DoulaRina’s Holiday Shopping Guide
Posted by doularama | Filed under Uncategorized
Those who know me may be surprised to learn that I, who so disrelish the commercialism of this season, have written such a blog post. The rest of you will likely be disappointed by my suggestions, but my hope is that I give all of you some ideas you wouldn’t have thought of on your own, probably because their usefulness makes them so boring. I’m not recommending you give your mother an iron on Mother’s Day, though. I think that these gifts will be more appreciated than that subtle suggestion to keep up the good work.
First I should clarify that I am a birth junkie and, as such, am giving here suggestions for the pregnant woman you may know. If you are looking for a shopping guide for someone else, all I say to you is shame- you should have done your shopping last January.
So, if you’re shopping for a pregnant woman and you’re reading this blog, it is quite likely that you can look up her registry and shop from where you are sitting. I don’t discourage that. I like to buy gifts from people’s registries because I know I’ve chosen something that they want (and hopefully need, but with baby things, there is sooo much they just don’t need). I don’t stop there, however. I like to add something to the gift so that it is more personal and thoughtful and so they don’t end up knowing how much I’ve spent. Go ahead and buy the bouncer, but then add a book. Not to be read while the baby is bouncing- I was thinking more along the lines of Active Birth by Janet Balaskas, The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger, Birth by Tina Cassidy or maybe The Birth Partner by Penny Simkin (which she should leave lying around for her partner to pick up). Ina May’s Guide to Childbirth by Ina May Gaskin has some inspiring birth stories she can easily read without realizing how much she’s getting from them. There are so many great books. For some more suggestions, click on my books tab. You might also consider getting her a mix of herbs to use in a sitz bath or regular bath to heal her postpartum perineum. I make a lovely organic batch you can purchase by contacting me.
Another fabulous idea is some spa time. This is actually good for any adult on your list. In fact, if you know me personally, please assume I am hinting directly to you. A gift certificate to a spa that has regular packages as well as prenatal massage is great because she can choose to use it while she’s pregnant or some time afterwards, when she will probably need it just as much. If she hasn’t used it by the time the baby is born, however, part of your gift should be a nudge to get going as it is likely she will never find the time to do it on her own.
My final suggestion is to offer to pay, either partially or in full, alone or with some friends, for the services of a doula. You might choose a birth doula or a postpartum doula or have the mother-to-be decide which she would prefer. Either way, you shouldn’t actually hire a doula for her, even if you’ve gotten a recommendation for the best doula in town, as hiring a doula is very personal.
I hope that there is a great decrease in the number of unnecessities purchased for the babies of 2010 thanks to this blog.
Happy shopping! (that’s an oxymoron, isn’t it?)
Ocytocin, Super Hormone
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Just last night, my husband and I were talking about that incomprable feeling one gets around newborns and I told him it was largely hormonal, referring to oxytocin. Oxytocin is my favorite hormone, and reading in The Biology Behind the Milk of Human Kindness that an oxytocin nasal spray was used on test subjects makes me picture oxytocin police spraying people on the streets who obviously need a boost (and it would be obvious). Oxytocin plays many roles in the lives of humans. It helps get the baby out by causing contractions and then it ensures that we will care for that baby by making us feel an overwhelming love for it. Of course, in our capital-loving society, here we see research being done on it’s possible effects on the world of finance. Is it too much to hope that Wall Street will become a little more loving because of this?
Disney Princesses vs. Open-Eyed Sneezes
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One day my daughter told me that she is the only girl in her class who doesn’t have a princess backpack. She wasn’t complaining, however. She was merely making an observation. It was no surprise to me and I was surely thrilled. Why should her bookbag look like everyone else’s? She had never even seen half of these characters until she started school.
At a flea market one day, my husband found a tasteful, handmade Snow White dress and bought it. It would be years before anyone would be able to wear it, but it was purchased and put away much like many of our other frugal buys, including my daughter’s junior-sized, plain blue, Lands’ End, non-princess back pack. Although the dress was probably made for a six-year-old, last year, at the age of four, it fit my daughter for Halloween. My little girl didn’t know who Snow White was, much less any of the other newly-appropriated Disney princesses, so some time before she was to don her disguise, we showed her the movie. No need for any other princess purchases, but that of the black wig.
Now, a year later, my daughter rubs elbows daily with children who are all too familiar with the trendy toys and looks. She likely follows converstions pretty well without really knowing what they’re about. She’ll describe one friend as “the girl with the Hannah Montana coat” and I’ll be able to pick her out, but neither of us knows anything about Miss Montana other than what she looks like. How could we not know that?
My daughter is different with a purpose. I always strived to be different as a child. I don’t know when it started. Perhaps I just noticed that we’re all different anyway, so why not try to stand out? It was a bumpy ride at times, but I wouldn’t have it any other way.
In my twenties, I started wearing mascara and I refused to open my mouth while applying it just because everyone else does it that way. It doesn’t really help. It’s just some kind of instinct and I declined to partake. I also heard, around this time, that it is impossible to sneeze with your eyes open. Well, not only did I feel I had to prove my superiority to the authorities of facial impulses, it also happened to be a practical matter one day as I was in the middle of closed-mouthedly applying my mascara. There I was having to sneeze and it was going to leave my makeup a blotchy mess, so I just didn’t close my eyes. It did take some effort, but it was not impossible.
Now, I really don’t mind if my children spend their lives clenching their eyes with every sneeze. They may even buy something just because someone else has it one day (but not with my money). What I do want is for them to end up being independent thinkers with some self-confidence. That would be different.
Formula-Fed America
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Oh my goodness! I haven’t been to the movies in years and this might just get me out there. Something tells me, however, that it won’t be a date night with my husband. Maybe he’ll meet me afterwards. I hope it’s not just being released on DVD- I need a good excuse to sit in a room full of adults for a couple of hours. Anyway, here’s the trailer. Please jump on the bandwagon. Too many of us don’t take a strong position on breastfeeding because we don’t want to make anyone feel bad. How much harm are we doing so that we don’t hurt their feelings? Share the facts and you’re bound to change some minds. See you in the movies…
Formula Fed America
How to Find Safe Personal Care Products
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At a recent postpartum visit, a client asked me what skincare products I recommended for her newborn and sensitive preschooler. I responded as a mother who has spent much time finding just the right personal care items for my family. I gave her the names of the products we use and then I gave her much more. I told her to check the Environmental Working Group‘s cosmetics safety database called Skin Deep. There, they have reviews of over 40,000 skincare products based on the effect their ingredients may have on us and the environment.
Just because your shampoo is “natural” doesn’t mean it isn’t slowly making you sick, you know. If you don’t find your brand in EWG’s database, you can do searches for the ingredients. Start with the most multisyllabic, I say. You can also see what they recommend based on the type of product you need. You will find results in a range of prices. If you’re in a hurry, you can quickly check out their Parent’s Buying Guide where you will find only the top-rated products.
I am so happy to be sharing this information with you! Good luck.
On Interventions
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In case you haven’t had a chance to read all of the books I’ve recommended here, I’m providing you this article from Utne Reader which gives you an overview of a couple of them. I think it’s important reading! Enjoy.
Drugs, Knives, and Midwives
by Elizabeth Larsen
The woman, who is expecting her first child, is a week past her due date. Even though tests show that her baby is doing well, her obstetrician decides to induce labor with Cytotec. It’s a drug that has not been approved by the Food and Drug Administration (FDA) for pregnant women, and it can cause contractions that are strong enough to lacerate the anatomical barrier that keeps amniotic fluid separate from the mother’s blood vessels — a situation known as amniotic fluid embolism (AFE). AFE is almost always fatal.
The woman’s contractions speed up immediately, but the doctor continues to give her Cytotec until her contractions are coming so rapidly that the baby is having difficulty getting oxygen. The fetal monitor shows that the baby is in extreme distress, so the doctor sets to work to save it.
Shortly after the birth, the mother starts to hemorrhage and goes into shock. The baby dies 35 minutes after birth. The mother dies a few hours later from AFE.
This nightmarish scenario is one of many from Marsden Wagner’s book Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (University of California Press, 2006). A perinatologist and a scientist, Wagner is a former director of women’s and children’s health at the World Health Organization (WHO). He’s also an old-fashioned whistleblower. By his lights, the American birth industry is in a crisis because we have turned a natural event into a medical condition. As a result, we’ve allowed obstetricians — and not the midwives who safely deliver the majority of the world’s babies — to control maternity care. The ironic result is that in our efforts to make birth as safe as possible, we have saddled American women and babies with a system that, despite being the most expensive on earth, puts us in the bottom tier of care for wealthy countries.
Today, more than 15 years after Jessica Mitford detailed the potential hazards of obstetrical forceps, fetal monitoring, and diagnostic ultrasound in The American Way of Birth and more than a quarter century after Immaculate Deception, author Suzanne Arms’ expose of high-tech birth, sold more than 250,000 copies, the number of American women who die around the time of birth is on the rise. According to WHO, 28 countries — including Croatia, Ireland, Kuwait, and Portugal — have lower maternal mortality rates. Forty-one countries have lower infant mortality rates.
It’s not just the shocking mortality rates that trouble Wagner and other reformers. Childbirth Connection, a New York organization dedicated to improving maternity care, recently published Listening to Mothers II, a national survey of 1,573 women who gave birth in 2005. Its findings document numerous indignities and dangers, most of which easily could have been prevented. Of the 25 percent of women who were given episiotomies (a cut in the muscle between the vagina and the anus to widen the birth canal), a startling 73 percent were not consulted before having the procedure.
While an episiotomy is a minor — albeit painful and often unnecessary — procedure, a cesarean section is major surgery, and 32 percent of Listening to Mothers II respondents had one. That’s a higher rate than the 29 percent cited by Wagner, itself a steep increase from the 21 percent reported five years earlier. Given that WHO has calculated that the optimal rate of C-section for saving the most women and babies is between 10 and 15 percent, what’s driving this trend?
Certainly, in this age of rising malpractice insurance costs, obstetricians want to protect themselves from being sued. But Wagner also thinks that C-sections offer doctors a way to bring the most time-consuming part of their practice under their control. ‘It means they can split their time between seeing patients in the office, doing gynecological surgical procedures in the hospital, and attending births, on a timetable of their choosing, and reduces the chance that they will be required to attend births at inconvenient times,’ he writes. ‘For some, it is perhaps their only chance to have a decent personal life.’ Wagner also believes that our skyrocketing C-section rates are driven by the internal politics of the birth industry. By promoting cesareans, doctors are choosing a procedure that midwives cannot perform.
Even in an elective cesarean, a woman is almost three times more likely to die than in a vaginal birth. Beyond the immediate health risks, having a C-section decreases a woman’s chance to become pregnant again and doubles the risk of an unexplained stillbirth in later pregnancies. In 2 to 6 percent of cesareans, a doctor accidentally cuts into a baby. Babies born from an elective C-section are twice as likely as babies born vaginally to end up in neonatal intensive care.
The widespread use of labor-inducing and painkilling drugs is another by-product of what Wagner sees as the rampant medicalization of American births. According to Listening to Mothers II, four labors in ten were started artificially. The most common method used (80 percent) was synthetic oxytocin, more commonly known as Pitocin. There is no disputing that induced labors can be medically necessary. But they also are done at the request of anxious mothers who are so exhausted by their pregnancies that they just want to be done with them. In theory, there is nothing wrong with trying to jump-start labor; since human life began, women have been walking, squatting, rubbing their nipples, swallowing castor oil, snorting sneezing powders, and having sex to give their babies a nudge. But nearly 20 percent of the women in the study who were induced said that they felt pressured by their doctors.
The problem with using Pitocin is that it makes contractions more painful and creates a snowball effect that often leads to pain medications such as epidural blocks, which spur their own set of complications. According to Wagner, a quarter of women who receive an epidural experience side effects such as fevers, urinary incontinence after delivery, headaches, temporary and permanent paralysis, and even death. Because a woman who has had an epidural cannot feel or move her lower body, she has to give birth lying on her back, which is less efficient than upright positions such as squatting or standing.
When Wagner challenges doctors who use Cytotec, he’s told that if they were to wait for FDA approval, they would be stalling the medical progress of their field.
This arrogance, Wagner warns, is endemic in the practice of medicine. He urges his readers to push past unfounded fears about safety to realize that 80 percent of births don’t need medical interventions. But while Wagner blames the medical establishment, a roundtable discussion in the journal Birth (Sept. 2006) takes a wider view that implicates our panicky, instant-fix culture. ‘We are a terrified, risk-aversive society,’ writes Michael C. Klein, professor emeritus of family practice and pediatrics at the University of British Columbia, who believes that we want the easy solution in all aspects of our lives. ‘[We] pop a pill and carry on being fat and out of shape, while [we] expect to die suddenly at age 90 in the middle of sexual intercourse. We demand it of society, the medical profession, ourselves.’
In their indignation, critics of the current birth system tend to overlook the fact that despite its myriad shortcomings, there have also been considerable advances in the way we give birth, and that birth fads and trends are products of their time and culture. Tina Cassidy’s Birth: The Surprising History of How We Are Born (Atlantic Monthly Press, 2006) is a fascinating tour through the dark days of craniotomies (puncturing the fetal skull to remove babies who were stuck), cesareans without anesthesia, and ‘Twilight Sleep,’ a method developed in Germany in 1914 in which women were drugged into a semiconscious state, strapped to their beds, and then had their ears stuffed with cotton so they wouldn’t be awakened by their cries of pain. Indeed, a fair number of women giving birth today were born to mothers who were unconscious. Fathers were routinely banished from delivery rooms until the 1970s, and newborns slept down the hall in nurseries and were fed formula on rigid schedules.
Most new families today spend the night together in the same hospital room because activists in the 1960s and 1970s demanded that birth become a more human, family-centered experience. Now, a new breed of agitators are starting to take matters into their own hands. In a December 2006 Boston magazine article, Cassidy details the efforts of Boston-area women who are fed up with unwanted C-sections, false positive prenatal screening tests, scant breastfeeding support, and incorrect predictions from doctors about dangerously large babies. The members of this ‘mommy uprising’ are hiring hands-on midwives instead of obstetricians and are insisting that they be allowed to have a doula — a supportive labor coach — present at the birth. Some are passing on the hospitals altogether in order to give birth in the familiar comfort of their own homes. But while studies have shown that home births are as safe as hospital deliveries for low-risk pregnancies, most doctors oppose them. In some states, attending a home birth is illegal, and home birth midwives and their clients (not ‘patients’) have been driven underground.
Wagner argues that midwives are key to fixing our broken maternity system and that they should be given the primary responsibility for women with low-risk pregnancies. (Obstetricians can be responsible for women with serious medical complications.) He envisions a system in which most maternity services are located in neighborhoods and not hospitals. If the United States had a national health care system, American obstetricians would no longer be able to maintain their monopoly on the birth industry. He also calls for doctors and hospitals to be more transparent, providing information about not only their C-section rates, but also rates of maternal and infant mortality, uterine rupture, and adverse drug reactions.
Of course, there are thousands of obstetricians who provide expectant and laboring mothers with compassionate, ethical, and medically first-rate care. And there are plenty of midwives who in their fervent belief in the rightness of their approach display the kind of arrogance Wagner ascribes to his fellow doctors. To make its way into the mainstream, midwifery needs to move beyond its earth mother image and take a more tolerant view of American women’s fear of excruciating physical pain. In her book Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood (Doubleday, 2001), Naomi Wolf articulates this challenge. Describing the difference between the alternative birth center and the maternity ward at her Washington, D.C.-area hospital, she writes that ‘the contrast between the two delivery floors seemed to sum up a failure to give women decent choices in childbirth. I did not understand why the polarity was so stark: the beautiful floor with its rigid set of options regarding pain, or the slaughterhouse atmosphere of the regular birthing rooms where I could receive medication for the body if I needed it, but nothing for the soul. My heart longed for the alternative birth center, its beauty, the openness. But could I stand the pain? And would my labor go so smoothly that no complications would arise to get me sent to the warrens down below?’
As anyone who has read Misconceptions knows, Wolf was indeed shuttled out of the birth center when her labor failed to progress according to her nurse’s time line. After Pitocin and an epidural, Wolf was rushed into an operating room for an emergency C-section. It’s a scenario, she later found out, that is all too common among American women giving birth. To paraphrase Wolf’s critique of the popular pregnancy manual that in her view encourages women to passively accept overly medicalized births, she did not get what she expected when she was expecting.
Mother’s Whistler
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