Archive for June, 2007

So I have my first doula client!

I’m not going to go into any details here as I want to abide to HIPAA code, but I have my first client! She’s a single mom in her early 20’s, due the end of July. She’s a multipara. Her birth partner will be a close friend. She also has a community of women who are really willing to adopt her and go over and above to help her with her needs - and it looks like she’s reached out on her own for help in the community where she can find it which is great. She’s knowledgeable about labor and wants the flexibility and control during the birth to figure out the best path for her - which meshes with my own philosophies very well. Both her and her friend are smart, funny and just a joy to be around. I think the birth will be great fun.

I leave tomorrow for my labor support training in Seattle. It will be amazing to meet a bunch of other women who can talk pregnancy and birth. Hubby is getting tired of being my only ears for this stuff.  :)  Already via email there has been quite a bit of interest in the other classmates for meeting up for dinners, sharing hotel rooms, carpooling - it sounds like this group of women may just end up being the beginnings of a great birth community, in addition to building on my own knowledge and skill level. I’m bringing my laptop so hopefully I’ll report on the road!

Support the Matthew Shepard act

One in six hate crimes are motivated by the victim’s sexual orientation. Yet Federal laws don’t protect these people. Watch the video. Then tell your Senators to support the Matthew Shepard Act.

Currently email support opposing the bill is 5 to every 1 email supporting it.

My pregnancy and birth book reading list

Two commenters - Agatha - asked for my birth reading list and on my blog,that makes it “popular demand”. I better post it before the masses beat down my door. So here is the list of books I have read and a review of each. Like I said in my earlier post, these books tend to lean toward more natural/less intervention heavy birth philosophies, some more than others. I really think overall that they give better information than traditional birth and pregnancy books.

Back when I was pregnant, I had all the regular books about pregnancy and childbirth that are recommended from doctors and friends. I did get some comfort from these books when I had a question, but I also found myself wanting more information than what they would give me. I felt like I was in a doctor’s office - the books flip-flopped between talking down to me (”oh, you are fine, Mom…” without giving me any real information) to being alarmist (”seek medical attention immediately” for a million different normal and benign symptoms without giving me an understanding of why) and what I really wanted was information about what was happening, why, what the risk factors were, and actual evidence-based advice (with the evidence given). I felt a bit manipulated at times, like the authors were more interested in protecting themselves from a lawsuit than providing the best care for me. (Sound familiar?) The best birth books neither belittle me or act as a scaremonger.

The Birth Partner: Everything you Need to Know to Help a Woman Through Childbirth by Simkin
I start with this book because it is my favorite and is literally jam-packed with information to help a doula or another birth partner such as a father, partner, mother or friend help a woman through labor. In the book is detailed, instructive information on everything from what to do before labor begins (exercises, visualization) to comfort measures (massage, positions) to how to give support in unique situations (cesarean, emergency home delivery). I can’t imagine learning how to be a doula without this book from the founder of DONA and Seattle Midwifery herself. I wish OBs and L&D nurses all read this book as well as part of their training. I think you know how highly I respect and admire Miss Penny. I love that she makes no value judgments in the book (doctor vs. midwife, hospital vs. homebirth or epidural vs. natural birth), but just gives information on both sides and lets the reader come to their own conclusions and make the decision that is right for them. The way she frames her language is a great role model for me when I begin serving women.  (And I will be meeting her in a week from today!  Pinch me!)

Baby Catcher: Chronicles of a Modern Midwife by Vincent
This book isn’t a textbook or a “how to” book at all - it is an autobiography. Yet I have learned so much from Peggy Vincent’s story. She starts her tale as a young, inexperienced labor and delivery nurse in the early days when women were strapped down and often put under during delivery no matter if they consented or not. Then she tells how she evolved into a doula-type nurse encouraging movement in labor, started an alternative birth center within the hospital she worked, and eventually as a midwife practicing on her own. Her life is filled with both heartache and pure joy and empowerment, with much more focus on the latter. I feel empowered by her words perhaps more than any other. She is absolutely another role model of mine. You will not be able to put this one down.  (When will this book become a movie already????)

The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier and Healthier Birth by Klaus, Kennell and Klaus
This book is written in a way that it speaks to many audiences: current and future doulas, prospective doula clients, and perhaps most importantly, doctors and nurses who may not understand what a doula is or why they are important. It is jam-packed with statistics that prove the usefulness of a doula and how they improve birth and postpartum outcomes for both mother and baby. I didn’t expect a lot of how-to information from this book but was surprised to find it filled with ideas and techniques that will be very useful to me in practice. Occasionally I found the book to jump around a bit and go on tangents but nonetheless is a very valuable resource, especially for collecting information that can explain to resistant parties what it is that I am about to do as a doula and why my work is valuable.

Pregnancy, Childbirth and the Newborn: The Complete Guide by Simkin, Whalley and Keppler
This book is a great alternative to “What to Expect” and is written by Penny Simkin so right away you know it is good, balanced and informative. Its information is holistic and occasionally challenges some of the more traditional information an OB might give without being aggressive. A mother should be set for life before, during and after birth with this resource at her fingertips. (I’m in the middle of re-reading this one now…)

Ina May’s Guide to Childbirth by Ina May Gaskin
What can I say about Ina May. She’s a living legend and either you love her or you hate her. (I love her.)  Sure, she lives on a hippie commune and has dislike for modern obstetrical practices that she does not hold back from sharing in sometimes an aggressive and condescending way (although it doesn’t make her wrong, does it?). Occasionally I read her book and see that she has anecdotal evidence but hasn’t cited medical research that a doctor might listen to which makes me want to seek out more information. It would be easy to dismiss her except for one key point. You cannot argue with her incredible birth statistics. I believe that many of her methods need further research, but truly I feel that long after we are all gone many of her ideas will become standard practice. She’s ahead of her time, that woman. In any case, her perspective is fresh, inspiring and intuitive (Oh, you mean that pre-eclampsia might actually be natural to some extent and preventable with a healthy diet to the rest? Perfect sense, right?) and I love looking at pregnancy and birth from this other perspective.  I’ll probably feed many of her ideas (in a more balanced way) to my clients.

The Ultimate Breastfeeding Book of Answers by Newman and Pitman
Why didn’t I have this book while I was breastfeeding? Perhaps I wouldn’t have had to stop at 9 months due to diminished supply and dangerous weight loss in both my kids. For sure I wouldn’t have spent that first month with Connor exclusively pumping because we would have caught that restricted frenulum earlier. And I absolutely would not have let the lactation consultant shove a bottle down his throat so quickly that put us on the road to nipple confusion hell. Somewhat like Ina May, Dr. Newman has a lot of strong feelings towards formula companies, doctors and the healthcare profession in general which he shares eagerly (and often rightly so). But his book is packed with techniques that will help moms (and doctors) understand breastfeeding with all the most recent studies cited. This book makes me want to rush out and certify become a lactation consultant even while I am certifying to become a doula.  And to start a local breastmilk bank.  And to….

I’ll post reviews of other books as I read them - there are so many great ones out there that I am eager to get my hands on….

Bad times and good friends

Yesterday was a bad day.  Not only did I find out that Rich would need to be taking extra responsibilities at work but I injured myself badly in the most asinine way possible.  I hurt my rib coughing when I felt and heard a “pop”.  My guess, after googling and being an annoyingly misinformed patient I’m sure, is that I have “slipped rib syndrome”.  It hurts like @#!$!#@! like it must be broken, but it is not and I am basically laid up on the couch on ibuprofin for a few days.  The fact that it is not broken was verified from my OB friend who made a house call on his way to work (I realize that my rib is quite a ways away from my vagina, but he’s much more qualified than I am, no?).  Thanks so very much Dr. M, and sorry I wasn’t able to express my sincere thanks while I was standing close to tears in my own living room with your hand up my shirt.

Speaking of friends who go over and above to take care of me when I am down, I am also so grateful for the friends who, when I called to cancel playgroup at my house that afternoon, took Connor off my hands for most of the day.  They also called to check up on me today and are taking him to swim class this morning.   So Annette, Tia and Lisa - thank you so much.  Let’s try for playgroup again soon.

“Evidence-based care”

I think that it is no secret that I tend to lean toward the more natural side of birth when it comes to interventions (although I strongly believe that a woman should be given all the information then make up her own mind).  I’m in the middle of reading book upon book for my doula certification - many of which I have read before and several new to me.  These books - hand-picked by DONA and Seattle Midwifery School are wonderful and I wish they were more the norm of what pregnant women educated themselves with instead of “What to Expect” et. al.

However.  I must wonder, in the middle of my holier-than-thou complex, what student OBs and L&D nurses read?  Aren’t their text equally as compelling and surely laced with studies and anecdotal evidence that “prove” the need for our current, high cesarean rate and all of our interventions?  (Or is it that OBs are just so busy they don’t have the time to read the latest study that disproves what they where originally taught in medical school?  Or maybe it is more about the fear of a lawsuit that could take them out of business so they do what the courts would see as the safest way to proceed - to do something - instead of do what we as natural birth advocates are taught is safer - to do less?)

Whatever the case, I don’t want to be so concieted as to think that what I am being taught is the be-all and end-all of “evidence-based care”.  There must be evidence on the other side or doctors wouldn’t be going down that path. I don’t think OBs are evil - in fact I am sure that they have the best interests of their patients in mind but they are being taught from an entirely different angle.  Why is this?  Is one side more “right” than the other?  I couldn’t say since I haven’t been equally balanced myself.

I need to get my hands on a copy of  Williams Obstetrics.

Better yet, I’d love to see a book written that compares each school of thought without any prior prejudices - or at least balanced prejudices.  Perhaps co-authored by a midwife and an OB?  To my knowledge there are no books like this on the market.

What the World Eats (in Richland)

As promised, I have a photo of our groceries for this week. Sorry about the quality of the picture - Rich hastily took the snapshot from outside our kitchen window in between helping me arrange groceries on the dining room table and keeping the kiddies from crawling all over them and we didn’t have time to arrange for better lighting. Because of the obvious logistics of getting a photo with the entire family without a professional photographer (and a bigger kitchen/dining room), I hadn’t planned on being in the picture at all - but Rich insisted. So there in the shadows behind the pre-grilled chicken for atop our salads (a new thing we are trying this week), there I am. Ignore the layer of sweat glistening on my face. It’s due in part to the mad rush of arranging groceries with only a small window of available time between a kid meltdown and another part that I am dressed for winter on a 85 degree day. (Grocery stores are cold!)

Yes, we really do eat this healthy. Although I admit that this is on the healthier side of our food parabola, it still represents a fairly “normal” week for us. We are hanging to the healthier side of normal these days because swimsuit season is hanging upon us, as are ten or so extra pounds from our sedentary winter. Even still, I see things that are there to poke fun at. Yes, as an American family we really do eat Macaroni & Cheese and Skippy peanut butter.

Another thing that should be said is that these are our groceries but not necessarily the be-all and end-all of what we will eat this week. We usually go out to eat about twice in a given week - once for lunch and once for dinner - and almost always the dreaded Red Robin both times. Connor has to have his macaroni and cheese and chocolate milk, you know. In fact, when he found out that there wasn’t a Red Robin where we were going to be moving to in England, he lost his optimism about the change. Also - there are probably a few things left over from last week in the refrigerator, pantry and freezer that we will be using this week. No - that doesn’t include any Oreos or ice cream. Dammit. And no, we will not be consuming that entire container of salt in seven days’ time.

Anyone want to join me in revealing your groceries naked for all to see? I’ll link to you here!

Food around the world

what typical families around the world eat in a normal week.  It’s quite interesting.  What family’s groceries do your grocery bags most resemble?

I think when I go grocery shopping next, I’ll take a photo of our groceries spread out similarly for all of you to see.  If anyone cares to join me, let me know and I will link back to you here.

Moveon.org has multiple personality disorder

If you have read me for a while, you know I’m a loyal MoveOn.org minion.  I’ve been an active-ish member for quite some time now even though they bombard me with emails about once a day.  I actually read said emails.  And I act on them - emailing my congressmen and even adding a thoughtful paragraph or two to their suggested form letter.

Despite the smam-ish nature of their organization, I still have always loved them.  I felt There was a common passion there for most of my hot-button issues.  And their grass-roots feel was charming to me - it’s like my email box is just one of many neighborhood stoops dotted across the Internet.  We’re much more powerful when we work together.

But something happened a few weeks ago that annoyed me, and has been poking at my frontal lobe ever since.  MoveOn supported a bill that I thought was incredibly backward.  That in itself isn’t a “case closed” for me — I don’t expect that any organization will align themselves exactly in my socially-liberal economically-classic global-economy schizophrenically-political sort of way.  The part that bothered me is that I have no real way to tell them that I don’t back it or why.

In late May (yes I’m incredibly late with this - my blogging has been nothing short of lethargic lately) I got an email from Ilyse Hogue, Moveon Campaign Director, asking me to support a bill supporting banning “gas price gouging”.  Moveon claims that by the end of the summer, gas prices will hit $4.00 by the end of the summer.  I should sign their petition because “gasoline price gouging should be made a federal crime before the summer price increases hurt more American families”.  Gas price gougers could be sent to prison for up to 10 years.

HR 1242 has now passed the house.  Of course it is a popular bill - any bill that makes our pocketbooks a little heavier is bound to be.  But the bill is so poorly written that any large increase in fuel could be seen as “gouging”.  Aren’t their real reasons for an increase?  And so what if fuel prices go up to $4.00 a gallon?  Maybe then our free market system - the system we are so proud of - will do its job.  When prices go up, demand goes down.  This is Econ 101, people.  In simple terms, Americans may finally get it - that driving less, using mass transit, and trading in their SUVs for more fuel-efficient models will actually benefit them.  Price increases in gas may be the only way for us to become less foreign-oil dependent and more greenhouse gas conscious.  You’ve got to hit capitalists where they will stand up and take notice.

When I attempt to click on “faq” or “contact” so I can tell them why I think this bill is a bad idea this page.  Obviously this is not an organization interested in my opinion.  They only want to use me when it suits them to add another faceless tally mark next to their cause du jour.

Still, I won’t be clicking “unsubscribe” quite yet.  Although I still feel as used and discarded as a condom in an Amsterdam back alley, I use them right back.  Moveon.org is an easy way for me to be alerted when certain bills or political action occur, and they give me an easy way for my voice to be heard.  On my own, I’m just a “concerned housewife from SE Washington State”.  Not a big mover and shaker.

However, I try and make sure I don’t blindly hit that pretty red “sign the petition!” button each and every time it crosses my laptop.  I do some research.  I listen to both sides.  Then I think for myself.

I strongly believe I’m not the only one who puts their own minds, hearts and consciences before those of a political party.  If that’s the definition of a political independent, maybe we should all classify ourselves that way.

We’re Baaaackkkk…

At the climax of our trail through Oregon, we found ourselves snowed in with a stomach-flu toddler at a lake we could not see through the blizzard, let alone drive around due to a closed road.   In June.  June, I say!  Did no one tell Crater Lake that it is summer?  But never fear, much fun was still had!

I want to move to Bend.  Ashland and Eugene would do as well.

Also, hangovers should not hurt on vacation.


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