Monday, November 30, 2009

"Orgasmic Birth" giveaway!

Debra Pascali-Bonaro has graciously offered to give away a copy of her film Orgasmic Birth! To enter (one entry per comment, please):
  • If you've already seen the film, write your own review. Post the review on your blog or website, and put a link to the review in the comments. Or post your review directly in the comment section. 
  • Write a question for Debra to answer. I will be interviewing her in the next few weeks and will use the most interesting, thoughtful, or probing questions. 
  • Talk about your own orgasmic/ecstatic/transformative (or whatever!) birth, especially in relation to the issues raised in the documentary.
 Giveaway ends Friday, December 11 at 5 pm EST.
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Friday, November 27, 2009

Review of Orgasmic Birth

I met the filmmaker Debra Pascali-Bonaro at the Lamaze Conference in October, and she gave me a copy of Orgasmic Birth to review. I’ve watched it three times and had three very different reactions to the movie. This isn’t a traditional film review; I won’t be giving a play-by-play of what happens in the movie. It’s more a written account of the conversations I’ve had with myself and with others as I’ve thought about the film.
The first time, I watched it alone while sewing. I found myself close to tears during the birth scenes. They were beautiful and moving. The noises and the movements evoked a bodily memory of my own births. When I watched these women move and heard them give birth, my body knew what they were experiencing.

The film follows eleven couples through their late pregnancies, births, and early postpartum time. While they were still pregnant, they spoke of their hopes and fears for the birth. They were interviewed again after their births and discussed how they felt about the experience. The film also features twelve different birth experts, including obstetricians, family physicians, pediatricians, midwives, academics, doulas, and birth advocates. Many of the names are familiar: OB/GYNs Christiane Northrup and Jacques Moritz, Dr. Sarah J. Buckley, Dr. Marsden Wagner, Ina May Gaskin, Elizabeth Davis, Penny Simkin, Eugene R. Declercq, and Robbie Davis-Floyd. Others might be new to some viewers: Carrie Contey, PhD, Maureen Corry, MPH, Richard Jennings, CNM, Ricardo Herbert Jones, MD, Lonnie C. Morris, CNM, Lawrence D. Rosen, MD, NaolĂ­ Vinaver, CPM, and Billee Wolff, RN.

Four of the eleven women give birth in a hospital with wildly different experiences: a first-time mom almost gives birth en route, not realizing that her labor is so far advanced. She commented that the hardest part was laboring in the car, when she could no longer move with her contractions like she could at home. A woman who strongly doesn’t want a c-section agrees to an elective induction and ends up with Pit, an epidural, and multiple vacuum extraction attempts. Another woman has a cesarean section for failure to progress. The other women give birth at home, some outside on their decks, some in birth pools, some in the corner of the shower, some on their beds. We see women squatting, kneeling, crouching, standing, swaying, walking, bouncing on the birth ball, hanging from a birth sling, climbing up and down the stairs. We hear them joke around and moan and sing and grunt and scream and cry.

Several of the women explained what they were thinking and feeling during their labors. For example, we saw footage of one woman screaming as her baby was being born. From the looks and sounds of it, you’d think she was in extreme agony. But the film cut to her explaining what was going on internally: It just felt so satisfying to scream, she said. Giving birth was the most satisfying work I’ve ever done. I loved that the birth scenes often included how many hours or minutes before birth. One woman had a very long labor: 38 hours. You see her laboring at 23 hours before the birth, then 18 hours, then 6, then 1, and then finally you witness the last minutes of pushing. Because you see the hours pass by, you understand that birth is a process that takes time and is sometimes just…slow and tedious and quotidian.
I watched Orgasmic Birth again a second time a few days later. My emotional response was more muted, and I found myself asking more probing questions about the film: What, exactly, was Debra Pascali-Bonaro trying to say with her film? Why did she choose “orgasmic birth” for the title? Might the idea of orgasmic birth set women up for failure when they actually go into labor and feel the rawness and intensity and pain, not just the bliss and the ecstasy?

I found myself particularly troubled with the word “orgasmic.” I think a number of other words describe more accurately what the filmmaker is trying to communicate in this film: ecstatic, empowering, or transformative come to mind. In our society, orgasmic is always used in the narrow, sexual sense. In that sense, orgasmic birth = having a literal orgasm during birth. But that isn’t really what the film is talking about at all. We do see at least one woman literally having an orgasm during her labor (she said it was very unexpected and quite lovely), but the other women experience something else, something more nuanced and more complex than simplistic sexual climax.

I thought about my own labors and births and there is no way I would label them as orgasmic. There wasn’t anything sexual in the experience. Sensual? Yes. Not in the erotic, titillating sense, but definitely sensual in the larger meaning—an experience involving all of the senses deeply and fully. Definitely ecstatic. Definitely painful and challenging at certain moments, mostly during the last hour or two before Dio was born. Empowering, yes. And normal and everyday too.

I wondered if my rejection of the idea of orgasmic birth was just a case of sour grapes. You know—for me birth didn’t feel like amazing sex, ergo it cannot for anyone else either. But I don’t think so. I totally understand how labor and birth can be pleasurable, enjoyable, and even sexually fulfilling for some women. I enjoy giving birth—not that every moment of it is sheer bliss and pleasure—but the totality of the experience, for me, is quite positive. Just not sexual in nature.

I do know some women in real life who have experienced moments of incredible pleasure (including sexual/orgasmic feelings) during birth, including a woman who I’ve known online for a while and finally met in person at the International Breech Conference in Ottawa. She brought her tiny newborn, not even two weeks old. This third baby’s birth was fast and furious, but twice during labor and pushing, she experienced moments of intense pleasure, much to her surprise. Click here to see pictures of her birth, complete with detailed comments. (Crowning pictures are quite graphic.)

I still find myself troubled with “orgasmic birth.” I worry that that particular phrase (though not necessarily the film) sets women up for failure. I can see women finding the idea intriguing until they actually go into labor. Then, as the raw power of labor threatens to engulf them, they will say: “$#@! This hurts! This doesn’t feel anything like sex! Give me the drugs!” Sex in our culture is also debased and commercialized. I don’t like the idea of linking our casual and sometimes crass attitudes towards sex to something as beautiful and sacred as birth (and I think sex should be beautiful and sacred, but it often isn’t in our culture today).

The other day, I looked up “orgasmic” in the dictionary and found that there is another meaning outside “the physical and emotional sensation experienced at the peak of sexual excitation, usually resulting from stimulation of the sexual organ and usually accompanied in the male by ejaculation.” The second meaning, one not in circulation in our everyday language, is “intense or unrestrained excitement” or “a similar point of intensity of emotional excitement.”

I had an “aha!” moment. Debra Pascali-Bonaro is arguing that birth can be a peak emotional, physical, and spiritual experience. And given the right setting and preparation, birth can include moments of ecstasy, transcendence and occasionally even sexual pleasure. Her film explains the hormonal and environmental similarities between making babies and having babies. If we see birth not as just a narrow equivalent of sex, but rather sex and birth and breastfeeding as a continuum of important and inter-related life experiences, then the phrase “orgasmic birth” makes much more sense. Think of it this way: if women were expected to make love in the same kind of setting that they labor and birth in (in a clinical environment, observed by unfamiliar professionals, monitored and tethered to machines, and above all their biological rhythms forced to adhere to a strict timetable), they would undoubtedly have a high rate of sexual dysfunction and disappointment.

Other thoughts I had while watching the film the second time: I wondered who this film is intended for. It’s definitely a film that people in the “birth world” would love (midwives, doulas, childbirth educators, birth activists, etc). But do we need yet another film that preaches to the choir? Would anyone with a more mainstream or medical view of birth even watch this movie? In other words, does the very nature of the film—and the title in particular—deter the very people who would benefit the most from watching it?

Remember the Today Show back in September that accused home birthers of being hedonistic? I had the thought that, while watching Orgasmic Birth, someone could watch the movie the wrong way and find fuel for that argument. Now, that person would have to ignore about 80 minutes of the film in favor of 5 minutes of material (or not bother watching the film and simply make assumptions about the message based on the title).

The hospital births that were decidedly not orgasmic or empowering or transformative (purple pushing, stranded beetle positions, "doctor knows best" mentality, multiple vacuum extraction attempts, cesarean for "failure to progress," etc) were a bit of a distraction. They showed these excerpts without enough time to explain what was going on and why. And the music, at times, was a bit too obvious in the emotions it was attempting to provoke. You know, the happy Enya-like music for the good parts, the stark, dreary music for the sad parts, etc.
I watched the film for the third time a few days ago with a group of family members: my husband, my sister-in-law Lisa* (mother of five children, the first three born with Pit and epidurals and OBs, and the last two born naturally with hospital-based CNMs), my brother-in-law Ken*, and his wife Mary*, who is 33 weeks pregnant with their first baby. Mary is seeing a hospital-based group of five CNMs. These midwives have a 7% c-section rate and seem very open to doing births in a variety of ways. Mary would like to give birth without an epidural, so we’ve been giving her lots of advice and suggestions with the caveat that she can take or leave them as she wishes. We kept a running commentary as we watched the film: advice, suggestions, reactions, and explanations of what was going on, which Mary found helpful.

After we watched the film, we had a long discussion about everyone’s reaction to the movie in general, and the phrase “orgasmic birth” in particular. Below is my paraphrase of our post-film conversation.

Lisa (mother of 5, last 2 born naturally): “The title didn’t really fit the film. The overall message of the movie was that birth is normal. The film showed really what giving birth was like for me when I gave birth naturally. And even how they showed those hospital births and how clueless people are and how they just do what their doctors say. That kind of behavior bothers me, and that’s how it was with my first three children. Now I know that my body does know more than what a doctor knows, and that I need to trust myself. If I were in Mary’s situation, I think this is the best movie you could watch. I like this film much more than The Business of Being Born, which was really Hollywood-ized. There’s more nudity in this film and more of the noises of birth—it’s really what birth is like.”

Mary (pregnant with her first): “It was invaluable to watch this movie with all of you, since you've already had several children. I liked hearing your multiple points of view during the movie.”

Lisa on Pitocin: “Pitocin is awful. If someone offers you Pitocin, RUN! Run away from that person. That’s why I got epidurals with my first three because I could not handle the pain once I was on Pitocin. It felt like I was being turned inside out. With my fourth baby [first natural birth] I was really scared because I didn’t know if I would be able to do it naturally. But really for me, the contractions didn’t hurt at all. Pushing did. I pushed my fourth out in a kneeling position, leaning over the back of the bed, which was raised up all the way. The nurse had never seen a woman give birth like that before. The only thing I didn’t like about the movie is that I don’t think birth is a sexual experience. The kissing thing doesn’t make any sense.” (A few of the couples kissed a lot during labor.)

We talked about the less commonly used definition of orgasmic (as a peak emotional experience), and they both totally agreed that that’s the meaning the film is trying to portray.

Lisa commented that orgasm [in the narrow, sexual sense] has nothing to do with birth to her. Linking it to sex, for her, didn't work. Mary agreed. Lisa commented that sex was often talked about as this “dirty” thing when she was growing up. They weren’t allowed to say the words "sex" or "orgasm," let alone have one. Mary commented that sex is often not what it should be and that it has too many negative connotations or implications in our society, so using the phrase “orgasmic birth” almost contaminates the birth. Lisa was pleasantly surprised to find that the film was different than she thought it would be like because of the title. The first few minutes are a montage of women in labor, making very sexual sounding noises (because, let’s face it, labor and birth often sound like that!) and she was thinking “oh boy, what am I getting myself into?!” They both felt that the title “Ecstatic Birth” more closely described the movie’s message. Still, Mary felt the title should stay the same, even though it’s not exactly the right fit for the movie, because it made her think.

Eric commented that he was most moved by the women who found that giving birth was a transformative experience—particularly Helen, who was a survivor of sexual abuse. (Helen was molested when she was 6, and raped when she was 19. She wanted to have her baby in a way that was safe, that was the opposite of her experience of sexuality in the past. She was worried that labor would trigger flashbacks, but giving birth became the most powerful thing that has happened to her body. She said, “I felt myself go away, and this woman who knew how to birth a baby came in. I felt transformed.”)

Lisa: “I now have complete trust in my body, myself, and my womanliness. The film did a great job of showing how birth is naturally. There’s a plethora of emotions in the whole process, from the excitement of first finding out you’re in labor, to impatience when it keeps going on and on.”

Mary particularly liked one husband’s comment about the birth, that “it felt like God was in the room.” She liked that the film communicated that it’s okay to be scared and it’s okay to cry or scream or whatever you need to do.

Towards the end of our discussion, Lisa commented: “Mainstream people aren’t going to watch the movie because of the title, and that’s a shame. How could I tell someone they should watch a movie with that title, especially some of my more conservative friends?”
It turns out that "Orgasmic Birth" was not Debra Pascali-Bonaro's first choice for the documentary title/concept. She pitched several other titles to media executives, including "Ecstatic Birth," but only "orgasmic birth" stuck. This makes sense of a title that is intriguing and controversial and memorable, but that doesn't exactly fit the content of the film. Her interest in the topic also comes from her own experience giving birth. From the Times Leader of NE Pennsylvania:

The birth of her own third child, 19 years ago, “was an orgasmic experience in the way that dark chocolate is,” Pascali-Bonaro says. “The release, the absolute release, as I felt his body slip from mine, was orgasmic.”
In sum: the birth scenes are incredible and the movie is worth watching for that reason alone. They're not overly romanticized or sanitized. I found them incredibly realistic, in all their variety, about what giving birth normally is like. I'd like a different title, because I think that it will keep many people from watching it, but I also understand the rhetorical power of "orgasmic birth."

* Not their real names. You know who you are!
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Giveaway of Permission to Mother

Dr. Denise Punger is hosting a giveaway of her book Permission to Mother. Click here to enter!
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Thursday, November 26, 2009

7 months old!

Dio turned 7 months old today--and what a lovely way to celebrate that on Thanksgiving. We're visiting Eric's sister for the week. She has five children ages 11 months to 11 years. On the way out, we stopped by to see my younger sister and her new baby girl. Dio definitely looks like a monster compared to his two-week-old cousin.

So what's Dio up to these days? He likes to copycat vocalizations. He grunts, I grunt back, he grunts again (or shrieks, or squeals, or says ah ba ah ba or ah pa ah pa) ad infinitum. He loves waking up Zari in the mornings. He breaks out into a grin the moment he sees her, and he lunges toward her bed to grab and poke her. He's been on a bit of a potty strike. He used to go right away every time, but recently he's been arching his back when I bring him to the potty. Sometimes he'll go if I can distract him enough. Oherwise I put his diaper back on and try again later. His second tooth is just about ready to pop through the skin. I just cut out his third daytime nap, so now he has a shorter morning nap and longer afternoon nap and goes to bed at 7 pm. He's still waking up at night every 2-3 hours to nurse, but sometimes has a 4 hour stretch. I hope that trend continues!

Dio's still nowhere near crawling yet, but he loves to stand up and hold onto things.

He loves taking baths. He's definitely chunkier than his cousin, who is a few weeks shy of 1 year old.

I suppose he has started eating solids. He has gnawed on the occasional apple, pear, banana, broccoli, and cucumber. Do banana peels count?

Yesterday we enjoyed the last sweater weather of the season. I saw snow today--time for winter coats!

One of Dio's cousins calls him "dandelion head." I like that.

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Tuesday, November 24, 2009

Why does birth matter?

This is one response to my earlier post Thinking, No Conclusions Yet, from Jenny Parratt's PhD research about how birth affects a woman's embodied self. 


I found this post and all the comments very interesting. I'm a mother and a midwife and I feel passionate that the actual birth experience does matter. I have spent the past 9 years researching women's experiences for my PhD with Professor Kathleen Fahy (at Newcastle Uni in Australia). My focus has been on how women's embodied self changes during childbearing. The 14 stories I collected for the research give a very detailed picture of women's experience before during and after birth. I've recently published them (called Feelings of change: Stories of having a baby). I don't give any commentary with the stories because they are pretty long the way they are, but I plan another book that shows my findings.

Briefly, here are some of the findings from my PhD (cited below). My findings indicate that any woman can experience an improved sense of embodied self as a result of childbearing generally and childbirth more specifically. Embodied self change that is most empowering occurs when a woman uses her own power during labour and birth. This process of change is facilitated by a sense of self-trust and by being inwardly centred. A woman’s improved embodied self is then manifested by an increased awareness of and capacity to use her inner strength. This has the consequence that a woman who experiences a sense of improved embodied self feels more confident in dealing with other challenging life circumstances. I therefore conclude that when a woman uses her own power during labour and birth she is most likely to feel an improved sense of embodied self during childbearing.

Parratt, J. (2009) Feeling like a genius: enhancing women’s changing embodied self during first childbearing. PhD Thesis. School of Nursing and Midwifery. The University of Newcastle, NSW, Australia
Parratt, J. (2009). Feelings of Change: Stories of having a baby. Raleigh:
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Saturday, November 21, 2009

Blogging break and books to read

We're out of town visiting family over Thanksgiving week, so I am trying to limit my time online. Don't expect much here until we're back home.

If you want some good reading material over the holiday, I'd suggest the following (all of which I am currently reading, and most of which I hope to review or discuss in the near future):

Birth Territory and Midwifery Guardianship by Kathleen Fahy, Maralyn Foureur, and Carolyn Hastie. Some of it is very very theoretical--even a bit hard for me to get through--but I especially loved the chapters on birth territory and on mindbodyspirit architecture. I'd highly recommend this book, and a few of the chapters in particular, for anyone designing a maternity wing or freestanding maternity center.

Proactive Support of Labor: The Challenge of Normal Childbirth by Paul Reuwer, Hein Bruinse, and Arie Franx. I challenge you to read the whole thing, cover to cover, before reacting to what they're saying. When I realized the authors were promoting the Dublin version of "active management of labor," I had the impulse to stop reading or at least to argue against it in my mind as I read. But I read the whole thing and found myself intrigued and challenged by their arguments. I'll write more about this book in the future, but their approach made me realize that the "birth spectrum" that so many in the birth world tend to talk about--ranging from a medicalized "technocratic" approach on one end, to a midwifery or "holistic" approach on the other--is sometimes entirely inadequate. This book, for example, promotes a style of maternity care that really doesn't fit anywhere on the spectrum. Some of the proposed practices might be seen as very medicalized, while others are extremely concerned with the woman's subjective, emotional experience of labor, of helping as many women as possible have spontaneous, vaginal, and non-traumatic births. Anyway, I'd love to hear your thoughts on this book once you've read it.

Deliver Me from Pain: Anesthesia and Birth in America by Jacqueline H. Wolf. Just started reading this today and I am loving it. A very thorough, nuanced, fascinating examination of obstetric anesthesia in the US, from the early days of ether and chloroform to modern attitudes about epidurals and the value of labor pain.

Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth by Mark Sloan. I haven't read this yet, but it's next on my list.

Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers by Nancy Mohrbacher and Kathleen Kendall-Tackett. I had the pleasure of meeting Kathleen at the Lamaze Conference, and I loved her presentation about the Seven Natural Laws. She was kind enough to send me a copy of her book to review, which I hope to get to soon.

I'm also watching Orgasmic Birth for the third time over the break, in preparation for writing a review of the film. I hope to show it to several sisters/sisters-in-law (and perhaps an adventurous brother-in-law?) and see what they think of it. I also will feature an interview or Q&A session with the filmmaker Debra Pascali-Bonaro.
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Tuesday, November 17, 2009

A tooth!

Dio's normal drooling turned into a veritable fountain a few weeks ago. He's been soaking through shirts and bibs and jackets. And he's been a bit grumpier than usual. We looked at each other and said, "maybe he's teething?" A few days ago I spotted two little bottom teeth just beneath the skin. So today I wasn't too surprised to feel Dio's first tooth poking through! The other one will pop out soon, I'm sure.
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Monday, November 16, 2009

More on birth centers and maternity centers

I'm currently reading Birth Territory and Midwifery Guardianship: Theory for practice, education, and research by Kathleen Fahy, Maralyn Foureur, and Carolyn Hastie (Butterworth Heinemann (Elsivier): Books for Midwives, 2008). Just today Science & Sensibility featured a review of the book by guest blogger Dr. Katharine Hikel. The review is worth reading--as is the book--but I wanted to highlight this particular excerpt when she discusses birth environments and brings up the idea of a freestanding maternity center: taking the entire birthing wing outside the hospital.
But what is the best birth environment? In a chapter called “Mindbodyspririt architecture: Creating birth space,” architect Bianca Lepori describes her designs for hospital-based birth rooms that are meant to enhance, not counteract, women’s abilities to give birth. She created suites of rooms with “Space and freedom to move; to be able to move to the dance of labor; to respond to the inner movements of the baby; to walk, kneel, stretch, lie down, lean, squat, stand, and be still.” The rooms have “Soft and yielding surfaces; or firm and supportive surfaces; different textures; the right temperature; soft curves; darkness or dim light.” A birthing woman can be ‘immersed in water, flowing or still; respected, safe, protected, and loved.” Access to the suite is through an antechamber; the bed is farthest away from the lockable door, and not visible from it, so that privacy is respected.

Lepori’s birth architecture reproduces the comforts of home. There is access to the outdoors, and private walking places. There are birth stools, exercise balls, bean bags, hooks for hammocks or ropes for stretching. Tubs and beds are large and accessible from both sides. There are accommodations for families. There are comfortable chairs for nursing. Medical equipment – supplies, oxygen – is tucked behind a screen or put in a closet. A refrigerator and light cooking equipment is available. This ‘birth territory’ certainly outshines the typical hospital OB floor; though it begs the question: Why not just stay home?

The answer, of course, is that, for those four to ten percent of births that truly need intervention, the OR is right there. It’s better not to have to transport a woman who’s labor has turned complicated; it makes sense – for many – to have all the birth territory under one roof.

This birthing-suite design indeed takes into account the all-encompassing, body-mind-spirit event of childbirth. It honors laboring, birthing women and families; it respects the process. It worked well for a designated maternity hospital in New Zealand – a facility already designed for childbearing. But most US hospitals are multi-use facilities; and though obstetrics is among the best money-makers for hospitals, childbirth is the only event that occurs there that is not related to illness or trauma.

The real question is, why not remove birth completely from the pathology-centered hospital model? Why not redesign birth territory to maximize best outcomes, minimize intervention, and replace the present medicalized view of birth as a disaster waiting to happen with the more normative, expectant-management, midwifery view? Move the whole shebang, from the waiting room to the surgical suite, out of the hospital and back into the community where it belongs.
The idea of a freestanding maternity center--one that has an OR and in-house OB and anesthesia, but that is completely separate from a hospital--is new. No one has ever done this before that I know of, and so no one knows how it would/should/could function. Would it be identical to hospital-style maternity care? Would women go there? Would being free from the confines of a hospital and all of its rules and regulations open up a space for a real change in maternity care?

One of the best ways to explore this new idea and offer up your own questions and ideas is to come to the Controversies in Childbirth Conference in Tampa, on February 19-21, 2010. The conference oragnizier, Alan Huber, just wrote more about the concept of freestanding maternity centers today, in a post called Birth Centers Versus Homebirth.
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Extreme makeover: diaper edition

He was done with his newborn size diapers (6-13 lbs) by about 6 weeks and was starting to bust out of the smalls (10-20 lbs) by about 5 months old. I just put Dio into the size medium diapers (18-36 lbs). Zari didn't go into the mediums until after she was a year old!

These size mediums are boring, though. White PUL, white hook & loop, white elastic, off-white bamboo velour.

I decided to give one of the diapers a makeover. I recently bought a snap press (why didn't I get one earlier???) and some new PUL prints and solids. I took apart the old diaper and, using the bamboo velour inner layer, made this:

I also liked my FuzziBunz so much that I made some of my own pocket diapers. First I made a pattern using the Fuzzibunz diapers. The green dotted one is a One Size knockoff, identical except I made snap elastic because I couldn't find buttonhole elastic in the right width. The sun & stars diaper is basically a Perfect Size knockoff, except I trimmed the seam allowances and put on FOE (fold-over-elastic) on as an experiment.

I bought microfleece for the wicking layer from a diaper supply store, but was very disappointed to find that it doesn't wick--it repels! So these pocket diapers I made have been leaking like crazy. They still repel water even with repeated washings. I'm giving up on microfleece and will switch to a high-tech atheltic wicking fabric like powerdry or procool for the wicking layer. For now, I'm using the pockets as a cover and just laying the absorbent soaker pad inside, rather than tucked underneath the microfleece.

I also made a stack of organic bamboo velour soaker pads for my new pocket diapers. They're 13x13", two layers thick, and fold into thirds with snaps. They really didn't need snaps, but I was having too much fun with my snap press.

And finally I made myself a new wet bag. My old ones are plain white and starting to come unstitched. This one's a lot more fun. The zipper is recycled from a bag I bought at a thrift store.

When I was expecting Zari, I made 24 newborn, 24 small, and 18 medium all-in-one diapers with hook & loop closure and FOE binding. Then I helped my sister make 48 of the same kind for her own stache. Now that I've made a variety of cloth diapers, I'd definitely do a one-size adjustable pocket diaper with snap closures if I were starting over again. I'd probably buy one stack of 36 prefolds for the soaker pads, rather than sewing my own. I like pocket diapers because they wash and dry really quickly, especially if your soaker pad unfolds into thinner layers. They keep your baby feeling dry because of the top wicking layer. And snaps don't wear out, wick moisture (which is a problem where I've sewn on my loop tape on the front of the diapers) snag up the diapers, or make a diaper chain in the wash. I like FOE because it's quick to apply, but it does wick moisture around to the outside of the diaper and, if your diapers have hook & loop closure, it starts looking ratty. So I'm leaning more towards a turned-and-topstitched style. And, if you use buttonhole elastic, you can make one-size adjustable diapers--which means you only need to make one set, not three or four!
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Friday, November 13, 2009

Book review: The Wet Nurse's Tale

Yesterday I read a book from cover to cover: The Wet Nurse's Tale, by Erica Eisdorfer. I meant to save it for this morning's work-out session at the gym, but the book was so much fun that it didn't even last a day. It's the story of a young English girl, Sarah Rose, and her adventures as a wet nurse. Sarah is plain but plucky, a plump heroine-of-size who always has a witty retort. There's sex (not too surprising, since nursing involves babies, and babies involve you-know-what), drama, and adventure aplenty. There's a dramatic conclusion where her father sells her son and she must rescue him from a rich woman who is slowly going mad. Lots of little details about day-to-day life in Victorian England make it all the more interesting to read. And, of course, there are lots of babies and lots of breastfeeding.

There are two narratives interwoven in the book. Sarah's is the dominant one, narrated in first-person, as if she were sitting in the room and telling you the tale of her remarkable life. The other story line is of Sarah's mother, who also was a wet nurse for as long as Sarah can remember. This second story is told through short narratives of the women who chose Sarah's mother to nurse their babies.

Give it a read--I'm sure you'll love it!
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Wednesday, November 11, 2009

Pinky has a question about birth centers

Pinky, one of my blog readers and a L&D nurse (well, she recently switched and now is working as a psych nurse) and CNM-in-training, is doing a paper on freestanding birth centers. She's like to know why or why not you'd choose a birth center. Here are her questions:
Would folks who want a homebirth because of the restrictive nature of the hospital, come to a freestanding birth center? Is there a demand for Birth Centers? Especially a Birth center across the street from the hospital that has a large staff and 24 hour Ob and anesthesia folks so they can handle anything you throw at them. And a Nicu would be good too. I was thinking, if we did start up a birth center across the street from the hospital I worked at, would it be used? If we build it, will they come?

So for any home birth folks out there, could you please leave me a comment on your thoughts. What would you need in a birth center to make it attractive to birth at?

Here's my response: for me, a birth center is a less appealing option to me than a home birth. There isn't any inherent safety advantage of a freestanding birth center over a home birth, since the same equipment will usually be present in each setting (Doppler for intermittent monitoring, O2, IVs for dehydration/hemorrhage, antihemorrhagic meds, adult and neonatal resuscitation equipment, etc.) I'd much rather be in my own turf, rather than be at the mercy of an institution's rules, restrictions, or protocols. Of course birth center rules/protocols aren't anything like a hospital's, but still, it's not your house and you are the guest in someone else's territory. If I am going to get into a car and go somewhere else during labor, there better be a darn good reason for it--i.e., I need medical attention in a hospital setting.

On the other hand, someone else might choose a birth center over a home birth for a number of different reasons. Perhaps they just feel safer birthing in an institution/going somewhere to give birth, rather than staying in their own house. Perhaps they don't have a nice or safe home environment and the birth center is really awesome and luxurious and has a great labor tub. Perhaps they live too far away from their backup hospital for their own personal comfort (for some women, this might be 30 minutes, for others, 1 hour), but the birth center is right across the street from the hospital (pinky's ideal scenario, which I definitely can see the appeal of; I mean, if you're literally across the street from the hospital, you can't really argue from a safety perspective).

I wrote about this a while back in The Best of Both Worlds? I should note that I don't really feel that birth centers are the "worst of both worlds." It was more a train of thought that I was following at the time. I'd love to see more birth centers, especially ones really close to a hospital, because I think they would attract more women who are not thrilled about birthing in a hospital, but want the proximity to emergency care if needed.

And for a really fascinating idea that has started to gain momentum, read about freestanding maternity centers (my phrase; they don't really have an official name yet). It's basically a freestanding birth center with an OR and 24/7 OB and anesthsia coverage. Not part of a hospital, but instead owned and run by doctors and/or midwives directly.

Alan Huber explains his concept of a physician-owned birthing facility  in Why are pregnant women forced to choose between X and Y? and has more followup explanation in What's my hidden agenda?. Dr. Stuart Fischbein has also been working on this concept and thinks it might be a way to solve our maternity care crisis. Read A new type of birthing facility.
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FuzziBunz giveaway winner & One Size Rewards Program

Jill of Peestick Chronicles is the giveaway winner! Send me your mailing address and the type & color of diaper you'd like.

Thanks to everyone for your comments, questions, and advice!

I wanted to let all of you know about the FuzziBunz One Size Rewards Program, which lasts through the end of this year. If you purchase 9 One Size diapers, you get $40 worth of FuzziBunz products! Rewards Program products include XS diapers, Daisy Print Perfect Size diapers, Changing Pads, Menstrual Pads, Diaper Totes, Burp Cloths, diaper pails, and extra inserts.
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Tuesday, November 10, 2009

Breastfeeding and DHA

Yesterday, my father-in-law sent me a link to information about lactation and DHA. He's an agricultural economist and directs an agricultural research centre in Canada. He was at a workshop on BioActive Fatty Acids with keynote speaker Dr. Bruce Holub, Professor Emeritus of Nutritional Sciences at the University of Guelph. My father-in-law wrote, "The bottom line is if you are nursing babies you need to take DHA!"

An excerpt from the lactation page on Dr. Holub's website:
DHA (docosahexaenoic acid, 22:6n-3) is a physiologically-essential essential nutrient and a key omega-3 fatty acid needed in high levels in the brain and retina (eye) for optimal neuronal functioning (learning ability, memory) and visual acuity, respectively.

For breast-fed infants, their only source of nutrition (incl. DHA) for growth and development is their mother's milk. The amount of DHA in the diet is a major factor determining how much DHA appears in breast milk for the baby to consume for health. Since fish is by far the predominant food source of dietary DHA, and since fish is consumed at a very low rate (approximately one serving every 10 days), the level of DHA in North American breast milk is very low. For example, Health Canada has reported that DHA represents an average of only 0.14% of the total fat in breast milk. This low level reflects the low dietary intake of DHA during lactation of approximately only 80 mg/day.
The research suggests that lactating women with a low dietary intake of fish should supplement with fish oil. I took fish oil during both pregnancies but stopped once my babies were born. This is good motivation to do keep up the habit!
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Sunday, November 08, 2009

Brown matter

No, this post is not about poop.

It's about creating a brown matter reservoir for composting. I just started composting last year, even though I've been married for 11+ years and we have owned houses for the past 9 years. It just seemed too scary and overwhelming, with all the talk about the proper balance of brown and green matter and turning and aerating and I just didn't do it. And then I decided that my lack of familiarity with composting was a pretty lame excuse and it was just time to start.

I'm a pretty laid-back composter. I simply toss any appropriate kitchen or yard waste into a pile, throw on the occasional shovel of dirt if I'm digging something up, and let it sit until it turns into compost. I don't worry about all of the fancy technical stuff. My method is often called cold composting. If you're more into composting, you can do hot composting, worm composting, and probably a lot of other kids that I don't even know about yet.

Our next-door neighbors gave us a tumbling composter last year, and that's been wonderful to have. It speeds up the process immensely, especially if you have the proper ratio of brown to green matter. 

So back to brown matter: it's nice to have a mixture of green matter (kitchen scraps, green lawn cuttings, etc) and brown matter (fall leaves, paper, etc) on your compost heap. But we've always had trouble finding enough brown matter except for the fall months when leaves were falling. So this year, we took apart an old chain-link fence that we're getting rid of and made part of it into a huge leaf/compost pile.

Eric cut the four posts out of the top rail (we have a metal cutting chop saw, so it's quick and easy to cut anything metal) and pounded them into the ground with a fence pounder (which we bought years ago for installing metal fence posts). That way they're pretty solid, but not cemented in. Which is nice because I don't want to have to dig them out if we want to move the pile! He made the enclosure about 10'x5'. He cannibalized other parts from the old fence to make an enclosure with a makeshift gate. Not fancy or pretty, but definitely functional. The leaves in our back yard went into the leaf container. The front yard leaves went into the street for leaf collection; we had plenty just from the back yard anyway. The leaf container is even fuller. After I took this photo, I did another round of raking.

And from a slightly different angle, here are our raised beds, which are on a sunny, graveled area in the back of our yard.

After my first year of vegetable gardening (we've always worked in France during the summers until this year), I have a better feel for how much of each vegetable to plant. Mostly I want more of just about everything. More beets, more kale, more peas, more carrots, more onions. more green beans, more tomatoes, more melons, more squash... One of the few things I might not grow next year is broccoli. Now I adore broccoli and I can't eat enough of it. But it takes up a lot of space and has a very small yield for all of the time and work involved. Anyway, I hope to double my garden space next year by adding a few more raised beds, tilling up some of the back yard that doesn't have gravel on it, and planting raspberries along the back (south) side of our garage. I also want to add fruit trees and fruit bushes next year: apple, pear, cherry, gooseberry, & red currant at a bare minimum.
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The world, as seen by Zari

Zari has learned how to take pictures and she is addicted. Lots of blurry ones of random objects, of course, but she's also taken some nice ones of us recently.

Zari loves to organize, sort, and line things up. Anything is fair game: rocks from my flower vases, sling rings, blocks, stuffed animals. Today it was plastic dinosaurs (her birthday present from my mom).

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Saturday, November 07, 2009

FuzziBunz giveaway!

I am exited to be able to sponsor a FuzziBunz giveaway! One reader will win their choice of a Perfect Size or One Size Fuzzibunz diaper.

How to enter:
Leave a comment with your favorite cloth diapering tip. Or, if you're new to cloth diapering, a question for the rest of us to answer! 

For additional entries (new comment for each entry, please):

 Giveaway ends Wednesday, November 11, 2009 at 5 pm EST.
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Friday, November 06, 2009

FuzziBunz cloth diaper review

A few weeks ago, a fluffy package arrived in the mail: two FuzziBunz diapers to review! FuzziBunz sent me a yellow One Size Diaper and an apple green Perfect Size Diaper in size medium. Now that I've used, washed, and dried both diapers several times, here is my detailed review of these cloth diapers.

First off, let me explain more about how FuzziBunz diapers are made and how they work. They are pocket diapers, which means there's an insert that you stuff inside the diaper and take out when you do laundry. The main diaper is made of two layers:
  • outer layer: PUL (polyurethane laminate): a common breathable, waterproof outer layer used in many cloth diaper systems)
  • inner layer: polyester microfleece, which wicks moisture away from the baby and onto the insert
The absorbent inserts are made of several layers of polyester microfiber serged together into a rectangle. I received one short and two long inserts. After the diaper is wet or soiled, you shake the insert out and toss both pieces into the diaper pail. The diapers are turned and topstitched with elastic along each leg opening and along the back waistband.

One nice thing about pocket diapers is that they dry more quickly than all-in-ones (AIOs). The FuzziBunz inserts are thick, probably at least four layers of microfiber terry serged together. If you used a folded insert instead of a layered, serged one, you could line dry these diapers in no time at all. 

Most cloth diaper systems use either hook & loop (velcro) or snaps for closure. FuzziBunz diapers fasten with snaps. Both the one-size and the perfect fit diapers have multiple snap settings so you can adjust the diaper to fit as your baby grows. Hook & loop is hands-down the easiest to fasten, especially at night when you don't want to turn the lights out, but it also wears out, snags in the wash, and attracts lint. (I know this from experience, because my own diapers have hook & loop. So far, the H&L has stood up well, but eventually I'll have to replace it.) The snaps take a little more manual dexterity, but you soon get the feel of which snap goes where.
FuzziBunz diapers come in a rainbow of colors and prints. I especially love the green daisy diaper. Mmmmmm....

Whenever a diaper claims to be "one size", I am curious to see how it's made. How can one diaper adjust to fit a tiny 7-pound newborn, then a chunky 20-lb baby (Dio's current size), then a 30+ pound toddler (Zari's size)?

FuzziBunz one-size diapers do it with 1) adjustable buttonhole elastic and 2) multiple snap settings. The back waistband and each leg hole have narrow buttonhole elastic that fastens onto hidden buttons. Each diaper has 6 buttons for the adjustable elastic: 2 on each leg and 2 on the waist. You can create 8+ different size settings on the legs and 4 on the waist. This picture shows the yellow One Size diaper with the elastics pulled tight (but not all the way to the smallest settings) and snapped up all the way, and then with the elastics let out and the snaps at the largest setting.

In the picture below, I have pulled the buttonhole elastic out from its "hide away hole" on the right side.

The elastics have numbers next to each hole, so you know that you have pulled the elastic the same distance on each side. There's a chart on the FuzziBunz website that gives suggestions for where to set the elastics, depending on your baby's size.

If your adjustable elastic wears out, you can get replacement pieces for a minimal fee. I called FuzziBunz to find out how this works. You can obtain replacement elastics if you bought the diapers new and can show proof of purchased from an authorized FuzziBunz retailer. If you bought them used, you're out of luck. (I tried searching the net for 3/8" wide buttonhole elastic and had no luck; it seems to only come in 3/4" and 1" widths). The elastic is easy to replace: simply hook the new piece to one end of the old piece with a safety pin and pull the new piece through.

Changing the snap configuration further adjusts the diaper's fit to your growing baby. Now, any one-size diaper will be quite bulky on your tiny newborn. But if you're willing to put up with extra fluff at first, the diaper will soon fit normally.

I tried both diapers on both of my kids. The yellow one size FuzziBunz actually have a trimmer fit at this point than the apple green Medium Perfect Fit diaper. The Perfect Fit diapers are about the same shape and size as the One Size, but they have sewn-in permanent elastic and slightly different snap configurations.

Zari has been wearing underwear for the past 6 months, but she was more than happy to model these for me. She especially loves stuffing the inserts in the diapers. (And how crazy is it that Dio's torso., bum, and thighs are as big as Zari's?!?)

I first tested the FuzziBunz diapers on Dio during the day, and I was pleasantly surprised at how I couldn't tell when he had peed or not. The microfleece wicking layer really kept him feeling dry, even when the insert was wet. But I was really curious to see how the FuzziBunz performed at night. Dio goes to bed around 8 pm and wakes up several times to nurse, usually every 2-3 hours. He wakes up between 7 or 8 am. When I am using my home-made AIOs (all-in-one cloth diapers made of hemp or bamboo fabric with PUL on the outside), I have to change diapers and/or potty him every time he wakes up. He doesn't like having a wet diaper, and at night this translates into extra night waking or restless sleep. So I put the FuzziBunz to the test. I stuffed each diaper with 2 inserts and tried several nights of no diaper changes.

Nighttime verdict: You *can* go 11-12 hours with a double-stuffed FuzziBunz, but by the end of the night it's really, really saturated and even the wicking layer can't keep a baby feeling dry with that much pee. Dio started getting rashes from having so much moisture against his skin all night. So I adjusted my routine and now change diapers and/or potty him when I go to bed (around 11 pm, which is when he wakes up for the first time) and maybe the next time he wakes up to nurse around 1 or 2 am. Then, with a fresh FuzziBunz on, Dio gets to spend the rest of the night without having to be disturbed by diaper changes. And me too!

Conventional cloth diapers have absorbent fabric right against the baby's skin, which feels wet as soon as the baby pees. (I don't mind this during the day, but it does pose a problem at night when you want your baby to sleep!) FuzziBunz , however, feel dry even when they're wet. You probably should change your FuzziBunz diapers once during the night if your baby is nursing as often as Dio is. By his age, though, many babies are sleeping longer stretches and nursing less, and you could probably get away with just one double-stuffed FuzziBunz at night.

Cloth diapers are a big financial investment up front, but they save a lot of money over the long-run. One Size diapers are a great solution to the initial cost of cloth diapers, since they will fit from the newborn stage until your child has potty trained. I suggest a minimum of 24 diapers and up to 36 if you have some generous family members who want to help out with baby expenses. I have 24 of each size of my home-made AIOs, and I wash every other day. You might be able to get away with fewer than 24, since FuzziBunz feel dry even when your baby has peed. FuzziBunz are available both online and in select stores. You can also find used FuzziBunz at Diaper Swappers.
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Thursday, November 05, 2009


I requested a copy of my medical records from the first vein clinic. They arrived yesterday and I was a bit embarrassed, after I read them right side up, to find that they actually said "in no acute distress." That's what I get for reading things upside-down...Too bad, since the "acute distress" part made for such a good story! 

I had a followup visit today with Dr. W at the second vein clinic. He and the ultrasound tech did a lengthy exam of the veins on both legs, especially the area behind my left knee that developed a blood clot during my last pregnancy. The verdict: he recommended endovenous laser treatment (EVLT) of the greater saphenous vein. He does this right in his office with only local anesthesia along the vein. The varicosities behind my left knee are next to some nerve bundles, so instead of removing those veins via tiny incisions, he would do sclerotherapy injections in that area. He reiterated that while these procedures will permanently fix the affected veins, it's possible that, down the road and especially after more pregnancies, other veins may develop varicosities. He said that if my right leg isn't bothering me that much, it's not worth treating.

At the end of the visit, I asked him if he charged any "cosmetic fees." He looked a bit perplexed. I explained that the first vein specialist I saw charged a "cosmetic fee" of $400 per leg, even for procedures that were medically indicated and that would be reimbursed by insurance. Dr. W asked why he charged this. I said that Dr. F had explained that it was because "we are very meticulous with our work." Dr. W replied, "Well, I guess I'll be very un-meticulous and not charge you an extra $400!" I joked that he should start charging this fee so he could buy fancy office furniture.

I think I'm going to do it, since my leg is really bothering me. Dr. W's office is working on getting a pre-approval letter from my insurance company, and then I can schedule the procedure. I want to get it done before the end of the year, since both Eric and I have had a lot of medical expenses this year (minor knee surgery for him, pregnancy & birth for me) and have hit our deductibles for the year.
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Wednesday, November 04, 2009

Food for thought

Another quick post...I was going to head straight to bed but just had to link to this one:

At Feminist Childbirth Studies, she discusses breastfeeding, feminism, cost, and value, a post inspired by a comment to an earlier post breastfeeding, sexism, and feminism.

Also read her Slow Food Parenting Series. I especially love her thoughts on breastfeeding as Slow Food, which she talks about in parts III and IV.
Part I
Part II
Part III
Part IV

Okay, it's time for bed, really. I look forward to reading your comments over on her site!
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A few links and a giveaway

The kids are playing with blocks, so here's a quick post with a few links to read and think about. And a book giveaway!

Jill of Keyboard Revolutionary wrote about how birth impacts a mother, a lengthy response to my earlier post Thinking, no conclusions yet. A few excerpts:
I'm not sure on which side of the fence I fall. I guess like in most things in life where there's a fence, I straddle it. Birth, to me, is definitely important. But is it THE most important thing in your or your child's life? Not really. And to say otherwise would do women a disservice, because birth is by nature a wild beast that can go rogue with no warning, and it's cruel and petty to verbally beat up women who fall prey to the werewolf (but that's what my next post is going to be about, so I'll just leave it at that). However, to say that birth holds absolutely no meaning isn't necessarily true either, at least not in my opinion.

I think the problem with these two lines of thinking is that they both seem to believe that only a "good", i.e. natural/drug-free/vaginal/home/water/etc. birth is capable of being a life-changing event. The former cling to this gold standard, and the latter reject, nay, outright abhor it, but vilifying something is still giving it power.

I believe that EVERY birth has the potential to transform a woman and offer her many lessons she can apply throughout her life, instead of just being one day of empowerment and awesomeness (or trauma and suckitude). Take for instance the births of my two children. They could hardly be more different. One, a Cesarean after a long hospital labor with "the works." The other, a VBAC waterbirth at home. Both have taught me countless things that have shaped who I am, not only as a mother, but as a woman and a human being....

I also learned what it felt like to be IN THE MOMENT. I think I coped with a lot of what happened before, during, and after my Cesarean by going outside my body and watching passively from afar, a trick I honed to near-perfection from a traumatic childhood and adolescence. I detached myself far away from the moment. But when Jacob's head came out of me and into my hand in the water, never before had I felt more alive and RIGHT THERE. For the first time I did not need to detach myself to survive. No, the only way to get through was to throw my whole self into it, with every fiber of my being....

Both of my children's births were profoundly important in my life. But they are hardly the axis that my or their lives revolve around. Although I still cuddle Jacob and think of him as my VBAC baby, I don't look at Jameson and think of him as my Cesarean baby. I suppose the potency of Jacob's birth might fade eventually - the pain certainly has! - but the power I gained never will. And what I learned from Jameson's birth set me up to receive it, so those lessons will always be with me.

Next, a lovely birth story. A few paragraphs that resonated, since one of my sisters is awaiting her fourth baby any day now and, at close to 41 weeks, is trying hard to stay patient.
Waiting is hard. Waiting to look into those new eyes and see that sweet spirit. Waiting to confirm whether it was a boy or girl. Wondering if that painful contraction meant something was happening. Hoping my husband would be home when labor started. Praying I would find the challenge and meet it and be refined.

After a few false alarms I resigned myself to surrender to the unknown. Labor would start eventually. There was certainty in a birth and a baby. And there was probably no way I was making it through another week so the certainty was soon.
And finally, a giveaway of Making Babies: A Proven 3-Month Program for Maximum Fertility. I recently received this book to review, and I am really impressed with it. Hope to get the review written soon!
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Sunday, November 01, 2009

Dio's first solids

A baby's first solid food is often an exciting milestone. You might snap photos of them tasting an apple slice or film them grimacing over mashed up carrots. Dio's first solid food was...well...a bit more exotic than mushy vegetables.

Today Dio was grunting and working hard to poop. I thought, "Hmmm, that's weird. It's not like breastmilk poop is solid." So when I changed his diaper, I found two small pieces of cardboard, still bright green on one side. They came from a thin box holding comic book candy sticks. I saw him chewing on it yesterday and fished a piece of mushy paperboard out of his mouth. Obviously I missed the other pieces.

I'll spare you the pictures.
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