Thursday, June 28, 2012

The Perfect Mommy

Sometimes I feel like my head
is going to explode from all the thoughts
that are swimming around in it.

Sometimes I wonder what life would have been like
had I gone to
there instead of here.

Sometimes I wonder
if people really understand how difficult life can be
for someone like me.

Queen of The Perfect Mommies
That’s what she called me.
Nice clothes
Perfect hair
Clean house
Smile on my face
Is that what they see?
Well, then they

Sometimes I want to leave my house unkempt
my kids’ faces dirty
and my hair uncombed
so everyone can stop assuming that I have it all together
that I’ve figured it all out
and that I am a machine that keeps on going
like a terminator.
I want to scream

Sometimes I want to remind people
that selflessness and humility
are two of the most important traits an individual can possess.

Sometimes I feel like I am wearing a mask in
my life.

Sometimes I feel so lonely it hurts.

Sometimes I get so down
on myself
I have to pull my soul back
from the depths of hell
to go on.

Sometimes I remember that my sadness is there
right beneath the surface
bubbling and brewing
Threatening to come out.

Sometimes I can put it away
sometimes I cannot.

Sometimes I wish I were more straightforward.

Sometimes I wish I didn’t need people’s approval
so much.

Sometimes I feel like I’ve only truly been awake
for the last five years.

Sometimes I wonder who I was
before my children.

Sometimes I wish I didn’t care what people think of me.

Sometimes I like to be depressed
The achy
feeling is a familiar and welcoming one.
It knows me better than anyone.

Sometimes I wonder if there is a God who is listening
I wonder if my dad is with Him.

Sometimes I wonder if I will ever be complete.
Will the questions ever cease?

Sometimes I question my truth
and sometimes I find the answer.

Sometimes I get even more confused.

Sometimes parenting my children
is so hard
that I get down on my knees
and pray
for strength and peace.

Sometimes I wish I could turn back the clock
and have my son
as a newborn once more.

Sometimes I close my eyes
and can smell my dad’s cologne
and hear his deep voice.

Sometimes my past haunts me.

Sometimes I can let go. Sometimes I can’t.

Only sometimes.

Tuesday, June 26, 2012

Emotional and Mental Barrier in Pregnancy

I never thought about the little things people say to a pregnant woman in pregnancy until recently.  I'm five months pregnant after seven losses, and my mind is already in an interesting place, but it's made me realize that everything you say to a pregnant woman has an impact.

The other day, I was involved in a discussion where a woman compared taking medications like Unisom and Zofran for Hyperemesis Gravidarium to Thalidomide and DES (Diethylstilbestrol) that was given out years ago to pregnant women.  Neither of those medications are on the market anymore because of the awful effects they had on the unborn baby, but it takes your mind to a place it doesn't want to go.

Thalidomide caused babies to be born without arms and legs and DES was found to cause infertility and sterility in female children.

It is extremely common to use medications and procedures in pregnancy without proper studies, so this has happened multiple times throughout history until they found they left profound impacts on unborn babies.

It is starting to become more common to research like mad in pregnancy to make sure you are doing the best thing for your unborn baby, but sometimes, you can't avoid interventions such as a medication that hasn't been fully studied.

I have been incredibly lucky this pregnancy and I haven't (yet) had to be admitted to the hospital for dehydration, though this comes at a price that does scare me.  I take a Unisom every night when I go to sleep so I can partially function the next day, and when that doesn't curb the extreme nausea and vomiting, I have Zofran on hand.  Every time I take a pill, I'm scared I am hurting my baby.  I wonder if ten to fifty years down the road they realize these weren't safe and I was doing more harm.

In the conversation where the medications I am currently taking were compared to medications that did cause severe issues in babies, it was really hard to separate the logic from the emotional.  I know without a doubt that for me the medication is necessary.  I have an almost five year old I have to be functional for, and I need to stay hydrated and nourished to be able to grow my baby.  I know this.

However, in pregnancy, your mind doesn't seem to work the same way.  Even if I know all this, all the doubts and worries and fears came rushing back to the surface.  It is incredibly hard to remember why you are making certain choices when the fear clouds your mind.

In truth, it's exhausting when you aren't able to simply let things roll off like you would if you weren't pregnant.

The mental and emotional barrier in pregnancy is thinner, if that's the right word to use.  You aren't just worrying about your own health anymore, there's another person that is completely dependent on you for survival.  It's an entirely different mental state than breastfeeding and raising a child.  Every choice I make right now has the potential to benefit or risk the health of my baby.  In reality, it's a lot of pressure!

Think to yourself, are you making that easier or harder on other women?  I do think that the more information a woman has about pregnancy and birth the better choices she will make for herself, but are we giving them more to worry about because we don't have their whole story?

The woman in the conversation didn't realize the impact she had on me, and probably the other pregnant women involved also going through the hell that is HG.  It's probably extremely hard to understand the mindset of a pregnant woman that feels she truly has no choice but to turn to medication when she has tried her entire life to live naturally.

Sometimes, we need to trust that a pregnant woman truly does understand what she is doing.  Sometimes, we need to let things go because unless we have been through the exact same thing, we don't know why they are choosing it.  Sometimes, it's best not to say anything.

And if what you are saying could cause her to worry more than she already is, especially if her entire life has been about living the opposite way?  It's definitely a good idea to step away and keep your thoughts to yourself.

Thursday, June 21, 2012

What Does Your House Say About You?

We just moved into a new home and are working on getting settled. After our time overseas we are thoroughly enjoying amenities we previously took for granted, such as ceiling fans, a sizable fridge/freezer, and carpeting. We are also trying to make the most of starting over in a new house, including giving considerable thought to where we want to put things, what we really need to keep, and going a bit greener.

Throughout this process, I've been thinking a lot about what kind of space we create when we make a home. Not just functionality or how it serves our own family members, but what it says about us.

Honestly, it's been a long while since I've been in someone's home and thought, oh I want my own space to be just like this. Or, wow the whole family feels really at ease here. On the contrary, most of the homes we've visited lately have been a lesson in what not to do. 

Following are some questions I started with when considering how we want to organize our family space:
  • Is it pleasant and comfortable? or intimidating and confining?
  • Does it say we value people? or we value things?
  • Does it whisper I'm living in the past? or I'm looking to the future?
  • Is it open and hospitable to all ages? or is it too restricting?
  • Do children (mine or visitors) feel like they belong? or like they're on the periphery?
Here's what I want for our home: I want it first and foremost to be welcoming. I want it to be a place where my parents are just as at ease as my four-year-old, where my neighbor would feel cozy popping over for coffee and my grown nieces/nephews would be welcome staying for the weekend. I want it to say, please come in and stay awhile, whether you are two or seventy-two we'd love to have you here. I want it to look clean and uncluttered, but lived in. I want my children to know it's their home, too. I want to use the space we have well, so that it looks and feels open and inviting instead of cramped, which is no small task when you have three little ones and tons of stuff. (I thought I was pretty good at letting go of things but I still have some work to do.) 

What is your home saying?

Thanks for reading and have a blessed day.

Wednesday, June 20, 2012

A Case for Cloth Diapering

It is quite common when discussing cloth diapering for the debate to quickly boil down to the end result - throwing something away vs. reusing it.  Often people will say something to the effect that one baby's waste isn't going to overflow a landfill.  It makes sense to think in these terms, considering the word "disposable" is in the name of one of the diapers being compared, but there are far more factors involved that should be considered.  It is not merely a question of throwing something away or reusing it.

I'm sure there are plenty of valid reasons for parents to use disposables.  Whether it's that both parents work full time and daycare doesn't allow cloth, or simply a matter of being unaware of the simpler, cuter options available these days (many still envision the rectangular prefold with a giant pin under plastic pants)...  whatever the case, I'm not interested in condemning anyone for using disposables.  Plenty of people I know who are amazing parents do so.  I only hope to open up the discussion to include a much larger picture - one that isn't limited to negotiating the merits of not throwing something away.

An argument that is often mentioned in defense of using disposables is the depletion of a natural resource in the form of water consumption for washing cloth diapers.  Over 300 pounds of wood is used to produce enough disposables for just ONE baby for ONE year.  Each single-use, disposable diaper takes 1 cup of crude oil to manufacture, resulting in billions of gallons of oil used worldwide for diapers annually, and 246 pounds of plastic used to diaper one baby for just one year.  That is just under one TON of plastic per year for every 8 babies in disposables.  I believe that crude oil figure is limited to the production of the polyethylene, polypropylene, polyurethane and polyacrylate that are in the actual diapers themselves and their packaging.  It does not take into account the machines used to clear cut the forests involved in that wood pulp production, nor the tankers used to deliver the oil to the diaper manufacturers, or even the fuel for the trucks that deliver the diapers to the retail stores.  Certainly there is fuel involved in manufacturing and delivering cloth diapers as well, but those diapers can be used repeatedly for years - not just once for a few hours. 

As for water, there is plenty involved in bleaching the wood pulp, and toxic, carcinogenic dioxins are the result of this bleaching process.  These dioxins don't dissolve well in water, and attach themselves to microscopic plants and animals, where they are eaten by larger animals and begin their way up the food chain, ultimately reaching humans. Since dioxins are difficult for animals to break down, each time it is ingested by a larger animal the toxic concentrations increase, through a process called biomagnification

Just as there is a ripple effect with dioxin pollution, including poisoning the people who work at the plants and live in the towns where they are located, the environmental impact of disposable diaper production is far reaching on a global scale.  Indigenous people are displaced to clear cut forests or drill for oil.  Land, water and air are contaminated during the collection of the wood and oil, as well as during the diaper manufacturing.  Approximately 28 billion disposable diapers are used in the US alone every year, and it is estimated that it takes 250-500 years for one to decompose.  This rate may be slowed even further if wrapped tightly in additional plastic.  If you look at the instructions on a package of disposables, it should say that solids are to be discarded in the toilet before throwing away.  Most users do not do this and add human waste to landfills. 

At a time when our natural resources are dwindling, I urge any parents out there who may have considered cloth to give it a second look.  It's not just a matter of filling up landfills.  I realize that all the types of cloth diapers and numerous brands can be daunting, but there is an abundance of resources and helpful mamas all over the web willing to reach out to new cloth diapering parents and help them navigate through it all.  Beyond the environmental impact, I haven't even mentioned the best part of cloth diapering - it's more affordable than disposables, and above all...those diapers are so darn cute!

Friday, June 15, 2012

A Memory for Father's Day: Belly Laughs

I don’t remember where we were living at the time. I don't remember what we were wearing or where we had been. What I do remember is that we were in the car and it was summer. I was wearing some sort of sundress and I could feel the hot car seat sticking to my legs. I think the car was stopped because I can remember him looking at me, but maybe we were just stuck in traffic or he was looking at me in the rearview mirror. I remember the sun was bright and shone with that yellowishness that only happens in the late afternoon before it starts setting. I don’t even remember what he said, whether he stole my nose, or even if he just made a face in the mirror to make me laugh.

What I do remember is the look on his face, the way his blue eyes glinted with joy in the late afternoon sunlight and his smile being so bright that it seemed to eclipse the rest of his face. I also remember the sound of him laughing at his own joke (whatever it was) and anyone who has ever heard my dad laugh know that his is the kind of laugh that pervades the air and makes you want to be a part of it. Most of all, I remember laughing one of those deep belly laughs that shakes your stomach until it hurts and makes you almost pee your pants. I remember laughing so loud the sound almost scared me and thinking I have the greatest daddy in the whole wide world and even at the age of probably three or so, I remember wishing that moment would go on forever. And it does in my heart.

And that’s it, that’s the whole memory, but aren’t I lucky to have the kind of dad that makes your first memories, no matter how fragmented, still joyful? Too often as parents we spend time worrying about the kind of memories we are making with our children by planning the perfect family vacations, the perfect daily schedule, or making the perfect home, but the memories that really last and are the most important are the perfect moments that no one can plan. You just have to show up and be available and they come to you and then last a lifetime. The rest is just unnecessary, unmemorable details. So, this father's day, celebrate the men in your lives who make themselves available as often as they can to make memories that never will never leave you.

Happy Father's Day, William Archer!

Thursday, June 14, 2012

Victoria's Birth

As promised, here is the birth story of my third child, born in April of this year. 

I was 22 weeks pregnant with my third child when my midwife told me that she would be retiring effective a few weeks before my due date. “Just give me another month,” she said. “I know I can get coverage in time to be able to deliver your baby.”

I live in New York, where certified nurse midwives (CNMs) can’t attend births in hospitals without a written agreement for backup with a licensed OB/Gyn. My due date was in mid-April, and my midwife was retiring at the end of March. She was hopeful that she could get someone to agree to cover her just for my birth, even though technically she would be retired. But there was no way I was going to wait a month to see if she could get coverage, and then making it even more difficult for me to find an alternative if she couldn’t. At the time, I adored my midwife and I was so upset that I would have to switch care, especially in the middle of my pregnancy.

As it turns out, my former midwife did me a favor. Never one to sit on things, I started calling midwifery practices as soon as I left her office, going in and out of a corner Starbucks to protect myself from the drizzling rain that chilly evening. I was incredibly fortunate to get a slot with a group of midwives I had considered with my previous pregnancy, and after the orientation, I knew I had made the right decision.

Being with this group of midwives meant that I would have a chance to deliver at the ever popular, and notoriously difficult to get into, Birthing Center within St. Luke’s Roosevelt Hospital. It was an amazing opportunity to finally have the birth I was hoping for, and one I would not have had with my former midwife (she was attending births at another hospital).

I tend to think that location is not as important as your support system. I think if you trust your birth attendant, for the most part the location comes second, though it also matters, of course (there are always exceptions). I knew a fair amount about this group of midwives from researching their practice and as I got to know each of them, I felt a great sense of relief and trust that they would be my advocates no matter where I ended up giving birth. Now that the Birthing Center had been dangled in my face, however, I wanted in.

This is a birth story, not a midwife recommendation, but I cannot write about this experience without discussing the fantastic care I received from this group. They advocate for, and trust, women. I commented to my husband after each visit what incredible listeners each of the midwives were and how comforting their advice always was. I was never rushed, never felt disrespected or stupid for asking any question, and my concerns were always addressed. Not a hand was placed on me without asking my permission—I was treated like an intelligent adult and my opinions and instincts concerning my pregnancy mattered.

It occurs to me that all of the above should be the standard—the fact that it was a new experience for me speaks to how much in need of improvement our medical system is, in particular our maternity care.  After years of “hand on the door” treatment, after the birth of my son, which left me emotionally and physically broken, after feeling essentially dumped by my former midwife—the type of care I received this time around was honestly something I had never expected.

Getting ready for this birth had meant I had to reconcile my feelings about my last birth. Though wonderful and life changing in its own right, it was also extremely stressful. Having your water break in the car somewhere in Manhattan while your husband is cursing at pedestrians is not exactly peaceful. This time my hope was to have a natural birth, but also a peaceful one, where I could appreciate the sensations and emotions. I knew I wanted to sit on a birthing ball and labor in water for as long as possible. I had bought a birthing gown, had a relaxation CD loaded into my iPod, had plenty of snacks, a picture of my kids to use as a focal point, good smelling lotion for massages—I was ready.

As I said in my previous birth story, each of my pregnancies and births has taught me something, and this one was no different. My darling Victoria took her time coming, making my pregnancy with her the longest and testing my limits and patience (both of which are very short).  She was in position for a good two weeks, moving down and pressing on my pelvis, making me feel like she was going to drop out any minute.

I had “pre-labor” symptoms from week 35 on. Then, I had almost two weeks of prodromal labor. I woke up every night around 3 a.m. with intense back pain and pressure, and would get a few good contractions that always made me think, “This is it.” No such luck. For an impatient control freak, this was a lesson. I was on an emotional roller coaster, up and down, up and down. Excitement, then disappointment. Incredible anticipation and elation, then restlessness.

Then there was the looming clock, the silent alarm imposed on my pregnancy by the almighty powers that be at the Birthing Center. The rule was, if you go over 40 weeks, 6 days, you automatically move to the regular Labor & Delivery floor. There are obviously many opinions on this matter, and my opinion is that this was the worst rule ever.

Many could chime in and say how ridiculous and wrong it is to have this sort of rule, and I would tend to agree with that. However, I’m sure the hospital has its reasons for instituting it, and whether I agree with it or not, I knew this going in, and I knew there would be no way around it. As a midwife whose blog I follow once said, “You buy the hospital ticket, you go for the hospital ride.” One note, since I’ve named the facility, this had absolutely nothing to do with the Birthing Center itself, nor its staff, nor the environment. It was wonderful.

My hope is that talking about this aspect of my experience will not overshadow my birth or the great facility that the SLR Birthing Center is. Risk out rules and all, they provide something that for many women like me is an opportunity to have the best of both worlds—birth without intervention with medical equipment and personnel close by.

Thankfully, the word “induction” was never even uttered by my midwives, and they had no problem with the pregnancy continuing so long as both baby and I were healthy. This time limit for the Birthing Center did, however, have a profound effect on my mental state (and that is the number one reason I oppose this rule). As the days passed and I got closer and closer to the “deadline,” I started to feel depressed. Once again, not good enough for the medical establishment. What was wrong with me that I couldn’t give birth within their parameters? Why wasn’t this baby coming already?

Then I got angry. There was nothing at all wrong with me. In fact, I decided, even if I did go into labor in time, I would show them and refuse to enter the Birthing Center! Besides, I reasoned that even if I did make it in time, the Birthing Center could be full, or closed. There was no guarantee I would make it in anyway. I would choose L&D and take control of my own destiny. No one was going to tell me where to birth, damn it.

On the morning of April 16th, at 40 weeks, 5 days, I woke up at 3:30 a.m. with the same backache, the same sporadic contractions. Here we go, I thought. Another sleepless night.

Only this time, after I had a snack and laid down on the couch around an hour later, I felt what I knew was a very real contraction.  About 15 minutes later I felt another, and then another 13 minutes after that. I woke up my husband and we timed a few together. Around 5:30 a.m. we called the midwife, and she called back with good news: the Birthing Center was open and awaiting our arrival. And of course, that’s exactly where we went.

Though I obviously was there for my births, they were all surreal, each for different reasons. With my son I was on various drugs and barely aware of what was happening. With my first daughter I had back labor and felt like I had one 45 minute continuous contraction. This time it seemed that I was actually going to get what I had hoped for, in the place I had wanted to be in for so long. I slowly got dressed, still in disbelief that it was happening. My husband picked up my mom and she stayed with our older kids. I woke my son and told him we were going to the hospital and gave my daughter a kiss as she slept.

In the car, I breathed through each contraction and chatted happily with my husband in between. Contractions were every seven minutes now. The last time we were in the car together and I was in labor, I was screaming at the top of my lungs and my husband was driving on sidewalks and running red lights.

We got to the hospital, parked the car, and up in the elevator we went. I couldn’t help but feel as if this was my first time—and in many ways it was. It was the first time I deliberately walked of my own accord into the place where I was to give birth. It was the first time I felt conscious, sane, and aware of what was happening. It was the first time that I was excited and full of anticipation, and I knew what the general progression of things was going to be.

We got to the labor floor and there was the sign, with an arrow: “Birthing Center.” Just seeing it now in my head brings tears to my eyes. We were here, we were going in, and I was going to have my baby in my arms soon. I don’t think I can adequately describe the sweet feeling of “knowing” that comes only from having this experience more than once.

We got in our room, I changed into my birthing gown (whereupon my midwife told me I looked like a goddess—bless her! I truly felt like one.), and sat for the blood test and fetal monitoring. Twenty minutes flew by, and I got on the birthing ball for a while. While I was on the ball, a woman I can describe only as the Best Nurse in Creation came in and after a pleasant chat suggested I get up and walk (contractions had spaced out just a bit). My husband and I went out to the blissfully quiet and private hall and walked. My midwives changed shifts but both ended up staying around, chatting with me about my birthing gown between contractions.

Best Nurse in Creation filled the jacuzzi tub, and then began the most awesome part of my labor. If you are reading this and considering laboring in water, consider no longer. It. Is. The. Best. I would do it a thousand times over. I labored in that tub, with my husband at my side, with the jets providing the utmost support and relief, for two hours. I don’t know how the nurse and midwife knew it was what we wanted because we never specified it, but they gave us privacy to labor, only coming in to intermittedly check the baby’s heartbeat and to see how we were doing.

I ate and drank to my heart’s content. I continued to be happy, relaxed, and in a positive state of mind, bowing my head and giving in to the flow of each contraction, making the sounds my body led me to make and visualizing opening and having my baby in my arms (though every time I did the latter I started to cry, interrupting my zen state). Contractions are likened to waves, and rightly so. Each one would start off low, then heighten and reach a crescendo before retreating and leaving me in an almost meditative state.

Once my “birthing sounds,” as they called them, started to get intense, my midwife came in and said we should probably check and see what’s happening, and then I’d either walk around or get back in the tub. Getting up and out of the water was like being pulled from a dream. But I was already nine centimeters dilated, and after two more hard contractions on the bed, I was ready to push my baby out. I remembered the sensations of the baby moving down from the birth of my first daughter, and I knew she would be here soon.

I pushed four times for only eight minutes—but it felt like an eternity! My husband said my face turned purple and broken capillaries would later confirm his observation. The physical sensations were at their most intense at this point and I was reacting to them. My midwife kept telling me to stop clenching my legs because I was holding the baby in and I said, “I can’t!” That’s when Best Nurse in Creation said, “Yes you can! Do it now!” And I did.

And then there was my baby, slimy and gooey like the others, looking exactly like her brother did seven years before. And I cried harder than I ever had at seeing my squirmy little one, another soul to love, another life to cherish. She was so beautiful and small and quite simply a miracle.

I’m still somewhat in disbelief that it happened this way. I’m indescribably grateful and I feel so lucky. Not that my body did what it was designed to do, mind you—I’m thankful to have had a healthy pregnancy that resulted in a healthy baby, and getting the birth I hoped for is the icing on the cake. After my first high-intervention birth, I felt like I had gotten robbed of the most amazing and miraculous human experience. And after having two intervention and drug free births, I wouldn’t have it any other way.

I wish more women would look upon labor and birth as a gift rather than as a cross we have to bear. As difficult as it can get, as intense as the physical sensations can be, for me it has been an immense privilege—to be able to communicate with my baby before she ever made a sound outside my womb.

Will we have another child? People are already asking. As we were getting ready to leave the hospital I was sad because I didn’t want to leave my birth behind. I knew I wanted to write about it as soon as possible, to be able to process it and remember the details. I almost want to have another baby so that I could get to relish just one more birth.

Time will tell. But if we start on this journey again, it will be a blessing and an honor once more. In the meantime, I look at my new little love and I thank her for giving me a sense of completeness that I never knew was possible.

Wednesday, June 13, 2012

5 Things Moms Want In a Doctor

Most doctors and pediatricians get into the profession because they want to help people. Most pre-med students and doctors I've talked to always say that they got interested in medicine because they want to make people feel better, they had a positive medical experience or a negative one (either themselves or through a relative) and they want either emulate that experience or make it better for others, or they love science and want to make life better for others. I've never heard anyone say that they want to go into medicine because they want to intimidate people, de-humanize people, ignore people, or condemn people for decisions that they've researched more thoroughly than they have. And yet, I've known many moms who have mentioned these three exact reasons for why they are switching doctors either for themselves or their children. I've even read about moms who purposefully lie or refuse to discuss things with their doctors for fear of being disrespected, disregarded, and disparaged. I'm sure that there are no doctors out there who would say that what they want patients to do is lie to them. So, where's the disconnect coming from?

I think that most doctors, even the ones who the moms are complaining about, probably do want to help people, they just aren't aware of what they are doing that isn't helping. So, I talked to some moms through the connected mom facebook page and some of the moms I know in real life, and I decided to compile a list to let doctors and pediatricians know what it is that parents really want in a doctor. These are the keys to getting parents to stay with your practice and developing honest, long term, and open communication with your patients.

1. Be honest yourself.
Be honest not just about what you know, but also about the scope of your knowlege and what you don't know. Don't be afraid to say when you don't know something or you haven't done much research about something. This sounds like one that would be easy, but when you are in a position of authority, you might have the urge to pretend you know more than you do. Don't. That was one of the biggest red flags moms complained about with doctors. Parents care about your credentials and that you are knowledgeable, but they care more about your honesty. My son had to go in for cranial surgery when he was ten months old because of a dermoid cyst located between his growth plates in his skull. The first two doctors I saw in our family practice were very honest with me that they thought it was probably a harmless cyst, but they honestly didn't know what kind of cyst could be so rigid and if that cyst was dangerous. They then gave me the option of pursuing more tests and seeing specialists. Their honesty helped me to get an accurate diagnosis for my son and he ended up with a surgery. It turns out that had the doctors bluffed me into false security, my son likely would have ended up with brain damage because we were (literally) micrometers away from neural damage. I did not choose new family doctors and I did not lose confidence in them because of their honesty. Instead, their lack of knowledge became an integral part of my decision making and likely saved my son from permanent consequences.

2. Treat every patient (no matter how small) as important
One of the most beautiful responses to my question of "What do you look for in a pediatrican or a doctor?" came from a mom on the facebook page. She wrote: "At my son's first pediatrician appointment, she took him in her arms,looked directly in his eyes and said "Welcome to the world, I am so very glad to meet you!" Another mom wrote, "I also look for a pediatrician (or family doctor) that actually talks to us, especially our daughter, rather than asking question after question. You get a lot more by talking to a child about their lives than asking pointed questions at their parents." Moms were clear that they didn't care how long they had to wait for an appointment as long as they felt they and their child were well cared for during their own appointments. Little differences, like making eye contact, asking before you touch them or their child, talking about the child's health rather than just running down the checklist of questions, made all the difference in whether or a parent would continue taking their child to you. As yet another mom put it, "If a doctor acts like they're too busy for me, it's always my last appointment with them."

3. Be respectful.
Parents look to you to provide accurate, educated health information and recommendations to parents so that they can make good decisions for themselves and their children. Because they are in the position to make the ultimate decisions, remember to respect their questions and their opinions, even if they are different from your own. One mom wrote about her annoyance with her doctor's fixation on her child's place on the low end of the growth chart. She and her husband are both small themselves and were also small as children. While it is her doctor's job to point out that her child falls outside the norm on the growth chart, the mom knows that her child eats well and is healthy. She gets frustrated that the doctor seems to "judge" her for not wanting to take action.

Likewise, there may be times when you disagree with a parent's choice such as when a parent chooses not to vaccinate, but you must respect that even though they have made a choice that you may not approve of even after you have given them all the information you feel is important. The decision is ultimately their's and not yours. Most moms seem to be fine with you giving an opinion contrary to their own as long as you show them respect for theirs. As another mom put it, "The most important thing for me is getting a sense of mutual respect. I don't feel like I need a pediatrician who agrees with all my parenting choices, but I do need someone who respects them and whose opinion I can respect. I want someone who will work with me and who is alright with me being informed and engaged, not someone who will do whatever because he says so."

4.Don't overstep your bounds.
Be clear between your research and your opinion. If a parent asks your opinion, of course you should give it, but make a clear delineation between what you know from personal experience and research and what you just think. Offer it as a piece of advice not "doctor's orders." For example, if a tired parent comes in and asks about sleep pattern normalcy, tell them what you have researched as in the normal range for that age because that is the medical, physical answer, but don't offer opinions on what that parent should or shouldn't be doing. You are offering medical information, but parenting decisions are up to each parent. You may never choose to bedshare, breastfeed, or cloth diaper, and you may believe that tantrums should be ignored or that infants shouldn't be held too often, but these are all highly personal parenting decisions that should be made by the person with the most experience with each individual child. While you may have seen that child every month for about twenty minutes to an hour since he or she was born, that parent has been with them all that time plus the other 23 hours a day. As one mom put it, "I really don't like it when doctors give you parenting advice, such as what to do about a temper tantrum, how to get your child to not throw things on the floor, sleep training, etc. I feel they are not trained in it and don't have any authority in that area[.]"

5. Don't forget how important everything you do can be.
What may be a routine diagnosis or procedure for you, may be intensely scary or life changing for a parent or a child. Make sure to show your compassion for people alongside your passion for medicine. Make sure that you soothe nerves and worries as well as you heal wounds. I remember that the second my son went limp from the anesthesia for his operation, my child was taken from me and I was told to "quickly give him a kiss and walk away." When it took me more than three seconds to respond and disappear, I was given the order more sternly. I understand that they were in a hurry to intubate him and that they were focused on my son's surgical needs and the task at hand, but they clearly didn't realize that my whole life was on that table and that I needed a few seconds to process that. I needed someone to actually look me in the eye and say, "We'll take care of your baby."

Thanks for reading and I hope this has reached a well meaning doctor somewhere!


Monday, June 11, 2012

On Judgment

On Saturday mornings, the Fort Greene farmers market lines the side of Fort Greene Park. The location is ideal, as families can pick up the weekly groceries and then take the kids to the playground just inside the park. Or in our case, my husband takes my son to the playground, while I pick up the vegetables, meat, half & half, and enough strawberries and rhubarb to satisfy my addiction for all things strawberry-rhubarb for the following week.

As I walked through the market this morning with my sister, we were once again talking about a thing that we often talk about, how women do this funny thing where we either judge the bejeezus out of each other or we accuse other women for judging the bejeezus out of us. Once we become parents this trait goes into hyperdrive to such an extent that all that has to happen is that another mother shows up with artfully arranged organic snacks in a stainless steel container and we feel judged because we have decided that with our snacks – the standard peanut butter and jelly sandwich (made of course with organic peanut butter and jelly but no one knows this since we left the jars where they belong in the refrigerator at home) in a plastic container that may very well contain BPA (or not, we just don't know because we've had them so long we can't remember if we bought them before and after BPA starting making the headlines) – we fall short. Or in some way, we feel invalidated, just because someone else does things differently. It's a leap of mental energy – mental energy that we very much need for other more important tasks, but nonetheless we use it anyway and carelessly – to accuse the other person of judging us or making us feel judged simply because they do something different.

My sister and I talked about this leap that happens, about how there are times we don't understand it, how it happens, how just because we do something differently than someone else, someone else feels judged by us. Yet, I concede that the places I judge myself the harshest are the places it doesn't take much at all for me to feel judged. The other person doesn't even have to say a word.

I've been on both sides of this coin. I've had mothers come up to me and admit that they feel intimidated by me because I write parenting articles and posts on how to be the perfect parent, or that because I write, I must have it all figured out. I've corrected them, to say that I have written no such thing about knowing how to be a perfect parent, that I actually write how I'd like to see the word “perfect” dropped from the English language or at the very least redefined to mean that as perfect parents, we lose it and then apologize and forgive ourselves and start over, just so our kids know that it's okay to make mistakes, to try, fail, and try again or that's okay for my kids to see that I too have emotions, or that I get frustrated or angry – and that I understand my anger and frustration impacts them and can even scare them. I correct them and say that generally the times I do things “wrong” are what I write about, and the times I do things “wrong” actually teach my children how to be resourceful like how to handle things when we end up on a subway ride without a toy to play with or in the park without snacks or a spare diaper or the baby's spare outfit.

Saturday morning, after my sister and I walked through the market and entered the playground where my son and husband were playing, I tried to figure out how I could put my market bag down without all of its contents spilling out. I had my 11-month old in her carrier and didn't want to have to bend over to pick up escaping apples or potatoes. One of my friends came running over. She was cute in her usual hip Bohemian Fort Greene mom way. She was especially energetic and happy. I instantly assessed that to be so hip and energetic, she must be very well rested and that it must be smooth sailing at her house with her two children, while at my house, we were lucky to get all four of us dressed to stumble out the door.

And so I said, “Oh, you're one of those smart, quick-witted mothers, one of those mothers with the answers...”

She said, “Are you kidding? Here you are wearing heels and a baby and carrying a bag full of vegetables. It's like a vision of perfection.”

I started to explain that I wasn't really wearing heels, that I was actually wearing heels made by the clog people so that they felt like clogs, but then I realized it was besides the point. I had just done that very thing my sister and I were just talking about; I had looked at someone else and instantly judged myself. It was like a bad habit left over from puberty, but worse, because I was still doing it and doing it without even thinking about it, almost as if it was an unconscious hard wired brain pattern, the kind of wiring that has you breathe without realizing it.

It wasn't even a thirty second interaction. We didn't discuss the usual hot topics that can cause parents to get weird, or their feathers ruffled, the topics like diet and snacks, discipline, TV watching, schools, or god forbid, vaccinations. It wasn't one of those conversations where I felt baited, like when a friend asked what we were going to do about my son's Pre-K in the fall. When I answered that we were going to try homeschooling, she immediately began defending her decision to send her son to school, and what a great school they had found for him. Even when I said, “That's great. We haven't found that – or we haven't found it close to our home or for less than $28,000.” She continued to defend her decision and her son's school. Even when I said, “Different families need different things.” She still defended. I left feeling weird and wondering why she had asked in the first place.

I have noticed since I've gotten caught in the judgment back and forth often enough and often without even meaning to or doing anything, that now, unless I'm with my closest friends (or friends that I know while we may do things differently, we know that we're all slightly neurotic about different things, and we're very good at respecting each other's neurosis) I no longer fall into the judgment trap because I don't casually disclose our various choices, or if I do, it's not without thought, or briefly explaining why we've done what we've done as an attempt to simply say, this is what works for us. Like that we no longer let our son watch TV because it made him violent and caused temper tantrums and I simply was unwilling to do it anymore. We don't do sugar because it also makes him nutty, not to mention, even with a lack of sugar (and juice, milk, bottles, candy, soda, or dried fruit), he has a mouth full of cavities that has the dentist stumped. I don't talk about vaccinations because that's a potential heated argument I have no desire to get into. When a friend asks for advice, I deflect with “Well, we're a little untraditional, but what we've found is...”

After talking with my sister and the brief interaction with my friend, I realized once again how comparing myself to others is just a reflex of my mind. It's not something I have to stay focused on. And, while I didn't know it in puberty, I know now that often others are also comparing themselves without even meaning to.

Recently, in an email with some beloved friends (versus some random online moms group), one mother asked, “How do the rest of you do it? Get snacks made? Get out of the house? Get time to yourself and get work done?” The discussion that followed was reassuring for all of us, as we all thought the rest of us had it all pulled together. Instead, we found that many of us often wear the same thing days in a row or that our children do, or that people pack snacks the night before, or drop the laundry off for someone else to do, or cook soup on Sunday so the week starts off with a few nights of leftovers. Some of us admitted that we throw parties just so we have to clean or that we've pulled the majority of our children's toys just so we don't have to continually pick up the pieces. I admitted that if you actually came over to our house, you'd discover that with two kids, two adults, two cats, a large dog and six chickens in the backyard, our home more resembles a circus than a peaceful sanctuary. Yet it's a circus that works for us, which is what I now remind myself when I notice that I'm feeling judged or inadequate.

Thursday, June 7, 2012

The Difference

I had my third child in April and had the best birth experience yet. I'm so excited to share the story, but the journey wouldn't be complete without first sharing the experience I had with my second child. So here it is, and I look forward to posting my latest experience next time.

What a difference three years make.

The first time I got pregnant, I had no clue whatsoever how carrying a child and birthing it would change me in the most profound, extraordinary way. I had no clue whatsoever how I really felt about pregnancy and birth.

I had no clue whatsoever that pregnancy is and should be treated as a natural condition and not a medical one, and that birth, in a normal and typical pregnancy, is and should be a physiological process, not a medical one, to be managed and ruined by malpractice fearing obstetricians and hospital staff.

My first birth was a traumatic one—save for the fact that I had my son healthy, the process left me raw and vulnerable, both physically and emotionally. Induced for what proved to be no more than the overly cautious doctors’ fears at a teaching hospital, I was treated like a birthing pod, without any consideration for my wishes, comfort, or privacy. I had a heavily medicalized pregnancy in general, and then a very high-intervention birth. I don’t even remember holding my son for the first time, and I don’t remember what he looked like, or if he cried.

Initially, I was happy with my experience, and after I gave birth I told my husband I wanted to send a gift basket to the hospital and my doctor practice. He looked at me like I was crazy and said, “Why? They were awful!” I was so shell-shocked from the whole thing that it didn't occur to me that maybe this wasn't the way it was supposed to be--I thought all births were that gruesome. It took me weeks to recover; a month later, I was still in pain.

After I had my son, I cried in the car leaving the hospital, when I got home, when I got in the shower. My baby wouldn’t nurse; drowsy from all the unnecessary medication he and I both received, he would fall asleep within seconds of latching on, and would wake up screaming from hunger mere moments later. Beat up, dejected, and depressed, I gave up. I thought it was my fault. I thought, my body is just not made for this. I can’t handle it.

Only upon further research, talking to women who had natural births, real natural births, and a lot of soul searching, did I realize that my birth experience was not the ideal--and it contributed both to my post-partum depression and to a negative view of pregnancy and birth in general. Once motherhood sunk in, I learned a lot about myself I didn't know before. While watching the hospital scenes in “The Business of Being Born,” my husband told me that he had flashbacks of our birth experience, and told me how negatively he felt about the whole thing. I realized then how traumatizing it had been for him as well.

Three years later, for my second pregnancy, I had a midwife and a chiropractor, which made all the difference. No longer forced into hour-long wait times for five minutes of actual doctor time, I was able to tell my midwife exactly what I hoped for, and she listened. My chiropractor was also an integral part of helping me achieve my goals. Having had two natural births herself, she not only helped my body, she helped my mind, by being positive, upbeat, and never wavering in her support of me.

Circumstances being what they are for us right now, a homebirth was not an option, but a low-intervention, natural hospital birth was. I did an incredible amount of research to arm myself with everything I could to be able to achieve what I wanted in a hospital setting. It was going to be tough, but through some fantastic websites, a blog written by a homebirth midwife from across the country, and my chiropractor and midwife’s guidance, I felt ready.

My second pregnancy was worlds away from the first. Though nothing compares to that first time, the second time was, in some ways, even more amazing. I ate extremely healthily and I felt great. I read nothing on pregnancy aches and pains, and stayed away from pregnancy and birth websites unless they were positive and re-affirming of my body’s design to do this.

I took every pregnancy body change in stride—no longer symptoms, I welcomed the changes and knew that they were facilitating the growth of my baby. Not forced to take tests to make sure my baby was “normal,” I was able to focus instead on the joy and miracle that being a mother can be. My pregnancy was like a float in the clouds, dreamlike, almost. I look back and can hardly believe that I was pregnant.

My daughter’s birth was unexpectedly fast and furious. I labored mostly in the car, with my husband swearing at the stoplights, scaling sidewalks, and calling my midwife with updates every five minutes. My water broke on the way, and I felt the baby descending as we arrived at the hospital. I was wheeled into a room, crawled on the bed, and gave birth. Just like that. My midwife arrived just in time, my husband just made it back from parking the car. My daughter was placed on my chest as soon as she was born, beautifully slimy and gooey, and I sobbed in joy and relief—she was here, I had done it.

Though I didn’t plan it this way, I don’t know what would have happened if I had been in the hospital longer. I don’t want to speculate. This was a gift. My daughter’s birth was the single most extraordinary and life-altering experience I have ever had, in completely different ways than my son’s. We had done it, her and I.

Afterwards, I felt like Superwoman, like I could do anything and everything. I felt giddy and elated. Calm and alert, my newborn girl nursed like a champ. I signed all the hospital forms while in recovery. I had blood drawn once, and that was it—no more needles. Since we were all in good health, we were released the next day—26 hours after the whole thing, I was home, on Christmas Eve, with the most precious present I could have asked for. My recovery was easy and quick.

I’m not sure what to say to people who feel that it doesn’t matter how the baby gets here, so long as the baby gets here safely, except that they should perhaps expand their definition of “safely.” Though medical conditions certainly arise in pregnancy and birth, making it necessary for medical (and often lifesaving) interventions, in a low-risk, normal pregnancy and birth scenario, the experience makes a huge difference. It did for me. Maybe I am more sensitive than others; maybe I have a heightened capacity for feeling negative and positive emotions. I know I’m not the only one.

During my research, I was bolstered by similar accounts from other women who had traumatic birth experiences, and then went on to something better. I was also frightened by accounts from women who went into the hospital hoping to birth naturally, and had interventions forced on them. Waking up the morning my daughter was born, feeling those first waves, I feared that I would go to the hospital too soon, get stuck in a bed with belts and needles, and end up on the operating table. Gratefully, blissfully, it was quite the opposite.

I adore both my son and daughter. Each of them have given me gifts beyond what I imagined, gifts I could never thank them for. Through the difficult experience I had with my son, I was able to clearly see myself for who I am. I was able to learn, I was able to change, I was able to move beyond the mainstream. Through my daughter, I was able to realize my strength, to challenge myself in every way possible, to achieve the peace and wisdom that can only come from being a mother. I hold her in my arms and I am so grateful.

I’m expecting my third child in April, and this time I hope that I can move even beyond what I have realized so far. And I hope that someday, I can repay my children for all they have done for me.

Tuesday, June 5, 2012

Guest Post - Start Something Beautiful

It started with an idea, I planted the seed and I'm watching it grow. 

I had this little idea that I could make a big change in the world if I was able to gather amazing breastfeeding photos of women of all sizes, shapes, colours and with breastfeeding children of all ages, and turn them into something beautiful. I wanted it to be a grassroots project with photos of real women breastfeeding their often hilarious children. I wrote a little blog post, and shared online. I created an email account to receive the photos and it's grow faster than I can imagine. 

Women from all over the world are submitting their photos into this breastfeeding project, and I'm not sure how I will ever choose between 10-20 to use in print - I'm still keeping the end product under wraps as I work out how I will finance this project, but that isn't stopping women submitting them. I started a facebook account for women to share their photos of them breastfeeding their children that weren't good enough quality for the finished print version and it's beautiful seeing what it has become. The wall is filled with photos and people wanting to know how they can be a part of this project. 

Start Something Beautiful will be a grassroots breastfeeding activism project, that will go to print in November, and pre-sale will begin in the Autumn of 2012. I hope that it will be a huge worldwide success and fill the days of people around the world with the sweetest images of love at its purest. The only incentive these amazing women had to share their images is knowing that they could win a free copy if their images was chosen - and they don't even know what the free copy is of! Women truly are opening their hearts, knowing that someone with a passion for changing the world, one woman at a time would do great work with what they share. I'm in awe. 

I want to include photos of twins, and tandem nursing, adoptive nursing, relactation breastfeeding, breastfeeding while babywearing, in cloth diapers or while practicing elimination communication, brand new babies, long lanky children, on top of a mountain, in the ocean, women of colour, women of all shapes and sizes! I want to make it feel totally acceptable, to embrace everyone, to make breastfeeding seem normal.

As a huge believer in seeing breastfeeding will help improve the breastfeeding rates and to help re-normalize breastfeeding. I hope that Start Something Beautiful inspires new mothers to try breastfeeding who may not have otherwise, or to give women who think she is the only person in the world nursing her 3 year old a sense of deep belonging. I want to celebrate the beauty that is breastfeeding in an accessible and daily way. 

So, please excuse me while I go calculate wholesale costs for your Midwifery office, and work out shipping costs for my new friends and collaborators around the world. Pre-sales of Start Something Beautiful will be available will the reveal of what exactly this project is. 

I hope you'll submit a photo, join the facebook group, tell your friends and support breastfeeding pairs in all the ways you can. 

Join the facebook group Start Something Beautiful to stay up-to-date on our growth and for the peoples choice voting!

Amber Skye Morrisey 
A student Midwife, Childbirth Educator, Doula, Placenta Encapsulator, Reiki Practitioner and Babywearing Educator

Monday, June 4, 2012

How to Apologize

Apologies are rare things to make the news, yet this week one did with Dharun Ravi's apology to the Clementi family for his actions that led Tyler Clementi to take his own life. I have followed this case the way I follow much of the news, in that I listen to NPR in my kitchen in the morning. Thanks to the iPhone, I check headlines and my favorite writers throughout the day. While I think Tyler Clementi's death tragic, and Ravi's actions that contributed to it abhorrent, I didn't obsessively follow the court proceedings. I didn't weigh in at Ravi's potential deportation or jail sentencing. Though I often have quite a bit to yell back at my kitchen radio about, I didn't yell about this case – or I didn't until I heard Ravi's apology this week.

Except that I don't know that we can call it an apology. Mostly, it was a statement read by his lawyers. When Judge Berman asked if Ravi had anything to say to the family about his actions, he said nothing. Given that Ravi made extensive attempts to cover up his actions, many commentators and Op-Ed writers concluded Ravi didn't feel remorse, or that if he did, it was only remorse for getting caught.

There is an art to apologizing, and it's not really one that is often taught. We think we are teaching our children to apologize: any time our toddler goes to a play ground and grabs a toy that isn't his, the knee jerk reaction is to demand s/he say their sorry. While this tells children they are expected to tell people they are sorry when they do something that upsets someone else, it doesn't teach them about responsibility for their actions or about being accountable for the repercussions of those actions. So, what we often end up with are people who say they are sorry, simply because it's expected of them to do so. And this is what Ravi's apology sounds like: his advisors standing over him like his parents used to do at the playground, “Now. Say you're sorry.”

Tyler Clementi's family was right to reject the apology and say that it was insincere. They were right to say that “a sincere apology is personal” and to point out that “it included no words of sincere remorse, compassion or responsibility for the pain he caused.” Because it didn't. An effective apology requires compassion and the ability to see the damage done from another point of view; the apologizer has to be able to understand why the other party feels wronged.

Instead, Ravi's statement allows that he just made a thoughtless mistake. He writes, “my behavior and actions, which at no time were motivated by hate, bigotry, prejudice or desire to hurt, humiliate or embarrass anyone, were nonetheless the wrong choices and decisions.”

If Tyler Clementi were my son, I'd give Ravi's apology a no pass too.

I too would ask for some authenticity, or at the very least, I'd ask, if your actions were not motivated by the desire to hurt, humiliate or embarrass someone, what were they motivated by? Because sticking a camera in someone's bedroom when they have a date coming over, and then inviting all your friends to watch is actually a pretty clear attempt to humiliate or embarrass or laugh at someone. Anytime we stick someone into the position of “other” or “different from us” we are hurting them. And anytime we seek to look good or feel included at the expense of someone else, you are bullying.

An actual apology takes courage. It takes courage to acknowledge one's hurtful actions and those it impacted, but when doing so, it shows the other party that you understand the cause-effect nature of your actions, and that your actions have repercussions that you didn't anticipate.

An actual apology also requires an explanation for why the offense happened, what motivated it, what led someone to take a considerable amount of action to hurt someone else. An explanation for the behavior has others see that you understand the damage of your actions and that your behavior is worth changing. Injured parties want to know that the wrongdoing won't occur again; an effective apology reassures them that it won't.

Often, effective apologies also make reparations. In Ravi's case, the court has assigned these in hours of community service. Still, it wouldn't have hurt Ravi to ask Clementi's family about what they wanted him to do or if there was anything he could do that would ease the pain he caused. It's thoughtful.

Everyone does things that hurts other people or at the very least bothers other people, but it takes vulnerability to admit that you were wrong or that you did something that really hurt someone else. On the playground, it is nice to apologize, but it doesn't mean anything if it's just out of expectation, and not actual compassion.