New version of "Breastfeeding With Comfort and Joy"

A recent doula client and friend stopped by before I left for France to borrow some birth and breastfeeding books for the summer. She picked up Laura Keegan's Breastfeeding With Comfort and Joy and said, "I love this book! It was the most helpful breastfeeding book I read before I had my baby."

I reviewed Breastfeeding With Comfort and Joy back in 2009. I am excited to announced that Laura has released an revised e-book edition with updated information (particularly regarding skin-to-skin care and laid-back breastfeeding), more photos, and nine videos. Some e-book formats play the videos directly (Kindle Fire, Apple Books), while other e-book platforms will include a password-secured link to the videos.

The videos show babies of various ages taking the breast and feeding, some in upright positions and others laid-back. You'll also see 1-week-old twins taking the breast, a mother hand-expressing milk, and a mother doing breast compression to help her sleepy baby finish nursing. Another mom talks about nursing her baby right after the birth by putting her baby skin-to-skin and letting him scoot up to her breasts and latch on by himself. Finally, you'll see a UNICEF breast crawl video and watch a short documentary of a premature baby whose life was saved by skin-to-skin care after the birth.

Of particular importance are the new photos showing laid-back breastfeeding, with moms comfortably reclined and babies laying belly-down on top of their mothers. Laid-back breastfeeding enables babies' hardwired instincts to breastfeed, helps babies latch more deeply and effectively, and lets mothers nurse without having to actively "hold" their babies--a huge plus when you are nursing round-the-clock!

Laura wrote to me about this new version of Breastfeeding With Comfort and Joy:

When women see breastfeeding work, are confident to get comfortable, and fall in love with breastfeeding without the distractions and information overload, breastfeeding will become part of our culture.

I really want the new release pushed because it is an excellent resource for women to advocate for skin-to-skin at birth and other things. The information is not an update but a richer resource because of the shared experiences and practices that have come out since the first edition both in my practice and online. I now have more images to support the timeless concepts.

For the practice of women to have their babies at birth to reach a tipping point, women need an all-in-one-place resource when they demand this from their birth practitioners. Otherwise the scattered internet searches overwhelm them and the message is lost.

Please consider this book for yourself, for an expecting friend or family member, or for your medical/midwifery/lactation consulting practice.

The new electronic edition of Breastfeeding With Comfort and Joy is available from Amazon, Kobo, and iBookstore.

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A bun in the oven: connecting the food and birth movements

This arrived today and made my week (month...or even more!).

It's Barbara Katz Rothman's new book A Bun In the Oven: How the Food and Birth Movements Resist Industrialization.

I've only read the first few pages and my mind is going a million miles a minute, making connections, thinking back to my graduate student years when I also studied food and environmentalism and wrote about radical French farmer Jose Bove who, with a group of angry farmers, dismantled a McDonald's under construction.

BUY IT NOW HERE (from NYU Press)!

(You can't buy it yet on Amazon, as it comes out March 22nd. But you can pre-order it here.)

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Review of Touching Bellies, Touching Lives by Judy Gabriel

I'm excited about a new book about midwives of southern Mexico: Touching Bellies, Touching Lives: Midwives of Southern Mexico Tell Their Stories.

Written by Judy Gabriel, a doula in Oregon, this book tells the stories of more than 100 Mexican midwives. Judy has lived and traveled extensively in southern Mexico, and she was fascinated with the traditional midwives who were rapidly dying out, replaced by sterile clinics and sky-high cesarean rates.

Judy began compiling these midwives' stories by asking a simple question: "Can you tell me about the very first birth you ever attended on your own?" From this question emerges an astonishing set of stories. You learn about how many of these women received their training from birth itself. Often they were thrown into a birth because no one else was available, and soon they were being called to another birth, and then another and another...The midwifery of southern Mexico was organic and self-taught and fluid. It also has come under direct attack from modern Mexican medicine, and unfortunately this hostility has accelerated midwifery's decline and near-extinction.

Judy has organized the book into geographical regions, with brief narratives of her travels as she tries to locate and speak with as many remaining midwives as she can find. You'll travel with her from Oaxaca to Vera Cruz, from Tabasco to the Yucatan.

Each midwife's story is narrated by Judy, who sets the scene and describes the woman in vivid detail. Judy recorded and transcribed her interviews, so the stories also contain long passages from the midwives themselves. Judy has also included photos of nearly all the midwives--a wonderful way to connect to these wise women.

These stories gave me a glimpse into another world. Even though the midwives lived and worked in the 20th century, their lives were often unimaginably different from anything I have known. Alongside their midwifery journeys, you'll also read about the women's lives: childhood, marriage, babies, hardships. It's fascinating.

Reading Touching Bellies, Touching Lives sometimes feels like reading a eulogy: Mexican midwives are an endangered species, and their extraordinary knowledge and experience are dying out with them. The transition from midwifery to obstetrics, and from home to hospital, was even more dramatic and abrupt in Mexico than in the US, and the pendulum swung more violently as well. Of particular value are the midwives' skills with the rebozo and massage. Seemingly simple but remarkably effective, these hands-on skills have helped countless women have better-positioned babies, more comfortable pregnancies and labors, and fewer complications in labor.

We are lucky to have these midwives' stories captured in Judy's book. At the end, she gives me reason to hope that Mexico is starting to value its midwifery heritage: a new government-sponsored midwifery school in Guerrero trains midwives in both modern medicine and traditional midwifery skills and knowledge. If this trend continues, Touching Bellies, Touching Lives will be able to function not as a eulogy for a lost cultural practice, but  as a guidepost and inspiration for anyone wanting to learn about or promote midwifery in Mexico.

Let me end with a short excerpt from Hermila, a Oaxacan midwife. It's fairly typical of how many of these women became called into midwifery. She was 17 years old when she attended her first birth. She recalls:

One day the village priest asked me to help a woman in labor. I asked why the midwife Lupe couldn't help her, and he said Lupe was getting too old to work. He said I would know what to do because my grandmother had been a midwife.

I didn't know anything about childbirth. I'd never been with my grandmother when she attended a birth, and I hadn't had any babies myself. But the priest was insistent, so I went to the woman's house.

She told me what to do.  I just made a tea and fetched things for her and, when it was time, I held  my hand under her skirt to catch the baby. When the placenta came, I thought it was her insides, but she explained what it as. She said I had to tie something around the cord, so I tore a strip of fabric from the bottom of my slip and used that. I was afraid to cut the cord; she had to do that herself.

Two weeks later I was called to attend another birth. And then there was another... [p. 1-2]

To learn more about the book, visit the book's website Touching Bellies, Touching Babies.

Available for purchase on Amazon and from the publisher Waveland Press.

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Eric's newest baby: book #2

Eric's second book, Hemingway on a Bike, was released last week by University of Nebraska Press. It's a collection of creative nonfiction--essays about raising children, fixing houses, living in France, and playing odd sports. And lots more.

Jess Walter, author of Beautiful Ruins and The Financial Lives of the Poets, wrote this about Eric's book:

A wonderful book of essays, wry and wise, in which Eric Freeze considers what it is to be a twenty-first-century literary man’s man in all his house-remodeling, sweet-parenting, foosball-playing glory.

I love this bit of praise from Bonnie Jo Campbell, author of Once Upon a River and American Salvage:

Eric Freeze is the kind of thoughtful writer and parent who will help us save the world.

One of my favorite essays is "Supergirl." It's about Eric telling stories to Zari about her superhero-alternative-universe-self who gets zapped by a radioactive jellyfish and gains supersonic flying powers. It's about a little girl's longing to be the hero, to defy gravity, to fly. It's about how being a parent means pouring your heart into silly stories that make your children giggle and stand a little taller at the end of the day.

Other things you'll read about in this book...

• Our crash-and-burn TV interview in London about Zari's "freebirth"
• Hemingway riding on a bike (obviously!)
• Matisse coming to Nice and being captivated by its light and colors
• Vulcans and all things Star Trek
• Toddler Zari running her heart out across a parking lot and nearly getting herself run over
• Mormons and their weird obsessions with beards

And so much more! You'll laugh! You'll cry! You won't regret it!

And even better...if you buy the book from the publisher before the end of October, you get 30% off the list price (and less than Amazon's current price).

To learn more about Eric, check out his new website

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Things I didn't expect (when I was expecting) by Monica Dux

I caught a nasty bug yesterday and have been stuck in bed (or lying prone on the floor with 4 children climbing all over me). I started reading Monica Dux's recent book Things I Didn't Expect (When I Was Expecting) to keep my mind off the fever and chills and racking cough.

This book is hilarious. I laughed out loud every other page. I gave up highlighting my favorite passages, because about about half the book would have been marked. Not only is Monica Dux spunky, irreverent, and witty, her observations about all the crazy s*** pregnant women put up with are also spot-on. (Yes, there is an entire chapter about poo. It's fantastic.)

I've been searching long and wide for a book about pregnancy and birth that actually says something new/interesting/useful. This is the book. Here's a synopsis:

Pregnancy is natural, healthy and fun, right? Sure it is, if you're lucky. For others, it's an adventure in physical discomfort, unachievable ideals, kooky classes and meddling experts.

When Monica Dux found herself pregnant with her first child, she was dismayed to find she belonged firmly in the second category. For her, pregnancy could only be described as a medium-level catastrophe. So, three years later and about to birth her second child, Monica went on a quest: to figure out what's really going on when we incubate.

Monica explores the aspects of baby-making that we all want to talk about, but which are too embarrassing, unsettling or downright confronting. She also looks at the powerful forces that shape women's experiences of being pregnant in the west, the exploitative industries, and the medical and physical realities behind it all.

Along the way, she fends off sadistic maternal health nurses, attempts to expand then contract her vagina, and struggles to keep her baby's placenta off her hippy brother's lunch menu.

Available in Australia at MUP and Random House. and Amazon(Australia). Readers outside Australia can purchase ebook versions, including Kindle, Kobo, ibooks, GooglePlay, and more. It is definitely worth purchasing.

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Currently reading

Memoirs and biographies

Finding Lina: A mother's journey from autism to hope by Helena Hjalmarsson. The subtitle ends with "hope," but I'm not sure I felt that hopeful at the end of the book. It was exhausting to read of this mother's efforts to help her daughter live with autism. I was struck by how much privilege Hjalmarsson had: her financial situation allowed her to live in New York City, hire nannies to help with her children, and devote herself full-time to intensive play and therapy with her daughter Lina. What happens to all the people without the resources or time for a myriad of therapies? Who can't afford innovative private schools? Who can't spend 8+ hours a day of floortime with their autistic child?

The World's Strongest Librarian: A memoir of Tourette's, faith, strength, and the power of family by Josh Hanagarne. Thoroughly enjoyable read by a librarian with a very, very bad case of Tourette's.

Catherine the Great: Portrait of a woman by Robert K. Massie. I had no idea what a fascinating, complex woman Catherine the Great was. Massie quotes extensively from Catherine's own memoirs. His translation makes her seem very much alive and relevant today, even though she lived over two centuries ago.

Orange is the new black by Piper Kerman. I haven't seen the Netflix series, but the book was quite fun to read.

Childbirth

Cut It Out! The C-section epidemic in America by Theresa Morris. Absoutley fantastic. While much of her subject matter is well-known to me, the way she put it all together and made sense of this huge mess that we call maternity care was brilliant. You realize that physicians are just as trapped and constrained as pregnant women are in navigating American obstetric care. You must buy a copy and read it right away!

Born At Home: cultural and political dimensions of maternity care in the United States by Melissa Cheyney

Misc

What's Mine Is Yours: The Rise Of Collaborative Consumption by Rachel Botsman and Roo Rogers. I loved learning about all the ways we're figuring out how to share our time and resources. (Of personal interest since we're currently sharing a house with a family of 10.) Felt a bit long for a book...would have been better as a long article, I think. I'd love to have a neighborhood tool library, for example, so we don't have to buy and own so many tools. At least we put ours to good use! I love the idea of car sharing, especially with all the smartphone technology that simplifies logistics.

Death, American Style: A cultural history of dying in America by Lawrence R. Samuel. Just started. Seems quite interesting.

Religion/Spirituality 

When we were on fire: A memoir of consuming faith, tangled love and starting over by Addie Zierman. A memoir of growing up Evangelical, of finding and then losing (and finding again) her faith.

Sarah the Priestess: The First Matriarch of Genesis by Savina Teubal. The Abraham/Isaac/Jacob stories make SO much more sense if you read this book and realize that Sarah was likely a priestess in a competing matriarchal culture and religion. 

If the church were Christian: Rediscovering the values of Jesus by Philip Gulley. Written about Christianity in general, but definitely applicable to Mormonism as well as other Christian denominations.

A Cultural History of the Book of Mormon (multi-volume series) by Daymon Mickel Smith. I have to admit, it's been hard going wading through the first volume. His thought processes and writing style are tortured at times, yet I'm sticking with it because I hear that it gets better in subsequent volumes and because his ideas are just so fascinating (I only wish they were easier to follow!).

The street-legal version of Mormon's book by Michael Hicks. Hilarious. Puts a fresh face on the Book of Mormon narratives by retelling the stories in modern-day language and syntax. I'm cracking up over how uber-self-righteous Nephi is. (Shout out to Michael Hicks: you need a better cover!)

By the Hand Of Mormon: The American scripture that launched a new world religion by Terryl Givens. An eloquent counterpoint to Daymon Smith's brilliant but very meandering history of this religious text. Givens looks at how various groups inside and outside the Mormon church have used, interpreted, understood, and viewed the Book of Mormon.

Fun reading

Thea Gallas Always Gets Her Man by Kristen Panzer. Loud-mouthed, pregnant lactation consultant meets murder mystery. The first of its kind, and highly entertaining.

Mercy Thompson series by Patricia Briggs (7 books out so far, 8th forthcoming next year): Moon Called, Blood Bound, Iron Kissed, Bone Crossed, Silver Borne, River Marked, and Frost Burned. Fun series with a spunky mechanic-shapeshifter heroine who's likely to be beating her foes with a tire iron, when she isn't having (mis)adventures with her vampire friend or her werewolf neighbor/lover/husband.  She'd probably laugh at the cover illustrations--she's more likely to be in a greasy t-shirt with dirt under her fingernails than lounging around looking alluring.

Circle Trilogy by Nora Roberts: Morrigan's Cross, Dance of the Gods, and Valley of Silence. Great fun. It's like Lord of the Rings, but sexy and very woman-centric.

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Mama Midwife: book review and giveaway!

Author and illustrator Christy Tyner has written a new children's book, Mama Midwife: A Birth Adventure. It's about about life when mom is a midwife. Christy's partner Michelle is a homebirth midwife, and their two children ages 4 and 5 are used to birth talk.

Why write a children's book about when mom is a midwife? Christy explains:

Growing up with positive messages about birth will hopefully reduce the fear created by the flawed model I grew up with. I was exposed to birth the same way most people are - through movies and television, where unfortunately most birth scenes are excruciating emergencies in a hospital that requires intervention. By contrast, my kids hear stories firsthand about whole families that participate in birth, where siblings are woken up in the middle of the night to come witness the birth of their baby brother or sister. They hear stories about the mom reaching down with her own hands to guide her baby out, about birth by candlelight in a warm birth tub, about babies that are placed immediately on the mother’s chest, and about dads and partners that provide amazing support, catch the baby and stay by the mother's side. And of course a perfect birth isn't always the case, but we talk about the transfers, too. I think they have a more realistic sense of the spectrum of birth experiences that are possible. Every time a baby is born, Michelle texts me a picture of the baby with his family. I show the kids, and we all celebrate. Their association with birth is joy.

Mama Midwife is populated with charming, whimsical animal characters. Miso the Mouse has a midwife mother. Miso watches and learns and plays midwife. She even gets to come along with her mom one special night. Here's a sample page from the book:

Zari was really excited to help me with this book review. In this short movie, she reads the first few pages and then gives her thoughts about the book. (Isn't it amazing that this grown-up girl was once a tiny baby...and now she's reading? sniff...)



To learn more about Christy Tyner, the book's origins, and Christy and Michelle's birth stories, visit the "About the Author" page.

Mama Midwife is available in both hardcover and paperback in English, Spanish, and Finnish. Click here for a complete list of distributors (US, Canada, UK, Finland, France, Germany, Spain, and Italy).

Now for the fun part...a giveaway!

To enter, visit www.mamamidwife.com and read more about author/illustrator Christy Tyner. Then come back here and leave a comment.

Open to U.S. residents. Giveaway ends at 5pm EST on Saturday, December 14. 

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Currently reading (and a giveaway!)

Non-fiction:

Breasts: A Natural and Unnatural History by Florence Williams. 
This book was a Silent Spring for breasts. Funny at times, gravely disturbing at others, it covers the history of the breast from just about every angle. You'll learn about the history of bras, breast sizes and shapes, and breast implants. You'll discover disturbing facts about how closely our breasts are tied to our environment and the many contaminants in our air and water. I love the front and back cover art!

Reading Birth and Death: A History of Obstetric Thinking by Jo Murphy-Lawless.
Brilliant, acute, spot-on, a must-read for anyone involved in maternity care. I only read through page 50 before I had to return it to the library. I'm going to check it out again and finish reading.







Fiction:

Someone Knows My Name by Lawrence Hill
A narrative of a young African girl captured by slave traders and sent to the American Colonies. She gains her freedom and becomes involved in the British abolitionist movement.

The Language of Flowers by Vanessa Diffenbaugh
Fantastic novel about an emotionally disturbed young woman whose childhood was spent shuttled around in the foster care system. She finds solace by communicating through the language of flowers. Some pretty intense parts but so, so worth it.

Sideways To the Sun by Linda Sillitoe
Written maybe 2-3 decades ago, a short novel about a Mormon woman and mother whose husband abruptly abandons her and leaves her to reassemble her life. She gains newfound strength as she is forced to support her family and figure out who she is outside of her Mormon roles of mother and especially wife.






Books on my to-read list:

• Born At Home: Cultural and Political Dimensions of Maternity Care In the United States by Melissa Cheyney
• The Blood Sugar Solution by Mark Hyman
• Complementary Feeding: Nutrition, Culture and Politics by Gabrielle Palmer
• A Cultural History of Pregnancy Pregnancy, Medicine, and Culture, 1750-2000 by Clare Hanson
• What's Mine Is Yours: The Rise of Collaborative Consumption by Rachel Botsman
• The World's Strongest Librarian: A Memoir of Tourette's, Faith, Strength, and the Power of Family by Josh Hanagarne
• Thea Gallas Always Gets Her Man by Kristen Panzer (just bought it for my Kindle!)

And finally, a giveaway!

I've been reading Everybody Has Everything, a novel by Katrina Onstad. It's about a couple who have been trying for years to have children. They finally accept their infertility, then they suddenly become parents to a 2-year-old whose father died in a car crash and whose mother was in a coma. The sudden leap into parenthood--maybe permanent, maybe not--destablizes their relationship and leaves them wondering: are we really able or prepared to take care of another human being?

The novel was a fun, fast, gripping read. It reminds me a lot of Dan Chaon's writing: depressing yet uplifting with its sharp observations of human relationships and the small details that make the story feel, well, less like a story and more like real life.

The publisher was kind enough to give me a review copy AND offer to sponsor a giveaway for five lucky winners!

To enter the giveaway:

• Write about a memorable parenting moment (funny, embarrassing, scary, crazy, whatever). If you're not a parent, write about something from your own childhood.
• Giveaway open to US residents
• Be sure to leave an email address, website, blog, or other way to contact you
• Contest closes on Friday, August 16 at 5 pm EST

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Postpartum Reading List

 ***Very Important Announcement***

Tomorrow (April 30) I will be posting an amazing giveaway related to one of these books where everyone who participates receives a prize. It will only last for 24 hours, so be sure to come back tomorrow for details!

During the week and a half that my mom was helping out, I read three books. I thought I'd read more, but I spent a lot of time working on Ivy's birth story and video.


When I was just 2 days postpartum, I read an advance review copy of Roanna Rosewood's Cut, Stapled, and Mended: When One Woman Reclaimed Her Body and Gave Birth on Her Own Terms After Cesarean. This book is hot off the press--I think it was released 2 days ago!

It was a powerful read. In short, it was the story of her three children's births, the first two by cesarean and the third by VBAC. But it was really a book about finding herself and coming into her power as a woman. And her journey to VBAC wasn't a simple one. Her first two cesareans both began as planned home births. She worked SO hard to birth her babies vaginally. There are no simple answers to why she needed surgery the first two times and why she didn't the last time. I love her story because it doesn't give easy answers or make simplistic pronouncements about needing to "trust birth." It's raw and real and doesn't have all the answers.

You'll remember Roanna from Panel 3 of the Human Rights in Childbirth Conference and from her eloquent address "Who has the right to speak for the baby?". Here she is speaking at the HRCC conference:



Cut, Stapled, and Mended: $12.36 on Amazon


Next was The Midwife's Tale: A Mystery by Sam Thomas. Definitely a fun read! You can learn more about the book and the author at this blog post or on his website.

The Midwife's Tale: $12.98 (paperback) and $16.97 (hardcover)


Last was Jennifer Margulis' expose of the baby industry (from conception to birth to the first year of the baby's life): The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line.

 

Written to be an eye-opener (and a bit of a jeremiad), Margulis' book examines how financial interests often undermine the health and well-being of mothers and babies. Some of the chapters were familiar, but others were new to me. Margulis blends investigative journalism with fascinating anecdotes and stories. Sometimes I felt the book was a bit too heavily weighted towards anecdote, but she's also trying to tell a good story as much as she is presenting facts and research.

The Business of Baby: $16.46 on Amazon

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Giveaway of the novel The Midwife's Tale: A Mystery

Earlier this year, St. Martin’s Press published Sam Thomas' debut novel, The Midwife’s Tale: A Mystery. The novel is set in seventeenth century England, in the midst of their civil war. It tells the story of a midwife named Bridget Hodgson as she tries to solve a murder before her friend – wrongly convicted – is executed for the crime.

I am thrilled to sponsor a giveaway of the book!

Sam Thomas wrote to me recently, explaining how he--a historian and academic--came to write a novel about a midwife: 

You might be wondering how an American man came to write about an English midwife. It’s a rather long story, so I’ll keep it brief. In a previous life, I taught history at the college level, and the focus of my research was the history of childbirth and midwifery, and I published several articles on the history of midwifery in historical journals.

When I left the Ivory Tower for high school teaching I wanted to keep writing about midwives, so I turned my hand to fiction. All of this is to say that while the book is fiction, the history is solid as can be.

I should also mention that Bridget Hodgson, the protagonist of my novel, is based on a real midwife of the same name who I discovered in the archives. I try to make clear that in the seventeenth century, the work of a midwife was broader in scope than today. Midwives not only cared for mothers and newborns, they played a vital ceremonial role in the baptisms and the (all too frequent) burials of the children they delivered.

In addition to this, midwives investigated crimes ranging from bastard-bearing, to witchcraft, to infanticide. The one constant between past and present, I think, is that the profession attracted strong, assertive women.

To enter the giveaway:

• Visit www.samthomasbooks.com, then leave a comment here about why you'd like to read this book
• For an additional entry, list your favorite fiction or non-fiction book about midwives (new comment, please)
• Giveaway open to US or Canada residents
• Giveaway ends Saturday, March 9 at 5 pm EST

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Currently reading

Eve's Herbs: A History of Contraception and Abortion in the West by John M. Riddle. I've read bits and pieces of this during my graduate school years, but this is a fascinating compilation of how women controlled their fertility from thousands of years ago until the present. Before ultrasound or over-the-counter pregnancy test and before our modern understanding of pregnancy, women often viewed a cessation of menstruation--which may or may not have been due to pregnancy--as dangerous. They would take herbs to bring on menstruation, and these herbs nowadays have known abortifactent effects. Definitely worth reading. I had to return it before I was able to finish it, so it's on my to-read list once I can ILL it again.

The Politics of Women's Spirituality: Essays by Founding Mothers of the Movement. I originally checked this out to read an essay I saw cited, but I can't remember which one it was. I paged through much of the book, but didn't actually read it in depth. I found the early 2nd wave feminism a bit too simplistic for my tastes. But it's valuable as a marker in the evolution of feminist thought.


Our Bodies, Our Crimes: The Policing of Women's Reproduction in America by Jeanne Flavin. Just started this today. I might use part or all of it for a freshman tutorial on reproduction that I hope to teach next fall.




A blog acquaintance shared a huge file of ebooks, so I've been reading two historical novel series set in England ranging from the 1100s-1600s. I've had fun learning all sorts of tidbits about English history. The first series included The Pillars of the Earth and World Without End by Ken Follet. Next was the Morland Dynasty series by Cynthia Harrod-Eagles, a set of five books beginning with The Founding.


Now for some Mormon stuff...

My mom gave me Terryl Givens and Fiona Givens' book The God Who Weeps: How Mormonism Makes Sense of Life for Christmas. They argue that the most compelling characteristics of a God worth worshipping is his vulnerability and compassion, his capacity for feeling and understanding human pain and joy. The book's prose sometimes is more fanciful that I usually care to read, but still quite moving. Also worth your time are the interviews with the authors at Feminist Mormon Housewives (Episode 27: The Nature of God and the Feminine Divine) and a 2-part interview (Episodes 385-386) at Mormon Stories.

Development of LDS Temple Worship, 1846-2000: A Documentary History. This book has a short narrative introduction, but most of it is, as the title suggest, a compilation of original source documents relating to LDS temples. So it's not something you'd exactly want to sit down and read straight through for enjoyment, but if you're researching the historical origins of certain policies or practices, this is the place to go.

Women and Authority: Re-Emerging Mormon Feminism edited by Maxine Hanks. A classic collection of essays and stories published in the early 1990s.

Why Theology Can't Save Us, and Other Essays on Being Gay and Mormon by John Gustav-Wrathall. I first listened to his extended interview with John Dehlin on Gay Mormon Stories and was so moved by his life story that I wanted to learn more (to listen, go to Part 1, Part 2, Part 3, and Part 4). I saw this book and (guilty admission) bought it right away for my Kindle. He really breaks apart preconceived notions of what it means to be both gay and Mormon and how one might reconcile the two. On the subject of gays and Mormonism, you can't miss reading Carol Lynn Pearson's books, from Goodye, I love You to No More Goodbyes: Circling the Wagons Around Our Gay Loved Ones to The Hero's Journey of the Gay and Lesbian Mormon. 

I have a subscription to the Exponent II, a quarterly magazine for Mormon women's writing.

And of course, I can't talk about Mormon reading material without mentioning some of my favorite blogs and podcasts:

• Feminist Mormon Housewives (and its associated podcast) keeps me sane. I've also started following the FMH Facebook discussions.
• Mormon Stories podcasts. I don't listen to everything (not enough time!) but I do download the most interesting ones. Great for when I'm walking around town or watching the kids.
• Gay Mormon Stories podcasts. I've listened to every one. Really interesting.  
• Doves and Serpents. I love their Parenthood Juggle series. 
• By Common Consent (occasionally)
• Zelophehad's Daughters (occasionally)
• Wheat & Tares (occasionally)
• And a new Mormon feminist blog that an acquaintance just started: Opposition in All Things

What have you been reading? I need to start compiling a postpartum reading list, like I did when Inga was born.
.

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Boob Hell: A book review

I've never been to boob hell. Not really even to boob purgatory, except for the plugged ducts I kept getting when Zari was around 4 months old. My experience with breastfeeding has ranged from mostly boob Omaha* to occasional boob paradise.

So I had mixed reactions to Rebekah Curtis' book Boob Hell. It's a memoir of breastfeeding her first baby, and it's filled with tortured descriptions of the pain and embarrassment she endured while trying to figure out how to nurse. This wasn't your ordinary sore-nipples-for-a-few-days kind of pain, it was close to 3 months of constant, excruciating pain, even when she wasn't nursing. She had a nipple so deeply cracked that it essentially split in two. She couldn't hold her daughter or bear to have anything brush against her breasts. Turns out she had a raging thrush infection and (my interpretation here) a baby who didn't latch on right. Between those two, she endured more than I think I ever could have. But Rebekah doesn't set herself up as a hero or even a warrior. She feels like she's failing no matter what she does: "I was failing at breastfeeding, and failing at quitting breastfeeding. Human history had never known a more stupendous failure."

Besides the physical pain of a bad latch, cracked and bleeding nipples, and a thrust infection, Rebekah also endures another form of hellish punishment: shame, embarrasment, and loneliness. At times, I felt impatient with the narrator. Newly postpartum, she has a houseful of family staying over. She feels trapped and overly self-conscious. So she ends up nursing her baby on a folding chair in her bedroom, completely miserable yet unwilling to either A) just nurse the baby and let others deal with it or B) ask the unwanted guests to leave. Yes, I know that it's hard to field friends and relatives when you're newly postpartum, but it's even worse to be "nice" and then suffer for it (and then complain/cry in secret).

Even after she's been nursing for a while, she still feels terribly awkward and embarrassed to breastfeed in front of anybody. Here's a scene when she's visiting her mom and grandma (referred to as "Grandma" and "Great Grandma"). 

     I positioned Baby to start on the safe boob. I had her burpie, a fresh nursing pad, and my receiving blanket. But when It came to the feature presentation, I found myself stalling, making unnecessary adjustments. I just didn't want anyone to watch me feed the baby; not my mom, not my grandma, not anybody. I grimly draped the blanket over my shoulder and Baby, reached underneath it to unhook my bra, and tried to hold her in the appropriate range, but she started flailing and gasping and soon the blanket was tangled around her head and arm, and my face was burning. Was Great Grandma still watching? I didn't want to look.
     "Come on, Baby," I muttered desperately, pulling the blanket back up. But she couldn't get it. Her hands flew and pulled off the blanket again and she cried in frustration. I wanted to do the same. "I'm sorry, we're terrible at this," I said angrily. "Well go upstairs and come back when we're done." I reassembled myself and hauled Baby upstairs where we could sequester ourselves in a bedroom.
     Dad [Rebekah's husband] knocked on the door a few minutes later and stuck his head in. "Doing OK?" he asked.
     "Why do they say you should just feed the baby wherever you are? Why don't they tell you that babies can't figure out how to eat without you being totally exposed? Why do they make you think that it's totally no problem to feed a baby under a blanket? Don't their babies kick and squirm and cry? I hate all those people, whoever they are!"

 Or this scene at a friend's house, where she and three other moms are gathered for lunch:

     We sat around Christine's table while the bigger kids ran and screamed. The lady with the newborn started nursing her, not with as much subtlety as I preferred to employ. I wasn't sure if I should look away. She didn't seem to be trying to make a point (no need in this group); apparently she just didn't care. It was distracting: although I wouldn't normally be looking at her chest, I now had to look consciously elsewhere. I struck me that this was how polite men must always feel around women in boob sweaters or short skirts.
     Baby also had lunch coming. But with Other Mom doing the deed at the table, I could hardly excuse myself to the living room. It would even feel rude to try the blanket trick, since she hadn't. My inner anchorite muttered, See, this is why you don't go out with people. I dug through my diaper bag at length as a signal that I was about to need everyone's eyes to be considerately averted. I straightened, unhooked, helped Baby latch, and hoped that my face wasn't as red as it felt. The other girls dutifully conversed around me.
     "Are you OK?" asked Christine after I started laughing at their comments again to signal my return to group interaction. "I mean, is it going OK?"
     "Yeah, it's no biggie," I said, smiling tightly.

Rebekah's character is aware of these inconsistencies. One time, she is sitting in her husband's office nursing her baby. A woman walks in, looking for Rebekah's husband. Rebekah's immediate reaction is to feel uncomfortable and embarrassed, even though the woman doesn't mind and hardly notices the nursing. Turns out the woman has been struggling with infertility. Rebekah reflects:

Why had I spent all this time angry about nursing mothers being forced out of society to feed their babies, and then when someone who doesn't have a problem with me feeding my baby shows up I get mad and scared?

Reading Boob Hell made me wonder how we ought to talk about breastfeeding. Should we teach that it's something that many or most women can accomplish with the right information and support? Or is talking about breastfeeding in a positive and encouraging way setting women up for failure? Should we instead focus on the potential problems and difficulties so we're not painting an unrealistic picture for new mothers? I understand the reasons for both approaches. Rebekah definitely feels duped by all the breastfeeding books she read. To her, breastfeeding is hard and painful, period. Anyone who says otherwise is simply not telling the truth: 

     Baby and I were in the middle of a feeding when my aunt stopped by to inspect the newest family member. "How's it going?" she asked me.
     Kind of rough," I said.
     "Rough how?"
     "Feeding."
     She nodded. "Yup, that's the way it goes."
     Maybe if we all know this, we could give each other a little warning? I thought. "Everybody at the hospital and all the books say that you might be sore for a day or two at first but after that you'll be fine as long as you're doing it right," I said.
     My aunt snorted and rolled her eyes. "Anybody who's ever done it knows that's not true," she said. "But at least you can drink again, right?"
     Can I?" I asked.
     "Oh, sure," she said, "You just can't get hammered."

On top of feeling shell-shocked at how difficult breastfeeding was, she can't even be honest about how she is actually doing:

     A friendly grandpa-type asked me how we were doing that Sunday at church. Just fine, I prevaricated.
     "You know, at this age, they pretty much just sleep and eat and cry!" he observed jauntily. "And the sleeping you don't mind, and the eating you don't mind, but that crying can sure wear you out!"
     I nodded, smiled. He patted me on the back and moved on. I stumbled into my husband's study so that I could get the crying over with before another caring person tried to be friendly. Why did I have to lie about this? Why did I have to pretend that I wasn't in the darkest valley of my life? Didn't anyone know, didn't anyone suspect that things might not be that great for a new nursing mom? Why were we all keeping up this act? I could only conclude that every acquaintance who'd talked to me since Baby's birth had no experience of breastfeeding, because if they had, their words to me would surely have been less presumptuous. The eating you don't mind. The eating you don't mind. The eating you don't mind.

Rebekah finally emerges from boob hell almost 3 months postpartum. Her constant pain between feedings finally dissipates and then, at a friend's urging, she tries gentian violet for her thrush infection. It does the trick after lots of ineffective remedies and useless advice from doctors and lactation consultants.

Boob Hell is self-published. I caught the occasional error and found her usage of titles rather than names confusing (her daughter was named "Baby," her husband was named "Dad," and her mom was named "Grandma"). The writing style is so-so, but her story is positively wrenching and at times frustrating. Frustrating that women go through so much suffering--whether undeserved, unexpected, or self-inflicted. Frustrating that she received so much bad/ineffective advice from numerous health care professionals Frustrating that she couldn't be open about her struggles with mothering and nursing.

I haven't ever been in Rebekah Curtis' shoes. And she's never been in mine. Towards the end of the book, she writes: "I don't understand the people who claim to have no problems and no pain, but I'll take their word for it since one of them was my grandma." I am hesitant to pronounce that breastfeeding WILL be hard and painful and difficult. Or that if you do everything right, you'll NEVER have problems. I know that it CAN be hard, and is for many women. But I'm still uncomfortable with spreading the idea that is is MEANT to be that way.

For those reasons, I'm not sure if I would recommend this book to someone who has never breastfed before. It's simply too overwhelming and discouraging. However, Boob Hell would be great for breastfeeding veterans--especially those who have faced and overcome challenges. Or for those postpartum moms who feel lost and isolated, whether they're cruising along in boob Omaha or stuck in the seventh circle of boob hell.

Paperback available at Lulu ($9.49) and Amazon (paperback & $2.99 Kindle). 

* Pleasant, nothing terribly remarkable, hum-drum (phrase borrowed from Rebekah Curtis)

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Optimal Care in Childbirth

I'm really excited to review Henci Goer and Amy Romano's new book Optimal Care in Childbirth: The Case For a Physiological Approach. In fact, I've put off writing about some other exciting developments in order to finish this review.

I've read through the whole book once and skimmed through many chapters a second time. That's no small feat, considering the book is a hefty 583 pages with small font.

Optimal Care in Childbirth is an outgrowth of Goer's two earlier books that made sense of maternity care research and obstetric practices: Obstetric Myths Versus Research Realities: A Guide to the Medical Literature (1995) and The Thinking Woman's Guide to a Better Birth (1999). Henci Goer has been a medical writer, speaker, and consumer educator for the past few decades. Amy Romano is a nurse-midwife with clinical experience in both home and hospital settings. She currently works as a consumer advocate with Childbirth Connection.


So what is Optimal Care in Childbirth about? What does it accomplish? And is it worth the investment? My answer is an unqualified yes. Here's why:


Optimal Care in Childbirth is not simply an updated version of Goer's earlier books. It delves deeper into factors driving maternity care, analyzes an expanded body of research studies, and critiques even more forcefully the abundance of poorly designed research and the gap between research and practice  In Goer and Romano's own words, the book examines:

• why the research shows so little benefit for physiologic care and so little harm from medical-model management
• what’s behind the cesarean epidemic
• what the research establishes as optimal care for initiating labor, facilitating labor progress, guarding maternal and fetal safety, birthing the baby, and promoting safety for mother and baby after the birth
• the true, quantified risks of primary cesarean surgery, planned VBAC versus elective repeat cesarean, instrumental vaginal delivery, and regional analgesia
• how the organization of the maternity care system adversely impacts care outcomes

The book begins with three introductory chapters. The first explains the impetus for writing the book. Goer and Romano note that while careful use of technology and obstetric intervention can save mothers and babies, injudicious obstetric practices do "considerable physical and psychological harm to mothers and babies." Their book sets out what optimal maternity care--"the least use of medical intervention that will produce the best outcomes given the individual woman's case"--can and should look like.

The second chapter examines the weaknesses of medical research. Although the rise of evidence-based medicine (EBM) is an improvement over the older GOBSAT (Good Old Boys Sat At Table) model of obstetric decision-making,  EBM has several downfalls. The privileging of randomized controlled trials (RCTs) often means that other kinds of studies are dismissed, even though they contribute important information. RCTs themselves are subject to poor design and flawed interpretation, and systematic reviews are no less immune to bias. Finally, EBM has become an almost inescapable dogma that precludes other ways of knowing and discourages individualization of care. Despite these drawbacks, EBM still holds promise for pointing to maternity care strategies that work to promote minimal harm with maximum benefit. Goer and Romano comb through the research literature, summarizing and clarifying what we do and do know know, explaining what works and what does not.

The third chapter gives readers an orientation to the rest of the book. They present their methods upfront, arguing that transparency is the best antidote to bias.

The rest of Optimal Care in Childbirth tackles the evidence and customs behind the following maternity care practices:

• cesarean sections (including cesarean rates, repeat cesareans, and VBAC)
• facilitating labor progress (induction, progress of labor)
• guarding maternal and fetal safety (fetal monitoring, oral intake in labor, epidurals)
• birthing the baby (second stage practices, instrumental vaginal delivery, fundal pressure, episiotomy)
• promoting safety for mother and baby after the birth (third-stage management, newborn practices)
• optimal practices for a maternity care system (supportive care in labor, midwife-led care, birth centers, and home birth)

Each chapter begins with an analytical essay explaining the historical and cultural influences behind the obstetric practice in question. The essays then summarize the evidence and examine how far evidence strays from practice. These essays are lively, impassioned, and wonderfully humane in tone. One would expect a book summarizing and interpreting medical evidence to be dry reading, but these essays are refreshingly enjoyable. Biting wit and humor intermix with thoughtful analysis and provocative questions.

Following the essays, Goer and Romano provide a concise list of strategies for optimal care based on the evidence. Here's an example of optimal care strategies from the chapter on second stage (pushing) practices:

The following strategies facilitate a physiologic second stage, maximize the chance of spontaneous birth, and minimize the chance of genital, perineal, or pelvic floor injury:

• Encourage non-supine positions. 
• Avoid interventions that restrict movement and position-changes. 
• Make physical props available and encourage position-changes, enlisting labor companions to assist with support, encouragement, and mobility as needed. 
• Encourage women to follow their spontaneous pushing urges. Discourage prolonged breath-holding. 
• If coaching seems prudent, suggest open-glottis techniques rather than prolonged breath-holding. 
• In women laboring with epidural analgesia, await a spontaneous bearing down urge before beginning active pushing efforts. Encourage open-glottis pushing when the urge develops. 
• Use a supportive and encouraging communication style to promote the woman's sense of safety and wellbeing and diminish her fears. 
• Guide the laboring woman in birthing the baby's head gently between contractions.

Finally, each chapter ends with several mini-reviews of the available research. The reviews carefully note inclusion/exclusion criteria, study design and limitations. and clarifying information. The mini-reviews are where you can really dig deeply into the research evidence. Mini reviews are numbered and organized by topic.

I was struck by how difficult it is to design studies that capture the nuances of an intricate physiological process. Despite mountains of research, very few studies measure more than one small element at a time. That is the nature of medical research, but it works poorly for understanding the complex, interconnected nature of human labor and birth. Too often, a study's design guarantees that very little difference will be found between the "control" (usually an intervention) and the "intervention" (sometimes another intervention, other times a physiologic practice such as oral hydration or walking during labor). Isolating one small practice while keeping the overall package of care unchanged usually shows minimal results.

I was amazed at how much information Goer and Romano were able to glean, despite the limitations of obstetric research. Overwhelmingly, the evidence points to the value of doing less--or rather, the value of understanding and supporting the physiological process so that labor and birth can unfold without undue complication or interference. It's not that obstetric technology has no place; it's just that most of the time, that technology could be safely replaced with patience, respect, careful observation, and following the woman's lead. In order to shift to this style of maternity care, we need studies that examine not just one small change at a time, but that compare entire packages or systems of care. Ambulation during labor in a conservative hospital environment might make little difference in the course of a woman's labor. Ambulation in a care setting that encourages mobility, provides a full range of non-pharmaceutical pain relief options, upholds maternal preference and autonomy whenever possible, and discourages routine use of technology is another story.

Optimal Care in Childbirth is a book we cannot do without. Imagine if every maternity care facility--from the busiest tertiary hospital to the smallest home birth practice--adopted all of the strategies for optimal care set out in Goer's and Romano's book. We would have a maternity care system that supports the wants and needs of laboring women, no matter their location or their individual health profile. We would have a system that delivers optimal care--promoting the physiological processes whenever possible and providing obstetric interventions judiciously and appropriately. We would have a system that uses fewer resources, leads to fewer physical and psychological complications, and has healthier, more confident, more satisfied mothers.

~~~~~

Optimal Care in Childbirth is available at www.optimalcareinchildbirth.com and retails for $50. The authors have offered Stand and Deliver readers a special 15% discount and free domestic shipping through October 31st. Use coupon code MOQLM3W8. Also available on Amazon.

Disclosure note: Goer and Romano provided me with a review copy and invited me to participate in a referral program.

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Midwife memoirs from the UK

I've discovered a bundle of recent UK midwife memoirs. I was reading retired midwife Sheen Byrom's reflections on the Human Rights in Childbirth Conference and noticed she'd written a memoir called Catching Babies. From there, I found several other midwife memoirs, none of which I had heard of before. Any others I've missed?

• Catching Babies: A Midwife's Tale by Sheen Byrom
• Tales of a Midwife by Maria Anderson
• Journal of a Student Midwife by Ellie Ryan
• Midwife on Call by Agnes Light
• Call the Midwife: A True Story of the East End in the 1950s by Jennifer Worth
• Farewell to the East End: The Last Days of the East End Midwives by Jennifer Worth
• Twelve Babies on a Bike: Diary of a Pupil Midwife by Dot May Dunn
• It Shouldn't Happen to a Midwife! by Jane Yeadon
• Bundles of Joy: Two Thousand Miracles. One Unstoppable Manchester Midwife by Linda Fairley (biography)
• The Midwife's Here!: The Enchanting True Story of One of Britain's Longest Serving Midwives by Linda Fairley (biography)

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Book Review: The Midwife of Hope River

I recently had the pleasure of reading Patricia Harman's third book and first novel, The Midwife of Hope River. The novel follows a fledgling midwife during the Great Depression. Fleeing from her troubled past as a union organizer, Patience Murphy moves to rural West Virginia to begin a new life. She finds herself on her own--as a woman and as a midwife--after her midwife mentor dies.

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Conditions in rural West Virginia are so primitive that Patience might have been living in the 17th or 18th century. Patience is one of two midwives in the county; the other is an old black "granny midwife" and well on her way to permanent retirement. Only the very wealthy can afford the county's sole obstetrician, so Patience finds herself with a rising caseload. Births were much the same as they would have been centuries previously; with hospital backup all but impossible for most residents, Patience has to learn how to handle just about everything herself.

The book isn't just about childbirth and midwives, though. It's a story about race relations, about American labor & union activism, about the development of obstetrics and the relegation of midwives to poor and rural populations. Most importantly, The Midwife of Hope River is a story of a woman coming to terms with her past and learning how to live--and love--again.

The book was a fun, absorbing read. If you love curling up with a good book, then you won't want to miss Patricia Harman's latest work!

Available at Amazon , Barnes & Noble, and Indie Bound. To meet Patrician Harmon in person, go to one of her book tour events! If she isn't coming to your area, you can follow her virtual book tour.

For more about Patricia Harman's writing, visit her website, Facebook page, or Twitter account. You might also be interested in my review of her memoir Arms Wide Open. 

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