Happy Birthday!

One year ago today I gave birth to Zari on the floor of my master bathroom. Now she's walking, crawling, eating food, terrorizing the dog, and getting more personality every day. How does that happen?

I feel like I should write something very profound, bordering on sentimental, but I can't think of a way to express the entirety of a year in a few words. So let me leave you with some pictures of Zari on her first birthday, in her Little Red Riding Hood costume I made for her. More pictures to come after her birthday party tonight.

But before you get to see the pictures of the costume, you get a blow-by-blow of its creation. Because of course I can't just go out and BUY a Little Red Riding Hood costume, or even just red fabric and a cape pattern. Nope. That would be too easy. I had to dye pieces of wool and silk, devise a pattern myself, and then sew it with lots of "help" from Zari. The wool is stuff I bought waaaaay back in high school. I made several baby blankets with it and had a long, narrow piece left over. The silk charmeuse scraps are left over from making my wedding dress.

The wool & silk awaiting their destiny, next to a pot of acid dye from Dharma Trading Co.

Dyeing in process.

Fabric is cut out. I wanted to make a big hood--I think they look more dramatic--
but it ended up way too huge. Oh well. It's still cute.

Zari helping me sew.

...And the end result!

Le Premier Cri (The First Cry)

I just discovered this fantastic French film Le Premier Cri that premieres tomorrow on Zari's birthday! It follows pregnant women all around the world, as they live, work, and give birth. You can download a trailer at the website. (For you non-French speakers, click on "La Bande Annonce," then on "Version Longue.") You can also click on different countries on the globe and read about the mothers profiled in the film.

The American woman featured in the film had an unassisted birth! And in Mexico, two friends have ocean births surrounded by dolphins, with the same midwife. I can't wait until this comes out on DVD!

Comments about To The Contrary

I part ways with Lynn Griesemer over the father's role in unassisted births. We've talked about this, and she has more of a "daddy delivery" philosophy about unassisted birth. I don't think men should be "front and center" in births. Women should be. After all, they are the ones giving birth! It's really not that hard to catch a baby, yet when men (or doctors) do it, they get all sorts of glory and acclamation. My husband's role at the birth was to sit in the other room and wait as I birthed our daughter (and to be errand boy when I needed food & drinks). Now, that was exactly what I wanted and needed him to do, so it's not like I resent that in any way. The most significant thing he did for me--more important than any coaching or catching or delivering--was giving me blessings when I asked for them. (LDS lingo here...let me know if you haven't a clue what I'm talking about.) The blessings gave me absolute certainty that both I and Zari would be perfectly healthy and that the birth would go smoothly. There is no machine, no test, no care provider who could do that!

Even though Lynn would not identify herself as a feminist, I do agree that birth issues are noticeably absent from almost any feminist platform. That's a shame, I think. The National Organization for Women has recently made some statements about birth issues, including a statement against VBAC bans, but otherwise feminism has been oddly silent on the birth side of "reproductive rights." I also think that the almost exclusive focus on abortion has alienated many women who are concerned with the rights of childbearing women. Women need more opportunities to unite, and unfortunately the abortion issue is one really good way to keep women divided.

Dr. Healy claims that she supports patient's rights to refuse treatment, yet she undermines that by her statement that "when you’re making that decision for a child, it’s a very different situation." Is it different? Pregnant women have the same medical and legal rights as non-pregnant people (with the very disturbing exceptions of court-ordered obstetrical interventions). This is the same double-talk that ACOG uses in its statement against home birth: "Although ACOG acknowledges a woman's right to make informed decisions regarding her delivery, ACOG does not support programs or individuals that advocate for or who provide out-of-hospital births" because "the American College of Obstetricians and Gynecologists believes that the hospital...is the safest setting for labor, delivery, and the immediate postpartum period." ACOG's active opposition to out-of-hospital births stands in direct contradiction with its claim to support women's choices in health care.

It's kind of like saying "We support your right to choose any color of car you wish. But you can only have a blue car, because we believe that all other colors are unsafe. In addition, we will actively oppose any car manufacturers who promote, sell, or distribute non-blue cars. We can do this, because we have a monopoly on the $33 billion-a-year business of car manufacturing, sales, and advertising. But remember, we support your right to choose!"

I agree with other commenters that Dr. Healy skimmed over the issue of babies dying in hospitals. Yes, it's true that neonatal deaths are fairly uncommon anywhere in developed countries. But her comments imply that a hospital is the only place that the low death rate can be ensured, and that any infant deaths that occur in hospitals are unavoidable.

The doctor also shows a blatant lack of knowledge about unassisted birth, or home birth in general, with her claim that first-time mothers do not make that choice. What irks me is that her statement will be taken as factual and authoritative, simply because she is a physician.

I am also puzzled by her comment that "you don’t know the health of that baby until that baby arrives." Isn't that one of obstetric's main claims--that it can monitor, assess, and predict the health of babies during pregnancy and birth? Why else all the monitoring during pregnancy (ultrasound, screening tests, etc) and birth (electronic fetal monitoring)? Is her statement an admission that the standard obstetric care really cannot predict outcomes with any accuracy, let alone avert them? Or is her comment meant to mean that women birthing at home cannot know whether or not their baby is healthy while it is in utero? Because certainly women can and do feel their baby kicking and moving, listen to the heartbeat, and keep track of the baby's growth. Read that way, her statement implies that a physician has a better knowledge of the unborn baby than the mother herself.

Of Eleanor's comment--which I find immensely condescending and anti-woman--let me just say that safety, satisfaction, and empowerment are not mutually exclusive. In fact, the factors that bring unassisted birthers pleasure (privacy; security; complete freedom to move about, eat, drink, and vocalize; not feeling observed or monitored or pressured to birth in a certain amount of time; lack of drugs and interventions and their known side effects; absence of stress and fear; optimal hormonal levels that help the mother experience ecstasy and bliss; ability to focus on labor and not on outside distractions) also enhance the safety of both mother and baby. The pitting of fetal safety versus maternal satisfaction is a cornerstone of the obstetric worldview, as Robbie Davis-Floyd notes in Birth as an American Rite of Passage. The midwifery paradigm, in contrast, perceives the mother and baby as an inseparable, mutually dependent unit. What is good for the mother is good for the baby, and vice-versa.

I fear that this discussion of safety is quickly turning into a dissertation itself, but let me briefly add some insights from Sarah J. Buckley. She argues that the safest, easiest, and most ecstatic births are ones that are undisturbed:

"Anything that disturbs a labouring woman’s sense of safety and privacy will disrupt the birthing process. This definition covers most of modern obstetrics, which has created an entire industry around the observation and monitoring of pregnant and birthing women...On top of this is another obstetric layer devoted to correcting the 'dysfunctional labour' that such disruption is likely to produce. The resulting distortion of the process of birth—what we might call 'disturbed birth'—has come to be what women expect when they have a baby and perhaps, in a strange circularity, it works."

In contrast, undisturbed birth and its “optimal hormonal orchestration provides safety, ease, and ecstasy." She explains: “When a mother’s hormonal orchestration is undisturbed, her baby’s safety is also enhanced, not only during labour and delivery, but also in the critical transition from womb to world....[I]interference with this process will also disrupt this delicate hormonal orchestration, making birth more difficult and painful, and potentially less safe.” She uses two analogies to explain the optimal conditions for undisturbed birth: lovemaking and meditation, both of which necessitate privacy, quiet, and freedom from feeling watched. “If we were to consider giving birth as the deepest meditation possible, and accord birthing women the appropriate respect, support, and lack of disturbance, we would provide the best physiological conditions for birth.” [1]

I also want to say that childbirth was definitely something that I embraced and enjoyed in many ways. Some parts were challenging, some were very very exhilarating. Pain was present at times, but so was immense pleasure, experienced in the form of an incredible endorphin rush between every contraction. Five minutes after the birth, I said, "that was hard work, but definitely doable." Distance runners experience this same mixture of pleasure, pain, exertion, and exhilaration. I can say this from personal experience, since I am very close to running a half-marathon. My longest run so far has been 10 miles.

Now, in case you are tempted to dismiss my experience by figuring that I must have an unusually high pain tolerance, let me set the record straight: I was known for my extremely low pain tolerance growing up. I would scream and wail over every little thing, so much that my mom didn't believe me when I broke my wrist and waited 10 days before taking me in to the doctor!

Eleanor's disparaging comment about enjoying labor and birth is destructive and indicates either some very traumatic personal experiences giving birth or very strong cultural programming that birth is inherently and inescapably traumatic.

And the final panelist...where to start? She reiterates that choosing to birth at home unassisted is selfish, yet her own childbirth preferences (using drugs, including general anesthesia) confer no physiological benefits to mother or baby during normal labor, and also pose many significant risks, as Dr. Buckley has thoroughly documented. We could very well argue, with much more substantial evidence than any of the panelists had, that any mother taking drugs for pain relief is selfish--caring more for her own experience than for the baby. (Not saying that I want to use this label, because there is too much woman-hating and guilt spreading out there already).

This concludes tonight's episode of "Rixa writes, raves, and rants whilst remaining reasonably restrained in her responses."

---

[1] Gentle Birth, Gentle Mothering 110-114.

Transcript of "To The Contrary"

I have a lot of comments swirling around in my head about this discussion, but they will have to wait for another post...Anyway, here's the transcript.

The Freebirth Movement:
To The Contrary
October 19, 2007

Host Bonnie Erbe: The latest trend in birthing is women delivering babies unassisted and at home. That means no hospitals, no drugs, no doctors. Instead, women and their spouses control the delivery process. Freebirther and author Lynn Griesemer says freebirths reinforce what it means to be a woman.

Lynn Griesemer: Hospital birth is just one-dimensional, where the doctors are looking to have a live birth, a safe baby, while making a profit and avoiding lawsuits. And to me, as a woman, to access your feminine power is much more than that in giving birth. It is spiritual. It is a very private event, and I did not like the fact that in the delivery room it was not a private event. When you can try to have it as natural as possible, a woman can really enjoy the experience actually.

Host: And it’s not just women who benefit, says Griesemer.

Griesemer: Men are an important part of birth, and in an unassisted home birth the man is front and center. He’s not just some passive person sitting on the side watching the whole procedure. He has shouldered a big responsibility if something were to go wrong. He’s right in there.

Host: After having their first four children the conventional way, Griesemer and her husband decided to have their last two children at home with not even a midwife present. Griesemer says while feminism has done a lot for abortion rights, she believes the movement has neglected childbirth.

Lynn Griesemer: We have a monopoly in this country of hospital birth. 95-99% of babies are born in the hospital. It’s a big money-making business, and women are not happy with that situation. And the medical community wants to totally annihilate the option of a home birth. The feminists could just maybe acknowledge the importance of birth—that it is one of the most key rites of passage a woman will go through and to not ignore it.

Host: But the unassisted home birth movement is a contentious topic in the medical community. While studies comparing the safety of do-it-yourself births versus hospital births are limited and not scientifically rigorous, the American College of Obstetricians and Gynecologists has denounced home births for the risks to both mother and child.

Griesemer: The problem is that there can be complications. Granted, it’s very uncommon. The vast majority of deliveries are perfectly safe and perfectly fine. But the problem with obstetrics is that there can be an emergency or problem that occurs without any forewarning whatsoever. So this is not something that we take lightly. We unassisted birthers do put safety as a number one concern. We don’t want to die; we don’t want our babies to die. We just have more courage, I suppose.

Host: Do they have more courage, Dr. Healy?

Dr. Bernadine Healy: I think this is foolhardy, not courage. And I think that I very, very strongly respect any patient who wants to walk away from medical care, whether it’s the latest medical care or hospitals, whatever. But I think that when you’re making that decision for a child, it’s a very different situation. And I think the biggest risk here is to the child. And even though it is infrequent, as it is anywhere, the mother is really being kind to her child to make that decision in the interest of it being a spiritual, feminist experience.

Host: Okay, but let me ask you this: Do babies die in hospitals when they’re born? Is there a percentage of loss of children born in hospitals?

Dr. Healy: Well, but very, very rarely. Usually those are problem children who have malformations or who are born very prematurely. I will say, in defense of the freebirthers’ movement, most of the time these are women who have already had many, many children. And quite honestly, they usually drop those babies fast. I mean, these are easy deliveries and they are the ones that don’t usually have complications. But you don’t know the health of that baby until that baby arrives. And I’m concerned about a little baby coming out who’s blue, who needs some sort of sophisticated care and it is not there and will be delayed getting it.

Eleanor Holmes Norton: The point of being a mother is to think first of the baby and not of yourself. This is the most self-centered decision a woman could make. And the whole notion that childbirth, under any circumstance, could be, quote, “enjoyable” is not what, quote, “labor” is all about! However, however, it is true that since the beginning of time women have given birth unassisted. And then as time went on we found a way—not to say that no child will be born dead or deformed—but to say that we can mitigate that today. It’s that they are throwing away because it’s romanticism at its worst.

Host: But what about in the 1800s before we had routine hospital births, it was often the mother who died in childbirth, not the children. I don’t know what the data are--you might be more familiar with it than I am—but isn’t the mother more likely putting herself at risk? That women are more likely to die in childbirth? I mean, women now outlive men. Why? Not because they’re really living percentage-wise that much longer, but so many fewer women die than 100 years ago in childbirth.

Dr. Healy: But, well, maternal mortality and child mortality tend to track together. So you can’t separate the two. But I think that the issue with mothers is these are mothers who have already been experienced. You don’t hear anybody who’s having their first baby who’s going to say, "we’re going to do it at home." Those tend to be the longer labors and those tend to be the more difficult deliveries. So I think that to compare it to what went on in the 1800s...If we want to take medicine and move it back to the 1800s, we’ll solve the whole issue of healthcare! We don’t have to worry; we won’t spend a penny on it. I mean, this is foolishness.

Panelist: Well I can tell you that I think as the lone person in this panel that hasn’t had children, I am not looking forward to the experience with no drugs, no doctors, unassisted at home! Please put me in the hospital where I can have that. Wake me up when it’s over! This is something that is similar to the Christian Science trend. These are people who have a very specific way of thinking that is, like Eleanor said, a very selfish one. And the health of the baby and their own health—the baby doesn’t have the choice.

Host: All right. We gotta go. That’s it for this edition of “To the Contrary.”

Sick

I spent all last night puking and visiting the bathroom with a high fever and chills. And then a few minutes before he was supposed to leave for work this morning, Eric started throwing up. I had to convince him to stay home--he was going to teach anyway!--and he promptly went back to sleep until after noon. We've been spelling each other off watching Zari so the other one can sleep. I can barely move. Fun fun fun.

Zari is chipper as usual. She's been fairly content to let us lie comatose in the room and watch her play.

I took some (generic) Pepto-Bismol this morning after the fourth time throwing up. It was a childhood favorite because it always did one of two things:

• tasted so gross that you threw up, and then you felt better
• settled your stomach, and then you felt better

I never thought I would be nostalgic about Pepto-Bismol.

Mama Knows Breast

Andi Silverman asked me to review her new book, Mama Knows Breast: A Beginner’s Guide to Breastfeeding.

This is not your ordinary how-to-perfect-your-latch or 10-ways-to-fix-thrush technical manual. It’s not a book about how to breastfeed. Instead, it’s a book about how to be a breastfeeding mom. In other words, it’s about the breastfeeding life. Mama Knows Breast includes advice about dealing with runny poop, nursing on the go, engorged/leaky/humongous breasts, horny husbands, or getting the most sleep possible.

Target Audience

I would give this book to a woman who is new to breastfeeding. She is determined to nurse her baby, but she does not have a lot of familiarity with the how-to’s and nitty-gritty details of life as a breastfeeding mom. Nursing pads, plugged ducts, and football holds are all fuzzy terms to her and she wants to figure this whole nursing thing out. It’s the kind of book that tells you what your mom, sister, best friend might say if they were around to give you advice.

This book would appeal less to women who have already nursed, since they will probably have figured most of if out the first time around. However, it would be a great gift for an experienced mom who has never nursed her children before.

This book should be given as a companion to a more technically-oriented breastfeeding book such as Jack Newman’s Ultimate Breastfeeding Book of Answers (one of my personal favorites, but I am sure there are other excellent guidebooks as well). Between the two books, any new nursing mom will have all the answers she needs right at her fingertips. If she’s really struggling with the latch or thrush or sore nipples, she can consult the technical manual for detailed answers. But if she just wants advice, encouragement, or a good laugh to keep her going during a 3 a.m. nursing session, she can turn to Mama Knows Breast.

Content

In her introduction, Andi Silverman sets the tone by reminding us that “mama knows breast”—no matter what your mom, doctor, aunt, or next door neighbor might say, YOU are the best person to decide what’s best for your baby. This book contains helpful advice if you are encountering challenges or even just unanticipated situations. As a pediatrician says in the book's foreword, “The key to success is trying different methods until you find what works for you. Have a sense of humor about it, and don’t give up. Most important, always ask for help....If you aren’t ready to pick up the phone just yet, Mama Knows Breast is a good first stop.” In the introduction, Andi reminds us that “breastfeeding is truly a matter of personal choice. It’s up to you. Your life, your decision. Do some reading, get expert advice, and then make up your own mind.” Her book includes advice and anecdotes from a lot of “ordinary” moms. Just look for the highlighted boxes with the heading “From the Mouths of Moms.” These snippets don’t always say the same things—instead, they show the variety of approaches that women have to breastfeeding.

Mama Knows Breast covers a variety of topics related to breastfeeding: the ups and downs of breastfeeding, basic latch and positioning, myths and realities of breastfeeding (from using medications to adoptive nursing), tricks of the trade from experienced moms, breastfeeding etiquette in public places, how a woman’s significant other can help her with nursing, sex life and relationships, relaxation techniques, and weaning advice.

Andi’s central point is that when it comes to breastfeeding, “mama knows breast.” However, I found that some of the information and advice she included deferred heavily to experts. For example, she included a story from a mom who started supplementing with formula and hired a night nurse because she was “doomed” with a “starving” son who was losing weight. The story ends with the mom extolling the benefits of supplementing! This is definitely not an example you’d expect in a breastfeeding-friendly book. There are also several times she defers to the standard advice to “consult your doctor.” Which is fine if your pediatrician or family doctor is up-to-snuff on breastfeeding, but unfortunately there are a lot of formula-pushing doctors out there.

Design and Layout

Mama Knows Breast measures a petite five by seven inches and has an appealing graphic design. It is quirky and feminine without being fussy or frumpy. From the illustrations by Cindy Luu to the font type and colors, this book has a 1950s retro-chic feel. The main font is robin’s-egg blue, and titles and headings are rocket red. At times, I found the font colors a bit garish and distracting, but they also make the book much more visually appealing than plain black-and-white. Every chapter includes numbered lists and headings that summarize the most important information. If you’re in a hurry (or have a hard time focusing—perhaps your baby is pulling at your hair or poking a finger up your nose) you can easily skim over the main points.

The illustrations show stylized zen mamas with ultra-cute pixie haircuts and yoga outfits, holding roly-poly babies wearing comfortable pajamas. Just looking at the pictures makes me feel cute, sassy, and hip. My only criticism of the illustrations is their simplicity. Sometimes there’s not enough detail for me to make out essential information, such as what a proper latch should look like, or how to do a cross-cradle hold correctly.

Breastfeeding is more than just transferring milk from mother to baby. It's a way of life. Mama Knows Breast tells us what it's really like with sass and style.

Business of Being Born coming to Eureka College!

It’s official!

Eureka College is hosting a screening of Ricki Lake’s documentary The Business of Being Born!

• What: screening of “The Business of Being Born,” followed by a discussion panel. The film is 87 minutes long.
• When: Saturday, November 17th at 1 pm
• Where: Eureka College, Becker Auditorium (located in the Cerf Center building). Eureka College is midway between Peoria and Bloomington, IL
• Who: Everyone is welcome!
  
• Cost: We are asking for the following suggested donations to cover the cost of bringing the film to Eureka College:
  
• $5 and up: students
  
• $10 and up: adults
  
• $20 and up: families

For questions, or to reserve your seats, please contact Rixa Freeze at eurekadocumentary@gmail.com.

Exercise update

I ran 10 miles on Saturday and 7 miles during the week. I missed one of my 3 mile runs because Zari woke up 7-8 times that night and I was exhausted. It's funny--it's almost harder mentally than physically to run for so long. I mean, it's physically challenging, but it's almost more difficult to concentrate on running for 2 hours. I find that when I don't focus, I start plodding along very slowly and inefficiently.

What women aren't told

I just came across this article about what women aren't being told about childbirth. It summarizes many of the main problems with our current maternity care system.

I met Dr. Eisenstein this spring while I was in Springfield lobbying for midwifery legislation to legalize CPMs. He came down from Chicago to testify in behalf of home birth and midwifery. On the train ride home, I and two other women were able to chat with him. He's a charming, delightful man.

Life with an 11-month old

What does an 11-month old do? Some of her favorite things are blowing spit bubbles and popping them, and making horse lips/blowing raspberries. She started eating solids around 10 months old, and now she gets tastes of what we're eating (except meat & dairy, which I am holding off for a little while).

She's still nursing every 2-3 hours at night and I am going a little crazy. I've tried putting her in her crib, which is near our bed, but she still wakes up just as much. When she wakes up at night, she will only fall asleep again I nurse her. If we cuddle, rock, or bounce her, she just gets mad and wakes herself up all the way. Sigh...yawn...

Here are a few recent videos from our everyday life.

Kicking her miniature soccer ball around the house:


Chasing Zeke and giving him his toys:


Dancing to the Beatles:

Sunday Express article

Another article just came out about unassisted birth in the UK: "The Women Who Want to Give Birth on Their Own" in the Sunday Express (October 7, 2007). The article's author is the president of the National Union of Journalists, by the way.

Chapter 4 is written!

16,265 words later (not including footnotes), I have finished a draft of my fourth dissertation chapter about "Safety, Risk, & Responsibility." Whew.

Next chapter will be about the interplay between UC and midwifery:

• how UCers view midwifery
• how midwives view UC
  
• UCers' experiences with midwives
• the effect of UC ideas on midwifery practice
  

and more!

Is Fat a Moral Failure?

We tend to speak of obesity as an individual's moral failure--they eat too much, they don't exercise enough, they don't have enough self-control or willpower, they don't buy the right foods at the grocery store, they snack too often . . . ad infinitum. Now, of course it is up to the individual to make many of these choices. But constructing obesity as an individual, rather than as a social, issue makes it easy to abscond responsibility for bringing about change. For example, we could point to numerous other factors that influence obesity, such as:

• lack of walkable cities and neighborhoods, which forces people to drive rather than walk
• the cheapest food is often not the healthiest (due in part to government subsidies of certain commodities)
• the diet industry, which often sells weight loss as something that should happen with no effort
• terribly unhealthy and un-nourishing school lunches
• availability of pop, junk food, and fast food at public schools
• schools cutting recess and physical education
• marketing of junk foods to children, especially via television

Looking at food issues this way, we can see how obesity is not just an individual problem, but a complex issue that has a lot of social and cultural influences, ones that we have the power to change.

I'm reading the book Conceiving Risk, Bearing Responsibility about the diagnosis of FAS. I ran across this passage that is relevant to our recent discussions about "blaming" overweight women for their pregnancy complications and also for the rise in cesarean rates.

The construction of the diagnosis of FAS reflects the emergence of an epidemiological paradigm emphasizing risk factors rooted in individual behaviors and predilections; indeed, it epitomizes our modern American tendency to locate explanations for disease at the individual—whether behavioral or biological—level rather than to see disease as the consequence of social conditions. Americans’ tendency to attribute social ills to individuals’ biology rather than to society mirrors our propensity to look for solutions to problems in medical technology, cures, treatments, and changes in individual behavior or “lifestyle.” Biologizing problems also individualizes them—taking them out of the realm of society and embedding them in the bodies of individual women, children, and men. This process of medicalization and subsequent desocialization is a powerful tool for maintaining the status quo, since it reinforces the belief that individual, not social, change is called for. (11)

Is is so much easier to blame the woman for her problems (and for the "rescuing" that she will need from herself) than to address the root causes of those problems. This is true not just for obesity-related pregnancy complications, but also for childbearing in general. From Ann Oakley's book Essays on Women, Medicine, and Health:

The fact that poverty is the biggest known risk to the health of mothers and babies is not something that most obstetricians wish to take on board....One of the biggest risk factors for the healthy survival of infants is the orientation on the part of many of the world’s governments to death—in the form or arms expenditure—rather than to life. (136)

excerpts from Woman in Residence

Here is an excerpt from Dr. Michelle Harrison's book Woman in Residence. She is family doctor who did residency training in OB/GYN; this book describes her experiences as a resident.

Imagine dancers on a stage. Once, doing a pirouette, a woman sustained a cervical fracture as a result of a fall; she is now paralyzed. We try to make the stage safer, to have the dancers better prepared. But can a dancer wear a collar around her neck, just in case she falls? The presence of the collar will inhibit her free motion. We cannot say to her, "This will be entirely natural except for the brace on your neck, just in case." It cannot be "as if" it is not there, because we know that creative movement and creative expression cannot exist with those constraints. The dancer cannot dance with the brace on. In the same way, the birthing woman cannot "dance" with a brace on. The straps around her abdomen, the wires coming from her vagina, change her birth.

The birthing woman plays in an orchestra of her body, her soul, her baby, her loved ones, her past and her future. And we do not know who leads the orchestra.

Doctors cannot lead the orchestra, because they are not within the process. Unable to hear the music, trained only in modalities of power and control, they can only interfere with the music being played.

What should they be able to do? They should stand ready to help the player in trouble to get back into rhythm. Instead, they take over. Instead of supporting the mother, they say, "Okay, you have failed. It's our piece now."

How do you get a 30 percent Cesarean rate? You orchestrate it. You write a piece in which the third movement is a Cesarean, then build the first two with that in mind. You write in a different language; you write in terms of centimeters of dilation, external fetal monitor, internal fetal monitor, pH, scalp electrodes, Cesarean birth experience, arrest of labor, protracted labor, fetal distress, episiotomy, prolapse, cephalopelvic disproportion, ultrasound waves, amniocentesis, "premium baby," post-mature (when the baby stays too long in the uterus), "maternal environment" (formerly known as mother). Those are the words, the notes, while the piece is played to the rhythm of fear.

Here is another excerpt:

Often I don’t like the women I've delivered. I don’t like them for their submissiveness. When I make rounds in the morning I ask, “When are you going home?” They answer, “I don’t know when my doctor will let me.” They have let themselves be imprisoned. For me, the submissiveness of one woman becomes my own, as though we were all one organism. . . . I used to have fantasies at Doctor’s Hospital about women in a state of revolution. I saw them getting up out of their beds and refusing the knife, refusing to be tied down, refusing to submit—whether they are in childbirth or when they were forty and having a hysterectomy for a uterus no longer considered useful. Women’s health care will not improve until women reject the present system and begin instead to develop less destructive means of creating and maintaining a state of wellness.

Too fat and too old

Sometimes I wonder if vaginal birth will gradually go the way of the dinosaurs: extinct.

A friend of mine who works in hospital administration alerted me to a Webinar (Web seminar) that took place yesterday about "Cesarean Delivery and the Risk-Benefit Calculus." The seminar discussed the anticipated 50% cesarean rate by the year 2017--that is 10 years from now. If that is true, this presentation argued, hospitals will need to construct maternity wings with the capacity to handle 50% and higher cesarean rates in the near future.

This presentation said that rising cesarean rates (both actual and anticipated) were mostly to blame because of maternal obesity and age. Quoting from the PowerPoint slides that accompanied the presentation (all referring to the projected future scenario):

• Larger mothers lead to unhealthier babies
• Obesity co-morbidities and medications complicate care of pregnant women
• Rates of gestational diabetes and pre-eclampsia skyrocket
• Increasing C-section rates cause downstream decrease in pelvic floor disorders (this claim was repeated several times, even though the medical literature reveals that cesareans do not prevent pelvic floor disorders)
  

Other contributing factors to the anticipated rise in cesarean rates will be:

• maternal age (which increases fertility treatments, which increases # of multiple births and high-risk pregnancies as well as congenital abnormalities)
• OBGYN lifestyle & liability issues

Some other predicted changes in maternity care over the next 10 years:

• The role of midwives moves to prenatal care as cesarean rates increase
• Insurance will drive midwives to work in large group practices
• LDRPs will be replaced by LDRs and a large increase in postpartum recovery rooms to handle the 50% or higher cesarean rate

The second half of the presentation was a historical overview of and justification for increased cesarean rates by Dr. Frederic D. Frigoletto of Harvard Medical School & Massachusetts General Hospital. What I found most disturbing were his assertions that increased cesarean rates result in "improved neonatal outcome." Specifically, his presentation claimed that increased cesarean rates had the following outcomes (all of which contradict most of the research on risks of cesarean sections):

• Lower rates of fetal hemorrhage, asphyxia, birth trauma, mechanical ventilation, infection, and meconium aspiration syndrome, and feeding problems

Is it just me, or does the marketing of a 50% or higher cesarean rate as health-promoting seem very, very creepy? Even when a cesarean is really needed for a true emergency, there is no denying the real toll it takes on mothers and babies. When a doctor performs a cesarean, it's not just an operation. It is the beginning of a new mother-child relationship! It creates an extra handicap, sending the mother home to recover from major abdominal surgery, to deal with the possible emotional and physical trauma of that operation, especially if it was unplanned or unwanted, all while taking care of a newborn.

I am also disturbed by the blame-the-woman mentality. Women are too old, too fat, too demanding (one factor he listed was the "premium baby" factor), too unhealthy...Especially the real negativity towards women of size. The problem with this attitude is that it often becomes a self-fulfilling prophecy.

I've been re-reading parts of Michel Odent's recent book The Caesarean. Here is his take on cesarean rates:

The aim should be that as many women as possible give birth vaginally thanks to an undisturbed flow of love hormones. However, the primary objective should not be to reduce the rates of caesareans: it would be dangerous, if not preceded by a first step. This first step should be an attempt to promote a better understanding of birth physiology and particularly a better understanding of the basic needs of women in labour.

His maternity clinic in Pithiviers was able to keep cesarean rates between 6-7% while simultaneously having some of the lowest perinatal mortality rates in Europe--something other countries were unable to do without a dramatic increase in cesarean rates. He explains why: women at Pithiviers labored in an environment which facilitated the proper timing and release of hormones. Drugs were almost never used. Pitocin was quite rare, only about 1% of labors. Women were free to labor in whatever positions they wanted, with no one telling them what to do. The clinic's highest priority was that the woman felt safe, secure, warm, and unobserved. For more details about his clinic, read Birth Reborn.

I have a PDF of the powerpoint if anyone would like to take a look at it, by the way.

The (unnamed) carrier is done

I haven't named my soft structured carrier yet (referred to as a SSC in babywearing circles), but here are a few pictures. It's very similar to a Yamo or an Ergo, minus the head supports. The body has darts in the seat area. The waistband is a high-density foam curved to fit a woman's hips. The shoulder straps are heavily padded and have a front chest buckle, much like a hiking backpack.

I think I will make a few changes to the design now that I've worn it a bit:

• make the body taller and a bit wider
• insert the shoulder straps longer (and the strapping shorter) so the padded part is longer
• insert the webbing higher up on the side of the body piece

I am thinking of making a pattern for the SSC so that other DIYers don't have to make all of the same mistakes and do-overs that I did! If I could find a way to print it up to scale, I could even sell the patterns...

Week 5: 19 miles

I ran 9 miles today (1 hour 40 minutes) in 50 degree weather. I was too cold starting out and too hot at the end. Go figure.

Some recent pictures, including my amazing garage sale find: a wooden high chair for $1!

Mother.Culture.Art Exhibit

Check out this new art exhibit featuring the many facets of breastfeeding. It's in California, but you can take a "virtual tour" as well. (Click on the mother.culture.art image).

Here is information from the press release:

On display through October 3, 2007 in Auburn, California

The Arts Building
808 Lincoln Way
Auburn, CA 95603
Phone (530) 885-5670

Auburn, California June 22, 2007: "Mother Culture," the socially influenced breastfeeding photo exhibition, will be unveiled during Breastfeeding Awareness Month, beginning August 9, 2007 through October 3, 2007, subsequent dates/venues will be announced soon.

Following her successful solo exhibition debut "Road to Reality" at Capitol Public Radio's Second Saturday Event in October 2006, the focus of Rachel Valley's work turned to the social examination of the attitudes toward breastfeeding in modern times. "MOTHER.CUTURE.ART" blends the beauty and challenge of establishing and maintaining a healthy dyad and an acceptable outward nursing relationship. The exhibition's subject matter is currently a charged one, with old cultural attitudes clashing with modern sensibility. Rachel Valley's portraits touch upon nursing in public, "extended breastfeeding", the family bed, and the sexualized breast co-existing with the nurturing breast, amongst other timely issues therein. The exhibition will begin August 9 in Auburn, CA and will travel afterward.

Rachel feels fortunate to have been given this platform of art and discussion to widen the eyes of our communities, to the tightrope a mother walks when making the conscious decision to feed her child's nutritional and emotional needs as intended. Given the success of the exhibition, a mother might finally find herself in an environment that allows her to fulfill the needs of her young wherever and whenever necessary, and with the support and sound information from her circle of influence. The exhibition is sure to stir emotions and reactions from participants and patrons alike.

Valley was inspired to use her art to speak to the public from her own not-so-unique experience. "After giving birth to my daughter, I started my journey into mothering and breastfeeding, and I was overwhelmed with conflicting information and hostile opinions," Rachel says. "My initial desire was to talk about it with other women, but constantly found myself in mixed company. In my attempts to receive and share good information about breastfeeding, I ended up stirring feelings of guilt, anger, and disappointment in others. On the rare occasion that I found someone that shared my positive nursing experience, I'd engage in stories and notions, and as a result made others feel left out, and unable to relate," she added. "Feeling frustrated and not wanting to upset, I was on the verge of silence, but my desire to challenge the 'norm' ruled out and I decided to let my art speak for me, and that brings us to 'MOTHER.CUTURE.ART.'"

Another perspective on "Mommy Jobs"

The newest thing in plastic surgery--Mommy Makeovers or Mom Jobs--has incited a lot of controversy. Breast and Belly has an interesting discussion going. Here's another perspective on attitudes towards mothers' bodies, from Ruth C. White, a professor at Seattle University (reposted with permission):

What they need is European friends... So here's my story....

I go to Barbados for a conference/vacation. I am wearing a black one piece I had worn for years because although I was a size 8/10 I felt my stretch marks and pooch were not worthy of exposing to the world. (Being a twentysomething hottie did not prepare me for poochy thirtysomething).

So I meet two young (not yet 30) Germans: one a charming, handsome, multilingual (5) stock broker (Paris) and one 6'3" walking Adonis of an investment banker (Frankfurt).

We meet sitting on the beach one day. They ask me why I wore the swimsuit I did instead of a bikini like the girl walking by. I explained about stretch marks.

The investment banker says: "But you had a baby." And I'm thinking "DUH!" Well, I liked him straight off and when he later told me that my poochy, stretchmarked stomach was his favorite part of my body, I just about wrapped him in brown paper and took him home.

But home I went alone and threw out the one piece and went and got me a low cut bikini from old navy. And I work it. With no shame to my game at all.

Now why did it take some hot young European stud to give me the gumption to parade my slightly poochy but very stretchmarked body on beaches from San Pedro to Montego Bay, Brisbane and beyond? In the meantime, poochy men were hanging over their speedos everywhere I went.

But now, I've got that same poochy bod on my facebook page wearing my bikini on my deck on Queen Anne (Seattle) hill as the first pic in my "my 40 year old life" photo album.

There is nothing pathological about stretch marks or varicose veins or tummy pooch. Like my girlfriend says, "it's how you work it!" If you have confidence in self, guys (although it seems most women are worried about other women's POV and that's the sad part) won't notice, just like how they don't notice a boob job. ("How can you tell?" whatever! LOL.) All they see is big boobs or great personality. With stretch marks all they'll see is big boobs or great personality LOL. And here's the kicker question: so what if they see stretch marks? Are they going to have testicle lift surgery anytime soon? Bet not! Why? We don't care. And guess what, they don't care about our stretch marks either.

But seriously, I think the construction of a non-existent ideal is based on us covering up all the time and having this puritan background which makes us ashamed of our bodies to start with. My European friends are used to seeing women's bodies in all shapes, sizes, forms and ages with no one "ashamed" to be seen. That creates a different environment.

I think we also need to accept aging for what it is. My story....
My 82 year old neighbor will come to her door while wearing her yoga bodysuit. She ice skates in a little frilly outfit once a week. And she's got wrinkles that reflect all the living she's done. And she's graceful and athletic and fit and fun and smart and everyone loves her.

Now that's beauty!!!

Week 4: 18 miles

I ran 8 miles today (1 hour 25 minutes) and I feel good except my quads are sore. I also ran my normal 3-4-3 miles during the week. Zeke's foot is healed, so he came with me today.