Wednesday, March 30, 2011

Postpartum Visits Revisited: Yes I said yes I will yes.

My attention was drawn this morning to an excellent, straight-to-the-points post entitled "How to Be the Best Postpartum Visitor in 15 Minutes Or Less". It is spot-on. By way of introduction, she says:
This visit is NOT about you. It is not about the parents hosting you and putting on a cup of tea so you can sit and visit and hold the baby. Think about how you would feel if you had either had surgery or ran a triathlon. What would you want people to do for you? This visit is about blessing the parents and making their life a little bit easier. Your prize is getting a quick peek at the cute new human.
Quite. I can't tell you how many moms are expected to play hostess to their visitors while they're still undergoing major healing, and possibly even more significantly, adjusting to the seismic shift that has just taken place in their lives. Postpartum visits need to be made in loving service TO the mother and new family. Here's her list of criteria for the perfect visit:

1. Bring a healthy meal. Include a salad or fresh vegetables. Only use disposable dishes. There is nothing more annoying than
a) having to wash more dishes when you have a new baby
b) having to try to return dishes to all sorts of random people when you have a new baby
2. In addition to your meal, bring cut up veggies and fruit, unsalted trail mix or nuts, or other such healthy snacks for daytime munching for mom to eat while she's nursing.
3. Go into the kitchen and spend 5 minutes clearing off a counter, washing a sink-full of dishes, loading the dishwasher etc. Don't ask permission, just do it. Then set the table for their dinner.
4. Before you leave your house, put some paper towels and some powdered bathroom cleaner like Commet or Ajax in a baggie. Stick it in your purse. While you are at the house, go and use the washroom...and while in there do a three minute bathroom shine-up, using your paper towels and cleaner.
5. Coo over the baby, but wash your hands before touching it.
6. If they want to eat right then, heat the food up and put it on the table, give everybody kisses and then leave.
7. Take the garbage out when you go.

Awesome, right? Even if your visits are professional (as a doula or lactation consultant or some other solicited service) there's still wisdom in the core message.

This post reminded me of a post I did on the same a while back, "The Answer is Always Yes", from which I excise one final point to add to the basically perfect list above.

I have one final suggestion. This is something to tell her in response to the inquiries of other friends and relatives who will want to visit. Almost invariably, when people arrange to come calling on a new family, they ask "Is there anything I can bring you? Pick up at the store? Anything?" THE ANSWER IS ALWAYS "YES". ALWAYS! This goes back to the learning-to-ask-for-help thing. It is SO HARD for us to get this lesson, and stop trying to prove we are superwomen who can do everything all by ourselves immediately after delivering the placenta, but there's no time like the postpartum period to start feeling comfortable with it. Have her keep a notepad by the phone, or in a very handy place if she relies on her cell. This notepad would be a great inexpensive gift, especially if a pen is attached so she doesn't have to look for one over and over. She can then keep a running list of things that she and the household need, just jotting them down as she goes. Orange juice, witch hazel, baby wipes, red raspberry leaf tea, onions, sanitary pads, flax meal, Rescue Remedy, dark chocolate, burp cloths, fresh fruit, a new thermometer, WHATEVER. If the list is literally empty, and she can't think of *anything* else - ASK FOR TOILET PAPER. It can always be added to the household stash. Make her repeat it with you: "The answer is always 'Yes'!"
It's more of an exhortation to the new mother, but friends and loved ones who are aware of this idea can encourage her in their phone calls prior to the visit, and help her to say embrace the yes.

Confession: I myself have been guilty of not bringing food in disposable containers. Yes, they're less environmentally friendly, but using them once in a blue moon (of the babymoon variety) is pretty benign, and there are also disposable products made of recycled materials one can use - check out Whole Foods or other similar businesses. I hereby apologize to anyone I put in the position of chasing me down to return a casserole dish!

Friday, March 25, 2011

Fun Friday Fact: The Other White Meat*

Like how I titled that as if "Fun Friday Fact" was a real thing, like Wordless Wednesday or Meatless Monday? Nope, I just made it up, because I couldn't think of any other way to tell you this little tidbit. It has come to my attention that Cervadil, the prostaglandin insert used vaginally to ripen the cervix when inducing labor, is apparently derived from . . . pig semen**.

It sounds like something totally make-believe, like the kidney thieves urban legend, or a plot element on South Park, or a nickname for a Wack Packer on Howard Stern. But try as I might to discredit this, every source I've been able to find so far seems to confirm that Cervidil is indeed a porcine product.

I have nothing further to say. Aside to note that I hope the label specifies that it is decidedly not kosher. Please, if this is untrue, someone in the know, disabuse me of this notion.

*Title credit to Justine at State of the Heart Parenting
**There's a plethora of other links out there, but I include this one because it includes a sentence I never thought I'd read, "I'd much rather have my husband's semen inside of me, than a pig's."

Monday, March 21, 2011

New Car Seat Recommendations - and a Note to Self re: Compassion and Judgment

Much happier forward-facing, much safer rear-facing. Sometimes mom just can't win.

The big news du jour is the new recommendation on car seats, specifically keeping them rear-facing until kids are two, rather than the previous official recommendation of one. It's pretty amazing to see how heated the discussion can get on something that might, on the surface, seem so simple and straightforward.

One commenter, ChiMomWriter, wrote this comment in the midst of a heavy debate on Christie Haskell's article: "My daughter screamed continuously on any car trip when she was younger, so I turned her around as soon as she turned 1. I agree with safety, but it was far more dangerous day-to-day for me to spend half of my time driving facing backwards trying to get to her. My son is more laid-back because he can see his sister."

I totally understand where you're coming from. Life is not always so black & white, and you don't know the variables in everyone's situation. I'm NOT arguing against the recommendation, I understand it & reluctantly agree with it. I am just saying I know what it's like to be a shut-in because of your kid's hatred of the car.

Words cannot express how relieved I am that Lily is over 2 and I don't have to face this decision now. Life with her while rear-facing was. an. absolute. nightmare. She's still not great in the car, but turning her around was like night and day for her temperament. I completely understand the safety reasons - no need to show me links of car crash decapitations, thank you, I've seen them and I get it - but am really feeling for the moms with difficult car babies today.

And the greater lesson here is a reminder on empathy when it comes to parenting, safety, child health and other choices. On the Facebook discussion, this comment was made, in re: some parents expressing reluctance or frustration with the news:
Oh and some pet peeves of mine is when people are giving information and resources to make some one or something more safe, and they ignore them. Why would you not want your child to be more safe with something so easy? It blows my mind.
It blows my mind that everyone doesn't exclusively breastfeed, if able, until 6 months and then continue until a minimum of two years. It blows my mind that everyone doesn't cosleep when the reduction of SIDS is so apparent. It blows my mind that people eat and feed their children processed garbage on a daily basis. And so on, and so on, and so on.

But guess what? Life is not always so black and white, and you don't know the variables in everyone's situation. And this applies not just to the moms championing the car seat recommendation, but to me, too, when considering parenting choices like all of the above. I do try to be mindful of this already, but it's good to get a direct and sobering dose of one's own medicine once in a while anyway, just to underscore the point.

I'm NOT arguing against the car seat recommendation, I understand it and reluctantly agree with it. I am just saying I also do understand what it's like to essentially become a shut-in because of your kid's seething hatred of the car.

So, does anyone who loves this recommend have any suggestions on how to improve life for moms with littles who are miserable in the car? Because for many, turning them forward improves their temperaments DRAMATICALLY. If Lily were under 2 when this came out, I'd feel like hanging myself (no hyperbole at all). The difference was that dramatic - and I was no longer trapped in the house losing my mind because of a kid who would scream bloody murder at any drive longer than 5 minutes.

Thursday, March 17, 2011

Orgasmic Birth? It's not what you think.

Take a wild guess what this is.

Go ahead.

Think about it.

Okay. What did you come up with? A new product from Good Vibrations or Toys in Babeland? That's what would make the most sense, right? That would have been my guess. And I would have been wrong.

See, a company called "Materna" has developed a product to help prevent tearing during labor. Steely Dan there is inserted into your vagina - yes, your vagina, while in labor - and then expands gradually over a few hours. That's right, rather than focusing on helping women find more physiologically appropriate ways to push, including good positions and lack of directed valsalva pushing, they thought a mechanized, expanding dildo was a better idea.

Is it too early for April Fools?

I was tipped off to this by Navelgazing Midwife, who directed us to head over and take Materna's survey. I encourage you to do the same. It's hilariously gobsmacking. Here's one of their questions:

I answered: "Yes. One question. ARE WE ON THE SAME PLANET? Because the idea of laboring with a slowly expanding DILDO up my vagina is not something that makes any sense whatsoever. Your logic is not our Earth logic."

My favorite part is the very next one, though:

22) Do you have a color preference for the device?

I checked "Other", and suggested that it have Sarah Jessica Parker's face on it, since this product is much better suited to Sex & the City than a labor and delivery ward.

And I thought the hemorrhoid preventing device was bad enough. Can you even imagine using one, let along both? OMFG.

Friday, March 11, 2011

Weekend Movie: The "Natural" Cesarean

This is a great portrayal of new possibilities. Cesareans can be made gentler, kinder, and more mindful of the humanity of all parties. I've written a before on ways to improve the experience of a cesarean, and am thrilled to see this video getting out there! I especially love the emphasis on keeping the mother and baby together at all times if possible, with skin-to-skin as the foundation. Bravo to this whole hospital team for being open enough to question their own habits and being willing to find a new way.

What did you think of this?

Monday, March 7, 2011

"Pregnant in America": My post-dates reaction

A Facebook friend just watched the documentary "Pregnant in America", and asked me if I wouldn't mind elaborating on my thoughts on the film. Who, ME? Mind elaborating? Have we met?

I'm not going to really do a formal review, per se, of the film because it's been about a year since I saw it myself, so I'll just share some impressions.

No, I didn't care for it at all. Maybe it's because I've been spoiled for all birth documentaries by "The Business of Being Born", which is not a perfect film but it IS a very, very well-crafted one. On top of presenting the information well, they manage to include just enough of the personal narratives to make it relatable without tipping the balance. It's entertaining, it uses humor without going over the top, it's paced expertly.

In my recollection, the couple in "Pregnant in America" - or rather, the filmmaker and father, since he is the central figure - don't achieve that kind of balance in any area. It is about them/him. This in itself could be compelling, as there are plenty of films out there that document a person's life or a particular personal story, but I found the director (and star!), Steve Buonaugurio, to be completely unsympathetic. He's abrasive, contentious from the get-go, and even downright combative at times: he seriously ambushes hospital personnel in the parking lot and tries to interrogate them. He's clearly fancying himself Michael Moore, but with none of the perspective and humor. Say what you will about Moore, he's a talented filmmaker (I happen to be a fan, but I understand if you're not crazy about him or his politics or both).

In one segment, Buonaugurio literally has "The hospital is the enemy" written on a flip chart. Let me take this opportunity to state that he does NOT speak for me, nor for many and I would dare say the majority of the birth advocates I know in real life and online. We have major, major problems in this country's maternity care, but the hospital is NOT the "enemy". I do agree that we overmedicalize many things, including birth, but there are times - yes, including some births - when the hospital is not only not the enemy, but the hero. Most of us know people who have been saved by hospitals in one way or another. A statement like that is an insult both to the people who have been saved and to the many people who work in hospitals and DO care very deeply, and have made their life work out of that caring.

So let's battle about policies with which we disagree, absolutely. But alienating the hospital altogether is a boneheaded, belligerent move. I found him so incredibly abrasive that I found myself wanting to disagree with him on just about everything he said, even though I'm ostensibly on the same "side". And yes, I keep referring back to him and him alone, because his wife, Mandy? Merely a bit player, a backdrop for his big opportunity to create a shocking expose.

There are some positives in the film. I really appreciated some of the interview footage, especially that of Joseph Chilton Pierce, along with mainstays Ina May Gaskin and Dr. Marsden Wagner. And . . . that's about it, really.

I'm most floored by his reaction to his own baby's hospital transfer. The couple did have a home birth that went well, until the baby's heart rate started deviating enough that the midwife advised transfer. The baby is kept for observation, but nothing is ultimately found to be a permanent problem. We're left in the dark as to the details. Buonaugurio is furious about the whole thing, and acts as though he is being persecuted by the NICU stay. I can understand being frustrated and scared, but I will always believe in erring on the side of caution. Can you imagine if the midwife had ignored these signs and it DID turn out to be something serious? The outcome could be tragic. But no, it's all about him.

There are so many other far superior films about the same topic. "The Business of Being Born" is the mack mommy of them all, of course. Again, it has its flaws, but it's worlds apart on a technical level, and it manages to maintain an even-handed demeanor despite coming from a clear bias; some opposing views are represented (even if minimal), and the film's perspective comes from clearly presented facts (some would say oversimplified, and they have a point) as well as from multiple personal testimonies. Buonaugurio just bludgeons you over the head from the start and never lets up. And I think he makes us all look like a bunch of narrow-minded, humorless zealots in the process.

There's a lesser known film called "Born in the USA" (not to be confused with the Marsden Wagner book) that is quite good despite being somewhat dated at this point - overall, though, it's still very relevant. I liked that part of the film focuses on a CNM struggling a bit within the limitations of a hospital setting. There's also a scene where a group of OBs and residents all get together for a peer review session that is quite the eye-opener; I'm actually surprised they allowed cameras in. Give it a watch, just keeping in mind that it's not the most current. I would even recommend "Orgasmic Birth" over "Pregnant in America", despite having some reservations about it.

Finally: Also? WORST TAGLINE EVER. Are you ready for it? "Pregnant in America: A Nation's Miscarriage".

I mean, really. I can't make that kind of crap up.

Wednesday, March 2, 2011

Happy IBCLC Day! (How timely is that?)

Today is the day where I thank my lucky stars that I had access to one of the very best IBCLCs out there, Jennifer Tow of Intuitive Parenting Network, LLC. Due to some serious challenges, my daughter Lily would never have been able to nurse without her expertise, immense patience and the support of her nursing support group. (If you haven't read the whole crazy epic, it's laid out here if you have the stamina.)

Our booby-trapped world needs more qualified, educated, and dare I say, real lactation consultants. The impact of bad breastfeeding information and advice (often well-intended but poorly-informed) cannot be underestimated. Take a look at this piece, aptly named "A Little Knowledge is a Dangerous Thing", about a self-styled "breastfeeding specialist" in the UK, Clare Byam Cook. She happens to be a retired midwife, but has no formal training in breastfeeding beyond her personal experience. Read the piece for yourself and cringe - then imagine how many mothers have had their breastfeeding lives impacted by this kind of sabotaging misinformation, without having any idea that this specialist is a specialist just because she decided to call herself one, and that her advice could easily sabotage a nursing relationship. Or better, check out her appearance on a British talk show comparing breast milk to Coke, among other bon mots.

Point being, beware the self-appointed expert. When seeking advice, be aware of what kind of training and experience they have*, or whether it's personal experience and self study - not at all without value, but something to be taken into account. Am I saying one HAS to be an IBCLC to have anything to offer on breastfeeding? Of course not. Mother to mother support has gone on for thousands of years. It's the very foundation of La Leche League, to whom we all owe a debt of gratitude for helping breastfeeding to reemerge after losing it for several generations.

However, those lost generations mean lost connections and often a dearth of accurate information that still affects us today, especially when it comes to addressing more serious conditions. Peer support is a fantastic thing, but being able to refer out to a specialist when needed is imperative. And I say all this from a place where I currently have my own limitations. My training has included basic breastfeeding, but extreme emphasis on the basic. Anything challenging that arises is considered beyond our scope of practice, and rightly so.

Did an IBCLC help you and your baby? Consider giving them a shout-out today.

*While the IBCLC is the gold standard, there are other designations, like the CLE and CLC. that are valuable as well. LLL leaders also go through a solid training.