On Cesareans

Lara just shared a lovely birth story. It is really interesting to read about this mother’s experience with her cesarean section, and the significance of other people’s opinions and judgments in relation to the mother’s desires and needs. Take a look:

http://birthwithoutfearblog.com/2011/08/31/a-necessary-cesarean-by-mothers-instincts/

- Noor

Expectations

Recently, I’ve been thinking about how a mother’s expectations shape her birth experience. When a mother is expecting, she is not just awaiting the arrival of a child, but also necessarily anticipating labour and birth.

Of course, before labour begins, there is no way of knowing how long it will be or how it will progress. A mother’s mental expectations can radically change the way she feels about herself and her ability to pace herself through labour. Free advice from strangers and friends as well as birth stories from other women can influence the way a mother thinks about her upcoming labour. However, there also seem to be prevalent cultural (perhaps generational?) sensibilities that impact how women view normal birth. Is medication a common and significant part of the birth experience? Should you “just get the epidural”? Such cultural attitudes seem to change over time, and also impact practices in hospitals and other institutions. Furthermore, they extend into breastfeeding and parenting as well. For example, how much effort do postpartum nurses put into helping new mothers establish breastfeeding?

No matter what the historical context, however, a major factor in preparing for birth is education. Parents-to-be who educate themselves about the birth process (through prenatal classes, books, and other resources) can take time to think about the variations of normal birth and about ways to cope with pain. They become better prepared to advocate for their preferences and to deal with unexpected situations. If there is a radical discrepancy between a mother’s expectations of labour and her experience on her child’s birth day, she might be shocked or become discouraged. For instance, if a mother has not prepared herself to work through 80 second long contractions, she might feel that 30 second contractions are very intense. If a mother is hoping for a very quick birth and experiences a long labour, she might become impatient. However, I think the point is not to to think through all the ‘what ifs’ and possibilities, but rather to become mentally prepared for hard work through purposeful pain. Once labour begins, focusing on the present and dealing with one contraction at a time can help tremendously in clearing away unnecessary expectations.

What is most significant in preparing for labour and birth? If you had a birth experience that did not go as you expected, how would you prepare differently if you could do it again? Do you have techniques to ‘live in the moment’ during labour?

- Noor

Another kind of handwork

During the past few weeks, I’ve been immersed in another kind of handwork. Finally focused at the loom, I am relishing the colours and textures of warp and weft.

The colours of the prairie in April

I finally finished weaving my first attempt at a baby wrap.

View from under the loom

At the end of June, I worked through the coursework of Level 2 of the Master Weaver program at the beautiful Olds College campus.

Olds College

Purple-blue columbine

Twill gamp

I sat outside on a bench outside the Ag Mech building after lunch one day, trying to comprehend overshot drafting. I spent the afternoon playing with different treadlings. It was wonderfully exciting to learn a new way of thinking (from individual threads to blocks), and be able to see my thoughts emerge physically in the weaving. I wonder what would happen if… and then a direct twill treadling produced undulating supplementary weft floats.

Overshot sampler with ladder hemstitching

I like how they use lettuce and other vegetables as landscape plants.

A half-hour squall blew in with icy winds one afternoon. Hail fell in drifts to the north, shredding the rhubarb at home. SubhanAllah, I’m thankful for weather.

Storm arriving

As I talked with spinners, knitters, and weavers at Fibre Week, I realized that people were relating to each other on the basis of the work they do with their hands. What job you have or even where you live didn’t particularly matter; it was the skill, creativity, and delight in working with fibre that brought these people together.

As weaving teacher Jean wrote, this kind of work takes practice, and builds up a muscle memory. And I think doula work and birth have a similar experiential emphasis. In small, incremental ways, the body remembers the way we spend our time.

- Noor

Riddle me this…

“You wouldn’t get a tooth pulled without drugs, so why would you give birth without drugs?”

Since when is childbirth like dental work?

Obviously, bringing a new life into the world is very different from rotten teeth. I suspect that this odd comparison emerged after anesthesia became commonplace in both dentistry and obstetrics.

In Deliver Me from Pain: Anesthesia and Birth in America, Jacqueline H. Wolf writes about the role of the media in creating public perceptions and opinions about pain and pain relief choices in labour. In contemporary North America, she writes, there is a tendency to “characterize labor and birth primarily in terms of pain caused and pain treated” (11).

Birth is complex, and the role of pain in the process of labour–physically, emotionally, and spiritually–is by no means completely understood.  By focusing exclusively on fixing pain, we often forget about other facets of birth and the transition into parenthood. While labour and dental work can both involve pain, the potential cascade of interventions in birth makes it important to consider the benefits and impacts of different pain relief options in each particular birthing context.

What do you think? Is all pain the same? Is pain always negative?

Recommended Reading: Breastfeeding

I just wrote a poem for you all! Hopefully the poem makes you all want to read these excellent posts about breastfeeding (particularly extended breastfeeding) in Islam by the very talented Woodturtle.

Breastfeeding in the Prophetic Tradition

and

Extended Breastfeeding in Islam

 

 

What are your views on breastfeeding? Do you have any stories or thoughts to share?

-Lara

P.S. If anyone is interested in British police dramas and/or birth on television, you might want to look into The Shadow Line. I mention this because they show a delivery for which the mother pushes on all fours, and then has immediate, nearly skin-to-skin contact with the baby!

 

Babies in Space

Spoiler warning! If you haven’t seen the two most recent episodes of Doctor Who (and you care about Doctor Who), you should probably avoid reading this!

Over lunch one day during the doula training course I took, we watched clips from various sitcoms in which women gave birth. They were from I Love Lucy, The Flintstones, The Cosby Show, and Roseanne. The common denominator of these TV births was that the focus was typically on the baby’s father/woman’s partner and how he coped (or did not cope) with the situation. In addition, they presented a very medicalized perspective on birth: when labour starts, you grab your suitcase, head for the hospital, and let the doctor (but not the Doctor) take care of the rest.

This was interesting, but pretty standard; we, as doulas, often talk about media stereotypes with regard to perceptions of what childbirth and parenthood should be like. These clips got me thinking, though. How are births portrayed in other television genres? I have no interest in thinking about reality television for as long as it would take to make a blog post, so instead I turned to science fiction.

What does birth look like in science fiction? There are plenty of relatively recent examples to choose from. B’Elanna Torres gives birth in the series finale of Star Trek: Voyager, in the middle of some kind of adventure;  Keiko O’Brien (Star Trek: The Next Generation) gives birth to Molly in Ten-Forward, with Worf as her “midwife”; Dana Scully gives birth to William in a remote cabin with only Special Agent Monica Reyes and an army of possible aliens in attendance; in the 2009 Star Trek movie produced by J.J. Abrams, James Kirk’s mother gives birth to him in an escape pod while his father dies saving the ship and her crew from hostile Romulans; most recently, Amy Pond gives birth to a baby she didn’t even know she was carrying (long story) in a very sterile-looking hospital ship (turn your volume way up for that last clip).

The common feature of all these births? The father of the baby is never there! Moreover, most of these babies are born during some kind of emergency or stressful situation, which is generally why the father cannot be there. While every mother in the instances mentioned

Agent Reyes coaches Scully to push and ignore the alien visitors

gives birth in the supine position, she is never offered drugs (at least not on screen). I wish that I could find some Youtube clips of Scully giving birth on the X-Files, because I find that to be the most interesting birth: one could argue that she has a doula present, in the person of Agent Reyes. (There is also a lot of odd Christological stuff that is never fully explained, but that’s not directly related to the topic at hand.)

Pregnant Amy Pond

Possibly the most disturbing birth in this set is that of Amy Pond, not least because she finds out that she is pregnant at the moment she goes into labour (and it does not in any way resemble an episode of I Didn’t Know I Was Pregnant), and at that moment, she is whisked away from what she knows to give birth in what looks like a cubbyhole with no support. Here again, however, she does give birth–the hostile aliens don’t just grab her and cut it out of her. I’m not sure if that counts for anything in this situation.

What do you guys think? Do science fiction births follow a pattern, or am I only remembering things that fit my theory? Have you noticed other patterns? Do they mean anything?

The Grammar of Informed Choices

“Your choice is the right one.”

A few days ago, I came across this statement in relation to the choices a mother makes when preparing for birth, and have been thinking about its implications. Through pregnancy and labour, mothers are often faced with many new choices, pressures, and decisions. With abundant amounts of conflicting advice in books, on the internet, from acquaintances, friends, and family, it can be hard to decide what is best for you and your baby.

During my prenatal meetings, we usually discuss a mother’s preferences for the birth. Of course, it is important to keep in mind the “inshaAllah factor” (as my mother calls it). But even if the birth doesn’t go “according to plan”, it is very important for the mother to be fully part of the decision making process. The choices she makes, from choosing a medical care provider to deciding what to wear during labour, help a mother become comfortable and relaxed enough to focus on the work of birthing. Where will the birth take place? Who will be there?

Here is my grammatical analysis of the sentence, as a way to start thinking about such choices.

As a second person pronoun, your indicates a conversation. You and I are both present and aware, in dialogue with each other.
As a possessive pronoun and adjective, your indicates ownership. In this conversation, your is not mine, his, or their, but rather refers specifically to you. At the same time, this does not indicate you in isolation: the layered facets and influences in your life contribute to this sense of ownership.

Choice, as a gerund, implies a preference and differentiation in the act of choosing or selecting. It emphasizes the ability and power of distinguishing the best option. As a noun, choice refers to something chosen because of its excellence or suitability. Choice also implies an abundance of worthy options from which to choose. As an adjective, choice includes a sense of care and thoughtfulness in selecting the most appropriate option.
Doulas are often asked for advice, but in the end, the decision is not theirs to make. As doulas, our job is to help mothers become informed, so that they be aware of their options as well as the relative advantages and disadvantages of those alternatives.

The verb in this sentence, is, occurs in the present tense, indicating the immediacy of the choice. This choice is relevant and important in the present context. Is lends a certainty and decisiveness to the act of choosing.

Right, as an adjective, was formerly used to describe a path or road that went directly towards its destination. The right road is straight and true. For this path to be correct and ‘truthful,’ the intention (awareness of destination) and the action (choosing which path to take) are aligned. The adjective right is referring to your choice, indicating that the the choice you make leads you towards the place you wish to reach. It is like canoeing–look in the direction you want to go, and your paddle will take you there. Point your nose in the direction you want to go.

When you're canoeing through rapids, point your nose in the direction you want to go.

Furthermore, the presence of a right choice implies that a wrong choice exists. By inverting the statement, your becomes mine, his, or their, while the choice is no longer right, but wrong. “Your choice is the right one,” when inverted, could read, “Their choice is the wrong one.” That is,  if the mother does not own the choices about her birth, they might lead in inappropriate directions, and the choices are no longer most suitable.

“Your choice is the right one.”
What a complex statement!

Thoughts?

-Noor
(With help from the Oxford English Dictionary Online)

So much of what a Doula does is to help contextualize a mother’s choices; we cannot make a decision, but we can impact the context of the decision.

I think that the relationship that Noor points out between “your” and “right” is particularly interesting: that “their” choice, or “my” choice would be the wrong one in that situation. This emphasizes that no matter how many desires and opinions are present in the birthing space,  there is one person (the “you,” the mother) at the center of it all (you could also say that there are two people, or a family, but that is a discussion for another post!). Lots of different choices will be made during a birth–how to act, what to say, what positions to try, what sounds to make, what courses of action to take–and all of these choices must take into account the mother and her new child. Every person in that room might feel that they are a ”you” with a “right choice.”  

As doulas, we need to be aware of those choices being made, and do our best to connect the choices that we make to the mother and her partner. If nothing else, the choices we make should remind the mother that we are there to support her through this experience; we are there to remind her that she does have a choice, and that it is the right one.

The difficult part of this is when a mother only has a limited number of options, when things do not go to plan. We can help a couple prepare for this in advance by asking them what their choices would be if a c-section became necessary: who would the mother choose to have with her in the OR? Does her hospital allow for skin-to-skin contact directly after a c-section? Would it be OK for her partner to show the baby to the family while the mother was in recovery? These might be hard questions to consider when you are counting on a healthy, natural birth, but this is the “inshallah factor”: trust in God, but tie your camel.

Even if we can’t control the course a birth will take, we can, as Noor pointed out, point our canoe (or our nose) in the direction we want to go.

If you are a mother, what are the three things you want most for the birth of your baby? The constant presence of your partner? To avoid pain medication? To have each procedure explained to you? To limit the number of people in the birthing room? To have everyone introduce themselves to you as they enter? To be able to eat and drink during labour? What else?

If you are a doula, what are some ways you can help a mother contextualize her experience in labour, either before, during, or after? What if she feels she made the wrong choice? How do you talk about that?

-Lara

Doulas and Hospitals

I just read this article by MotherWit Doula, and I think that it contains some important lessons for all doulas — as well as for expectant mothers — regarding the doula’s scope of practice.

This is particularly relevant in Ontario right now, as there are hospitals considering policies that would require doulas working with mothers there to carry over a million dollars in insurance.

It is important to remember that a doula cannot control a mother’s experience, nor can she make any clinical judgement calls. She is there to support, support, and support. She gives encouragement and praise and comfort, but she also has a responsibility to remember her limits. A good doula knows that she needs to work as part of a team to keep the mother and baby healthy and happy.

-Lara

With what intention do we enter a birthing space? MotherWit Doula makes a very important point that “the client and her partner are not victims” but rather can make conscious choices about the birth. A doula supports the mother by providing information and reminding her to advocate for herself. As an educated and trained support, the doula brings her skills to a birth not to change or influence individual birth practices, but to help the mother make better, more informed decisions in her own journey. The critical attributes of a doula include listening, being reflective, responsive, and supportive.

Especially as a new doula, when I’m driving to a birth, I rethink my role. Why am I attending this birth? What is my intention? How can I best support this mother? Ultimately, the doula is the member of the birth team who is there solely for the mother.

-Noor

So many ways to sleep a baby…

One of the most important issues in the lives of new parents is sleep. A re-arranged sleep schedule can be a difficult adjustment for someone who has sleep difficulties, or needs a solid eight hours of sleep to function. It can also be frustrating to hear lots of advice (much of it contradictory) about how to put your baby to sleep, how much rest your baby needs, and how you should be sleeping. It’s not easy to wade through so much “authoritative” advice and still feel confident making your own choice.

Image from iStock photos

A few months ago, I read a very interesting article about parenthood and co-sleeping called “Sleeping with the Baby.” It wasn’t published on a parenting site, or in a baby book, but in the New Yorker. It is currently located in the “Stories” section of author John Seabrook‘s website.

What I liked about this article was that it was a story – the experience of two new parents trying to decide what to do: it didn’t claim to be advice, nor did it claim to have an answer.

I liked it so much that I sent it around to all the parents that I know — parents-to-be, new parents, parents with toddlers, parents with elementary school-age children, parents with teenage and university-age children, and even my parents — and asked them what they thought.

The responses were so interesting that I asked permission to post them here. What I loved about them was what I loved about the article: they were individual, interesting, personal, and well-informed. There were a lot more responses than what I’ve posted below, but these were all conversations in person, and I don’t want to try to transcribe them from memory in case I get things wrong. I will mention, since only one of the responses posted below is from parents who slept in the same bed as their baby, that three of the families that I talked with in person did bed-share with their babies (and that one of those bed-shared babies was me!).

Parents-to-be:

• excellent article. but as a 6’2″, 250 lbs deep sleeper who frequently rolls in bed (i rolled off the bed last night and hardly noticed – seriously), the idea of co-sleeping with my baby freaks me out. but maybe that’s just soon-to-be parent jitters.

• Hmm. An interesting article. The author does not make the distinction between co-sleeping and bed-sharing, which is a distinct difference. Technically, co-sleeping is sleeping with the baby in the same room as the parents, while bed-sharing is sleeping with the baby in the same bed as the parents. I will never, ever sleep in the same bed as my baby for several reasons: my husband is a heavy sleeper and frequently rolls over without waking; I have to sleep with lots of pillows and blankets, which are serious suffocation hazards; and I cannot guarantee I will sleep lightly enough to hear if my baby is fussing or suddenly trapped under a blanket. I think it’s a dangerous proposition that I won’t risk. However, I plan on having the baby sleep in a bassinette next to my bed, at least for the first little while (unless my husband’s snoring wakes the baby!). I thought that bringing up SIDS was a slightly dated interpretation. As far as my internet research (and make of that what you will) goes, SIDS has been linked to off-gassing of crib mattresses. The incidence of SIDS has dropped dramatically even since the medical community has promoted the ‘back to sleep’ stance for infants–the idea being that the baby’s face is turned away from any noxious or toxic fumes by being on its back. I’ll be buying a wool and cotton crib mattress that doesn’t contain any plastic compounds. They’re hella expensive, but I think worth it.

Parents with school-age children:

• My husband and I just had a good chat….thanks for sending the article. What struck me the most? “Not one of the anti-co-sleeping authorities gives any really compelling reason that kids should sleep on their own, other than the parents’ convenience.”This was good enough for me. I couldn’t sleep when I had my first baby in the room. I was a wreck. So therefore she was in her own crib in her own bed by 6 weeks (my second baby didn’t even get one night in our room!) and would sometimes come for a snuggle after the 6am feeding, but that was it. Did my husband have much say in the decision? Not really, but he was a rock once I decided to put my first baby in her crib.Don’t get me wrong, I’m not anti-co-sleeping for other families, I just couldn’t have her in the same room as me and then function the next day. I really like what Ferber ends up saying at the end “My feeling now is that children can sleep with or without their parents. What’s really important is that the parents work out what they want to do.” So true. What drives me batty is listening to a friend say that “Gaby won’t sleep on her own and I’ve never had a good night ‘s sleep since she was born”. Gaby most certainly would sleep on her own if she had always slept on her own, but now that she has slept with you for the last 7 years, she’s not keen to leave, so please don’t bitch to me about your parenting choices. Looks to me like you made the choice to have your child sleep with you, so be grateful for the choice you made and see the joy in it, you’re not getting sympathy from me!!!I’m a little sad that I missed out on sleeping with my children (my second child doesn’t like me being in her bed for too long at bedtime, boo hoo!), but I know it was the right choice for me. Will my girls turn out ok and be bonded with us (their parents)? Yes. They will be fine, just like other friends of mine who happily still co-sleep with their children and DON’T bitch about it!!!

Parents with teenage and university-age children:

• Interesting article and always an interesting discussion.  As for my husband and I, we slept with both babies.  As I had a miscarriage on our first try, there was no way these beautiful babies of mine were going to sleep away from me. I felt such a strong urge to protect them…there would have been no way I could have rolled over – I’m not that kind of a sleeper (and there was no way that I was going to let my husband roll over – because really I’m not that kind of a sleeper). I did gradually start moving them out of the bed, into a basinet right beside me, but they probably ended up back in bed after the second or third waking. I guess something that could influence your decision is what kind of sleeper are you?? I know at the beginning it was probably a little harder for my husband, because he was used to being the one who got all the attention, but after awhile, he came to love their presence with us.  I can’t really describe the feeling of sharing a space with a beautiful little soul, when the whole world is still, and all you can hear is their breathing…there’s really nothing like it, and I wouldn’t have traded that feeling for anything.

So, what do you think? Would you bed-share with a newborn? What about co-sleeping with older children? What was your plan before your children were born? Did it change once they came along? You can post your responses in the comments, or email them to us privately. With your permission, we’ll post some of the stories here with the others!

-Lara

Alternatives and Choices

Bismillah: inaugural post!

Welcome to our blog!

I called this post “Alternatives and Choices” because it refers directly to what I want to talk about (cloth menstrual pads) but also because it is a main theme of this blog: knowing and understanding your options and learning what works for you. A doula is there for you during your pregnancy to provide you with the information and support that you need to feel confident making decisions for yourself, your family, and your new baby; this Doulalog is a place to post thoughts and ideas that might get you thinking about the kinds of choices that you can make in your everyday life…

I wanted to write about cloth menstrual pads after reading this post on A Cure for All Things (the blog of a fantastic doula in Massachusetts). I think that menstrual cups are a great alternative to disposable products, and I wanted to mention one other: cloth menstrual pads. These pads are available for purchase from a variety of sources (Lunapads and Moonpads, for example), and are also relatively simple to make if you (or your mother, or a friend) have a sewing machine or some stitching-savvy.

I use both methods, and I find that they are useful in different ways. I like the menstrual cup especially for when I’m travelling, as it is compact and easily washed almost anywhere. I prefer cloth pads for days that I am home and especially near the end of my period when the flow is lighter and more irregular. They are also a good option for people who aren’t comfortable inserting tampons or menstrual cups.

Cloth pad in progress

My mother (a very talented maker-of-things) made my current set of cloth pads for me by special request, and I have been using them regularly for the last year and a half. The clean-up is very simple: I soak them all in a mixture of water and vinegar and then machine wash them with the towels at the end of my period. Some people find that they have less intense cramps and lighter periods when they use these pads, others like them just because they are an economically sound choice, and many like them because they are an environmentally sound choice, producing little to no waste. I expect that when mine wear out, I’ll bleach them out and use them as rags to scrub the bathroom.

There are some very comprehensive tutorials for making cloth pads by Hillbilly Housewife, AlterEco and the very literally-named Make Your Own Cloth Pads. Each of them has a slightly different way of doing things, so find the one that makes sense for you!

What do you think? Are you comfortable with the idea of using cloth pads? Do you have any hesitations?

-Lara