Labor Repose

Labor Repose
LaborPayne during her 6th homebirth (9th baby) at age 44

Saturday, November 29, 2008

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.

Friday, November 28, 2008

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.

Friday, November 21, 2008

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...

Sunday, November 16, 2008

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.

Saturday, November 15, 2008

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 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.

Thursday, November 13, 2008

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.

Monday, November 10, 2008

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.

Thursday, November 6, 2008

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?

Tuesday, November 4, 2008

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.