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Pregnancy in the time of Trump.

I have to admit, I’ve been kind of a wreak this past week (and no, I’m not pregnant). On the outside, it looks like I’m managing everything okay, balancing caring for a toddler with activism and work and life, but inside I’m distracted, anxious, tense, and compacting all my feelings deep down so that I’m not just a walking mess. For those of us who share progressive values, these are truly upsetting times. Speaking as a Muslim woman, my community is on high alert and experiencing bewilderment, anxiety, grief and anger, and I know that we share our alarm with the broader community of people of color, immigrants, LGBTQ people, and others.

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Being pregnant during periods of anxiety, grief, and anger can be complicated. We know that the stress that we experience in pregnancy is also experienced by our babies. Cultural traditions worldwide recommend that pregnant women not look at or think about upsetting things. Unfortunately, that’s not the reality that we live in, or that of many of our sisters around the globe.

I think back to a lesson I learned from Karen Strange, a midwife and educator. She talks about the impact of stress on our babies, and suggests that when we experience a “stress event,” (say, reading the news…), that we take a moment, a deep breath, and then send a message like: “Hey little baby, that wasn’t about you. I love you, and I can’t wait to meet you.” She calls this a “love bath.”

We could all use a love bath.

Some stress reduction techniques that are wonderful in pregnancy include:

  • Mind-body movement, such as yoga
  • Acupuncture (amazing for stress)
  • Herbal teas, such as chamomile, lemon balm, and skullcap, and valerian and passionflower for sleep
  • Prenatal massage
  • Walking in nature

And generally, be sure to nourish yourself. This doesn’t just mean good food and clean water, it means beauty. Listen to beautiful music, let your eyes rest on beautiful things, surround yourself with friends (and take a break from discussing politics), and seek out goodness, connection, and joy. You are the one who can control whether you get sucked under by this tide of dark absurdity, and you get to choose how much light to let in.

Image Source:

“Pregnant,” Peter Dahlgren, Flickr Creative Commons

Seven ACOG positions all parents should read.

The American College of Obstetrics and Gynecology (ACOG) is one of the leading professional organizations of physicians who work in the area of obstetric medicine. Obstetricians practicing in the United States are influenced by ACOG statements and practice bulletins, and it’s important that parents familiarize themselves with the recent position changes that are relevant to birth, choice, and justice.

If you are writing up a birth plan or birth preferences and discussing them with your provider, and you find that there’s push back to any of your preferences that are supported below, PRINT OUT the committee opinion and bring it to your doctor or midwife. If they still don’t support it, find a new care provider.

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1. Doctors and midwives should avoid unnecessary interventions. (January 2017)

ACOG acknowledges that “many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor,” including routine amniotomy (when the doctor or midwife breaks the bag of waters around the baby), continuous fetal monitoring, IV fluids, laboring in one position, initiating pushing upon full dilation without the urge to push, and others. They acknowledge the benefits to staying at home in early labor, massage, hydrotherapy (aka labor tub or shower), doulas (“continuous one-to-one emotional support”), frequent position changes and movement, and mother-directed pushing (“open-glottis pushing”). Furthermore, care for low risk women should should be collaborative and individualized.

2. Delayed cord clamping is beneficial for babies (January 2017)

ACOG has found that delayed cord clamping (of at least 30-60 seconds) benefits both preterm and term infants. For preterm babies, it improves transitional circulation, establishes better red blood cell volume, and decreases the need for blood transfusion, lowers the risk of brain hemorrhage and other problems. For term babies, it increases hemoglobin levels and gives better iron stores, preventing iron deficiency anemia, which is a serious global public health issue with lifelong ramifications. This statement is a big deal for those of us who feel passionate about delayed clamping, and a long time coming!

3. Laboring in water is a good idea! (November 2016)

ACOG concurs with studies that have found a reduction in the use of anesthesia for women laboring in warm water. They still recommend birthing on land, because the “benefits and risks of this choice have not been studied sufficiently to either support or discourage” water birth.

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4. Women and people have the right to choose where they birth (August 2016)

ACOG agrees that “each woman has the right to make a medically informed decision about delivery,” including where she will give birth. Though they still maintain that the hospital and accredited birth centers remain safer than planned home birth, this statement is an important departure from their earlier position on home birth.

6. It is never okay to coerce a pregnant person into a choice against their will (June 2016)

ACOG states that “[f]orced compliance—the alternative to respecting a patient’s refusal of treatment—raises profoundly important issues about patient rights, respect for autonomy, violations of bodily integrity, power differentials, and gender equality.” Physicians must respect a patient’s decision, even when they disagree with that decision, and they must pay attention to the individual context from which that women/person comes. They state that it is unacceptable to use the court system to force a parent or parents into making a decision against their will.

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7. Racism and ethnic disparities exist in obstetric care (December 2015)

ACOG acknowledges that racism and ethnic discrimination exist within the medical system broadly and in obstetric and gynecologic care specifically, and that it is perpetuated by individual practitioners and on the systemic level. They recognize the need for diverse practitioners, research that acknowledged disparities, diversity training and recognition, and the need for approaching each person as an individual. The responsibility for addressing racism rests on all of us–doctors, midwives, nurses, doulas, lactation consultants, childbirth educators–and each of us has a part to play in dismantling systemic oppression.

 


 

Image credits:

Yada Liao, Flickr Creative Commons

“Hello there!” Bethanie Petrick, Flickr Creative Commons

“Elizabeth Maternity Photo,” Cheriejoyful, Flickr Creative Commons

Why we should heal our livers before pregnancy.

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One of the most important things I’ve learned in my midwifery studies and in attending home births around Boston is that our diets have a direct impact on our pregnancies, births, and postpartum, and midwives not only pay very close attention to what their clients are eating, but will often use diet as the first means in addressing signs of imbalance, and more often than not changes to our diet are enough to bring us back into healthy balance.

As a mother of a toddler, I’ve also thought about how my diet has impacted and continues to impact my daughter, in pregnancy and nursing, and in terms of the foods that she now eats. The foods, the pesticides and herbicides, and the environmental toxins that I consumed before and during pregnancy, and while breastfeeding, and which she consumes now, are part of her, for better and for worse.

One step that I encourage in my herbal practice before getting pregnant is to use the six months to a year before actively seeking a pregnancy to focus on our health (our partners too!). This maximizes our own health as we embark on pregnancy, and gives excellent resources for our babies to draw from when they’re in the earliest and most sensitive stages of development (and when deficiencies in nutrients such as folate can cause neural tube defects like spina bifida).

A basic way to start is by loving your liver. Your liver performs hundreds of metabolic functions—that is, the processes our bodies perform to maintain life. These roles include detoxifying waste products of digestion, environmental toxins and chemicals, and clearing hormones from the body (which is so important for our fertility). One of the liver’s most critical of these functions in pregnancy is to make albumin, a protein which keeps the right amount of fluid in our blood and which helps prevent the dangerous disease toxemia (also called preeclampsia).

I strongly recommend that people planning to become pregnant in the next year focus on supporting their livers. It allows us to remove heavy metals like lead, mercury, aluminum, and others, from our bodies so that our babies don’t do it for us. It aids in maximizing our fertility. It sets the stage for our children’s life-long health. And, it can also be a profound and enlightening wake-up call for parents who have never really taken a good look at what goes in their bodies.

Supporting Your Liver in Preconception and Pregnancy

A well-rounded, whole foods diet will go a long way to support your liver in pregnancy. The basics include ensuring that each meal contains two servings of brightly colored vegetables, consuming dark leafy greens daily, and opting for soaked and sprouted whole grains, beans, and legumes.

  • Cruciferous vegetables such as broccoli and kale help produce enzymes that support the liver’s role in detoxification.
  • Dark leafy greens are not only folate rich (which the developing embryo needs), but they help reduce inflammation and are full of antioxidants. Bitter tasting foods, especially greens, are associated in traditional medicine with the liver, perhaps because they’re rich in the highly beneficial antioxidant glutathione.
  • Cook with a wide variety of fresh herbs, including cilantro (and its seed, coriander), parsley, oregano, turmeric, which are safe in pregnancy for dietary intake. These herbs are rich in antioxidants. Garlic, and especially raw garlic, reduces inflammation and supports the liver. To cook with garlic, crush your cloves and wait 15 minutes either before cooking or consuming raw to reap the maximum benefits.
  • Berries are high in antioxidants and are a good source of minerals, while also being low on the glycemic index (which measures the amount of sugar being processed by your body, including fruit sugar).
  • High fiber diets help to bind and move toxins and hormones that the liver has cleared from our blood, and fiber is especially useful in pregnancy when our digestion has slowed down (which means that we reabsorb toxins sitting in our colons, yuck).

Additionally, it is crucial to remove harmful foods from your diet that can stress or harm your liver and health.

  • Remove foods containing artificial ingredients, sweeteners, and colors (ahem, processed and packaged foods) and do your best to eliminate foods sprayed with pesticides and herbicides; these categories of foods are taxing on the liver, which works overtime to remove these harmful chemicals from your body.
  • Eliminate sugary drinks and snacks, and refined grains.
  • Choose organic, pastured meat, dairy and eggs. This is an investment in your health, and your baby’s health.
  • Reduce or eliminate caffeine and alcohol, which stress the liver and both of which are linked to fertility challenges, and which can have all sorts of effects on a baby in utero.

There are also wonderful herbs to support the liver, and thankfully, several of these are recognized to be safe for pregnancy as well as nourishing and nutritive.

  • Burdock root, dandelion root, and yellow dock root are three excellent herbs for the liver. Burdock root can also be purchased in Asian markets and some health food stores as “gobo root,” and can be sliced and added to stir-fries.
  • For an iron-rich, nourishing and liver-supporting tea in pregnancy, mix equal parts burdock root, dandelion root, yellow dock root, and nettle. Steep 1 oz herbs in 1 qt boiling water for 2 hours, strain and discard herbs. Drink up to 2 cups daily.
  • Turmeric is a phenomenal herb to support preconception liver detoxification, not to mention a powerful anti-inflammatory, up to 2,000 mg daily. It’s safe in pregnancy to cook with, but if you’re going to use therapeutic amounts then I suggest consulting with your midwife or doctor.

For more ideas on liver detoxification, check out the following:

Image source: “Freedom,” Lauren McKinnon, Flickr Creative Commons

The Microbiome!

Say hello to your little friends.

Did you know that bacteria outnumber your human cells by about 9:1? Yup. We are more bacterial than human, by far. We share our bodies with hundreds of species of bacteria that live in our mouths, on our skin, in our small intestine, in our vaginas, and pretty much everywhere else. They are really, really important. They shape our digestion, immunity, metabolism and mood, and help produce vitamins and enzymes. We also have a growing body of evidence to suggest that many of our health issues today–for example, autoimmune disease–are a result of meddling with our microbes.

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Lovely lactobacilli.

Why do I think it’s important to write to you about this? Because we need healthy bacteria in order to be healthy ourselves, and to have a healthy birth, and to have a healthy baby and healthy family. It’s an issue to be aware of because we live in a society that tends to view bacteria as the enemy; antibiotics are so prevalent in our food systems (they’re given to animals to suppress illness within the industrial food system), in our healthcare system, and in our everyday lives (ditch the antibacterial stuff!).

When I work with pregnant women, or postpartum mamas, I talk a fair amount about our bacterial flora. For example, Group B Streptococcus (GBS) is a type of bacteria that lives in the rectum and vagina, and a positive GBS test (tested around 36 weeks) can limit some of our choices in labor; GBS is controlled by healthy lactobacilli populations in the vagina. Babies’ guts are colonized at birth, either by vaginal flora or by the bacteria on our skin if we have a cesarean (or our doctors’ skin, which is not so optimal and raises risks for lifelong health issues). Literally one of the purposes of breastmilk is to feed our baby’s bacteria. And finally, infant colic and eczema can be caused by less than optimal gut bacteria.

In the meantime, just know that we’ve got to take care of the bacteria that make us happy and healthy by feeding and nourishing them with the right foods, by caring for our health and avoiding taking antibiotics unless necessary, and embracing the microbiome.

Ok, you’re feeling it. Now what do you do?

  1. Include plenty of high fiber fresh fruits and vegetables in your diet. We call these “prebiotics,” because they nourish your buggies (not to mention they provide so many important vitamins and minerals for pregnancy).
  2. Include fermented foods in your diet. These are foods made or preserved by bacteria (and food preservation was critical in the days before refrigerators and canning) and no matter where in the world you’re from, your people ate them. My Polish ancestors ate sauerkraut, yoghurt, and cheeses. Yours might have eaten torshi left, or injera, or kimchi, or laban kishk, or miso. There are countless wonderful options to choose from, and they are so easy to make. Check out the resources below for ideas. I guarantee, it is simple enough that anyone can do it.
  3. Seriously, if you can avoid taking an antibiotic, your body will thank you. We should really reserve antibiotics for serious infections. A 2015 study found that a single course of antibiotics changes the composition of your gut bacteria for a year. A YEAR. Strengthen your immunity naturally by eating a healthy diet low in simple carbohydrates, using herbal immune support, eating probiotic fermented foods, getting quality rest, and addressing stressors (if you think you’d benefit, I do herbal consultations that fit the bill).
  4. Should you take a probiotic (and which one)? It can help for a range of issues (especially if you’ve taken antibiotics in the past year), but if you balk at the expense then ferment your own foods and eat them daily.

The simplest place to start is just by including some common fermented foods in your diet: try plain, whole milk yoghurt, lacto-fermented pickles, sauerkraut, kimchi, miso soup, organic tofu, and/or kombucha. All of these can be found in your local grocery store. Eat these foods, even a small amount, every day.

The next step is to make your own. It’s easy, and seriously fun. Try starting with yoghurt, which you can make overnight. The only ingredients are yoghurt starter and milk!

Resources

Tips for my sisters.

A Muslim woman recently asked for some general pointers for birth, and I want to share it with all women and people who are pregnant and just starting to try to make sense of all the information out there. This one especially goes out to my sisters.

1. Know your options. Your care provider may be limited in his or her choices, by the protocols of their institution or group practice, by their insurance policy, by his or her views about pregnancy and birth, and even by their work schedule. Know that there are different approaches to birth, and that working with a midwife is associated with a lower risk of cesarean and better outcomes. Know that your provider works for you, you don’t work for them. Find out their c-section and episiotomy rates. Do they support VBAC? Ask the right questions. Find the provider who is 100% committed to you, and if you feel like a just another pregnant body passing through their practice, find someone who sees you, you, all of you, you as a whole person with hopes, fears, expectations, preferences, emotional and spiritual and psychological and so many other dimensions. With respect.

2. Surround yourself with positivity, because we live in a culture of fear around birth, where birth is pathologized (this is not a universal view, and it has a specific history in the United States). Two resources I like for this are birth videos (see my playlist here) and The Birth Hour, a podcast with tons of birth stories. I also recommend reading beautiful and positive birth stories. Here’s one I love from my dear friend Shannon, a midwife in the Bay Area, and mine. Know that as you’re watching and reading and listening to positive stories, that your body is not different, that your capacity to carry your baby with joy and taqwa and your ability to birth with joy and tawakkul is no different from other women who walk away from their births feeling strong and humbled and joyful.

3. Nourish your body with excellent foods (listen to this and then this). Take a food-based prenatal vitamin, not a synthetic vitamin. Eat your dark leafy greens!

4. Move your body and connect body and mind through restful but focused movement. Prenatal yoga is wonderful. I also like this podcast episode on body alignment in pregnancy (there are tons of great episodes to listen to from Taking Back Birth). And, I strongly recommend chiropractic care in pregnancy.

5. Hire a childbirth doula (seriously, the science says so!). Hire someone that you feel supported by, and who totally reinforces your power.

6. Take a childbirth ed class, but not the one offered by the hospital. Take one that opens your eyes to how incredible you are as a birthing woman, and that reveals birth as an amazing process that happens through you, and which you and your baby and your partner participate in. I strongly recommend HypnoBirthing, but I also like Birthing from Within (the Birthing from Within book is fantastic and a great read, especially for people who process creatively).

7. Don’t just learn about and prepare for birth, but actively prepare for the postpartum (this postpartum worksheet can help). You’ll need rest, nourishment, time away from people and responsibilities, support, and lots of extra love, for weeks.

8. Use zikr to connect to Allah and reflect on His Rahma for you just as you nourish a little one in your Rahm. Invite space in yourself to be curious and in awe of all that is unfolding within you and around you, and make space in your life to receive this guest and this gift.


I you feel like you’d benefit from a conversation, I do birth consults. We can talk about anything you want, but some suggestions are: determining what kind of experience resonates with you, what kind of care is appropriate for you, understanding birthing and pregnancy options, processing and releasing fears, anticipating the postpartum, and really just holding space whatever comes up in pregnancy and postpartum. This is judgment free, for all kinds of births, all kinds of pregnancies, all kinds of people. I love companioning women through pregnancy and birth and postpartum, and what I like about these conversations specifically is that I can do them with women around the world.

Doula Wisdom: How to VBAC

Last night, my friend Shannon Staloch and I hosted our third conference call Q&A on birth. We focused on VBAC–vaginal birth after cesarean–and heard from a special guest, Muneera Fontaine. Muneera is a childbirth and postpartum doula (and mother of three, and PhD candidate!) in the Washington D.C. area. She shared her own experience of birth, including a frustrating first birth during which she was pushed to schedule a c-section for an estimated “large baby,” only to find out later that it wasn’t medically necessary (read more about the evidence for induction/c-section for estimated big babies here). She went on to have two successful VBACs, and to train as a doula.

Here are some takeaways from the call, representing the wisdom of three birthworkers:

  1. Process: Muneera talked about the importance of emotionally processing previous c-section births. The emotional toll of undesired birth experiences, including those we would categorize as traumatic, is very real. This is especially so when women are treated as if they have no choice or say in the decisions around their bodies, births and babies. In birth, women are especially sensitive and vulnerable to care provider messages, and many moms walk away from the experience believing that their bodies are broken. Connect with a meetup group hosted by the International Cesarean Awareness Network to talk to other women who are planning or have had successful VBACs, or find support in a Facebook group. Examples include Solace for Mothers (to process trauma) and Black Women do VBAC.
  2. Prepare: Some possibilities here include: prenatal yoga, a VBAC-positive childbirth class and especially one that addresses specific fears (HypnoBirthing is a good option), and chiropractic care for pelvic balancing and encouraging the baby to enter the pelvis in an optimal position. Shannon mentioned that she recommends that mothers planning to VBAC in her homebirth practice strengthen uterine scar tissue by taking 1,000 mg of vitamin C and treating the external scar with vitamin E oil.
  3. Hire a Supportive Provider: I always like to remind parents that their provider works for them, and not the other way around. You hire an OB team, a midwifery team, or an individual midwife, and they work for you. It is critical to find a provider in a practice with a low c-section rate and a high VBAC rate. That way, you know that they walk the walk and don’t just talk about supporting VBAC. Respect, information, clarity, and informed decision making are critical, regardless of the outcome, so work with someone who prioritizes those elements of care. Talk with local childbirth educators, VBAC mamas, ICAN groups, or other resources to find out names of providers with the best reputation for VBAC. Check out your hospitals c-section rate here (USA only).
  4. Birth in a Supportive Environment: Not all hospitals allow VBAC, and of those that do, some hospitals have a higher c-section rate than others (see #3). I tell any birthing parents to investigate the options available to them in the birthing room. What are the policies in that space? Are you able to move, eat, shower, use a birth ball, have supportive people present, etc? Consider birth centers and homebirth as alternatives. Shannon noted that she has had numerous homebirth clients who came her way because they could not find a hospital or birth center that would permit them to VBAC. On that note, if you’re curious about homebirth but unsure, you can always interview one or more local midwives to learn more without making a commitment to an out-of-hospital birth.
  5. Review Your Records: Request the records from your previous birth and review them with your new care provider. Muneera noted that going over her records made her realize that it wasn’t her body that didn’t “work, it was that she hadn’t been allowed to even try to birth at all! A sensitive record review can help shed light on where different steps could have been taken to avoid a cesarean, or can highlight how and why a cesarean was necessary. Both outcomes can help mothers process their initial experience/s and release feelings of shame or grief around their body.
  6. “PositivitySurround yourself with positive affirmations, positive people (ICAN members and Facebook groups, for example) and positive VBAC stories. Connect with others, be vulnerable about your fears, receive love and support, and build positive expectation around VBAC.
  7. Hire a Doula: Studies show that doulas significantly reduce the risk of an initial cesarean. They help to create and maintain a supportive environment for birth, help parents stay focused on their goals, provide information and space for conversations with care providers during birth, and give so much of the emotional encouragement that mothers need during VBAC.
  8. Avoid induction. Induction, especially when using combined prostaglandins (cervical ripening agents such as Cervidil) and Pitocin, increase the risk of uterine rupture and overall have a three-fold increased risk for a subsequent c-section.

Though overall VBAC rates are low in this country (the most recent number I saw was 9.2% in 2010), it’s important to remember that most women (75% according to one study I saw) who attempt a VBAC will indeed have a vaginal birth. Some women will not be able to birth vaginally, and for them, a cesarean may be a critical intervention for her and her baby’s safety.

Process, Prepare, Surrender

My take on a repeat cesarean is this: we question information that is provided to us as authoritative, based not on antipathy towards our providers but because we must advocate for ourselves and our families first with skepticism. From skepticism we gain information, and knowledge. We take steps to prepare ourselves for the best birth outcomes–including emotional processing, physical preparation, and building a fantastic birth team–and we do our best.

At the end of the day, birth is not about being in control. It’s about relinquishing control, surrendering to the force of our bodies, to the force of birth, and framed by whatever our belief systems teach us. This never means giving our power to a system that sometimes chews and spits women out; it means acknowledging that we do our best as mothers, we make the best decisions we can for ourselves and our families in the moment, and we must honor all of that.

Let’s say you did require another cesarean; how might it be different? Include in your birth preferences a list of preferences should that occur. Thinking through a subsequent cesarean is not about chipping away at positive expectations for VBAC, it’s about contingency planning and empowering yourself with information. For example, you can request to have the curtain lowered in order to see your baby being birthed (without seeing the incision site), you can request delayed cord clamping (60 seconds), immediate skin-to-skin, music, and quiet conversation.

For Mothers in the Seacoast New Hampshire, Maine and Greater Boston Area

Here are some resources that I like to share with doula clients birthing in the greater Boston and Seacoast, NH area.

Other reading

Photo Credit: popularpatty, Flickr CC: http://bit.ly/29nT1ej

Edible Weeds: Purslane

boston_herbalist_purslanePurslane, with its tear drop-shaped, jade leaves, has carpeted my garden plot. Michael Pollan calls it one of the “most nutritious plants in the world,” and for good reason. Humble purslane, which takes over areas of disturbed soil (like my garden) or cracks in the sidewalk, is an incredible source of nutrients, including amino acids, vitamins A, C, and E, magnesium, calcium, and potassium. This is what especially motivates me though… purslane has one of the highest vegetable concentrations of omega-3 fatty acids, specifically alpha-linoleic acid. Here I am downing pricey fish oil, when all this ALA is popping up for free!

For those interested in herbalism, purslane is cooling and moistening, perfect for those who are hot and dry, loud, ruddy, and with a tendency towards anger. But, in the summer, it’s a great salad herb because we generally all need some cooling down. Herbalist Susun Weed calls purslane a superior nutritive herb for treating depression and strengthening our bones, making it a wonderful herb for women. I would add that this is a great plant for those nourishing their fertility, because vitamin E is an important antioxidant and critical for hormone balancing.

I first noticed in in Turkish markets where I recognized the familiar leaves; I was so delighted to learn that this was food.  Called semizotu in Turkish, baqleh (بقلة) in Arabic, and verdolaga in Spanish, purslane is used all over the world in salads or sauteed. I love it Turkish style, with strained yoghurt, garlic and olive oil (Yoğurtlu Semizotu), or in a Levantine fattoush. The fresh leaves are used in the summer, and the stems pickled for use in the winter. Here are some ideas from Pinterest.

In the picture above I made a cold grain salad of lentils, quinoa, finely chopped butter lettuce and a mix of bitter mesclun greens, some braised amaranth, cucumbers, and purslane. I seasoned it with olive oil, salt and pepper, and could also have added grilled fish, hard boiled eggs, other finely chopped herbs (dill, parsley and cilantro would be nice), etc. A perfect summer lunch!

PS. I love that when I post about plants, I hear on Instagram and on Facebook about all the ways they’re used in your countries and kitchens. Please share any favorite recipes in the comments below!

 

What does great sex teach about birth?

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Ben Haley, Flickr Creative Commons

(I’m drawing inspiration for this post–and some info for this post–from this great Ted Talk by Kate Dimpfl, a doula in Ithaca, NY. It’s also watchable below and is totally worth watching).

You might be reading this, having had a baby, and thinking “what the hell is she talking about????” Maybe you had a good experience, maybe not so good, but either way, birth is intense. It pushes us past our physical limits (and then some), can feel good, uncomfortable, very painful, or somewhere in between, and is a reminder that we’re just not in control. At least, our brains aren’t.

But hear me out.

I’m not saying that you need to have a pleasurable, orgasmic birth (though some people do), or that you need to be “smooching,” masturbating, or having sex during birth (people do all of those too). I’m saying that the things that make sex good also make birth good. Or rather, the things that support a positive sexual experience will also support a positive birth experience.

Things like:

  • Consent
  • Emotional safety
  • Quality care
  • Privacy

Consent: Does a mama give fully informed consent for a procedure? Has the care provider taken the time to truly explain the procedure, its risks and benefits, alternatives, and whether she has an option to wait? Is she and/or her partner being ‘frightened’ into agreeing to something they’re not comfortable with? Does the mama feel like she has control over the choices being made; that she is able to make choices? Or does she feel a total loss of control over the situation?

This is a different kind of control than the one I mention above. Birth is so much about the mind giving up control and submitting to the power of the body. Birth trauma is linked to feelings of a loss of control over choices that a woman makes about her body…sound familiar?

Emotional Safety: Does a mama feel safe to labor? Does her body trust that she’s safe? Does she trust her caregivers and support people? Are there people in the room who make her feel anxious or uncomfortable, maybe family members who are themselves anxious or fearful, or nurses constantly walking in and out of the room? Does she have reservations or fears about the birth, about parenting, about her care provider or about her partner? Is there a time limit set on what she is “allowed” to do? Does she feel pressure to conform to expectations? Are the mama’s emotional safety needs acknowledged, especially in cases where she has experienced previous sexual trauma, or previous birth trauma?

Quality Care: Does the woman’s care provider approach her with respect, attentiveness, knowledge, and curiosity? Is she treated as a number, a statistic, a machine, or is she a whole person with psychological, emotional, spiritual, physical, and social dimensions? Does the care provider support the woman, regardless of the choices that need to be made? According to a study by doula and researcher Penny Simkin, women’s positive memories of birth were not related to what happened during birth, but rather to how women were treated by care providers and hospital staff.

Privacy: Are there bright lights overhead? People walking in and out of the room? Loud conversation taking place all around, or out in the hallway? Is the door left open? Does mama feel exposed? Are there people standing around just watching her? Is she able to intimately connect with her partner, to feel loved and supported? Think about what it takes for (most) women to reach orgasm.


 

All of the above support a woman’s labor in that they assist in the natural process of shutting down the neocortex of the brain–the part responsible for speech, rational thought, and decision making–and allowing the woman to go deep into herself. Instinctive breath, movement, and sound carry her through dilation, transition, and pushing, bringing her to crowning. The hormones that we see during a pleasurable sexual experience (oxytocin and beta-endorphins) are the same hormones as physiological birth, and they help to mitigate discomfort and pain, promote bonding, and allow the birth process to unfold smoothly.

And why else might it matter? Watch the video below to hear more from Kate Dimpfl about how these factors impact the course of labor, the possibilities of cesarean section, maternal mental health, relationships, and more.

 

Infertility and social media

On Saturday I’ll be speaking at a conference on maternal mental health in the Muslim community sponsored by the Muslim Wellness Foundation in Philadelphia. We’ll be covering infertility, miscarriage, and postpartum depression; I’ll specifically be talking about infertility. In preparation for our conversations, I’ve been speaking with Muslim women who shared with me their own stories of infertility.

Flickr CC: Abigail Batchelder
Yet another one. Flickr CC: Abigail Batchelder

One thing that strikes me about these experiences is that social media is a common source of pain and frustration. As we watch our friends lives scroll by, it can seem that everyone is getting pregnant, everyone’s kids are having birthdays, everyone’s marriage is perfect, that other people’s careers are taking off, that other people live in beautiful places we’ll never visit, that other people just… have it together.

A study in the Journal of Social and Clinical Psychology found that Facebook use is associated with depression when people engage in “social comparison.” That is, when we look at other people’s photos and compare our lives to theirs, our lives can look pretty crappy against a few deliberately shared moments of sunshine. Another 2003 study correlated Facebook use with loneliness, isolation and depression. And yet, we know that Facebook is not an accurate depiction of life (at least, I hope we know that). On my newsfeed today I see posts about a popular Instagram user who decided to quit the platform, calling her posts “contrived perfection made to get attention.”

Facebook is not a pretty place to be when we’re going through something alone. I spoke with a woman today who struggled with infertility for years and now has two children. She worries that people see her life and think it’s perfect, and have no idea how much effort, how many tears, how much stress, went into those pregnancies. She’s worried because she used to feel the same pain when she saw other people’s photos.

Here’s the flip side to that isolation. When we assume that other people’s lives are perfect, it makes it harder to reach out for help. When we assume that other people aren’t struggling, we feel alone and isolated in our experiences. It’s challenging enough to be vulnerable. I know from experience, however, that when we choose to be vulnerable we give others we trust the permission and safety to be vulnerable with us. And then, wow, the stories come flooding in. (If you haven’t watched Brene Brown talk about vulnerability, then check this out).

And really, social media itself is not the devil. Social media can also be a powerful platform for women to connect. Supportive groups and message boards make a huge difference to those suffering with infertility everyday, especially when women don’t feel supported by their families or communities. And, I’m not saying that we shouldn’t share our joy — joy is good and it’s wonderful to celebrate our lives together. But, it might be wise to remember that many, many people are watching. I’m not responsible for how other people feel, and I also choose to share my joy with people who share it back and are here for me when I share my pain, too.

And if we are struggling — and we’ve all got struggles — then we’re not doing anyone any favors by curating a blissful life / Barbie body / ideal family / baking skills on Instagram or Facebook (ok unless you’re Christine McConnell).

PS. You can now install programs like Rather that use key words to swap out images of things you don’t want to see with pictures of things you do want to see, like cats or Gremlins inspired cakes.