by MotherWit | Mar 30, 2010 | Uncategorized
I’m super excited, because tomorrow I will be meeting with Holly Dressel, who has co-authored books with David Suzuki, as well as done some of The Nature of Things shows. She is an amazingly engaged, involved lady, and an important voice on the subjects of environmentalism and healthcare. Holly is embarking upon a writing project with an OB/GYN friend of hers on the over-medicalization of birth. Guess what doula she’s interviewing? Oh yeah, it’s me…doing a little happy dance. I promise to represent us in a way that will make y’all proud. I know it’s a big responsibility, and I don’t take it lightly.
My agenda is to emphasise the importance of the emotional support a doula provides throughout the childbearing year to bring balance to births in higher tech settings (than home), emphasising that for women choosing to birth in a hospital, they can have what they perceive to be the best of both worlds….good clinical care with access to technology if necessary, and attention to their comfort/support needs and solid continuity of care. I will will also dispell some myths that we’re all about only natural birth, and explain that we advocate choice. I will also discuss the role of doulas in out of hospital births with midwives, and talk about the studies done by Klaus and Kennel which give evidence of the efficacy of our care. I will mention the important organizations upon whose shoulders all doulas stand, whether or not they are affiliated with anyone in particular, and discuss how our job is to educate and provide proper information, and to be part of a team, meaning we work with the decisions of primary healthcare workers and their patients (our clients), keeping our own agendas out of it.
Wish me luck!
by MotherWit | Mar 27, 2010 | Uncategorized
Hello All,
As I’ve mentioned, I will, providing all is politically stable and enough resources can be gathered, be going to Madagascar in September.
I am now a member of Taratra Reny Sy Zaza, which means “Shining Light, Mothers and Children”. This group was founded by the traditional midwives, mothers, and young women of Mahatsinjo, Madagascar, whose mission is to promote women and children’s health in that region.
Karen Samonds, family physician Deborah Golberg, midwife Sarah Hunter and I (doula Lesley Everest) will be going to Madagascar to do an educational exchange with the midwives there, as well as hopefully with the doctors who work from the Tsinjoarivo hospital 15 km away from the area we will be staying.
The intent of this trip is to give the midwives some basic equipment (they have nothing), some training in preventing and dealing with complications in the childbearing year, as well as trying to improve conditions in the hospital (which is an 8 hour walk away). Karen sent me some photos of the Tsinjaorivo hospital, and there is basically a slab in the middle of a “delivery”room (and that’s it), and a couple of recovery cots. A few basic pieces of equipment, medications, and some training could do wonders in lowering the rates of newborn and maternal death in this region.
This will not be a case of “helicopter medicine”, where we Western folks sweep in haughtily, telling everyone they’re doing it all wrong, dumping a limited supply of equipment without proper instructions, and then take off with a “good luck”. These workshops will be conducted with the utmost respect for the tradition and vast amount of experience the midwives have. The Taratra midwives who are good friends of Karen, who has spent many months per year in Madagascar out of the last 10 years of her life, told her these workshops are something they want. And we are fascinated to learn of how they deal with complications in birth. As a doula, I am really excited to learn about the massage techniques they use to treat infertility, and am curious about how they support a mother in a long birth. Karen told me their approach to birth is very much like that of a doula.
Some of the areas Karen and the midwives have identified as being useful to focus on are:
1) Contraception and STD prevention. Many of these women have more children than they want, and really want to know how to prevent conception. They were not aware that there are more fertile times in the cycle than others. Also, condoms were not something known before. Men tend to have multiple partners, so STDs are an issue. Male and female condoms will be huge on our list of things to bring or have donated and shipped.
2) Nutrition throughout the childbearing year. Malnutrition is a huge issue for the women of Mahatsinjo. They have many children, do not have an adequate diet, work extremely hard, thus often don’t have the strength to cope with things such as lots of blood loss in labour. Pre-eclampsia is very common. The diet consists of rice, manioc, and other really starchy things. Some fruits and vegetables are available, but it is not known by the women what can provide better nutrition. Also, smoking and drinking rum are habits that are common, and not known to be harmful to a developing fetus. Vitamin A deficiency is a huge problem. Donations for prenatal vitamins for women and children are being arranged, as well as a workshop in prenatal nutrition.
3) Equipment and skills. As I mentioned, midwifery skills are very basic, and there is no equipment. We’re coming up with a list of things that will help the midwives do their jobs more easily, as well as things that will be helpful to equip the small hospital. A hanging scale for babies, tape measures, fetoscopes, blood pressure cuffs, stethoscopes, suturing equipment, drugs to control bleeding, etc. are part of the list, and we are hoping to get all of these things donated and sent over, or to raise the funds to buy them. The doctor and midwife on the team will do trainings to enhance the skills of the midwives and hopefully doctors in this region (Advanced Life Support Obstetrics). Teaching basic neonatal resuscitation procedures as well will most likely reduce the rate of neonatal mortality considerably. There are some books also on the list of necessities that will help provide information to a reader who perhaps doesn’t actually read, but learns from pictures.
4) Breastfeeding and infant nutrition. Karen told us that the women there are not aware that colostrum is extremely valuable to the health of the newborn. Breast milk is not seen as the amazing nutrition we know it to be. When Karen arrived in Madagascar with her first child, the women could not believe that a baby could be so chubby and hale with exclusive breastfeeding. Coffee is given to infants in order to “give them strength”. Low birth weight and diarrhoea are common causes of infant death in this region. We are hoping basic information about the nutritional and immunological benefits of breastfeeding will go a long way in preventing the extremely high rate of illness and death in young children.
Other topics will arise as we do more planning, but these are the basic things we have been discussing.
What we need is to raise funds! I am putting this out there in the hopes that it will get passed on and the word will get out. Any sponsorship, donation, funding, volunteering of time to help fund raise, etc. will be a blessing. Karen has gotten funding from the African Women’s Development Fund, but it is not enough to have the team or the equipment that will make the best of our time in Mahatsinjo. We are asking for help! Information about the Sadabe organization (which was founded by Karen and her husband Mitch, and seeks to find a better and more effective coexistence for Madagascar’s humans and its wildlife) and Teratra Reny Sy Zaza can be found at http://www.sadabe.org/ You also have the opportunity to make donations on that site, or you can contact me at info@motherwit.ca I will be putting something on my site for donations soon as well on http://www.motherwit.ca/ We are also thinking of holding a silent auction, so donations of products or services are welcome as well.
You have the opportunity to make a profound difference in the lives of these women and children by helping us provide the empowerment they are asking for to develop their knowledge and skills in caring for themselves and their community. You will be honoured on the Sadabe website as a friend and supporter.
Please pass this on and help us make this trip a reality!
Thank you, and have a wonderful weekend
by MotherWit | Mar 22, 2010 | Uncategorized
I just sent off my registration to the trainer of the CAPPA Lactation Education course coming up here in Montreal in April. I am quite excited about this. I am a former La Leche League Leader, have been a doula for quite a while, and personally spent 17 years breastfeeding and/or pregnant (tandem nursing, child led weaning, all that)… so I’m pretty handy with the boob. With this experience along with my perinatal massage work, I have probably had my hands on over 500 sets of breasts, and have educated verbally near twice that. In fact, I teach others how to help with basic breastfeeding. But there is always room for more learning.
I think it is extremely important to keep educating oneself. I occasionally go to conferences on lactation…I LOVE conferences. There is one coming up this spring in Quebec City on Kangaroo Care which I am dying to go to, but am unable because the volume of clients I already have booked up for them. It’s quite hard being booked around 8 months in advance, because planning things becomes quite a challenge….I was already booked before I knew about the conference. Anyhow, I was so happy to hear of this opportunity, because there are new studies and approaches always coming out, and I think a birth attendant should be kept up to date. The doulas on my team are also taking this course (except for Kimberley, who is already a board certified lactation consultant).
If you birth workers out there get the opportunity to do trainings here and there, do them! Even if you don’t choose to do the certifications (which I probably won’t in this case), the knowledge will be with you. You will always learn something. It’s important to never get too complacent with your knowledge. If you don’t keep up to date, you’re going to start having clients ask you about studies and techniques you’ve never heard of. Thanks to CAPPA, for this opportunity to increase my knowledge base and enhance my skills.
by MotherWit | Mar 18, 2010 | Uncategorized
I want to announce an amazing fundraising event that will be taking place on April 11th, 2010, from 9am to 5pm in Montreal. Dr. Lewish Mehl-Madrona, author of Coyote Medicine and several other wonderful books on the subject of healing ourselves and our culture through storytelling, will be leading a workshop called Birth and Healing: Healing and Birth.
With Dr. Mehl-Madrona, and I quote “we will explore birth as metaphor. Birth is an ultimate symbol for change and transformation. Birth represents a physiological reality in which metaphor and biology meet. Metaphors of release, surrender, ‘going with the flow’, and energy are all helpful to giving birth. We will challenge the conventional birth crisis stories, embedded in the language ‘failure to progress’, ‘incompetent cervix’ being ‘sectioned’, membranes ‘rupturing’. By exploring these metaphors we can learn more about how to help women give birth and how to help anyone birth a new self, a transformation, a change. Midwives and doulas manage energy without interference or obstruction. Healing requires this same type of management. We will explore how the training of midwives and doulas is ideal for becoming involved in all kinds of healing. We will explore through role playing, re-enactments, and other techniques being ‘midwives of healing’ for conditions other than birth. Guided imagery and visualization will help us in these explorations.
We will explore how giving birth and the work and preparation required to do so, can be healing for women on multiple levels.”
Rivka Cymbalist, founder of Montreal Birth Companions, is a dear friend of mine, and MotherWit Doula Care is committed to helping promote fundraising events and gathering donations where we can to support this essential service. This is a message from Rivka to everyone who wishes to contibute to potentially improving a birth experience for a woman of need: “Help us fund the Montreal Birth Companions. Montreal Birth Companions is a non-profit, non-funded organization. We provide doula services to low-income and otherwise disadvantaged women and we train doulas within ethnically or culturally isolated areas of the city. Our goals are to provide women with doulas who are sensitive to particular needs, and to provide low and no-income women with education and a valid means of support.
Our organization is not government funded and relies on donors to provide support for seriously disadvantaged women.
All profits from the Birth Workshop will go towards paying doulas to accompany needy women during childbirth. Larger donations are eligible for a tax receipt. For information see:
http://montrealbirthcompanions.homestead.com/”
Location:Centre Communitaire, 6767 Côte-des-Neiges, Montreal, QC, H3S 2T6
Contact: Rivka Cymbalist
Montreal Birth Companions
montrealbirthcompanions@yahoo.ca
or
lewismehlmadrona@gmail.com
On a personal note, I am very excited about attending this workshop. I am big fan of Dr. Mehl-Madrona’s work, and feel he has contributed much to my approach to holding the space for a birthing woman. I used to have somewhat preconceived notions in my mind..”oh, that lady was born by C-section…she’s probably going to have a really rough birth,” or “wow, she experienced sexual abuse in the past. We’re going to run into problems.” or, “the more emotionally clear you are and the calmer your approach to birth, the more you are guaranteed of a good outcome.” Many are aware of the quantum physics theory which states that an object changes according to who is observing it. Well, I knew that giving birth in an environment which uses disempowering language like “I delivered my patient”, or “to go through natural birth is barbaric” definitely had an impact on women, but I didn’t consider that my having a preconceived story could potentially create self-fulfilling prophesies as well. Though we many not be so powerful as individuals to totally derail a birth with our thoughts, people’s energies influence each others’, and can subtly shape how a woman perceives her birth giving abilities and her birth experience.
Now when I have clients with serious challenges, I don’t project those thoughts at all. Our culture already has enough stories to categorize people. I prefer to come with a clear mind and the feeling in my heart that the intense birthing energy is beyond definition and prediction in terms of how the birth will go or how a woman will cope. We just need to be skilled, clinicians and support people alike, to deal with whatever comes up. I can hold the space for a woman in labour, outline some options, talk through challenges, make her more comfortable, and support choices, but Birth is pretty much in charge. Birth can be a tremendous Healer, bring women joy and empowerment unparalleled. Sometimes, Birth is a tough Mother, and can illuminate areas where we need to grow. And sometimes we cannot interpret it at all..it is up to the woman to make meaning of her experience and our job to connect her to those places she was graceful and powerful where she could be, giving her a richer sense of her resources from which to draw healing.
When I let go of any stories that didn’t support the here and now (but rather projected into the future), I saw amazing things. Women who considered themselves “damaged” birthed like dynamos. Women who themselves were born traumatically felt very safe and nourished in labour and had no problems. Some who were hard driving athletes, seemingly devoid of much vulnerability, birthed as gently as lambs. Conversely, some who felt very clear and open to me had lots of challenges. And vice versa on all of those scenarios. I don’t think it’s because my thought process magically made the birth better, it’s more that I probably didn’t notice before how great things were going in some “risky” births because I was clinging to my hypotheses, perhaps focusing more on the negative, and creating a story from that. Perhaps my notions prevented me from providing support in a way that could have helped things for the better.
We have tremendous power to change the fearful feelings surrounding birth in our culture. Ina May Gaskin had her finger on the pulse when writing Spiritual Midwifery and Ina May’s Guide to Childbirth….half those books are chock full of stories…powerful, amazing birth stories! They’re not all sweetness and light…there are stories of challenge and even loss. But they are stories of triumph and compassion all the same. Our culture is starving for these stories. How many times do I reread those stories when I’m pregnant, connecting with those images of power? Ina May and her people at The Farm created their own collective idea of birth as a woman centred, normal, healthy event which could absolutely be achieved with minimal intervention most of the time. They weren’t being cavalier either…they believed in excellent clinical skills and medical back-up, acknowledging Birth’s unpredictability sometimes. But those few incidents of emergency did not warp their belief. They continued to approach birth with strength, little fear, and positively…they were prepared, yes, but paranoid, no. And they prove this theory of the effect of a culture’s positive approach to birthing, balanced with skilled care, with the outstanding statistics they continue to enjoy.
So next time you hear a friend telling another friend, “I can’t believe you want a natural birth..you’re going to be BEGGING for ‘your’ epidural the second it gets hard.” or “Oh my God, your belly is so HUGE! You should have a C-section otherwise your lady bits will be destroyed!” look your pregnant buddy in the eye, smile, and say, “your body is amazing, and well designed to birth just great!” You can do your part to contribute to our wounded birth culture’s healing by not adding to the horror stories. Also, telling a woman who has just had a C-section, “hmmm, maybe if you hadn’t had an epidural (or induction, or birthed in a hospital, or had done more emotional work, insert condition here) you wouldn’t have needed a C-section, does not promote healing at all. Just because you are on the natural birth boat doesn’t mean you are necessarily healing. It’s possible your opinions are judgements, and don’t help compassion grow, which is what’s ultimately needed. We can be both VERY pro natural birth, AND very compassionate and non-judmental towards women who have experienced different birth journeys. To be compassionate is not necessarily to enable what you may think is misguided thinking.
My personal “thank you” to Lewis Mehl-Madrona for having inspired many a period of deep thought for me about the power of story and images in birth, and “thank you” to Rivka for pulling this all together!
If you don’t live in Montreal, but in somewhat surrounding areas, like Ottawa, near-the-border towns in Vermont and New York, you should try to make it. You will be receiving a lot of important learning, and helping women having more nourishing births.
by MotherWit | Mar 18, 2010 | Uncategorized
I just had a nice email conversation with a lady whom I am very exited about having in my doula training this summer, and she said, “thank you for sharing your doulawit,” which I think is a really sweet, but powerful phrase. MotherWit means “intuitive knowledge” and “practical wisdom”, a phrase I absolutely love. I was turned onto it when I read the book Motherwit about Mrs. Logan, an Alabama “granny” midwife. If doulas have a specific brand of wisdom (and I think we do, given our skills focus on being non-clinically observant, intuiting what a woman needs specifically for her emotional and physical comfort), I guess it is doulawit. Thanks to Odette for that. “Wit” is such a great, all purpose word tag. When I cook up a fantastic meal (if I do say so myself), I am a kitchenwit. When I am tired and foggy, I am a dimwit. When I’m being particularly dense (probably while doing taxes), I’m invariably a nitwit. The “wit” I get, though the “nit” I’m not sure, unless it literally means having the wit of a nit (louse egg). You would agree if you saw me trying to do my taxes.
I met a lady yesterday who expressed to me how hard her last birth had been on her, how it had ended in C-section after 60 hours of labour and pushing for awhile. She had really really wanted a natural birth with a midwife, but it’s not the way the cookie crumbled. We talked about the epidural she received after a couple of nights up and little progress, and she cried with the memory of the profound relief she felt from the pain of relentless back labour. We validated that epidural. She wants a VBAC this time, but is concerned about going through what she truly experienced as suffering for a long time before deciding upon pain relief. This woman is an athlete…a very tough one, and like many women who are used to punishing their bodies for a result, birth can become a kind of self-competition. While these “pushing through” skills can work extremely well for a normal labour, when things get long and hard, it sometimes gets the better of us. I used to be a VERY competitive gymnast, so I know this firsthand. Just to make a bit of an analogy: One of the girls on my gymnastic team had terrible back pain. She was working on an uneven bar routine, and was so determined to get it perfect, she kept pushing through. She was in tears, talking to herself the whole time, and when people would come to ask if she was okay, she would shoo them away, saying she was fine, just trying to get the routine down…no matter what. Now if she was feeling good and was experiencing that great “burn” and “high” of a fantastic workout with the reward of getting her moves down, fabulous. But to be handicapped by injury, to be an emotional wreck, and to have no end in sight about the amount of times it’s going to take to do this routine to achieve the goal of getting these moves just right (and in fact probably won’t because the fatigue and injury reduce the likelihood of things improving any time soon), what is of all this “pushing through” about?
What would it have been like for this gymnast if she had had a loving coach who ever so gently took her hands, looked into her eyes, and said, “I know what a trooper you are. You are outstanding. I am concerned about how you’re feeling right now. Let’s talk about it a bit.” And maybe within that compassionate space that girl could get some perspective and say, “you know what? I’m in agony, and I don’t know what else to do.” And then they could talk about what she really wanted to do, as opposed to clinging to harsh expectations she was holding for herself. Perhaps all she’d need was a hug, a back rub, a good cry, then go back to the routine and get it down after awhile. Perhaps she’d discover a nap was the best thing. The important thing, would be to have someone listen to and care about her.
In this lady’s case (the pregnant woman, not the gymnast), the end result of her birth (aside, of course, the beauty of having a great kid and loving motherhood) is lingering feelings of not being sure of her body and afraid of taking up that “routine” again. While she is totally interested in moving through a normal birth unmedicated if this is how it unfolds, that place of misery she experienced, not realizing what it was until she had the perspective of pain relief, is something she is terrified of. I asked (paraphrasing), “what would it feel like to you if this birth could be about allowing yourself to feel truly nourished during labour…not to have the goal of muscling through a hardcore experience necessarily, but to become aware of your boundary between pain that works for you and suffering? What might it feel like if it could be okay for you to not feel like you’re punishing yourself physically at the potential expense of your emotional well being, and know that those around you will absolutely honour choices without question, encouraging you when you are happy to move forward, and encouraging if you decide to have a break?” More tears of relief.
My interest is in trying to hold the space for a woman who has experienced trauma in birth or in her life come to decisions that will be healing for her, honouring that the healing process is unique for every individual woman. Some people might think natural, or even vaginal birth is the panacea of healing for women who are traumatized, and while natural birth can certainly be a huge ray of healing light to many with its empowerment and joy, it is not always so. It’s so important for us as birth attendants to not project that as an absolute ideal.
Lesley
www.MotherWit.ca
