November 19, 2008

Collecting money for our work

Personally, it took a lot of time on the path of martyrdom for me to really get clear about how that self-sacrifice thing does not serve anyone. I have done many births in my career for free because I “felt sorry” for the couple. This is a kind of arrogance about others that usually ends in disaster. Now it seems particularly ridiculous that I did a lot of this free work when I was a struggling single parent with two little kids who I could barely feed. What was I thinking? I would burn out my friends with unreasonable requests for babysitting, let my pantry get bare, be exhausted and cranky with my children and still not collect money from the clients because they were “so poor.” Learning to see others as whole, complete, capable adults took a long time.   

When we charge a fair fee for service, as other workers do, we leave the relationship with the client whole and complete. I remember doing a birth for a couple for a ridiculously low fee because I was told “He is a seasonal worker and they really want to have a birth in their own home.” About three months after the birth, the family phoned to tell me they were going on a trip to Disneyland. I was very resentful and did not want them to have a nice holiday when I had gone into debt to be at their birth. Lesson learned. Now I’m thrilled when my clients tell me they are buying nice things because they owe me nothing.

Even if people have a tough time with finances, there are still things they can sell if they want the service you offer. There are enough pop bottles on the street to generate the money for a midwife or doula. There are grandparents who would love to pay for a midwife/doula service for the new grandchild. There is a way to pay $50 per month for a year if one really wants birth services.

I love this quote from Dr. Kloosterman of Holland, who is an obstetrician and a great friend to the natural birth movement:

“All over the world there exists in every society a small group of women who feel themselves strongly attracted to give care to other women during pregnancy and childbirth. Failure to make use of this group of highly motivated people is regrettable and a sin against the principle of subsidiarity.” (Note: The principle of subsidiarity is that nothing should be done by a larger and more complex organization that can be done as well [or better] by a smaller and simpler organization.)

It’s important to note that Dr. Kloosterman doesn’t say “give care for free or for a ridiculously low return.” “Make use of this group” does not mean “make this group into martyrs.” I have seen so many good women come and go from the birth movement who do not have a balance between what they give and what they receive. It simply doesn’t work to be dishonest about our own needs and the needs of our families when we go to births.


First published as “Midwifery Tip from Gloria Lemay,” The Birthkit, Issue 36 and available online on the Midwifery Today E News

November 19th 2008 Posted to Holistic midwifery & doula education

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Profile of a Professional Caregiver

This was given to me by a nurse.  She said that it had been circulated at her labour/delivery unit and caused a real stir among the staff.  The first time you read it, the reaction is “Oh yes, I know a lot of caregivers like that.”  The real value is to read it several times and take it to heart for yourself. 

Profile Of A Professional Caretaker
       
1.            Caretakers usually have grown up with a strong parental injunction, “Don’t be selfish”. Consequently, they go through life masking their self-concern. They turn all their attention to the concerns of others and largely ignore their own emotional needs. They live in a constant fear of being indicted on the charge of “selfishness”.


2.            Caretakers are usually lonely and emotionally undernourished. They operate in an emotional trade deficit. They give enormous amounts of compassion to others and never get enough emotional nurturing in return. They have many friends but few intimate, nourishing relationships.


3.            Caretakers are always subject to depressions as a result of their stroke deprivation. This stroke deprivation results largely from the caretaker’s unwillingness to receive compliments or care from anyone else. They are afraid to accept care from others for fear it would jeopardize their role in life.


4.            Caretakers are predictable, steady, useful and safe. They are sensitive to the needs of others. They are also boring! They are not particularly enjoyable because they only smile and rarely laugh. (A spontaneous, raucous, belly laugh is of great therapeutic value.)


5.            Caretakers have much difficulty remembering names, even the moment after an introduction. They are so preoccupied with their own self-consciousness (“How Am I Doing?”) they don’t pay attention to others.


6.            Caretakers wear sweatshirts with a message on both front and back. On the front we see, “How Am I Doing?” On the back we read, “Try Harder!” All emotional transactions of the caretaker are designed to gain approval.


7.            Caretakers are usually very harried. They over-commit their time and over-promise themselves. They are usually running late because they cannot break away for fear of encountering disapproval.


8.            Caretakers are afraid of their own anger as well as the anger of others. They avoid conflict at all costs and direct all their anger toward themselves where it is safely converted into depression.


9.            Caretakers are only able to exercise assertiveness when they are attacking social injustice or acting as advocates for their clients. They rarely assert themselves in direct self-interest.


10.          Caretakers are almost paralyzed when it comes to asking for what they need emotionally. They would much rather withdraw or pout than ask for nurture.
              
by Thomas Wright

  ______________________________________________________________ I don’t think there’s a “cure” for this way of being but it is nice to be able to get those raucous belly laughs by looking at my own behaviour.  A few years ago, the women in my Midwifery Study Group were invited to a Christmas dinner party.  I said “Let’s make this the most fun thing that has ever happened.  What should we do at the party?”  This created a lot of perplexed faces including my own.  We all knew how to do a great birth but we didn’t know how to have fun—I was hoping that the other women would know and that was what motivated my question.  The best I could come up with was “Let’s all wear red to the party!”  Whoo-hooo!  One of the other women came up with “Let’s play board games!”  That was it, so that’s what we did.  We actually did have a ball that night and laughed until our stomachs were sore but that planning conversation was such a demonstration to me that I’m severely crippled in the area of horsing around and playfulness.

 

November 19th 2008 Posted to Holistic midwifery & doula education

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November 17, 2008

Are we getting anywhere with ending circumcision?

I sense that I’m not a good person to be answering the question.  I’m like a fish that swims in the fishbowl and does not realize that there is water, if you know what I mean. I belong to several large email lists for ‘intactivists’ and I even belong to one list that is for men who are restoring their foreskins.  By immersing myself in the subject each day, I get the impression that great strides are being made and the end of this barbarism is in sight.  Then, I go out in the “real world” and I wonder what the truth is about this whole subject.

Statistics would be helpful but accurate accounting is hard to come by.  In my province, B.C., Canada, hospitals are not cutting babies any longer and right across Canada, no provincial medical plan will pay for it.  Although both of these measures are commendable and hard won, it means it is now difficult to know what is being done privately in doctors’ offices.  It’s estimated that our rate in B.C. is about 10%.  My American cohorts think this is a wonderful statistic but I find it absolutely sickening.  One in 10 boys being unnecessarily tortured can not be condoned.  We do have a formidable tool in this province for ending circumcision of baby boys and that is the position statement of our provincial College of Physicians and Surgeons.  A baby boy died in 2002 after his parents had his foreskin amputated at the Penticton Hospital.  Soon after that tragedy, which was reported to the press by a hospital whistle blower, the doctors’ regulating body took a tougher stance on this insanity.  Ryleigh McWillis’ death has meant that many Canadian boys have been saved from this painful, permanently mutilating procedure.

What makes me wonder about what’s going on in the “on the street” reality of life in my province is the feedback that I get when I meet people who have nothing to do with the birth field and nothing to do with intactivism.  I am taking a business course right now and have been assigned to a team with two young (30ish) men and a young (25ish) woman.  The other night, at our team meeting, we each declared one of our commitments to the group.  I, of course, let them know that I am committed to ending circumcision.  The two men proceeded to agree with me (I suspect to be polite) but both muttered  afterward about “Of course, it’s cleaner to be cut”. . . this is a sure sign that they both are cut and have been sold a bill of goods about how they are “cleaner”.  The real surprise and heartening reaction was from the young woman.  She stated “I can’t believe you, since when do we cut off body parts instead of washing them?  Would you cut off your ears because they are dirty?”  Wow!  how did she get so educated?  I’m just starting out with this team but I’ll be getting deeper into their information and beliefs about this subject.  I’m happy not to be preaching to the converted and you never know where opening up this subject may lead.

November 17th 2008 Posted to Intactivism, Newborn care

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Blood typing the infant of a Rh negative mother

When the mother of a newborn baby is Rh negative and the father is Rh positive, there is a good chance that the baby will be a positive blood type. Blood in the umbilical cord and the placenta will be only the baby’s blood. Here are instructions on how to obtain a sample:

  1. At the time of birth do not rush the clamping and cutting of the cord. I like to see the placenta birthed (this will usually take longer than 30 minutes if Nature’s way is followed) before clamping and cutting of the cord.
  2. Take the bowl with the placenta to the kitchen and get everything together before taking your blood sample. You will need
    • 2 pairs of nonsterile gloves to protect yourself from body fluids
    • 1 container with a lid in which to put the placenta
    • 1 blue waterproof 17- by 21-inch underpad
    • 1 3-cc syringe and needle
    • 1 purple test tube with stopper (Check with your local hospital to determine what color stopper they prefer. The purple stopper tube has an anticlotting chemical in it to prevent the blood from clumping.)
  3. Before putting on your gloves, write the necessary information on the label of the test tube in very tiny printing. Remember: it is very important that blood samples not get mixed up at the hospital. You will get along well with the blood bank if you mark your samples carefully. In my area, we print the mother’s full name and date of birth, the title “Cord Blood,” baby’s date of birth, and mother’s personal health number. When you get to the blood bank, they will also want you to fill out a requisition. On that form, put attendant’s name, pager number, the physician’s name, and the mother’s date of birth and personal health number. Write for the instructions “Type infant cord blood for screening; infant of Rh negative mother.”
  4. Now that you have all your supplies together and the tube is labeled, take the cord blood before inspecting the placenta. Pull the placenta out of the bowl and put it on the blue pad so that it is sitting on the counter with the cord draped over the edge of the counter; the clamp is on the end of the cord. You want to keep the label of the tube clean and legible, so you may want to change your gloves or wipe blood off them on the blue pad’s edge. Take the lid off the tube and hold it at the clamped end of the cord. Cut off the clamp by making a fresh cut in the cord and allow the blood to run into the test tube. When a half-inch of blood has accumulated in the bottom of the tube, close the tube and rock the blood back and forth. If you can’t get enough blood you may have to squeeze the blood down from higher up in the cord or cut the cord again near one of the black blood pools that you can see along the cord. Occasionally you may have to run the 3-cc needle into one of the vessels on the fetal side of the placenta, draw back on the plunger to extract the blood, and then squirt it into the test tube.
  5. Now you can do a complete inspection of the placenta and then put it away with a lid and label on it in the refrigerator.
  6. When you take the test tube to the lab, ask the technician to page you with the results as soon as possible. If the baby’s blood is Rh negative, ask the lab to fax a copy of the result for your records. If the baby’s blood is Rh positive, the lab will require a blood draw from a vein in the mother’s arm. Again, be sure you have the requisite stopper color test tube. The maternal sample is taken to the lab and checked for baby’s blood cells. If there are none in the mother’s blood, a low dose (120 micrograms) of WinRho (Rhogam in the United States) is given. If baby cells are present in mother’s blood, I have had as many as 900 micrograms prescribed. The package includes instructions on how to give the injection intramuscularly. It is given into the large muscle on the upper outer quadrant of the thigh. If you have to give more than 300 micrograms, you must give it in multiple sites. Injecting anything under the skin can cause harm, so be very careful you are sure of what you are doing and that you’ve had good instruction.  There will be an instruction leaflet in the box of Winrho (Rhogam), read it carefully before giving each injection because the information can change.

First published by Midwifery Today , 2004, updated Nov 18, 2008

November 17th 2008 Posted to Holistic midwifery & doula education, Homebirth

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November 14, 2008

Mary Cronk’s list of assertiveness tools

Mary Cronk of England is one of my favourite midwives in the world.  She’s been around the block a few times and knows how medical professionals can intimidate women.

Here are her tips for regaining power when those around you are trying to bulldoze their agenda through.

 “I suggest you calmly inform your midwife of your intention. and remember my suggested replies to unhelpful professionals.”
1. “Thank you for your advice, I will consider it carefully and let you know my decision”
2. I don’t think you can have have heard what I said
3. Would you like to repeat what you have just said?
4. I am afraid I will have to regard any further discussion as harrassment
5. What is your NMC pin number (for a British midwife) or, “What is your GMC pin number” (for a British Medical practitioner)

I have a sixth phrase to be used *in extremis* “stop this at once” and I am pleased to report that I had it used against me by a woman to whom I had taught it. I  got too enthusiastic while doing
a VE and she ordered me to “stop at once” I did! Regards, Mary

November 14th 2008 Posted to Holistic midwifery & doula education

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November 13, 2008

Cleft palate

The only baby I’ve seen born at home with a cleft palate was such a beautiful, memorable experience.  It was right at Christmas time.  First baby.  Woman gave birth in water.  As she caught her baby and slowly lifted him to the surface of the water in the darkened room, she said “Oh, I think he has a little cleft lip.” We were 3 midwives there.  We all saw the most beautiful aura and peaceful presence around this little baby.  The parents held him and greeted him in the usual way.  He nursed at the breast.  Later we realized the cleft involved the palate, too, and we explained to the parents that we should have him looked at by a pediatrician at Children’s Hospital sometime in the first 12 hours just in case he had some other problems that weren’t as obvious. 

The days following his birth involved a lot of interactions with medical personnel.  Even though the baby had no other problems, we had to have fittings with a palate cover that would make feeding easier and make sure that the baby was thriving.  To give the parents as much information as possible, I photocopied some pages from my nursing textbooks about cleft palate and part of what it said was ” the nurse should realize that the baby in the mother’s arms is not the baby of her dreams.”  We all thought that was a weird thing to assume.  As the mother went through the system to get the cleft repaired in the ensuing year, she said she never encountered a single nurse who didn’t say “I know the baby in your arms is not the baby of your dreams, Linda”–she was glad I’d given her those photocopies so that she knew what they were repeating.  The mother actually said that she thought babies who didn’t have a cleft palate looked boring! and she also said she was having the repair done so that he would have all the best life could offer him but, for her, he was fine just the way he was.  She attributed her complete acceptance of her son’s beauty to the fact that everyone in the room at his birth saw his magnificence.

November 13th 2008 Posted to Homebirth, Newborn care

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November 12, 2008

Midwife’s Psalm

The other day, I saw a post from the lovely Linda Bennett, midwife extraordinaire, that was a mother’s version of the 23rd Psalm.  Thanks for sharing that, Linda.  Whenever I see a great idea like that, I feel the need to adapt it to other applications.  So, here is a 23rd Psalm for all of you midwives out there.  Disclaimer: I’ve written it for you from my experience of being a midwife for 17 years prior to regulation in my province.  I am no longer a midwife (that is a title reserved in my province for members of the “College of Midwives of B.C.” and I am not a member of that organization.)

I am a midwife, I am safe in the world. I am allowed into the lives of others and am given the words that I speak. Yea, though I make mistakes, none are so great that they can not be forgiven. All I could want is supplied to me and my heart rises up with joy and gratitude. When I am afraid, I know that I am surrounded by a Presence mightier than the petty tyrants of this world. The only enemy I fear is the one within me. There is always an abundant table before me if I will but look and see it. My cup runneth over, if I say so. Surely, I am blessed to have a vocation that I love and that serves the Higher good. My heaven is here and now. In service, I find peace and tranquility and I dwell in the love of the moment, moment by moment. Ah woman.

November 12th 2008 Posted to Holistic midwifery & doula education

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Cesarean on demand?

   

In May of 2006, it was announced that a researcher in my city, Vancouver, BC, had received funding to do a study on why some women “choose” to have a cesarean without making any attempt to have a vaginal birth.  Just recently a limited program was announced at the local Maternity Hospital to “counsel” women about their “choice” and convince them to at least begin birth with the intention of a vaginal exit for the baby.

Now that the horse is out of the barn,  concerned medical minds are tsk-tsking about the ever increasing rate of elective cesarean operations.  The answer to “why” women are choosing this course of action is simple.  When childbirth is hurried due to a need to keep the hospital beds turning over, it becomes dehumanizing and completely undignified.  In the past 20 years, doctors and nurses have been pressured to make childbirth more efficient.  Hospital accountants and insurance payers want to know why someone has to be taking up a hospital bed for 48 hours when they only have to dilate to 10 centimetres.  Just as a person can’t multi-task when they are making love, birthing women are inherently inefficient in giving birth.  Real childbirth takes more patience than anyone in techno/accounting world could possibly muster.  If one tries to make birth “efficient”, then women must be induced, augmented, anaesthetized and, after all that, 1/3 of them will still get major abdominal surgery.  It is natural, after hearing story after story from friends  about “managed obstetrics”, for pregnant women to say, “Not me! I won’t go in and have a chemical soup run through my veins, have my baby oxygen deprived by induction drugs, and then, after hours of torture, get a cesarean anyway.  If that’s how it’s likely to end up, why not just schedule a cesarean in the first place?”     

The rising cesarean rate is a product of a culture that wants to scrimp and save on the cost of childbirth.  The problem is that the cost of this “efficiency” is untold human suffering.  Recovering from abdominal surgery is excrutiating.  Breastfeeding and caring for a newborn baby after abdominal surgery is a nightmare. 

Postpartum depression and cesareans go hand in hand.      

When a society has a rate of cesareans over 30% for first time mothers, it’s a sign that the people who are in charge of obstetrics have become very aggressive and don’t care about the pivotal life experience that childbirth is for women. It’s a sign that the women in the community who take care of birthing mothers have been silenced.  It’s a sign that childbearing women are on their own with no community support for their most important life transformation–being born as a Mother.

November 12th 2008 Posted to Homebirth, VBAC Very Beautiful & Courageous

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November 9, 2008

Birth Victory

This poem was on one of my email lists today.  I think it illustrates so clearly how powerful it is when a woman overcomes all the doubt and fear and takes birth back for herself and her family.  Written by Cherie Boison, I must say “Way to go, woman, and thanks for getting this down on paper.” Gloria

 

I gave birth
Too large of a baby
Too flat of a pelvis
Said I couldn’t do it
I gave birth
Too risky they said
Too much overdue
C-Section scar
I gave birth
Glucose intolerant
Group B positive
What’s your end game?
I gave birth
Without their interventions
Without their fears
Surrounded by calm peaceful love
I gave birth
Let that contraction go
Listen to your body
Holding hands
I gave birth
Birth stool in my kitchen
Birth tub on the floor
Trusting it all
I gave birth
Strong pain
Stronger support
Moaning low
I gave birth
My body isn’t broken
My spirit is healed
My heart is so thankful
I GAVE BIRTH! 

2008 by Cherie Boison

November 09th 2008 Posted to Waterbirth, VBAC Very Beautiful & Courageous

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November 7, 2008

Advice for President-elect Obama from Alice Walker

This post was sent to me by an American midwife.  I, too, would urge the Obama’s to keep their family core healthy as an example to all of us.  Gloria

Alice Walker, author Color Purple

 

Dear Brother Obama, You have no idea, really, of how profound this moment is for us. Us being the black people of the Southern United States. You think you know, because you are thoughtful, and you have studied our history. But seeing you deliver the torch so many others before you carried, year after year, decade after decade, century after century, only to be struck down before igniting the flame of justice and of law, is almost more than the heart can bear. And yet, this observation is not intended to burden you, for you are of a different time, and, indeed, because of all the relay runners before you, North America is a different place. It is really only to say: Well done. We knew, through all the generations, that you were with us, in us, the best of the spirit of Africa and of the Americas. Knowing this, that you would actually appear, someday, was part of our strength. Seeing you take your rightful place, based solely on your wisdom, stamina and character, is a balm for the weary warriors of hope, previously only sung about.I would advise you to remember that you did not create the disaster that the world is experiencing, and you alone are not responsible for bringing the world back to balance. A primary responsibility that you do have, however, is to cultivate happiness in your own life. To make a schedule that permits sufficient time of rest and play with your gorgeous wife and lovely daughters. And so on. One gathers that your family is large. We are used to seeing men in the White House soon become juiceless and as white-haired as the building; we notice their wives and children looking strained and stressed. They soon have smiles so lacking in joy that they remind us of scissors. This is no way to lead. Nor does your family deserve this fate. One way of thinking about all this is: It is so bad now that there is no excuse not to relax. From your happy, relaxed state, you can model real success, which is all that so many people in the world really want. They may buy endless cars and houses and furs and gobble up all the attention and space they can manage, or barely manage, but this is because it is not yet clear to them that success is truly an inside job. That it is within the reach of almost everyone.I would further advise you not to take on other people’s enemies. Most damage that others do to us is out of fear, humiliation and pain. Those feelings occur in all of us, not just in those of us who profess a certain religious or racial devotion. We must learn actually not to have enemies, but only confused adversaries who are ourselves in disguise. It is understood by all that you are commander in chief of the United States and are sworn to protect our beloved country; this we understand, completely. However, as my mother used to say, quoting a Bible with which I often fought, “hate the sin, but love the sinner.” There must be no more crushing of whole communities, no more torture, no more dehumanizing as a means of ruling a people’s spirit. This has already happened to people of color, poor people, women, children. We see where this leads, where it has led.

A good model of how to “work with the enemy” internally is presented by the Dalai Lama, in his endless care taking of his soul as he confronts the Chinese government that invaded Tibet. Because, finally, it is the soul that must be preserved, if one is to remain a credible leader. All else might be lost; but when the soul dies, the connection to earth, to peoples, to animals, to rivers, to mountain ranges, purple and majestic, also dies. And your smile, with which we watch you do gracious battle with unjust characterizations, distortions and lies, is that expression of healthy self-worth, spirit and soul, that, kept happy and free and relaxed, can find an answering smile in all of us, lighting our way, and brightening the world.

We are the ones we have been waiting for.

In Peace and Joy,

Alice Walker

 

November 07th 2008 Posted to Uncategorized

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