March 23, 2012

Quick post - the case for home births

What happened to my quick posts in between longer ones? hmmm.  OK, have to get better at that part.  So, here is a quick one.  Just wanted to share this article from the Huffington Post.  It's worth a read and a brilliant response to this article that an OB wrote in the Atlantic Monthly recently.  The Huffington Post writer does a great job of showing why the OB's account of this birth actually MAKES the case for home births that are done in coordinated way with hospitals.  She's right.  If only we could get the systems to work in tandem, we would shoot up from having some of the worst maternity care in a western nation to perhaps having the best! Midwife model of care is not about "rogue midwives" and women working in isolation - there is an aspect of cooperation between midwives, home births, birth centers, OBs and hospitals that I think is the real core of this whole "movement" (I've talked before about how I think the use of that word for women choosing midwives, home births and natural births is not appropriate) and that I think women really crave.  Anyway, I'd love to know that if I need to transfer to a hospital next time I am in the baby-having way, I will not get crap over it and will get the care I need without prejudice.  In the OB's story, he actually does all the right things, mostly because the mom makes her preferences known and forces him to utilize all choices before getting out the scalpel as he so clearly would have preferred (don't you know- he has a golf game/birthday party/is afraid of being sued?).  The OB does what he should have done but because he is forced to do so and then complains that this is the problem with home births and midwives and that he had to clean up the midwife's "mess!" He makes himself sound like an ass, frankly.  What isn't he getting? You did the right thing and the baby ended up being born healthy by vaginal delivery instead of mom having to endure major surgery after the midwife correctly transferred her to the hospital in a timely fashion - doesn't that mean the home birth and midwife care worked? Doesn't that mean it all turned out well? I want to thank this OB for posting this though - he so clearly can't see the forest for the trees and instead of making the case against home births, he makes the case for them!
Also, please note women, you have choices.  They can't do anything to you without obtaining informed consent - it is illegal to do otherwise.  Unless it is a dire emergency for you and/or baby.  This mom was smart - she questioned the doctor's push for a c-section and asked him to try other options before resorting to that.  The OB admits repeatedly in the article that a c-section was never at any time medically necessary - that to me, is malpractice.  Trying to push surgery on women who don't medically need it is a violation of their Hippocratic oath at the very least.  Good for this prepared mom who had her midwife by her side, was prepared for labor and birth, knew about all the possible interventions and made her choices known!

March 15, 2012

Pension Plans, College Funds and Sweaty Toothed Madmen

Most men lead lives of quiet desperation and go to the grave with the
song still in them.

Henry David Thoreau

This famous quote by Thoreau has been rattling around in my head on and off for the last year or two. Some might think that's depressing, but I find it instructive.  Not only that, once I started paying
attention to it, the words became a great motivator.
When I was a teenager, I fell in love with Walt Whitman and Thoreau.  I read Walden and have more copies of Leaves of Grass then I care to count (most received as gifts from past boyfriends and bearing
romantic and "deep" inscriptions).  Whitman, much like myself, was a Long Island native.  I choose to identify him with my birthplace rather than those that have followed (Billy Joel, Debbie Gibson, Joey
Buttafuco - OK, admittedly, I like Billy Joel.).  My favorite poem was, predictably, "O me! O life!" and yes, Dead Poets Society had been released, we owned it on VHS and I probably watched it 50 times.  So, sue me.  Here is the poem, for those of you wanting to refresh your recollection:

O me! O life! of the questions of these recurring,
Of the endless trains of the faithless, of cities fill'd with the foolish,
Of myself forever reproaching myself, (for who more foolish than I,
and who more faithless?)
Of eyes that vainly crave the light, of the objects mean, of the
struggle ever renew'd,
Of the poor results of all, of the plodding and sordid crowds I see
around me,
Of the empty and useless years of the rest, with the rest me intertwined,
The question, O me! so sad, recurring--What good amid these, O me, O life?

Answer.

That you are here--that life exists and identity,
That the powerful play goes on, and you may contribute a verse.


Walt Whitman (AKA Sweaty Toothed Mad Man)


Anyway, this poem runs along the same lines as the Thoreau quote and I've been mulling over both of them for a while.  I didn't know much about Thoreau's life so I read a little about him on Wikipedia (I love me some Wikipedia).  It reminded me that he was a transcendentalist.  At least, for a while.  According to further Wikipedia "research" (I use that term lightly) the transcendentalists' core belief was the inherent goodness of both man and nature. Transcendentalists believed that society and its
institutions - particularly organized religion and political parties - ultimately corrupted the purity of the individual. They had faith that man is at his best when truly "self-reliant" and independent.  It is
only from such real individuals that true community could be formed.
Much of this dovetails amazingly well with my beliefs as a Buddhist.  Last month, I spent a weekend attending a meditation program and as always, it comes back to basic goodness.  That's essentially what transcendentalists like Thoreau believed.  Whitman, on the other hand, was a humanist, smooshed in between the transcendentalists and the more cynical, I suppose you could say, realists.  Wikipedia again: humanism "focuses on human values and concerns, attaching prime importance to
human rather than divine or supernatural matters." Again, dovetails nicely with Buddhist beliefs in many ways.  The experiential value of being human – of experiencing for yourself the inherent basic goodness of all life instead of buying into a supernatural force.
This is all pretty heady stuff, I suppose, but it has been responsible for a sea change in my thinking over the last year or more and is why I am making some pretty radical choices in my life, especially in
terms of career.  Radical from some people's perspective, but not from my own within the context of Thoreau and Whitman and not within the context of what I am learning through my Buddhist studies and meditation practice.
I am not fulfilled in my current chosen career as an attorney for a state agency.  When I went
to law school, I did so for idealistic reasons (don't laugh).  Although lawyers have a reputation for corruption, many of us are in fact, devoted do-gooders and public servants.  You just don't hear about us as much because we don't make any money and we rarely make headlines.  After law school, I went to work for a small two person private firm representing people in employment discrimination cases but I was quickly disillusioned.  Our bottom line drove most everything just so we could stay afloat.   After 9 months, I quit.  I decided I wanted to take a job as a government
lawyer – what I considered and still consider to be a public service position.  I felt I would have more of a chance of helping people and society at large that way.  Also, the trade off for making very little
money, was better hours, more job stability and good benefits.  So, I became a government lawyer and 8 years later, I remain one.  Of course, by now I am totally disillusioned once again.  And the thought
that I may directly help people or be of benefit to society at large in this career path has completely vanished.  Realism is the backlash of transcendentalism, indeed.
Now, I am faced with my next move.  Do I simply leapfrog from attorney job to attorney job looking for the one that will fulfill my ideals? Will I be able to find me "dream job" that way? Has my dream changed or have I simply realized that I won't achieve it on this career path? My core beliefs about humanity and society and the interconnectedness of us all remain the same and have deepened through my Buddhist practice.  I believe that there doesn't need to be a split between your beliefs, the way you lie your life and your job.  Nor should there be.  We spend most of our waking hours at a job – the bulk
of our lives, in fact (does that depress you? if so, maybe you should consider a career change as well!)  So, it better be for more than a good health insurance plan and a pension.
This all came to a head sometime last year.  We sometimes receive blast emails throughout my state agency.  Sometimes they are announcements about high level changes in leadership, an event coming up, or the latest round of pay cuts and health insurance premium increases while thanking us for our continued hard work.  Every once in a while we get an email about a person that has died – usually someone higher up in the agency whom most staff (we have thousands of employees spread throughout the state) would at least know by name.  Last spring, we received an email about a woman that had died.  She was not a high level staff person, just a low level staffer, but she had been with the agency for 30 years.  The email announced the regret of her passing, talked briefly about the job title she worked in, and then stated that she had "passed away at her desk after 30 years of service."  Wow.  Several of us were taken aback by this blast email announcement.  A couple of us reacted with incredulity followed swiftly by depression.  To die as a civil servant at your desk in a cubical after
30 years.  The Thoreau line almost immediately cropped up in my mind's eye: Most men lead lives of quiet desperation and go to the grave with the song still in them.  Maybe (although doubtful), it was her dream to die at her desk performing what she considered to be an important civic duty.  Sounds a bit of a stretch, but maybe.  And maybe she had done other far more gratifying things with her life
and was happy the way it had all turned out.  Maybe.  But for me, that embodied exactly what I don't want to happen.  I can think of nothing more sad and depressing then dying at my desk at a government job.  That moment, I decided it was time to take some real steps toward my goal of working in a field I was passionate about and that I knew would have a direct
impact on many people's lives – becoming a labor and postpartum doula and childbirth educator.
I have spent a lot of time wallowing in regret over my law school education (and an ill-fated year of master's work that proceeded it) because it left me with student loans that are simply unpayable
in my lifetime and act as a yoke around my neck.  I have spent and continue to spend a lot of time talking with DH – can we do this? Can I stop being a lawyer and instead follow my passion? From a financial standpoint, it's daunting.  Since we've had Tiger and have to pay for childcare, we are barely
making it every month as it is.  There is another quote though, from my teacher and guru, Sakyong
Mipham Rinpoche that is applicable here: Warriorship means that when
there are obstacles, we do not back off
.  At some point, I just decided to change my perspective.  Not only can I do this, I will.  It will mean a lot of sacrifice and it is scary, but it is too important.  This is my life, after all, and I only get one shot at it - this go round, anyway.  It would mean ditching the stable job, the benefits, the pension plan.  It would mean perhaps way less money in a college fund for Tiger.  But, I talked to DH about this – what kind of role models do we want to be for our son? Do we want to show him that you stuff your dreams inside and decide they're just that, dreams, and instead work a 9-5 that is soul crushing just to make sure you have stability? Is that what life is all about?
I watched my loving parents work like dogs at "9-5" (more like 8-7) jobs their whole adult
lives until they recently were able to retire.  Just struggling to get by and keep a roof over our head and food in our bellies, but hating it.  Just frustrated and mad and underpaid and underappreciated when it came to their jobs.  And we saw them, well, not as often as we all would have liked.  They worked long hours, they had long commutes.  My brother and I learned to cook dinner and do chores early on.  We were "latch key" kids, like my kid and so many kids are.  It didn't totally ruin us, it was fine.  But, I swore I would never do that – I would never work a boring job I didn't like just to get by.  And yet, at almost 35 years of age, I am doing just that.  Sure, your priorities change.  You get married, you have kids, you rack up way too much debt, everyone tells you you need to have a pension plan, a college plan, a stable job.  And for some people, that's enough.  Or they say it's enough.  But, if I'm honest, it's not enough for me.  I have to think about what lessons I will pass onto my son.  And I
truly believe, he'll forgive me if he doesn't have a great college plan as long as he saw me doing what I wanted to do – taking a risk and following my passions.  And the people that will come in and out
of his life due to this career change are wonderful, amazing people.  It will change his life too.  After all, I would not have gotten on this path if it weren't for my experience in giving birth to him.  He
gave me this gift and I will not squander it.
What about retirement? By the time I make the switch and leave my 9-5 law job behind (which is still some years off), I'll have 10+ years into the retirement system and I'll keep saving.  It won't allow me to retire at 55 or even 65 or maybe ever fully, but if I'm working at a job I really love, I won't need to retire from it in the way I would need to from the current career path I'm on in order to really start living my life.  I don't want to start living until I'm 65 years old. Who knows? I may not make it that long! 
So, since I'm still working, I'm sinking money into getting the training and certifications I need to in order to make this switch by the time I'm in my early 40's.  I'm taking on clients when I have the chance.  I'm learning how to start a business.  I've got business cards and I'm distributing them and finding other ways to market myself.  I'm working on two certifications at once to increase the
scope of the services I can provide.  DH is admittedly scared but very supportive.  We envision a different life for us and our family.  He has aspirations as well.  We will downsize and cut expenses. Somehow it will work.  We'll cover my loans and our bills.  We'll make sure to
keep our life insurance current so Tiger won't be stuck with our student loans.  Tiger will enter school in a few years and when we have a second baby, that one will hopefully not be too far behind him.  We'll have more time with our kids, more time together.  I keep saying it like a mantra: Somehow it will work.  It's all about courage and perspective and the aspiration.  It's the belief in the basic goodness that drives me.  I will not die at my desk.  I may die by the side of a woman giving birth or at home with my family, but I won't die with my song still in me.  I will spend this next part of my life singing and that will be my legacy to my children.
What is your song? Have you listened to it lately? What can you do to
pay it heed?

March 7, 2012

What NOT to read regarding pregnancy and birth



I often see articles that I want to blog on, but then I delay because writing a blog entry takes a long time and it takes even longer to edit it and add the links in.  In talking this through with my husband the other day (who has decided to copy me and start blogging too), he pointed out I could just do short blogs on articles that interest me and that I want to share with others in between the longer, meatier ones.  Oh yeah! As we used to say when I was growing up – " duh!" He's always smarter than me.  So, I'll be trying that out for a while starting with this post.

Funny and spot on article this week called "What To Expect When You're Expecting: The Mean-Girl Advice Book" – taking what is probably the worst pregnancy book out there down a few pegs and calling it out for its alarmist and negative portrayal of your childbirth year.  When I was pregnant, first with my miscarried baby and then with Tiger, I actually bought this book despite being warned by even my fairly mainstream epidural loving friends and relations (not disparaging here, just saying it's not like they were my earthy crunchy momma friends) that it was terrifying and should not be read.  I bought it anyway, knowing it was crap, just as they had bought it and so many million other women have.  It is and was a truly awful book, as many of you know.  Read the article for some of the funnier/more disturbing highlights.
I only read it during the beginning of my pregnancy and thereafter,  just skipped around to the "this is what's happening with that little life form inside you this week" parts.  It was unfortunate that I read a lot of it in the beginning of my pregnancy with Tiger as I was already a nervous wreck after my prior miscarriage and it just added fuel to the fire.  Anyway, the book fell by the wayside when I was introduced to my favorite pregnancy/childbirth preparation books – Ina May's Guide to Natural Childbirth,  Birthing from Within by Pam England, and the Pregnancy Book by Dr. Sears (please read these books, pregnant women – they can change your entire perception of your pregnancy and of birth), even if you love epidurals! They are empowering and helpful for every woman, no matter what type of birth she wants.   
I also own another pregnancy book I bought called "I'm Pregnant!" by some doctor chick.  I don't mean to say that demeaningly, and she is actually a medical doctor (unlike the author of What to Expect); however, it's hard to take a book seriously that uses an exclamation point in the title.  Also, the cover is a photo of her, looking very un-OB/GYN-like as she stands casually leaning against a wall, arms crossed, white pants and a small top that shows off just a hint of a very not pregnant belly.  Dr. Casual tries to be very cool in this book – medical facts about what's going without trying to sound alarmist and appears to be more OK with things like natural childbirth and waterbirth, but it's clear she's not real serious about those things and the book is still alarmist and most of the pages focus on what could go wrong, all the tests you may have to have, and why you feel like crap.  The book isn't great, obviously, but it does have some really cool ultrasound images of what's going on in your belly and some more decent advice pregnancy-wise than What to Expect, but it's still pretty negative in tone and not at all useful for actually preparing for childbirth (the stages of labor section of this book is where she really pulls the fear factor out).
Another awful book I read when I was pregnant was the Girlfriend's Guide to Pregnancy.  I was handed down this book by some of my friends who had kids before me – smart women who I trust.  It was maybe the most insulting book I've read when it comes to pregnancy and birth.  I actually threw it in the trash after reading pretty much all of it (I kept looking for redeeming value) because I wanted to make sure at least one copy of this book was taken out of circulation and never saw the light of day again.  If I was a book burner, I'd have a happy bonfire with this one.  It's supposed to be funny, but really it's just that kind of awful inane girl talk BS I can't stand.  I'm just not that type of woman.  The women in that book, especially the one that wrote it, is EXACLTY the type of woman I dislike and the reason why for much of my life, my friends were exclusively male.  Ah, well, someone like myself who actually loves pregnancy and childbirth is not that author's audience anyway and she's far richer than me so she can just laugh at my hatred of her crappy book. 

Back to What to Expect, I was also given a copy of another book in the What to Expect line (it's a whole damn franchise) – the First Year book.  I was told this book was "better" than the pregnancy book by one of the mom's who had warned me not to read the pregnancy one.  It was not.  I opened it up in the first few weeks of my child's life when I was looking everywhere and anywhere for breastfeeding help and was so insulted by what I found in the pages of that book regarding nursing that it went in the trash can just like the Girlfriend's Guide.  Not only did it give mother's the usual What to Expect negative treatment of breastfeeding "it's exhausting", etc, but it also gives it the alarmist treatment as well and really is not supportive of women nursing over one year.  So, it's actually very easy to know what to expect with the "What to Expect" line of books - expect overall negativity, alarmist advice, and medical inaccuracies.  Sounds like it fits right in line with what our society often portrays about pregnancy and birth.
The overall problem? These books feed into the neuroses and worries we already have about pregnancy and birth.  They are not in any way affirming, confidence building or positive.  And often, they are downright wrong from a medical standpoint.  So, don't buy them.  Throw them in the trash! Buy the books mentioned above or others like it or buy none at all (blasphemy!).  There are some great books and websites with positive birth stories in them.  Read those.  Steep yourself in positive energy regarding pregnancy and birth (while understanding what obstacles you may encounter and what choices you may have to make at the time).  It will have an effect on your pregnancy, your baby and your birth.  Buy one of those buttons that says you only want to hear positive birth stories and wear it proudly.  Talk to friends and your midwife about questions you have.  Make new friends by tapping into a mom's network and/or La Leche League in anticipation of needing community when you do give birth and in postpartum.  Create your own little birthing tribe. 

Any pregnancy and birthing books you love and couldn't live without? How did you keep the negativity surrounding pregnancy and birth in this country at bay when you were pregnant or did you indulge in it? Did it have an effect on your pregnancy and birth?

February 19, 2012

Dön (Draper?) Season

Have you noticed, in the last 5 or 6 days, a number of things going wrong in your life? Illnesses? Car trouble? Accidents? Maybe even deaths of loved ones? Just a string of generally not so great days? Well, if you have, there's actually an explanation in my Buddhist tradition of why things are going wrong this time of year. We're just about at the midway point of Dön season. For the uninitiated, this does not refer to fact that a new season of Mad Men is coming up (although, that's happening too – and
let's not diminish the importance of that event). In the Tibetan Buddhist tradition, dön season refers to the 10 days leading up the Tibetan New Year (Losar) when all the karma you accumulated over the
past year comes knockin' on your door and when you open it, tries to kick you in the groin – strictly in a spiritual sense, of course. It is not a time of year where you should do much of anything. Lay low, meditate, do yoga; don't travel, make big decisions or start a new project or relationship, if you can avoid it. Here's a good talk by Sakyong Mipham Rinpoche explaining Don Season.
As one article in the Elephant Journal from 2010 aptly stated: "It’s a reminder that when you are a f*ck-up, even a basically good f*ck-up, it has consequences. The seeds of negative karma that may not even have ripened for four, eight, or twelve lifetimes can suddenly actualize into disasters and calamities in a most immediate and painful way." Cheerful, no? But, it's not all gloomy.
At this time of year, in the Shambhala Buddhist tradition, we practice a chant called the Pacifying of the Turmoil of Mamos every night. It's a protector chant, so we're supplicating to protector deities.  But, what does that mean? Are there real flesh and blood creatures out there whom we're asking for protection? Maybe. But, I prefer this explanation: "The deities or dharmapalas [dharma = truth, teachings, palas= protectors] symbolized in the protector chants are, in one sense, projections of our own inherent potentialities to overcome these obstacles. So, in supplicating them, we are arousing our own inherent wakefulness and confidence to rise above these negative energies."
So, not completely cheerless after all, and a great reminder that there are repercussions to all our actions. Every time we don't engage in mindful speech or action, it is never just left at that - never just a singular event - even if it may seem that way at the time. On the other hand, let's not be so hard on ourselves. We're not enlightened just yet and we've likely done many things over this past year which were not mindful, but we're working on it, working on uncovering the seed of right body, speech and mind that already exists inherently within us. The Shambhala website offers this description of the
purpose behind the mamo chant: "The mamo chant is recited in order to pacify the karmic cause of personal, social, and environmental chaos that accumulates at the year's end." The chant contains some pretty esoteric imagery and was originally only practiced by vajryana students, but the Skayong decided to open it up to all practitioners as he believed the chant would be helpful to all of us, regardless of our level of meditation practice.
In some ways, it can seem punitive – these karmic forces coming to call each year. But, in reality, it's just a very concentrated reminder of the interconnectedness of all our actions. We call upon the protective energies around us during this time period and we take time each day to meditate and reconnect with our basic goodness before going forward into a new year, which we enter in joy and celebration and with a heightened awareness of the workings of karma and how our own actions affect the world around us. Although it's preferable to practice the mamo chant with others led by a vajryana practitioner at your local meditation center (misery loves company and so do protectors?), there is a shorter version of the chant you can do at home. Since we have a small child, DH and I are practicing the chant at home – trying to do so before bed at least every other night.
I'm not usually a superstitious person, but this time of year makes me nervous. I do try and lay low as much as possible and I try and be really mindful about the possibility of accidents, especially around the home with my child and out driving in the world. It's impossible to stop life though. For instance, at work I have to give a negative evaluation to an employee during this time period – but, I'll try to be really mindful in what I say during the evaluation - maybe more so than I would have been at another time of year.   A potential doula client calls me and I have to have a consultation with her during this
time – I can't very well tell her "no, we'll have to wait to meet even though you're due in 6 weeks because, don't you know it's dön season??" But, I will be very mindful of my speech and actions during that meeting and not make any further moves (signing the contract, taking payment, etc) until after Shambhala Day.
Regardless of whether you believe in protector deities or karma, it's not a bad thing to have one time of year where you are really reflecting on your actions and the repercussions of them, both long and short term, as well as the interconnectedness we all share and about our basic goodness. Besides, there's not just negative karma - what about all the great things you've done this year - both big and small that have had ripple effects you could not have dreamed of? This year, I'm trying to put my nerves aside and focus on those things, but I will definitely breathe a sigh of relief next Wednesday, when we celebrate the new year. What ways can you increase your mindfulness over the next year? Maybe
there is one small thing (for me, it is mindful speech, which I will be working on a lot in the coming year) you can work on.  What is one unskillful thing you engaged in during the last year that had repercussions you didn't foresee? What about a mindful action you took or words you spoke that likewise had a ripple effect?
Be safe in the coming days. With the ending of dön season, Don Draper
season is just around the corner!

Link here for a more detailed description of the mamos and what they are.

Postscript:  In the couple days since writing this post and originally publishing it in its not so cleaned up form, the don season has really hit my home.  One of my grandmothers passed away and my toddler became ill with a sinus and ear infection.  Also, small things happened like letters coming the mail telling us we owed sums of money we don't have and then the mamos ate the graham crackers we bought during yesterday's food shopping (where else did they disappear to?).  Is don season a self-fulfilling prophecy, I wonder? Although I am nervous to travel at this time, my child is feeling better and we will make the 4 hour drive to my grandmother's wake and funeral tomorrow.  I hope the mamos will be appeased by the graham crackers (they're organic!) and protect us through these last 2 days of this challenging season.  We're in the home stretch!

February 6, 2012

Learning to Unlearn

"It is a happy talent to know how to play."
Ralph Waldo Emerson

We think and talk a lot about play in our house these days.  Tiger is almost 18 months old and his imagination is really starting to spring to life.  For example, he loves trains.  OK, that's putting it mildly – he's obsessed with trains (especially a certain engine named Thomas and his
friends).  Lately, every day objects are suddenly trains – the radiator, a blanket he tows behind him, the beads on his busy zoo bead cube, daddy's belly (we're not sure why, but it routinely is imagined
to be a train these days).  Some parts of the day, the radiator is a radiator and he walks up to it and says "Hot, hot." But, other times, in his mind's eye, it magically transforms into a train and he walks up to it, runs his hands along it and says "Choo! Choo! Train!" DH and I are very intentional about how we react at those time, we don't say "no, that's not a train, it's a radiator."  We say "oh! Is that a train? Choo! Choo!" and play along.  He knows it's a radiator.  We don't need to worry he'll think radiators are trains and fail his identification of household appliances unit of kindergarten (who the
hell knows what they teach in kindergarten these days? They might have to learn this skill to go onto first grade).  He just imagines it to be something else sometimes.  And so we try and imagine it that way too.
DH and I have talked a lot about this and our tendency as adults to correct.  We want our kids to get it right.  Be the smartest.  Use the right words for the right objects.  So we correct them.  Even in their play.  And I think that's a spirit crushing activity.  I've seen it in my little guy's face when he points to a
circle and says "star," or repeatedly refers to blue as "purple."  If I correct him – "no, that's a circle," "no, it's blue;" he gets this sad look on his face like "oh, I did something wrong."  He's 18 months old. It doesn't really matter if he sometimes calls a circle a star because he really likes stars.  It doesn't matter if he says blue is purple because he loves the color purple (and the word) and wants to say it as much as possible.  DH and I have talked about our tendency to correct and how we've needed to check that and instead say something like "I can see how that looks like purple" or simply, "yes, purple."  Most of the time, Tiger is just looking for praise – he loves to hear us praising him for using his words, for getting it right.  And that's more important at this stage than him actually getting it right.

A recent article in the NYT talks about the movement that is growing up around the importance of play.  It's worth a read for any parent.  As the article points out, when we talk about play, we're not talking about screen time, video games or electronic toys –even those that bill themselves as "educational." We're talking about rolling in the mud, throwing toilet paper in the air, making a fort - messy play.  It does my heart good when I walk into my house at the end of a work day and see toys strewn everywhere, glitter stuck in the cracks of the hardwood floors, books strewn everywhere, fingerpaints out on the table, a fort in the corner, and a very happy kid.  The house is a mess and it's tiring to know we'll have to clean it up after Tiger goes to bed, but it means that he's spent another great day learning to play with our wonderful nanny and her daughter.  That is, without a doubt, more important than a tidy house.  But, believe me, it's taken a while for DH and I to adjust to that and get comfortable with it.  Oh and there is not one, I mean not a single, plastic-lights flashing-noise making toy.  We simply don't have any.  Well, we have one, a baby Einstein thing that plays music
and tells you the colors in English, Spanish and French.  He uses it on the changing table sometimes and it did help him learn to say his colors, but he could have learned them from us and his books and
flashcards without that toy.  Otherwise, all of Tiger's toys require imagination and motor skills to power them.  We still have plenty of toys (TOO MANY), but I am always shocked when I go to a house full of these really loud, flashing toys and the kid seems to be having fun
but they're just kind of sitting there.  Maybe pushing a button or something.  No imagination required.  Huh? Why? Also, those toys are annoying as hell.  So, again, why? I can guess why –because although Tiger is becoming increasingly self-directed in his play and can now play for much longer stretches of time on his own, he still largely needs and wants a partner to play with.  That means, DH
and I spend a lot of time of the floor playing with him and running around the house doing the same (it's winter now, so we're mostly housebound although global warming has given us a few days where bundled up wagon rides were possible).  It's physically tiring after long days of work and not great nights of sleep (2 years molars – yay), not to mention the focused attention it requires can be very draining.  But, really, we get only a few precious hours with him on week days and on weekends, we trade off sleeping in, so what better is there to do than play? It can be challenging getting dinner together, but a couple of nights a week we eat eggs or PB&J or (gasp!) hot dogs (uncured), which Tiger would prefer to a roasted chicken anyway.  So be it.  On days where we're really exhausted, DH and I just lay on the living room floor for a bit and Tiger is happy to crawl all over us laughing, kissing and tickling.  We even play a game called "night night" where DH and I pretend to go to sleep on the floor and make a ridiculous snoring sound and then Tiger jumps on us yelling "It's day! It's day!" until we get up.  He requests this game nearly every day and asks for it "again! again!" and it doesn't require much energy on the part of the adults.  Plus, we're role playing sleeping, which is something he needs to do often as we continue to work on his own sleeping issues.
Tiger also has very limited TV time – ½ hour per day.  He rarely throws tantrums over wanting more and rarely requests TV if he's already had his allotment.  When he does, he usually is easily directed to a book or train or musical instrument.  So, that seems to be working out for everyone.  From time to time, if I need to get something done (like dinner) and he's really needing attention, I have
used the TV as a babysitter.  I hate doing it, but sometimes it happens and so be it.  For the most part though, Tiger's world of play consists of non-electronic toys, imaginative games, arts and crafts,
books and as much outside play as the weather will allow.  Coupled with plenty of trips to the local museums, indoor play spaces, the local train station and even our local airport.  Our nanny is just so
great at coming up with imaginative games and also letting the kids lead the play (her 4 year old daughter comes to the house 3 times per week and is Tiger's best friend).  I am constantly amazed at how easily our nanny accesses their world and taps into that realm of the imagination that all of us adults have lying dormant in our mind.  I've been struggling with that the most – finding my imagination again.  That and letting go of the very practical and stressful adult world in order to inhabit Tiger's.  When Tiger grabs the toilet paper roll and starts pulling, we let him pull.  Then we throw up the wads of white paper in the air and yell "it's snowing!"  There is definitely a part of me thinking about the mess and also how expensive TP is and how we now have wasted a whole roll, but I'm able to see that part of me is ridiculous and childish and that the part of me that is laughing and loving my child's experience of this roll of white, fluffy paper is actually far more sane.  It's not always like that.  DH and I have talked about our resistance to fingerpainting.  Tiger loves to paint, but it's so messy and such a hassle, we rarely do it with him and leave that to the purview of our nanny who has him generating paintings at a pretty furious rate.  Beautiful swaths of blue and green.  Fiery reds and
oranges.  They adorn the walls of my office and home.  I need to work on dropping whatever outing we have planned on a Saturday in favor of "paits" when he asks for them.
I haven't quite figured out how to re-activate my imagination, however.  That part's trickier.  I had a fierce one as a kid.  I played for hours alone with my imaginary friends or with neighborhood and school friends pretending the basement was an ice skating rink, that I was a
mechanic fixing my bike, etc.  My best friend growing up had a wild and vivid imagination and we spent days upon days up through even our middle school years playing in imaginary worlds.  When we got older, the games morphed into stories, which we would write in spiral notebooks during and after school, putting our real life friends and teachers into wild imaginary (and often funny – at least to us) situations.  Where did that all go, I wonder? The truth is it didn't "go" anywhere – it's just been layered over by all the "have to's" and "need to's" of the adult day-to-day world.  I haven't found the magic key to unlock that door, so instead I'm letting Tiger re-educate me.  I'm learning by watching him learn about his imagination and accepting his invitations to join in those games with him as often as possible.  As he gets older and indulges even more in this imaginary realm, I hope that I
can drop my adult mind and follow him in.
So, readers, how do you access your imagination with your kids? What kind of games do you play with them and how do you encourage old fashioned, messy play? I would love to hear your stories, tips and suggestions.

February 1, 2012

Judge not?

My natural mom friends have been passing around this youtube video on Facebook – maybe you've seen it. It's from the S**t people say series – this one is called "Sh** crunchy mamas say." We've all been laughing extensively over it in the vein of "it's so funny because it's true." We've eagerly been self-identifying the amount of things in that video that we ourselves have said or thought. I'm heartened to see we all have a sense of humor about our "natural momma" label – a label that for many of us, is self-imposed and that we proudly wear (if not, admittedly, flaunt it at times).
It really is a funny video. And yes, I have said many (but not all) of the things in it and have thought even more of them. I'm not quite as bad as the worst stereotype of the crunchy momma (like Maggie Gyllenhaal's hilarious portrayal in the really sweet and wonderful movie "Away We Go"), but sometimes I approach it. It got me thinking about parenting and judgment – within the "natural parenting" movement in particular.
I actually think about that a lot because as I try and educate parents and people through posting articles on FB, through my blog or through my work as a doula, I have to be really aware of how I am presenting information and how I am framing my opinions. I've learned that if you present things in a certain way, the people it needs to reach most will simply tune you out or write you off as a fruitcake and not hear the information that it is actually important that they hear and consider. As a doula, this is very important. When my client asks me a question – "what should I do about xxx?" (circumcision, breastfeeding, vaccines, etc.), it is beyond my role as a doula and the scope of practice I operate under, to tell them what to do. It is, arguably, beyond my role to tell them my personal opinion. A big part of my role as a doula; however, is to provide information to my clients – point them to resources and encourage them to make an informed choice based on what they read. It's a fine line, though, because many of the resources I find are invariably skewed toward whatever opinion I may hold on the topic. So, I have to be careful to try and present both sides of the coin, so to speak. However, if there is no medical research to back up one of the sides, my client needs to know that (for instance, to pick an easy one, there is no medical research backing up that you cannot vaginally deliver a "big" baby, in most circumstances). So it is with all research – it's hard to be really objective.
I will give my opinion to clients, but I am really forthright about telling them clearly that it is my opinion, not fact, and I often try to couch it as "here’s what I did and why it was right for me and my husband" or "here's what I think about that and why." It's dangerous ground, though. I know from experience that I looked up to my doulas and holding a contrary opinion from them can, at times, be difficult. This was through no fault of their actions; it was merely what went on in my mind and with my emotions. I do remember my husband feeling "ganged up on" by the women (myself and our 3 doulas) when it came to certain topics. I'll use the example of whether or not to circumcise Tiger. I try not to preach about circumcision because I truly believe it is a very personal decision. However, I'll gladly present you with evidence and resources about it, if you're interested in and I will admit up front that Tiger is not circumcised. This was not a choice that was made lightly by me and DH. I knew, from the research I had done (Dr. Sears has a great list of questions you should ask yourself before making the choice in either the Baby Book or the Pregnancy Book) that I was firmly against circumcising our little boy. But, DH wasn't so sure. He is circumcised and obviously has a lot more attachment (no pun intended) to the subject. So, in this one area, I made my opinion clear but also told him I would largely defer to his decision. After a doula session toward the end of my pregnancy where we talked about the subject, DH was feeling outnumbered. It had been abundantly clear that all the women in the room were against circumcision, although our doulas were careful to point us to research and try to elicit how we felt, instead of telling us what to do or even stating their opinions (it came across anyway). At this point, DH hadn't read any of the research and a quick reading through Sears (especially the graphic but true description of the operation) and some other info made his mind up quickly and firmly against circumcision (whew! Because although I said I would have "largely deferred" to his decision – it would have been really hard for me to swallow had he decided he wanted Tiger to be circumcised and I'm not sure what I would have done). We have never once regretted the decision not to circumcise and in fact, are really happy we didn't. But, again, as a doula and even as a fellow mother, it's really not my place to say what others should do. And I don't think the practice should be banned – I just think we need to really educate people before they make a choice. I didn't mean to get into the nitty gritty of this topic – it's been gone over on plenty of other blogs and articles. Heated arguments will ensue, but that's not really the point of this post.
Really, what I wanted to talk about (believe it or not) was judgment. Putting aside my role as a doula for a second, as a mother - and an admittedly pretty "natural," "crunchy" or "liberal" or whatever your choice term is, one – I have found that even within my own circles of other natural mommas, I have encountered, bore witness to, or heard of some pretty intense judgment of other people's parenting. Behind their backs, but actually more often than not, to their faces.  I think in some ways, that the natural parenting movement has within it an even harsher edge of judgment and criticism than more mainstream parenting circles. Even more than criticizing those parents who are more "mainstream," there are lots of judgments floating around about other natural parents. Like – you're crunchy, but not crunchy enough. God forbid you let your kid watch ½ hour of TV or eat a cookie made with refined sugar every once in a while, the parenting police are in full effect! I hate the parenting police! I am friends with some women I really respect who will turn the parenting police act on full force at the drop of a hat – just get nasty! I try to stop myself when I feel like I may be going there. Sometimes it's hard – there's so much information out there and lots of parents ignore it or buy the "well, we did worse things to you and you survived it" nonsense that parents with grown children sometimes defensively spout. And your beliefs as a parent are so strong – you KNOW you're right that that mom should not give her 12 month old McDonald's in front of the TV, but she's also got a 3 year old and has her reasons. Putting on the parenting police act won't help. She won't even hear you. She'll just turn Elmo up louder and think "thank god I don't have to cook dinner because I don't have the energy."
I haven't often been the subject of judgment from other parents, at least to my face, but I'm pretty scary so that may be why. I have encountered a little bit of disagreement from time to time because there is one area where me and many crunchy mommas just don't agree – vaccinations. I am not anti-vax and I preface anything I say to my mom's group on that subject with that fact. That way they can just ignore me (much as they seemingly ignore medical research in which countless studies have found no link between vaccinations and autism) and go on conversing with each other. See how snarky I got there? It's just so easy.  So I see how the parenting police happen! I've seen the scorn that can be levied by a natural momma who thinks you're just a poseur. Be careful or you'll have an ergo and a bottle of camilia thrown at you!
All this judgment – where does it come from? Our own insecurities sure, but there's more to it. There is just so much information out there. It's difficult to keep up with the latest baby product that's been found to contain toxins or whether infants acetaminophen causes asthma, or that there's arsenic in apple juice. It's so hard, but it's also our duty as parents to try and keep on top of this information and to change our practices accordingly, based on what we're comfortable with after we see the research. If you're OK with a certain amount of arsenic in apple juice then OK, read the study and decide that your kid will still drink juice. I make these calls all the time – how much is too much? I know I should keep my kid rear facing in the car seat until he's at least age 2, I've read the studies and they scare the shit out of me, but my 17 month old, 26 lb toddler with long legs is miserable and I'm miserable and I have to practically break him in half to get him in there and then he screams on long car rides. So me and DH talked and decided we're not driving 10 + hours to visit my parents in April with a screaming uncomfortable kid in the backseat. Until then, he remains rear facing – but for that ride, we're turning him around. Alert the parenting police!!!! It's OK if someone wants to say, "do you know there is research on this – here's the link?" it's NOT OK for them to say "you're negligent and/or killing your kid if you turn them around before age 2." And frankly, if you say that to me, my reaction is going to be a very polite "fuck you" and I probably won't read whatever research you've pointed me because you've annoyed me. But, when I go home I'll feel bad that I'm going to be responsible for killing my kid. Not bad enough that I'm going to deal with 10 hours of screaming toddler meltdown in the car, but still I'll feel like a BAD MOM.
Enough with the bad mom shit, people. We all love our kids and we're all trying to make the right decisions for them and for our families. I doubt there's anyone out there thinking "how can I intentionally harm my child today?" and then researching it and giving them a shampoo with Johnson & Johnson in a front facing car seat while pouring lead and arsenic laden apple juice down their throat. Maybe there are some people, but they're sociopaths (and very good at multi-tasking). The rest of us are just trying to get through it doing he best we can and loving our kids fully and hoping we don't screw them up too badly. The only thing I think that is negligent parenting these days is not doing your due diligence – not reading the research before turning the car seat around, not reading the labels to see what's in the products you give your kids (children's toothpaste with parabens? COME ON), etc. We have easy access to so much information these days and our parents didn't. So, we have a responsibility to perform due diligence before making these choices.
That said, acting as the parenting police toward other parents and casting your judgments their way will get you nowhere fast. You may disagree with another parent's choices (and even voice that disagreement to your spouse or whatever) but remember that every time you levy a judgment against another mother to her face, that mother goes home and somewhere inside her thinks you're right and she's a BAD MOM. She's probably already had that thought 20 times today without your heavy handed attempts to get her to agree with you. As mothers, we do a fine job beating ourselves up without the help of others.
So, remember, your opinion is your opinion and should be stated as such. Providing research to back it up is essential, but make sure to let the person you give the research to make their own informed choice, whatever it may be. Educate don't judge!
And always, always keep a sense of humor about yourself and your beliefs. 
Having said all of this, please know that on every given day I have countless judgments of others running through my head and it's something I work with as actively as possible.  I know that after reading this post, DH will hit me with a frying pan for being a hypocrite, but I've got a tube of arnica gel right next to me so I should heal up nicely!

January 25, 2012

The Importance of Choices

A friend and fellow momma sent me this great link to a blog post she thought I would like.  It's from another great blog I love (and one that puts mine to shame), called mama birth.  Anyway, the blogger talks about having birth clients who are reluctant to make the choices they can and need to make in order to help pave the way for the birth they want and how frustrating that can be as a birth support provider.  The post is really aimed at moms and tackles the issue of responsibility head on.  As she says,  in birth, as in most things in life, there are no "do-overs."  A traumatic birth experience will stay just that and if you have another birth, you have the opportunity to try and head another bad experience off at the pass, but ultimately, the key to that lies only with the pregnant women.  We as birth providers can lead them to research, talk to them about how they are feeling and mirror back what we are seeing, we can make helpful suggestions, but at the end of the day, the moms and their partners have to make the decisions and step up to the plate.
Many women in our culture seem to be passive during pregnancy and even during labor.  Like they are just the vehicles carrying this life - they don't want to know what's going on with their body, their baby and what they can do to have a healthier pregnancy, much less what the options of their birth are.  They also seem to feel that they have no control or say over what is happening or what will happen – it's up to the doctors, midwives, nurses, fate or your brand of god.  All of whom, it is assumed, know better than just the lowly woman who is carrying the child and her partner in crime.  Seems a bit ridiculous, no? However, I know some really smart, really independent, strong women who have chosen to put blinders on throughout their pregnancy(ies) and birth(s).  We can blame society for the way birth is portrayed in this country or the medical establishment and there is some responsibility there (as I have discussed in previous posts), but in the end, the responsibility lies with the birthing women.  They have many choices and although it takes strength to inform yourself and exercise those choices during pregnancy and labor, I would venture it takes less strength than actually birthing a baby (in my experience anyway).   
I understand this phenomenon all to well, having been through it myself with my pregnancy with Tiger.  I knew I wanted a natural birth, my husband and I weren't ready to birth at home, and so we hired a doula, as we had a friend who had used one and swore she would never birth without one.  After interviewing a couple of wonderful people, we hired our doulas (we were fortunate to hire a group of 3 extremely experienced women, all of whom worked together and backed each other up at births, and were actually midwives awaiting licenses in my state.  We hired them probably about my 13th or 14th week.  At that time, I was with an OB I loved, let's call him Dr. Natural, who was my friend's OB (the one who had a doula at her first birth) and who had guided me compassionately and skillfully through my miscarriage and D&C with our first baby.  Dr.  Natural was great – he had previously been partners with the most notable natural birth OB in our area and it was the only practice of OBs who did waterbirths.  But, he left that partnership and moved over to Big Unfriendly Conveyor Belt OB Practice.  You know the type I'm talking about – there were 7 or 8 docs, and you "rotated" through all of them and although you had your "primary" OB, if that OB wasn't on call when you went into labor, you were at the mercy of whoever was.  They had 2 midwives in the practice, but I later learned they're not allowed to "catch" babies, even though as a midwife you are clearly qualified to do so, so I have no idea what these "midwives" do or why they are there.  Anyway, my friend had vocalized her fear many times during her first and also during her second pregnancy that Dr. Natural would not be on call during her labor.  But, Dr. Natural had "specialed" them – meaning the service was allowed to call him when she went into labor even if he wasn't on call and if he could (and/or wanted to), he would attend her birth.  It worked out both times for my friend – Dr. Natural was not on call but her husband fought with the scary Dr. Medical Intervention who was and got them to call Dr. Natural who showed up for the births.  She was lucky.
By the time we hired our doulas, I was already getting stressed out over Dr. Natural possibly not being at my birth.  I loved him – he is a wonderful OB that really gives me faith that there are wonderful, smart, OB's out there who are not just surgeons, but understand and support letting the body go through the process of birth naturally.  He has 5 (yes five) kids and I believe they were all born by natural birth and some in water.  He continues to research and learn and was fond of saying to me that basically, the medical establishment understands very little about the wonders of birth, so don't get too caught up in all the rules of what you should and shouldn't do during pregnancy.  He was always honest and forthright with me and always cognizant of the emotions underlying being pregnant, especially after a prior miscarriage.  However, when I asked him during my first pregnancy while I was still OB shopping if he would be OK working with a doula, even he, Dr. Natural of the Cosby Show sweaters and fuzzy beard, said to me "Sure, if they know they're place." (AHEM).  Anyway, at our first appointment for my pregnancy with Tiger, he told me and my husband without needing to be prompted that each pregnancy was different, that pathology had shown no reason to think I would have another miscarriage, that almost all women have one and I could move on with confidence that I would have a healthy and happy pregnancy and birth.  Because I was nervous, he suggested an ultrasound at 8 weeks, which I know many people would be in disagreement with, but it put mine and my hubby's mind a bit more at ease to see that all was fine at that early stage.  
However, after one more prenatal with Dr. Natural, it was time to begin the mandatory and dreaded "rotation" through all of the OBs and the midwives at the practice before coming back to Dr. Natural in the final visits.  I tried to be open minded, but it was obvious from the start that things were not right.  With each prenatal, the new OB (new to me, anyway), would come in the room and start asking questions that showed he had not read my chart, i.e. "what's your name?" how far along are you?" "is this your first pregnancy?" (I never got to meet with the female OB at the practice, but my friend told me the OB had asked her "what's a doula?" at one of her visits – we call this a BAD SIGN in my business).  Anyway, the doc would usually just launch right in then, checking the fetal heart tones, asking if I had any questions, maybe chit-chatting a bit.  With every visit I had to explain (and re-live) my miscarriage because they never bothered to read the damn chart.  They had no interest in who I was, my history, or what kind of birth I wanted.  In fact, they never even asked me what kind of birth I wanted.  They seemed annoyed with my questions – like, they weren't important enough – and one of them even put it into context for me "I have pregnant teenagers who are still smoking as patients."  My query about the research showing you shouldn't eat too many nuts during pregnancy because the baby could develop a nut allergy, in other words, were frivolous.  The appointments were never more than 5-10 minutes with the OB. 
I knew in my heart that this wasn't the right place for me, my husband or my baby.  These other doctors were horrible.  And I had become just another pregnant cow on the conveyor belt.  The hospital they had attending rights at was 5 minutes from my house, but was not where I wanted to deliver.  Also, I had such strong emotional distress when I went for appointments to the same office where I had learned of our first baby's death and my D&C had been performed, I had requested to switch to their satellite office, which was much further from our house and my work, but didn't hold the same associations.  Despite all of that, it took a lot of good questions and mirroring back my feelings and needs from my doulas to get me to a place where I felt like I could leave the practice and the hospital.   
Why was that? I'm pretty strong willed, but the thought of switching practices had me in knots.  I felt guilty leaving an OB who had treated me so well; I was scared of going to another practice who I hadn't been with through my prior miscarriage.  I was in some ways feeling apathetic and that I had little or no control over the care of me and my baby – it was happening TO me, instead of FOR me and my baby and I wasn't a participant in it.  I didn't understand that it didn't have to be this way because every medical experience I had had up to that point, especially surrounding reproductive issues, had been that way. 
My doulas were great.  I was coming up on 18 weeks and I remember one of them asking me how I felt when I came out of a prenatal.  This seemed a strange question to me.  I had never thought about it.  "Do you feel like a Goddess?" she asked.  I most definitely did not.  She told me I should feel that way.  Huh.  I should? She asked me to think about it and maybe just take a tour of the only hospital in our region where waterbirths were available and that was run on a midwife model of care and maybe just talk with the midwives there. Then tour the hospital the conveyor belt practice delivered at and see how we felt.  
DH and I started talking about it and decided to go ahead and just see what else was out there.  First, we toured the hospital we were scheduled to deliver at.  I should take this time to say (and I may have said it in prior posts) I HATE hospitals. I am terrified of them.  I can't stay in them too long or I start having a panic attack.  The hospital tour was awful but revealing.  The place was rundown (they knew it and were remodeling/expanding, but the expansion would not be done in time for my birth).  There were no, not one, LDRPs (labor delivery recovery and postpartum rooms).  You were almost guaranteed a roommate in recovery and postpartum.  The rooms were small.  It was hot.  There was faded wallpaper on the walls.  The NICU was shiny nice and new, that was the one bonus.  The tour was led by an administrative tour guide, ostensibly, not a nurse.  We never met a nurse and the ones that waved to us from the nurses' station looked harried and annoyed.  The tour guide talked a lot to us about "liability" and "policies and procedures." She handed us a lot of pamphlets about these issues.  She seemed more concerned about covering the hospital's ass than anything else.  When one of the mom's on the tour asked about having the baby "room in," the tour guide asked "why would you want to do that? You can, but there's a nursery and you'll need your rest." At that point, it was over.  I wanted to just walk out.  There was no way I was delivering here.  NO FUCKING WAY.  This was a big hospital and the labor/delivery unit was just another arm of that big, hulking administrative machine.  Done and done.
Next, we met with the head midwife over at our local small, waterbith having, natural birth friendly, midwifery model hospital.  She was and is awesome (see my prior post recounting the tale of my first birth as a doula – she was the midwife who talked my client through her all natural VBAC delivery).  The conversation we had went on for over an hour and I never felt rushed even though they had a packed house of laboring women upstairs .  We talked about everything I had been too intimidated to broach with the other OBs and that they had never asked about.  I left there feeling confident, happy and, yes, like a birth Goddess.  Because they were filled to capacity, we couldn't take a tour that day, but the midwife suggested we call back anytime and just ask if there was a room open for us to see.  She gave us the direct number for the labor/delivery floor.  Although we would rotate through the 4 midwives and not know who would be on call at the time of birth, they all shared the same birth philosophy, so I didn't have to worry about who I would end up with.  I told her our 19 week anatomy scan was scheduled with the conveyor belt practice in a couple of weeks and asked if I should keep it, if we decided to switch.  She was candid and said they did a more in-depth ultrasound at that practice, so she would advise keeping that appointment and after it, signing the waiver to get my medical records and leaving the practice then. 
That weekend we called over to the hospital and they had a free room and said to come on over to have a tour.  One of the nurses on duty showed us around.  She and all the other nurses were friendly and kind.  They were laughing and joking.  They all took time out to say hello and ask how far along I was.  They even fielded our questions about what pediatricians they recommended.  The unit was small (only 6 rooms) and all LDRPs.  The floors were hardwood, clean, bright and everything looked new.  No faded wallpaper.  Waterbirths were available.  They were not only supportive of, but used to natural births.  There were OBs on call if needed in an emergency, but otherwise, you were with the midwives.  Doulas were present at most of the births as most of the moms who birthed there did so because of they knew their birth choices would be supported.  I didn't feel like I was going to have a panic attack.  It was nice there.  There were big windows with nice views.  I could have my baby there.
We decided pretty quickly after that.  My husband was still a bit scared, but I was unwavering.  I knew what I felt – I was paying attention to that now.  I knew now that I had choices and that the choices I made would be extremely important to me, my baby and the type of birth we would have.  I had a responsibility now to do what I needed to in order to ensure I had everything in place to heighten the odds of a healthy birth experience.  That was on me.  It was my first duty as a mother, just as important as taking my prenatal vitamins, exercising, and eating the right foods.
We went ahead and made our first appointment with the midwives to take place after the anatomy scan.  That last appointment at the conveyor belt only served to solidify that we were making the right choice in switching.  I had the anatomy scan at the radiology place downstairs in the same building as the primary office of the practice (I couldn't go to the satellite office for that).  We were emotional – still so scared something was wrong.  The sono was done in the same room as where I had found out our first baby had passed.  But, all was perfect and we found out we were having a healthy baby boy.  We took our ream of pictures and our happy selves upstairs for what we knew would be our last appointment with the practice.  We were meeting with the midwife who had been awful during my miscarriage.  We gave the front desk woman our ultrasound results hot off the presses and I watched her with my own eyes place it in my folder and put the folder on the door of the room we would be in.  We were called back and waited for horrible midwife.  When he arrived, he breezed in and started the whole "how far along are you?" bit and then after he heard my answer, asked the follow-up question of the year "oh, have you had your ultrasound yet?" I was flabbergasted.  Again, he hadn't looked at my chart AT ALL.  He hadn't even looked at the ultrasound results we'd had done not 10 minutes earlier.  That was the whole point of the appointment, douchebag!! I had to tell him yes, it was in my chart.  He grabbed my chart and looked at the ultrasound.  "looks good.  Any questions?" No, definitely not.  He didn't even remember he knew me from before.  I'm sure he sees hundreds of patients, but my miscarriage had only occurred 1 ½ years earlier and it had clearly been the first time he'd had to break that news to someone (or so I tell myself to explain his atrocious and bumbling behavior), but it was just so perfect.  The perfect send-off from the place.  As we checked out, I told the front desk person I wanted my medical records, that we were leaving the practice.  She seemed surprised – "Oh, did you tell Steve?" (the midwife - what kind of a midwife name is Steve, anyway? ).  I said, "no." Why the hell would I do that? She gave me the waiver to sign and asked where I was going, I told her and she kind of rolled her eyes.  And that was it.  We left and never went back and it was without a doubt the best decision we made during my entire pregnancy.  Without making that shift, so many things would have happened a different way and I can almost guarantee you I'd be writing this from the perspective of a woman who wanted a natural birth and ended up with a c-section.
My entire outlook changed from there – my confidence level increased.  I looked forward to the appointments with the midwives just like I did with my doulas.  I started to look forward to the birth.  I have always felt bad that I left Dr. Natural without meeting with him face to face to tell him why.  But, as the only not shitty doctor at that place, he is always crazy busy.  I would never have been given an appointment just to talk to him.  And I have never written the letter I have always meant to write, explaining to him how valuable I think he is and how bad that practice is.  I do still feel kind of like I OWE him an explanation, like he's a father figure and I let him down.  And maybe that’s why I haven't written it.  Because I don't OWE him anything.  I was the customer and they treated me poorly.  They owe me an explanation, not the other way around.  That's a big problem with calling pregnant women "patients."  We're not "patients," we're customers or clients.  But doing that switches the power dynamic.  As patients, we don't know as much as the doctors do and we have no say and we have to wear paper gowns with our ass hanging out.  As customers, we're paying for a service and it better be what we want and we do actually have a say and you can shove your paper gown.
Maybe the truth lies somewhere in between because I am not a doctor or a midwife – I want them to know more than me and to advise me when it's warranted.  But that means I have to trust them and that I am still a participant in this whole process and have needs that are important .  You wouldn't buy a product from someone you don't trust so why would you have your baby in a place and with the attendance of a person or people you don't trust?
This long winded story is to say that I've been there.  And having doulas was such an important part of my pregnancy and birth for many reasons, but mainly because they pointed me to the resources, asked me the hard to answer but necessary questions and held a mirror up to me reflecting back what they were hearing in a way that gave me the push I needed to take responsibility for what was going on and make choices instead of being a passive "patient" and witness to my birthing process.  This is part of why I became a doula.  I hear a lot from people things like – "I can't switch doctor's," "I don't have the money to hire a doula," etc.  My first client as a doula was a great example of taking responsibility – after she learned at 36 weeks her baby (her second) was not breech (as her first had been, ending in an emergency c-section) – she realized the VBAC was hers for the taking, she hired doulas (me and a partner) and through some questioning, she realized her practice would not support her and she quickly and (seemingly) easily switched to the midwives and hospital we referred her to.  She knew what she needed to do to have the highest chance possible of having her VBAC and she didn't equivocate even though many women would have played the "it's too late in my pregnancy to switch" card.  And she got the birth she wanted and then some (see previous post)! But, even she had difficulty parting ways with her practice.  I advised her at what we knew would be her last appointment with them to ask for her medical records and told her she didn't need to tell them why.  She did so.  However, when I asked her very close to her EDD if she'd told the practice she wasn't with them anymore, she admitted she was no good at "breaking up with people." And that's it.  It's an emotional response that's going on here, coupled with this feeling that we're just a wee bit smaller than the doctors. I felt the same way about Dr. Natural. 
I have heard so many "shoulda-coulda-woulda" stories from women about their births.  If they had only switched doctors, hospitals, hired a doula, hired a midwife, birthed at home… things would have been different.  Maybe yes, maybe no.  But the best you can do is prepare the best birth tribe with the best people who support your wishes and whom you trust that if they say something needs to be different from what you desire, it's for a legitimate medical reason.  There are no do-over's.  I know a lot of women who did better the second time around, having learned their lesson.  But, the scars of that traumatic birth remain.  And you always hear from people "as long as the baby and mother are healthy, that's all that matters." But, I put forth this hypothesis – that isn't true.  A woman can love her baby intensely and be so glad the baby is healthy and that she is healthy and still grieve the way a birth happened.  There is room for all of those emotions and they should all be honored.  I would think that having a traumatic birth experience and then basically being told you're not allowed to be upset about it lends itself to postpartum depression.  I hope as a doula to be able to touch on these issues with clients before and after their births.  If something happened that was not as planned or was upsetting, giving a new mom a safe place to talk about it, cry about it and feel sad about it while assuring her that doesn't make her a bad or selfish mother is so important.
I hope that this can become part of the postpartum care we birth professionals provide to our clients.  Because while there are no do-overs, there is the possibility for healing and support and for many women, there are second (and third) chances.  By increasing women's awareness of their choices and their responsibility over their pregnancies and births, we can hopefully change the face of maternity care in this country from the inside out.