essentialmidwifery

Birthy Thoughts by Jane E. Drichta and Jodilyn Owen

Mulberry Bush Economics August 21, 2014

Filed under: Birthy Thoughts,Jodilyn — EssentialMidwiferyCare.com @ 12:56 am

After a year and a half in private practice, working with families from all walks of life, I recently surprised myself with an observation I made. I am stunned nearly on the daily by the observations of the families I work with. “This is pain without sorrow, I will be fine”…pronounced about 4 minutes prior to crowning by a first-time mom. “I am made a mother in the most unexpected and welcome ways” confided a mom who had adopted after years of trying to conceive, only to find herself pregnant 3 weeks after the adoption was finalized. Well on and on it goes, I could quote my clients until I’m the old granny midwife I recently promised a young girl I would be so that I could be with her when she has her babies…but my realization came when focused on the one part of the Out of Hospital Birthing World rarely discussed: The Money.

We are paid the smallest percentage per office visit and birth relative to hospital-based care imaginable. Even if the insurance companies paid us what we bill, we would still be saving them millions per year for the care of low-risk women and babies. But they don’t—they pinch, they squeeze, they delay, they deny, deny again, fight, lose papers, call with demands, don’t answer call-backs unless you manage to navigate dozens of voice prompts while the moon is aligned just-so (and when the moon is aligned just-so I don’t have time to be on the phone pushing buttons, I’m watching women become mothers!) I’ve filled out credentialing forms three times for more than two companies. They still can’t find them. I completed paper work for one company in May of 2013 and was approved as a provider in June of 2014 (woot, woot!). And yes, I pay a biller who has been trying to tag-team these people with me in the name of access to healthcare for women who want it when they want it where they want it and how they want it. Which I fully support! In fact, this idea of “access to care” has been termed a basic right by the big politicos.

Of course women have recognized that birthing is steeped in human rights issues, the story of feminism in our country, and right to self determination for centuries. I love the women called Shifra and Puah in the bible, not just because they were midwives, but because they exhibit one of the earliest acts of women engaging in civil disobedience in the name of doing what is right, in the name of preservation of life.
Not only do I wake up every day happy to go to work and to do what I do, I seem to keep paying the lease to the clinic on time. In the beginning I had some help from family to get me going—but now I’ve paid them back and keep writing checks every month to pay the rent. I can still hear my grandmother singing to my son while she bounced him on her knee, “All around the mulberry bush, the monkey chased the weasel. The monkey thought ‘twas all in fun, POP! Goes the weasel. A penny for a spool of thread, a penny for a needle. That’s the way the money goes, POP! Goes the weasel” Of course I had enjoyed that song when I was little, but it was only hearing her sing it then to my son, at a time when money was stretched tight in our family, that I began to understand the lyrics. And again over the past months I’ve felt we’ve had a little of what I’ll dub “Mulberry Bush Economics” at play in our practice. And while I thought I was alone, running like a mad-woman round and round, turns out I am not so alone after all and I’m not chasing anything.

The women who come into our care have always been offered the option of payment plans to cover the large deductibles, lack of insurance, or non-covered services. A high percentage of families choose this option. We simply have them fill out a piece of paper to let us know when they plan to make payments and ask them to let us know if that plan changes at all. Seeing so many small checks instead of a few big ones made me wonder, how on earth do I keep paying the lease? And that’s where I made this most amazing observation. Women have their babies. They start making payments when it works for their family, often times stretching quite a ways out into their first year. And that means that each mother is supporting other mothers as they gestate and birth. And then those mothers support the next group that comes along. And now we’ve got a thriving economic system which keeps the doors open and provides opportunities for women to access care who would not be able to afford it otherwise. It is a dizzying wonderful marvel.

In my practice I realized very quickly that the healthcare system is ineffective and uninterested in promoting optimal health for all women and families. It is short-sighted and lacks motivation to invest in the health of communities. It is layered and designed to funnel money to companies who work really hard to take money from families and keep money from providers and the institutions trying to serve them. Instead of waiting around for permission to participate in the usual way, we built ourselves a little boardwalk straight across the swamp and invited other providers and community service organizations to join us.
And just like that women who had no prenatal care had slow-paced individualized care with births in the location of their choice. It’s not perfect, there are places we have to jump over broken planks and times we don’t quite reach the women on the other side in the way I hoped we would. But I am delighted with it. I look forward to expanding it. And I am thrilled that the economics have followed the practice and we all get to dance around the mulberry bush, though no longer chasing that illusive monkey. We simply join hands and celebrate the results of creating community through this deeply spiritual, visceral, and financially remarkable system of ours.

 

A note from the evolving community midwife…(jodilyn) November 27, 2013

Filed under: Jodilyn — EssentialMidwiferyCare.com @ 9:18 pm

Six months into this new space and it’s been quite an experience.  This post is a personal update from chilly though sunny Seattle:

The process of opening my own practice with a store front that people drive and walk past has meant that the door to the building is in constant motion, with all sorts of people coming through.  We have the well documented occurrence of middle age men sliding through the door toe-first, “I just wanted to see what is happening in here because when my daughter was born, her birth was…” We have families thinking about conceiving, trying to conceive, just peed on a stick, and well into pregnancy seeking a different model of care that is convenient and family friendly.  There are the bouncy 8-10 year olds who come for Girl Sense, and the salesmen who stop by to use the bathroom between calls.  We have grandparents who come in for a drink of water on their walk, and they always mention the hope of glimpsing some babies. We had the middle schoolers packing the building and spilling out into the parking lot who came to get to know a safe-spot in their neighborhood. And of course the mamas, expecting and new, the babies, the families, and the providers who work or have meetings here.  It’s a zig-zag, criss-cross, busy-busy tiny little building.

We have also had a run of mothers who are seeking prenatal care for the first time when they are quite a ways into their pregnancy.  Some have grown up in a health care system that denies their right to informed, respectful, and culturally humble care and they have a lot of anxiety about walking through those doors again (There’s a future post when I figure out how to articulate what I’ve seen this year).  Some have been told that they have no options other than a direct road to the OR for the birth of their babies.  Some didn’t realize that they could access care in Seattle if they don’t have insurance or cash. Some mothers are working one long job or two or more jobs and can’t get to the OB during business hours. I have been fortunate to have the door to my office swing open and to be able to receive mothers where they are at.  To meet them in their time and space and to provide them a sense of possibility and very real options for care.  We’ve had the absolute blessing of a gathering of like-minded providers who can pace themselves in time with mothers and babies.  They provide donation-based services, for free, or on a sliding scale so that barriers to holistic health care get a little bit easier to cope with.

My dear friend who is a midwife from another country talks about women walking to the hospital from remote villages, and the other providers chastising her for not making them shower and clean up before she provided care.  She gifted me the most poignant example of the strength of midwifery and community based care when she said, “why would I tell them to change themselves for me”?  I have taken her lesson to heart, to stay open to the people who present themselves at the door, who are kind enough to come in and trust me to be with them as they find their way.  I have been taught the kind of earthy lessons that only come from moments like these.  I have been humbled, and raised, and smacked down, and distraught, and comforted, and I’ve been able to love really, really hard.  And contrary to common sense, it doesn’t wear me down at all.  It is fulfilling and challenging.  It can be tiring but the kind of tired that comes from hard work. I do take a few hours here and there to read or walk in the woods or sit with friends and scheme about the future. I’m still in a relationship with a certain heavy-bag (thanks Arcaro Boxing Gym) and that morning workout allows me to prepare for each day and get out the frustrations.  I get to stay connected with my family. This year has not been all-fun and goodness, it’s had a bit of plain awful, and a share of colossal heart breaks (is there any other kind?) and it’s been loaded with some pretty big whoppers in the mistakes category. And I am lucky I get to try to repair the mistakes, heal the fissures, and grow as a human.  But all-in-all pretty good stuff and the happy finding that midwifery has not become clinical for me but remains relational and holistic and a means to bring babies to healthy mothers and fathers who are ready to meet them where they are at and receive them in love.

Wishing you all a healthy, joyful, meaningful holiday season and new year, and looking forward to seeing who comes through the door in the next six months.

 

“A person is a person because he recognizes others as persons.” October 17, 2013

Filed under: Jane,Uganda — EssentialMidwiferyCare.com @ 7:40 pm
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The above quote comes from a personal hero of mine, Anglican Archbishop Emeritus of South Africa and Nobel Peace Prize Laureate Desmond Tutu.  I love that guy. Completely badass.

First days here pass in a blur. Between the jet lag, the (absolutely required for me) ambien use, and the time difference, we are all walking around like cotton wool encased zombies.  The group is starting to get to know each other; living in such tight quarters breaks down barriers quickly, and it is always interesting to observe the ins and outs of interpersonal relationships.  the group is much smaller this year, but I feel it is more intense. The three American participants are not only experienced doulas, but two of them are student midwives, and the other is working towards going to nursing school.

I redid the entire curriculum this year, as last year my role was more supervisory.  The majority of the teaching was done by my colleagues, Kristina Kruzan and Melinda Ferguson. This was awesome for the first year, as it enabled me to watch what worked and what didn’t, see how the Ugandan cultural activities resonated and generally keep an eye on the big picture .  This year I don’t feel like that is quite so necessary, so I can focus more on the actual workshop content.  The curriculum this year was designed to cross the streams a little bit, exploring some deep advanced topics from both the doula and midwifery perspective. I think it turned out really well, and I am very excited to teach it.

All the participants are on such personal journeys of their own.  It is amazing to see how deeply they are connecting with each other this early in the trip. I am hearing very intense stories being told: histories and struggles, hopes and dreams, deeply private experiences…all are coming out so quickly and easily as we walk these red dirt roads together. I find myself caring so deeply for these women. They are open and present and eager for the lessons Africa will teach them.

So the cast of characters:

Marquita is an amazingly intelligent young woman, who is having the singular experience of being an African American in Africa. She has a unique road to walk, as she searches to integrate her southern upbringing, her work with marginalized communities in Seattle, and the huge overwhelming ness that is Uganda.  She is a bright light in the Seattle birth community, and I hope I can be a solid support to her as her heart opens even more here.

Kathryn is a pre nursing student with the eventual goal of becoming a CNM.  She has wanted to come to Africa for a long time, and is very friendly and eager to make connections.  She is the first to ask someone’s name, to ask questions, and to draw a smile from someone.  She is embracing the Ugandan way of connecting, never failing to ask after someone’s family or spend a few extra minutes in conversation.

Finally we have Jolene joining us.  I feel I know her the best, having attended two of her six births over the years.  She is also hosting two Korean boys this year, bringing the number of children in her household to eight. The Ugandans love this, as many of them have large families themselves.  She has brought a photo book of her family to share, and it is a big hit.  She is a lovely soul, sweet and generous, with a lot of sauciness to spice things up.

One of the most interesting things about returning year after year is the fact that the project coordinators change every year, as do the development volunteers.  It is so fun to see how the different personalities shape the energy of Shanti, making it truly a different experience every time.  I will introduce them tomorrow as it is getting late here and I am barely able to keep my eyes open. It seems like jet lag gets harder a I get older. It has been a long day changing money, riding bodas and being embraced and welcomed back by the staff.

Sister Mary, the head midwife at Shanti, a delightful person in all ways, took us on a tour of the center, which was awesome, as always.  Then Kato, the groundkeeper took us on a garden and village tour, pointing out the many useful plants that Shanti cultivates and that grow wild.  Kato’s heart is broken right now, having recently lost his 8 year old son to leukemia, but his smile was as bright as ever.  I shared a little about my own experiences with loss and cancer…not sure if it helped or not, but sometimes it helps people feel not so alone in grief.  The loss of a child is the same the world over, unfortunately.

We covered some pretty basic stuff today, like the history of the doula profession, focusing on Penny Simkin’s work, naturally, but also my friend Dr. Christine Morton’s work on the sociological impact of doula care.  I urge you to check out Christine’s work.  Her dissertation, Doula Care: The (Re)-Emergence of Woman-Supported Childbirth in the United States, was the first scientific exploration of doulas and their role in modern childbirth.  Her website is www.christinemorton.com, and she has a new book out soon.  The information seemed to go over well with the group, and everyone got into a feminist tizzy about why women birth professionals, including nurses and ob-gyns, do not have their experiences documented, either formally or informally.  Fascinating stuff.

Back at the Guest House we had a relaxing evening, trying to make ourselves sleep when our bodies thought it was 9 am, but somehow we managed.

And in case you are keeping score at home, still no sign of our lost luggage.

 

There and There Again: A Midwife’s Tale- Jane October 12, 2013

Filed under: Birthy Thoughts,Jane,Uganda — EssentialMidwiferyCare.com @ 7:06 pm
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It is highly unlikely that anyone has ever actually died from happiness. I have taken anatomy and physiology four times over the course of this wandering life of mine, and it is completely uncommon for the limbic system to simply explode, leaving a patina of oxytocin dripping down one’s face. Uncommon , but not absolutely theoretically impossible, so I am leaving it open.

Before I left, Always Longsuffering Pat (hereafter to be known as ALP) Asked me if I were excited. No, not excited, with its adrenaline tinged barely concealed hysteria. Not excited, simply happy.  Happy to see my friends, happy to go back to a place where, against any odds one can measure, I fell utterly and completely at home.

And now I am here, at whatever 8:30am means after crossing so many time and space barriers. And now at 8:30, I notice my happiness is tinged with joy. Joy and I are not well acquainted. We nodded at each other as we passed in the  corridor in school,   and she moved in for a bit when holding a newborn was a possibility, but we are not usually on a first name basis.

Except here, in a country most people cannot find on a map, now would they care to. We took the long/short way here.  Long in frustration in that our first flight was cancelled, and we lost two pieces of luggage filled with medical supplies. But short in the way that bonding and laughter makes the time fly, and anticipation makes the breath be short.

Arriving in Entebbe airport and dealing with the lost luggage took the better part of two hours as we are passed from clerk to clerk.  Finally it became obvious nothing else could be done that night and we went outside to meet out pick up.

Midnight in Uganda is the most midnight place ever, dark as dark, the Milky Way clearly visible, leading us somewhere just over the horizon. And waiting just outside was Ben, our driver and my friend. Hugs and greetings were exchanged and I may or may not have flipped a surreptitious tear to the red dirt below my feet.

Ben looked great, as did the new Project Coordinator, Salam, and one of the volunteers, Cara, an Australian who shares my hatred of birds. Clearly a woman of discriminating and refined taste.

After the usual journey of hours over pot hole invested roads, we arrived at out guest house in Kasana. It is a new one from last year, very conveniently located. The proprietor also owns the volunteer house we use at Shanti, so this is keeping it in the family. It is very comfortable and even has solar power, so we may end up with more power than I am used to there. May. Anything can happen. The linens here are so clean, and all monogrammed. Adrine has done a wonderful job. She is a business women with whom to be reckoned. If you remember our adventures with the electric showers last year…let’s just say we seem safe so far. And even hot water mostly. I am so happy. Adrine has done a beautiful job.

Like most women everywhere, Adrine was in constant motion. Women always move, right? When laboring, our hips sway, our bodies shake. Even if confined to bed, our feet will jiggle, our fists will clench. Unseen’ our cervixes will slowly open (and sometimes quickly close; remember to read beyond textbooks.) our hearts beat faster, we blink, our mouths open and close.

Just as artists swish paint brushes over canvases,women move through life in a state of creation. Creation is movement. As much as we would like, babies do not just fall out even the fastest twenty minute labor , while over quickly, brings a lot of physics and a lot of feelings to the table. And even the slowest 4 day, ctx q 10 until pushing, which then takes another three hours as that baby inchworms her way down…it too brings it’s own dance, it’s own perfect movement.

When babies become children, a woman’s movement increases. Running late, stopping by the store on the way to school, running in to drop off the lunch that was truly meant to be handmade, but is now covered in plastic wrap and branded with etching we hide under our coats, rushing to work or the doctor, or to the gym where before we move we have to pick our feet out of a quagmire of guilt and others’ ideas about our bodies, moving home or to the coffee shop, or to supportive meetings where, if we are lucky, we can move into projects of the family, of the heart, of the spirit.

Always moving. None can be still for long unless we schedule a meditation session, or time for prayer. But still, these are a conscious slowing, done on purpose, a respite, never completely still. We are after all women. We move.

I see this movement at Shanti, and not just In its laboring and birthing women, but in the project coordinators, in the volunteers, (almost exclusively women) who move across continents and philosophies, who move against cross cultural norms who seek to oppress, who say that our movement means nothing and we should be frozen.

I see it in the Ugandan staff, these most excellent midwives and support workers who are always always learning, stretching across the divide of what they have been taught and what they know is possible. Over the past four years, I have seen them come to a new place, one guided by intuition and love, a desire to move each birthing woman forward rather than backward.

So much movement. And while it is highly unlikely that I will die of happiness, literally, my heart is swelling like the Grinch at the end of that Christmas special with Boris Karloff. I am ready to move.

 

Texting while driving and texting while feeding the baby, two sides of the same coin?–Jodilyn September 17, 2013

I thank you in advance for your patience as I am about to put some pieces of my recent experiences together and share some thoughts I have for new moms and the professionals that serve them. I recently read some research on texting and driving that immediately made me flash to the reactions when I asked a group of new moms what it looks like when they are nursing or feeding their babies.  Almost all of them mimicked holding the baby in one hand and frantic thumb movements on an imaginary phone in the other.  That image has stuck with me over the past week as I try to sort out the buzzing in my head about these two seemingly different vignettes—driving and breastfeeding.  Somewhere under the day-to-day of caring for moms and babies in the midwifery practice I have been putting the pieces together.

I met this week with a woman who has been working with moms and babies for a couple decades longer than I have—she is a lovely source of compassion, strength, and wisdom.  As I was listening to her talk I realized why these two images were connecting for me.  She was talking about how mothers and babies now have a third party in their relationship—technology.  This is not new news.  It’s just that there tends to be a pretty rigid opinion from many professionals that moms who allow the third party to enter are neglecting the needs of the primary relationship between mother and baby.  I’ve never been one to judge from a super rigid stance, and have spent countless hours introducing the world of babies to mothers who have a hard time finding a balance.  I’ve never told anyone to turn off the computer or the phone permanently—in today’s world, and the woman I was talking with was saying just this, we have to know that this is just how it is.  And then we have to work with it.  It’s terrifically difficult for a woman who has spent her adult life in the work force tracking progress and time-to-target goals, explaining her work to others through the use of spread sheets, presentations, and lectures with sources cited, graphs and charts to not bring that into her new life as a mother.

It is not unusual to show up for a postpartum visit and be handed a notebook full of information about a baby from a mother who is very skilled at tracking and recording.  It’s easy to look at this and point out everything wrong in this approach.  But guess what?  This mother is just bringing what has worked for her really well in the past forward with her into this new relationship.  And that’s why we are here—midwives, doulas, postpartum help, support group leaders—all of us.  We are here to allow her to shine *and* to introduce different ways to be with baby.  It is an un-plugging that is as much a learned, and learn-able skill, as how to use Excel.  But we know that a mother who has learned to do everything she has to be successful in the workplace, can learn everything she needs to know to be successful with her baby.  It can be hard, and confusing, and there’s no ?Help? button in the upper left corner of the baby.  But she will find her way, and it will be her own way, and it will not always look like some of the pundits think it should.  There’s no one prescription that works for everyone.  It really helps to sit with other mothers and hear their stories, and it really helps to have a professional in the room who does little more than nod and affirm a mother’s experience of her baby and her new life.  And hopefully she finds what works for her and her baby, and hopefully she is surrounded by people who celebrate and have awareness of just how enormous an accomplishment that is.

Now back to the frantic thumbs and feeding the baby.  Here’s what new research is showing—that as we humans text a few interesting things happen.  Our breathing becomes rapid, shallow, or non-existent (we hold our breaths until we must breathe).  Our pulse increases.  Our temperature goes up.  Sound familiar? Many of us will recognize the physical symptoms of “fight or flight”, or the human body in the sympathetic state.  To be super basic about it, there is a massive release of several hormones in our body that prepare us to act to save ourselves.  And it’s contagious.  We share our hormonal responses, breathing and heart rate with others who are near us.  You see where I am heading…in all of the research and work I have done with kangaroo care with preterm babies and skin-to-skin with healthy babies, science and observation have taught us that this principle holds true.  A mother will help regulate her baby’s temperature, heart rate, and breathing just by being close to him.  One of my favorite moments in my professional life was the first time I placed a pulse-oxymeter on a newborn and took him out of the incubator and put him on his mother’s bare chest, then wrapped them up together in a sheet.  I got to watch as the little machine confirmed what so many others had discovered before.  The system works.  Moms work.  Babies work.  Moms and babies work really well when they are together.  It was thrilling.

By this point it is clear that the connection I am making between texting and breastfeeding and driving is all about the physiological consequences of both.  We all know that if we are catching up on facebook we are not eye-gazing with our babies or talking to them, which is important emotional tending-to that babies need.  And now we know there is something just as powerful happening in the mechanics of our bodies when we use feeding time to get things done online.  But as any mother in the first year of mothering will pointedly tell you—there’s not very much time other than those times to catch up.  And socializing—even social media socializing—is critically important to many mothers so that they can maintain a sense of connection with people who speak in full sentences.  This is the world we live in.  Do many of us wish it wasn’t so?  Yes.  Do many of us wish mothers had the time and resources to unplug totally and just *be* with their babies?  Of course we do.  But we have what we have.  The real question is how to work with it—how to create a balance that works for mom, baby, and the mother/baby relationship.  So here’s my simple proposal.  If you’re a mom and you’re catching up while you are feeding your baby, take intentional, slow, deep belly breaths while you do it.  Keep yourself out of “fight or flight”, and in the state so appropriately dubbed “feed and breed” or “rest and digest”.   Your body can actually only be in one or the other at any given time.  Simple deep breathing will keep your heart rate and temperature down, and your baby will reap the benefits of your biologically soothing presence.  If your baby is awake for the feeding, take a chunk of the time—maybe it’s even 3 or 5 minutes, to eye gaze, to talk gently, to tell your baby the story of your day so far, or a funny story from your childhood.  Then take a deep breath, tell your baby you are going to catch up on some work or social stuff while she continues to nourish herself and then hit the facebook, email, or spread sheets (while continuing to breathe well).  Babies are really understanding people.  And just like everyone, they do best when we communicate with them and help them make sense of their stories.

If you are a professional—just teach the mothers you work with, in prenatal visits, private sessions, groups, or classes, this simple lesson:  that humans breathe too fast and shallow, and that our temperatures, pulses, and breathing rates rise when we are texting or using technology while trying to do something else that shifts frequently and requires a lot of attention. Teach them to intentionally take slow cleansing breaths while nursing.  Talk about taking some of the time while nursing to tend to their emotional health and connection with each other.  Tell them it is not about right or wrong, this way or that way, my way or the highway.  It is about balance. Finding the right balance for them, their family, their baby, and their relationship with those they love.  And oh, of course, no texting while driving, please.

And as a ps, if you are a mom or dad interested in (or struggling with) finding balance and transitioning into life with baby, and would like to spend some time in the presence of this incredible woman I was conversing with, just check out Buela’s website.  She does home visits and will be at Essential Birth & Family Center once a month providing low-cost CranioSacral therapy for local families.

 

Midwifery by Ipee Freely. –Jodilyn May 9, 2013

Filed under: Birthy Thoughts,Jane and Jodilyn,Jodilyn — EssentialMidwiferyCare.com @ 6:17 am

I’ve been struggling with where to park this one…do two midwives really have the right to question common practices in elementary schools across the nation?  In the spirit of sharing the hours (and hours and hours) of time we’ve spent laying on someone else’s couch and talking about what we can do to inoculate girls and young women against the myriad ways that adult women don’t feel empowered to take care of themselves, or use their voices to state their needs, or introduce topics that might bring conflict into their lives….here goes.

Jane and I were on the phone (again!) and we got sidetracked (again!) and started sharing stories about girls we know, the girls we were, and the time we’ve spent teaching girls.  Up comes the topic, “It’s like pulling teeth to get a girl to use the bathroom without asking permission first.” Not often the hot topic in midwifery circles—at first I thought we were talking about empowering girls to empty their bladder.  Ms. Jane, ever the former school teacher, shared stories of telling her students that if they would just use the bathroom when they need to without telling her about it, or asking her permission to do it, she would also abstain from telling them when she needed to use the bathroom.  In the perfect way that she has, she made it clear to them that this arrangement would work as long as they used it responsibly and didn’t linger, loiter, or use the time to organize against The Man. Now don’t be shocked all you folks who rely on stickers and hall passes and complicated systems whereby only one student can use the bathroom pass at a time (please watch Weeds and note the girl positively begging her teacher to be allowed to use the bathroom—pleading which was ignored and denied—and the subsequent in-situ explosion). But her system—the one where the teacher says, “I trust you to know the needs of your body and manage those needs in a responsible way,” worked.  On and on the conversation traveled until there was a flash inside my head.

It’s no wonder that birthing is so darn hard for so many American women.  We are taught to deny our most basic bodily sensations from a very early age here.  And then it is reinforced year after year and hour after long hour in some cases.  A full bladder is a wonderful thing—the sensation of pressure that results from hydration is so informative.  Not only does it tell us that we are taking care of our bodies by drinking, but it tells us that our bodies have a system used to regulate liquids, toxins, vitamins, and all of the other lovely little goodies that compose our urine.  But mostly it is great because our body yells at us to get up and move and use our very amazing and natural abilities to create change and restore comfort.

You can see where I’m going…if we spend our lives denying the signals in our bodies that positively scream at us to move or make change or simply let go the urine in our bladders…how on earth are we supposed to suddenly respond to those signals for which we have never developed receptors?  Why would we ever even know what to listen for, how to listen, or how to receive and react to the messages our body and baby send us during labor and birth?

Don’t get me wrong, it all works…eventually.  Because gravity and the force of what my son once proudly and loudly referred to as, “the MOST POWERFUL muscle in the human body!!” do tend to conspire to eject our babies from our bodies despite everything we do, and don’t do to aid in the process.  All of the extra time it takes us to just let our bodies take over is too much time in the world of modern obstetrics, and 30-40% of us here in Seattle will have our babies in the OR because of the time we are taking with labor.  It appears that the increased cesarean rate may be traceable to the rules of elementary school as much as anything else.

You draw the conclusions—and consider—the conversations you will have at the next parent-teacher conference.

 

What’s in Your Arms?–Jodilyn April 17, 2013

Filed under: Birthy Thoughts,Jodilyn — EssentialMidwiferyCare.com @ 3:57 am

Times like this drive us all right back to the basics—are we loving each other well enough?  Are we paying attention in the moments that we have our loved ones nearby?  Are we who we intended to be?  For mothers, all those nuero-receptors stuck in our guts and our hearts fire without their normal checks and balances.  For a brief moment at least we see our children through the eyes of the frailty of life and the unquenchable thirst of time.

And though my youngest is now a strapping man-sized child of 13, I just want to gather him in my arms and feel him close to me, to say nothing of my 18 year old who is on the other side of the world having a fabulous college experience. So why is it that when the world goes to pieces it is our arms that feel like the safest place to shelter our children?  Surely gathering everyone in a sturdily made bomb shelter outfitted with 20 or 30 years of supplies would be safer—but the gut and the heart call our children to our arms instead.

New mothers often struggle with questions of how to be “the best” kind of new mother.  We read books by the dozens, watch videos, attend classes, and subscribe to “parenting philosophies”.  We tumble from one to the next, constantly in search of the next better method to follow.  We could blame the internet or the smart phones, Amazon or the year 2013, but taking a brief tour through the history of parenting psychology shows us that we are not alone in these struggles.  Our American grandmothers struggled with all of the same issues—pamphlets and doctors and the neighbors all piped very loud messages into their ears and brains.  When I have the opportunity to talk with student and practicing midwives, it is a very rare occasion that I don’t quote Dr. Donald Winnicott (a protégé of Freud’s, who lived from 1896-1971) for one reason or another.  I love his sense of mother’s rights, of his trust in the mother as the best expert when it comes to her children, and his calming demeanor which shines through in his writing as he address mothers head-on.

Dr. Winnicott talks extensively and beautifully about what happens in the arms of a mother.  It seems like a crime to paraphrase too much, so indulge me as I quote him on this issue—a task I cannot do in real life without catching my voice and taking deep breaths.

“There is room for all kinds of mothers in this world.  And some will be good at one thing, and some will be good at another.

Or shall I say some will be bad at one thing and some bad at another?

Some are anxious holders.  It may be worth while looking even a little more closely at this business, because if you do handle your baby, well I want you to be able to know that you are doing something of importance.  This is a little part in the way in which you give a good foundation for the mental health of this new member of the community.”

He goes on to say that he could have chosen any topic at all to illustrate how wise and important mothers are, but he chose the seemingly menial task of holding babies to demonstrate his beliefs:

“You are specialists in this particular matter of care of your own children. I want to encourage you to keep and defend this specialist knowledge.  It cannot be taught.

Then you can go and learn from other specialists about more technical things  [like vaccines and vitamins]  But only if you keep what is natural in you is it safe for you to learn anything that doctors or nurses or others can teach you.”

It is in the holding of our own baby that we flourish as an expert—comfort in our arms is one of the primary needs of a newborn, and we provide that! It is in the holding of babies that we give them their sense of the world, of cause and effect, and the confidence to know that their one secure base is reliable and trustworthy.  They see themselves reflected in our regard for them.  They smell us and we smell them.  We bond deeply from this place of holding.  Our hearts are knocked together, beating in time with each other.  We breathe together in this position, and find comfort and desire to nurture here.  Our milk pulses downward towards their needy, growing, bodies. And as our eyes lock with theirs, we share intensely personal space with each other here.  As our children grow, they start to move away from our arms, but return for bonding, healing, and grounding throughout their lives.  We instinctively know to hold them—even as they become men or women, even as they have their own lives and connect with us in thousands of ways outside of our arms.  We know that we have done our best, deepest work in that small space which is the span of a couple dozen inches at the widest part.  Our children know that they gained their sense of safety and balance in those inches.  And that is why, even when they are grown, the original home-base is the one that calls us to each other with such fantastic eloquence and urgency.

 

 

 

 

 

 
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