Diet Coke

We were excited to be invited to a party last night. Two dykes asked us to come to their home for a double birthday party and meet a group of business dykes as an aside.

So, we're at the party and talking to one woman who is surviving breast cancer (we seemed to share the same hairstylist) and another couple who moved from New York City recently (including the psychologist), to another woman who seemed extremely wary of us at first, but warmed up later, and more. There were women we never met at the party, but many sat and yacked with us about how my partner and met (they found it amazingly humorous that we met at a breastfeeding support group meeting), about the cocci, about cancer healing, and what she and I do in our lives.

We are pretty darn colorful. I find it weird when the conversation stops and all eyes in the area are talking to us, asking us questions, and then everyone listening as we share our well-honed stories. (My partner has got to stop sharing that we had squirting wars, though. Dykes just don't get the humor in that.)

I did not talk about placentas in the refrigerator. Or vaginas. Or birth stories.

Several women asked if I caught the hosts' child and I smiled and said, "nope." I didn't add that they didn't even want me for their doula and then ended up with a cesarean. No, I kept that part to myself.

So, we're saying our good-byes. My partner and I were the youngest women there at the beginning of our 40's. It was 10:00pm.

Honey gathers up my 2 Diet Cokes with Splenda and makes a comment about the blue cap and how she didn't recognize it in the fridge.

One of the birthday girls looks at me and says, "You know those are bad for you." And, just about sick of everyone making comments to me about my Diet Coke, I said to her, "Hmmm, should we find what you do that isn't healthy and pick at it?" I was, for a second, horrified that it came out of my mouth. And then, I just stood my ground and stared at her in the eyes. She was nearly toe to toe with me, too.

She was kind of baffled, but her face didn't register confusion too well (Botox? too many anti-depressants?), but she looked at me funny. I said, "You know, I work in a holistic healthcare office and I have to hear that all the time." And she moves away and says, "oh, well, I bet you do... blah blah blah." I made one defensive comment that sounded like, "At least it's made with Splenda and not Nutrasweet!" and then I stopped because I just don't give a crap to defend myself.

Why do people feel they have to poke at me? About something like Diet Coke? It's not like I'm smoking or shooting heroin or anything. On the way home, I told my partner I need to come up with some good comebacks.

You know, Diet Coke isn't good for you.

Really? Wow, no one has ever told me that before.

You know, Diet Coke isn't good for you.

Well, I'm weaning the vodka out of it, isn't that a better choice?

You know, Diet Coke isn't good for you.

You know, people who pick at other people, especially a total stranger, aren't very nice.

Annoying.

Still no baby.

GPS

I read an article in Real Simple magazine about a GPS (Global Positioning System) luggage tag. I thought it was a fabulous idea! Especially for those that travel loads. My partner made the astute comment that it would need to be hidden inside the suitcase somewhere so it isn't removed or cut off. So, then I think, the whole piece of luggage, embedded inside the actual material it is made of... that is a great idea!

Not far from this thought came the swirling realization that soon... I predict before 10 years has passed... that the possibility to embed a GPS chip inside a newborn will exist. Honey said she wouldn't want GPS in her, and I can understand that (I can imagine those prone to affairs would refuse monitoring as well), but the mother in me... the one who took her kids for KidsPics through the years in case they were kidnapped... that mother part of me thinks it is a dandy idea.

The possibilities of a person having GPS are endless! Watching on the computer where your child is at any given time. Seeing how fast they are driving in the car. Even seeing other GPSers in the car with her. Won't that be wild?

Yes, it is very Big Brother, as my partner reminded me. However, typically technology starts weird and then we get used to it. I wonder how long it will be into the first GPS baby before we start saying, "Remember when we used to have to call on the cell phone and if they didn't answer how much we worried?"

I frequently wonder what the heck we did before cell phones.

Sometimes I feel really, really old.

Oh, and I am raising my hand right now to learn how to insert GPS into a newborn. I can just see doctors and hospitals vying for the fastest GPS insertion.

Is that weird I would want to do that? I really thought for a long time I wanted to learn how to circumcise only because people insist on doing it and they might as well have someone loving and respectful cutting on their baby, right? I kind of have given up wanting to, or expecting to, learn how to do it. You can let go of your penises, boys.

My Annual Math Test and More

I participate in a study at a local university hospital... testing the effects of crystal methamphetamine and HIV on the brain. I am the control, not doing or having either one. Yesterday was my fifth year in a row doing this! I call it my Annual Math Test because there is one segment in there that used to make me cry doing it. I would get anxious about it in January! knowing that summer was right around the corner.

The speaker says: 2 and then 4 - I say 6 - the speaker says 2 - I add the last number the speaker said to the number the speaker just said and say 6.

Well, the test is in three segments. The first I can sort of do and the chick yesterday convinced me to do that part, but the second and third segments make my brain hurt! The speaker goes fast and fast during the second and third segment. It is a listening/memory test and I hate failing anything. Plus, I can add most numbers quickly enough... but some I have to really think about. 8+5 has always been hard. Or 7+6. My dad drilled adding "9s" into me so I don't have any problem adding 9s, but the others, it takes a split second to catch it... like 8+5. I say in my head: 5+5=10+3=13 and then I can spit it out. But, when taking this test thingie, it is too long a process.

The 5 hours of testing include a buttload of bloodwork, a breathalizer to make sure I am sober (I was), a pee test to see if I've used drugs lately (I haven't), and several dexterity and memory tests.

There is one that has pegs, but I call them keys because they are pegs with a nub on them. As fast as I can, in order, I have to use my right hand to put the pegs into their slots, which are turned different ways on the peg board. I do great with my right hand. With my left, however, it is like using someone else's hand to put them in. I am so right-brained!

Another is naming 15 objects and throughout the day repeating what they were. I usually do pretty well on that one because my mind groups them together; pets, construction equipment, seasons, etc. They aren't given in that order, but my mind takes each word and plops it into its own subject box sort of thing. I have learned lots about how I think doing this all these years!

I also have to look at a group of 8 objects and then, after a few moments, draw what I remember... in their place on the paper. I have to do this several times. By the third time, I am not so bad. There are usually 2 I cannot, for the life of me, remember. Then, just to show what a bad artist you are, they show you the paper and have you draw directly from it so they can compare your work.

I have to visit with a psychologist, a nurse, and a technician during the day, too.

They give you a voucher to a horrible Mexican restaurant and pay you $75 for 5 hours' work. (I had to use a calculator to figure out that was $15 an hour. laugh)

The study was just extended, but they didn't know if I would be called next year or not. Although, the people there thanked me a zillion times because I am one of less than a handful who have come throughout the whole study.

Probably because I was a control and not a user, eh?

Open Letter to Tom Cruise

Regarding your comments about Brooke Shields and her use of anti-depressants for her Postpartum Depression (that they are "dangerous" and she should use vitamins instead), you know not of what you speak.

Until you have had a child yourself and experienced the very real and very frightening feelings of postpartum depression, I believe you have no say in the matter. You do have kids, but they were adopted; therefore, no hormonal shifts in your formerly beloved "Nikki."

PPD is horrifying to anyone experiencing it. And to finally admit that the woman needs help is an act of bravery beyond words. To accept medications for something that people like you believe is "all in the mind," well, I honor those women who choose life instead of dying the slow and dark death of depression.

You, Mr. Cruise, might consider learning a bit more about PPD... the clinical side... before making comments such as yours. Damaging, dangerous comments that might sway other women who were finding their way to help and healing through medications... sway them deeper into their personal abyss.

And, Mr. Cruise, let's hope you or your children never need any sort of medication for diabetes or high blood pressure or Parkinson's Disease or, God forbid, depression. You will find that each pill you eventually swallow to save your life a bitter pill indeed.

swimming along

I was thinking today:

* Someone is finding out they are pregnant right now.
* Someone is finding out their partner is having an affair right now.
* Someone is losing their virginity right now.
* Someone is dying right this moment.
* Someone is living in their new house tonight.
* Someone had a parent die today.
* Someone found out they have cancer today.
* Someone came out as gay or lesbian today.
* Someone quit watching tv today.
* Someone became a vegetarian today.
* Someone had gastric bypass today.
* Someone cried because they gained back all the weight they'd lost.
* Someone got a job today.
* Someone lost their job today.

I got into the pool by our house today and it was really nice. Different than the clientele by the office. Fatter. I swam 20 laps, several crawl, several breast and some side. I tried to do back stroke... and am really good at it... but it hurt so bad I had to turn over and crawl instead.

As I swam laps, I thought about how easily I slipped into my swimming self. I count the lap I am on as I stroke... stroke, stroke, stroke, stroke-breathe... stroke, stroke, stroke, stroke-breathe... and then when I touch the wall, I begin counting a new lap. So it sounds like this in my head: two, two, two, two-breathe (the last number and breathing happen at the same time)... two, two, two, two-breathe... tap the wall... three, three, three, three-breathe... etc.

When I am ready to rest, I lower myself and tilt my head back and raise up out of the water, letting the water pull my hair back out of my face. Only, I have no hair to water back! Total and complete habit. I found that very interesting that I would have that memory. Sarah called it "body memory." Habit. Old, 38 year old habits. I've been swimming since I as 6 years old.

Why did I stop after the gastric bypass? I find it bizarre now. I swam at 350 pounds for years! No qualms about it at all. (Would have preferred to be a size 6, but I didn't let it stop me from getting in the water and swimming.) Then, as I lost the 190 pounds that first year, I had so many serious body issues... sagging skin... I felt repulsed by my own body and couldn't dare get into a suit or go in public in one. Perhaps because I am fatter right now I feel more comfortable now. I wonder if that is it. Hmmm.

My partner and I talked about how we love love love the smell of chlorine on our skin and our towels. Neither of us has negative memories in the pool. Both of us love pools as opposed to the ocean, although the ocean is beautiful to look at. So are pools. Clear and cool and clean and contained. Even after my shower, I smelled like chlorine! smile

My client hasn't delivered yet.

I'm having severe anxiety over if the baby is breech or not. Should I send her for an ultrasound? Will that knowledge change anything I/we do at the birth? Do I not trust my hands that much? Can't I borrow someone's ultrasound machine? I want to be calm. I want to trust. I want to know that I can do this... that SHE can do this... even if I don't know if the baby is breech or not.

I feel the head (whatever is in the pelvis) and it feels like a head. But, when I feel the roundness at the fundus, it wobbles... like a head. I move it and think I feel a thigh kicking me, but what if it is a hand punching me to let go of his ears? Whatever is in the pelvis is deep in there. Even if it was the breech, would I do anything about it? Ask mom to do anything about it? Hasn't she had enough trauma, stress, worry this pregnancy? Can't we have an ultra-calm birth?

What if there is lots of mec? Will I do a vaginal exam? (It makes me cry as I touch the worry inside. It's probably best to write it out, yes?) Will I do a vaginal exam at all? If I find a breech, I will call the midwife who is experienced in breeches... not the one I asked who said she couldn't come, but another one who said she wouldn't do breeches or twins but now says she will.

I pray this birth goes straightforward. He's a big baby. Mom says 9 pounds. Her last was 8 pounds 8 ounces... major conehead after 3 hours of pushing. Why am I scared? First licensed birth?

I go tomorrow for my annual math test. Except I don't do the math test part. I'll explain tomorrow.

I stayed out of the office today and worked from home, doing a lot of paperwork that needed to be done. I finished!

I signed up for my Neonatal Resuscitation Class in July today.

Off to sleep. I have to leave the house at 7am for the Annual Math Test. Back in the afternoon.

Unless the baby comes.

Oh, please goddess... please be vertex.

I forgot to blog about the billboard I saw in Florida… at the toll plaza at Okahumpka. Twice I tried to stop in time to take a picture of it, but missed on both counts and there was no turn-around place. Anyway, it was an anti-circumcision billboard and I would never have seen it had my daughter not pointed it out. I couldn’t believe there was such a thing in Florida!

And, if you haven't seen this link... LOOK NOW!

http://www.komotv.com/qt/schram_060705.wmv

And then, read this response from him after 1000 emails!

http://www.komotv.com/stories/37352.htm

Today I had a consult with a woman that I hope becomes a client. She totally wants a home birth, but her husband wasn’t so sure. They had their last baby in a birth center and she got there at 10 centimeters… she hated leaving her house and doesn’t want to this time.

I also had a childbirth education reunion class and one couple nearly had their baby in the car and the other had theirs before the midwife arrived. Something in the air!

The couple who nearly had their baby in the car… she felt pushy before leaving the house and then she got into a wheelchair sitting sideways at the hospital. Once in the room, the nurse hollered at her to not push until the doctor got there even though the head was nearly crowning. The nurse called the doctor again – frantically – and while they waited, they tried to put monitors on her and start and IV as the couple screamed NO! As the doc arrived, he walked over to her and said, “push” and then FUCKING CUT AN EPISIOTOMY! She said she screamed, “You jerk! You didn’t even ask!” and told him how much that hurt as her baby fell out of her body… she didn’t get to feel or see or anything. The mom doesn’t quite realize how horrible it was… what the doctor did… but she is high as a kite that they had such a painless labor and birth (until the cut) and had no intervention (until the cut). I put the bug in their ear that it doesn’t have to be that way and they excitedly said they would be having a homebirth next time without a doubt. I quietly said they could certainly dream, and probably attain, a much more gentle birth than this one, but congratulated them on the really cool parts. And, to make it more amazing, this child sleeps from 7pm – 6am every night. 2 months old. For 6 weeks so far. Sheesh. Do my kids sleep through the night yet?

I wanted to cry for her perineum.

I want to cut the doctor’s perineum.

I think I will put a couple of my articles on the blog. I like a couple that I have written and had published in local magazines and would love to share them here.

I feel incredibly sick today. I don’t know what is going on. Nauseous as heck and threw up a couple of times at the office… took a long nap… and still feel horrid. Fever, I am sure.

Sadness & Gladness

When I spoke at the conference, I met a woman who was UCing and asked if she could call me if she needed help... like if she needed suturing. I said I would.

I spent yesterday at a meeting with a group of LMs and a couple of CNMs and it was GREAT. One of the CNMs is leaving the hospital to do homebirths and is going to work with my other fave LM and I to get her feet wet in the community. We love love love this midwife and are ecstatic about her joining our community.

So, one of the CNMs went to work last night and then, at the end of her shift, she called me to tell me that a woman had a UC and during the birth had a shoulder dystocia. A 10-minute shoulder dystocia. The baby died. They went to the hospital (I assume via 911, but don't know for 100%) where the docs and police descended on her. I can't find any information on her on-line or via my law enforcement contacts and we know it isn't illegal to UC, but that they can sure make her life hell... as if losing her child isn't enough that she has to live with forevermore.

My partner suggested I offer information to UCers about what to do if they should find themselves in a similar situation. It boils down to "I want to speak to my lawyer."

Did you plan a homebirth? I want to speak to my lawyer.
Did you have a midwife? I want to speak to my lawyer.

Very sad.

A complicated potential client isn't going to work out. She is a habitual user (crystal and marijuana and alcohol) who has been clean for a couple of months and wanted a homebirth so her baby wouldn't be put "in the system." After a nearly 3 hour discussion filled with disclosure, I found out more information via my legal contacts and she neglected to share a few incarcerations. She also flaked out on me today, calling 18 minutes before I was supposed to be at her home visit to tell me today isn't a good day and she hadn't gotten the $1500 I'd required yet. She lives 90 minutes away. It's a good thing I asked her to call me to let me know she had the money and what time she wanted me... 4 or 5. I debated calling her during the day and my midwife-friend's apprentice, who spent the day with me, said she would call the woman, but, for me, I needed to see the woman's committment to her desire for a homebirth.

If someone really wants a homebirth, they work hard for it. She did not. So, I'm going to email her to let her know I can't do her care.

Now the dilemma is do I call her care provider she's been seeing to mention she is considering an unassisted birth ... or what? What do I do with the information? I'm confused.

I attended a GREAT birth on Sunday morning at 1:37am. A Rabbi's wife... no vaginal exams, very loving and peaceful and gentle. I was the assistant and all I did was help clean up since I sat outside the door until the birth was nearly over. 6th baby.

The interesting part is she had another local midwife who spent 4 hours holding a cervical lip back with her FIFTH BABY! Absurd. I spent some time today writing about how cervices dilate at different rates... not like a complete circle at all times... and that perhaps at the end of labor, the cervix just naturally has one part fatter than another. If we kept our fingers out of the vagina, we wouldn't even know the cervix dilates like that. But, since we do know that, can't we just leave it alone?

This midwife has been known to have a whole lotta lips to lift. Suspicious.

I did a home visit today on an almost 37 week client. I now have two charts I'm carrying around. smile My former breech client comes in tomorrow (she's still my client, but the baby isn't breech anymore). She should be delivering any second now. Wheee! The client we did the home visit on today... I assisted her birth last time, too. She chose me over her last midwife much to the chagrin of that other midwife. I was honored! We totally are hoping for a gentle loving birth. She had a hospital shoulder dystocia the first time and then this last homebirth, the midwife kinda wigged out anticipating a dystocia and was rather aggressive with mom and baby. She needed sutures and hemorrhaged... I believe due to the aggressiveness, but we'll see.

I look forward to some peaceful upcoming births. We need some peaceful births.

We all deserve peaceful births. Love to the mama who lost her baby today.

Back Home

And working my head off!

I want to learn how to do diaphragms and cervical caps, even though there are no more cervical caps in this country, Canada makes some nice ones called Oves that we’ve used. I want to learn to inseminate. (Someone said to me: Men can do it, how hard can it be?) I want to have a Well-Woman Day at least once a month here to get things hopping. I need to find places to announce the Meet the Midwives Nights. I am scheduling the childbirth classes a year in advance… we are going to do one on a weeknight and another on Saturday morning. There is so much to do!

I have a woman who thinks I am going to be her midwife, but I haven’t agreed to it yet. I can’t find anyone to assist me. There are social safety and physical safety issues at play and every bit of instinct says to stay away. I will have to tell her when she comes in next.

Why do women who are abused keep going back to the man? I cannot fathom why they do the yo-yo thing and come and go depending on the man’s actions. How hard can it be to realize they are not going to change unless they quit drinking/drugging/sexing and get help… continuous help. When a woman doesn’t realize it is abuse, that is one thing, but when they verbalize the knowledge that it is abuse… and describe episodes in detail… how can they selectively forget that? It is just baffling.

True Email

This came in my email today. I deleted the name, not that it matters. And this is verbatim.

hi! i'm pregnant right now. i'm a lot over due. almost 2.5 months now. it really is a true pain. these will be my 10,11,12, and 13 children. this is my 4th pregnancy in about 3, 4 years.

Let me know how you're doing!

P.S.I am only 25 years old.I've been married for2 years.

Is this a hoot or what? It reminds me of when men used to try to get into the irc Dyke chatrooms.

I don't think I'll be emailing back.

Just Thinking Oddly

* I go months and months without nasty letters and in one week get two. Apparently, I hurt someone else's feelings on a list I am on. I re-read the post she spoke about and don't see anything mean at all in it, so I wrote her back (she wrote privately, but cc'd it to the list owner) explaining myself and sort of apologizing if she took what I said in a way I didn't mean it.

I am looking at myself to see if I am being too harsh with my words. I don't think so, but I'm listening. I figure the more out there I put myself, the more criticism is going to come my way, right?

* The other woman who ranted about me on a list emailed me privately and we seem to have come to some peace. She told me how insensitive I was to women's feelings regarding their doctors. I'm trying to be sensitive, but sometimes I feel like I can't win for losing. I'm trying.

* My co-teacher expressed a desire to apprentice with me. We were going to meet to talk yesterday, but she got stuck counseling a doula client (stuck, time-wise) and we had to put it off until I get back from Orlando.

* I am home sick today. I got dressed and drove halfway to work, barfing twice along the way, and then chose to come home again. Sucky, too, because I had a home visit and 2 prenatal visits. The other midwife is going to do the home visit and one prenatal - the other I will cancel until I return. I just did one on her on Sunday, so she should be fine. Complicated stuff I have going, too. I look forward to writing the resolutions.

* I've had a fever for 2 days now. I upped the Acyclovir. I think it is part of the illness I feel.

* How do some midwives adopt an "apprentice" by interviewing someone just once? I think it is -need- more than a desire to teach. A new woman came into the community, but no one knew anything about her. I interviewed her and found her solemn (as a student-midwife described her). I knew she wasn't the apprentice for me. Then, within a day or two, I heard she was apprenticing with another midwife. Very odd to me.

* One midwife went to a birth with only this new "apprentice" and a student. No other experienced midwife. When questioned, she defended it with, "I just felt like everything would be fine." Blessedly, another midwife gently explained the need for two midwives if at all possible. Very odd to me. I couldn't imagine going without someone else equally trained.

Slinging Mud

* Midwives have such a high divorce rate. It is very difficult to have a partner that jumps up during dinner, lunch, breakfast, out of the bed (even when not feeling well), out of the sex bed, out of restaurants during anniversary dinners, out of movies, drives back from weekend trips, and leaves everyone's birthday parties at one time or another. As a daughter of a midwife once said, a midwife takes care of everyone BUT her family. It must seem like that much of the time, especially to a spouse or child.

My partner has another life without me. Yet, when I need her for something, she is always there. Always. I was talking to friends, wondering if she were the one throwing a conference, if I would volunteer to work 18 hours at a registration desk to make things easier for her. I don't know if I would be so graceful. She is so kind and loves me so very much. It pains me that I don't show her more, like volunteering to do stuff for her. Is there any way to thank her properly?

* A woman was tirading about how important it was to convince women to cancel inductions and cesareans. It was a rant I couldn't ignore (but should have) and generally spoke about women's choices in birth and when does informed mean informed enough. Just because she hasn't read Thinking Woman's Guide does that mean she is any less informed than we are because we haven't read What to Expect? The woman wrote a thesis back asking me absurd questions... as if I were the midwife who picked veggies in the garden with her client and just daydreamed a positive birth experience and only shared beautiful birth stories instead of any formal prenatal care.

She also interjected a paragraph that she knew my kind of support because she had come to me to talk to me about her horrid first birth experience and I'd been "condescending and demeaning." She said that because of me, she didn't tell anyone else about her birth for over a year, assuming all midwives were like me.

Well, I couldn't just let that sit. I addressed her hurt feelings and then let her know that her decision to not tell someone was just that - her decision. I told her that I never felt condescending or demeaning when I speak to women and opened the door to communication. A door, I am sure, she won't even look at. Some have said she is the walking wounded. She has started her own healing group, but from what I have heard, has a LONG way to go before she can even hear someone.

In the letter directed to me, she also said that my reception led her to UC and she thanked me for that (snottily). I learned she did not UC... she attempted a UC, but went to the hospital. I don't know if she had a VBAC or a CBAC. I will ask. (She had a CBAC)

It's hard working with angry women sometimes.

* Working with the student midwives yesterday, we tested our hemoglobin and glucoses and my Hgb. was a dismal 10.0. I bought a protein drink, some Enriching Greens capsules, Yellow Dock, and an iron I can assimilate (ferrous fumerate). I have to do something. This faint feeling needs to go.

is mental illness that prevalent?

Why are so many women so sick with postpartum depression? My theories include the disassociation of women's minds and spirits from their bodies during a hospital birth. (Abuse, but not yet recognized as such.) That our bodies are meant to till the fields, hike miles to get water, make our own clothes, grow our own food, and run from the predators. For goodness' sake, when we were doing all of those things we didn't have time to worry about a booger inside the baby's nose. And I do mean worry.

The family I am tending to hired a live-in nanny-type and then fired her the next day because her daughter stole her zoloft and she was manic without it. Apparently, she wouldn't shut up and stay out of the house.

I was there again last night.

I wanted to take a picture of the baby this morning. I mean, I am pretty good at it and all, but I wanted to ask permission. Tentatively, the mom said, okay, maybe one. I just looked at her. As I focused, she turned away, covering him and asking if I had already done it and I said I had not. She said she didn't think she wanted any pictures of him yet. Before I could think, I blurted out, "You'll regret that, too, in about 15 years. These weeks are the most speedy of the changes and someday you won't even remember him being this small." And I packed up the camera and waved. "See you tonight!"

She is a germiphobe. After these pp doula jobs, I wonder who isn't anymore. She was concerned that I was carrying the bottle and nipples outside to the cottage (where the baby and I sleep) without their being covered. I said to her that it wasn't like I was dredging them in the Ganges River where people poop and drink and pee in the same water. I said it lovingly. And she let me go without covering the bottles.

I didn't tell her about the midwifery meeting where we just had a child drop his pacifier under a midwife and when she picked it up, it had a slug on it. She flicked it off and set the pacifier behind her. Sure enough, the kid walked right up and popped it into his mouth before any of us could at least wipe it off on our pants. We laughed hysterically and did comment on the amount of women who would be horrified at that situation. We shrugged and said, "well, he's building slug immunities now!"

First Babies

I think we should all have our 4th kid first. It would make things so much easier.

I was called last night about a woman, 7 days postpartum, who seemed to be in an emotional crisis and they were looking for a PP doula. They lived about 70 miles away. After talking to the woman's mom (forevermore known as grandma/gma), I felt it would be good to go and see her because the gma seemed to be in some denial about how serious it was, the things she was saying.

I got there and sat with the new mom for about an hour, talking to her, and she had been having feelings of dying, feelings of the baby dying (but not by her), anxiety to beat the band, and major insomnia.

Clinical postpartum depression doesn't usually hit for at least 4-6 weeks postpartum, so if this woman was this sick at one week out, she REALLY needs help. With talking, she admits to having anxiety for years, never treated. Time to be treated, I told her.

The family is very holistic. Their pantry and fridge was like being in Whole Foods or Trader Joe's. The gma was distraught about her daughter taking meds, helping herself feel better that it might not be forever. I encouraged the gma to stay in the here and now and to Let's Get Through Today sort of thing.

The mom was making plans for the baby should she be hospitalized. She wants gma to take the baby and spoke a lot about how she did not want the dad to have the child. Dad, apparently, is struggling himself, by being an insensitive oaf. On purpose? Hard to tell.

I spoke in-depth about this "going away" feeling and it seemed to help.

PPD is so painful.

What I Learned from Oprah Today

That Mean Girls are insecure and they meaner they are, the more insecure they feel. The more people gossip and say mean things, the less good they feel about themselves.

I could say this in about 40 hundred different ways. It lays on the surface of my brain as an oil slick on the lake.

I knew this, but hearing it in different ways, in the context of my life, with Mean Girls all around me sometimes... weirdo clients, bizarre midwives, neighbors who throw eggs or puncture tires... it helps to be reminded.

I feel stronger.

Queen's Anger

Note to Doulas:

Don't take credit cards.

While this happened awhile ago, I had a surge of fury about it last night while I was at the hospital tending to a UTI I have (Macrobid - bid x 7 days).

Client hired me, spent HOURS with me prenatally. Issues arose that guided them to a cesarean. I helped them choreograph the cesarean and the day before she had the baby, spent 3 hours with her and her husband. She was going to schedule her cesarean, but the night after we met, she went into labor.

I'd gone to bed exhausted that night.

I awoke at 3:30am and found my phone and pager in the closed office as opposed to on the dining room table where I'd left it. The pager was beeping. The phone had several messages on it. When I listened, I heard she'd gone into labor and I immediately called the client. I'd missed the birth (a cesarean), but got dressed and went to the hospital right away. I was there by 4:10am (the birth was at 1am).

I spent hours with the client that night, and 2 other postpartum hospital visits. I also went to the home for a long visit, helping with nursing and guiding the mom to more comfort with her new baby. Dad called me on several occasions, worried about his wife's mental health. We spent a lot of time talking.

And then, the parents got mad that I'd missed the actual birth. We offered $200 back even though I would not have been permitted into the OR. Even though I was there 3 hours pp and had spent LOTS of time with them pre- and post-partally. Even though, with counting, I'd spent about 30 hours with them. We sent them a check.

Then we get a statement from American Express that the client wanted all their money back. (Now, it gets complicated and includes back and forth with paperwork, he said/she said, and accusations on all sides.) Blessedly, I keep meticulous records in my Red DayTimer and I faxed all of those dates (with other personal notes from my daily life) to AmEx. Who, in turn, sent them TO THE CLIENT!!!!!!!!!!!!

My head nearly spun off its spindle.

Weeks passed with discussions back and forth between my partner and AmEx and then a lull. A letter came in the mail about 3 weeks ago that said that AmEx gave the clients their money back.

All of it.

We wanted to scream. So my partner did. Right in AmEx's ear. She made them re-open the "case," but it is remote anything else will be done. She cancelled our AmEx acceptance at the office and our account with them because of their inept-ness in understanding what a doula does. Their "reasoning" (and I use that term loosely) was that I missed the birth. No amount of explanation of doula work seemed to sink into their heads.

The client also has our $200 check still. So they made money off the deal.

I don't know why I felt the fury of this while at the doctor last night. But, even now, it is there. So, I thought the most productive way to deal was to offer doulas (and midwives) the verbage to add to their contracts regarding doula/birth care.

We added something to the effect: In the odd case of the doula missing the birth due to circumstances out of her control and her inability to obtain a back-up, the client will receive a $200 refund (or whatever is appropriate for your practice - $200 is a quarter of what a contract is). Doula will assist the client for an additional post-partum visit either in the hospital or at home, wherever the client deems necessary.

What happened to my pager and phone that night? My step-child moved it into the office and closed the door "because it wouldn't shut up." It was the first - and last - time I ever slept without my phone next to my head.

A Story

A woman 20 weeks pregnant feels she is going into labor. She'd already lost twins at 23 weeks and another baby at 20 weeks, so she has a pretty good idea of what she is talking about.

In the hospital, they explain she really needs to consider cerclage... where the cervix is sewn shut until the end of pregnancy. She agrees. She is 2cm dilated already.

During the stitching, her membranes are accidently ruptured.

She is now hospitalized, ass end up (Trendelenberg position) with monitors on as she waits another 20 weeks for her baby's birth. She doesn't move except slightly side to side. No bathroom privileges. No trips to Babies R Us for receiving blankets. No La Leche League meetings or childbirth classes. Just lying, ass end up in a hospital bed, waiting.

The hospital doesn't have an exquisite NICU, so through consultation, it was decided to wait until the woman was 24 weeks along and send her to the Big University Hospital (BUH) where they could take better care of the baby should he be born early.

During the weeks, a guess is made that the membranes have re-sealed, however her amniotic fluid volume remains terribly low... between 2 and 4. Normal would be 18.

The extremely difficult 4 weeks go by and the woman, via ambulance, ass end up, is shipped to the BUH.

At the BUH, the doctor admits her and says she doesn't need to remain ass end up anymore. That there is no research showing that Trendelenburg does anything for women trying to keep a baby inside... that there is pressure anyway, so she might as well get up and do something. She refuses. She asks to see another doc who says the same as the first. She asks for another. Same answer. She goes through this 6 times, including with perinatologists, who tell her it is fine to get up.

She doesn't believe so, but she guesses they must know what they are talking about.

The nurse gives her a sleeping pill for her agitation and sends the woman to the bathroom to pee before bed. It is the woman's first upright in over 4 weeks.

She climbs back into the bed and the nurse attaches the monitors back on and wishes the mom a good night.

About 30 minutes later, the nurse wanders in and says the baby must have moved because they haven't heard the baby in about 20 minutes.

She can't find the baby, so they bring in an ultrasound machine. The baby's heart has stopped.

A vaginal exam shows an occult cord prolapse through the 2.5 cm open cervix.

This happened here, to one of my midwife's clients, last week.

The mom that lost her baby is a lawyer.

Doula Post

On-going discussions about women's choices, how doulas hate them, how much should doulas tolerate/accept... has moved into our own ignorance even in education.

My comments:

This another part of my own walk that I see as women birth in ways I personally find aborrhant. I was that lemming! I was that woman who walked blindly down the induction, medication, episiotomy, etc. path and who, through sheer luck of the draw, found herself surrounded by Bradley, LLL women who gently illuminated the other path around the lake.

And I took that path.

I believe that if I, the ignorant of the decades, can find it, so can other women. I believe that we who do birth work share our experiences. The ripples begin and end in places we never have an awareness of.

Be the example you want others to follow.

This is my personal motto and I strive to work those words.

A voracious reader, my first birth mimicked the birth books. Hospitalized with all the inherent accoutrements.

When I learned there was another viewpoint, I took that to its extreme and UC'd.

With my third, I found (some) balance and had a U-Labor and a (somewhat) assisted car birth.

This was an earlier time (my car baby is now 19 years old), but back then, each time I thought I had completed my evolution. What else was there to learn? How many different ways can a baby be born? When #3, I'd attended maybe 30 other births. I am now 800 + above that number and while there are two *routes* for babies to be born, there are infinite WAYS for them to be born.

Because I have watched myself, and DOZENS of others, walk this path from Medical Model to Belief in Women & Birth Model, I remind those who cringe at women and their choices that, in 20 years, she might be a magnificent doula/midwife *because* of this part of her walk.

Even if YOU believe the woman doesn't have her baby's best interest at heart, even if YOU don't see her thinking of things, I believe SHE thinks she does. And isn't her perception as valid as yours? In fact, her perception is her reality. Your perception of her is YOUR illusion.

with regards to stripping membranes "hurting" the baby and a midwife saying that no, it doesn't hurt the baby

As a midwife, I would answer that question the same way. No, it doesn't hurt the baby. It might move things in YOU to another level... might rupture the membranes... might blah blah blah, but hurt the baby? Physically? No.

That is the question that people usually mean when they ask: Will it hurt the baby? (Can I have sex? Will it hurt the baby? If I ride the ferris wheel, will it hurt the baby?)

with regards to an epidural hurting the baby

But, this is the interesting part. Even midwives... even homebirth midwives... don't believe that what you asked hurts babies. In the way things are asked, I hear (again) "physically" and no, epidurals don't physically hurt the baby. It can cause issues in mom that have an effect on the baby so I don't even see the midwife answering evasively. She was answering clearly as to how she heard the question.

And many Many MANY medical and midwifery people don't believe either of the situations you asked about have ANY consequences at all. Even epidurals are seen as benign in many midwifery circles.

with regards to one's "ignorance" at a previous time and the doctor's belief that they are acting in the best interest of the mother and baby

But, see, they ARE acting in the absolute most wonderful interest of your baby. They still are and do. They believe 1000% that their care is optimal, correct, safe, and validated via studies and experiences. It is rare that I hear whispers of economics, lawsuits, or time contraints as reasons for what they do, although those of us here know better. They really, really REALLY believe they are doing the right and best thing. They think that those of us asking for individualized care, occasional monitoring, etc. are nuts and that we are asking for a dead baby by our "selfishness." I've heard that several times. "If I didn't have to go to court to defend my actions, I'd say 'leave her off the monitor - let her see what happens when she does.'"

I love my evolution. I love that I had a highly mechanized birth 22 years ago. It has helped shape me into the birth worker I am. Just as every birth, vaginal, cesarean, home, hospital, birth center, birthrape, hands-off, gentle, frantic, death-shrouded, life affirming birth I have attended has helped shape me into the birth worker I am.

And my evolution continues.

Why...

... don't Catholics let people die in peace?

I am so lost as to the reasoning for the fighting for Terry Schiavo's death/life and now all the praying for the Pope's healing. I don't understand why they don't pray for them to just die sweetly and quickly. Very weird. And all in one week.

The most bizarre irony of all of this death talk is that Terry Schiavo found herself in that vegetative state because of anorexia - she was killing herself through starvation. And then, she actually dies that way via the courts, her husband, and ultimately, her own choice. Isn't that the most odd thing? None of the reporters say anything about this part of the story. I would highlight the crap out of it for all those anorexics out there.

Do YOU want to be a vegetable? No? THEN EAT ONE!

(probably not so funny to anyone else but me)

I taught some midwifery students today and had a good time. We talked about situations surrounding transports. I like asking, "what makes you squirm?" Helping the women to find their outer limits of comfort for different scenarios... high blood pressure, hemoglobin, transient tachypnea of the newborn, etc. It was great... and I learn a lot about the women and their strengths and how they learn and think. I remind them that one of the best things about these classes... with midwives and with each other... is that they see that each of us has different strengths and comfort levels and if they have a woman with creeping BP and are getting out of their comfort level, they can call in another midwife who isn't so uncomfortable and work together... or refer, whichever they want to do (even if that referral is to the other midwife).

The midwife I work with a lot sat in on some of it and we play off each other well, so it was really nice.

It seems a cult-ish "positive thought" workshop has spread over some of the midwifery community. It has gotten difficult dealing with some of the women who have gone through this because they seriously drop work, money, and friends and family for this "training." One of my own practitioners is driving us bonkers as she removes herself from her duties and, instead of these "trainings" improving her attitude, her drive for success, and her work, it is making her not be available to anything BUT the trainings.

It's hard watching because I keep seeing the women who are not anchored in themselves latch onto these trainings. The seminars are ego-raising! If you go back to the very very beginning of my blog, when I talked about PSI, it is the exact same thing, but in a different dress. A Break You Down to Build You Up thing. In these seminars, people find community where they had none. Family where they thought/felt/really had none. They are infectious! I agree, but they are supposed to assist in a person's success, not downfall. And I am watching women around me fall a lot.

Slinging Your Baby (published article)

Babies have been carried since babies have been born, yet, in our culture, babies are carried in their car seats (what some call “plastic buckets”). Wouldn’t it be nice to bring our babies close again? To remove the foot-wide space of plastic and embrace the tenderness that is our child? All too soon, those babies grow up and are gone; hold them tight while you can.

The way most of the world carries their children is with a sling. From rebozos in Latin America to the kangas of the Maasai, baby wearing is very much the norm. Our own culture and even our local community is seeing an increase in baby wearing. Where does someone start who has never worn a baby before?

Many different types of slings exist. Some are simple cloth, others silk (the choice of materials are endless!), some with padded shoulders, some that go on the front of mom or dad with the baby facing in, and others facing outward. Style and comfort can be combined as you find a sling that is tailored just for you. An experienced mom or a specialty store that offers natural supplies for baby can certainly help you out. in has been a resource for many families as they embark on their journey towards slinging. Women of all shapes and sizes can find the sling that is right for them; the one that doesn’t pinch, cut, or sit unused in the closet.

It can take some time to get used to wearing the sling and even some time for the baby to get used to being in the sling. Practice makes for easy-going days and accomplishing things that you might not otherwise have been able to do. Laundry, shopping, and daily walks become a reality once you hit your stride with the sling. The more you wear the sling, the more you will enjoy it.

Nursing in the sling is a cinch and for those that find modesty very important. They afford mom plenty of freedom and time out in the world.

Dads love slings, too, and are able to offer mom some time alone if she is needing that. When colicky evenings traumatize new parents, a sling can offer the baby some tender swaying and some semblance of the memory of being in the womb. Either parent is able to head to the beach or walk around the block, allowing mom or dad some exercise and head-clearing time.
Many wonder if carrying a baby on one hip or the other is tiring, but most who regularly carry their children find it surprisingly easy; not quite the same as when carrying a baby when they are on the inside, which can be more uncomfortable. The extra weight of the baby is evenly distributed as the sling curls around your back and sides.

Slinging a baby is merely one part of what has become known as Attachment Parenting… a belief that the child’s needs are at least as important (if not more so for a time) than the parent’s needs. AP families are also known to co-sleep, have extended nursing of their babies, child-led toilet learning, and even a concept known as un-schooling (allowing your child to live and learn in life, not in a structured school environment). But others who don’t necessarily ascribe to the complete AP picture can benefit from slinging their babies and might consider a trip to the local sling shop for a fitting.

After all, don’t we all love to be held?

Hibiclens & Precip Births (separate topics)

A question arose regarding Hibiclens being on a list of supplies from the midwife. I reply:

Hibiclens (that is the proper spelling) is used in lieu of antibiotics in labor for a woman who is GBS positive. That is the only thing I can imagine using it for in birth.

You can read about it at:

http://www.gentlebirth.org/archives/gbs.html

Many women do not want antibiotics, but want to do something and the Hibiclens, while controversial, seems to do a pretty decent job in helping babies avoid GBS infection as they pass through mama's vagina. It is not standard treatment at all in North America, but in countries where antibiotics are unavailable or scarce, the Hibiclens seems a great alternative.

My personal take... NOT speaking as a midwife, but as a mama - if I was GBS positive, I would choose to do nothing and watch the baby closely afterwards. If I were negative, I would absolutely not let someone near me with Hibiclens. If I was forced to choose between antibiotics and Hibiclens, I would choose the wash.

If a woman chooses the wash, it should be done ONCE, diluted, and not until birth is imminent.

Another question regarding precipitous babies and their inability to breathe because of the speed of the birth was brought up... truth or fiction?

I answer:

It can be both. Most of the time, precipitous births, just like most births, do fine. However, there can be complications, just like in slower births. You ask about the baby's breathing, so I will address that first.

Babies who fly through the vagina in a fast and intense labor have two issues at play. Babies, for all intents and purposes, hold their breath during contractions. The umbilical cord provides their oxygen, but if contractions are so hard the baby and the cord are mooshed, the baby can have a harder time. If contraction follows contraction with nary a moment to breathe, the baby can show their stress when we listen with a doppler.

I encourage women having precip births to BREATHE and breathe deeply as much as possible even through the contractions. Making noise/singing is fabulous! It takes oxygen to make moaning or singing noises and babies benefit greatly.

So, if a baby comes out after having this intensity as their labor, they can be rather surprised to find themselves out and needing to breathe on their own. The other look I see (and it is called this in most medical circles I have been in) is "stunned." Babies have their eyes open and might even blink, but you can see in their eyes they are momentarily freaked out at being on the earth. They didn't have the hours and hours to get ready for their transition; instead, they find themselves needing to breathe on their own and it can take a few moments for their complete spirit/soul to follow... and then they take their first breath.

Most precip births are perfectly fine and even with a stunned baby, just touching them and looking in their eyes to let them know they are fine and safe and perfect is usually enough to bring them "home" into your life. At the most, a "kiss" of a puff or two of air from your mouth is enough.

Someone mentioned tearing, which you didn't ask about, but babies who fly from uterus to your arms can tear the vagina since it can take some time to stretch the vagina gently to allow the baby's entrance. I have come to believe the adage, if it hurts, don't do it! If you feel burning, wait and let the burning feeling go away. Let the uterus do the work for you. And yes, precip labors' uteri can push those babies out in one giant whoosh! so any extra help from mom probably isn't necessary.

(I've been writing a lot about this for my book, so forgive me if I go on a tiny bit more.)

The only real concern is bleeding after a precipitous birth because the uterus is just as stunned as the baby to be empty. Nursing right away or at least nipple stimulation and (I cannot stress this enough) TELLING YOUR UTERUS TO CLAMP DOWN! Some women choose to use herbs and others obtain pitocin just in case, but unless a real issue is unfolding, allowing the body to catch up just takes a few moments (maybe 2 minutes).

Women, too, find themselves surprised or even shocked that the birth has happened and it is very important to stay in touch with the body at this time. Getting totally high after the birth of the placenta and making sure bleeding isn't an issue is great.

end post

I just thought these were good points to share.