Friday, October 27, 2006

Rocky Mountain "Hi"

At the Denver Art Museum I was struck by two artists and their work. The first, by Paris-born sculptor Louise Bourgeois, reminded me of the famous midwife of the same name who, centuries ago, used "mock mothers," dummies, that she fashioned out of wicker and leather to teach other midwives about the mechanics of birth. Some man-midwives (men attending birth) around the same time, were experimenting on real mothers, often prostitutes or destitute women who gave over their bodies for study in order to receive free maternity care. Bourgeois, the (still living) sculptor, created a giant bronze eviscerated carcass, hanging from its haunches from the ceiling. The grotesque figure stopped me dead in my tracks. Obviously, I connected all the dots in my head, and thought of how the man-midwives saw these poor mothers as nothing more than a lump of meat to feast on.
Another artist portrayed the Mona Lisa as obviously pregnant -- that is why she is coyly smiling, afterall -- exposing the fetus in a cutout of her belly. I felt like birth was following me everywhere. Indeed, it followed me all the way to the Tattered Cover's newest bookstore on Colfax, in what used to be a theater. After my talk, the questions focused on cesareans, and why so many women are having them. A labor and delivery nurse/doula who works in a rural hospital (that does not have 24-hour anesthesia coverage) said that her facility had banned VBACs, or vaginal births after cesarean. Of course, such bans are the real reason why the c-section rate is rising so dramatically, to 33 percent. But her story brought home how women, simply by virtue of where they live, are limited in their birthing options. It's a shame.
Next stop: Seattle, on Nov. 1, 7:30, Third Place Books in Ravenna.

Denver tonight

My website had the wrong address for my Tattered Cover appearance tonight. Here is the proper info: 7:30pm at The Tattered Cover on 2526 East Colfax Avenue.

Thursday, October 26, 2006

Phoenix (up)rising

There was another great turnout at a reading tonight, in Phoenix, at Changing Hands bookstore. The crowd was comprised of pregnant women, new mothers, grandmothers and even some kids, but the thing that united them all was a sense that we, as a society, should be talking more about birth, and we should go beyond expecting or appreciating a healthy baby -- we should also value a woman's experience. One woman, who had had two cesareans decades ago, said she felt less like a women because she did not get a vaginal birth, something she was "really up for." She wanted to know if higher c-section rates were contributing to increased incidence of postpartum depression. I think a lot of things are leading to more and more postpartum depression -- from women being disappointed, to having little or no support after the baby is born. In other cultures throughout time, women would often be supported by family and neighbors for more than a month. The mother could ly-in with her baby while others prepared meals, did the laundry and looked after other children. It's an idea whose time has come. Ahri Golden, of Thin Air Media (see the Berkeley posting below)is pushing the concept of time banks for new moms. Check out http://www.timebanks.org. At the very least, bake a lasagna for your neighbor when she has a baby. It's the tend and befriend system (likely an adaptive behavior) that women have used for their safety and protection throught the ages so they would have a social network to help them when men were off hunting wooly mammoths.
On a more serious note, I am posting the address for the National Stillbirth Society, founded by Richard Olsen, who was the first one seated in the bookstore for my talk. His story is on the site. www.stillnomore.com
Next stop: The Tattered Cover in Denver tomorrow night.

Park City

The event at the Spotted Frog was a great success, as dozens of readers -- including three pregnant women, many dads and two midwives -- sat around a fire, sipped wine, and asked pointed questions. The discussion continued well beyond the reading, and conversation followed me back to the home of friends Paul and Katherine, who live in Park City. In fact, it was the men who seemed the hungriest for answers about the eternal debate between natural vs. medicalized childbirth. (It was well past midnight when we realized the debate should be suspended for the time being.)Passions ran high on all sides, but at least no one ended up in tears, which is how the event at Kepler's concluded, with a mom who was sad about a c-section from a breech, along with her baby's heart defect, requiring surgery. "We're both scarred," she said.

Tuesday, October 24, 2006

From a doula...

"At age 50, I am writing my first piece of fan mail. I have been a childbirth educator, doula and doula trainer for 20 years, but more importantly, I have loved birth all of my life. I’m sure you’ve encountered women like me in your research – women who, for all kinds of reasons, or no reason at all, simply just love birth, breastfeeding and women’s bodies. And lately, with the c-section rate climbing to nearly 40% in my area hospitals, I’ve needed to defend my views on the normalcy of birth to almost everyone. I thought my knowledge of birthing history was relatively extensive. Until now.

When I first read the New York Times review of your book, I said to myself: “just what the world doesn’t need – more ammunition for the public to use about the horrors of birth.” Never the less, I couldn’t get to the bookstore fast enough. And I certainly couldn’t read your book fast enough. I reread parts of it. What I was most impressed with was your ongoing message that we, in most cases in the past and present, should just leave birth alone. I loved your support of midwives and doulas and women’s ancient wisdom and how men, to put it politely, changed everything. You made it very clear that it was usually interference (and ignorance) that made birth so dangerous (and that is certainly still the case today.) I so appreciate your balanced views.

As a doula trainer, I have already made your book required reading for my workshops and I’ve been quoting you extensively.

You are wrong about one thing, though. Those of us who choose homebirth are not brave – we’re chickens. Hospital birthers are the brave ones for putting themselves on that slippery slope of intervention the minute they walk into the institution. Talk to fellow Bostonian Nancy Wainer about supporting you for a VBAC!

My best wishes to you, not only as a young mother but certainly, as the excellent author that you are."

Fresh Air feedback part II

This entire document comes directly from a nice man named Murray who seeks responses:

A Childbirth Experience

During the birth of my son David (a breech presentation) it was noted that the birth was not progressing well in that he was not moving down the birth passage. An inspection of the passage with my hand revealed that his legs were up thereby requiring a larger than normal opening for delivery. During the inspection, I discovered that touching and ultimately massaging a certain location in the passage produced strong muscular contractions which further dilated the passage. By periodically massaging the respective tissue in that location so as to simulate the normal expansion process characteristic of the first stage of childbirth, the passage was opened sufficiently to allow me to pull his legs down one at a time, after which he slipped out without further effort on my wife's part.

The area where I massaged, as far as I am aware, has not been medically identified with the sensing and control properties that I have described. Neither my son, now an award winning M.D. in general practice (I have bragging rights), or other doctors or midwives that I have provided this information to have related experience or knowledge.

It would seem that in a head down birth, the baby’s head contacts the sensitive area of the passage that I had discovered and performs the same function as my hand had to produce the periodic contractions characteristic of the first stage of childbirth. Since the head would normally be in contact with and covering that area, its effect on the contractions would be difficult to detect thereby explaining why the "Feller” nerve had not been previously detected. Leave it to an Electrical Engineer to discover. It is of course recognized that the “Feller” nerve may already be known but that its functioning as I have described it, had not been previously observed. It is also possible that my wife is unique or that some other explanation is valid. Since this birth experience relates to only a single event, it is evident that considerable research is needed to ascertain precisely the functioning of the related mechanisms. For the moment however, the “Feller” nerve explanation seems most plausible.

As a further consideration, it may also be that the “Feller” nerve, when pressured by the head of a fetus which has reached its limits of growth in a confined area, is the direct initiator and/or the regulator of the of the birth process, an item which I understand, had not previously been well understood.

Since my son was born in 1964, my experience although mentioned to several doctors and midwives, has not sparked any interest that I am aware of in the medical community. My experience however, suggests that the massage technique could be useful for managing births and in particular, breech births, and that it could be helpful in reducing the need for cesarean procedures. Of note is that with the massaging, the dilation of the birth passage was so effective that expulsive efforts on the part of my wife were not required. The risk of tearing was eliminated and the total time between the manual rupture of the amniotic sac and my wife taking a shower and dressing after the birth was only about 4 hours.

David was my second child. My first, Lisa, was born 2 years earlier on the same Saturday within 1/2 hour. Conception had been planned for a birth during the late winter so that the child's digestive system would be mature enough to handle the fresh fruits and vegetables of the following warmer seasons as they became available. My wife and I had explored various childbirth methods and not having discovered medical practitioners practicing those arts to our satisfaction, elected to have our births at home by ourselves. My wife was very diligent in mastering birthing techniques and was well rewarded for her efforts. Our daughter was born head down in about 3 1/2 hours with relative ease, after which my wife took her shower and dressed.

Of further note is that for a year prior to the conception of our first child and thereafter, we consumed mostly minimally processed organically grown foods. We used the placentas from both our children’s births for fertilizing melons-worked great.

My health maintenance efforts rely on the "minimum risk approach". I make an honest attempt to be knowledgeable of and select the best practically available food, water, air, environment and life style while minimizing exposure to high risk factors. That "honest attempt" does not make it easy because it requires constant surveillance, evaluation and decision making which would be largely absent if one merely went along with local custom. The hope is that these efforts will be rewarded with a significantly longer and healthier life and that my mental processes will be based upon reason, personal responsibility and the quest for knowledge and improvement.

Fresh Air feedback

My interview on Fresh Air really seemed to strike a nerve. Here, in no particular order, are some of the comments I received from total strangers. I will post them separately so that people can comment:
"I heard you speak on the radio today and I wish you luck with your new book. It sounds very interesting. However, there is something that surprised me about your childbirth experience. It appears that you were surprised when you first entered the hospital about their policies and procedures concerning the birth process. Since you appear to be so well-informed, I was surprised that you did not choose a hospital that had policies and procedures compatible with how you wanted your birth experience to be. I had my son 20 years ago and, even then, it was part of many women's education to decide what kind of experience they wanted and choose a compatible hospital. That's why I chose Newton Wellesley. First and foremost (and the most important requirement for me) is that they did not have any medical residents in obstetrics. Secondly, they did not require a fetal monitor and I was able to eat, and even drink throughout. I had a midwife and used the birthing room. I was 2 months short of 42 years old!"

My response:"Debra, thanks for writing. I was informed. I had a birth plan. I
specifically stated that I did not want an epidural. I did not want
residents attending. I did not want an EFM. I did not want an IV. What
I was ignorant about was the level to which hospitals ignor birth
plans, and push all of the above as standard. I also asked for a
midwife, and was told to she was too busy to deal. I think alot has
changed in the last 20 years and much of the progress made as a result
of the natural birth movement has been lost. I hope you enjoy the
book."

Fresh Air in San Francisco

My interview with Terry Gross aired today on NPR. (Check it out at http://www.npr.org/templates/story/story.php?storyId=6374616). Already I am getting emails from around the country from men and women sharing their amazing stories and wanting to talk more about childbirth today. Please feel free to post here. I will be giving a talk in Menlo Park tonight at Kepler's, a lovely independent bookstore, followed by another event in Park City, Utah, tomorrow, at the Spotted Frog.

Sunday, October 22, 2006

Babies, barefoot, and Berkeley

As I was driving over the Bay Bridge, my sister-in-law, Annmarie, called with some news: She's pregnant! Annmarie is quoted in my book, looking into the future, saying that she would prefer a scheduled c-section whenever the time came. But after she read my book, she said she had reconsidered. It will be interesting to see what happens. Regardless, I'm so excited for her and my brother, Jake. The phone call came as I was heading to see my OTHER sister-in-law, Amanda Bower, who just had her second gorgeous baby boy, Callum Flint. He was born by scheduled c-section, just like the first, who was breech. Amanda vascilated between a VBAC and another section, but the 10-page liability waiver her OB gave her pushed her over the edge, and into the OR. In the end, it was a good thing, because the cord was wrapped around the baby's neck and had a true knot in it. I was expecting to hear many more dramatic stories tonight at The Birth Tour, here in Berkeley. And indeed, I did.
The gathering, in a yoga studio, involved people sitting barefoot on pillows and sharing stories of how they were born, as well as how they gave birth. The gathering was the final stop on a nation-wide tour put on by Thin Air Media, which has collected many such tales on tape, to be played on NPR next year.

Saturday, October 21, 2006

Blowing through Chicago

Somehow I managed to get myself from Madison to Chicago, through rush hour, in time to settle my backside into a chair at the WGN radio studio at the Tribune Tower for a 30-minute live interview. And somehow I managed to not be distracted as pedestrians on Michigan Avenue waved and gawked through the plate glass windows that encase the ground-floor studio. One caller delighted in telling us how easy it is having kids. Kathy, the host, was rolling her eyes. Another woman wanted to know if baby slings were the perfect solution to the two-stage gestation issue. (That is, we give birth to babies at much earlier stages in their development than other mammals -- think of horses that can walk soon after birth -- because if we waited any longer the kid would be too big to push out.) I agreed the slings were a great idea, allowing us to act like kangaroos, carrying around the baby until they were old enough to get around on their own.
Then on to the lovely Ambassador East Hotel, for an XM Satellite radio show hosted by Judith Warner, whose column in the New York Times I always enjoy. Warner, whose children were born in France with the help of midwives, said she was surprised by how "bad doctors come off" in my book. True, it's not a pretty history. Today, in America, obstetricians do high risk very well. They do low risk poorly.
The day wrapped up with a great talk at the Women and Children First book store. The event was attended by, among others, one of only three lay midwives in the giant city of Chicago. She wants to know when health insurers will start properly reimbursing midwives for their work. Good question. Next up: The Bay Area.

Thursday, October 19, 2006

Marvelous (and Maraniss) in Madison

Before it was my turn to sit before a microphone at the Wisconsin Book Festival, I dropped in on a talk by home-grown literary hero David Maraniss, author of the recent biography of baseball legend Roberto Clemente. One of the things that struck me was how Maraniss said he had lost sleep for months as he neared the end of writing a Bill Clinton biography a decade ago. Maraniss had trouble reconciling the conflicting aspects of the president's personality. What was the essential truth of Bill Clinton? Finding the essential truth, Maraniss said, is what drives all of his writing. And the truth is, there are many truths, and rarely is it black or white. This idea struck me again an hour later, after my talk, when someone asked what the best way is to give birth. "It must be at home, with a midwife, in an upright position," one earnest man said asking and answering his own question. The truth is...I believe the best way to give birth is however a woman feels comfortable. If it's at home or at a hospital, she needs to feel safe and supported, or else labor might not go so smoothly. Consider the case of monkeys who, when they feel frightened during labor (predators lurking?) actually stop contracting. The human equivalent of this is "white coat syndrome," where expectant mothers' labor stalls when they get to the hospital. Why? Because they are surrounded by strangers in uniform. (Perhaps that is why half of all women get Piticon after they arrive on the maternity floor.) But the same stalled labor could happen if a woman is home alone...
I shared the microphone with Laura Kipnis, professor of media studies at Northwestern; she just wrote The Female Thing: Dirt, Sex, Envy, Vulnerability, which looks at the state of feminism today. She, too, was asked the classic prescriptive question: What's a woman to do? Work outside the home or inside of it? Kipnis ducked and dodged, saying that while we have been so busy trying to do all the things that men can do, she neglected to ask the question about whether the things men were doing were actually worth doing. Of course, there's one thing men can't do: Give birth. Though if Kipnis had her way, neither would women. At least not vaginally. According to her, technology (a la cesareans) is the ultimate feminist choice. That may be, but unless a women really needs a c-section, three recent studies have found that the operation is more dangerous for mothers and babies than vaginal birth; babies benefit from labor and being squeezed through the birth canal helps clear their lungs and gets them breathing. To say nothing of the fact that major abdominal surgery can invite complications. This, I know, is true. And if more women knew that, they might not want a c-section unless they really needed one.

Taking flight in Milwaukee

I had a feeling, when I first saw architect Santiago Calatrava's gorgeous pavilion he designed for the Milwaukee Art Musuem, that this city had a way of embracing new ideas. The structure, which looks like a bird about to take off over Lake Michigan, was inspiring as I passed it on my way to Harry Schwartz Bookshop last night. Indeed, I felt some wind beneath my wings at the reading, attended by childbirth educators, doulas, mothers and women curious about history, health and the strange story of man-midwives dressing in drag. The conversation amongst themselves even continued after I had left. One woman said she is sensing a pendulum swing, with some mothers starting to rebel against the over-medicalization of childbirth. To that end, check out a new report released today by Childbirth Connection, a group that has been around since 1918 to improve maternity services. The astonishing survey, called Listening to Mothers II, asked more than 1,500 women who gave birth in an American hospital in 2005 what their experience was like. Go to www.chilbirthconnection.org. Next stop: Madison.

Wednesday, October 18, 2006

If it's Tuesday...

...it must be St. Paul, Minnesota. A city that is clean, friendly, and as my cab driver told me, loves winter. Which is why I am sitting by the fire at the St. Paul Hotel as I reflect on the Charles Schultz (native son) statue of Sally reading an open book on her lap, a fitting metaphor perhaps for this tour. After I signed a stack of books last night at Micawbers here, the very nice ("Minnesota Nice") owner of the charming book shop drove me back to the hotel, past the house where F. Scott Fitzgerald (another native son) grew up. It's not surprising that so much creative talent has come out of here -- especially since the only alternatives are ice fishing, ice sculpting, and snow mobiling. Next stop: Milwaukee.

Monday, October 16, 2006

Cleveland

Today, before my scheduled reading at Joseph-Beth Booksellers on the outskirts of Cleveland, I stopped in at the Rock and Roll Hall of Fame, where I marveled at a display of costumes and realized that Britney Spears's clothes (even from her first tour) would be too big for Mick Jagger (even today). But the best part of the visit was stumbling, anew, upon Menudo. I had forgotten about Menudo. That's why I love digging in the bins of history. You never know what you will find. Thankfully, the pop group was a little like Leboyer Baths, a short-lived concept that we can chuckle about today.
After that, unsure what else to do in this town, I headed over to the book store a bit early, and was introduced to "our resident autograph seeker," as he was called. The man did not ask me to sign MY book for him. No, he asked me to sign HIS book for him. It was a slim book -- a classic autograph book, which was numbered 300-something on a little white sticker on the cover. "Sign it to Charles, like the prince." My mind was racing. What on earth was going on here? I just did what he told me to do as he explained that he had 30,000 autographs in his collection. The names were stored in an alphabetical database on his computer. He had Salvador Dali's signature, which he had procured just 15 minutes from the very place in Lyndhurst where we stood. He also had Bogey and Bacall's, Woodward and Bernstein's. What, I asked him, possessed him to want mine? "Yours goes in the creative arts category," he said. With that, I handed him back HIS book, and thanked him.

Friday, October 13, 2006

Beginning my book tour

I leave Boston in three days, boarding a plane for Cleveland, where my 14-city book tour begins. And it seems like I'm in my ninth month of pregnancy: My bags are packed, the house is clean, there are prepared meals in the freezer (or at least there will be before I depart) and my husband is incredibly anxious. ("What's your mother's cell phone number again?") I also feel like I'm about to explode. With anticipation. I've been waiting for so long to talk about my book with people all over the country. I feel like it's been a generation since we've discussed childbirth in the context of our culture. What does birth mean for women today? Are we doing it right? Are other countries doing it better? Do we feel more empowered than ever as women or has the act of birth become just another item on our to-do list? Judging by the radio interviews I've been doing for the past three days, I will probably be spending most of my time talking about why birth is difficult, why so many women are having cesareans, and whether it's a good thing to have men present in the delivery room. But I hope the discussion goes even deeper as I touch down in St. Paul, Milwaukee, Madison, Chicago, Berkeley, Oakland, San Francisco, Salt Lake City, Phoenix, Denver and New York. (Seattle, Miami and Fort Lauderdale to come a little later.) Anyway, if we don't meet on the road, perhaps we can talk here.