Some memories of my babygirl on her birth day nine years ago:
She pushed her own way out of me, and cried when only her head was born. I have a visual of her feet pressing a strange lump out of my belly at the top of my uterus when the contour of my belly had otherwise flattened due to her head being all the way out and her chest in my pelvis, with the accompanying sound clip memory of her first cry.
She moved constantly during labor.
She looked exactly like her father from the very moment she was born. Acknowledging this was the first conscious thought I had when she was laid on my belly.
Her eyelashes were incredible. The nurse commented on them right away.
She intently examined Scott while he held her for the longest while.
She was awesomely round and delicious, and covered in soft fur that lasted years and years. Some of it is still there.
She had dimples that showed when she made some facial expressions, and they were not in the usual dimple spot, but much higher, on the top of her cheekbones near her eye. I still see them when she smiles a certain way.
Happy, happy birthday baby. You know that I didn't like some of the things that happened when I was giving birth to you, but I'm glad you also know that your arrival made me unspeakably happy, that I was awash in love for you from the very first moment I touched you, and that I treasure the memories of us in your birth. What you may not know is that motherhood is much the same - no matter what happens, always, always, love trumps the rest. I love you, daughter of my heart.
Sunday, June 24, 2012
Friday, June 22, 2012
Crossroads
The past several months, I've focused on living in the moment with my kids, but I've also been looking back at the past several years to try to glean the life lessons I learned. In the past few weeks, I've increasingly been looking forward at the paths I can choose for my career and how they would impact my family life. Right now I see four:
1. Home birth midwife. Despite this having been the ultimate goal of the academic and apprenticeship program leading toward my California midwifery license, at this time, I find this to be the least likely choice. The six months away from call has impressed upon me that my family life did suffer while I was on call and that my desire to be off call came from more than pure burnout. On the other hand, perhaps six months simply wasn't enough time to recover, so I'm not going to take this option off my list yet.
2. Hospital midwife. I always had an ultimate goal of serving women in the hospital. When I began my apprenticeship, I hoped to practice home birth midwifery for 15 to 20 years and then return to school to become a CNM, switching gears to hospital birth. I believe that the 99% of women who give birth in the hospital deserve compassionate, evidence-based care just as much as the 1% who birth at home. I'm also clear about the challenges of being a CNM in the hospital: the lack of independence, the protocols that defy the evidence, the reduced time with clients. Those challenges are not the only stumbling block I would have to choose to overcome; after spending 3 years working toward obtaining my license, there is little appeal to starting from scratch and working through 3-5 more years of school to get my MSN and certify as a nurse-midwife. The upside of this option, other than the call to serve, is that I would have a schedule. It also pays well enough that I could work part-time and still contribute financially to my family, and offers malpractice insurance.
3. Birth center midwife. There is a birth center in the north bay, and ones in various stages of planning in Berkeley, Napa, and Modesto. Some of these would entail quite a commute, but I could see myself working one clinic day and one 24-hour period of on-call work by staying in the town that day, for example, if any of these birth centers needed that type of help. This option would have the benefit of the schedule (including scheduled, limited call time) and of working within the model of midwifery care rather than medical care, but would likely pay little and may have some of the drawbacks of hospital care, such as lack of time with clients or continuity of care. Plus, like all other licensed midwife options, there's no safety net of malpractice insurance. I would need to learn Spanish for two of these birth centers - which is actually a plus.
4. Consultant midwife. My biggest short-term idea for a career path is to begin my own business providing supplementary care to women planning hospital birth. This would not involve care during the birth - they could also hire a doula if they wanted birth care - but would entail several prenatal and/or postpartum visits in which I would provide all the care that home birth midwives provide their clients that OBs and Kaiser midwives don't have the time (or in some instances, such as holistic options, the knowledge) to provide. I would also provide home induction services to help women start labor without hospital intervention. I am very excited about this idea, as I think there is a huge need for this, particularly in the bay area, where there is a large number of women who desire the kind of self-mastered, education-driven health care that our current hospital maternity care system is ill equipped to provide on its own. I would make my own hours and be my own boss, which highly appeals to this child of freelance musicians. However, I would be giving up attending births, and after six months of sabbatical, I already miss birth.
There are also some other ideas floating around in my head, such as lactation consulting, which I'd always intended to do next after getting my license, though burning out ended that idea in the short term.
Much to consider, and I'm leaving all these ideas open. My current plan for the remainder of the year is to work on a model for the consultant midwife business, and try to enroll in one class at a junior college or CSU East Bay to start finishing the prerequisites for the three nursing schools I would apply to if I decide to go that route. I also hope to be called every now and then to assist any midwives within striking distance, to keep my skills and sensibilities fresh. I just got a lead on this today, and surprised myself by tearing up with relief and happiness at the prospect of getting to attend another home birth sometime soon.
Clarity would be nice, and sometimes I get frustrated that I'd really like to both be a home birth midwife and the kind of mom that I am when I'm not on call, but looking at all the options available to me, I feel blessed to be able to have these choices to make, and comforted that regardless of the path I choose, I will be serving women and families. I'm also grateful for what clarity I have managed to glean that has helped me refocus my priorities on my family.
1. Home birth midwife. Despite this having been the ultimate goal of the academic and apprenticeship program leading toward my California midwifery license, at this time, I find this to be the least likely choice. The six months away from call has impressed upon me that my family life did suffer while I was on call and that my desire to be off call came from more than pure burnout. On the other hand, perhaps six months simply wasn't enough time to recover, so I'm not going to take this option off my list yet.
2. Hospital midwife. I always had an ultimate goal of serving women in the hospital. When I began my apprenticeship, I hoped to practice home birth midwifery for 15 to 20 years and then return to school to become a CNM, switching gears to hospital birth. I believe that the 99% of women who give birth in the hospital deserve compassionate, evidence-based care just as much as the 1% who birth at home. I'm also clear about the challenges of being a CNM in the hospital: the lack of independence, the protocols that defy the evidence, the reduced time with clients. Those challenges are not the only stumbling block I would have to choose to overcome; after spending 3 years working toward obtaining my license, there is little appeal to starting from scratch and working through 3-5 more years of school to get my MSN and certify as a nurse-midwife. The upside of this option, other than the call to serve, is that I would have a schedule. It also pays well enough that I could work part-time and still contribute financially to my family, and offers malpractice insurance.
3. Birth center midwife. There is a birth center in the north bay, and ones in various stages of planning in Berkeley, Napa, and Modesto. Some of these would entail quite a commute, but I could see myself working one clinic day and one 24-hour period of on-call work by staying in the town that day, for example, if any of these birth centers needed that type of help. This option would have the benefit of the schedule (including scheduled, limited call time) and of working within the model of midwifery care rather than medical care, but would likely pay little and may have some of the drawbacks of hospital care, such as lack of time with clients or continuity of care. Plus, like all other licensed midwife options, there's no safety net of malpractice insurance. I would need to learn Spanish for two of these birth centers - which is actually a plus.
4. Consultant midwife. My biggest short-term idea for a career path is to begin my own business providing supplementary care to women planning hospital birth. This would not involve care during the birth - they could also hire a doula if they wanted birth care - but would entail several prenatal and/or postpartum visits in which I would provide all the care that home birth midwives provide their clients that OBs and Kaiser midwives don't have the time (or in some instances, such as holistic options, the knowledge) to provide. I would also provide home induction services to help women start labor without hospital intervention. I am very excited about this idea, as I think there is a huge need for this, particularly in the bay area, where there is a large number of women who desire the kind of self-mastered, education-driven health care that our current hospital maternity care system is ill equipped to provide on its own. I would make my own hours and be my own boss, which highly appeals to this child of freelance musicians. However, I would be giving up attending births, and after six months of sabbatical, I already miss birth.
There are also some other ideas floating around in my head, such as lactation consulting, which I'd always intended to do next after getting my license, though burning out ended that idea in the short term.
Much to consider, and I'm leaving all these ideas open. My current plan for the remainder of the year is to work on a model for the consultant midwife business, and try to enroll in one class at a junior college or CSU East Bay to start finishing the prerequisites for the three nursing schools I would apply to if I decide to go that route. I also hope to be called every now and then to assist any midwives within striking distance, to keep my skills and sensibilities fresh. I just got a lead on this today, and surprised myself by tearing up with relief and happiness at the prospect of getting to attend another home birth sometime soon.
Clarity would be nice, and sometimes I get frustrated that I'd really like to both be a home birth midwife and the kind of mom that I am when I'm not on call, but looking at all the options available to me, I feel blessed to be able to have these choices to make, and comforted that regardless of the path I choose, I will be serving women and families. I'm also grateful for what clarity I have managed to glean that has helped me refocus my priorities on my family.
Sunday, June 17, 2012
Boy parts
D, during his required post-bath towel cuddle:
"Mommy, this is my penis."
Me: "Yes it is."
D: "And where is my scrotum?"
Me: "Right there."
D: "What is my scrotum?"
Me: "That's it."
D: "No, WHAT IS IT??? Like, my penis pees. My anus poops. What is my scrotum?"
Me: "You mean, what does it do? What is it for?"
D: "Yeah."
Me: "It keeps your testicles in it."
D: "My tessicles?"
Me: "Yes, they're very important parts of your body inside your scrotum."
D: "Can we eat them?"
Me: "No, they stay in your body, we don't eat testicles."
D: "Oh, okay. Can we eat possicles?"
Me: "Yes, eating popsicles is a much better idea."
"Mommy, this is my penis."
Me: "Yes it is."
D: "And where is my scrotum?"
Me: "Right there."
D: "What is my scrotum?"
Me: "That's it."
D: "No, WHAT IS IT??? Like, my penis pees. My anus poops. What is my scrotum?"
Me: "You mean, what does it do? What is it for?"
D: "Yeah."
Me: "It keeps your testicles in it."
D: "My tessicles?"
Me: "Yes, they're very important parts of your body inside your scrotum."
D: "Can we eat them?"
Me: "No, they stay in your body, we don't eat testicles."
D: "Oh, okay. Can we eat possicles?"
Me: "Yes, eating popsicles is a much better idea."
Body
Last night, I went swimsuit shopping. It's a story for another time, but in short, my clothes don't fit me anymore because I gained 10 pounds during a two week course of prednisone that I needed for an allergic reaction to amoxicillin. That weight gain has made me 10 pounds heavier than I have ever been outside of pregnancy or postpartum.
I laughed at myself for the conflict I always have between my ideal (self-acceptance, focus on inner beauty rather than outer) and reality (hot damn I am a perfectionist). I didn't enjoy seeing a higher number on the swimsuit tag than ever before. I found things about my body that I'd love to change - some that will change as I work to lose that prednisone weight, and some that won't because that's just how my body is built thanks to genetics and my nine pound babies. But I also appreciated things. I appreciated the fact that the Victoria's Secret body I used to have has been replaced by something much more important: a mother's body. I appreciated the way the extra weight has contributed to the boobs. Most importantly, I appreciated my health and the availability of the powerful drug that kept a miserable allergic reaction from crossing over into a life-threatening one. I appreciated that I'd matured enough to have this perspective, having no idea that the perspective was about to increase further.
Right after the swimsuit purchase, I saw a young woman with an older woman whom I assume to be her mother given the way they were interacting. The older woman was obese, but not in any unusual way in today's society; I never would have noticed her weight under normal circumstances. It was her daughter's weight that brought my attention to it.
This young woman was the thinnest person I have ever seen. This is an understatement. The first part of her that I saw was her shoulder, and I thought it was deformed for a moment before I realized it was just lacking all muscle and fat. As I changed focus and saw her whole body, my eyes stung with tears, my stomach lurched, and I recognized that I risked hyperventilating in time to take slow, conscious breaths. Living death was walking in front of me. I worked to control my body, to breathe, to keep blinking my tears back, to keep my shaking to a small tremble, and in doing so I let my thoughts go.
"Anorexia. Could it be anything else? Chemo? Genetic disease? No, she's wearing other hallmarks of anorexia, the makeup and hair coloring that obscure her, and that hair is eating disorder hair, not chemo hair, not healthy hair. She's got months to live if nothing changes, I can't believe she's not hospitalized, she's got a week or few before that, or maybe they just let her out? No, they wouldn't, not with her still so skinny. Her mother, doesn't she see it? It's so severe, how could she not see it? Has she fought her heart out to save her, but it's a losing battle like watching your child battle a drug addiction? Does her heart break every day? Or is her image of her daughter just as distorted as her daughter's image of herself? Am I a jerk for wanting to say something to her, for wanting to just say, "Please get her help, this is dangerous"? Or am I irresponsible to let this family walk away not having said anything? Even if she gets help now, she's probably done permanent damage to her body - what will happen to her in the long-term? How can I keep my babies from this? And everyone else. This needs to end for everyone."
I wonder what percentage of Americans have a healthy relationship with their bodies and with food. I wonder what percentage of Americans are a healthy weight. Obesity poses health risks, but from the studies I've seen, the risks of underweight are even greater. All the impossibly thin people we see in the media - the "sexy" and "fit" - contribute to both underweight and overweight. People then either do all they can to conform to impossible standards to the point that healthy choices are disregarded, or recognize that it's impossible and giving up to the point that healthy choices are disregarded. The food crisis contributes too - if your food isn't nutritious, you can either eat too much of it in an effort to get your needs met, or you can easily starve yourself since you weren't getting your nutritional needs met in the first place.
Of course, it's not just our society; true anorexia nervosa is a mental illness that crosses cultural boundaries. But just as the asceticism of the medieval church led to a rash of anorexia then, our culture is embracing ideals that contribute now.
Eating disorders have a higher mortality rate than any other mental health disorder. If you or someone you know struggles with one, please intervene as soon as you recognize it. It's not worth your health.
http://www.anad.org/
I laughed at myself for the conflict I always have between my ideal (self-acceptance, focus on inner beauty rather than outer) and reality (hot damn I am a perfectionist). I didn't enjoy seeing a higher number on the swimsuit tag than ever before. I found things about my body that I'd love to change - some that will change as I work to lose that prednisone weight, and some that won't because that's just how my body is built thanks to genetics and my nine pound babies. But I also appreciated things. I appreciated the fact that the Victoria's Secret body I used to have has been replaced by something much more important: a mother's body. I appreciated the way the extra weight has contributed to the boobs. Most importantly, I appreciated my health and the availability of the powerful drug that kept a miserable allergic reaction from crossing over into a life-threatening one. I appreciated that I'd matured enough to have this perspective, having no idea that the perspective was about to increase further.
Right after the swimsuit purchase, I saw a young woman with an older woman whom I assume to be her mother given the way they were interacting. The older woman was obese, but not in any unusual way in today's society; I never would have noticed her weight under normal circumstances. It was her daughter's weight that brought my attention to it.
This young woman was the thinnest person I have ever seen. This is an understatement. The first part of her that I saw was her shoulder, and I thought it was deformed for a moment before I realized it was just lacking all muscle and fat. As I changed focus and saw her whole body, my eyes stung with tears, my stomach lurched, and I recognized that I risked hyperventilating in time to take slow, conscious breaths. Living death was walking in front of me. I worked to control my body, to breathe, to keep blinking my tears back, to keep my shaking to a small tremble, and in doing so I let my thoughts go.
"Anorexia. Could it be anything else? Chemo? Genetic disease? No, she's wearing other hallmarks of anorexia, the makeup and hair coloring that obscure her, and that hair is eating disorder hair, not chemo hair, not healthy hair. She's got months to live if nothing changes, I can't believe she's not hospitalized, she's got a week or few before that, or maybe they just let her out? No, they wouldn't, not with her still so skinny. Her mother, doesn't she see it? It's so severe, how could she not see it? Has she fought her heart out to save her, but it's a losing battle like watching your child battle a drug addiction? Does her heart break every day? Or is her image of her daughter just as distorted as her daughter's image of herself? Am I a jerk for wanting to say something to her, for wanting to just say, "Please get her help, this is dangerous"? Or am I irresponsible to let this family walk away not having said anything? Even if she gets help now, she's probably done permanent damage to her body - what will happen to her in the long-term? How can I keep my babies from this? And everyone else. This needs to end for everyone."
I wonder what percentage of Americans have a healthy relationship with their bodies and with food. I wonder what percentage of Americans are a healthy weight. Obesity poses health risks, but from the studies I've seen, the risks of underweight are even greater. All the impossibly thin people we see in the media - the "sexy" and "fit" - contribute to both underweight and overweight. People then either do all they can to conform to impossible standards to the point that healthy choices are disregarded, or recognize that it's impossible and giving up to the point that healthy choices are disregarded. The food crisis contributes too - if your food isn't nutritious, you can either eat too much of it in an effort to get your needs met, or you can easily starve yourself since you weren't getting your nutritional needs met in the first place.
Of course, it's not just our society; true anorexia nervosa is a mental illness that crosses cultural boundaries. But just as the asceticism of the medieval church led to a rash of anorexia then, our culture is embracing ideals that contribute now.
Eating disorders have a higher mortality rate than any other mental health disorder. If you or someone you know struggles with one, please intervene as soon as you recognize it. It's not worth your health.
http://www.anad.org/
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