Sarahthedoula

Babies

2010-01-07T12:08:00.002-05:00

Looks like this would be worth watching. Made me smile at least. :)

A New Decade

2009-12-31T15:59:00.002-05:00

Remember this time 10 years ago? It was Dec 31, 1999 and the world was all in a tizzy that computers couldn't cope with the turnover to 2000. People stocked up on essentials just in case stores closed due to the crisis. People stayed home in case traffic turned disastrous (would airplanes fall from the sky?! would traffic lights stop working?!). My parents ran a group home at the time, and were required to purchase a generator which would run half their household. They had enough bags of pasta and canned goods to last for weeks upon weeks (also required of them by CAS). I partied with friends (aka - now my husband & inlaws!), because I felt safe at their house.... just in case things went badly. I had (older) friends in the computer industry who said there was nothing to fear. I'm glad they were right!

New Years Eve 2009

2009-12-31T15:34:00.003-05:00

For the first time in my adult life, I'm not going out on New Years Eve. Since high school a small group of us have gotten together for the evening. This year though S's hubby works, and we didn't really feel like going to the party we've been going to the last few years. Instead snack food and nibbles and a light sprinkling of alcohol are on the menu for just N & I, who plan to stay at home and watch movies. Only a little bit to drink, as my current clients are 36 and 37 weeks now. I don't expect to be called by either of them, but I'd rather be safe...! N has 3 days in a row off work which is lovely. He is happy when he comes home from work now, and that makes me happy too. We've yet to see how it really works out financially, but we'll know soon enough. Worst case scenario: I go back to working two jobs + my doula business so we can make ends meet. That's not ideal, but its also not terrible. The accountants at his new job forgot to collect his last batch of timesheets so he is behind a paycheque. Hopefully that gets fixed soon. Tomorrow we're meeting with the above-mentioned friends for New Years Day brunch, and Saturday we have to go buy a washing machine as ours packed up and died this week. We'll be able to buy a 2nd hand machine thanks to grandparents who lovingly gave us Christmas money this year. And neither of us have to do anything at church on Sunday, so we might just stay home and enjoy the whole day together. We'll see. I have this week off work, as the church office is closed. It's not paid time off, but time off is still nice. Just another couple hours till N is home from work, so I need to get off the computer and start working on tidying the house and getting food ready for tonight. He doesn't expect me to do the household stuff, but he does really appreciate it, and I like doing it, so it works out well. Never thought I'd be the happy housewife who enjoys cooking and cleaning and making a house become our home - but it turns out that I am.

Freeing myself of guilt

2009-12-28T11:08:00.005-05:00

I'm trying to reduce the number of things in my life which leave me feeling guilty more than happy/fulfilled etc. I'm prone to feeling guilty, even when its not necessary.... I'm also prone to sticking at something longer than I need or want to, because I'm afraid of disappointing people or appearing to be a failure. There is only so much time and emotional space available in a day, so I'm evaluating the things that most frequently cause me to feel guilty, and plotting ways to free myself of them. I don't mean the things I genuinely should feel bad about, but the stupid things that just weigh me down.

The first and biggest, is that I resigned from my non-profit job. Yes, it was a very worthy cause. Yes, they make a significant impact in the community. Yes, there was room for me to keep on working as a doula and making a difference in the lives of young women. BUT, all the other parts of that job (the personal fundraising, donor maintanence, public relations, continuing lack of strong leadership, etc) wore me down, tired me out, and left me feeling bad that I hadn't done "more." So, I left there so I could use my time on growing my doula business.

Next up, I cancelled my membership at the gym. I LOVED my gym membership this summer and fall, but with changes in N's work schedule, and me cutting back a job (even if it was ajob that paid poorly and unpredictably), I felt guilty a lot that I wasn't going more often and making 'full use' of what I was paying for. The environmental impact and gas expense of driving back and forth to a large facility was also a consideration. So - I quit that too and have simplified to Pilates at home. I love how I feel after a good Pilates workout, and there is no guilt involved!

I'm looking at what groceries I bring into the house, and whether they add value to our lives. I am trying to find a balance between foods that are nutritious, tasty, and can be prepared in the amounts of time I have available.... AND that are also respectful of both the environment and the plight of many people in the world who don't have enough. As N points out, we already do a LOT in this area, but I want to do more.

Some areas of guilt I can't eliminate quite as easily - like how I feel when I've spent time with certain people in my life. But I can remind myself that I am not responsible for the choices they make, or for the consequences of their choices. I can focus more on loving them as they are, instead of stewing over how I ought to fix things.

Finally, there's this blog... I really do think a LOT about what I should post and when I should post, and whether a post could get me in trouble if read by the "wrong" people and if anyone is upset with me for not having posted more...
(I'm sure you can see by now that I have some 'guilt' issues!)
I'm not closing the blog, but I'm officially declaring what you already know - - my writing is sporadic and varied. I figure if I declare it 'out loud' then there can be no unmet expecations.

My current guilt-reducing efforts have been made public. I am clearing out guilt to make room for joy.

May the moments of joy you found this Christmas season expand and grow in 2010, so that every corner of your life is suffused by joy-ful and guilt-free living!

7 year itch

2009-11-24T15:56:00.003-05:00

I've been thinking for a couple years now that it was time for me to move out of my non-profit job. For a whole variety of reasons I've needed to wait. But not anymore. Effective December 31, 2009, I will be officially resigned from my non-profit job. It feels great. I just sent out my final letter to my donors yesterday, so it will probably be a couple days till it is truly public. But its close enough that I felt like sharing here.

I have clients booked for January 19 & Januay 27, and am waiting to hear from a third couple due January 2nd. But when I don't hear from a couple within a couple weeks of the interview, I usually assume it's a "no". I'll wait and see.

I may be doing some newborn care for a client, while she's at work. Not exactly doula work, or postpartum doula work, but its related work and would pay.

I was also offered a job as a receptionist at a local funeral home. It would just be a few hours at a time, as needed (ie during funeral services). The person who approached me about the job was going on vacation for a couple weeks, but I sent them my resume as a reminder for when they're back in the office, and am waiting to hear back on that.

And today, my husband N resigned from his job as a mechanic, because he was offered a job in another shop which pays better and has perks like medical/dental benefits and shares in the company. Sometime in the next 2 or 3 weeks he'll be starting at his new place of employment.

It is certainly a season of change for us.

And if you're a local person who has recently heard the rumour that I'm pregnant - its not true. That one seems to cycle around town every few months. I'm learning to accept that it doesn't mean I've gained weight each time the rumour circulates. When I heard it a couple weeks ago I freaked out that I was gaining weight, but a few moments later saw a local business-woman I know, who immediately remarked on how great I looked and how much weight had I lost since she saw me last? The answer to that was "Not even a lb, but I've been exercising more??"

So there you go. An update from my corner of the globe.

The waiting is killer

2009-11-02T10:29:00.006-05:00

A client calls me to say her water has broken - what should she do? I do my usual: Any instructions from your caregiver or hospital? GBS status? What's the fluid like? How do you feel? 99% of the time your dr will say to go straight to the hospital. It's always your choice. Trust what your body is telling you. Not supposed to put anything in the birth canal (fingers, your partner, tampon, whatever). You could try a brisk walk and see if that gets things moving from crampy to contractions. If its night-time you can try resting or a warm bath/shower so that you can maybe get some final rest before the games begin. You can always call your caregiver if you need/want their input etc.... What feels right to you at this point?

She decided that she would take a bit more time at home to see what happens. Maybe have a shower, make sure her bags were all organized to go, have a brisk walk outdoors to see if she could get things moving, and then call me later.

Bah! the waiting is killer! A recent client said she'd call me when she reached the hospital and knew what was happening. Then it all unfolded so quickly I almost missed it. My instincts were to go meet them, but she said she would call me from the hospital so I agreed. And then I kicked myself all the way to the hospital when it unfolded the way it did.

So I wait. For the phone to ring. Or an email. Or a text. Something?! Soon?! I am so impatient.

Birth & Sexuality

2009-10-29T07:49:00.003-04:00

I'm learning more and more, that in order to be comfortable with birth, you sometimes have to be comfortable with human sexuality. I don't just mean in the obvious senses either - of course there are sounds and scents and body positions and an intensity in birth that are reflective of our sexuality. Ina May Gaskin is famous for her belief that 'what got the baby in will get the baby out'. Lou Paget's book "Hot Mamas" even includes instructions on how to kiss for maximum benefit in labour. (a chicken peck just won't do it!)

Two births come to mind on this topic:

One Dad tenderly touched his partners's labia and spread them so he could see his baby descend. Massaging her vulva, gently reaching inside Mom with his fingertips to feel and welcome his child, to feel for himself her changing cervix. I was surprised to see his hands move so freely (and nicely surprised that none of the medical caregivers objected).

One Mom was labouring in the shower. Between contractions she would lean against the shower wall, eyes closed, and allow the water to wash over her. When a contraction came, she would lean against me, face buried in my neck, one arm around my waist. If it was really intense, her fingers would grip tightly, her mouth would open wide and she would alternately moan, and bite my shoulder (not painfully or dangerously). Her other hand was stimulating her clitoris throughout her contractions. I have to admit - - I was a bit shocked. As a doula I've supported plenty of women in the shower while labouring. And bodily functions just don't phase me. A woman self-pleasuring while leaning against me for support was a new one though.

In 'both' cases (stories are composites) I felt like an intruder on their most intimate moments. I offered to step away if they wanted some time alone. But no - I wasn't intruding. I was holding their birth space wide open, so they could do whatever they needed to, to manage their labour. I did my best to fade into the background - holding open the space without taking up any of their space - leaving them free to shift and move and touch and breathe and kiss and welcome their child.

Let the games begin - please?

2009-10-16T12:08:00.006-04:00

I'm glad that when one of my clients truly needs a cesarean, they have access to it - safely and quickly. I understand that while our Cesarean rate in Canada is higher than the WHO says it ought to be, and that's because many unneeded cesareans occur, I am still glad that we have safe cesarean's available when they're needed. That being said....I miss vaginal birth. I wanna see a baby come out the old-fashioned way!! I go on-call again tomorrow, for two moms with the same due date, and am also back-up for another doula. Surely 1 of these will be a great vaginal birth?

Most of the hospitals I visit as a doula are a mixed bag when it comes to breastfeeding. For example:

As the nurse was prepping the room for Mom, I told her that when Mom was ready to breastfeed, I didn't mind helping with that. She replied with a very skeptical "good luck". I calmly said "I'm aware of her history - but I'm sure its still managable" (she'd had some potentially complicating, but still likely managable, medical issues related to her breasts). "No no." The nurse said "Her boobs are flat. There's nothing in them and she'll never be able to feed her baby. You just know these things after a while" I was stunned, but only said "Well, it never hurts to try"

Mom & baby did not latch in the first hour, but did have skin-to-skin time, and we covered breastfeeding basics for when Mom & baby were both ready. I encouraged Mom to have as much skin-to-skin time as possible, and suggested that when learning to breastfeed, its usually better to stop a session before Mom or baby get too frustrated. Then express/pump and feed by finger, SNS, or cup, and try latching again at the next feeding. If you get frustrated everything becomes even more difficult - there's always another feeding to try at. And most babies get the hang of it by 6 weeks or so, if Mom has good support and keeps at it. I heard from my client later that while the baby wasn't latching yet, she had pumped lots of colostrum and was giving it to baby by finger feeding. Good for her - - so much for "empty flat boobs"!

Two doctors approached me separately after a recent birth, and asked if they could have my card and refer some of their young/high risk Mom's to me (they are both aware that I do that kind of work through the non-profit job).

The next few weeks will be full for me - - clients and doula work is a big part of it (yeah!) but there are also extra events and activities with both my jobs. It'll all work out though.

I Should've Listened

2009-09-24T07:47:00.004-04:00

I've been doing well the last couple months at getting almost daily exercise at the YMCA: Aquafit 2x/wk; 40mins on the eliptical + 40 mins weight-training 2x/wk; Pilates for 20 mins 2x/wk. I've been feeling good and seeing small muscle changes. It didn't feel like 'too much'.

Then the busy back-to-school season hit, and it was the week of my period anyway - exercising didn't make the to-do list, and it didn't feel 'right' anyway, so I took a week off. Next week I added the aquafit & Pilates back. Yesterday I added the eliptical and weights back. I didn't really want to - I wanted to just go home. But I told myself I'd been lazy long enough and needed to push through it and then I'd feel great. I eaked out 30 minutes on the eliptical instead of 45. I only did one set each of the final two exercises instead of three sets each.

Fast forward to 12:30am and I wake up with a sore throat and a congested nose. I tell myself I'm just dehydrated (got up to drink water) and will feel fine by morning. Fast forward to now, and I want to go back to bed. I don't feel AWFUL(although the sinus headache & sore throat are no picnic) - - but I DO want to curl up on the sofa with green tea and raw honey, instead of facing the packed day ahead of me.

Thursday is one of the busiest days of the week at my church job, but its not so bad. I could make it through pretty easily knowing that I could come home and curl up with tea. Except Saturday is a big fundraising event for my non-profit job, and since I am on-call currently, I can't just have a plan for myself to do it, I have to have a plan for myself, and a back-up plan in case I'm not available at any point. Same goes for all the prep. Normally I would just pop out for a couple hours on Friday and wrap all the prep up. But if I get called to a birth on Friday, there won't be enough time left, so I have to go to town this afternoon and get it done. Just in case.

I should've listened to my body saying "go home and take it easy" yesterday.

One foot in front of the other right? Fortified by echinacea, vitamin c, siberian ginseng, and decaf green tea with raw honey.

If I wanted you to know

2009-09-21T08:35:00.006-04:00

The other day, an older woman I know came up to me, placed her hand on my stomach and said with a 'knowing' smile: "Are you expecting dear?"

My inner thoughts: WTF? Does she know something I don't know? Wait a sec - of course not. And WTF?! Why are you touching me?! Get your hands off me and mind your own business. &*#@% I haven't even gained weight! ....W T F?!

My spoken words: *smile* Nope. I'd tell you if I was pregnant.

Her hand drops like a rock. Her face falls. She smiles awkardly, and says "...oh". Then a little while later she says quietly "I hope you're not upset that I asked."

My inner thoughts: Yes, I am actually. It was rude and presumptuous.

My spoken words: No, its fine. Really. *smile* When we're expecting, we'll tell people when we're ready. You don't have to guess. We'll tell you when we're ready.

Seriously people! Mind your own business. I am not pregnant. And if I was pregnant, and I wanted you to know, I would tell you. If I haven't told you then get over yourself and just wait a few months. I'm not a big person - at some point it will become obvious.

What if we didn't want to be pregnant - the 'are you?' question would get tired quick. Or even worse - if we want to be pregnant but can't get pregnant? Salt in the wound.... Pregnancy is taken for granted and it shouldn't be. It is LIFE at its very essence - and that is beautiful and anticipated, but it is also unpredictable and difficult at times.... yes, you can trust birth. But you also have to acknowledge the reality of the world we live in.

It's one thing when its just whispered rumours and another thing altogether when people start touching me. I already have plans for a whole collection of t-shirts which make it very clear that touching me is not an option. It's my body. You wouldn't rub my belly if I wasn't pregnant (story above not-with-standing - she thought I was pregnant) A pregnant body is an amazing sacred space in which LIFE is being created. Maybe older women just want to touch a piece of that life and feel it again for themselves. But it is not theirs to take. Even as a doula, I do not touch a mothers belly unless she specifically invites me to, or if it is in the course of a comfort measure, and then I ask permission first. Always. I think that touching a woman's body without her permission throughout a pregnancy, is just one of the many subtle ways we take away a woman's sense of control and ownership of her own self.

Obviously, I feel very passionately about this. Being touched by people who have no right to touch me is one of the things that freaks me out the most about the possibility of being pregnant some day. As a pregnant woman, you're expected to smile graciously and stand there while strangers and acquaintances alike rub you like a budha or lucky rabbits foots. I don't approve.

Fall Tally & UC births

2009-09-10T07:54:00.009-04:00

My Nov 8th client's edd is actually Nov 4 (the very first EDD she was given, was Oct 31) and may be revised again after her next medical appointment.

Thursday I met for the first time with the Oct 31 clients who hired me over the phone last week. Paper work is all signed, and they paid part of my fee (more than just the deposit) up-front, which is very helpful this month. I've been worrying all week about how to pay my bills (no non-profit paycheque) so their early payment was an answer to prayer.

The Oct 6 clients contacted me to say "- - please say you have space for us still....!" I do, and meet with them today. It will be a bit of a crunch to get all the prep fit in, but it'll all work out one way or another.

The second Oct 31 clients decided to go with a doula partnership from closer to where they live. It's two women who co-doula. So you interview and pick your primary, but they both do your prenatal stuff, and you get one of the two for your birth (whoever is available at that moment). The co-doulas are also part of a group which includes CBE's, postpartum doulas, and lactation educators, so its kinda like one-stop-shopping. I can see the appeal. And am actually a bit relieved. I know lots of doulas have 2-4 clients a month, but Oct 6, Oct 31, Oct 31, and Nov 4 just seemed a little scary to me, who has rarely had more than one client at a time.

More and more of my clients have been requesting extra time/info in the areas of trying out comfort measures, learning to breastfeed, and newborn care/comfort. I've purchased a few good quality educational dvd's, and now offer to go through them with my clients before they're full-term. All three of my current clients, want to go through all 3 extra sessions. I'm excited to be able to work with them in this way so they can feel more educated and prepared. But I'm also wondering if I should include this in my standard doula fee (which is already a VERY flexible sliding scale), or if I should offer these as "additional private sessions" at a small extra fee? I'm not a certified LC, or CBE, but I do know (through reading, conferences, and experience) a fair bit in both these arenas. Knowing myself, I'll just keep including it in what I already do, and consider it a 'bonus selling feature', which helps to set me apart.

I've also been thinking a lot about the potential role of a doula in a UC birth (Unassisted Childbirth) lately, and specifically, how I feel about it. I recently spoke with a woman who is absolutely determined that she will have a VBA2C next time around, and if she can't find a caregiver willing to support that, she has already determined that she will plan for an unassisted homebirth. As we talked, she shared with me some of her history, and by the time we said our good-byes, I told her she was welcome to call or email me anytime, and if there was anything I could do to help, to feel free to ask.

Then I got home and went "Huh, what DO I think about the role of a doula in an unassisted homebirth?"

Here are most of the viewpoints I've heard so far.
"Unassisted means unassisted and if they want a doula they want assistance, so it doesn't even make sense..."
Unassisted (in my understanding) can mean a range of things, from 'no one is present except for the birthing woman herself', to 'no people are present in a professional capacity, but family &/or friends might be present' to 'no medical professionals are present, but non-medical professionals such as a doula might be'. And I'm sure there are other variations within the same theme.

"Being a doula at an unassisted birth is too risky for the doula, as she is the one with the 'most training' at the birth, and is therefore liable if something goes wrong, and she risks being charged with practicing medicine without a license."
This is the view I hear most often, as a DONA certified doula. I understand it.... mostly.

"There is no reason why a Mom should be denied the hands-on comfort and support of a doula, just because she has chosen to birth on her own terms, outside the traditional norms of the medical or midwifery care systems. As long as the doula has a really good relationship with the client, clearly states her SOP, stays firmly within her SOP, has all the typical contracts & liability waivers signed, and is comfortable assuming the level of risk - it's ok to doula at an unassisted homebirth."
I think independent doulas (ie not certified through a well-known governing body such as DONA or CAPPA) have a better chance of fitting in this category. In fact, this is probably the view I find myself most closely aligned with (at least from this theoretical standpoint, where I don't ACTUALLY have to make a choice). BUT, because I AM a DONA-certified doula, I absolutely recognize that choosing to doula at an UC puts not only myself at risk, but the organization as a whole, and I don't have the right to do that. So - no UC births for me. Not because I feel it's inherently wrong, or even because I'm unwilling to take the risk, but because I understand its not just about me.

I firmly believe in working with women to ensure they have good quality information, so that they can make the decisions that are right for them. That includes the decision to birth in ways that don't fit our societies' norm such as UC, but it also includes when a woman chooses to birth in a hospital, or refuses a suggested induction - for example. Having and understanding good quality information includes understanding the risk levels involved in your various choices, and being willing to live with the outcomes of those risks should they come to pass. To be honest, I don't know how well any of us can 'understand a risk', until we have felt its firey breath on the back of our necks. We live in an inperfect world. So we do our best to trust birth; trust women; and be true to our part in each story.

Feast or Famine

2009-09-03T21:47:00.004-04:00

I was really excited to have clients in Jan, Feb, Mar, and May of this year, plus my postpartum doula work in February. April, June, July, August, September - nothing.

And the only other client I had on the horizon is due Nov 8. (the September & December clients both ended up not needing a doula) But over the course of just a couple weeks, I'm now waiting to hear back from a couple due Oct 6, and am interviewing tomorrow with a client due Oct 31.

Tonight my home phone rang and a nervous sounding guy asked if this was "the uh, doula office? Did I say that right?" We chatted for a while and I answered his questions about what a doula does etc. His wife had put on his to-do list for him to call my name and number and find out for himself how a doula could help. He sounded positive by the end of the conversation, and said he or his wife would be in touch. I had to go out for an unexpected errand, and when I returned, N said that the couple had called back, and would like me to phone them back tonight. I called back, and she said she was pretty sure they wanted to hire me, was I available on their due date of October 31? I told her that I have a client due Nov 8, and am interviewing tomorrow with someone due Oct 31, but that I work with back up doulas and so they wouldn't be left stranded. "So, could I hire you right now - over the phone?". "Um, if you're comfortable with that, sure?" "Okay then. We want you to be our doula. When can we get together?"

I'm telling ya, its feast or famine! I like feasting, even if it is a bit nervewracking to line up all the appropriate back-up. Fortunately I have a network of about 6 doulas, not just one. eeps! I'm super excited!

Stirring the Hornet's Nest

2009-09-03T12:47:00.007-04:00

Every two months, we put out a newsletter at my non-profit job. For our September issue, I wrote an article which challenged commonly held beliefs about teen pregnancy. I was really hoping to make people think, and knew that some may be offended. But I was okay with that - sometimes the truth is hard to swallow.

Here's the article:
The canary in the mineshaft - "sarahthedoula"

Teen pregnancy has been all over the news in “our area” this summer. According to our local health unit, in 2007, 9% of our births, were to teens. Only about half of the teens who get pregnant, go on to give birth – the other half of pregnancies end in either miscarriage or abortion. In reality, the number of young women experiencing a pregnancy could be even higher, as the health unit can only account for women who choose to go through the public health care system, not for those who miscarry at home, or who go to a private clinic. That “9%” works out to a birth rate of 17.6 mothers aged 15-19 per 1,000 teens in “our area”, while the provincial average was 12.5. Something is going on here….. and we need to pay attention…. but not for the reasons you might think!!

Most people refer to teen pregnancy as a ‘problem’. It has long been assumed that giving birth as a teen will result in that mother-baby being pulled down into a lifetime of poverty and dependence on government and family. Research is showing that in reality, when teen parents are well supported, and given the same educational chances as their non-parenting peers, then by the time they are in their 30’s, they’re doing just as well.

It has long been assumed that teens get pregnant because they don’t know how to prevent pregnancy, they don’t have access to contraception, or they don’t use contraception properly. Research is showing that in reality, teens get pregnant for a wide variety of complex reasons – the ‘problem’ can’t be solved just through better sex ed classes and free condoms.

Most of us feel intuitively that teen pregnancy is a problem… but the problem isn’t what we think it is, so the solutions aren’t what we’ve thought they are. For that matter, moral and religious teaching on its own isn’t making much of a difference either.

I believe that teen pregnancy is problem because of what it is a symptom of: a lack of hope, which leads to an increase in risk-taking behaviours. Just as the death of a canary signalled miners that the air wasn’t safe for them to breathe, an increase in teen pregnancy rates signals to the community that their teens need help – their teens need hope. Hope is at the centre of Christ’s message, and it is a gift that every one of us can give. God knows the plans he has for each of us – plans to give us hope & a future. (Jeremiah 29:11) “When kids are empowered with information and stimulated by hope for the future, it has a contraceptive effect. Education. Employment. Their own bank accounts. Good health. Family involvement. Self-esteem. These are also contraceptives. It’s the total fabric that is important” (Ludtke)

Now, more than ever, we at “non-profit” need your support. We need your prayers and your financial gifts, so that we can continue to minister to the youth of “our area”. We need you to pour into us, so that we can pour the love and hope of Christ, into the lives of teens, every day. Together, we can bring hope to a generation.

*********
This morning, our administrator forwarded the following message to me:

Dear Ms “sarahthedoula”

I was disappointed in the the newsletter, mostly because of your article on teen pregnancy. I certainly don't agree with your assertion that it is not a real problem. I, in common with many Christians, do not approve sex outside marriage and most of all sex among young people without using contraceptives.
I think you have been misled by research. Research, particularly in the social ssciences has a bad reputation. My own area was education and the vast majority of projects did ot follow proper statistical procedures. There are two main reasons: First, most of the people doing the research are not statistically adept; Second, much research is carried out with a clear design for specific outcomes. Research on the family has been largely taken over by feminists whose bias and/or ignorance colour their alleged findings.

Your core assertion that"when teen parents are well supported, and given the same educational chances . . . . (later) they're doing just as well". Note 1: No mention of what percentage is well supported. 2) You can't measure "chances ", so it probably means if they get the same education as their peers. 3) For that limited group, mainly coming from strong supportive families, that may well be true - but meaningless if we don't know the proportion involved. My guess would be a minority. 4) You seem to be implying that the rest of us should be giving special support to those who choose not to give their babies up for adoption. I don't agree. Why should we reward them for their bad decision? Boys and girls who cannot access education but are not parents are more deserving. 5. Typically, the research tells us how the mothers are doing - but what about their children? Children do better if they have a family with a father and a mother.
You state correctly that our schools are not helping the situation with their sex education. programs. You incorrectly state that "moral and religious teaching on its own" does not work. (Unless the "on its own" qualifier excludes parents who set their children good examples. Who on earth would think that moral education by immoral people would have a good effect?) How would you know that given that our schools, even most Catholic schools, don't give moral and religious instruction in this area? It would be interesting to know if girls from strongly religious homes within an intact marriage are as likely to become pregnant as those from non-churchgoing homes; and if there is a difference between secular religious (e.g., the United church) and more strongly religious homes (e.g., Pentecostal and Presbyterian).
Given that I reject the feminist idea that girls are free individuals who should make their own choices without regard for old-fashioned, outdated religion and morality, I do not agree that the central problem is lack of hope, but rather the absence of a strong moral and/or religious framework and the decreasing number of homes characterized by loving parents, a faith in God, and the embodiment of the central virtues of truth, courage, justice (the golden rule) and humility. That lack certainly does give rise to a me generation in which lack of personal responsibility and hope are typical features. Why would one hope when one believes in nothing much beyond personal entitlement?

(Brief complaint about an article written by a different staff member…..)

I look to “non-profit” to reject the modern secular view of society not to join it.

Sincerely,

mid-upper class WASP

********
I knew as soon as I read the opening line who the letter was from. I and one of my co-workers have upset this person before (we did a workshop on teen culture which apparently was just "too much") At any rate - I have to work with one of my co-workers to somehow appease this person now. I won't be apologizing, or retracting anything, but they just might receive a heap of statistical evidence and source material. Seriously though - did they actually READ what I wrote?! And this line especially kills me: "I reject the feminist idea that girls are free individuals who should make their own choices without regard for old-fashioned, outdated religion and morality." Has this person time-warped back to the middle ages?? Oh well. I'll deal with it all after a fabulous long weekend. :)

P.S. Because it is a general newsletter to a WIDE audience, we almost never include the statistical specifics - the reader just glazes over and misses the point then. Our sources are always available upon request though.

Homebirth with Midwives in Canada

2009-09-02T08:21:00.003-04:00

Check out this great article - published August 31, 2009 - which outlines a study showing that planned homebirth with midwives is as safe as a hospital birth! It's not really news to many of us who are already advocates for midwifery and homebirth, but it is definately an article I'll be able to pass on to pregnant women I know.

16 & Pregnant

2009-09-01T16:16:00.003-04:00

Have you checked out this show on MTV? It is very honest and insightful. There are only 6 episodes, and a 1.5 hr follow-up episode where Dr.Drew interviews the teen parents to see how they're doing now. I'm sure it'll be in re-runs, but if you don't have MTV, you can watch the episodes online here. If you have an interest in teen pregnancy, be sure to check these out.

Trust III & Other bits

2009-09-01T10:38:00.004-04:00

So after much mulling and pondering, I've decided on a course of action. The next time I see my client, I'm going to suggest that if she has questions or concerns about her birth, she request a copy of her medical records from her caregiver. That way, the power is is her hands to determine how much information she does or doesn't want. This is the option that feels best to me, for these circumstances. Thanks so much to all of you for your input - its been invaluable.

In "other bits":
Now my parents are moving the weekend of the 12th, so the long weekend is free after all. But we've decided not paint because its just cosmetic, not money or energy saving. There are many other things we can do, which will save us in heating costs, and are a better use of limited finances, in our opinion. N's Mom doesn't seem happy that we've decided not to paint. She says: ...but you'll feel so much better about your house once its painted... I really had my heart set on getting that done...
But its our money and our time, so we're not putting either towards painting this Fall.

Yesterday N & I celebrated our first anniversary together. We both had to work as it was an ordinary Monday to the rest of the world, but we had a nice supper out in the evening. Sunday morning we decided not to go to church, and to just have a quiet day with only the two of us. I think N's parents are a little 'miffed' with us, as they believe in attending church every Sunday no matter what, and they were doing a presentation on their time in Africa this summer, this week. The next time they see us after we've 'skipped' a Sunday, they always want to know what we were doing and why we weren't at church. Meh. We're adults. We don't have to go to church just because they go to church. And we don't have to answer to them if we don't go.

Oh the joys....

I'm interviewing with a potential client on Friday. They are due late October so it would be a quick turn-around if they hire me. I'm also waiting to hear back from a potential client due early October. She needs permission from her caregiver to have an extra person in the room before she can hire me. That birth would have an even quicker turn around. Crossing my fingers that they BOTH work out!

Trust Part II

2009-08-27T10:37:00.005-04:00

I met with my local doula group last night, and posed the same story to them, which I posed to you, in "Trust".

Their responses were very different, so I've flip-flopped again. A couple said they would have been so mad that they would've spit it out right away. And a couple said "don't tell her - that time around birth is so fragile and delicate, it will likely do Mom more harm than good to know at this point".

More importantly, they me asked some really good questions:

What do you think the effect on Mom will be, if you give her this info?

What do you think the effect on YOU will be, if you give Mom this info?

What's in it for you if you tell, or don't tell?

How might it affect your relationship with this client?

How might it affect your relationship with the caregiver(s) and hospital if Mom responds negatively to them as a result of information you give her?

How might it affect your ability to serve other Mom's who have the same caregiver or hospital?

And then came a suggestion:
What about making an appointment to talk to the caregiver directly, and just tell them what you saw, and ask them to "help you understand"?

The idea of caling of the caregiver to talk about this scares me actually.... but I think it is a really good suggestion. So now I'm pondering that possibility too. We'll see.

P.S. We've cancelled housepainting to help with the move so I don't have to try and be two places at once. :)

Oi

2009-08-26T10:37:00.004-04:00

My parents moved out of their 9 bedroom farm house back at the end of June. It was stressful and not fun. They are moving again in September. When they asked me about our availability to help with the move, I said we were not available the long weekend as we're painting our house, or the weekend of the 26th as I have to work.

My Mom just called to say they're moving at the end of August, can we help?

"So - you're moving this weekend?" I asked. "We're supposed to be taking N's siblings out of town for the day but I guess we can postpone that."

"This weekend is the last weekend of August?! No that's too soon, we're moving the next weekend."

"So you're moving on the long weekend?"

"Yes, we're moving on the long weekend - are you available to help?"

"Uh...... I'm going to have to talk to N about that..... we're supposed to be painting our house that weekend. I told Dad that already."

"Oh. Well - let's just leave it all up in the air and decide when we get closer" she replied.

"I can't just leave it up in the air - we're painting our entire house in a weekend and have N's family booked to come help. If we're going to cancel or postpone the whole thing to help you move, I kinda need to let people know in advance that their long weekend is going to be free or that we need help with your move." (feeling very frustrated and torn, but trying to keep talking with a calm and patient smile)

"Well, just never mind then. Pretend this conversation never happened. Pretend we're not even moving. It'll be fine. We'll figure it out."

*Sigh* "I'll talk to Nathan and see what we can do Mom. We know you need help moving. I'll get back to you or Dad."

And then she entered an area with bad cell reception and our call got cut off.

I shouldn't have sighed and I know it. I hate it when she does that *sigh* thing to me, and I turned around and did it to her. Why is it that phone calls with my Mom almost always leave me feeling like a horrible daughter?!

I called my Dad to try and confirm dates for the move. He didn't recall that I had told him about what dates we're not available, and said he was just moving whenever Mom wanted to, to try and keep her happy (or at least less sad, mad, and whatever else). He said they'll be able to get help from people at their church this time and that it's fine if we don't come.

I feel wretched. We're only painting the house on the long weekend because N's Mom decided it wouldn't be very expensive (less than $200, we have a small house) and that since they were free that weekend, we would all get together and do it that weekend. She didn't really ask us - just kinda stated her idea and when I didn't immediately disagree (I was non-committal), assumed we were good to go.

I'm sure someday I'll be a mother/mother-in-law to adult children and will somehow understand where they're coming from, but for today, as the married daughter, all I can say is:

Argh *sigh* Oi @*&%^! (and repeat, with much head banging)

Trust

2009-08-25T10:34:00.018-04:00

I believe that developing a relationship of trust with your caregiver is essential in pregnancy.

So what happens when, as a doula, I discover that the caregiver has possibly lied to Mom, and that Mom accepted some major decisions, based on that? Mom believes her body failed and has made peace with that. But sometimes when our paths cross, she makes comments which lead me to believe her peace is not complete.

I worked with a woman who was doing all she could to achieve an intervention-free/ natural/vaginal birth. That was part of why she hired me as her doula.

Mom had been experiencing pre-labour contractions for a while. When she finally went into labour, I met her and was working with her closely as her labour progresed. At admission she was 1 cm. She was not being monitored, and we didn't see much of the medical team. A few hours later, Mom's contractions had picked up to every 3 minutes, lasting a minute, and Mom was working hard through them. My estimate based on her outward physical and emotional signposts was 4-5 cm dilation. And while I am wrong sometimes (usually when Mom has been induced with pitocin), most times I am within a cm of the medical caregivers (cg's) assessment. I believed she was 4-5cm and moving fast, so I let the caregivers know what her contractions were doing, since she wasn't being monitored or checked.

A while later her cg came in to do an internal exam, and said my client was only 1cm still, that the baby was floating/not in a position to come down for delivery, and that no progress had been made. "We can't go on like this forever" her cg said "it's time for a cesarean". My client was confused and concerned, so the cg agreed to get a second opinion from the on-call cg. Primary cg pulls on-call cg aside for a private chat. Primary cg comes in to do an internal and says "Yep - it's just like your primary cg said. A cesarean is our best option now." Mom was disappointed, but trusted her primary cg implicitly and so agreed to the surgical birth.

Personally, I was confused - their assessment just didn't match what I was seeing. Mom got wheeled off to surgery, I walked by the nurses desk towards recovery, and the patient board said that my client was 4cm, 100% effaced, and -0- station. WTF?! That is NOT what they just told my client! The information they gave my client led her to accept major abdominal surgery that she didn't want, and maybe didn't need.

My client believes that her body isn't cut out for birthing babies, and she has made her peace with that. But I am so very torn. Which is the lesser of two evils, for my client to believe her body failed, or to believe her trusted cg lied? And is it my responsibility to give my client the information I saw on the patient board? Our paths do cross occasionally, and she'll toss out a tidbit from her birth like "my baby was never well-engaged right?" or "I never dilated very far right?"... Thus far my response has been "That's what your cg said." Comments like those ones, lead me to wonder how complete that 'peace with herself' actually is. Is my response to her a cop-out? Am I perpetuating a lie? Do I need to sit down with her and tell her what I saw, then allow her to draw her own conclusions? I don't think her cg was being malicious. She trusted her cg and I want to too. I am sure they had their reasons for saying my client needed a cesarean, even if those reasons aren't the reasons they told my client. How do I best protect the trust which my client placed in me?

So - - what do you think?

Saving Homebirth

2009-08-23T16:25:00.003-04:00

Scroll to the very bottom to learn about Saving Homebirth in Australia.

A Cesarean Birth Guide

2009-08-17T14:02:00.000-04:00

A Cesarean Birth Guide

In planning for the birth of their child, many women express concern or anxiety over the possibility of a cesarean birth. The World Health Organization (WHO) recommends that the cesarean rate should not be higher than 15%. With a cesarean rate in Canada of 28% in 2008, the concern of pregnant women is not unfounded. Women wonder what “really happens”, what choices they have, what is “normal”….. I have designed this guide sheet to help answer some of those questions. A guide like this can’t account for every variation and circumstance, but it can help you think about what you might need or want. It is simply a guide, not an iron-clad form. It is intended to be a starting point for discussion between yourself and your support team – particularly your medical providers.

“We have a secret in our culture, and it's not that birth is painful;
it's that women are strong.”
Laura Stavoe Harm

In case of a planned Cesarean:

• You will be instructed not to have any food or liquids (not even water or ice chips) for 12 hours prior to your scheduled surgery time. While a mom commonly will have had food or drink more recently than that in the case of an emergency or unplanned cesarean, the surgeons try to minimize risk as much as possible in a planned cesarean.

• You will be instructed to arrive at the hospital 1-3 hours prior to your scheduled surgery time.

• In some circumstances you may be able to arrange for the cesarean to take place once labour has begun, rather than on a pre-selected date, in order to ensure the babies readiness. If your cesarean birth is planned to take place before the baby is considered full-term, an amniocentisis may be done to determine fetal lung maturity.

From this point on, whether it is planned or not, it proceeds quite similarly.

• Once you arrive, you’ll be shown to a room, where you will be given a gown to change into, possibly a hairnet and booties too. In most cases you are told to remove all your own clothing, jewelry, hair accessories etc.

• You will be connected to an external fetal monitor (two belts around your belly) which monitors any contractions you’re having, and the heart rate of your baby. The monitor is removed once the surgery is imminent.

• You will be given medication to dry the secretions in your mouth and upper airway. You may also be given an antacid.

• The lower part of your abdomen will be washed and possibly shaved as well.

• A catheter will be placed in your bladder to keep it empty and to reduce the chances of injury. This may take place after the epidural or spinal anesthesia has been placed. If you are concerned about the discomfort of having it placed, you can ask that they wait until the anesthesia has taken effect to place the catheter.

• An intravenous needle will be inserted into a vein in your hand or arm to allow for the administering of fluids and medications during your surgery. You may already have an IV in, or a saline/hep lock from the course of your labour.

• You will be moved to the OR, while your support person waits outside. The OR is typically cool, and very clean. You can’t control much in terms of “atmosphere” in an OR, but, if there is time, you may have some input into the sounds of the OR. You could request that your own music be played, or that the room have no music. You could request that you are told every step of the way what is happening, or that everyone stays as quiet as possible throughout.

• You will be given an anesthetic for pain relief. Typically this is in the form of spinal or epidural anesthesia, but general anesthesia may be used in certain circumstances. (For instance, if it is an emergency where time is of the essence, or the mother is not a candidate for epidural or spinal anesthesia due to something like a prior back surgery). If you don’t have anesthesia already in place during your labour, then the anesthesia is typically administered in the operating room rather than in the labour/birth room. If the epidural/spinal is given in the OR, you are usually instructed to lie down quite quickly, while you still have control of your legs and abdominal muscles, before the medications take full effect.

• Some anesthesiologists give medications to help you relax as well. Some of these impact your ability to focus on what’s happening and/or your ability to remember the events afterwards. If this is of concern to you, be sure to mention it when the anesthesiologist interviews you.

• The anesthesiologist will be closely monitoring all your vital signs throughout the process. He or she may use things like: an oxygen mask or nasal tube to give you extra oxygen if needed; a monitor that goes over a fingertip to read your oxygen levels and/or pulse; sticky leads on your chest to monitor your heart rate. Feel free to ask what they are doing or what something is for, if you want to know more.

• Your arms will be laid out to the sides. In some cases they are restrained using “soft-restraints” or velcro straps. Other times you are simply instructed to leave your arms still and they are unrestrained. If this is an area of concern for you, you can speak to your doctor and see if there is any room for negotiation on restraint.

• A screen/drape will be placed above your chest to keep the surgical field sterile, and blocking your view of the delivery.

• Your abdomen will be washed with antiseptic solution and covered with a sterile drape.

• Once the medical team is ready, your partner will be brought into the room, and seated near your head. If it is very important to you to have a second support person with you, such as a doula, you’ll need to talk to your doctors about that. In many ways, the anesthesiologist controls the OR, and so you may need to talk to him/her in addition to the primary OB. Sometimes they simply won’t allow another person to be with you for the whole process - space is tight and it is major surgery in an OR. BUT they may be willing to let you “trade off” once the baby has been born. For example, your partner would go with the baby to the nursery, and your doula would step in to sit where your partner was before.

• Once the anesthetic has taken full effect, an incision will be made through the wall of your abdomen and then the wall of your uterus. You will probably feel slight pressure at the incision site, but not any pain. Although your caregiver will attempt to use a so-called bikini cut (a horizontal cut that is low on your abdomen), a vertical skin incision is sometimes made in an emergency.

• Regardless of the type of skin incision, the uterine incision is made horizontally and low down on the uterus unless the position of your baby or the placenta demands a vertical cut instead.

• Sometimes you feel a lot of pressure. You may also feel light-headed, nauseous, anxious, or highly emotional. Occasionally the anesthesia will cause you to feel as though you can’t breathe. If these things, or anything else you’re feeling, become uncomfortable, be sure to tell the anesthesiologist, who will be at your head closely monitoring you. They may simply reassure you that it is a normal sensation, but many times they can also make adjustments to help you be more comfortable.

• The amniotic sac will be opened and the amniotic fluid will pour out &/or be suctioned out. If it is important to you, you may request that the operating room is silent at the time of birth, and that your voice is the first the baby hears as you welcome your child to the world. Related to this, you may request that they not announce the sex of the baby, so that you can discover and announce this yourself when you see your baby for the first time.

• Your baby will be eased out manually or, on occasion, with the aid of forceps or a vacuum extractor. You may feel a tugging sensation as well as feelings of pressure, if you've had an epidural. You probably won't feel anything if you've had a spinal, except pressure on your upper abdomen if the doctor needs to apply pressure to push the baby out through the incision. These pulling and tugging sensations can be quite intense and vigorous though. Again, mention it to your anesthesiologist or nurse if it becomes too much for you.

• Typically, your baby's nose and mouth will be suctioned. The umbilical cord will be clamped and cut, and the placenta will be removed. The doctor will hand the baby to the nurse or other caregiver responsible for assessing the baby. You can request that they delay the clamping of the cord if this is important to you. Even more, you can request that the placenta and baby be kept level with each other, or that the placenta be slightly higher than the baby, until the cord stops pulsing in 5-10 minutes, allowing the baby to equilibrate its final blood volume, thereby reducing the babies risk of respiratory difficulties. Alternately, you can ask that the doctors wait to clamp and cut the cord until after the baby has taken its first few breaths. To keep the baby warm during this time, he or she can be laid on the mothers legs. If it is an emergency these things may not be possible, but you can certainly ask.

• Oftentimes, but not always, the baby is held up over the sheet so that you can see him or her right away. You can ask them to do this, and in some cases they are willing to lower the drape or set up a mirror so you can see the baby emerge, if this is important to you. If that’s just ‘too much information’ that’s okay too. Although a cesarean birth may not be what you had ideally envisioned for the birth of your child, it is still a birth nonetheless. Be sure to read the Birthing From Within webpage on cesarean birth - it has some simple suggestions for this stage of the birth, which may help you feel more connected to the process.

• If you wish to take any photos or videos of the birth, you will need to negotiate that with the hospital and the individuals involved in your cesarean.

• The baby's caregiver will quickly assess the baby (Apgar test). The baby will typically be taken to the side of the OR, assessed, diapered and swaddled, then briefly returned to Mom for a kiss before being taken to the nursery. Sometimes the baby is bathed in the nursery. If you would prefer to do this yourself at a later time be sure to talk to the nurses about this. You can request, if you like, that either Mom or the partner have a few moments of skin-to-skin contact with the baby, before he or she is taken for assessment, or you can request that these assessments wait until after the first hour has passed. They may be able to move Mom’s gown so that the baby can rest on her bare chest (with assistance of course!), being sure to stay out of the sterile area. If Mom’s arms have been restrained, you may request that at least one of them be undone, so that she can hold and touch her baby. Your hospital may not allow any of this, but it doesn’t hurt to ask.

• One of the moments many couples find difficult in a cesarean birth, is when the baby is taken to the nursery and the partner has to decide whether to go with the baby or stay with the mother. In some hospitals you can request that a nurse (or midwife) be assigned to the mother-baby, so that the mother, partner, and baby can stay together (skin-to-skin when possible) and then go to recovery together.

• The doctor will look around inside your abdomen to ensure that the bladder and other organs are all in good shape still - this can feel mighty strange, even if you are not consciously feeling it. Your uterus and abdomen will be stitched up. The stitches in your uterus will dissolve on their own. Depending mostly on your doctor's preference, your abdominal incision will be closed with stainless-steel staples or nonabsorbent sutures, which can be removed anytime after three or four days, or absorbable sutures below the skin surface, which dissolve on their own. If you plan to have more children, and would like to entertain the possibility of a VBAC (vaginal birth after cesarean), ask the doctor to use a double layer of stitches to close up your uterus.

• You will be taken to the recovery room, where your blood pressure, pulse rate, and respiratory rate will be monitored, and you will be watched for excessive bleeding and other potential complications. You may be given antibiotics to minimize your chances of infection and will be offered pain medication either through the IV or in an injection after the anesthetic wears off. It is important for the well-being of both the mother and the baby to spend as much time as possible in the first hour skin-to-skin. This will require some extra hands-on assistance from your support people, as you deal with the effects of the surgery and medications.

• If for some reason skin-to-skin time is not possible for mother-baby, the baby still benefits from having skin-to-skin time with the mother’s partner/baby’s father instead. This skin-to-skin contact is commonly referred to as “kangaroo care”.

• You will be moved to a room on the postpartum floor. If you are intending to breastfeed, your nurse will show you how to position yourself and your baby to ensure that you are as comfortable as possible, despite your incision. (You will want to either place a pillow over your incision and rest your baby on that while you sit up straight in a chair, or feed your baby when you are lying on one side.) If it all possible, try to start breastfeeding within the first hour of birth, as both you and the baby are “primed” for feeding to occur during this time.

• A Cesarean is major abdominal surgery, and can have an effect on how quickly your breastmilk comes in. Colostrum is all your baby needs in the first few days; breastmilk is produced a few days after the birth. The body only has so much energy available, and when a cesarean birth has occurred, the body focuses on repairing itself before moving on to the task of making breastmilk. It is absolutely possible, and very beneficial, to breastfeed after a cesarean birth, but it may require some extra time, effort, and professional help. Don’t be afraid to ask for help!

• Six to eight hours after your surgery (typically), your catheter will be removed and you will be encouraged to get out of bed and move around. Don’t do this unless the nurse is with you! Here is a step-by-step guide to getting out of bed:
• No matter what- GO SLOW! Make each movement deliberate and slow and in steps.
• First, get yourself over as far to the side of the bed as possible. This can be done while laying flat or with the head of the hospital bed elevated.
• When moving in bed (as in above movement) place your feet flat on the bed, knees flexed, and lift your hips/midsection with the strength of your legs. Use the arm rails to help move your upper body.
• Once over at the side of the bed get into a sitting position, as high as you are comfortable.
• Next, start to turn your entire body as a whole to face the direction you are headed. Use the arm rail as support.
• Swing your legs down towards the floor while using the arm rail to lift your upper body straight up.
• Now, get yourself in a proper sitting position, feet flat on the floor. Keep your head up. Now just sit there. Get your bearings.
• Once you feel stable, its time to stand! You may want to scoot yourself further to the edge of the bed to get a better footing.
• To stand, pretend you are doing a reverse squat- in other words- use your legs! Stand up straight using your legs, trying not to bend at the waist.
• Do not hunch once you are standing. Stand tall!
• Just stand for several minutes, again, getting your bearings.
• When walking, keep your head forward, not focused on the floor- this can be dizzying.
• When sitting, do another squat- use your legs!
• Some like an abdominal binder or support pillow to hug across the belly.
• You may require intravenous fluids for a day or two until you're able to start eating and drinking. You may be given a stool softener in the hours/days after delivery, to make your first bowel moments less uncomfortable. Typically they let you eat once you’ve passed gas, although some hospitals allow you to eat right away. Gas build up can be very uncomfortable, so you can try (once the epidural has worn off) bending both knees up (so they are in a triangle shape), then one at a time, slowly extend a leg straight and then bend it up again. This not only helps move gas around, but reduces your risk of a blood clot. Breathe deeply as you go.

• Your early bowel movements can be unnerving. Your internal organs all got jostled around in the surgery, and so it is not uncommon to feel as though your intestines are going to come spilling out if you ‘push’. You can try setting your feet on a small stool while you are on the toilet, as this is a more optimal position for elimination. Take your time - - this too shall pass!

• Your doctor will probably prescribe an analgesic to help you cope with the discomfort and pain that typically accompany a cesarean recovery. If you are concerned about the effects of pain relievers on breastfeeding, speak to your postpartum nurse or a lactation consultant.

• You will be discharged from hospital three to five days after your surgery, and assuming all goes well, you will typically be able to resume your normal activities four to six weeks after your baby's birth (after your 6-week checkup).

• Breathe deep. Take your time. Ask for help. Rest whenever possible. Surround yourself with people who believe in you and support you as a mother. Call your healthcare provider if anything along the way, including after you get home, doesn’t feel right.

Source Material:
“The Post Pregnancy Handbook” 2003 ed. Sylvia Brown & Mary Dowd Struck
“The Essential C-Section Guide” 2004 ed. Maureen Connolly & Dana Sullivan
“Gentle Birth, Gentle Mothering” 2008 ed. Dr. Sarah J. Buckley
Birthingfromwithin.com 2009
Rebirthnurse.blogspot.com 2009
SOGC.org 2009
Webmd.com 2009
Who.int 2009

The Language of Worship

2009-08-15T08:31:00.003-04:00

My parents have to move again - probably in September or October. Not fun. On Friday I needed some time to step away from everything and be distracted for a while. A grande espresso chocolate truffle latte and a few hours in Chapters was just the distraction I needed. And I put some pieces of my life together that I hadn't realized had fallen apart.

I purchased Frederick LeBoyer's new book "The Art of Giving Breath with Chanting, Breath & Movement". One of my favorite lines from the opening pages is: "You must realize that a birth is like an explosion of joy. Life surges up in you, so strong that it breaks all limits, all barriers. It is like a river rising so high that it engulfs and sweeps away everything in its path. What is it that “floods” over everything at a birth? It is life! It is love! And yes, it is joy! And all this has so much strength that it can frighten and overwhelm you." As I listened to the CD, and breathed/sang the tones, I could feel my heart rate slowing, my breath deepening, a calm settling. I figured that was a good sign as to its usefulness for labouring women. Next I popped in "devotion" by Steve Bell. As I listened to him sing, I realized two things:

The first, was that Steve Bell pronounces his words in a very similiar way to how the tones on LeBoyer's CD are pronounced, and thus has a very similiar calming effect on the body. Sound is movement - air molecules vibrate and bounce off our eardrums. Then our brains translate that movement into something we 'hear' - into a 'sound'. But those vibrating air molecules don't just move against our eardrums, they move against everything they come into contact with along the way - our bodies and the world around us - and can have an impact on us and the world in more subtle ways too. (just think of being at a really loud concert where you can feel the music pounding against your chest, or making your guts rumble for example). Certain sounds vibrate in such a way, that they have a calming effect on our bodies. The tones of LeBoyer's CD, and Steve Bell's music, are those kind of calming sounds.

The second, was that music/song, is the language of my faith. For years I have heard people like Michael Frost express the idea that most of the Christian music on the market today is more like a love song than a worship or faith song. I disagreed. I felt that the songs I was singing accurately expressed how I felt about my relationship to God. And then I got married. I suddenly realized that if I substituted N's name at every mention of God/Jesus/Holy Spirit, the song would still make sense. In fact, it felt like it made more sense. And without realizing it until yesterday, my connection to my faith - to God, has been slowly erroding because I haven't had a language of music to connect with. Steve Bell's music is a language I can speak; that I can connect with. But I need more. So I'm on a search for music which expresses my relationship with God - not with my husband. Any suggestions?

Back in the swing of things

2009-08-13T11:59:00.002-04:00

I think maybe the craziness that has been this summer is slowly easing into a gentler and more acceptable pace for August. One can hope.

N & I finally have decent internet at home. Woo Hoo!!!! I've added exercise at the local Y to my daily routine, and now I can add online/doula/blog time too. We're building a deck on our house. It is low to the ground (no need for a railing or step even) and will be a vast improvement over the small concrete step I was always teetering on the edge of, as I carried my stuff in and out of the house for various meetings, jobs, and so on.

I have a few birth-y posts stewing in my mind. Something called "Breastfeeding Sucks!.... and that's ok" and something about the pros and cons of being interviewed in a clients' home and an essential baby stuff list which is peppered with green living info and a cesarean birth guide sheet.

They'll be posted here soon!

The Scoop

2009-07-02T12:52:00.002-04:00

So here's the deal - N & I had a great time on vacation last week, visiting family in New England and making a couple quick stops in New Brunswick. We capped off our vacation by unexpectedly helping my parents move. Their move was expected. Our late-night involvement in the move was not. Monday was a very long and intense, but fruitful, staff meeting at non-profit job, and that night was a family birthday party. Tuesday, I found out that the unborn child of a client has a fatal defect. I locked my keys in the car because I was so distracted by this. Once I got in my car again (thanks to my MIL) I was off to help N's family get packed up, as they are heading to West Africa for a month, tomorrow. Tuesday night, just as we were getting ready for bed, I got a call saying the alarm system had gone off at my non-profit workplace so I had to go in and deal with that. We got there (on an 'empty' tank of guess no less!) only to find out it was a false alarm, and they just didn't bother to call me back and tell me (which is a pain, because it meant 30 minutes of driving each way). I found out by email on Wednesday am, that later Tuesday evening, a young adult jumped off the roof of the building and is in critical care. He was not connected to the non-profit, just liked the look of our building I guess??

Wednesday - phew - was a lovely reprieve, as we took in the Canada Day festivities in our small town.

Today was a busy day at work, as I tried to juggle the various groups who use our hall, to make room for a group who really wants to use the hall, and who we really want to partner with. There is a pile of errands that MUST be completed today (things like renewing the plates on my car and putting my paycheque in the bank), then tonight we are supposed to be at N's parents house, to get the rundown on things before they leave (I'm supposed to be the contact person for emergencies, we're taking the family dog to live with us for a month, and we're the back-up help for the people looking after their house). At the same time, we are supposed to be helping my parents move a 12ft x 4ft solid oak table out of their old house and into their new house.

Okay, I've vented sufficiently, and a thunderstorm is rolling in, so I have to go.
Thanks.

How to feel

2009-06-18T09:38:00.009-04:00

I learned recently that a client has decided not to have a doula (ie me) for their birth after all. I absolutely respect their decision and why they made it, but can't help feeling a bit disappointed on a personal level. As doulas we're allowed to have a personal level right? Because of course, professionally, it's all about balanced education, and informed choice, and non-judgmental support... and I kind of feel like I shouldn't be disappointed. The insecure piece of me though, says they don't want me because I failed to be all that I should have been. Which I know is a misguided and selfish pov... I know their decision wasn't about me. It was about what was best for them. And that's the way it should be. So a piece of me is also glad for them - that they are learning and growing and making the choices that are right for them as they journey through this pregnancy.

There is still plenty of time for another client to fill in that space, or for me to have a space in which to enjoy the rest of life. Okay. It's all good.