Big Push

PushMedia Alert
From The Big Push for Midwives Campaign

CONTACT: Steff Hedenkamp, (816) 506-4630, steff@thebigpushformidwives.org
FOR IMMEDIATE RELEASE: Friday, December 19, 2008

Sen. Daschle welcomed to Heartland Maternity Care Community Meeting
New HHS Secretary invited to hear the stories of doctors and midwives, mothers, families, and others on the affordability and quality of maternity care in Missouri and Kansas

WHAT:
New HHS Secretary Sen. Tom Daschle is graciously open to attending one or more Health Care Reform Community Meetings 1 as outlined at Change.gov. The window of opportunity for him to attend is for meetings held in homes and neighborhoods between Dec. 15 and 31. We are planning a meeting "Maternity Care Community Discussion in the Heartland,” and we have invited Sen. Daschle to join us.

WHY:
The conversation will explore the national maternity care crisis, which sits atop the two crumbling pillars of affordability and birth outcomes. The recent “D” and “F” grades that Kansas and Missouri received respectively from the March of Dimes for pre-term birth rates will be examined. Further, the need for our community, our state, our nation, to immediately shift its ingrained belief “that more medical intervention, regardless of cost, is better—even when the evidence doesn’t support such a claim” will be explored, specifically as it relates to mother and child health. We’ll take a look at states like Washington that have saved millions of dollars by integrating licensed midwives into the maternity care systems of their states.

WHO:
Sen. Daschle, Sen. Claire McCaskill and Congressman Emanuel Cleaver, and their key staff, have been invited. We have also reached out to key state and local legislators here in the area. Attendees include leadership from the March of Dimes, Swope Health Services, Truman Medical Center-Lakewood, as well as doctors, midwives, constituents, and maternal and child health professionals, educators and doulas from across the region.

Sen. Daschle can hear the stories from families like Joe and Jen Wright of Lee's Summit , MO , where their struggle as a one-income household has been to pay all of the out-of-pockets expenses associated with the midwives’ care they have sought out for their family of five. Or from young pregnant moms like Shawna Couture of Overland Park, Kansas, who can tell him about the many obstacles within her Medicaid coverage as she tries to access the affordable care of midwives when she gives birth to her baby in May 2009. And he can hear from mothers in the military from Whitman Air Force Base in MO, about their problems with Tricare coverage of maternity costs, as well as outcomes.

WHERE
509 SE Miller Street, Lees Summit , Missouri , 64063

WHEN
2 p.m. CST on Saturday, December 20


I will be attending this meeting today, prior to heading to the Holy Land retreat centre for a time of quiet and contemplation and a Winter Solstice celebration with my good friend Morningstar. I'm hoping for a productive meeting and a chance to have face time with other local activists.

Fast Unbroken

My fast is yet unbroken. The homebirth mom from October did not consent for me to be present at her birth, and I do not stand witness to the births at the hospital where I supervise my students. As yet, it has been two years since I've seen a birth. The birth fast continues. I've also wrestled lately with thoughts of returning to midwifery. I won't go back to the CNM program. That leaves direct apprenticeship or a CPM program. I have a year to finish up my master's in education, then I'll think on it some more. A part of me still believes I can best serve women and midwifery, by not becoming one. I like my role as activist, and I can say and do things that midwives cannot. I hope to be able to affect positive changes in birthcare for women. I just haven't figured out the best way for me to do that. Yet.

Fit Test

I can't help it. I do feel somewhat like I've sold my soul to the devil. I will be free to attend meetings and conferences as before, but 40 hours out of my week I'm accountable to some other entity. It will take some getting used to. I'll give it a whirl and see how it goes. This afternoon I move into the office with all the other nursing instructors and I'll have my own desk. I both look forward to this and hold some trepidation. I tell myself- I'm only renting out 40 hours of my life per week- doing something I really like and that makes a difference- and getting compensated in exchange. Even so, it is a big change. I'll have to see if it fits.

Taken to Task

It is done. I have accepted a full time position teaching. I begin in two weeks. I've set my business up to run for the most part without me with my son as acting manager, and my office manager doing nearly all my duties now. I'm almost obssessive now about retiring my debts. This new job is the way to see that happen. I will be lead instructor of a team of three teaching OB/Peds. One has been a great partner to work with, and the other has yet to be discovered and hired. My goal now is to set about making OB/Peds the best rotation for the students. I want their experiences to be very positive (whether or not they choose these areas of specialization). I'll have the month of December to work out the kinks and get started in January. Simultaneously, one burden is lifted (steady income for the coming economic times) while two others are placed (dealing with the politics of the workplace and making a quality learning experience for my students). Today is my boss's last day. I will miss her, she has been wonderful to work with. Her replacement starts the same day I start fulltime. I'm hoping for the best. I plan for and look forward to the change and transition. My office manager and mother-in-law are our back ups for care for Josiah, otherwise he will continue here at home with Daddy since DH works nights, and the teens are home from school before he leaves for work. Even so, a part of me misses him already. Its amazing how much a baby changes the joy level of a home- even one that seemed perfectly happy before.
Speaking of babies, did anyone happen to catch the segment on Doulas on the Today Show? Well you can catch it now here. There were some nice things said about doulas, but mostly it just made me miffed. They made sure to play up the 'dark and evil' side of doulas as presented by a physician whose hospital had banned them! Then they ended by calling doulas a luxury for priviledged women! I can feel the letter writing campaigns forming. My doula listserve is already heating up. It seemed quite biased and portrayed physicians and nurses at the top of a birth hierarchy (with doulas firmly at the bottom), but I reject this view. In my scheme, moms and babies are central and everyone else is subservient to them and their needs (a circle, not a pyramid). I feel a new chapter to my book coming on...

Veg Head

I have to write about this new restaurant I discovered. I've been attempting for some time to go somewhat vegetarian/vegan. I say somewhat because I want to keep fish and seafood but I'd really like to limit eggs and dairy. Its been interesting doing eat out food without meat since that's what most of their menus are built around. I enjoy the black bean soft tacos at Chipotle's, and the veggie burger at Burger King, and the shrimp and spinach salad at Applebee's. At the Olive Garden I could live forever on their Portabella Mushroom Ravioli, with sun dried tomato sauce. However my absolute favorite place to eat out for a quick lunch is Panera. They usually have 2-3 vegetarian soups on the menu, and 2-3 delicious vegetarian sandwiches. My current favorite is the Mediterranean which includes tomato, cucumber, feta, and hummus. Speaking of hummus, there's a terrific little Mediterranean restaurant around the corner from me called the Holy Land, where I can get a yummy hummus and falafel sandwich on soft warm chewy pita bread with a salad and spanikopita- one of my favorites. Yum. And recently, I had the most delightful sandwich at the breastfeeding task force meeting in St. Louis. It was stunning in its simplicity. It consisted of sliced tomatoes, cucumbers and mushrooms on little mini sandwich buns. That's it, no cheese, it was a vegan sandwich, just veggies. I added mayo (non-vegan) and mustard to mine and it was delicious! I was amazed at how good something so simple could taste. Please feel free to send me your ideas for vegetarian/vegan lunch items I can prepare for myself or places where I could find a tasty meal (I do a lot of business lunches- so I do eat lunch out a lot, but I like to make my own lunches otherwise).
Now back to the new vegan restaurant I discovered called SEED. It's located between Union Hill and Hospital Hill, in an area undergoing rapid re-gentrification. I'm sure right now their rent is cheap because they are surrounded by industrial types buildings, and old rundown houses, but re-gentrification is slowly encroaching. Just a couple of blocks away, rows and rows of tidy new townhouses have gone up on Union Hill totally obscuring the quaint little cemetery where rests the bones of some of Kansas City's earliest settlers. You'd never know it from the list above, but my favorite class of restaurant is the independently owned restaurant, not the chains. My city happens to be home to many wonderful and unique independent restaurants and SEED (also the HOLY LAND) is one of them. It's a classic little store front eatery. You walk in and there is lovely artwork on walls painted in serene colors. The whole thing has a very calming and soothing affect. We walked up to a counter and place our order with a tall handsome young man sporting shoulder length dread locks. The restaurant is owned by a young African-American couple with a new baby. The midwife who takes me here for lunch, happens to be their homebirth midwife. Unbeknownst to me- I introduced them. You see, I routinely get calls and emails from folks looking for midwives and I just send out my list of midwives who have agreed to let me give out their info. So after our meal I get a hug from the proprietress for introducing her to her midwife. How nice! But anyway, back to the food. The menu itself first strikes me as limited and unimpressive. It is very small and basic- no Haute cuisine- just burgers, BLTs, and tacos. I think to myself, this is vegan right? But my midwife friend assures me the food is delicious. I order the veggie burger with avocado on the side. The midwife orders tacos, and her student following her for the day and lunching with us, orders the "chicken" sandwich. The sandwiches come with french fries but I also order a bowl of the soup du jour: tomato. While our food is prepared I peruse the small two room restaurant. The second room is even cozier with sofas, candles, lamps, and shelf-lined walls filled with books and for sale items. The for sale items are all "Black Power" stuff slathered in the Red, Black and Green flag, silhouettes of giant Afros, and black power fists and other 60s symbolism. One shelf is filled to the brink with old vintage black films from just before and during the blaxploitation era, another with books touting black national demagoguery. There are mugs and t-shirts and shelf after shelf of shameless commerce items devoted to the original and revised social philosophies of the Black National and Pan-African movements. Have no idea what I'm talking about? Well lets just say the whole thing was a tribute to another era in time. To top the whole thing off, there having lunch with a small group surrounding him is a local African-American community leader. He fits right in. It's like they planted him there as part of the decor. I find my way back to my table and wait for my food. The restaurant is about 3/4s full even though we arrive around 1:00 past the lunch rush. We wait a while because the midwife says everything is prepared fresh when ordered so it takes longer. When lunch does arrive, its worth the wait. My veggie burger is superb nestled between a sprouted wheat bun with caramelized (rather than mearly grilled) onions. I add my slices of avocado, which by the way are perfect, no small feat here in the Midwest where avocados are definitely not in season. The fries are nice thick steak fry cut, generously peppered, but not an excessive amount like most restaurants do, and non-reasy. They are obviously baked and not fried. The taste is pure heaven. I can't believe a veggie burger can taste so good. I also enjoyed my bowl of hot thick tomato soup. Midwife orders a large pear/pecan salad for us all to sample. I put some on a plate and slather it in their homemade poppyseed dressing. I take a bite. Again I'm amazed. How can something so simple taste so good. The greens are organic mixed baby greens (very high quality) with chunks of soft (firm not mushy) sweet pear and pecans )whole and half pieces) strewn across them. That's it. I can hardly stop eating it, its so good. I finish my small plate of it from first bite to last before I resume my burger consumption. My mouth is rejoicing, everything I taste is some small masterpiece. I want more. I order from the ample offerings of their smoothies. I get the Almond Joy- a mix of chocolate, coconut milk, and almonds. Its the perfect ending to round out a near perfect meal- not too sweet- which smoothies can tend to be. Shamelessly, when the midwife asks if I want to taste her tacos, I take half of one, because I really do want to try everything on the menu! The taco 'meat' is nestled inside an organic blue corn taco shell topped with lettuce, tomato, vegan cheese, and avocado. Vegan sour cream and salsa are served on the side. It was delicious. The obviously nonvegan student declared her 'chicken' sandwich to taste 'just like chicken' and I note that it appears to be served on a homemade oversized biscuit rather than a bun. The place, the food, the owners, the ambiance, all a delicious little treat for the palate and the soul. I can hardly wait to go back...soon.

Life on the road...

Brain dead but blogging- completed my whirlwind trip to St. Louis yesterday- 8 hours of roundtrip driving! My buddy Charlene was supposed to help me drive back, but she has night blindness, so she contributed by talking to me and keeping me awake. We had our state breastfeeding coalition meeting at St. John's Hospital. What an awesome facility. That place was huge- 8600 births a year (about 10% of folks born in MO are born there). The L&D, a well baby nursery, an admit nursery, NICU, stepdown NICU, and postpartum units were spead over 4 floors and they are building a new building to add even more! Their new NICU was particularly swank- it had private 'pods' (private rooms) like an adult ICU would have, not just an open wards of isolettes like most NICUs I've seen. The NICU stepdown (also something I've never seen) was for feeder/growers (this is lingo for babies who are not sick, just small). Thier NICU even has a 'milk tech'- a job I've never heard of. This person's job is to mix the special formulas for the NICU babies including human milk coming from the banks in Denver and Texas. Just the new NICU expansion we toured was ADDING 46 beds!!! They deliver on average 25 babies a day! Thier NICU pods included a room for quadruplets! This place was really impressive in its scope. They have a staff of 5 lactation consultants not including the 2 who are dedicated to the NICUs. Having said that, we didn't get to tour the labor and delivery unit, (but in my mind I imagine a giant conveyor belt)! I heard something about a 40% c/s rate (they weren't shouting that from the rooftops). But all in all an impressive facility with wonderful hospitality. Our hostess for the day touted that hospitality was a conerstone of their philosophy of care- and it showed, in many small ways and interactions with the staff. The meeting itself was cordial and productive. We had about 20 attendees from throughout MO (1 Kansan, and 1 Illini), and we voted in the officers, and bylaws. The website is up and going http://mobreastfeeding.org and we gave feedback on what kinds of information should be included on it. It was nice to see so much diversity, folks from large and small hospitals, folks from cities and rural areas, folks from outside the hospitals, folks who were and were not LCs, folks from government agencies, folks in private practice, and folks from non-profs. We also discussed ongoing plans for statewide activity (or what will be the primary role and function of our organization). We ended the day planning for the next meeting. I liked that we also discussed our sister organization in Kansas (no website as yet but they are a really productive group) and what we can do collaboratively with them. For those reader who want to get involved with a breastfeeding coalition in your own state, follow this link to the US Breastfeeding Committee. They have all the state coalitions listed. We had a productive meeting and a much nicer drive back home (thanks to Charlene). Today, I look forward to a relaxing date with my husband tonite at a church dinner, a movie with my daughters this afternoon, and shopping for myself for a coat and boots. First things first- I need to get payroll done at the office. I'll enjoy this relaxing weekend. Next weekend, its two more 12 hours shifts at the hospital with my students. Life is good.

The Breast Roadtrip Ever

I spent the day today, trailing a local lactation consultant (one of only about 50 African-American LCs countrywide!). I spent the day watching her do what they keep telling me can't be done- increasing breastfeeding rates in the African-American community. Next week I hope to observe a caucasian LC doing the same thing in an urban hospital. Both visits will be documented and added to my literature review for my thesis. The topic: The impact of lactation on infant mortality rates in the African-American population. I slipped away at noon to lunch with the midwife who worked across the hall in the OB clinic. She took me to a great new vegan restaurant called Seed. I had the best veggie burger ever, and got to listen to the midwife tell me all about her plans to start a birth center. I want a piece of that dream. Tomorrow I hit the road at 6am to travel across the state to attend the Missouri Breastfeeding Taskforce meeting in St. Louis. I'm excited to meet up with my fellow 'breast enthusiasts' from across the state. I also attend the meetings for the Kansas Breastfeeding Taskforce since Kansas City staddles both states. My 'breast buddy' Charlene and I hope to get both groups to do a joint conference here. Not looking forward to the drive, but excited to be with my statewide peeps.

Welcome to my World

I've just come off a 24 hour weekend doing clinicals at a local hospital. I really enjoy this part of the work. I had 5 students on both Saturday and Sunday for 12 hours each. I placed them in NICU, mother/baby, newborn nursery, and of course the much coveted labor and delivery. One student went to the cafeteria for a break and missed her patient giving birth! (bummer) Her patient dilated from 5-10 and pushed baby out in about 15 minutes. Oh well, that's what you get with a Gravida 5. There was a forceps delivery which opened a discussion during noon conference about forceps, vacuums, and cesareans. It's such a delicate balance to try to open the students eyes about birth in an environment that is very one-sided in it's approach. Our de-briefing at the end of the day during post-conference is the best part of the day. I encourage the students to have lively debates with me and with one another about what they see and experience on the unit. It can challenge their beliefs to the core and the resulting conversations are quite stimulating. While the use of forceps dominated on day two, the other day saw two moms on the unit test positive for cocaine. For those students the hot topic was social issues in pregnancy. One student could simply NOT imagine why any woman would forgo prenatal care. We had a very spirited discussion about delayed or no prenatal care, and why some healthcare clients make such a choice or how their choices might be limited. We discussed the role of the nurse as a part of an interdisciplinary team. There is the birthing client in the center and her family, then comes nurses, physicians, pediatricians, anethesiologists, clerks and admistrators, social workers (sometimes), dietary services, nurse practitioners, lactation consultants, all manner of specialists (if problems arise) clergy, and technologists and in a teaching institution, lots and lots of students of every kind. Speaking of which, we discussed the role of the student and trials and tribulations of walking the tightrope that is the student role. This is a fascinating opportunity for me to view the world (of birth) through the eyes of students, some whom bring only their own experiences of birth, and others that don't even have that. I love the challenge of drawing them into my world and seeing them become excited about it, or angry about it, or curious about it, or even dismayed about it. And somewhere in the middle of all that emoting, and digesting, and experiencing, and debating, and perceiving... learning somehow occurs.

Mind Over Mentor

I have a 'slow' month this month- no lectures to teach, only about 4 12 hour shifts to supervise at the hospital with LPN students (they only observe- they don't actually do patient care in OB, except on mother/baby). Only now have I had time to 'digest' the two conferences I attended last month on SIDs and birth trauma. I could do a post on each of them, they were so informative and fascinating. I probably will do a synopsis on the SIDs conference in a day or two. In the meantime, I've decided to break my birth fast (I have not attended a birth since Josiah's) and hang out with a local homebirth midwife this month. She says she has the perfect mom for me to meet and attend (with the mom's permission of course). I have had inklings of becoming re-involved with birth on some level. I could be on-call for L&D shifts at the local birth center. I could inquire about a full blown apprenticeship with one of several midwives here in town. None of these options seem quite right for me now, but I'm glad to know options are available. For now, I'm content with my observation. I will also spend a few days with a couple of lactation consultants (one in a hospital and one in a community based clinic) to interview them for my thesis. Both these LCs are phenomenal. They have each nearly single-handedly turned around breastfeeding rates for the AA moms they care for. I want to observe how they do it first hand. I want to write and speak about the methods they use to influence AA moms to breastfeed, so I can share their successful strategies with everyone else. I've learned a lot devoting my semester to literature review, but I'm eager to see some strategies in action. I'm looking forward to spending my month with women I consider models of success and mentors in my chosen areas of interest.

The Noble Savage

I didn't mean to let the month of October pass without an acknowledgement of Josiah's 2nd birthday. He is afterall, the inspiration for this blog. Here he is pictured with his big sister, coveting her soda. He's a typical two year old, into everything not nailed down or locked up. His favorite word is 'no' his favorite food, oatmeal (and any candy he can get his hands on), his favorite toy, a wooden lawnmower (it has wooden beads in it that pop when he pushes it), and his favorite passtime is reading with Daddy. We are currently tackling the task of potty training which he finds quite a novelty (he'd just as soon be naked from the waist down, thank you very much). He's constantly covered in cat scratches since he thinks its worth the price of pulling the cat's tail. No object we deem sacred is safe from his wayward grasp. He's an excellent climber, especially with a footstool nearby. He leaves no faucet unturned, no drawer unmolested. He growls better than he speaks, and occassionally snacks from the kitty dish. The distinctions between him and the pets are few at this point- save one. Have I already mentioned, he's the delight of our lives?

Rebirth of a Nation

There is an historic moment that now confronts us. Though the focus of this blog is birth, I'd be amiss not to recognize the momentus birth of a new presidency that now confronts us. Though two worthy individuals began this race, one has triumphed. May his presidency usher in a new era of peace, compassion, and prosperity.

Will Blog for Food

I didn't attend MANA this past weekend. I wanted to. I was scheduled to speak. But it was a nonpaying gig and I couldn't afford the airfare to upstate Michigan. I really wanted to go, but ironically I gave the same presentation (slighty tweeked) here in my town at another conference. After I notified MANA that I wouldn't be speaking, I got an invitation from another conference that had before rejected my application. They had a slot open up and asked if I wanted it. It was right here in town, so I jumped at the chance. I spoke on Sunday morning at the Professional Nursing Education conference. I spoke on using blogs for teaching nursing students. (I slightly tweeked it from the MANA presentation on the impact of blogs on healthcare). I ran into several nurses I knew, including one of my professors from nursing school. I even picked up a few tips on improving hospital clinical experiences. It was very nice. Yes it is ironic that I spoke at a conference for nursing educators when I've only been doing it for 5 minutes. Even more ironic is the fact that when I sent in my original request for proposal- I wasn't teaching at all- and had never thought about teaching. As much as I wanted to go to MANA, I never had time to miss it. My weekend was a blur of posting midterm grades, checking care plans, and writing powerpoints, and shopping for baby dolls to be used for neonatal assessments and infant baths. Later this week, the hordes will descend on 'kid's day' as my students do head to toe examinations on real children (mostly homeschoolers- they're available during the day, and there are usually 5-8 kids in every family- so I don't have to ask as many people!). As for the two classes I'm taking towards my masters, I turned in my first draft of my research literature review. My research topic is, the impact of lactation on infant mortality in the African-American community (the news is all bleak, folks). For my health assessment class, last week we practiced vaginal exams on teaching patients. (Teaching patients are folks who get paid to let you examine them, and they instruct you as you go.) I think I did terrible- you'd think I'd know my way around a vagina after all those years in L&D! It's an interesting contrast being both the student and the teacher simultaneously. I came across an article on being compassionate to nursing students and that nurse educators can be abusive instead of nuturing. I took it as a warning- to check my motives, and attitude when dealing with my students- and everyone who comes into my sphere of being.

Clinical Nirvana

My long hiatus has been filled with clinicals, didactics, a new classroom full of nursing students, as well as work on the two classes I'm taking. This past weekend, I spent two 12 hour shifts at the county hospital with my students in labor and delivery (L&D), mother/baby (M/B), antepartum (AP), neonatal intensive care unit (NICU), triage, and well-baby nursery (NSY). I must admit, it was a blast. I felt right at home in my old hospital. It's been four years since I worked there, but much of it was the same. I liked being there in a new context. I arrived early each day (around 6am) to find assignments for my students between the various areas (the guy with the special needs child eager to be a NICU nurse got the single spot for the NICU, the earnest eager pediatric LPN got the only open prized L&D slot, the birth phobic guy will go to the well baby nursery, and so on.) Once all the students were assigned and with their nurses, I spend the morning running from unit to unit checking on them, making sure they are taking full advantage of learning opportunities. I encourage one to start and IV in triage, another to bathe a baby in the nursery. During a lull in the activity, I pull several students into the nursery to do an exam on a day old newborn. We take his vitals, listen to his bowel sounds, test his reflexes. We peruse the nursery looking at the other babies for dermatologic alterations like milia, petechia, skin tags, and port wine stains. At lunch time, I gathered my students for noon conference. We have a twelve hour day, so I try to break up the time a little. At noon I bring them into a birthing room for a scavenger hunt. They pull a slip of paper out of a bowl and see if they can locate items like trendelenburg bars, personal protective gear, graduated cylinders, and and delee suction traps. Then we grab lunch from the cafeteria and meet in a conference room. The students take turns sharing their case studies. After lunch, they head back to their various units to continue following their preceptors. I run to and fro, checking on various ones. I watch as one give a shot of demerol, another hangs an IV bag, yet another draws admit labs. They all do beautifully and I'm so proud of them. During a lull in the activity I work on powerpoints for my lectures on my laptop at the nurses station, catching up with former co-workers I haven't seen in four years. Around 5pm I gather them all up for postconference. I have them get out their workbooks and we do test prep for an upcoming exam. They talk excitedly about their experiences on the floor. Over the two shifts, 5 students got to see babies born, the NICU guy is clearly walking on air over his experience. As he leaves the unit for the day he grabs his preceptor Aurora, a tiny but mighty Filipino nurse who has been in this NICU for over 20 years, and gives her a heartfelt hug. I love watching their faces in post conference as they talk excitedly about their day. I watch as nursing 'takes', as they begin to own it. I love the way that makes me feel. My boss keeps asking me to come on board full time. I'm considering it...

The Third Level of Creation

Here are a few images from my Spa party. You see a few of my guests receiving their spa massages, pictures of the food table (my knack for food styling comes from my years as a sous chef back in the day), and the lovely young harpist who serenaded us all evening. My guests received neck and hand massages, sipped fruited bubbly mineral water and feasted on vegetarian fare that included spinach quiche, spanikopita (handmade by me!) baked brie, stuffed mushrooms, a centerpiece of fresh fruit and artisan breads, and a lovely star-shaped cake (gifted to me by a talented local caterer and friend). Another part of the centerpiece (depicted in a photo) shows my life list- the top 10 things I want to do before I die. I encouraged my guests not only to make special restive and reflective moments for themselves during their busy days, but to also compose a similar life list composed of goals and activities that are important to them. I encourage you dear reader to do the same. It gets your goals out of your head, and when you share them with another person, it brings them into creation on a whole other dimension. It's important to share our goals to bring the energy of others into their manifestation. Just like this party. I had to have a thought of it first (creation at the primary level), then I had to plan it with the buy-in of others who were involved such as guests, musicians, and service providers (creation at the secondary level), and then I had to follow through and do it (tertiary creation). And so our lives manifest themselves. Create your own Spa for the Spirit. Grab a stick of incense, a candle, a CD of your favorite music, a cup of hot tea, and that book you've been dying to read, and create your own sacred moments in the quiet solitude of your own backyard or barricaded in your bedroom. It doesn't matter what you do with this sacred quiet time, dance, howl, or sit quietly in meditation. The important thing is to do what feeds and replenishes your spirit.

Spa for the Spirit

Between teaching my class and being a student in two others, I have to now devote some time to healthcare blogging. That will be the subject of my upcoming presentation at the MANA conference next month. Without comments or other feedback, its impossible to know the impact of blogging in the lives of others. I would love to hear from readers about how blogs (not just this one of course) have impacted their view of health and healthcare in general and birth in particular. I would love to share your insights with my audience.

In the meantime, I turn 46 this month, and as is my practice- I plan a fun party every year. I do this because I believe women do not celebrate themselves or their big moments in life enough. I want to set an example. This year, I am planning a Spa for the Spirit party in my backyard. There will be tiki lanterns and Fall flowers all around. I will have massages available, a facilitator leading relaxation experiences, wholesome vegetarian refreshment, live harp music, and an indoor 'Red Tent' for gathering in. It will be women guests only and I will create a ritual to honor each one individually for the gifts they have bestowed on my life through their friendship. Beloved Readers, consider what small rituals you can create to honor your special occassions. Don't miss out on your celebrative moments.

Teacher Becomes Student

Yesterday in class Sr. Morningstar came to speak to us about spirituality in healthcare. Just as she was beginning introductions, a student in my class had a seizure. After 911 was called, and the student attended to, class continued, but not as it would have before. Morningstar took the opportunity to address the condition of our spirits after the event. It was a brilliant lesson come to life. Instead of a lecture about spirituality in health, we had a real life experience of what it is to address the spiritual needs of the body in distress, and the family in distress (in this case, we were the family, who had experienced a beloved one experience a trauma). The entire event seemed whole and complete as Morningstar lovingly tended to our spirits and gave us opportunity to process what we had experienced. This is such a missing element in healthcare today. I hope my students get how important it is to care for the whole person, from this experience.

G Marks the Spot

Since I received such interesting responses to my post on orgasms, I'd like to probe a little deeper on the subject (so to speak). Since my own journey started, I have become fascinated by the subject of female sexual response. Here's a synopsis of what I have learned from reading, and experimentation. If its helpful to anyone, I'm glad. Most of what I find in the way a research is written about female sexual dysfunction rather than normal response. (My theory about this is that if males would worry less about 'enhancement' and more about 'engagement' the problem might solve itself!) I also learned a lot on this topic when I took training to become a sexual assault nurse. When nonconsensual intercourse takes place, the woman's body fails to 'prepare' for intercourse through the softening, swelling, and lubrication of tissue that occurs naturally when consensual intercourse is about to take place. This accounts for a lot of the injury that can occur during forced intercourse.

There are two primary ways the female experiences orgasm (though I've also seen others reported in the research), vaginally via the Grafenberg Spot (or the G Spot) and clitorally via the clitoris. Stimulation of either can trigger an orgasmic response. The clitoris is located between the labial folds and looks like a small bud. It has lots of nerve endings and is very sensitive and light stimulation with the fingers, tongue, or penis (or a vibrator) can produce an orgasm. Use of a rhythmic motion (circular or slapping) helps. The G-Spot (some scientist still aren't sure it exists!) is located on the anterior wall of the vagina (the vagina is the interior genital tract and anterior means towards the front rather than posterior which is towards the back). Feel along the anterior wall of your vagina with your fingers until you feel a rough patch of tissue (it feels distinctly different than the surrounding tissue) about the size of a quarter. That is your G-Spot and again light, prolonged stimulation can produce an orgasm. The G-Spot can be stimulated with the fingers, the penis, or other objects for that purpose. Along with an orgasm, some women experience ejaculation. Female ejaculation (no its not urine) can occur with orgasm. The amount of fluid ejaculated varies from a trickle to multiple gushes (amazingly scientists still debate the reality of this phenomenon). These trickles or gushes accompany the strong rhythmic muscle pulsations that characterize the orgasm.

Notice how little of this has to do with the penis. Most women don't experience orgasm through penile stimulation, but rather by digital (or other) stimulation. Women can and may experience multiple orgasms prior to the male ending intercourse with his own orgasm. Curvature of the penis may account more for enhanced stimulation than length or width (my own theory).

So there you have it, LaborPayne's orgasm primer. The research to verify its veracity is up to you...

I Have A Dream

I had a dream last night. In it pregnant women from all over the community gathered at community wellness centers. They came with their big bright bellies in colorful array. They were in all stages of pregnancy. The experienced pregnant women acted as mentors to the first time pregnant women, coaxing them along and encouraging them. As they entered these 'wellness centers' they were greeted and welcomed to 'their' center. There were no waiting rooms because it was more like a community center- a place that belonged to them- they were not visitors, they were owners. As the women entered they went straight into the communal learning center, a big open room with sofas and comfy chairs all around. The women sat and told their stories and asked their questions facilitated by a nurse, and counselor/social worker. The nurse did a brief presentation on something birth related, and again the women asked questions, sometimes answering among themselves, not always looking to the professionals to have the answers. After about an hour, the sharing session ended and the women began to wonder out of the community room into an assessment area. Here they began to dip their own urine, and weigh themselves, etc. and record their findings on information sheets left for them to do so. There were also computers available for the women to enter their information into their computerized patient record that they kept possession of (not the healthcare organization). After their self assessments, they had one on one time with their midwives. This time consisted of relaxed conversation and positive reassurance. There were no exam tables, again only sofas and chairs in private attractive rooms. There was no medical paraphernalia to be seen. If the midwife needed a measuring or assessment apparatus, she carried it in with her and took it out again when she left. If she wanted to examine the woman's body, it was done on the sofa, but there was little of that. The time together was mostly talk and this talk was mostly initiated by the women, not the midwife. If she elected to have her mentor or partner with her, then it was so. When the time ended, there were hugs all around before the women departed and went on about their days.

When I woke up this morning, I knew I had dreamed of a new model of prenatal care. It was on my mind because I had spoke to my academic advisor about my research project for this semester on the topic of infant mortality and the impact of breastfeeding. She asked me what else impacts infant mortality and I told her the delay or lack of prenatal care. When she ask why there might be a lack or a delay, I told her about all the factors that influence a woman's (especially a woman already at high risk) choice not to seek healthcare during pregnancy. I talked about our questionable approach to prenatal care and how it could much be improved upon. I'm sure these thoughts led to the dream. Many of these features I've seen enacted, but not all together. I've read that when we think a thing, we create it on one level, when we think and speak it, we create it on yet another level, and when we think, speak, and act on it, we bring it into being. Now is the time to think, speak, and act on new models of care for pregnant and birthing women.

Knowledge vs Wisdom

Healthcare is full of knowledge. This is not synonymous with being wise. We revere physicians and other healthcare providers for their knowledge, as 'authorities' even as they wield their power in an unwise fashion. As a culture, we value knowledge (the knowing of facts and figures) over wisdom (the prudent appropriation of that knowledge). Like children with matches we are enticed and mesmerized by the glow of technology. When the use of one birth technology proves detrimental, we create another technology to offset the effects without it ever occurring to us to disband or modify the use of the original technology. Pit inductions lead to fetal distress? Cesarean to the rescue. Epidural anesthesia causes a precipitous drop in blood pressure? Inject the mother with another medication to bring it back up. The immobilization of fetal monitoring leads to increased pain sensory in the mother? Then inject her with systemic narcotics that can inhibit oxygenation of the infant. We replace one inadequate technology with another, all the while patting ourselves on the back that we have the knowledge to fix what we ourselves have broken. What has been lost in our 'progressive' quest for a better way of birthing, is wisdom. It's still quiet voice has been drowned out by the shouting of that young upstart, technology. It is not my wish to disband technology, but to make it a servant instead of the served.Women have actually forgotten that they know how to give birth! This astonishes me. When I birth in my home without the paraphernalia, without the shoulds and should nots, without overseers directing my every move, my body shows me how to proceed. Herein lies the conflict. Women's bodies express one thing, and the 'giver of care' tells her another. Amazingly, she listens to and obeys that which is outside of and apart from her, rather than her own intuitive knowing. The body in birth becomes at war with outside forces. The woman's body says feed me, I need sustenance for this journey. The 'providers of care' say, no, you mustn't eat or drink, if everything we do doesn't work, we'll have to do surgery on you and you'll need an empty stomach (they don't say this, but this is why you are refused food and drink) even though giving you food and drink may prevent the need for that eventual surgery by giving you the strength to endure labor and pushing! Incredibly, they cling to the technology (surgical intervention) when the simple wisdom of listening to the body would have circumvented the need for the technology in the first place. This was my greatest frustration as a nurse. The wisdom of the body is not valued at all. The knowledge of technology is overvalued. (Indeed it is all that is taught and therefore all that is learned.) I observed in total disbelief on one occasion, when a mother could not have an epidural because of a pre-existing medical condition. She screamed, cried, and writhed in agony for her entire labor while her family complained on her behalf to hospital authorities. Her 'givers of care' explained over and over that their hands were tied, they could not use their technology because of the risks. It absolutely never occurred to them to use nonpharmacologic comfort measures. How could it? They didn't know any. They had no other tools for helping this mother. (By the way, I begged them to allow me to go in and help the mother, but I was denied. The family was too worked up and the mother too out of control, I was told. They simply didn't believe that what I had to offer could replace technology.) Instead of the body peacefully yielding in birth, it is forced to fight. It fights the bullied affects of medications forcing it to do what it is not yet ready to do. It fights the unnatural implications of being on someone else's artificial time constraints (who says that birth should be 15 hours long and that the woman should dilate 1 cm every 60-90 minutes???) The body even fights itself when the woman's mind tells her to obey authoritative others, and her spirit tells her to obey herself! Have you ever heard a care provider say, " Okay honey, I'm going to tell you when to push..." This is an absurdity. If the mother has an epidural and cannot feel when to push, the care provider places a hand on the mother's abdomen to feel when the contraction starts. The care provider then relays this information to the mother. The mother's body is speaking, but the mother needs an interpreter to interpret the message because the technology has come between her and her body!

The Bible states that 'knowledge puffs up, but love edifies- 1Corinthians 8:1. In the healthcare provider quest to make ourselves indispensable, we have fluffed up our feathers to make ourselves look bigger and more powerful than we really are. We have forsaken the glories of wisdom (and the wise use of technology) for the simple self adoration of appearing all knowing.

Love vs Fear

Beloved,
A particular locale may not be an appropriate place to birth your baby, not because technology has run amok, but because fear has. The typical hospital maternity unit is permeated by fears (but so can a birth center or a home be also). The caregivers fear you the client will sue them over the least perceived transgression, the nurses fear the doctors, the doctors fear the nurses (yes, it's true), the hospital administration fears the healthcare client, the followers fear the leaders, the leaders fear the followers and so it goes. What is the most common emotion women in our culture express about birth? Is it not fear? Our culture facilitates, and teaches our women to fear birth, through its traditions of negative fear-inducing stories. Careproviders play into this by treating birth as a risk-driven physical event to be tightly monitored and controlled rather than a spiritual event to be surrendered to and embraced. We give lip service to 'physiological birth' and 'normalization' but even the creation of these terms give testament to our pathological view of birth. All this fear ends in a lack of trust, but it begins in a lack of love. Where love is, fear cannot abide. We can begin to change our collective fear of birth by changing our stories about birth.

1. What if my birth story is not positive? Should I lie or just not tell my story?

Tell your story, dear heart, but tell it with gratitude and with hope.

2. Isn't this just wishful thinking? Can't bad things happen to me or my baby even if I 'love my birth' and 'trust my body'?

Yes, they can. That is why it is important to be grateful for the wise use of technology or the presence a skilled technician if you need either. But begin with love, dear heart. Listen to your own inner wisdom and intuitive knowing and don't allow it to always be drowned out by hyper vigilant inspectors looking for what's broken in order to fix it. (After all prenatal care does save lives- even if our model of it needs some tweaking.) Just don't allow theirs to be the only voice you hear or even the loudest. It's one thing to be diagnosed with gestational diabetes and require additional testing and monitoring. It's another to have been deemed a normal, healthy pregnancy and be bullied into an induction because you are 39 weeks and 6 days pregnant. The first is a rational response to a real concern, the second a fear-based response to current political pressures that have very little (if anything) to do with the woman herself, her pregnancy or her baby.

These are difficult things for me to write. I am after all a part of the healthcare culture and system. But remove us back to our rightful place: knowledgeable assistant at times, sometimes trusted guide, but never as savior- we cannot bear that role with grace. We were never intended to do so. If women are to take a greater role in their own births, then by necessity, we must take a lesser.

There is no fear where love exists. Rather, perfect love banishes fear, for fear involves punishment, and the person who lives in fear has not been perfected in love. 1 John 4:18

A Return to Love

Here is what we need to do:

One: Love our bodies as they are. Short ones, tall ones, fat ones, sleek ones, flabby ones, toned ones- it doesn't matter. We must first make friends with our own bodies. Our culture teaches us to loathe our bodies no matter how they look- we can never quite measure up. That is why we need to stop right now and choose to love our bodies no matter what they look like. I choose to love my chocolate brown skin, my full lips, my gray-speckled hair. I love it all. I find no fault with it. I groom it and dress it up and endeavor to look my best everyday. While I do have a goal to lose weight, I don't give myself negative messages. I make good food choices and work out almost every day. I know if I keep this up, I will lose weight, but I don't care about looking good tomorrow. I care about looking good today. So I buy nice things that flatter my physique as it is today. I must confess I have a great sense of style and I do get compliments almost daily on my appearance- despite the fact that I do not fit the standard of beauty in our culture. To the unobservant eye, I'm an overweight, old, black lady. Yes, I am those things, but to my own eyes, I am also beautiful. I believe that I am- so I project that view out onto the world from the inside of me. Hell, I'm downright sexy. A few rolls of fat can't stop the sexiness from oozing out through my pores. I believe with all my being that I am beautiful, therefore others believe it too. (There is a great lesson here. We cannot convince others of that which we ourselves do not believe .) How do you start to love yourself? Perhaps you have been bombarded all your life with messages that you are inadequate and do not measure up. Start there. Change those messages (at least the ones that come from inside you). Whenever you start to criticize your body, stop and change the words, even if you don't quite believe them yet. Say to yourself, "I accept my body." "I love my body." "I am grateful to my body." Women who do not love their bodies, do not believe in their bodies ability to birth. So let's start there. Love your body.
(You might also read 'A New Earth' by Eckart Tolle)

Two: Recognize that our bodies are not us.
They are the shell we travel this life in. While it is important to love your body, it is equally important not to mistake it for being you. You are a triune being, composed of body, mind, and spirit. Your spirit will live on, your body will age and die. It is all too easy to get caught up in the life of the body. Especially if you are a mom and have little ones at home. But please recognize, dear ones, that you are more, so much more, than today's laundry list of chores and meetings, and doings, and havings. Take time to honor your mind (read a good thinking book, or practice daily phrases of that language you always wanted to learn!) and to honor spirit (light a candle during daily quiet time, make time for prayer, or meditation, or if those kinds of activities don't suit you, dance wildly to music you love and that speaks to your soul, howl at a full moon!) You want a life of balance- well you don't get it by being mired in the body. Get out of the body if only a few minutes a day and pamper the mind and the spirit. You know what makes birth such an amazing experience? It doesn't just happen in the body, it happens to our minds and spirits as well. All the great landmark events of human experience do. We just get distracted with the physicality of birth, yet it is a tremendous mental/spiritual event as well. Make a plan today to honor all aspects of your amazing being- body, mind, and spirit.
(To emphasize these principles, it might be helpful to read Victoria Moran's 'Creating a Charmed Life')

Return to love, dear ones. Do not give in to our culture's condemnation or perversion of the feminine form. We must learn to love ourselves, and then loving birth will come to us.

Birth Prophecy

For most of my life, I believed I was non-orgasmic. That is, I did not achieve orgasm during intercourse or as a result of intercourse, but only through masturbation. For a long time, this was an issue of great concern to myself and my husband. I read many books over the years, tried many 'techniques' all with the same disappointing result. But we persisted with both faith and creativity and some years ago now, we quite abruptly stumbled upon not 'the right technique' but the flood gate. Once we discovered, through trial and error, what triggers worked for me, we were delighted to find, that not only was I capable of achieving orgasm, but it was only the beginning of new found heights of responsiveness that I had never before even dreamed of. It appears foolish to me now, to think that I or any other woman could be labeled 'non-orgasmic.' The female body (indeed the human body) has amazing capabilities that because of our limiting beliefs and paralyzing fears lie mostly untapped and unknown. The same can be said for birth. We do not know what the body is capable of. We do not know because of the fears others seek to instill or because of false beliefs we choose to embrace. We think the issue is medicated birth vs natural birth, doctor vs midwife, or assisted vs unassisted. But I tell you this, the true lesson is love vs fear, control vs power, knowledge vs wisdom. We can cling to modern medicine to separate us from our own bodies, to relieve ourselves of any responsibility for our births, but the power to birth is within us still. We must fight to reclaim it - knowing it is already ours.

A New Beginning

Thanks for following me to my new blog. Homebirth Diaries will shut down after folks have had time to make the transition.