available" during a VBAC to "immediately available." "Our goal wasn't to narrow the scope of patients who would be eligible, but to make it safe," says Dr. Carolyn Zelop, co-author of ACOG's most recent VBAC guidelines.

But many interpreted the revision to mean that surgical staff must be present the entire time a VBAC patient is in labor. While major medical centers and hospitals with residents are staffed to provide this level of round-the-clock care, smaller hospitals typically rely on anesthesiologists on call. Among obstetricians, many solo practitioners are unable to stay for what could end up being a 24-hour delivery; others calculate the loss of unseen patients during that time and instead opt to do hour-long cesareans, which are now the most commonly performed surgeries on women in the U.S.

Some doctors, however, argue that any facility ill equipped for VBACs shouldn't do labor and delivery at all. "How can a hospital say it can handle an emergency C-section due to fetal distress yet not be able to do a VBAC?" asks Dr. Mark Landon, a maternal-fetal-medicine specialist at the Ohio State University Medical Center and lead investigator of the NIH's largest prospective VBAC study. (See 9 kid foods to avoid.)

Part of the answer has to do with malpractice insurance. Following a few major lawsuits stemming from VBAC cases, many insurers started jacking up the price of malpractice coverage for ob-gyns who perform such births. In a 2006 ACOG survey of 10,659 ob-gyns nationwide, 26% said they had given up on VBACs because insurance was unaffordable or unavailable; 33% said they had dropped VBACs out of fear of litigation. "It's a numbers thing," says Dr. Shelley Binkley, an ob-gyn in private practice in Colorado Springs who stopped offering VBACs in 2003. "You don't get sued for doing a C-section. You get sued for not doing a C-section."

Of course, the alternative to a VBAC isn't risk-free either. With each repeat cesarean, a mother's risk of heavy bleeding, infection and infertility, among other complications, goes up. Perhaps most alarming, repeat C-sections increase a woman's chances of developing life-threatening placental abnormalities that can cause hemorrhaging during childbirth. The rate of placenta accreta--in which the placenta attaches abnormally to the uterine wall--has increased thirtyfold in the past 30 years. "The problem is only beginning to mushroom," says ACOG's Zelop.

"The decline in VBACs is driven both by patient preference and by provider preference," says Dr. Hyagriv Simhan, medical director of the maternal-fetal-medicine department of Magee-Womens Hospital of the University of Pittsburgh Medical Center. But while many obstetricians say fewer patients are requesting VBACs, others counter that the medical profession has been too discouraging of them. Dr. Stuart Fischbein, an ob-gyn whose Camarillo, Calif., hospital won't allow the procedure, is concerned that women are getting "skewed" information about the risks of a VBAC "that leads them down the path that the doctor or hospital wants them to follow, as opposed to medical information that helps them make the best decision." According to a nationwide survey by Childbirth Connection, a 91-year-old maternal-care advocacy group based in New York City, 57% of C-section veterans who gave birth in 2005 were interested in a VBAC but were denied the option of having one.

Zelop is among those who worry that "the pendulum has swung too far the other way," but, she says, "I don't know whether we can get back to a higher number of VBACs, because doctors are afraid and hospitals are afraid." So how to reverse the trend? For one thing, patients and doctors need to be as aware of the risks of multiple cesareans as they are of those of VBACs. That is certain to be on the agenda when the NIH holds its first conference on VBACs next year. But Zelop fears that the obstetrical C-change may come too late: "When the problems with multiple C-sections start to mount, we're going to look back and say, 'Oh, does anyone still know how to do VBAC?'"

missing ritual

I have written before about my feelings that birth and death are similar, connected. And that I am sorry, angry even, that our culture seems not to know how to deal with either particularly well...we lack the ritual present in other cultures that might help lead our way. I saw this and thought it important - it is the first in a series in Slate.
Reading it, I couldn't help but think of friends who had lost a parent or a husband or a child. I especially thought of Molly and Stacey, whom I love...I hope this isn't too hard for them to read.
For others who see themselves in this, I am deeply sorry for your pain too.

The Long Goodbye
What grief is really like.
By Meghan O'Rourke
Updated Tuesday, Feb. 17, 2009, at 7:32 AM ET
--------------------------------------------------------------------------------

The other morning I looked at my BlackBerry and saw an e-mail from my mother. At last! I thought. I've missed her so much. Then I caught myself. The e-mail couldn't be from my mother. My mother died a month ago.

The e-mail was from a publicist with the same first name: Barbara. The name was all that had showed up on the screen.

My mother died of metastatic colorectal cancer sometime before 3 p.m. on Christmas Day. I can't say the exact time, because none of us thought to look at a clock for some time after she stopped breathing. She was in a hospital bed in the living room of my parents' house (now my father's house) in Connecticut with my father, my two younger brothers, and me. She had been unconscious for five days. She opened her eyes only when we moved her, which caused her extreme pain, and so we began to move her less and less, despite cautions from the hospice nurses about bedsores.

For several weeks before her death, my mother had been experiencing some confusion due to ammonia building up in her brain as her liver began to fail. And yet, irrationally, I am confident my mother knew what day it was when she died. I believe she knew we were around her. And I believe she chose to die when she did. Christmas was her favorite day of the year; she loved the morning ritual of walking the dogs, making coffee as we all waited impatiently for her to be ready, then slowly opening presents, drawing the gift-giving out for hours. This year, she couldn't walk the dogs or make coffee, but her bed was in the room where our tree was, and as we opened presents that morning, she made a madrigal of quiet sounds, as if to indicate that she was with us.

Since my mother's death, I have been in grief. I walk down the street; I answer my phone; I brush my hair; I manage, at times, to look like a normal person, but I don't feel normal. I am not surprised to find that it is a lonely life: After all, the person who brought me into the world is gone. But it is more than that. I feel not just that I am but that the world around me is deeply unprepared to deal with grief. Nearly every day I get e-mails from people who write: "I hope you're doing well." It's a kind sentiment, and yet sometimes it angers me. I am not OK. Nor do I find much relief in the well-meant refrain that at least my mother is "no longer suffering." Mainly, I feel one thing: My mother is dead, and I want her back. I really want her back—sometimes so intensely that I don't even want to heal. At least, not yet.

Nothing about the past losses I have experienced prepared me for the loss of my mother. Even knowing that she would die did not prepare me in the least. A mother, after all, is your entry into the world. She is the shell in which you divide and become a life. Waking up in a world without her is like waking up in a world without sky: unimaginable. What makes it worse is that my mother was young: 55. The loss I feel stems partly from feeling robbed of 20 more years with her I'd always imagined having.

I say this knowing it sounds melodramatic. This is part of the complexity of grief: A piece of you recognizes it is an extreme state, an altered state, yet a large part of you is entirely subject to its demands. I am aware that I am one of the lucky ones. I am an adult. My mother had a good life. We had insurance that allowed us to treat her cancer and to keep her as comfortable as possible before she died. And in the past year, I got to know my mother as never before. I went with her to the hospital and bought her lunch while she had chemotherapy, searching for juices that wouldn't sting the sores in her mouth. We went to a spiritual doctor who made her sing and passed crystals over her body. We shopped for new clothes together, standing frankly in our underwear in the changing room after years of being shyly polite with our bodies. I crawled into bed with her and stroked her hair when she cried in frustration that she couldn't go to work. I grew to love my mother in ways I never had. Some of the new intimacy came from finding myself in a caretaking role where, before, I had been the one taken care of. But much of it came from being forced into openness by our sense that time was passing. Every time we had a cup of coffee together (when she was well enough to drink coffee), I thought, against my will: This could be the last time I have coffee with my mother.

Grief is common, as Hamlet's mother Gertrude brusquely reminds him. We know it exists in our midst. But I am suddenly aware of how difficult it is for us to confront it. And to the degree that we do want to confront it, we do so in the form of self-help: We want to heal our grief. We want to achieve an emotional recovery. We want our grief to be teleological, and we've assigned it five tidy stages: denial, anger, bargaining, depression, and acceptance. Yet as we've come to frame grief as a psychological process, we've also made it more private. Many Americans don't mourn in public anymore—we don't wear black, we don't beat our chests and wail. We may—I have done it—weep and rail privately, in the middle of the night. But we don't have the rituals of public mourning around which the individual experience of grief were once constellated.

And in the weeks since my mother died, I have felt acutely the lack of these rituals. I was not prepared for how hard I would find it to re-enter the slipstream of contemporary life, our world of constant connectivity and immediacy, so ill-suited to reflection. I envy my Jewish friends the ritual of saying kaddish—a ritual that seems perfectly conceived, with its built-in support group and its ceremonious designation of time each day devoted to remembering the lost person. So I began wondering: What does it mean to grieve in a culture that—for many of us, at least—has few ceremonies for observing it? What is it actually like to grieve? In a series of pieces over the next few weeks, I'll delve into these questions and also look at the literature of grieving, from memoirs to medical texts. I'll be doing so from an intellectual perspective, but also from a personal one: I want to write about grief from the inside out. I will be writing about my grief, of course, and I don't pretend that it is universal. But I hope these pieces will reflect something about the paradox of loss, with its monumental sublimity and microscopic intimacy.

If you have a story or thought about grieving you'd like to share, please e-mail me at morourkexx@gmail.com.

Meghan O'Rourke is Slate's culture critic and the author of Halflife, a collection of poetry.

Article URL: http://www.slate.com/id/2211257/

Copyright 2008 Washingtonpost.Newsweek Interactive Co. LLC

sharing the wealth

When I was born, there was another baby who needed milk & his mom was unable to feed him, so my mom did (at the hospital's request, as there were some sort of special circumstances)...I've never nursed someone else's baby, but I have donated my milk to a baby who's mom was undergoing chemo.
What about you - would you do this for another? If your baby were very hungry and you couldn't feed her, would you welcome someone else doing it? I know there are questions of health etc. (in the case of my donation, medical questions were asked of me), but I'm talking about how this feels to you, in your heart? I say yes & yes.

Thanks to Cooler Than The Cat for posting...

Another reason to get you Vit. D

From DONA's newsletter:

Vitamin D deficiency linked to cesareans
Women deficient in vitamin D had a four times greater risk of having a cesarean says a multivariable analysis published in the Journal of Clinical Endocrinology and Metabolism. Theories are that skeletal and smooth muscle strength is compromised and it is possible that there might be an association to diagnoses of cephalopelvic disproportion and failure to progress as well as preeclampsia due to a link with immune status. The researchers conclude that a randomized controlled trial is warranted because vitamin D deficiency is on the rise. Read about it here.

serindipity

I got to attend a lovely birth of a sweet baby boy today...my dear friend, their doula, had to leave by a certain time (unusual) to attend her son's birthday party, so I was able to come in and witness and be a small part of this lovely passage. I was able to still make it to the class I was teaching just a few minutes late...I love it when it all works out!

happy sigh...

Happy V Day

On this Valentine's Day, consider checking out the film, Until The Violence Stops, documenting the growth of Eve Ensler's The Vagina Monologues, which has grown into an international grassroots movement to stop violence against women and girls.

XOXO swak

a-ha

I feel like I've had a personality transplant...I am SO much less crabby now that I am going to the gym 6 days a week (instead of 3) and as a result getting about 7 or 8 hours of sleep instead of maybe 6. And eating a lot less sugar.

I know it's not rocket science & I'm a dope for taking so long to figure this out, but seriously, I'm feeling like such a better version of myself.

Welcome baby Aoife Jean!

(pronounced Eefa)...a beautiful Irish name for a beautiful Irish/Australian girl. Slow to start, your labor sure picked up speed...10 pounds but not a stitch...your momma was the picture of calm and strength and your dad was right there lending his own quiet strength and telling the world that you were a girl!
What luck to have a nurse who used to work in a birth center (the same one where I, myself, gave birth to my second son), as well as such a wonderful doctor - a true gaurdian of the sanctity of birth.
Welcome to the world, Aoife!
My 4yo was right - you were born on 2/10!

where's the moxie?

(first - I attended a birth of a little girl who's middle name is Moxie!  cool)

I'm feeling a little less brave today, somehow.  Maybe because my focus is half on waiting to hear from a momma in a little labor.  Originally we thought she would give birth yesterday...because that's what my 4yo had said would happen ("What are we gonna do after your birth tomorrow, mom?).  Sure enough, she went into labor yesterday AM but it's been fits & starts.  Yesterday at 3pm he revised his prediction to today (not last night, so I actually slept well, but did speak with the momma once in the night).  So we'll see...lot's of contractions again but not really gathering steam yet...I may head over, if she likes, to see about some positioning.

Meanwhile, gotta get to the gym - must train!  A little over seven months sounds long (before the triathlon), but I know it will go quickly.