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Wednesday, March 30, 2011

The A's and B's of AP

If you're a mom in any of the online parenting forums one recurring acronym you might see is AP. AP is for Attachment Parenting and it's a parenting style that is a throwback to ancient tried and true parenting techniques. Many parents practice AP without even realizing it. AP is a very natural and instinctual way to care for your baby.

Basicallly the principles of AP break down into 7 B's:

Birth Bonding- Most often this is referred to as skin-to-skin contact. It's crucial that mother and baby get time for birth bonding directly after labor. Skin-to-skin contact has many benefits. It creates an oxytocin spike for both the parent and the baby (yes even daddy will experience this hormone spike). Oxytocin promotes bonding and encourages milk letdown. It also calms baby and and helps mom heal from child birth. If circumstances are not favorable for immediate bonding don't worry! There is no critical window for bonding that is missed if mother doesn't get to birth bond immediately. Birth bonding is something parent and child will continue to practice and experience throughout your baby's childhood. Just remember! get in as much skin-to-skin as possible it's good for the whole family.

Breastfeeding- Nutritional benefits aside, the breast is where a baby is meant to be. Not only for nourishment physically but to provide baby with emotional security. The breast is where mother and child will get to know one another and establish their relationship. Breastfeeding teaches mom baby's cues and helps them get in sync with each other. Understanding what each gesture baby makes and responding appropriately is the first communication mother and baby will experience with each other.

Babywearing- I mentioned babywearing in an earlier post but did not have the time to touch on it fully. In the future I will dedicate an entire post to this practice, but for now, just the basics. The practice of birth bonding in many ways carries over into babywearing. Babywearing is a method of carrying a baby on the parent's body via sling/wrap/mei tai etc... Wearing your baby while doing everyday things like shopping for groceries or doing laundry is a great way to free up both hands while still having your baby close to your body. This contact is comforting to baby and gives baby an opportunity to see and experience new things. Babies carried in this way tend to fuss less and parents become more sensitive to baby's needs. This, too promotes bonding. And, unlike breastfeeding, both parents can participate.

Bedding Close to Baby- Usually referred to as co-sleeping. This can range from sharing a room with baby to sharing a bed with baby. Sleeping close to your baby promotes healthy lactation. Simply being near mom during the night can keep baby's feeding schedule regular which improves mom's milk supply. Being close to mommy and daddy comforts baby at night, which can be a scary time. It also helps baby sync up to mom and dad's sleep schedule. On average, babies whose parents co-sleep in some capacity are far less likely to die from SIDS or crib death.

Belief in the Language Value of Baby's Cry- Understanding that a baby cries for a reason is crucial. A baby's cry is a signal that there is a need. It's important to respond to cries to establish trust. Just because baby is not wet, hungry, hurt or sick doesn't mean baby is crying for "no reason".  You may not live in a jungle full of wild animals ready to pounce on an unattended child at any moment, but your baby isn't born knowing that. Everything is new to a baby, all baby knows is mommy and if mommy isn't close by it can be frightening. Responding to your baby's cries can also teach you to distinguish between the different cries so you will eventually learn the difference between a hunger cry vs. a frustration cry. This further cements good communication.

Beware of Baby Trainers- In essence, use your head. Not all advice is good advice. What we do as parents now will affect the relationship we have with our children and our children will have with the world. Putting a baby on a schedule for your convenience and allowing your baby to "Cry it out" may seem like good ideas in the here and now but can have long term consequences. Trying to keep your child on a rigid schedule can set you up for failure, particularly in regard to breastfeeding. Feed baby when baby is hungry, change baby when baby is wet. These things are common sense and cannot be mandated by schedules no matter how badly you would like them to be. Ignoring your baby's cries tells them "I don't care what you have to say". Imagine what that does to a child, to believe that their voices don't even matter to the people who are supposed to love them the most. Trust your parental instincts. If you are given advice that doesn't jive with that do your homework before you try it.

Balance- I know it's easy to get wrapped up and make your entire life 100% about doing for baby and 0% about doing for yourself. This is probably the hardest principle of the 7. Balancing your relationship with your child and the rest of your life can be so difficult. Especially if you're a first time parent. I'm struggling with this one right now. Particularly for mothers who are married or in committed relationships it's important to take time for yourself and your partner. The example of a healthy relationship with your spouse is critical for a child. Furthermore the desire to socialize or learn and have new experiences doesn't just shut down because a woman has become a mother. But attempting to find balance in your life can be one of the things a mother feels most judged about. Anything a mother does away from her baby will be judged by others, but most critically by herself. This is also the most personal principle of the 7, because what balances out in my life may not work in yours.

Attachment Parenting isn't anything new. People have been parenting this way since the dawn of man. It's only recently that society has gotten away from it and adopted rigid, restrictive parenting practices. Obviously each parent has to choose for themselves what is right for their family. I would encourage you to look into Attachment Parenting further. I firmly believe that everyone can take something away from this model of parenting.

Monday, March 28, 2011

What does a doula do?

Right after "What is a doula?", "What does a doula do?" is probably the question I get asked the most!

In larger cities doulas are much more common and in-demand. But living in a small town and trying to develop a practice has presented unique challenges. Too few people have actually ever heard the word "doula" so it's difficult to convince people that they really need something they've never heard of and know nothing about.

A doula's role is unique to each mother she works for, as each mother has different needs for each pregnancy.

Much of a doula's job is to offer education and guidance. Pregnancy and labor often present a mother with many different decisions. Making a decision with confidence that it's right for you and your baby can be difficult if you don't understand all the nuances of each option. A doula is well educated and can explain every option and help her make the decision that falls best in line with the mother's birth plan.

Most often, doulas are called on to act as comforters. Doulas are trained in many different methods of drug-free pain management. You may be suprised to know how small things, like patterned breathing and guided visualization, can help manage pain. But so much of the comfort a doula offers is emotional. Birth is such a personal and transcendent experience for a woman. It can take her through the complete range of human emotions in a very short amount of time. Having continual support from an experienced woman is priceless! It offers the freedom to scream if you need to scream or cry if you need to cry. A doula is not there to hamper your emotions. She is there to allow you to confront them with love and understanding.

In many ways a doula is your cheer leader. Oftentimes she will gently remind you that your body is made to birth your baby. That you can give birth. And to celebrate with you as you get through each contraction. Unlike a doctor or nurse your doula is with you 100% of the time (except for brief bathroom breaks). She may suggest different positions or actions to help you get through when labor becomes particularly difficult. Unlike a doctor or nurse who may not support your wishes or respect your birth plan, a doula is always on your side!

Your doula will also help you to get off to the best possible start with breast feeding your baby. Doulas are trained in breast feeding support and can offer valuable advice and insight. Unfortunately, much of the art of breast feeding has been lost from everyday society. And the medical model of child birth doesn't usually provide adequate information or support.

Doulas are constantly seeking to expand on their practices and a lot of doulas will offer a bevy of other services outside of what I previously mentioned. Miscellaneous services a doula may offer include (but are not limited to):

Placenta Encapsulation- if you so choose, your placenta can be saved. A professional trained in placenta encapsulation will dry your placenta and grind it up, add herbs and put it into pill form for mom to take. I'll write about it in a seperate post but placentophagy (consumption of the placenta) has scores of benefits for mommy!

Accupressure/Massage- Activating certain pressure points has shown to be effective in relieving many difficulties during pregnancy. And we all know that massage can be very healing and relaxing.

Babywearing- Your doula might have received special training in babywearing education. Babywearing is an ancient and extremely beneficial practice that can cultivate healthy bonding between parent and baby.

TENS machine- Transcutaneous Electrical Nerve Stimulation unit is a machine that has electrical diodes that are applied to areas where mom is experiencing discomfort that block pain signals. Specialized training is required to use this device.

Blessingway ceremony- A blessingway is a mother-centered birth celebration. Typically a Blessingway is very spiritual and is tailored to the mother's individual spiritual beliefs. Doulas who perform Blessingways will guide a mother's guest through ceremonies meant to bless the woman on her way to becoming a mother by honoring her strength, adorning her body (i.e brushing her hair, decorating her belly, washing her feet etc...) and offering small gifts, prayers and positive thoughts.

Aromatherapy- The use of essential oils in different fragrances to relax the mother and ease discomfort.

These are just a few examples of the other services a doula may offer. When interviewing a potential doula be sure to ask what extra services she offers. Extra services may cost more but it can be well worth it.

Even if your doula doesn't offer any services outside of the standard model of practice there are many benefits to having a doula present for your birth.

Studies show that labor with a doula is actually shorter than labor without (a whopping 90 minutes shorter on average!!!)  Typically when I ask a potential client what her ideal birth would be one of the most common words used is "short". A shorter labor is ideal for many reasons and labor that is an entire hour and a half shorter than average could mean the difference between a drug free labor and using chemical pain management that can cascade into many different medical interventions you probably want to avoid.

Laboring with a doula often leads to less labor augmentation measures such as pitocin. Pitocin is a synthetic oxytocin (the hormone that starts labor). It's often administered to speed labor along. Unfortunately pitocin labor is much more difficult and painful than average labor and can cause your baby to go into distress.

Having a doula present for your labor can also drastically reduce the odds that you will require the aid of forceps or vaccuum extraction. These methods of removal are undesireable they can potentiallycause lasting injuries to your baby. Even if administered safely it can cause your child to have a head ache. This can inhibit their desire to initiate breast feeding and create bruises and sore spots on their tender little heads.

Overall having a doula present for your labor makes the experience better. The way you remember an experience as life changing as birth, is just as important as the experience itself. For a client to look back on her labor with fondness and satisfaction is a doulas goal. A mother can go against every aspect of her birth plan but as long as she can look back and be happy with what she's accomplished a doula has done her job correctly.

What a doula doesn't do...
There are so many things a doula contributes to child birth but there are clear cut things a doula does not do.

A doula does not replace a spouse or partner in labor. It's true that a woman whose spouse or partner is no longer present in her life, or can not be in attendance for the birth can greatly benefit from the presence of a doula. However, a doula is not there to get in between the mother and her partner. In fact, a doula encourages the partner to be an active participant in the birth. For this reason a doula is not only greatly appreciated by the mother but by her partner also.

A doula is not a medical professional. A doula can not prescribe or administer any medications or perform any medical procedures. She may recommend home remedies for common problems but it's merely on an advisory basis. She offers non-medical support only.

A doula does not make decisions for a mother nor can she offer or deny consent for any procedures on the mother's behalf. For example, if your doctor offers an epidural, even if that is against her birth plan, a doula may only remind mom that it runs counter to the established birth plan. She can not tell the doctor not to give it to her. Sometimes it can be difficult to stand up to a doctor and refuse consent for a procedure that you don't want, but a doula can only support your decision to do so.

I hope you found this informative. There are so many nuances to a doula's role in childbirth. I would like to get in to them all but that could fill entire volumes! This post is just to cover the basics. In the future I will dedicate entire posts to delving further into a specific detail of doula care but for now I hope you come away from this post with a good place to start on understanding what a doula contributes to child labor.

Saturday, March 26, 2011

breast feeding: the vicious circle of gold

A woman who breast feeds and is passionate about her right to do so, in public or in any other capacity, is not an exhibitionist seeking to purposefully make others uncomfortable because it gives her some sick sense of satisfaction. She, like you, is a free citizen with a life and responsibilities that may call her away from the home. Or may simply not suscribe to the outdated notion that a mother should be confined to the home merely for the fact that she is a mother.

Just because a breast feeding mother chooses not to confine herself to a filthy bathroom or cover herself with blankets that make her baby stuffy and uncomfortable while she nurses, does not mean she is immodest. She has a responsibility to nourish her child. Whether or not it makes you uncomfortable is not a consideration for her. Because she cares more for her child than she does for your delicate sensibilities.

She does not seek your approval. And that is why she is despised.

She regards her breasts as utilitarian first and sexual second. That is why she is misunderstood.

If she carries on breast feeding silently, you think she is poor and uneducated.

If she breast feeds with pride and argues it's benefits, you think she is uppity and self-important. 

Ask yourself why it offends you. Who benefits from your negative opinions of breast feeding?
Not you, since you experience discomfort as a result.
Not the mother who is looked down upon and disrespected.
Not the child whose healthy breast feeding relationship is challenged.
And certainly not society as a whole.

The only people who benefit from this mentality are the formula companies, who've subtly influenced public opinion against on of the most normal human bodily functions. They've convinced everyone that a false sense of modesty and avoiding moderate discomfort is more important than the health of a child.

They've made billions by poisoning our children and making women fearful and doubt their ability to adequately nourish their own children. They've made it a taboo to encourage a woman to breast feed so as not to make her "feel guilty". But the only thing she'd ever have to feel guilty about is the fact that she bought into those lies in the first place.

They've created a vicious circle of gold by making it next to impossible to breast feed and then villefying those who know better. So breast and formula feeding mothers both feel judged by one another and we are too busy arguing amongst ourselves to realize who is really to blame in the first place!

I hope this helps open an honest, judgement-free dialogue about the challenges and benefits of breast feeding. I hope we can regain the feeling of sisterhood mothering once gave us. And I hope this encourages all people to reconsider their negative opinions of breast feeding.

Wednesday, March 23, 2011

Inspirational Jealousy

Today I was having a doula consult/pow wow with my good friend Michelle. She is currently planning her second home birth and I have the privilege of being her doula!

We were exchanging birth stories and the contrast of quality between her home birth and my hospital birth was like night and day.

"It was great!" she began wistfully, "My midwife was so encouraging. She told me exactly what I needed to hear."

Yeah...I labored alone for 14 and a half hours. My OB didn't even come into the room until Korban crowned. He barely spoke to me and certainly never looked me in the eyes.

"She only checked my cervix twice."

An L&D nurse was in my room every hour on the hour to stick her fingers in my vagina without so much as a "hello".

"When I was losing energy she brought me some food to nibble on."

I only got ice chips and was allowed to suck on some hard candy. Not a single morsel of real food crossed my lips the entire day.

"The only truly painful part was the crowning."

I was so afraid of being that screaming, cursing woman in labor that I got an epidural when I no longer had the strength to whimper in silence.

She was in the privacy and comfort of her own home.

I was in an unfamiliar hospital with the door swinging open constantly without regard to who was in the hall and able to see me nude. My room was SO cold that I couldn't tell if my shaking was from hunger, cold, or the anesthesia. And all kinds of strange staff members were walking in and out without even bothering to knock.

She was surrounded by loving support.

My anesthesiologist made fun of me for wanting to labor naturally.

Her midwife delayed cord clamping as a matter of routine.

My OB had to be asked and after the fact regailed us with the alleged "risks" of delayed clamping.

Her midwife respected her birth plan.

I was warned against "reading too much".

Her midwife understood that labor should start on it's own.

I was bullied for refusing an induction.

She had an empathetic and caring woman who revered the birth process.

I had a man who thought he knew how to birth my baby better than my own body.

I'll admit I'm jealous. She got to have the birth of my dreams! But that's actually a good thing for both of us. It's a good thing for all womankind! It affirms what women have been taught they weren't even allowed to even hope, that labor could be wonderful! And dare I say it? Enjoyable.

My jealousy fuels my drive to achieve my audacious dream of emotionally, spiritually and physically fulfilling labor.

Michelle, thank you for inspiring me with the beauty of your jealousy-inducing birth story! I am looking forward to being a part of, yet another, one of your amazing home births!

Tuesday, March 22, 2011

Begin at the Beginning

Beginnings are never easy. At least not for me. Whoever came up with "Once upon a time..." Is an absolute genius! I know it's trite, but the trite of today is the genius of yesterday.

So...

Once upon a time there was a young woman who was pregnant for the first time. She was thrilled! She had been on birth control since she was 18. She and her husband had been trying to get pregnant for nearly a year and she began to worry that her ship had sailed, although she'd never allow herself to think it, let alone, say it aloud. But all that was in the past because now she was pregnant and all the worry melted away!

Until one day she had her first check up...

She sat in a room with every kind of prenatal drug imaginable postered garishly on the wall, diagrams of insides, and warnings against doing this or not doing that! It was overwhelming.

But more overwhelming than that was the silence.

Women were perched, teetering on the edge of their seats, staring blankly. Waiting until their name rang out like a thunderclap from a nurse in sickeningly pink scrubs. Maybe it was the nausea but the room seemed uncomfortably small and looking around made all the colors on the wall swirl around and slosh behind her eyes. So she did like the others and stared down. Daring not to look at them for fear of breaking some unspoken code of conduct.

She had to pee. She wanted to puke. She distracted herself with a magazine for a millisecond before the sound of her name rang out. She jumped, just a little, and stood to walk back with Nurse Pepto; the resonance of her own name still stinging her ears.

Nurse Pepto's entire countenance was as loud as her voice. Besides her bright pink scrubs she had high bobbed hair lined with bright blonde highlights that had been fluffed and quaffed and held fast into place with hairspray. She wore strong perfume, large earrings and so much jewelry she tinkled as she walked.

Nurse Pepto handed her an empty cup with instructions to fill it. Then gestured toward a bathroom to allow the young woman to do as instructed. The young woman had to pee so badly but steadied herself as she would have to undertake the precarious work of aiming into a cup. She wasn't aware at the time that with a growing belly this task would never get much easier. She would just accept the spills and splatters as unavoidable and move on with life.

She had managed to get what could be considered an adequate sample into the cup, placed the sample inside the cupboard, and was lead into a room with a table that had scary stirrups sticking out. She was instructed to remove her clothes and drape herself with pink paper. The young woman hadn't before realized how cold the room was.

Again she did as instructed and waited for the doctor. Outside her exam room she could hear loud talking, doors opening and shutting, and the occasional phone ring. The sound of her own exam room door opening caused her to jump, once again. The doctor entered. He had dark hair and an orangey tan.

The young woman's legs were placed in the stirrups and the doctor made small talk while he examined her most private areas. His hands were cold. The young woman stared at the ceiling and attempted to answer his banal questions while she was terribly uncomfortable and prayed her voice did not betray her. She breathed deeply counting tiles in the stark white ceiling surrounded by shiny sterile metal, waiting for the moment she would be told she could put her clothes back on. Praying it would be soon. By the time she was told to do so her clothes had already become as cold as the room and the sensation of sliding them over goosebumped skin was like rubbing sandpaper together.

Everything was "normal" and she was sent home, grateful that it was all over. But it wasn't over. She would have this experience again and again with a growth of frequency directly paralleling the growth of her belly. For the first time in her pregnancy she began to feel alone.

She felt separate from her husband, separate from her baby, and sometimes even separate from herself. She stood alone, a stranger to herself in a wholly new experience that was completely different from what she had ever imagined it to be.

She thought she'd feel different. She thought she'd feel a connection to her baby, a kinship with her foremothers. She thought she'd feel their strength as she moved forward on this journey. But instead she felt frightened, then lonely, then nothing.

Speaking with other mothers did not lend her the confidence she'd hoped. Only the promise that "in the end, it will be worth it." And the assurance that what she was experiencing was "normal" and that she was just being "hormonal". The end seemed so far away. But she never dared question whether it will all have been worth it. She had tried so hard, and come so far, to get to this place in her life that it had to be. Still...she wanted more from the experience NOW not later!

So she began reading, and connecting with other mothers who felt the same. She began to arm herself with knowledge and began to realize that, for the educated mother, every doctor's visit would be a battle of wills. Some days she would come out feeling triumphant, but more often she would come out feeling utterly broken down.

Her husband loved her, and tried to help, but he lacked the depth of understanding that only experience could give. Why should she have to battle with men over the designs of her woman's body?
 And for another thing, why was she expected to do this alone?

It was then she realized the calling that had always eluded her. No woman should feel this way about pregnancy. No woman should fear her body is incapable of carrying out the task that nature had bestowed upon it. No woman should have the truth about her strength hidden from her. Someone has to be there, someone has to show them.

And that someone is me.

Katherine Henderson: wife, mother, and friend, answering the call to serve as a doula to any and all that asks it of her. Doula is Greek for "woman's servant" and serve I shall.