Another contradiction I've noticed about myself: I believe all life exists in many shades of gray, and yet I have an overwhelming need to label things. Even if the labels are vague, it doesn't matter. I need them.
Someone recently told me that this would become a crippling social need if I wasn't careful. If that comment had come from a close friend, I would have taken it to heart and owned it. But this was someone I'd barely even known, and their ability to see into me so profoundly bothered me. They were 100% right, and yet I got defensive. And so I've spent the past couple of weeks dissecting it.
The conversation was innocent enough, focusing on mere political identities and nothing more. I had said that I considered myself a "nomadic leftist," meaning I tend to float between far-left ideologies on any given day. The offending comment came after I had mentioned that this is a common theme for me, adding labels (even if I just pulled them out of my ass) simply due to a need to clarify my place in the world.
My dissection of the conversation, however, was about way more than a political identity. In the past six months, I've gone from having it "all figured out" to having absolutely no idea what I'm doing, where I belong, with whom I identify, etc. When those things are clear (or just clearly vague), I'm in my element. When they're not, that's when the dissection and over-analysis begins. "What did so-and-so mean when s/he said that?" I start to obsess. It's really not healthy.
Same goes for my relationship with C. I've been making people laugh by calling him "my ex-ish," but that's not a joke. It's really the best I can come up with right now. He's not my "ex" because that would imply that we're divorced, right? Which we're not. Ex-ish is, I suppose, a shorthand version of "the husband I'm separated from and probably will divorce," but with a smidgen of humor so that I don't have to follow it up with, "But really, I'm fine."
A close friend told me not to worry about it, that such a tendency comes with a total openness about what I'm thinking and feeling. I don't tend to hold much back. I will usually tell you what I think, which not everyone is used to. "It's mature," I believe were her exact words. Mature or not, I can see how it would get annoying. You could look at me with an innocently-raised eyebrow and I will spend the remainder of the day wondering why. Not that my sense of self hinges completely on what you think, but because I just plain want to know. Did I say something you found to be ridiculous? Interesting? Offensive? I can usually read people pretty well, but now and then non-verbal interactions leave me clueless. As do verbal ones, on occasion... "Hey, remember earlier this week when you said you 'liked' October... what did you mean by that?" It can really be that innocuous.
Don't get me wrong... this impulse (can we just go ahead and call it a compulsion?) stems from a vested interest in human thought and behavior. Believe me - I've dissected this many times over - it's hardly about how people see me, at least not in the "I have to be loved" sense. If I could have one superpower, it would be to be able to read people's thoughts. Partly out of curiosity, mostly out of a true desire to know what folks are thinking at any given time. It's probably my tendency to over-empathize.
(Sure let's go with that.)
Thursday, November 10, 2011
Sunday, November 6, 2011
Zero to Sixty
When things are complicated, we tend to want to skip to the end, a time where the complicated has turned into wisdom. A time where we can move on with our lives and dedicate ourselves to simplicity.
Of course this is impossible. We may find a way to "fast forward" to some kind of conclusion, but in doing so we deprive ourselves of the valuable experience we wanted to run to in the first place. And in the end, that can make things more complicated than they already were, and probably a whole lot more regretful.
I've written a lot, here and in a private journal, about the value of "sitting with it." I have come to accept that this is the only way to handle difficult life events, but it takes a lot of reminding myself. It takes even more energy to remind the others involved. When you're in something with somebody else, you're tied together even when you're separated. This is especially true when the relationship is long: not only are there emotions to untangle, there's also material objects and logistical matters that - let's face it - have their own share of emotional entanglements.
The real complicated stuff comes when you're ready to run with some things but still need to sit with others. You're already stretched thin enough from emotional wear-and-tear and the exhaustion of your day-to-day life; one part of you running off while the other struggles to stay put is a true testament to our elasticity. You have to have elasticity, otherwise you'll be torn in half. Fortunately I've always been flexible.
Sometimes, though, the "ready to run" part takes off like a leashed dog who's just seen a rabbit. It takes you by complete surprise. Your arm gets yanked, your wrist strained from the leash almost slipping from your grasp, and you fight to keep things at a more reasonable pace. It's still too fast for the part of you that needed stillness, but way too slow for the one that needs motion. Onlookers view the event, knowing full well what it feels like but laughing all the same, mostly because your "no-really-I'm-fine" demeanor has cued them to do so. Still and again, no amount of flexibility can sustain such instantaneous force applied, and you're bound to at the very least be sore from the event, even if your arm hasn't been completely torn from its socket.
The simple can be so complicated.
Of course this is impossible. We may find a way to "fast forward" to some kind of conclusion, but in doing so we deprive ourselves of the valuable experience we wanted to run to in the first place. And in the end, that can make things more complicated than they already were, and probably a whole lot more regretful.
I've written a lot, here and in a private journal, about the value of "sitting with it." I have come to accept that this is the only way to handle difficult life events, but it takes a lot of reminding myself. It takes even more energy to remind the others involved. When you're in something with somebody else, you're tied together even when you're separated. This is especially true when the relationship is long: not only are there emotions to untangle, there's also material objects and logistical matters that - let's face it - have their own share of emotional entanglements.
The real complicated stuff comes when you're ready to run with some things but still need to sit with others. You're already stretched thin enough from emotional wear-and-tear and the exhaustion of your day-to-day life; one part of you running off while the other struggles to stay put is a true testament to our elasticity. You have to have elasticity, otherwise you'll be torn in half. Fortunately I've always been flexible.
Sometimes, though, the "ready to run" part takes off like a leashed dog who's just seen a rabbit. It takes you by complete surprise. Your arm gets yanked, your wrist strained from the leash almost slipping from your grasp, and you fight to keep things at a more reasonable pace. It's still too fast for the part of you that needed stillness, but way too slow for the one that needs motion. Onlookers view the event, knowing full well what it feels like but laughing all the same, mostly because your "no-really-I'm-fine" demeanor has cued them to do so. Still and again, no amount of flexibility can sustain such instantaneous force applied, and you're bound to at the very least be sore from the event, even if your arm hasn't been completely torn from its socket.
The simple can be so complicated.
Tuesday, November 1, 2011
Sitting With It
I woke up this morning overcome with anxiety. It was awful, a feeling I haven't felt in weeks. Needless to say, I skipped my class and even crapped out on a consult. That didn't make the anxiety any better, but I finally allowed myself to let it go, knowing that today needed to be spent for myself.
A quick self-inventory revealed what should have been painfully obvious: I haven't stopped moving since before I went to New York. That was 15 days ago. New York was non-stop go (and very little sleep to boot), and upon my return my life has consisted of catching up. There was work, plus my doula mama had her baby, and I've been spending time at Occupy Greensboro cooking and helping out in whatever way I can. Everything that has kept me strong over the past few months - good food, down time, yoga - has taken a backseat.
Not that I'm complaining. All of the aforementioned "stuff" that has kept me in a constant state of motion has been wonderful. I am truly happy these days. But I need to remember to take the time to sit with these experiences whenever possible, even only for just an evening.
It's kind of like running or any sort of cardio workout for that matter. The real pain comes when you stop. If you don't stop at your body's first cue to do so - out of fear or just the inability to sit still - you're just delaying the inevitable. But the pain will be worse.
Let me back up a bit. First off, I have come to realize that I have fallen out of love. This isn't any big new breaking thing; like these things tend to go, it has been in process for probably weeks now. But only in the past week or two have I realized what it was: falling out of love.
Since coming to this realization was so liberating, my take on it has been almost completely celebratory. Drinks with girlfriends, etc. Charlie signed a lease on Friday, and that in and of itself made me want to celebrate. Things are moving forward, and I no longer feel that they're going in the wrong direction.
Of course, none of this is 100% good. Had I taken the time to scratch the surface of what has happened, I would have realized the intense pain that also comes with falling out of love. And so, with the good feelings and celebrations behind me, I allowed myself to feel the other side. Obviously, it wasn't nearly as pretty.
There were warnings... last night, I went to a fun Halloween vinyasa practice that was as irreverent as it was challenging. Lots of prana, lots of ujjayi, lots of crude jokes and laughter. Sitting with that practice in savasana, I realized I was crying. Or not. My eyes were watering, a lot. I wasn't sobbing or weeping or anything like that, but there were definitely many tears streaming out of my eyes. It felt very therapeutic, and I left with a renewed sense of clarity. My biggest mistake was that I didn't sit with it longer, and as a result woke up this morning with a slight hangover and a lot of anxiety.
The whole experience was buffered by the fact that the person I'm falling out of love with is a lovely person, and when I called he was ready and willing to talk me through it. He'd been through the exact same process only several months ago, after all. We talked for a while, and it made me realize how lucky I am to have such a great person to go through this with. As I've said, none of this is malicious. There's very little resentment, and only the occasional screaming match (which is to be expected).
These ups and downs are to be expected, but I know I can ease the anxiety factor by allowing myself to sit with things more frequently. Major life changes are usually wonderful and scary all at once, and I know I can do better for myself by simply letting things sink in before moving on to the next big thing, even for only five breaths.
A quick self-inventory revealed what should have been painfully obvious: I haven't stopped moving since before I went to New York. That was 15 days ago. New York was non-stop go (and very little sleep to boot), and upon my return my life has consisted of catching up. There was work, plus my doula mama had her baby, and I've been spending time at Occupy Greensboro cooking and helping out in whatever way I can. Everything that has kept me strong over the past few months - good food, down time, yoga - has taken a backseat.
Not that I'm complaining. All of the aforementioned "stuff" that has kept me in a constant state of motion has been wonderful. I am truly happy these days. But I need to remember to take the time to sit with these experiences whenever possible, even only for just an evening.
It's kind of like running or any sort of cardio workout for that matter. The real pain comes when you stop. If you don't stop at your body's first cue to do so - out of fear or just the inability to sit still - you're just delaying the inevitable. But the pain will be worse.
Let me back up a bit. First off, I have come to realize that I have fallen out of love. This isn't any big new breaking thing; like these things tend to go, it has been in process for probably weeks now. But only in the past week or two have I realized what it was: falling out of love.
Since coming to this realization was so liberating, my take on it has been almost completely celebratory. Drinks with girlfriends, etc. Charlie signed a lease on Friday, and that in and of itself made me want to celebrate. Things are moving forward, and I no longer feel that they're going in the wrong direction.
Of course, none of this is 100% good. Had I taken the time to scratch the surface of what has happened, I would have realized the intense pain that also comes with falling out of love. And so, with the good feelings and celebrations behind me, I allowed myself to feel the other side. Obviously, it wasn't nearly as pretty.
There were warnings... last night, I went to a fun Halloween vinyasa practice that was as irreverent as it was challenging. Lots of prana, lots of ujjayi, lots of crude jokes and laughter. Sitting with that practice in savasana, I realized I was crying. Or not. My eyes were watering, a lot. I wasn't sobbing or weeping or anything like that, but there were definitely many tears streaming out of my eyes. It felt very therapeutic, and I left with a renewed sense of clarity. My biggest mistake was that I didn't sit with it longer, and as a result woke up this morning with a slight hangover and a lot of anxiety.
The whole experience was buffered by the fact that the person I'm falling out of love with is a lovely person, and when I called he was ready and willing to talk me through it. He'd been through the exact same process only several months ago, after all. We talked for a while, and it made me realize how lucky I am to have such a great person to go through this with. As I've said, none of this is malicious. There's very little resentment, and only the occasional screaming match (which is to be expected).
These ups and downs are to be expected, but I know I can ease the anxiety factor by allowing myself to sit with things more frequently. Major life changes are usually wonderful and scary all at once, and I know I can do better for myself by simply letting things sink in before moving on to the next big thing, even for only five breaths.
Sunday, October 23, 2011
New Name, New Look
Pretty much the same blog. So why the change?
Where to begin?
Life has thrown some major changes my way in the past few months. Blogging in general has taken a backseat to my own need to simply survive. Between school, lactation, birth work, a new job, and a wealth of personal stuff, my down time has mostly consisted of resting and binging on contrived TV shows like Grey's Anatomy.
Which was all well and good, but it's time to pick myself back up and use my down time for things that are productive and meaningful to me. Things like writing. Looking back, I see that my blog has (not surprisingly) consisted mostly of political rants and raves. Also well and good, and these issues remain very close to my heart. But my day-to-day experiences have been so unique to anything I have lived before, and I would like to use this forum to share those insights as well.
Without going too deeply into private issues that involve other people that I care deeply about, I'll just say this: I am facing the possible end of a very long-term relationship with the person I love. This came as some surprise, and so I have spent the last several months of my life dealing with that loss. I have come to terms with a lot so far and will continue to do so. These new experiences have been painful and inspirational all at once. I've both grieved and remained hopeful, usually also all at once. But that's getting more personal than I'd like to at this point in time on such a public forum.
So back to the new name.
Yoga has provided a kind of sanctuary for my troubled head; it has fueled my drive to be a better person, both physically and mentally. When I was a dancer, I allowed myself to "cop out" on upper-body strength with self-defeating excuses ("My arms are hyper-extended so it's really hard to build muscle," "I have bad wrists," etc). Yoga always seemed like a non-judgmental zone where I can peacefully build such strength on my own schedule. Before long, I could chaturanga, something I never thought my hyper-extended arms and aching wrists would allow me to do. Then last week, I did my first full arm balance, a totally-rad eka pada koundinyasana (say that three times fast). I felt so good about it that I later busted my face while trying to show off to some friends after a few glasses of wine.
The point is this: practicing yoga has, for me, given me the fuel I need to get through the day. It strengthens me physically, spiritually, and emotionally. I accomplish things in my physical body and it gives me the ability to become a stronger person overall.
In yoga, poses are timed not in seconds but in breaths. A downward dog in surya namaskara, for example, is usually held for five breaths. Other resting poses are, in my experience, held for five as well. This allows for the pose to "sink in," for the yogi to sit in the pose and get stronger all at once. Sometimes the pose gets exhausting, my legs or (more often) arms get tired, and it becomes uncomfortable. I want to move to the next pose without letting that feeling sink in and take effect. But I know that I have to hold it in order to become stronger, to be able to hold that pose for longer and to do it with more strength and grace. When I'm feeling overly ambitious, holding a resting pose such as child's pose for five breaths seems like a waste of time. However, I know that taking those five breaths to allow my body to feel the result of the previous series is just as important.
I'm not going to spell out how that all relates to my current quest for survival... you can probably put two and two together. But while we're on the subject of survival...
The most influential people in my life right now are those who have been able to offer wisdom about the difference between pain and suffering, as well as the difference between surviving and thriving.
My education as a birth doula has always harped on the difference between pain and suffering. Pain is a part of life. It is a normal human experience. In the context of childbirth, this is obvious. My job as the doula is to help a person cope with the normal pain of labor such that it does not become suffering. We learn that how you approach the inevitable discomfort (or pain) shapes how you experience it. Once pain becomes suffering, it is no longer normal. My yoga practice has helped me transpose this idea into my day-to-day life in a time where my very unpainful life became almost unbearable. With proper compassion, coping skills, and attitude, pain is only pain. Suffering is optional.
The same goes for the difference between surviving and thriving, except that a period of survival is required. The likely end to a long-term relationship has to involve a period of intense pain, and in those moments, you are in survival mode. Then, slowly, you do more thriving and less surviving. You start to live again. For me (and I imagine most folks in my situation), this has happened so organically that I almost didn't realize it. It was October 10, just a few months after all this started, and I realized I was happy. I had a groove going, things were promising, and I was no longer in a 24/7 cycle of survival. Pain was present, but intermittent. Suffering seemed more optional as I realized that I was in control of my pain. I was thriving.
If you have made it this far into this very slapdash and very vague entry, you've probably realized that it has taken weeks to complete. Where I was at the top of this page is not where I am today. Things change, that's the only constant in our lives. Things always change.
So I hope you will continue following my journey from survival mode to a state of living for myself, a place of equanimity in constant flow. The future is indeed unwritten, but this period of intense personal growth makes all that seem less frightening. I just need to remember to act when action is required, but to sit when stillness is the best practice. Five breaths.
Where to begin?
Life has thrown some major changes my way in the past few months. Blogging in general has taken a backseat to my own need to simply survive. Between school, lactation, birth work, a new job, and a wealth of personal stuff, my down time has mostly consisted of resting and binging on contrived TV shows like Grey's Anatomy.
Which was all well and good, but it's time to pick myself back up and use my down time for things that are productive and meaningful to me. Things like writing. Looking back, I see that my blog has (not surprisingly) consisted mostly of political rants and raves. Also well and good, and these issues remain very close to my heart. But my day-to-day experiences have been so unique to anything I have lived before, and I would like to use this forum to share those insights as well.
Without going too deeply into private issues that involve other people that I care deeply about, I'll just say this: I am facing the possible end of a very long-term relationship with the person I love. This came as some surprise, and so I have spent the last several months of my life dealing with that loss. I have come to terms with a lot so far and will continue to do so. These new experiences have been painful and inspirational all at once. I've both grieved and remained hopeful, usually also all at once. But that's getting more personal than I'd like to at this point in time on such a public forum.
So back to the new name.
Yoga has provided a kind of sanctuary for my troubled head; it has fueled my drive to be a better person, both physically and mentally. When I was a dancer, I allowed myself to "cop out" on upper-body strength with self-defeating excuses ("My arms are hyper-extended so it's really hard to build muscle," "I have bad wrists," etc). Yoga always seemed like a non-judgmental zone where I can peacefully build such strength on my own schedule. Before long, I could chaturanga, something I never thought my hyper-extended arms and aching wrists would allow me to do. Then last week, I did my first full arm balance, a totally-rad eka pada koundinyasana (say that three times fast). I felt so good about it that I later busted my face while trying to show off to some friends after a few glasses of wine.
The point is this: practicing yoga has, for me, given me the fuel I need to get through the day. It strengthens me physically, spiritually, and emotionally. I accomplish things in my physical body and it gives me the ability to become a stronger person overall.
In yoga, poses are timed not in seconds but in breaths. A downward dog in surya namaskara, for example, is usually held for five breaths. Other resting poses are, in my experience, held for five as well. This allows for the pose to "sink in," for the yogi to sit in the pose and get stronger all at once. Sometimes the pose gets exhausting, my legs or (more often) arms get tired, and it becomes uncomfortable. I want to move to the next pose without letting that feeling sink in and take effect. But I know that I have to hold it in order to become stronger, to be able to hold that pose for longer and to do it with more strength and grace. When I'm feeling overly ambitious, holding a resting pose such as child's pose for five breaths seems like a waste of time. However, I know that taking those five breaths to allow my body to feel the result of the previous series is just as important.
I'm not going to spell out how that all relates to my current quest for survival... you can probably put two and two together. But while we're on the subject of survival...
The most influential people in my life right now are those who have been able to offer wisdom about the difference between pain and suffering, as well as the difference between surviving and thriving.
My education as a birth doula has always harped on the difference between pain and suffering. Pain is a part of life. It is a normal human experience. In the context of childbirth, this is obvious. My job as the doula is to help a person cope with the normal pain of labor such that it does not become suffering. We learn that how you approach the inevitable discomfort (or pain) shapes how you experience it. Once pain becomes suffering, it is no longer normal. My yoga practice has helped me transpose this idea into my day-to-day life in a time where my very unpainful life became almost unbearable. With proper compassion, coping skills, and attitude, pain is only pain. Suffering is optional.
The same goes for the difference between surviving and thriving, except that a period of survival is required. The likely end to a long-term relationship has to involve a period of intense pain, and in those moments, you are in survival mode. Then, slowly, you do more thriving and less surviving. You start to live again. For me (and I imagine most folks in my situation), this has happened so organically that I almost didn't realize it. It was October 10, just a few months after all this started, and I realized I was happy. I had a groove going, things were promising, and I was no longer in a 24/7 cycle of survival. Pain was present, but intermittent. Suffering seemed more optional as I realized that I was in control of my pain. I was thriving.
If you have made it this far into this very slapdash and very vague entry, you've probably realized that it has taken weeks to complete. Where I was at the top of this page is not where I am today. Things change, that's the only constant in our lives. Things always change.
So I hope you will continue following my journey from survival mode to a state of living for myself, a place of equanimity in constant flow. The future is indeed unwritten, but this period of intense personal growth makes all that seem less frightening. I just need to remember to act when action is required, but to sit when stillness is the best practice. Five breaths.
Wednesday, October 5, 2011
Whales are badass.
To preempt NOW Foundation's Love Your Body Day (October 16, y'all!), I thought I'd share this gem I came across today.
A while back, at the entrance of a gym, there was a picture of a very thin and beautiful woman. The caption was "This summer, do you want to be a mermaid or a whale?"
The story goes, a woman (of clothing size unknown) answered the following way:
"Dear people, whales are always surrounded by friends (dolphins, seals, curious humans), they are sexually active and raise their children with great tenderness.
They entertain like crazy with dolphins and eat lots of prawns. They swim all day and travel to fantastic places like Patagonia, the Barents Sea or the coral reefs of Polynesia.
They sing incredibly well and sometimes even are on cds. They are impressive and dearly loved animals, which everyone defend and admires.
Mermaids do not exist.
But if they existed, they would line up to see a psychologist because of a problem of split personality: woman or fish?
They would have no sex life and could not bear children.
Yes, they would be lovely, but lonely and sad.
And, who wants a girl that smells like fish by his side?
Without a doubt, I'd rather be a whale.
At a time when the media tells us that only thin is beautiful, I prefer to eat ice cream with my kids, to have dinner with my husband, to eat and drink and have fun with my friends.
We women, we gain weight because we accumulate so much wisdom and knowledge that there isn't enough space in our heads, and it spreads all over our bodies.
We are not fat, we are greatly cultivated.
Every time I see my curves in the mirror, I tell myself: "How amazing am I?!"
Sunday, September 4, 2011
What the doctor said, what the evidence says
This past week I attended the fastest birth I have ever (and maybe will ever) attend. By which I mean, the mother's water broke at 7:30, and the baby arrived at 9:30. We all got to the hospital at 9pm, and she was 8.5cm dilated. The mother had a history of rapid labor, so this wasn't exactly a fluke. Regardless, everyone was wonderful by the end of the night, including the mama who, while a bit shell-shocked, felt like a total rockstar for the way her body was able to work.
After a history of high-intervention preterm birth, this family was determined to have a normal birthing experience. And normal it was, except for the sheer rapidness... of course, seeing how the labor began on its own and progressed without any medical intervention (including pain medication), it was normal. Fast, but normal nonetheless.
The doctor, however, was not exactly an advocate for "normal birth" in many respects. In the short 30 minutes of contact I had with him, I found him to be abrasive, paternalistic, condescending, and just plain rude. I keep turning the story over and over in my head, and I just can't make sense of several things he said and did.
Let me be clear: this is not just some sort of wingnutty vendetta by some conspiracy theorist doula (see previous post). My philosophy of birth is based in sound, evidence-based research. I respect anyone who provides care according to the research, be they midwives, obstetricians, lactation consultants, nurses, doulas, or educators. This isn't me railing against the obstetrical field just because some guy was mean to my client... this doctor displayed a clear disrespect for the evidence-based practices from which positive birthing outcomes have shown to come.
His major offenses are as follows.
1) Physician-Directed Pushing
What happened:
The mother was completely dilated minutes after I arrived in her delivery room. However, she did not feel an urge to push right away. This did not stop the doctor from trying to speed things up. Once he found her to be complete, he immediately started telling her to bear down and "hold it for 10 seconds." The mother said she did not feel the urge to push yet, so she was going to rest. The doctor's response was, and I quote, "Honey, you're not going to have a baby by just lying there and resting."
What the evidence says:
Once the cervix is completely dilated, the baby's head drops into the the birth canal. During this time, the uterus must "re-form" over the baby's buttocks. This can take up to 1 hour, though it generally takes about 20-30 minutes. This has been fondly named the "rest and be thankful" phase of labor.
A woman who has not had an epidural will get a strong urge to push, called the Ferguson reflex, when the uterus has completely clamped down and is ready to help her deliver her baby. There is much research to suggest, in fact, that pushing before the urge is completely pointless; all the mother is doing is wasting much-needed energy. This is so true, in fact, that many caregivers will advise a woman who has had an epidural to "labor down" for at least 30 minutes (rest and wait) before they begin pushing.
So really, the doctor was completely wrong... she was going to have a baby by sitting there and resting. In fact, she was doing her body a favor.
2) The Friggin' Lithotomy Position
What happened:
When mama was finally ready to push, the doctor immediately began placing her legs into stirrups. This, to me, seems like a major violation. To place a woman's body into such a position without asking first, well, that's just wrong. The mama cried out, "NO!!!" and quickly moved her legs back to a place that was comfortable for her. Her husband then explained that she hadn't wanted to give birth in this position. The doctor visibly rolled his eyes and said, "I can't deliver a baby when your legs are shut!"
What the evidence says:
Here's a "duh" moment for you: the human body is capable of a number of different positions! {gasp!} There's really no reason to think that a laboring woman's legs can only be either in stirrups or completely shut.
In fact, lying flat on your back with the legs in stirrups increases your likelihood of tearing and decreases the elasticity of the perineum by 30%. Our Bodies, Ourselves declares this position "the single most dangerous position" for childbirth.
3) Immediate Cord Clamping
What happened:
It was the parents' wish to wait to cut the cord until it has stopped pulsating. This is not common practice with obstetricians, though it is usually done with midwife-assisted birth. Seconds after the baby girl was born, the obstetrician reached for the clamps. The husband, keeping a close eye on the doctor's every move, asked, "Has it stopped pulsating?" The doctor looked at him with a condescending glance and said, "Yeah... sure."
What the evidence says:
More and more parents are asking their care providers to delay cord clamping, and with good reason: immediately following birth, the remaining blood retained in the placenta rushes into the newborn infant. To immediately clamp off the cord is to waste a boost of high-nutrient cord blood that could very well benefit the newborn.
The umbilical cord will usually stop pulsating on its own in about 2-3 minutes, during which time the newborn can receive up to 25% more blood than an infant whose cord was clamped within the first minute of life. This boost has been associated, in healthy full-term infants, with higher APGAR scores, higher red blood cell counts through the third month of life, and decreased iron deficiency during the first year of life. In preterm infants (>37 weeks gestational age), delayed cord clamping is associated with decreased risk of late-onset sepsis and better health outcomes overall.
Why is this not a more common practice amongst American obstetricians? Their midwife counterparts usually wait at least 2 minutes, and obstetricians in European nations delay clamping as well. The only known risk is hyperbilirubinemia (jaundice), but such a condition generally resolves itself with early breastfeeding.
The only explanation I can come up with is that delayed cord clamping takes time, and when you're in a hospital labor and delivery unit, time is always against you. The wam-bam-congratulations-ma'am mentality leaves countless women feeling like they are being worked through a machine instead of experiencing a joyous, empowering occasion that they can feel good about. Such a mentality also explains why the doctor didn't want to wait for the mama to feel the urge to push.
Of course, the medical field in general just doesn't jive with the process of childbirth. Childbirth is unpredictable, and doctors don't like unpredictable. Hence we've seen an alarming rise in the induction rate... an alarming (and unnatural) percentage of babies being born Monday-Friday, 9am-4pm. While medical science has indeed saved countless lives in managing births that have become problematic, normal birth should be left to take its own course. Care providers who work with laboring folks need to take a breath and slow. It. Down.
“The woman’s body is smarter than the doctor. Time, patience, and the baby will come. Respect the woman’s rhythm." -Dr. George Tiller
After a history of high-intervention preterm birth, this family was determined to have a normal birthing experience. And normal it was, except for the sheer rapidness... of course, seeing how the labor began on its own and progressed without any medical intervention (including pain medication), it was normal. Fast, but normal nonetheless.
The doctor, however, was not exactly an advocate for "normal birth" in many respects. In the short 30 minutes of contact I had with him, I found him to be abrasive, paternalistic, condescending, and just plain rude. I keep turning the story over and over in my head, and I just can't make sense of several things he said and did.
Let me be clear: this is not just some sort of wingnutty vendetta by some conspiracy theorist doula (see previous post). My philosophy of birth is based in sound, evidence-based research. I respect anyone who provides care according to the research, be they midwives, obstetricians, lactation consultants, nurses, doulas, or educators. This isn't me railing against the obstetrical field just because some guy was mean to my client... this doctor displayed a clear disrespect for the evidence-based practices from which positive birthing outcomes have shown to come.
His major offenses are as follows.
1) Physician-Directed Pushing
What happened:
The mother was completely dilated minutes after I arrived in her delivery room. However, she did not feel an urge to push right away. This did not stop the doctor from trying to speed things up. Once he found her to be complete, he immediately started telling her to bear down and "hold it for 10 seconds." The mother said she did not feel the urge to push yet, so she was going to rest. The doctor's response was, and I quote, "Honey, you're not going to have a baby by just lying there and resting."
What the evidence says:
Once the cervix is completely dilated, the baby's head drops into the the birth canal. During this time, the uterus must "re-form" over the baby's buttocks. This can take up to 1 hour, though it generally takes about 20-30 minutes. This has been fondly named the "rest and be thankful" phase of labor.
A woman who has not had an epidural will get a strong urge to push, called the Ferguson reflex, when the uterus has completely clamped down and is ready to help her deliver her baby. There is much research to suggest, in fact, that pushing before the urge is completely pointless; all the mother is doing is wasting much-needed energy. This is so true, in fact, that many caregivers will advise a woman who has had an epidural to "labor down" for at least 30 minutes (rest and wait) before they begin pushing.
So really, the doctor was completely wrong... she was going to have a baby by sitting there and resting. In fact, she was doing her body a favor.
2) The Friggin' Lithotomy Position
What happened:
When mama was finally ready to push, the doctor immediately began placing her legs into stirrups. This, to me, seems like a major violation. To place a woman's body into such a position without asking first, well, that's just wrong. The mama cried out, "NO!!!" and quickly moved her legs back to a place that was comfortable for her. Her husband then explained that she hadn't wanted to give birth in this position. The doctor visibly rolled his eyes and said, "I can't deliver a baby when your legs are shut!"
What the evidence says:
Here's a "duh" moment for you: the human body is capable of a number of different positions! {gasp!} There's really no reason to think that a laboring woman's legs can only be either in stirrups or completely shut.
In fact, lying flat on your back with the legs in stirrups increases your likelihood of tearing and decreases the elasticity of the perineum by 30%. Our Bodies, Ourselves declares this position "the single most dangerous position" for childbirth.
3) Immediate Cord Clamping
What happened:
It was the parents' wish to wait to cut the cord until it has stopped pulsating. This is not common practice with obstetricians, though it is usually done with midwife-assisted birth. Seconds after the baby girl was born, the obstetrician reached for the clamps. The husband, keeping a close eye on the doctor's every move, asked, "Has it stopped pulsating?" The doctor looked at him with a condescending glance and said, "Yeah... sure."
What the evidence says:
More and more parents are asking their care providers to delay cord clamping, and with good reason: immediately following birth, the remaining blood retained in the placenta rushes into the newborn infant. To immediately clamp off the cord is to waste a boost of high-nutrient cord blood that could very well benefit the newborn.
The umbilical cord will usually stop pulsating on its own in about 2-3 minutes, during which time the newborn can receive up to 25% more blood than an infant whose cord was clamped within the first minute of life. This boost has been associated, in healthy full-term infants, with higher APGAR scores, higher red blood cell counts through the third month of life, and decreased iron deficiency during the first year of life. In preterm infants (>37 weeks gestational age), delayed cord clamping is associated with decreased risk of late-onset sepsis and better health outcomes overall.
Why is this not a more common practice amongst American obstetricians? Their midwife counterparts usually wait at least 2 minutes, and obstetricians in European nations delay clamping as well. The only known risk is hyperbilirubinemia (jaundice), but such a condition generally resolves itself with early breastfeeding.
The only explanation I can come up with is that delayed cord clamping takes time, and when you're in a hospital labor and delivery unit, time is always against you. The wam-bam-congratulations-ma'am mentality leaves countless women feeling like they are being worked through a machine instead of experiencing a joyous, empowering occasion that they can feel good about. Such a mentality also explains why the doctor didn't want to wait for the mama to feel the urge to push.
Of course, the medical field in general just doesn't jive with the process of childbirth. Childbirth is unpredictable, and doctors don't like unpredictable. Hence we've seen an alarming rise in the induction rate... an alarming (and unnatural) percentage of babies being born Monday-Friday, 9am-4pm. While medical science has indeed saved countless lives in managing births that have become problematic, normal birth should be left to take its own course. Care providers who work with laboring folks need to take a breath and slow. It. Down.
“The woman’s body is smarter than the doctor. Time, patience, and the baby will come. Respect the woman’s rhythm." -Dr. George Tiller
Labels:
birthing options,
childbirth,
health care,
pregnancy
Tuesday, August 30, 2011
Your Doula Training: The Cast of Characters
Note: The following blog entry is an intentionally irreverent parody of doula stereotypes. While it is true that several characters depicted below were inspired directly by women in my doula trainings, any likeness to anyone in particular is purely coincidental.
That being said, let's reinforce some stereotypes!!
------------
So you're becoming a doula!
You've probably already decided that your personae fits within your understanding of what a doula is. Understandable, that's what I thought as well. Until I attended my first training. It was then I realized that "the doula personae" is not always what you think. In fact, there are many kinds of people (highly different from one another, as you'll find) who believe they also embody these qualities. You might experience some serious cognitive dissonance when you meet them. How could you be the same kind of person as her?! Are you really that crunchy/grandmotherly/opinionated/touchy-feely?
Don't panic. You're probably not very much like most of them. There are maybe hundreds of pregnant folks in your area, and they probably each have a very unique perspective on what a doula is. That's why families interview more than one of us... heaven forbid a conservative religious woman ends up with a transgendered anarcho-feminist, or vice-versa.
You will notice, however, that there are definite patterns in the personae of aspiring doulas, each with their own unique perspective on birth, women, and life in general. Let's take a quick tour of the major ones, shall we?
The Experienced Mama
If her mismatched, spit-up-stained attire didn't give her away, her advanced insight into the birth process most definitely did. The Experienced Mama is the one who has had a number of varying birth experiences. She can speak from experience on induction, c-section, VBAC, and natural birth. She has probably taken a variety of childbirth classes, and who knows, may be on track to becoming a childbirth educator herself. When it comes to breastfeeding, she's experienced it all, and probably is still nursing her youngest child. A kind, sisterly woman in her 30s, The Experienced Mama will score big on the relatability factor when she starts going to interviews.
The Religious One
You picked her out the moment she drove up in her full-sized van covered in pro-life bumper stickers. She's not just religious; she's an unapologetic fundamentalist. Like The Experienced Mama, The Religious One has had a variety of birth experiences... how could she not, she has 10 kids! Of course, unlike The Experienced Mama, her birth experiences are likely to be recounted with vaguely-relative Bible passages.
Here's a woman who believes in "keeping her womb open to the will of God." Meaning, she does not use any form of birth control (including FAM), believing that God will decide how many children she will have. She pipes in rather often, decrying the modern age as a force that has made women forget "what their bodies were made for." Her clinging to "the way God intended it to be" rubs the majority of the room the wrong way regardless of religious affiliation. Look for an entertaining spat between The Religious One and The Rabid Feminist during lunch.
The Rabid Feminist
She made her entrance donning a tank top that read "FUCK PATRIARCHY." Between that and the vulva pendant hanging around her neck, The Rabid Feminist doesn't hide why she's interested in becoming a doula.
She probably has a history as a pro-choice activist or a clinic escort. She is fascinated by the process of childbirth, the strength of laboring women, and finds it all to be political in nature. She drives the group slightly bonkers with her constant correction of "the generic he" and her many off-kilter remarks about how not all pregnant folks identify as women. Despite her fierce attitude, she seems rather taken with The Natural.
The Natural
Here's a woman who, before the training even begins, seems to radiate doula. We're always told that being a doula is more about presence than experience, and in this person's case we believe it. She has probably never attended a birth before, and while she knows childbirth basics, she in no way possesses any more trainable doula skills than any other person in the room.
The Natural has a voice that immediately calms. It's quiet while being firm, reassuring and instantly relaxing. When she speaks, shoulders around the room drop an inch. Her face naturally rests in a pleasant expression, even if she is not physically smiling. In her other life, she is probably a Reiki practitioner or a clinical herbalist. She's adorned in loose-fitting, neutral toned garments and several pieces of under-stated turquoise jewelry. Look for The Natural purchasing bulk herbs in your local organic co-op.
The one thing that brings the whole group together, aside from the desire to be doulas, is the growing disdain for The "At My Birth, We..."
While she means well, this is a person who can't seem to stop relating every single topic back to her own experience. It seems literally anything said by the trainer or fellow participants can be related back to The "At My Birth, We..." Discussing epidurals? She thought about having one of those, but by the time the anesthesiologist got there the baby was already born. The double-hip squeeze? Her husband did that, and it helped for a little while but not during transition. Turkey sandwiches for lunch? She had one of those after the birth of her 1st child, but after the 2nd she'd had roast beef. By the end of the training, the entire group could write whole volumes on this woman's birthing experiences.
She might be the same person as The Experienced Mama.
The Conspiracy Theorist
The entire medical establishment is out to get you. At least, that's the case if you believe The Conspiracy Theorist.
Having no medical experience herself, The Conspiracy Theorist "knows in her heart" (or possibly read somewhere on the internet) that inductions and c-sections are never actually necessary. She pipes into the discussion rather infrequently, but every time she does, her remarks raise eyebrows around the room. "Did you know that the postpartum eye goop has been shown to cause blindness in rats?" "Did you know vaccines contain a chemical that brainwashes children?" "Did you know that school lunches contain tracking devices so that the government can keep an eye on you at all times?"
The Conspiracy Theorist is the only person in the room who scoffs when the trainer discusses car seat laws and will likely be the same person who gets all doulas banned from the area hospital.
The Traumatized
The uncontested heartbreaker of the group, The Traumatized has experienced the worst that the field of obstetrics has to offer. Maybe she was uneducated and timidly agreed to an unnecessary induction. Maybe she had care providers who wouldn't inform her about what was going on. Maybe she had her first baby young, or maybe she had endured a c-section after the epidural had worn off.
Whatever it was, The Traumatized brings tears to everyone's eyes when she gently recounts her birth experience. Her impetus for becoming a doula rests primarily in her mission to ensure no woman ever has to endure what she endured. Or maybe she later had a beautiful birth experience with a doula and wants to share that with the world. The Traumatized can speak to the cascade of interventions with tears in her eyes, though as a survivor she in and of herself is a healer. She may inadvertently add fuel to the flames burning within both The Rabid Feminist and The Conspiracy Theorist.
The Bored Housewife
This week, she wants to be a doula. Two months from now, she might be enrolling in karate classes. The year prior, she briefly considered selling Mary Kay.
The Bored Housewife probably suffers from "Empty Nest Syndrome." Her entire adult career has centered around being a wife and mother, and now that the kids have left the nest and her wealthy husband spends most of his days on the links, she needs to find a new cause to keep herself active. She's sincere about her passion, but she lacks the motivation to move forward with it. Or maybe she does and becomes the best doula ever. Only time will tell.
The Birth Junkie
Some people jump out of airplanes. Others shoot up heroin. This woman gets her fix attending births.
The Birth Junkie is nothing if not passionate. She will go on to love and connect with every mother she works with, but let's face it... at the end of the day, the reward is in the crowning. Such an adrenalin rush lasts her several days, at which point she collapses on her bed awaiting her next client's call. Though she may be older, The Birth Junkie never seems to get tired of the work. Younger doulas look up to her and regard her energy as nothing short of awesome. Her only downfall is that she tends to relive her own birth experiences vicariously through her clients.
She may be the same person as The Professional Grandmother.
The Retired Nurse
In her years of working labor and delivery, this woman has seen it all. If the doula trainer cannot answer a question about the physiology of childbirth, bet your bottom The Retired Nurse can.
She worked as a L&D nurse for a while, but the long hours and hospital wear-and-tear finally got to her. With her nursing career behind her, The Retired Nurse is excited to be responsible for only one laboring family at a time, and better yet, she doesn't have to subject women to vaginal exams ever again! As an added bonus, she already knows all the area's midwives and obstetricians. Her pitfall will be her impulse to adjust fetal monitors or do a quick blood pressure check during labor, but overall, you can count on this one to be a champion doula.
The Professional Grandmother
Your first conversation with her ended with you thinking, "Well isn't she nice!" That's her inner doula already shining through. The Professional Grandmother is what you'd consider to be a "motherly doula." Her kids are all grown and maybe have even had the privilege of having her at their own births. Women will hire The Professional Grandmother first and foremost because she reminds them of their own mother (without all the maternal baggage, of course).
That being said, let's reinforce some stereotypes!!
------------
So you're becoming a doula!
You've probably already decided that your personae fits within your understanding of what a doula is. Understandable, that's what I thought as well. Until I attended my first training. It was then I realized that "the doula personae" is not always what you think. In fact, there are many kinds of people (highly different from one another, as you'll find) who believe they also embody these qualities. You might experience some serious cognitive dissonance when you meet them. How could you be the same kind of person as her?! Are you really that crunchy/grandmotherly/opinionated/touchy-feely?
Don't panic. You're probably not very much like most of them. There are maybe hundreds of pregnant folks in your area, and they probably each have a very unique perspective on what a doula is. That's why families interview more than one of us... heaven forbid a conservative religious woman ends up with a transgendered anarcho-feminist, or vice-versa.
You will notice, however, that there are definite patterns in the personae of aspiring doulas, each with their own unique perspective on birth, women, and life in general. Let's take a quick tour of the major ones, shall we?
The Experienced Mama
If her mismatched, spit-up-stained attire didn't give her away, her advanced insight into the birth process most definitely did. The Experienced Mama is the one who has had a number of varying birth experiences. She can speak from experience on induction, c-section, VBAC, and natural birth. She has probably taken a variety of childbirth classes, and who knows, may be on track to becoming a childbirth educator herself. When it comes to breastfeeding, she's experienced it all, and probably is still nursing her youngest child. A kind, sisterly woman in her 30s, The Experienced Mama will score big on the relatability factor when she starts going to interviews.
The Religious One
You picked her out the moment she drove up in her full-sized van covered in pro-life bumper stickers. She's not just religious; she's an unapologetic fundamentalist. Like The Experienced Mama, The Religious One has had a variety of birth experiences... how could she not, she has 10 kids! Of course, unlike The Experienced Mama, her birth experiences are likely to be recounted with vaguely-relative Bible passages.
Here's a woman who believes in "keeping her womb open to the will of God." Meaning, she does not use any form of birth control (including FAM), believing that God will decide how many children she will have. She pipes in rather often, decrying the modern age as a force that has made women forget "what their bodies were made for." Her clinging to "the way God intended it to be" rubs the majority of the room the wrong way regardless of religious affiliation. Look for an entertaining spat between The Religious One and The Rabid Feminist during lunch.
The Rabid Feminist
She made her entrance donning a tank top that read "FUCK PATRIARCHY." Between that and the vulva pendant hanging around her neck, The Rabid Feminist doesn't hide why she's interested in becoming a doula.
She probably has a history as a pro-choice activist or a clinic escort. She is fascinated by the process of childbirth, the strength of laboring women, and finds it all to be political in nature. She drives the group slightly bonkers with her constant correction of "the generic he" and her many off-kilter remarks about how not all pregnant folks identify as women. Despite her fierce attitude, she seems rather taken with The Natural.
The Natural
Here's a woman who, before the training even begins, seems to radiate doula. We're always told that being a doula is more about presence than experience, and in this person's case we believe it. She has probably never attended a birth before, and while she knows childbirth basics, she in no way possesses any more trainable doula skills than any other person in the room.
The Natural has a voice that immediately calms. It's quiet while being firm, reassuring and instantly relaxing. When she speaks, shoulders around the room drop an inch. Her face naturally rests in a pleasant expression, even if she is not physically smiling. In her other life, she is probably a Reiki practitioner or a clinical herbalist. She's adorned in loose-fitting, neutral toned garments and several pieces of under-stated turquoise jewelry. Look for The Natural purchasing bulk herbs in your local organic co-op.
The one thing that brings the whole group together, aside from the desire to be doulas, is the growing disdain for The "At My Birth, We..."
While she means well, this is a person who can't seem to stop relating every single topic back to her own experience. It seems literally anything said by the trainer or fellow participants can be related back to The "At My Birth, We..." Discussing epidurals? She thought about having one of those, but by the time the anesthesiologist got there the baby was already born. The double-hip squeeze? Her husband did that, and it helped for a little while but not during transition. Turkey sandwiches for lunch? She had one of those after the birth of her 1st child, but after the 2nd she'd had roast beef. By the end of the training, the entire group could write whole volumes on this woman's birthing experiences.
She might be the same person as The Experienced Mama.
The Conspiracy Theorist
The entire medical establishment is out to get you. At least, that's the case if you believe The Conspiracy Theorist.
Having no medical experience herself, The Conspiracy Theorist "knows in her heart" (or possibly read somewhere on the internet) that inductions and c-sections are never actually necessary. She pipes into the discussion rather infrequently, but every time she does, her remarks raise eyebrows around the room. "Did you know that the postpartum eye goop has been shown to cause blindness in rats?" "Did you know vaccines contain a chemical that brainwashes children?" "Did you know that school lunches contain tracking devices so that the government can keep an eye on you at all times?"
The Conspiracy Theorist is the only person in the room who scoffs when the trainer discusses car seat laws and will likely be the same person who gets all doulas banned from the area hospital.
The Traumatized
The uncontested heartbreaker of the group, The Traumatized has experienced the worst that the field of obstetrics has to offer. Maybe she was uneducated and timidly agreed to an unnecessary induction. Maybe she had care providers who wouldn't inform her about what was going on. Maybe she had her first baby young, or maybe she had endured a c-section after the epidural had worn off.
Whatever it was, The Traumatized brings tears to everyone's eyes when she gently recounts her birth experience. Her impetus for becoming a doula rests primarily in her mission to ensure no woman ever has to endure what she endured. Or maybe she later had a beautiful birth experience with a doula and wants to share that with the world. The Traumatized can speak to the cascade of interventions with tears in her eyes, though as a survivor she in and of herself is a healer. She may inadvertently add fuel to the flames burning within both The Rabid Feminist and The Conspiracy Theorist.
The Bored Housewife
This week, she wants to be a doula. Two months from now, she might be enrolling in karate classes. The year prior, she briefly considered selling Mary Kay.
The Bored Housewife probably suffers from "Empty Nest Syndrome." Her entire adult career has centered around being a wife and mother, and now that the kids have left the nest and her wealthy husband spends most of his days on the links, she needs to find a new cause to keep herself active. She's sincere about her passion, but she lacks the motivation to move forward with it. Or maybe she does and becomes the best doula ever. Only time will tell.
The Birth Junkie
Some people jump out of airplanes. Others shoot up heroin. This woman gets her fix attending births.
The Birth Junkie is nothing if not passionate. She will go on to love and connect with every mother she works with, but let's face it... at the end of the day, the reward is in the crowning. Such an adrenalin rush lasts her several days, at which point she collapses on her bed awaiting her next client's call. Though she may be older, The Birth Junkie never seems to get tired of the work. Younger doulas look up to her and regard her energy as nothing short of awesome. Her only downfall is that she tends to relive her own birth experiences vicariously through her clients.
She may be the same person as The Professional Grandmother.
The Retired Nurse
In her years of working labor and delivery, this woman has seen it all. If the doula trainer cannot answer a question about the physiology of childbirth, bet your bottom The Retired Nurse can.
She worked as a L&D nurse for a while, but the long hours and hospital wear-and-tear finally got to her. With her nursing career behind her, The Retired Nurse is excited to be responsible for only one laboring family at a time, and better yet, she doesn't have to subject women to vaginal exams ever again! As an added bonus, she already knows all the area's midwives and obstetricians. Her pitfall will be her impulse to adjust fetal monitors or do a quick blood pressure check during labor, but overall, you can count on this one to be a champion doula.
The Professional Grandmother
Your first conversation with her ended with you thinking, "Well isn't she nice!" That's her inner doula already shining through. The Professional Grandmother is what you'd consider to be a "motherly doula." Her kids are all grown and maybe have even had the privilege of having her at their own births. Women will hire The Professional Grandmother first and foremost because she reminds them of their own mother (without all the maternal baggage, of course).
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