yep

Lately, I've been asked a lot by prospective student midwives and classes of high school students to share about the hardest part of being a midwife.

I usually will laugh and say it's the lack of sleep that goes along with birth work. But honestly, I don't really mind missing sleep. In the moment, it can be hard to have been physically awake for more than 24 plus hours, but we make do.

I've been really pondering this question internally, though: What is the hardest part of being a midwife (for me)?

I've come to the conclusion that it is the never ending questioning that I do of myself, or my actions, of how things play out.

There are a handful of births that haunt me, that I constantly turn over and over in my head, thinking about them from different angles, wondering why things happened the way they did. This has got to be the hardest thing. I've attended a couple of births which I have thought about daily for what seems like months, and then the memory slowly fades from my daily thoughts, and then when a random occurrence brings up the memory, it feels as if a scab has been pulled from my skin and my emotions are raw all over again.

(I want to make it clear that these handful of births had good outcomes...healthy mother, healthy baby. Some were transports, some were homebirths.)

Being a midwife has taught me so many things that have nothing to do with birth or babies. It has been an amazing journey. I suspect that many midwives begin their journey with their ego leading the way. There are many other professions where this is probably the case, but in midwifery, I run across it often. I know that for me, personally, being involved in birth and midwifery has taught me (and I am still learning!) big huge lessons about the ego.

Where are the mothers?

I live in a city with a hospital that has roughly 3,500 births every year.

Their cesarean rate is very hard to find (as are most hospitals'), but based upon information from some of the doctors and nurses that work there, it is estimated to be around 50% (some say closer to 60%). The rate is, in part, this high because the hospital doesn't "allow" VBACs. So, the many first-time mothers whose labor inductions fail (induction rate is very high in my area) or whose labor is taking too long that end up having a cesarean...with future babies, they are told that they must have a repeat cesarean. I have met many mothers in my city that have had 4 and 5 cesareans. It is criminal.

There is a hospital about 20 minutes away that allows providers to attend VBAC, though not every provider does.

Where are the mothers? I am a little surprised to see how very, very few women seek out the services of a midwife for an out of hospital VBAC. I would expect there would be such a demand that we would be needing more and more midwives to accommodate the demand. But, there isn't.

Of course, not every mother will decide that an HBAC is the right choice for her. But, it makes me wonder...where are the mothers? Ar they signing up for repeat cesareans? Are their doctors telling them that, although their hospital doesn't 'allow' VBACs, even the National Institute of Health came to the conclusion that a VBAC is a perfectly safe option and that perhaps they should look into different birth options? I seriously doubt that.

There are approximately 50-60 homebirths each year in my county. It would make me so happy to see that number sky-rocket in the coming years.

Pet peeve

I need to clear something up.

I notice all of the time on message boards, news articles, or among conversations in person, that many people are under the assumption that DEM (direct entry midwife, a midwife who has not entered midwifery through a nursing degree first) and CPM (certified professional midwife, a term created by NARM) are synonymous. When asking about midwives or referring to midwives, it sounds like you now have two choices in the US: Certified Nurse-Midwife and Certified Professional Midwife. This is not true. CNM and CPM are not the only options, and DEM is not the same as CPM. (Though most CPMs are indeed DEMs, the reverse is not true).

All of these letters make things confusing.

A midwife can be a midwife without being a CPM. There are many, many fabulous and highly expereinced midwives in our country whose title is 'Midwife', not CPM or CNM or CM. And there are currently wonderful student midwives in this country who are apprenticing with a homebirth midwife who have no plans whatsoever to become certified. We need to stop expecting some certifying body to determine who is a midwife.

Please, please, please, people...stop referring to ALL non-CNM midwives as "CPMs". This is simply not true and it does a huge disservice to midwifery.

EC the second time around

The following is my own experience with EC. There are many great website explaining the why's and how's of EC, and I will include links to some at the end of my post. I am not attempting to teach people how to practice EC with this post, but I simply want to share my own experience with it here.

~~~~~~~~~~~~~

With my first son, we practiced elimination communication (EC) from about 3 months old onwards. We used cloth diapers when we went out until about 7 months old, and from then on, we just took him potty wherever we were and stopped putting him in diapers. He was reliably dry (or would wake to potty) from about 7 months onwards, as well. We had carpeted floors at the time (for those wondering).

I wasn't sure how I was going to approach diapering with my second baby. I knew we'd use cloth diapers, and I knew I'd be taking him potty sometimes..I just wasn't sure how I'd manage doing EC full time this time around, since I not only had an another child to care for, but I knew I'd be taking my baby with me to births and appointments for a good part of his first year.

So, my second boy was born. Within the first few days, I started putting him on his potty for bowel movements. It seemed to help him calm down and he was less gassy. (I recall this as well from my first son.) He was still almost always in a diaper, usually a prefold held on with a snappy. I didn't put covers on his diapers when we were home, because I wanted to know right away when his diaper was wet, so I could promptly change it. I would also always talk to him about his pee "Oh, did you just pee? OK, I'll get you a clean diaper. You can pee in the potty, too. That might be nicer for you."

My second son sitting on his potty, 5 months old.

When he was with my during prenatal appointments or births, I always had a diaper and cover on him (or an all-in-one diaper), and wasn't able to pay much attention to his pottying. I'd just try to check frequently to see if he'd peed yet (maybe every 30-60 minutes when he was awake) and then change his diaper. Yes, I went through MANY diapers this way. But, I think it was key in helping him to not get used to the feeling of ignoring that function of his body or the feeling of a wet diaper.

When we were home, I began to let him be diaper free more and more. I found that we 'caught' more pees this way, and it felt like much less work to wipe up a 'missed' pee than to put his diaper on, take it off to offer the potty then put it back on. I also noticed that when he was diaper free, he seemed to empty his bladder more fully. When he would pee in his diaper, it was as if he'd pee a little, then 10 minutes later a little more, etc. When we took him potty and he peed, he wouldn't need to pee again for maybe 30 minutes. The interval between pees has increased as he has grown. (For example, he is now 17 months, and sometimes goes 3-4 hours without needing to pee).

He was in diapers MUCH more than his older brother was during his first year, partly because he was with me at work and partly because I don't feel like I was able to pick up on his cues as well as I could with my older son. In fact, I'd even say that I feel like he wasn't doing any cues for a long while. I mostly relied upon my own intuition that he needed to pee.

In the car, he was in diapers, and around 12 months old or so, I started just setting a diaper in his carseat and then setting him in his car seat. That way, it was there in case he peed, but it wasn't attached to him. If we drover more than 30 minutes or so, he'd usually end up peeing. We also had these nifty waterproof pads in his seat that I really like. In the last month or so, I've stopped putting a diaper in his seat, as he is so reliably dry now. My normal routine when we are driving somewhere is to take him potty just before putting him in his seat, and he usually pees. Then I pull his pants up and sit him in his seat with no diaper.

In the baby carrier, I place him with just pants, not diaper. When he was younger, I would sometimes place a folded prefold between he and I when he was in the carrier, just in case. However, he normally lets me know he has to pee by sort of squeezing his legs when he is in the carrier.

For bowel movements, he has much more reliably let me know since the beginning. The sign that he gives me now is so hard to explain. I can actually even hear it in his step if he is running to me from another room to tell me he has to poop. It is so interesting to see how I have learned that cue so well.

At night, we have been sleeping with him diaper free since about 4 months old. It was just easier to keep his diaper off and take him potty than changing his diaper. I keep a little potty (or two) by the bed on the floor, and have gotten to know his nighttime elimination habits. He normally won't pee until he has nursed when he wakes in the middle of the night. When he starts to sort of move around and not able to focus on nursing anymore, I know he needs to pee. When he empties his bladder in his potty, I know he won't need to pee for a few more hours, so we sleep deeply in peace. And, now that he is 17 months, he usually only needs to pee once in the night (even though he wakes to nurse 2-5 times during the night), and occasionally, he won't pee at all and will hold it all night. We he wakes in the morning or from naps, the first thing we do is take him pee. He will then pee almost all of the time. I do keep a large over sized waterproof pad that I made underneath the sheet in out part of bed, just to help protect the bed. I also have 2 smaller waterproof pads that I place a prefold on top of and then lay that underneath him. When he was younger, I would regularly miss pees every few nights, and this was a nice and easy way to keep the bed clean. Now it rarely gets used. Nighttimes are actually pretty easy. This is no doubt due to the fact that babies don't pee when sleeping deeply. They will always rouse to pee (though it may seem that they are sleeping...they are likely just in a light sleep cycle). They also tend to produce less urine at night, thanks to the antidiruetic hormone.

The aspect that I love about EC so much is the simplicity. It feels so normal and seamless to me. There is no 'potty training' time, it just sort of morphs into a baby/toddler who knows what their body is doing. I don't think it is the "best" way to approach diapering and pottying, but it is certainly a real option and one that some people will really come to enjoy. However, I do acknowledge that the vast majority of people in our culture do not want to fuss with taking their baby potty.

I hope from this post you gleamed a small insight into what it is like to EC. It might sound like a lot of work, and indeed, there have been times where I feel crazy for doing this, and I wish I could just stick a diaper on my baby and not think about it for a few hours. But, those feelings of exasperation are short-lived, and I truly love the connection that EC'ing has given me with my babies as they have grown.

I always tell people that I don't view EC as easier or harder than traditional diapering potty training. I figure that it may really be about the same amount of work overall, but simply expended in a different manner.

I could talk and write so much about EC. However, I already feel like this post is a bit scattered, so I will stop here. Maybe I will write more another day.

~~~~~~~~~~~~~

Here are some links if you would like to learn more about EC:

Diaper Free Baby groups

The EC Store

What is EC?

What is EC? (a different article)

Diaper Free! The Gentle Wisdom of Natural Hygiene

Born Potty Trained

Visions of Breastfeeding

I wrote this post back in August during World Breastfeeding Week and am finally getting a chance to post it.



Some reminders to the pediatricians, perinatologists, and other care providers who may have forgotten (or never learned otherwise):

• Breastmilk DOES have everything all of the vitamins and nutrients that babies need. Really, they don't need vitamin drops made by a huge artificial baby milk company given to them daily. (Since Vitamin D is the 'hot button' on this topic, read this page if you want more info.)
  
• The amount that you express, by hand or with a pump, is NOT reflective of how much your baby gets when nursing, nor of your milk supply as a whole.
• Babies don't know how to read a clock. Please follow babies' signs and signals for as to when and how often to breastfeed. (Imagine someone telling you that you may not eat as it hasn't been X number of hours yet, even though your body is telling you that you are hungry.)
• Co-sleeping is SAFE and one of the best ways to promote breastfeeding in the early weeks. Please don't tell parents to simply not co-sleep, telling them they will kill their baby. Instead, please teach parents how to co-sleep safely. Sleeping snuggled in bed with baby happily nursing at the breast is far safer than an exhausted mother sitting in her arm chair nursing her baby, trying desperately to not drift off to sleep.)
• Nipple shields can be a useful tool when used judiciously. They are not a band-aid fix for sore nipples, baby not latching or not latching well, or every breastfeeding mother. Yes, nipple shields can save the breastfeeding relationship, but 99% of the times when I encounter them, they were unnecessary and cause problems.
  
• Babies do not all gain at the same rate. Read this, please! An excerpt:
  

  Many rules about weight gain are taken from observations of growth of formula feeding babies. They do not necessarily apply to breastfeeding babies. A slow start may be compensated for later by fixing the breastfeeding. Growth charts are guidelines only.

• Six months of age isn't a magic number. Babies don't suddenly begin needing solids at six months old. Many babies aren't interested in solids until they are 8-9 months old, and sometimes not until they are 12 months old. That is ok. Breastmilk is enough to meet the nutritional needs of a healthy baby for the first 12 months (and sometimes beyond).
• Rice cereal is not necessary. In fact, 'baby food' (the sort you buy in cans) is not necessary. Please, tell parents to skip the processed food (mainly, boxed rice cereal) and offer their baby real food when they are ready for solids. Fruit, vegetables, beans, meat, whole grains. The sort of iron that is in frortified baby cereals is nasty junk, nothing near as effective or good for your baby as the iron that is in breastmilk.
  
• Please visit Dr. Jack Newman's site. He is an amazing resource, and you can even email him directly with clinical questions.
  

I leave you with a quote from Dr. Grantly Dick-Read

A newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.

Reversal of position!

It seems the AAP has heard the public outcries to their revision of policy in regards to infant female genital mutilation. It has reversed this policy back to the original one of nonsupport.

To quote Dr. Judith S. Palfrey, president of the academy:

“We’re saying don’t do it. Do everything that you can to support that family in this tough time, but don’t be pulled into the procedure.”

Dare we hope that they will continue to NOT endorse male genital mutilation?

Our boys deserve to be protected just as much as our girls.

Let's just stop cutting our babies

I recall talking once with an Intact America rep at a midwifery conference and he was very happy to hear that I was interested in getting some literature to hand out to my clients. He told me that many of the midwives he had talked to at the conference said that, while they supported his orgainzation's aim, they didn't feel it was their place to bring up the topic of circumcistion with their pregnant clients; that is wasn't their place to discuss it.

In my experience, education is of the utmost importance on this topic. I have seen countless families who originally planned, without question, to circumcise their baby boy, but then once they learned more and because informed, they instead kept their boy intact. Indeed, more and more families in the United States are keeping their boys intact. In my region of the country, around 70% of baby boys are now left intact. Even still, 30% of boys being cut is too high.

I bring up the topic prenatally with my clients, if they know they are having a boy and if they don't know the sex of their baby. It is sometimes an anxiety-filled conversation, but its an important one. I myself am the mother of 2 intact boys and married to an intact man (as are the majority of men in South America, where my husband was born).

Quoted directly from the National Organization of Circumcision Information Resource Center website, here are the basics on male circumcision:

No national or international medical association recommends routine circumcision.

Only the USA circumcises the majority of newborn boys without medical or religious reason.

Medicalized circumcision began during the 1800s to prevent masturbation, which was believed to cause disease.

Today's parents are learning that the foreskin is a normal, protective, functioning organ.

Today's parents realize circumcision harms and has unnecessary risks.

Circumcision denies a male's right to genital integrity and choice for his own body.

This brings me to the recent news that the American Academy of Pediatrics revised their policy on female genital mutilation (now called 'cutting'). I believe that this move is likely related to the fact that they (along with the CDC) are currently reviewing their policy on infant male genital mutilation (aka circumcision), exploring whether or not they are going to continue to NOT endorse circumcision. If I am correct in my connecting the two, I am fully expecting the policy of infant male genital mutilation to be reversed. (I hope I am wrong.)

When I originally heard the news of the AAP and CDC reconsidering recommending circumcision and now backtracking on their original opposition to all female mutilation, I felt such shock and disgust. How about we just stop cutting our babies? No, really! Sharp objects belong nowhere near genitals of babies and children, in my opinion.

Marilyn Milos, director of NOCIRC, recently sent the AAP this letter in reply to their policy revision on female genital mutilation, which ElementalMom so wisely blogged about.

CNN recently published a good article on the topic of female genital mutilation. A Somali film director and activist, Soraya Mire, counsels genital mutilation survivors and families who want to have their daughters cut:

She sleeps with her cell phone tucked under her pillow, so she can answer at all hours.

"You don't have a right to do this to your children," Mire tells the immigrant community. "You are continuing the abuse."

Fatima Mohamed, a Somali immigrant and activist, was herself cut and says of her own daughter:

Her 11-year-old daughter is too young to comprehend genital cutting, Mohamed says. Instead, they discuss her daughter's dreams to become a pediatrician. Perhaps in a few years, Mohamed will tell her the truth.

"I would never do it to my daughter," she said. "I don't want it. This has nothing to do with religion or culture. I believe nobody should control my child."

Really, this applies to both sexes.

On the topic of Jewish male circumcision, have you seen the documentary CUT? It's worth a watch!


This is something that affects all of us. Our babies are born perfect, whether they have labia and a clitoris, or a penis and scrotum between their legs. How about we just don't cut our babies?

Clarification

Because I think there may be some confusion from my last blog entry, I wanted to clarify something.

The rule changes that are being proposed will not make breech, twins, VBACs and postdates 'illegal' or absolute risk factors for licensed midwives. They will still be 'allowed' to attend them out of hospital.

But, they are creating stringent criteria in each of those categories, proposing to dictate under what terms a VBAC, breech, twin, postdate birth would be considered safe enough to stay home (with a licensed midwife).

For example, if the baby is breech, is must be frank breech with an estimated fetal weight less than __gms. Or....once you hit 41 weeks, you must have a weekly biophysical profile and get a score of __ or better to continue with a homebirth. (AGAIN, THIS IS JUST AN EXAMPLE OF SOME OF WHAT I HAVE HEARD BEING PROPOSED. ITS STILL ALL IN PROCESS).

Oregon's current rules dictating what is an absolute risk factor for out of hospital birth with a licensed midwife are very BROAD with lots of grey area. They were originally written this way on purpose.

It should be up to each mother and each midwife individually to decide if they are comfortable proceeding with an out of hospital birth, not up to the licensing board. I think that the informed choice process is critical in this issue.

So, when writing those letters, please remember they are not (at this point) discussing making VBACs, twins, breeches, and postdates illegal...but are trying to put restrictions and set in stone guidelines around them. (Not good for birthing women!)

Come to the meetings if you can!!!

To all Oregon mothers!

(eta: See my post on clarification of this issue here)

We need EVERYONE in Oregon to write letters in support of keeping birth choices open for birthing families!

The Board of Direct Entry Midwifery is currently reevaluating our current rules and regulations, reconsidering what should be considered an 'absolute risk factor' and what should risk women out of the care of an licensed midwife/out-of-hospital birth. This is taking choice out of the consumer's (YOU) hands and they need to hear from you!

The things that they are focusing on are:

POSTDATES
TWINS
VBACs
BREECH

There are board meetings being held on each of these topics (some of which the dates have already passed). Upcoming meetings can be found here and are as follows:

June 2, 2010, 9am , topic: BREECH and TWINS
ODVA Auditorium, 700 Summer Street NE, First Floor, Salem, OR

June 16, 2010, 9am , topic: VBAC and POSTDATES
ODVA Auditorium, 700 Summer Street NE, First Floor, Salem, OR

August 5, 2010, 9am , topic: TBA
Rhoades Conference Room, 700 Summer Street NE, Third Floor

August 12, 2010, 9am , topic: TBA
Rhoades Conference Room, 700 Summer Street NE, Third Floor

These meetings are open to the public, but there won't be time for public comment. (Because why would they want public comment when they are working on rules to protect the public, right? ). Even so, your presence is needed! Please attend, and show your support for birthing choices in Oregon. (when you sign in, you can write "Support Birth Freedom!" or something similar). You don't have to stay for the entire meeting, and you don't have to be there right when it starts. Even if you can only come for one hour, please do!

Since there are no times for public comment, we need to FLOOD their mailboxes with letters in support of women having the choice to choose where and how they give birth. Email letters to samie.patnode@state.or.us or snail mail to Oregon Health Licensing Agency (OHLA), Attn. Samie Patnode, 700 Summer St. NE, Suite 320, Salem, Oregon 97301-1287

Speaking as a birthing woman, I am highly insulted the the state is trying to tell me what is safe and what is not safe when I give birth. A mother is of course still be able to stay home alone if her midwife has to risk her out and discontinue care, but no woman should choose unassisted birth because she is backed into a corner!!

Many of you are aware of the lovely law in Oregon that allows midwives to be unlicensed if they choose. However, our voluntary licensure law is ALSO at risk. While there are many who are under the false assumption that licensed midwifery is safer midwifery, this couldn't be further from the truth. What mandatory licensing does is LIMIT choice for families.

More than ever before, we need the state of Oregon to hear from the consumer of midwifery care (birthing families...YOU!!!) that you won't stand for your choices being limited and restricted!! Please write and come to the meetings!!

To summarize, here are the main points that your letters should include:

• keep our rules and protocols as they are!
• allow women to choose for themselves once they have been given informed choice! (women are smart enough!)
  
• support voluntary licensure!
  

If you have never had a breech baby, or aren't planning a VBAC, or never go past your due date, or have unassisted births and don't utilize midwives, please don't think that this won't affect you. It does. It will have far reaching effects for all women planning out-of-hospital births. Please act. Please make your voice heard and pass the word on!

The human being behind the midwife

There are births that stay with us forever. All births that I have attended have moved me, changed me, shaped me to be the midwife and person that I am today. But there are some births that stay at the forefront of my consciousness for a long, long time.

I am not a confrontational person. I don't mind standing up for myself, or speaking up when I need to. But, I really like peace between people and have always struggled with my 'need to please' everyone. When I was in school, I would have rather skipped class than show up to class with my homework incomplete. Oh, the shame! Truth be told, having this blog is one of my attempts to thicken my skin just a bit, as when you are writing on the Internet, it is utterly impossible to please everyone.

I am forever grateful to every learning experience life throws at me. Midwifery is an incredible journey and ego-tamer.

Thank you to all of the families who have allowed me to serve them, and continue to allow me to serve them.

In peace.

The Arrival of Sierra Journey

My client has graciously allowed me to share her daughter's birth story here. A beautiful story of the birth of a beautiful baby!

In her words....

~~~~~~~~~~~~~~~~

Our Journey

It was on Beltane, May day, your due date. I was never a believer of "due dates" and whenever people asked when you were due, I told them springtime.

Yet, you came earthside on such a beautiful, warm day. The trees were just starting to blossom with little buds. I could feel the twinge of labor coming on, slowly and lightly. I told my dear partner, Jesse, that it was time, and we drove to a friend's farm.

When we arrived, I was just in the mood to take a slow amble around the farm. We walked on a tiny dirt path through the tall grass to a little pond surrounded by huge trees and flowers. The contractions slowed down. I guess the rocking sensation of walking relaxed you. We slept outside on the grass under a tree for most of the afternoon.

I woke up with the urge to go take a warm bath. Jesse and I got into the bathtub and I felt so relaxed...and then the contractions started rushing in with gusto. Blood was coming out in little bits. Jesse told the midwives that things were really progressing. They got on their way, and we filled up the big blue birthing tub outside on the grass. I absolutely loved the smell of fresh grass and watched two little spring robins play around.

The rushes became stronger and stronger. Soon, I lost nearly all my sense of control and just let go. I let the sounds inside of me out. I moved around madly with every pang of contraction. Our midwives came outside to check on your heartbeat once in every while. They were completely silent and stayed inside most of the time. It was starting to get dark and cold outside. I asked my midwife when she came outside, "When will I know how or when to push?" She smiled and said that my body would do it for me, and that you and I would work together.

Not very long after that, I decided to head into the bathroom with Jesse. I took a few sips of water, and with three ABSOLUTELY overwhelming contractions, I yelled and felt like I was about to throw up. I felt like I was being turned inside out. There was absolutely no holding back. You came so FAST. I was standing up. Jesse could see the intact water bag come out first, your head twisting out. The bag broke and you slid right out, in your father's hands.

Jesse immediately gave you to me. You quickly raised your arm towards me, your fingers spread out, touching my heart.

And then I realized that your birth was unhindered and beautiful. The way women in so many cultures have done it for centuries. I felt so empowered, strong.

And the rain immediately started pouring outside.

Why "Radical"?

My husband has said before that he doesn't understand why I would identify myself as 'radical'. He thinks it has a negative connotation. And, maybe it does in many situations. Honestly, I was originally inspired to pick the name 'Radical Midwife' for my blog by the amazing Radical Midwives Association in the UK.

But, there is more. I cannot tell you how often I feel on the fringes of the 'norm' in midwifery. Sometimes it is almost as if I live in a bubble, where I assume at least most midwives not only practice evidence based midwifery, but also know what 'trust birth' means and act on it. Well, if I live in a bubble, it is popped on a regular basis every time I venture out on the Internet or start talking about birth and midwifery with other students or practicing midwives.

The opportunity to reconsider the name of this blog arose recently when I opened a twitter account to begin twittering. I had to choose a user name. After some thinking, i went with 'radicalmidwife'. The obvious reason being that it matches the name of my blog, so people who know me by my blog will recognize me. However, this also compelled me to re-consider the word 'radical', to be sure its still how I want to identify myself (it is).

So I looked up the definition of 'radical':

From the Merriam Webster dictionary:

Etymology: Middle English, from Late Latin radicalis, from Latin radic-, radix root

Date: 14th century

1 : of, relating to, or proceeding from a root: as a (1) : of or growing from the root of a plant (2) : growing from the base of a stem, from a rootlike stem, or from a stem that does not rise above the ground b : of, relating to, or constituting a linguistic root c : of or relating to a mathematical root d : designed to remove the root of a disease or all diseased and potentially diseased tissue
2 : of or relating to the origin : fundamental
3 a : marked by a considerable departure from the usual or traditional : extreme b : tending or disposed to make extreme changes in existing views, habits, conditions, or institutions c : of, relating to, or constituting a political group associated with views, practices, and policies of extreme change d : advocating extreme measures to retain or restore a political state of affairs
4 slang : excellent, cool

First off, I love that the word relates back the the Latin form of 'root'. I am constantly thinking about what is midwifery, at its root, and how to get midwifery back to its roots. The 1st definition doesn't really apply...I'm not referring to plants, or linguistics, or mathematics, or eradicating diseases. The 2nd definition listed above fits nicely, though, and of course I can't deny that I love the 4th definition.

3 a and b are more interesting to ponder:

3 a : marked by a considerable departure from the usual or traditional : extreme b : tending or disposed to make extreme changes in existing views, habits, conditions, or institutions

Midwifery is one of the oldest professions / occupations in human history. Yet, I feel we are at a cross-roads on many levels. "Traditional" midwifery or "modern" midwifery? And, what do they even mean? Do they mean the same to everyone? I'm not going to get into this right now; that's another blog post that I promise I will write.

I still really feel like 'Radical Midwife' is a fitting description of myself.

Standing up for homebirth

This video was posted back in August,2009, but I just came across it. In light of what is brewing here in Oregon (which I will discuss more in a separate post), it makes me wish we had a representative who would stand up for homebirth and mothers' rights like Mr. Andrew Laming does here.



To learn more about what is happening with midwifery/homebirth in Australia, here and here you go.

My newest son's birth story

Long overdue, here finally is the story of my second son's birth.

Julian Hugo, born July 10, 2009, weighing 9lb, 11oz.


~~~

July 9, we went out to eat at River's favorite thai restaurant. My due date was July 13, and I wasn't feeling like anything was going to happen anytime soon.

I finally laid down to bed around 11:30 that night, and turned out the lights. I felt a contraction that felt strong, and so i glanced at the clock: 11:42pm. A few minutes later, I felt another one, then as it eased off, it felt like I had peed myself. It was just a tiny trickle of fluid, but I jumped out of bed to go into the bathroom to see what was going on. With the light on, I wiped and saw specks of white: vernix! Before I knew it, another contraction started, my 3rd one, and it was really intense!

I got up to tell Walter what had happened, and he muttered something about wanting to get at least an hour of sleep, as he was thinking it was going to be another long labor like it was with our first son. I was fine with that at that moment and went back to sit on the toilet. My contractions were coming every 3-4 minutes right away, and I was pooping like mad, as my body started clearing everything out. Within a few contractions, I was needing to vocalize loudly with each contraction. I knew soon that I did indeed want to call my friends over. This was something that I had considered while pregnant, and I had even sent the three of them an email explaining that if I called them when I started labor, that they were to enter through our side door, not talk to me, and go quietly to another room. They were to also do nothing to me unless I specifically asked. (they are all midwives).

So, i called them. I think i texted P first, then texted A, then called T. When I was talking to T, I had to put the phone down and moan loudly through a couple of contractions. About 20 minutes had passed since my first contraction.

Then my noises woke up River, who was crying. He has a tendency to vomit when he cries hard, and as he was crying in confusion at having just woken up and odd things happening, that's just what he did. So, Walter was occupied with calming him down and cleaning up the mess, and I felt I had made the right decision to call my friends over, as I wasn't sure if Walter would be able to work on getting the pool filled. But, River soon calmed down and Walter got the pool going. I think he was a bit upset about not getting any sleep, as he was still thinking the birth was many hours away. :)

As soon as there was some water in the pool, I got in. At some point, Walter said that they were all there, and I told him to tell them to come over to me. i really needed to talk to them, to complain and tell them how much it hurt.

I want to discuss the pain for a moment here. Let me say that i was in labor with my first son, who is now 6 years old, for a day and a half, and had intense back labor. I never felt anything down in the front of my belly, it was all in my back. I was hoping to not have a repeat of that this time around, and indeed, I didn't have one back-pain twinge. However, the pain of the contractions this time around were just above my pubic bone, and it was like nothing I'd ever felt before! The only way I got through each one was to moan/yell. My son, I learned later, had said that i sounded like an elephant. Those contractions HURT! But between contractions, I felt no pain whatsoever, which was very different from the constant dull back pain during my first labor.



So, i was there in my living room, in the birth pool, with my husband somewhere close by, my son playing in the other room with P, and T and A sitting near me as well. I felt so angry about how much it hurt, and the fact that the water wasn't helping the pain at all. I kept telling them how much it hurt, how they were crazy to have more babies, etc. At one point I remember thinking that I couldn't be a midwife anymore, because how could I tell women to go through with this when it sucked so much! haha! Of course, at that moment, i also thought I had hours more of laboring to go. P made a comment, I think, about how it wouldn't be long and that I'd be meeting my baby before sunrise. I scoffed at that, sure there was no way. At some point, i asked one of them to check me. I could feel my baby's head and some cervix, but couldn't reach well enough to know how dilated i was. The midwife in me knows that dilation means nothing. But, it felt important to me to know that i was close, whatever that really means. They asked me if I was sure I really wanted to be checked, asked if I just wanted them to talk me out off it, asked what i wanted from the exam. I snapped that, yes, I wanted it, and that I wanted them to tell me I was nearly complete and not 4 centimeters or similar. I found out later that there was a silent argument in the hallway about who would do it, as they knew I wasn't happy and didn't want to have to be the one to tell me what i may not want to hear. In the end, T checked me, and I could tell in the way she looked that I wouldn't like the news. I was 6 centimeters, which was so disappointing!



I'm a little fuzzy on time, but I think this was around 2 hours after my first contraction. At some point, my body started to bear down involuntarily. After the first time it happened, I remember yelling out that I wasn't pushing! (even though I obviously was, I was still convinced it would be hours more and I didn't want them to think that I was pushing already.) He was born at 3:03 am, after 3 or 4 pushes, into my own hands in the water, with my older son and husband looking on. About 3 hours and 20 minutes of labor in all. It was amazing!




The placenta took a while to come and was finally born while I sat on the birth stool. We did a lotus birth, meaning we didn't cut the cord. It fell off on its own when Julian was 3 days old.

What I've been up to lately...

Pure love!

The Birth of Benjamin

(What follows is the birth story of sweet Benjamin Timothy as told by his mama, reposted here with permission. He was born at home on January 5, 2010, weighing 8 lb 8 oz)



My birth with this baby started 4 yrs ago with the birth of my first. After 10 days of prodromal labor, Cameron was born on a cold day in February at 42 weeks. I went to the hospital in sheer desperation for sleep b/c of the constant contractions. At that point, I didn't care about the baby any more. They tried to break my water but only got a little leak. He was born 6 hrs later. I wanted something different with my next baby.

Elijah was born two years later, in May, after an AROM induction at 42 weeks with an experienced midwife at home. While it was a homebirth, I had kind of been relegated to the bedroom for most of labor and was not very active during labor. Overall, better than the hospital, but still, something was missing.

I consciously know when Benjamin was conceived. I told my husband that I would get pregnant that night. We were in Salem, Oregon, looking forward to a move, scoping things out and excited about our future as a family. I confirmed pregnancy 2 weeks later.

We moved and Bret couldn't find a job so I worked 6 months part time at a local hospital as a registrar to support us. I was tired all the time, the boys were missing me, but Bret still didn't have a job so I didn't have a choice.

I found a midwife as soon as I moved up here. Lennon was comfortable to talk to and I felt free to want the birth I hadn't had yet. She was very willing/capable to handle more difficult births, if they arose. I was nervous both about the possibility of 42 weeks again and also that Elijah & Cameron had been breech until 37 weeks.

Two months before my due date, Bret got a very part-time on call job. Two weeks before my due date, he got a full-time job with benefits. God's timing is impeccable. I stopped working a week before my due date b/c of intense contractions that kept me up all night. I had to call in sick to my two last shifts and felt really bad about that.

Family came for the holidays, I thought Monster would come then b/c of some major labor type activity. But no. Family left. My due date passed and I started to doubt my ability to go into labor. I had emotional breakdowns. I ate brownies. I ate extra sharp yellow cheddar cheese, the only thing I've ever craved in a pregnancy. I got swap packages ready. The boys were wearing me out with Bret's 12 hr work shifts so I was ready for baby to come.

Monday, Jan 4th, Bret came home from work and I asked if I could go do some errands sans boys. I was highly irritable and pubic symphysis dysfunction had just set in painfully making it hard to be a good mommy. So, I went out, fed the horse, went to a store to buy some puzzles for Cameron, toys for Eli and chocolate for me. Stopped by the grocery store for prescription meds and some herbal cough syrup for Eli. Got in the car and suddenly peed all over myself. It was very embarrassing b/c I never had any sort of incontinence. I kept peeing and couldn't figure out why.

It suddenly hit me as I drove into our parking lot, that my membranes could have possibly ruptured. So, I crossed my legs, waddled upstairs and told Bret to go get the bags from the car. Soaked my first pair of pants. Called Lennon and she said it could be just a small leak but to keep her updated.

Ate dinner, had some of the regular old contractions I'd had for weeks. More leaking, definitely was not pee. The boys were tired so I put them to bed at 6:30 instead of the normal 8:30. Both went down fairly well and I noticed contractions picking up to about 5-7 min apart and not too strong.

Called Lennon to update her. Updated some of my friends online who were eagerly waiting to hear about baby. Went to sleep from 10:30-midnight and stronger contrax woke me.

Got up, went in living room for a while and then Elijah woke up and wandered out. He apparently thought it was morning. I laid him in bed, he was dry coughing a lot so gave him some cough syrup. He did NOT want to sleep, kept singing to himself, sitting up and smiling at me. The contractions were getting stronger and I was having to blow through them a little. He loved that and would blow back.

I NEEDED him to sleep so I could get up and call Lennon. I couldn't leave him to get Bret if he was awake 'cause we'd start it ALL over again. So I laid there...for 2.5 hrs, trying to move with contractions and blow quietly. Finally, he was asleep. I jumped up, checked the clock and contrax were 2-3 min apart. Called Lennon, asked her to come right away (she's an hour away) and woke up Bret to go into the boys' bedroom.

Finally, I could start labor. I paced and rocked almost the whole labor, swaying. The contractions were getting strong in my back and hips. Lennon and Angie (midwife apprentice) arrived at 3:40 or so, walking in without knocking and I smiled at them and said I was glad they were there, that things were getting painful and I was tired of being alone. I don't think they had any idea how far I was b/c I was smiling, lighthearted. We had agreed earlier in the week not to do any vag checks unnecessarily so there was no picture of how far along I was in that sense.

I felt like there was a stall when they arrived though, that I sensed an intrusion for a while and needed to regain my composure and start going back into my little dark quiet space. I asked them if we could just have the blue cafe lights on in the living room with minimal lighting and they were fine with that.

Even with them there, I was alone in my labor, sometimes sitting on my knees rocking to all fours, sometimes just standing swaying. My noises turned from low moans to horse lips and a few "ow"s when things would sting a little. My midwife kept telling me softly, "You're making this look easy. You're doing great."

In between contrax, I wanted to throw up. I knew that sometimes that opens you up and I felt like throwing up, but I couldn't make myself do it. With my gallstone issues, throwing up has always meant there was something wrong with me and for some reason, the mental block was there that this was NOT wrong and I shouldn't do it.

Transition came and went quickly. I remember a few things I said, something like, "How did I ever do this twice already? What if he never comes out? How do I make this go away?" At one point, I started crying and frantically reaching out for a hand, meeting Angie's. My eyes were closed. I've always handled pain w/ eyes closed. I cried and was scared a few times but knew that I was safe.

And then, I started whispering, "Down, down, baby, come out. It's time. I don't want to do this anymore. I don't like it. It hurts. Come down now." I have no idea if I was whispering, but it seemed quiet to me and I kept saying that during the next 2 or 3 contractions.

I realized suddenly that I had to push. Someone woke up Bret and he came out as I grunted my first push. I was draped over the little exercise ball and rolled back and forth to push. I remember being relieved that it was almost over. I remember a little fear at the change in pain as he came down. There were a few pushes and he came out in a ball of screaming baby. They helped me sit back and put my bewildered but quieted son in my arms. I soaked him into my soul.

It was less than two hours from Lennon arriving and baby meeting the world. I'm really glad I was able to labor that much on my own.

That was the birth at 5:22 am. It was quiet, dark and sweet.

Lennon and Angie left a while later, after cleaning up. I reclined on the couch sleeping and DH went back to fend off the early waking boys. When they came out at 8, they walked in quietly and then Cameron said, "Mommy, you had the baby!" Cameron wanted to kiss him and kiss him. Eli just smiled and patted his hand and head and kept nodding. Later, Cameron gave me the most perfect example of how I've tried so hard to raise him. He said, "Mommy, you did a REALLY good job. He looks so cute from being born. That was a lot of hard work." What an affirmation from an almost 4 yr old!

I was so empowered by this birth. It was what I wanted. It was the birth I'd been searching for since my first pregnancy. I had imagined birthing in the quietness of night, in the light of the blue bulbs strung along the wall, in the quiet and surrounded by people that believed in me.

I was dumped on with a lot of responsibility in my first post-partum days, unable to get the help I needed to rest. When I have been overwhelmed, I have clung to the sweet dark peace I felt after Benjamin came to me that early morning. While my body has been tired, my mind clearly greets that memory and gives me strength to just get through one more minute, one more hour, one more day.

Unscrupulous

I am currently pumping milk once a day for donation for a sick adopted baby girl. I was nearly out of breastmilk freezer bags, so when I was at the grocery store yesterday, I picked some up. The grocery store is a large chain store, with one of those coupon machines that spit out coupons for you when you check out based upon what you purchased.

Imagine my surprise when I glanced at the coupons the cashier handed me, and one was for infant formula. Great, I thought. I suppose it must have been because they can tell I have a baby, since I was buying breastmilk freezer bags.

When I looked closer at the coupon, though, I couldn't suppress a disgusted laugh at what was written upon the coupon. It has a picture of a cute baby along with a picture of the formula which they were advertising (which I will not name, so as to not give them free advertising). The words read:

"Thinking of supplementing your breastfed baby? Consider X brand, our closest formula to breastmilk. Clinically proven to benefit infants in all three areas: growth, brain and eye, and immune system development."

So, not only were they targeting me because I had purchased a baby item, but they were banking on me, as a breastfeeding mother. You know, because I might not have enough milk, or maybe I don't like nursing in public or want to have a break from the task of nursing my beautiful boy..... right. And, you know, it is pretty close to breastmilk....its almost the same thing! Right???

Oh, it all just makes my blood boil.

It really makes me feel ill. I don't know how those who work in marketing for the formula industry sleep at night.

The birth of Sean Sylph

My dear client (and friend!) Lee has given me persmission to share her birth story of her sweet stillborn son, Sean Sylph.

*********

Late in the afternoon on September 10th, at 33 weeks of pregnancy, we found out that baby Sean was no longer alive. The morning of Friday, September 11th, after a difficult night, I told my midwives that I was ready to no longer be pregnant and I wanted to go ahead with the birth (we were originally planning for Saturday morning).

After a morning spent with my parents and Jake, we went home and prepared. I set up an altar and Mike and I made sure the house was ready, then I rested for awhile while Jake took a nap. At 3pm, my parents came and picked Jake up. My midwives, Lennon and Angie, arrived.

First Mike and I performed a smudging ceremony to cleanse ourselves and our space.




Then we went upstairs to get started. I was very pleased to find that I was already 6 centimeters dilated, and then Lennon broke the bag of waters. I went and sat in the bathtub to let the water flow out, and eventually filled the tub with some warm water for comfort. About 15 minutes after breaking the waters, I had my first contraction. The contractions were very mild at first, and slowly built up in intensity, frequency, and duration. I stayed in the bathtub for quite awhile, keeping myself upright to help things move along more quickly. Mike sat in the bathroom with me, and my midwives were in the bedroom next door, ready to check on me whenever I called. I had a candle brought up and lit and put in the corner of the bathtub for something to focus on.

Suddenly things changed and I found I could no longer be in the bathtub. I was immediately so hot and dizzy that I broke out into a sweat (it was 90 that day!) and practically ran to the bedroom where I got on my hands and knees on the bed and threw up into a bucket, except only water came out. This was probably transition! I started feeling a little better after that but the contractions were incredibly intense and close together at this point. I just kept myself as comfortable as I could on the bed with pillows to help prop me up to stay upright. Contractions continued to come and go, and I sipped cool water in between and breathed through each one.


Soon I moved to the edge of the bed and sat through a few contractions to ease the pressure on my knees. I asked for the birth stool, which the midwives brought up and set up for me. It felt great to sit on. After a few more contractions, I had a contraction where I let out a long, low, primal moan that surprised me but felt really good. The midwives immediately came into the bedroom and began setting up for the birth. Pushing was slow, with long resting times in between contractions. The baby soon crowned, but wasn't born until about 40 minutes later.


Sean was finally born at 5:40. Mike was the one who caught him and cut the cord. He was put down in front of me and I gently caressed his face and examined his body, toes, and fingers. This was so hard to do. I could see for myself that his body was not normal, his face hadn't developed properly, but he was still my baby that I had loved and carried inside me for 7 and a half months.

I was given the time and space to just look at Sean and be with him. I sat back on the bed, exhausted, and waited for the placenta to come. It took awhile, just like with Jake's birth. When it finally did come out (easily), the midwives found that it hadn't developed quite normally, either. During this time Mike sat with Sean and held him and connected with his spirit.

After the quick, 2 hour labor and birth, I was able to then sit back on my bed and rest. Sean weighed in at 7 pounds, 3 ounces! Mike and I sat with Sean and just held the peace for awhile, contemplating it all.

When we were ready, at about 8:30pm the guy from the funeral home came, and Mike took Sean down to the car and laid him inside. I watched from the upstairs window and then cried as the car drove away.

My parents brought Jake back, and Mike and I hugged our boy tight.


(The middle name: a sylph is a sky spirit, seen in the form of particularly-shaped cloud wisps.)

*********

Thank you, Lee and Mike. Thank you for allowing me to be with you during such a sacred, beautiful and sad event.

The veil

It is a sobering fact that birth and death are closely related. Flip sides of the same coin. Thankfully, birth and death are usually spaced far apart in one's life.

Not always, though.

This month, two of my dear clients have lost their babies, much too soon. Both babies passed from their bodies within 9-10 days of each other. The first in the 26th week of pregnancy, the second in the 33rd week or pregnancy. Otherwise known as intrauterine fetal demise. I don't like that term, though. It sounds much too cold to describe something that deserves all the compassion we can muster.

As a midwife, this felt like a bad dream. Could this really be true? I felt like my heart had been riped out.

The days and weeks that followed have been a time that I can only describe with one word: humbling. I have been in utter awe at the strength of each of these women, in birthing their babies and subsequently saying goodbye to them, and each of these families, in grieving and doing the hard work of moving forward and healing. These babies were/are both dearly loved and very much wanted.

I cannot describe in words how these two babies have touched my life and my work. They will never be forgotten, and will be loved and remembered. Though their time with us was much too short, the gifts each baby gave to all of us whose lives they touched are many.

He's here!

(and, I'm here still, too. :)

Our newest family member, Julian, made his way earthside on July 10, 2009. It was a fast and intense birth. I was a bit shell-shocked for a few days, but looking back, it was such a wonderful birth! He was a big boy, weighing in at 9lb 11oz (my first baby weighed 6lb 6oz).