Saturday, October 31, 2009

Two rare and stunning (GRAPHIC) views of birth in photography

My attention was just drawn to some absolutely stunning photographs by birth doula, childbirth educator and photographer Patti Ramos. Here she gets seriously up close for some crystal-clear shots of the crowning, emerging head:


To me, this is just gorgeous, not scary or off-putting in the least. It looks like everything is working just exactly as it's meant to, tissues slowly spreading, fanning - taut, yes, but not out of proportion in any way. On the contrary, it seems perfectly proportioned. (I might add that mom's grooming skills are rather remarkable here. Forgive me, but I couldn't help noticing and being pretty impressed.)

I just love seeing how the fontanels overlap here. How beautifully designed!


Almost outta there . . .

The 9 pound, 6 ounce boy (take that, CPD scaremongers) reaches for mama with some peppy jazz hands.

Look at that amazing umbilical cord, pulsing away!

And at last, the placenta, the Tree of Life, as Ramos points out. She has some great shots of it emerging, too, as well as more of the birth overall - please make sure to check out the whole thing.

So after seeing those gorgeous, enlightening shots, I started poking around her site for some more great sets, of which there were plenty. Particularly intriguing to me was this series, showing the unusual presentation of the intact amniotic sac, which emerged FIRST! I never even knew such a thing was possible, did you? Wow!


I then came across this photograph of a uterus just after a c-section, which I had never, ever seen. She aptly titles it "The Wounded Womb". I've seen plenty of c-section-in-progress shots and even a few videos of varying degrees of graphicness, but never a shot of the uterus itself. In fact, I've never seen an actual UTERUS, just representations of them. Even in the cadaver lab I did as a massage therapist, I didn't get to see the uterus. So this was a revelation.

Warning, again, extremely graphic. I will give a little space in case you aren't sure you want to see this.


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It is resting on the mother's abdomen, just after the first layer of suturing. Patti points out that the fallopian tubes are visible on either side of the uterus - another revelation; I had never been able to fully visualize them. They kind of look like headphones or Princess Leia buns. But I don't meant to trivialize this. It's both a sobering and a monumental sight.

All these glimpses here, dramatically different as they are, renew my awe of the mighty female body and the resilient glory of childbirth. Thank you Patti, for sharing these.

Friday, October 30, 2009

Signs, signs, everywhere there's signs

In the last week or so, this has been all over the blogosphere, Facebook, Twitter, and the internet entire:


Just amazing, isn't it? Anyway, it's been so well-distributed I wasn't even going to bother doing my own post, but then Crunchy Domestic Goddess just did a really good round-up on all the other posts about it and I had to share.

In a way, its existence and internet ubiquity is almost a good thing, not just in the "at least they're honest" sense (having known far too many women who have thought that had a supportive OB only to be duped at the last minute, in a sadly common bait & switch) but also because it's really made the internet rounds and is generating a lot of discussion, including some in circles that might normally be much more of the trust-the-doctor mindset.

GAH, though. Really, what's next?

We will not accept clients who have read any of the following: "Pushed" by Jennifer Block, "Your Best Birth" by Ricki Lake and Abby Epstein, or anything by Sheila Kitzinger, Henci Goer, Marsden Wagner or Ina May Gaskin. Writings from the Sears library may be approved on a case by case basis. Viewing of the films "The Business of Being Born" and "Orgasmic Birth" are likewise prohibited. Attending ICAN meetings is strictly forbidden. Please schedule an appointment with our IT assistant to have the following websites blocked from your computer: The Unnecesarean, Science and Sensibility, Mothering.com, Stand and Deliver, Gloria LeMay, My Best Birth, and Navelgazing Midwife. Periodic computer updates will be required. Remember, we care about the welfare of your baby!

Sunday, October 25, 2009

Teaching a mom to fish, leading a mom to water

So as you may know, I completed my three-day postpartum doula training through DONA a few weekends ago. This is just one step of the certification process, but it's the biggest one, and I enjoyed it thoroughly. I was worried about being away from my daughter for so long - over 12 hours every day, including the commute, but she was a total champ, and I think it was good for her and Daddy to spend so much time together. I was also pleased to see that I can still pump a good amount of milk, at 18 months, which I did in a corner of the conference room every 3 hours or so.

We learned an incredible amount in such a short span of time - it would be ludicrous to try and reproduce or even summarize it here. The underlying refrain we kept coming back to, no matter what the topic was (infant bathing, nursing, integrating older siblings, addressing postpartum depression, light housekeeping) is the phrase "maximizing self-sufficiency". Sounds a little bit corporate speak, right? A little approved-by-committee? Yep, I get that - but it's also pretty spot-on, and really helps to distinguish a huge part of how postpartum doulas are different from, say, housecleaning services or babysitters or even "mother's helpers". There IS some overlap, some grey area, with those services, and we will often be doing a bit of all those things.

Part of the difference does have to do with additional training in breastfeeding, recognizing postpartum depression, and overall postnatal recovery. Part of it is the multifunctional nature of it, since we do a little bit of everything, including some grunt work (especially at first), but there's more to it than that. It's much more about helping the family to slowly become more and more capable of doing all these things on their own, focusing on how best to support the new, confident mother. At first, the job may involve doing the laundry pretty regularly. But then, what happens when the term of employment is over, and mom never figured out how to work it into her routine, and doesn't know what settings and products are best for the cloth diapers and baby clothes, and hasn't worked out a trade-off with her partner on laundry duty? When the doula departs for good, and hasn't addressed that, she's just leaving a void where her services used to be. She just made the family dependent on her for doing their laundry, and now what?

So it's the classic adage, made maternal: if you give a mom a fish, she eats for a day. But if you teach her how to fish for herself, she eats for a lifetime. And at first, just getting her to eat for a day may be the most important thing - but the long-term needs to be kept in mind. This was a really important revelation for me.

It was also interesting/amusing/embarrassing to see just how many things I had done DEAD WRONG with my first very unofficial client that I had taken on the week right before the workshop. (I had put the word out that I was going to be seeking practice clients soon, and this mom needed help, so, I figured, why not? She knew I was pre-training, and was happy to pay the extremely reduced rate, and just needed the extra hand.) For one thing, we are never, ever to install car seats for clients, for what in hindsight are obvious liability issues. D'oh! But in the moment, that's what she needed done, so I just went ahead and did it. For another, we are never ever ever ever to drive the children anywhere. No way, no how, for even more obvious reasons. That one I could really smack myself for, but in the moment, again, she asked if I would just drive the loaded-in kiddos (four total, including the new wee bairn) around the block a few times while she got dressed before departure for an outing, and I just said, "Okay, sure!' GAH, when I think of what could have happened . . . but now I know better. There were a few other instances too, more benign than those examples but still a little off from the postpartum standard of practice. Ah well - I feel all the more professional now.

Now for the other adage - one that is considerably harder. I'm working with my first 'real' client now (still part of the certification process, but post-training), and wouldn't you know I get a HUGE challenge right out of the gate. This mom is working on breastfeeding after a reduction, and is having some serious challenges. I am having a really tough time with the limitations of our scope of practice as doulas. We do have training in the basics of breastfeeding, but anything even slightly out of the ordinary and we are to refer, refer, refer. Well, she's already seen a lactation consultant, but frankly, either this LC is terrible or mom is not quite following the directives. Whichever one it is, I am really struggling against what I suspect is some bad information, and what I know are some counterproductive practices. So I'm already frustrated with how my hands are tied as a doula when it comes to breastfeeding. So much so that I'm thinking more and more about becoming a lactation counselor (and maybe eventually an IBCLC), but that's too far in the future to help me now.

I want to encourage this mama more than anything, but I CANNOT push her. I'm not sure I should get into the specifics here due to client confidentiality issues, but suffice it to say, I am doing my best to offer as much good information as possible, and making it as easy as possible to organize their lives around the practices that will support nursing - and her supply - as much as possible. One of the hardest things is having had the extreme difficulty of my own nursing experience and NOT sharing the information that I learned from that experience with her. DONA really drilled this into our heads, too -it isn't about us.

I understand the values and the rationale behind that, and with why keeping that in mind is important, but honestly, it's just not possible to remain 100% pure about that. If we learned a trick that was really useful in diaper changing, of course we're going to teach that to our clients, so why would I not be able to offer coaching in using a Lact-Aid, for example? So yes, I've broken the rule a bit already, despite my efforts to keep personal experience minimized and focus on information from expert sources (I bring printouts of articles and other handouts to pretty much every visit).

After our third visit, I got in touch with my own brilliant guru of a lactation consultant, to bounce some things off her. She had some great specific advice, but more importantly, she recommended making the mother state aloud exactly what her goals are - because, honestly, I never actually asked her what they were, specifically. It wasn't on the DONA questionnaire that I gave her. Perhaps no one had asked her this. A rookie mistake, maybe, but when she said this, I realized that I had been approaching this as what *I* would do, according to what MY goals would be, instead of having her articulate it to me, and for herself. Big difference.

And then, she said, the path is to ask yourself each step along the way: "Are the steps I'm taking now steps that will get me closer to my goal, or further away from it?" I remember having to ask myself that every day - every feeding, even. So I asked her to state what her OWN goals were (it was in the context of reviewing a questionnaire, so it fit perfectly & didn't feel confrontational). She right away distinguished what she perceived as "Ideal" vs. "Realistic", which I thought was revealing, and we took it from there.

The BFAR book is titled "Defining Your Own Success", and it's a double-edged sword, of a concept, in my opinion. Some women post-reduction may REALLY try everything and still not be able to produce 100% for their babies. So for them, it's important to be okay with redefining success for themselves, and not feeling like a failure because they are not able to exclusively breastfeed. I absolutely get that. But the flip side of that is that some other women are going to set such low expectations and even hopes for themselves from the beginning, that, as we can see, completely undermines and possibly even sabotages their efforts and intentions from the beginning.

So if my LC's process is to be followed, as long as every day, the mother consciously takes the steps she knows she needs to take in order to move toward her goal, THAT is success. That's defining your own success with integrity. There's nothing to feel guilty about if you've taken the steps towards your own goal, whatever that might be, and it doesn't work out perfectly for reasons you cannot control. If you know the steps you need to take for your own goal, whatever that is, and are not willing to take them, well, then, that's a little different. So I want to make sure that she is as well-informed as possible, and that she herself is clear on her goals, and that she herself is clear on the steps that are to be taken, in her own mind.

So my revised plan with my client (who I really like and respect, incidentally) is to try to keep reminding her of her own goals and the steps that we identified together as the ones that are most supportive of her ideal, and continue trying to integrate those steps into her daily life. And the biggest personal challenge for me is to not take it personally when she makes different choices - and remember that (here's that second adage) I can lead her to water, but I cannot make her drink. I can help her find the best water there is, I can put it into beautiful glasses with ice cubes and fresh lemon wedges, I can create a comfortable place for her to sit and have the water . . . but I cannot force her to drink it.

Monday, October 19, 2009

The R word

Well, I had no intention of posting so soon on the same topic again, but YET ANOTHER feminist website has weighed in on the Joy Szabo case, and once again, the comments have had me yelling at the computer screen like a crazed soccer hooligan. I was going to leave my comment there and just walk away, but the comment system at Jezebel is either on the fritz or they're moderating the comments and leaving some out, since I wrote this almost 7 hours ago, posted it, and it hasn't shown up yet. Fortunately for thee, gentle readers, I had the foresight to paste it into WordPad, so what the heck, I'll just share it with you here. The topic this time was specifically the issue of whether or not it is fair to compare a forced c-section with rape.

As I was alerted to this by our Mother Superior (Jill at Unnecesarean), the first paragraph is a paraphrase of her own reaction on Facebook, for which I asked permission to yoink. The rest is my own, including reactions to other commenters, quoted within (and do see the comments thread for yourself, for sure).

And yet another comment section veers off into cesarean vs. epidural vs. unmedicated birth and the point is completely missed. If you walk into a hospital to give birth and you do not consent to a procedure and it is performed on you anyway, THAT. is. the. problem. And that is assault.

If you think using the word "rape" is inappropriate, you're entitled to your opinion. All I will say is that I have read firsthand stories about incredibly brutal treatment of laboring women in hospitals (including some, but not limited to, c-sections), which were every bit as heartbreaking as some personal accounts of rape.

No one is saying that c-sections are not sometimes necessary and life-saving and wonderful. They absolutely are, when needed. And that is completely, categorically beside the point. No one is saying "OMG C-SECTIONS = ALWAYS BAD", as one commenter actually characterized birth advocates. (If that's honestly what you took away from a site that promotes choices in childbirth, and helps women who desire a natural birth to achieve one, no wonder we have a failure to communicate.)

"But don't tell me I was violated when I wasn't. C-sections are not rapes, or even inferior births." First, if you consented to the procedure, of course you weren't violated. That's the entire point. And I'm sorry, but again, no one, NO ONE, is saying that all c-sections are rape.

I also just want to point out that the hospital refusing to support a VBAC for Joy Szabo was the very hospital that provided her the prior c-section in the first place, in case anyone missed that point; obviously, they are capable of providing emergency c-sections! If a facility is not able to provide an emergency c-section, they have no business handling labor and delivery in the first place, period.

Anyway. It's about women having control of decisions made about their own bodies. It's about reproductive rights in every sense of the term.
I know not all fellow feminists turn a blind eye to the maternity care crisis, but conversations sparked like these make it crystal clear that some definitely do, and I think it is a crying shame. I want to point something out from one of the more well-known forced c-section cases (and I do not mean coaxed or coerced, I mean literally forced - if you haven't read Laura Pemberton's story in "Pushed" or online, it's a must). After being brought to the hospital by the sheriff:

Once at the hospital, she was allowed a “hearing” in her hospital room, with an armed sheriff, the State Attorney, and obstetricians crowding her room. Although a lawyer was appointed to represent the fetus, no lawyer was appointed for her. She spoke between contractions, without the benefit of counsel, telling the judge about the extensive research that she had done to support her decisions. Despite the fact that she could already feel her baby’s head in the birth canal and neither she nor the baby showed any signs of danger, the obstetricians were convinced that she exposed her fetus to too much risk by continuing to deliver vaginally: the judge agreed. Laura Pemberton was sedated, and her baby removed via caesarean section.
Let me repeat. "Although a lawyer was appointed to represent the fetus, no lawyer was appointed for her." Take a moment to let that sink in.

I don't know what they're teaching in women's studies these days, but that's enough to make me want to take to the streets.

*****

Not to be the blogger who's always blogging about how they haven't had time to blog, but it's been a rather exciting week with my first official client! I still have much left to say from my training, and thoughts on all the things I've already learned, but then online scuffles and kerfuffles keep dragging me away from my own posts. More to come, I promise - again.

Monday, October 12, 2009

If you go out in the woods today . . .

What to do with a placenta after the baby's born? I thought I'd heard it all.

Making a lovely tree print. Hanging out with it in a salad bowl for days, lotus birth style. Chowing down on some chili, spaghetti sauce, or even a blended 'cocktail', for the daring. Encapsulating it, for those who want the benefits in a tidier, less-squeamishness-inducing way (I hope to eventually offer this service myself). Burying it under a tree - which I still plan to do with Lily's someday. Leaving it wrapped and labeled in the freezer for years on end with intentions of doing one of the above is a very popular option. Or "donating" it to cosmetics companies, which if you're in the hospital may be pretty much your only choice.

But here's one that is truly news to me: making a teddy bear out of it.


A crafty alternative for those who don’t necessarily want to eat their baby’s placenta, but want to pay their respects to the life sustaining organ by turning it into a one-of-a-kind teddy bear. Green’s ‘Twin Teddy Kit’ ‘celebrates the unity of the infant, the mother and the placenta,’ and enables preparation of the placenta so it may be transformed into a teddy bear. The placenta must be cut in half and rubbed with sea salt to cure it. After it is dried out, it is treated with an emulsifying mixture of tannin and egg yolk to make it soft and pliable.

I'm not sure I'll be adding this onto my list of optional postpartum services just yet . . .

All I can think is "Annie, Annie, are you okay?"

Remember that SimONE Birthing Simulator I was grumbling about a few weeks back? The one that was just a torso, pelvis and a couple of amputated stumps for legs? Thought that was creepy, did ya?

Good news! Or not? From the Discovery Channel:



Eventually "Noelle" will turn on some hapless resident, oh yes, she will . . .

(Thanks to Passion for Birth. As she said, "No voice, on her back, how many infractions can you see of the Healthy Birth Practices? The non-evidenced based practices keep on rolling...")

Saturday, October 10, 2009

Weekend Movie: Do You Doula?

Here's a short documentary that I think is a mostly very good public service for doulas as labor support:



Wait, what does she mean by "mostly", though?

I have to quibble, though, with two little things, and I'm very interested in what birth doulas have to say about it. At about 2:11, in the section on "What is the doula's role when working with hospital staff?" a mother states that a doula is "an important liaison between the mother and the [hospital] staff", and shortly thereafter, a doula states that she sees her job as "running interference" between the family and hospital personnel.

Eep. I haven't even competed my birth doula training yet, and I know this is an extremely dicey issue. Using language like "liaison" and "running interference" is a bit misleading, and some doulas HAVE gotten into trouble when overstepping their bounds. You risk alienating the staff, or possibly getting kicked out of the room altogether, leaving the family with no support at all.

Still, the video is overall pretty good, and has a very positive tone. What do you think? I'd love to hear from moms, doulas, nurses, and others.

Thursday, October 8, 2009

Lightbulbs


I just had a major lightbulb go on above my noggin over at Unnecesarean. The topic was postdates, and the conversation turned to induction. One commenter wondered about her own induction-turned-cesarean, and a midwife going by Birthkeeper replied:
As a Midwife, I would say that yes, your cesarean likely could have been avoided just from what you told me. When an induction occurs when a baby and body aren't ready, the body does just what it's supposed to do: it protects the baby. It's not a malfunction of your body, but rather functions rather beautifully in what it's supposed to do. Unfortunately, in the hospital, that means a cesarean for failure to progress. :( But had your body and baby been allowed to work in its own timing, it's very unlikely that you would have had a cesarean at all. I'm so sorry that you were led down that path.
The bolded part about blew my mind. WOW. I never thought of it that way before, but I think this is an amazing truth; in a way (a sad way, but still) a failed induction - in most cases - is actually an affirmation of the wisdom of the mother's body, devoted to its prime directive: protecting the baby. What a revelation! Brilliant . . . and a bit heartbreaking to think of how often it is unnecessarily violated.

I've had a few other lightbulb moments recently, including quite a few from my postpartum doula training this past weekend, of course.

One might seem completely obvious to you, and this is one of those situations where you kind of understand something, but it doesn't really click with you until something illuminates it. I definitely know the basics of breastfeeding, and even understand some unusual complications, due to my own experience. So I know, of course, that the main source of nipple pain when breastfeeding is a poor, shallow latch. And I know that a proper latch means taking in much of the areola, not just the nipple. I've even heard hard and soft palate mentioned in discussion of this before. But it wasn't until we watched the short film "Follow Me Mum" that I visualized exactly how this functions! Latched on to it, if you will.

The above isn't from the film, but it shows the physiology pretty well. Feel inside the roof of your own mouth, and notice where the palate changes from hard to soft. Now take a look at the top image: In the film, they distinguished between the hard and soft palate, and it was crystal clear to me how, if the nipple extends far enough back, it will be compressed against the SOFT palate and will be comfortable. If it doesn't, as shown by the example below with a tongue tie (though other factors, like positioning, can cause this to happen too), the nipple instead is going to be compressed against the HARD palate instead. Ouch!

If this is patently obvious to you already, then more power to you, but I really have a deepened understanding now. I grok this in fullness.

Another revelation from the workshop, that was more of a "DUDE, how cool is that?" moment: Babies spend about 50% of their sleep cycle in REM sleep. Did you know that babies, unlike adult sleep cycles, enter REM sleep first? Maybe you did. I remember reading that as well. Cool enough.

But did you also know that a breastfeeding, cosleeping mom's sleeping pattern actually adjusts to her baby? Even though she is an adult, she, too, will enter REM sleep first, and will follow the baby's cycles, and is thus more easily rousable when baby stirs to nurse. "Physical closeness causes a mother and baby to share sleep cycles. A baby usually wakes during light sleep and the mother is then likely to be in light sleep as well. She can settle the baby without her sleep cycles being seriously disturbed. Awakening from deep sleep is what leads to exhaustion." How freaking amazing is that? (All the cosleeping info on that whole page is very worth reading, by the way.)The more I learn about breastfeeding, the more I understand how intricate and miraculous the relationship between mother and baby is; the "breastfeeding dyad".

Finally, one other lightbulb from an ICAN webinar I attended the week prior to our training weekend. Insert another disclaimer about how this might already be obvious, old news to you. The topic of induction came up (bringing us full circle to the beginning of this post). Toms of great info is being shared, particularly about the various ways that early induction works against the mother's body - there have been a plethora of posts about this lately, like the aforementioned Unnecesarean one on postdates, as well as the recent multitude of riches included in the blog carnival from Science and Sensibility on letting labor begin on its own - so I won't even get into it here (definitely check the carnival out, though).

Where was I? Oh yeah, the webinar. We were talking about induction, and that led to the overdiagnosis of cephalopelvic disproportion. A childbirth educator and doula remarked that before reaching term, the relaxin released by mom's body throughout the course of the pregnancy, designed to allow the ligaments to stretch and therefore open the pelvis, may not have had enough of a chance to complete its job. AHA! We know that the Big Baby card is often a load of hooey anyway, for a number of reasons spelled out here, but here's yet ANOTHER reason. (Side note: relaxin also helps to soften the cervix by breaking down collagen.)

So there's a sampling of recent a-ha's, not to go all Oprah on you. Whether you learned a new tidbit or two, or whether you got to go "Pfff, she didn't get that already? What a rube," I hope you enjoyed.

Tuesday, October 6, 2009

Reproductive slights


Two days ago, feministing (a site I generally love) weighed in on Joy Szabo's VBAC battle, which is the most recent case to push women's birthing rights into the spotlight. The case itself is well-covered by other bloggers and mainstream news sources as well, so I won't rehash it here, and the feministing piece itself is fairly straightforward, in the sense that it asks the same questions many other people are asking about birth rights, VBAC safety, and women's autonomy.

It was the comments that got to me. The furied pace of the posting has died down by now, but I'm left with an extremely bitter taste in my mouth. Public Health Doula's blog was the one that first alerted me to this (you'd better believe that I, too, am a card-carrying feminist). As she says:
It just raises my hackles when women who in many other contexts would aggressively question medical/legal authority and advocate for a woman's right to make choices about her own body go off on the "Well, if her DOCTOR says it why would she put HERSELF and everyone else at RISK" line. As if your reproductive autonomy ends when you choose to continue a pregnancy, and you must willingly hand your body over to the medicolegal system. As if VBAC access in no way equates to abortion access. As if it's OK for a hospital to threaten to get a court order for unnecessary surgery, because "She's the one who decided to get pregnant and decided to have a VBAC, so she's got to live with the consequences. The hospital has to protect themselves". I'm glad there are other commenters who see the irony here, but shocked that there are those who do not.
There are indeed those who do not get it, fellow feminists who show up to fight off Operation Rescue protesters when they decide to descend upon a clinic, women who would gladly go underground to help provide safe abortion should it ever become illegal again, activists who are passionate beyond words when it comes to the sovereignty of a woman's entire being. Yet when it comes to birth choices, all the way from the more paternalistic nuances of many hospital policies to the more specific issue of VBACs versus forced repeat cesareans, the apathy and sometimes antagonism of some feminists (certainly not all) is stunning to me.

Over at feministing, a "Lilith G" wrote:
I'm sorry, but money IS a factor for the hospital, as are their concerns about liability. It's wiser for the hospital to say beforehand that they can't do certain procedures than to reduce the quality of care throughout the hospital due to increased financial strain.
Just one example, of course. Others reflected variations on this sentiment. Enabling doctors' fear of legal liability suddenly takes precedence over a woman's right to decide for herself. I couldn't help jumping into the melee myself, though by the time I arrived it was starting to abate. Someone invoked the Hippocratic oath, someone else called bullshit, and I added:
Oh, but didn't you hear? It's been revised to "First cover thy ass, THEN do no harm, as long as it's still economically advantageous," if I follow the logic being thrown around here.

Cesarean birth carries significantly more risk than vaginal birth, and the risk increases with each subsequent cesarean. When necessary, they are lifesaving, it goes without saying. But to force one on a woman for any reason other than an emergent life-threatening situation? Outrageous, and I'm honestly astonished that more feminists aren't taking to the streets to protest these outrages.
There are some great responses being given there, too, by other fellow feminists. but I'm still amazed. One poster - a self-described "future doctor" - even said that a woman who refused a cesarean and unfortunately had a poor outcome (citing exactly zero details of the case) should be punished. for. her. choice. Think about that.

These situations are complex, to say the least, don't think I'm saying they aren't. I know that wishing liability and economic issues didn't play such a huge part doesn't make them go away. I just feel so strongly that women's rights organizations like NOW should be playing a much, much bigger role in helping to promote real choices in childbirth, so it's astonishing to see some feminists not only ignoring but actively fighting the inclusion of BIRTH under their definition of "reproductive rights". For some, that really does only seem to mean access to abortion.

Jennifer Block wrote about this perplexing apathy from the mainstream feminist community in "Pushed: The Painful Truth About Childbirth and Modern Maternity Care" (which, for my part, if I could get every woman in America to read just one book, that would be it):
Although informed of this issue, women's rights groups have taken no action. Barbara Stratton called every women's health, reproductive rights, and feminist legal organization she could find to take on the issue: the National Organization for Women, the Center for Reproductive Rights, the National Women's Health Network, Planned Parenthood, NARAL, the list goes on. Not one group offered to platform the issue. Some had never heard of VBAC. "Groups say they're about reproductive rights, but it's really not about the full spectrum of reproductive rights; it's all just about abortion," says Stratton . . . The National Organization for Women did pass a strongly worded resolution on VBAC in December 2005, after much lobbying by Stratton and other members of ICAN, but there has been no other sign of NOW's commitment to the issue.
This all reminds me the most of one of the things pro-choice groups and individuals alike often object to about some pro-life activists, and rightly so, in my opinion*. Many (though not all, of course) pro-lifers fixate solely on the act of abortion itself, to the exclusion of either working on preventing unwanted pregnancies in the first place OR, even more appallingly, trying to help care for and support those pregnancies once they transition into being real, live babies, often into impoverished circumstances. (I won't even get into the issue of violence against abortion providers.) Their sole mission is to get the baby born. Then they're on their own. Buh-bye! Feminists rallying for choice absolutely RAIL against this hypocrisy.

And yet, once a woman decides to carry a pregnancy to term, unbelievably, some "pro-choice" women turn their backs in the exact same way. The complicated relationship of various streams of feminism to motherhood, and the particularly testy relationship to the experience of pregnancy and childbirth, surely plays a part in this. Again, I'm aware that it's a complicated issue, but I still fail to understand how feminism as a whole hasn't embraced birth advocacy. And it's not just about VBAC, it's about birth rights, period. But as Jill of Unnecesarean puts it, "Never underestimate the desire to preserve one's view of the medical hegemony by continually defending and privileging medical authority, even if it means selling out other women. Never underestimate the furor of the subset of feminists who view mothers as inherently selfish and childish. Vaginal birth is, of course, a selfish preference based on one's moral code."

Block again spells it out:
Women are given ultimatums. Not only women seeking VBACs, but all obstetric patients are told, in essence: you can give birth here IF you don't go too far past your due date, IF your water hasn't been broken more than a few hours, IF your baby is head down, IF your baby looks small enough, IF your pelvis looks big enough, IF your cervix is dilating fast enough, IF you'll wear this monitor and stay in bed, IF you'll have some Pitocin, IF you'll let us break your water IF you'll lie on your back and push when we tell you to push.
I don't get how any woman who calls herself a feminist can read the above and not feel a rallying cry build up within.

*Though I am pro-choice, I mean no disrespect to people who consider themselves personally pro-life.

Monday, October 5, 2009

Monday Movie - an "MBAC"?

I was going to skip my usual weekend movie altogether, and just post about the (faaaahbulous) Postpartum Doula Training I just completed*, but this is too good not to share immediately. I'm seeing it pop up on a lot of other birth community blogs, but in case you haven't seen it, here's a story that is so much more than a VBAC. It's also the birth of a midwife, born to her calling as a result of a cesarean - an MBAC, perhaps.

My Journey to a VBAC from Lindsey Meehleis on Vimeo.



I commented thusly on Unnecesarean:

I am completely blown away by this woman. Such an incredible story. She is already walking the path I am only barely beginning to follow, despite being 10 years (or so) younger, at least with regard to her "calling" as a doula, LC, and eventual midwife. I was lucky to have dodged a c-section with my first birth, but for her, it seems like it was - however traumatic and unnecessary - a catalyst that set her on this incredible path. I wonder if she sees it this way - that without the c-section, she might not have discovered her passion and her true vocation?

Major kudos to you, Lindsey. You're a hero and a role model and an inspiration.


*Manana! I promise!

Thursday, October 1, 2009

Tomorrow! And a response to the latest Code Mec.

I thought this day would never arrive - but here it is, only a day away! My three day DONA training workshop, part of my certification as a postpartum doula, starts TOMORROW!

I'm so stoked . . . and also a little worried, as I'll be away from Lily for over TWELVE HOURS each day. The most I've ever left her for was 6 hours, just this week (while working with my first client - I know, a little backasswards, but I gotta be me). She did okay, but 12 is a looooooong time. I'll be leaving before she wakes, which could be tough on her, and then there's naptime, which is always started with nursing. But I know her daddy will dote on her and keep her fed and hydrated. I was also reassured today, while at the aforementioned client's house (more on that later), to find that I can still pump 4 ounces of milk in about 5 minutes. *snap* So at least my supply isn't threatened.

Anyway, I'll see you next week. In the meantime, in case you haven't seen it, Navelgazing Midwife's latest post is a masterful parody of the CODE MEC article recently put out by Medscape.

And here's some eye candy.

Sociable