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?

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 13^th or 14^th 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.

"Let your monkey do it"or why it's F'in amazing to be a woman!

The quote above is one from midwife extraordinaire Ina May Gaskin's must have book "Guide to Childbirth".  In preparation for my labor with Tiger, I wrote up sayings on index cards that I thought would inspire me and help support me through the weeks leading up to labor and through the labor and birth itself.  These quotes came from various sources - from books I was reading in preparation for the event, from things my birth tribe (doulas, midwives, acupuncturist, chiropractor, and even the physical therapist who taught my prenatal exercise class) had said and also from friends and family whom I had asked to bring quotes, sayings and stories about birth and parenting to our baby shower.  In the weeks leading up to my "late" delivery (42 weeks + 3 days, give our take), I read the cards over and over, and as my prodromal labor dragged on, seemingly endlessly, the cards kept me company when I couldn't sleep through the contractions in the wee hours of the night.  When the time came to use them during labor, I remember looking at them in the birth pool while we were still at home, as I was going through transition - I believe DH handed them to me and asked if I wanted to look at them and I threw them across the room (which turned out to be a good thing because I puked shortly thereafter.  A lot.  And since I didn't puke on the cards, I was able to save them to stash in Tiger's baby book). 
Anyway, "let your monkey do it" was one of the quotes on the cards.  I had already read through Ina May's book at least once by the time I was writing up the cards, but in the waning weeks when I was waiting for labor to really kick in, I re-read one of the lovely birth stories every night to give me inspiration.  The monkey quote had stuck with me (and not just because I think the word "monkey" is silly) - it was something about getting primal, going to that place where we are often so discouraged to find in ourselves by this society, especially as women.  But it is this very place that we women need to go when we birth babies - we have to, in a sense, become cave women again - we have to tap into our monkey and let that monkey do the work of birthing our babies.  Ina May goes on to explain what she means by this: "Letting the primate in you do the work of labor is a short way of saying not to let your over-busy mind interfere with the ancient wisdom of the body”.
Ah, this sounds familiar from my meditation practice! Our over-busy mind interfering again with out innate wisdom (or buddha nature).  It's not an easy thing to attain - especially in a relatively short span of labor - somewhere between 8-48 hours or so.  In my own labor and birth, I was lucky enough that I was able to tap into my monkey fairly easily and early on and it served me well through a long and difficult labor.  I had the hardest time accessing it during pushing - I had to be given pitocin at the end of my long journey because my contractions had spaced and needed to be "beefed up" so I could push Tiger out.  That was the only time I remember being scared - even after 1 + days of labor and stalling with only a lip of cervix for almost 12 hours, I didn't get fearful until they told me they were starting a small amount of pit so I could push.  That was my time (I think most everyone has this time when you are birthing naturally) that I asked for pain meds - simply out of fear of what I had heard pit contractions were like.  But my team held fast, told me "no" and reminded me it would slow my already long labor (which they knew was what I wanted to hear) and we went forward.  Those contractions were really scary and I endured them for 2 hours while I pushed Tiger out - in those moments it took my doula's voice in my ear (and my midwife's voice from down between my legs) telling me not to hold back because of fear, to go into the fear and beyond it - to get my mind to stop interfering and let my monkey take over. 
I was reminded once again of this need for accessing the primal in birth a couple of weekends ago when my first doula client gave birth to a baby girl by all natural VBAC early one Sunday morning.  We lucked out as the midwife on call is the top of her craft - soft when needed, but firm at the same time and absolutely no bullshit.  She knows what needs to happen to bring women into that space - to access their monkey- and she has the ability to guide them there.  In fact, at one point in the wee hours of the morning, we were chatting and she repeated the Ina May quote "she needs to let her monkey do it." I remembered back to my own labor and understood what she meant.  My client, like me, is a smart professional woman who, unlike me, seems to be really in control of herself and her emotions.  Or, as the midwife put it, she's "in her head." This is often a laudable quality, but in labor, it can get in the way. 
My client had doubted her ability to birth without pain meds and her focus was mainly on the VBAC, but the fact is that the ability to VBAC is something that is interdependent with many other factors, as what happens in birth and in life in general, always is.  It's that nasty old cascade of interventions - epidural leads to a prolonged labor and could lead to the use of pitocin which in a VBAC can be particularly worrisome if you're using a practitioner who's worried about uterine rupture.  At 2 AM, after getting some sleep thanks to some helpful sleepy/relaxing meds, my client called me at home and asked me to come back to the hospital.  She was crying - they contractions were getting more painful and she was scared she could not keep up with what was to come.  "I just want it to be over." I empathized with her - I have been there and I know that feeling.  She had been talking about her possible desire for "potato salad" (her code word for the epidural) almost since we had set foot at the hospital (before she was in active labor).  She told me again that she thought she wanted the epidural.  I had a very frank conversation about how it would prolong her labor and if she really wanted it to be over, the best and fastest way was to let nature do it's thing.  She cried more.  It's such a hard place to be in and I felt for her, but I had to tell her the honest truth about what getting the epidural would mean. 
A couple of hours later, back at the hospital, I knew that my client had turned a corner, had given in and was letting her monkey do it, when I heard her screaming and banging her fists on the tub with each contraction.  She was in transition - we had finally gotten her in the tub as another attempt at avoiding the epidural - "let's try this and see how it works and then we can talk again about potato salad." The trusty "midwive's epidural." Sure enough, she wouldn't let anyone in the room except her husband for an hour - a good sign.  Then her husband came out and said firmly "she wants potato salad." The assistant midwife and myself called in the big guns and our guru midwife had her "come to Jesus" talk with mom.  Then the screaming started and tears filled my eyes because I knew in that moment she had given herself over and she was going to birth this baby without intervention.  She let the midwife massage her back after many hours of not letting anyone but her husband touch her.  She made all those wonderful moans and groans women use to get their babies out after hours of total silence during her contractions.  It was beautiful.  The midwife talked her through each contraction - mom telling her she wanted the epidural with each one, the midwife telling her she'd get it after they got through that contraction - just one more.  The midwife got her out of the tub very slowly to check her "before we give you the potato salad" and sure enough she was fully dilated.  My client in side lying on the bed, grabbed hold of the rails with one hand and her leg with the other and said something like "let's do it NOW!" She pushed strong, she pushed like she was born to do it, and one hour later - her baby girl was born into dad's hands and placed immediately on mom's chest where she shortly thereafter began to nurse.  Mom said "guys! I did it!" and high fived all of us.
This is what birth can and should be.  So often we lose sight of this - how it can be.  Even if medical interventions do become a necessity - we can still keep that same spirit intact.  I visited mom, dad and new baby girl the next day and they were both elated.  Mom was able to be up and about - so different from her c-section recovery.  Dad was still grinning ear to ear when I talked to him about how it was to catch his second daughter.  I felt so honored to have been there to witness it, to do any small part in supporting this couple and this baby.
When I talk about natural birth, I get varied reactions.  Most of my friends gave birth naturally, as did my mother with me, so it's pretty commonplace in my circle.  I do have a few friends that have chosen the epidural route and some friends who ended up needing medical interventions or c-sections.  And then I get the people who react with "are you crazy? why would you do that?" when I tell them I gave birth naturally.  I think each person chooses what's right for them - for me I think it's crazy to have a huge needle voluntarily stuck between the vertebrae in my spine when it's not medically necessary.  I also don't want to have to battle the often not talked about side effects of an epidural.  The swelling I had in my feet after I needed IV fluids during labor was enough of a pain in the ass - headaches and pain at the injection site? No thanks.  I also feel bad that some women don't want to experience this truly unique thing that only us women (and not even all of us, sadly) can do- and I think a lot of those choices are made by women because of a lack of understanding, information, and a culture that portrays birth as a medical emergency, as something to fear.  I think many woman, if given all the information, would actually chose to try and birth naturally and that's part of my goal as a doula, a future childbirth educator and in this blog - to start giving women information.  Some women are threatened by the "natural birth movement" (I actually think that's an oxymoron - we should be talking about the "over-medicalization of birth movement") - just as some women are threatened by breastfeeding or  choosing not to circumcise a baby boy.  But, we're all adults here and you can't blame someone else for your feelings.  Those who are threatened by these things may need to look deeper at why - if they feel guilty on some level, that's something within themselves that may be worth investigating.  If they truly made the choice they feel was best for them - or what they really wanted regardless of whether it was a best practice - then there's no need for feeling threatened or guilty. 
But, I've wandered from the topic - all I wanted to say really was women are just the most amazing, powerful creatures on earth.  I am fortunate that my work as a doula allows me to be reminded of this and to touch that place in me with each birth I am a party to.  This doesn't just come up in birth - whenever you're in a tough spot and really need to dig deep to access your strength - try letting a little of your monkey take over and see what happens! 

Going public (and perhaps rogue?)

Well, I have been lackadaisical in blogging, but it's been on my mind so I decided to open up my blog to the public (eek) and see if that forces me to do more with it.  As I type this, I am doubting my decision, so maybe I'll pull back by the end of the day - I'll sit with it a bit. 

Thinking a lot these days about my calling versus what I do for a living.  My calling, which I didn't discover until very recently, is working with women in preparing for and going through labor (natural childbirth being my strong preference) and assisting them during the postpartum period and with breastfeeding.  So, I am becoming.  Becoming what? A labor and postpartum doula, a childbirth educator and a lactation educator.  What does that mean? Here's an explanation on the scope of practice for these "jobs" (and I use quotes because although they are paid jobs, it's hard for me to consider any of them a job as I associate a job with something I don't want to actually do) from the Childbirth and Postpartum Professional Association (CAPPA) website http://www.cappa.net/about-cappa.php?scope-of-practice.  I share this resource for those of you who may be pregnant or are trying to get pregnant and are thinking about and planning your labor and birth. 
There are many resources out there that people do not seem to know about.  I am always shocked that in 2011, I still routinely hear from pregnant friends this question: "what is a doula?" I move in certain circles where these things are just known.  I am always happy to educate and expand people's knowledge of what birth can be. 
I decided to train with CAPPA and work toward my certifications in these areas instead of just "throwing up a shingle" because I believe that having a scope of practice and being affiliated with a professional association is a good thing  for both me and my clients.  Besides, there is a lot for me to learn - going through my own natural childbirth was something that I think goes into the experience and qualifications category - but there is so much more to know to be able to effectively help women and their partners during birth.  Also, I'm a lawyer by trade and we like things like licenses, degrees, certifications and professional associations.  It just makes me feel safe, for lack of a better word.
In the past year, I have been lucky to help some of my friends via email and phone prepare for their natural childbirth and/or vaginal deliveries (some with epidurals) and to field their questions about breastfeeding and other postpartum issues.  I've had a great experience doing so and I've gotten feedback that my advice has been helpful.  Often my advice is born from my own experience and I do a lot of pointing women to resources that are out there to help them.  Any day where I have helped and supported a friend with her labor and postpartum needs, is a good day for me.  Today was such a day when I recieved an email from a friend who recently gave birth inviting me to view her blog about her labor and her postpartum experiences (plus cute pics of her beautiful baby girl).  I was one on a small list of people invited whom she thanked for sharing a positive birth story that helped and encouraged her through her own natural childbirth.  So, today is a good day.  This is my calling.  This is my purpose. 
I come to a job every day because I have to and I work it because I need to help support my family - but it is not my calling.  Perhaps it once was, but every moment is a new moment, we are always changing so our dreams change as well.  My training as a Buddhist hammers this home again and again - everything is impermanent.  My plan: within 5 years, to be engaged in my calling - to be working with women and their partners and spreading the gospel about natural birth - and doing some law work on the side to fill in the financial gaps.  I put this out to the world because perhaps it will help doors open in ways I could not imagine - much as my pregnancies (one miscarriage and one beautiful healthy Tiger boy) opened doors in my life I could never have foreseen (I'll post more on that at another time).  I carry very hefty student loans, that is what currently stands in my way from quitting my job today.  I am trying to find ways to make this all work - anyone out there in the world want to lend a hand or have some ideas? I'd love to hear your stories, thoughts and words of encouragement.
Next post, I'll share my journey - how I got here - including my birth story.  Thanks to all the women out there who continue to do this good work and inspire me forward.