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?