Wednesday, January 27, 2010

In which I am no longer an apprentice midwife

Say WHAT?!?!?!?!?

It's true. I am an apprentice midwife no longer.

But WHY?!?!?!?

Because my life isn't working well right now, and something has to give.

Mainly, I don't have the resources -- the time, the energy, or the money -- to balance my family responsibilities with birthwork. I miss my family and my dog when I'm at a birth, I miss them when I'm doing prenatal appointments, I miss them when I'm home but I'm an absentee wife/mother/owner because I'm birth-hungover. (In theory, I would also miss them when I'm off studying, but I haven't been doing much of that for the last few months, sadly.)

We won't even talk about my personal (not family-related) interests, except to say that a few months ago, when Leigh suggested we start watching The Office from the beginning, I nearly cried at the thought. Because as much as I wanted to see it, I knew that would take even MORE time away from my family and my dog and my schooling, and I would prefer not to even watch it than to add more on to my already-full plate.

Seriously, the idea of watching The Office stressed me out. That was probably my sign.

(I did end up watching it, and I love it!)

But I have this bad habit of being hard on myself, and I couldn't see that I was doing too much. Honestly, it didn't seem like that much to me. I have another bad habit of comparing myself to others; there are tons of apprentices and midwives out there with more kids and more responsibilities than me, so why couldn't I do it? But now I look back and think, A husband and four kids. Three dogs (when I started my apprenticeship). Homeschooling. Not to mention the other things I started doing along the way: cooking, becoming a child passenger safety tech, dog training.

It was actually the Child Passenger Safety Technician thing that got me on this path. I took the class, I got my certification -- but then I found that I just didn't like it. I enjoy knowing about car seats, I enjoy putting thought into what my kids are riding in, but I have no interest in attending community events and installing seats.

It took me several months to get to that point, though. I got my CPST certification in September -- and spent the week after my class in the hospital with dehydration! -- and I just recently came to this conclusion.

It was a really radical thought, though, that I could stop being a CPST  because it felt disingenuous. However, it was also totally not-radical because the world kept on spinning when I made my decision. That was when I started thinking that maybe I could stop apprenticing and I'd survive that too.

Also a contributing factor: the events that led to giving our dog Deuce back to Dustin's grandparents, and giving our dog Tex to my parents. I did not like having three dogs. I admit that. I didn't really want three dogs. But I thought that because I had at one time or another chosen to have all these dogs, I should keep them all forever, no matter what my feelings were. I felt utterly terrible when Deuce went to San Diego, and Tex to Florida. But now I don't. They're happy -- no kids! long walks on the beach! warm weather! -- and I'm happy with just having Maizey. I love her tremendously.

So, I've just discovered that you can realize you've made a mistake and cut your losses, rather than suffer with unhappiness because you feel you "should."

I've also discovered the value in taking time to make a decision. The value in contemplation and thoughtfulness rather than blindly going after whatever you want at that particular second, like a certain two-year-old I know.

Midwifery is supposedly a calling that won't be denied. But I can tell you that missing your family, not having any money (and the stress that causes in relationships), and sleeplessness can really dull those feelings. Right now I am nearly at the point where I resent pregnant women. !!!!

Of course, some of this has nothing to do with my apprenticeship; being a doula at hospital births burns me out. Being a doula felt like a Catch-22: I took lots of clients because I needed the money, because I was spending so much on my apprenticeship and school. But -- duh! -- if I'm not spending as much money on apprenticing, I can turn clients down if I see red flags during the interview. (Which, for the record, I've seen and ignored, only to kick myself later because I should have listened.)

Also, this practically goes without saying, but I'll say it anyway: none of this has to do with Leigh. I love my Lii. She's a wonderful friend who has always been there for me. Telling her that I wanted to stop apprenticing was incredibly difficult, even though I knew that as a friend she'd understand. I told her, truthfully, I'd turn down an apprenticeship with Ina May Gaskin right now. I can't do this right now. I don't want to do this right now.

She gave me a really beautiful compliment, probably without realizing it was a compliment: she said that my life is really full without midwifery.

It is. My life is really full. I love my husband and kids, I love homeschooling, I love cooking, I hate cleaning, I love my dog, I love training her. I can fill up 24 hours a day without even thinking about birth. Thank you for saying that Leigh.

I'm going to continue this blog because one of the other things I love to do is WRITE! But I'm changing the name. If anyone has any suggestions about a new name, let me know!

Saturday, January 16, 2010

In which I have so much to say, but not much time to do it

I'm realllllllllllllllllly tired due to all the births I've attended recently -- six in the last three weeks, but who's counting? I have several birth-related blogs half-written in Word that I want to share, but first I want to give a Maizey update.

Last Sunday she woke up and refused to leave her crate. When she finally came out, she started running into walls and furniture. Her pupils were dilated. I immediate took her to an emergency vet an hour away where she was diagnosed with acute blindness. I was shocked, although it was obvious that she couldn't see. The vet prescribed prednisone, a steroid that would hopefully reduce the swelling that was the underlying assumption for causing the blindness.

She responded beautifully to the steroids and regained her sight. I was so happy.

I took her to an ophthalmologist vet on Friday, who gave somewhat disappointing news: she has/had optic neuritis, which causes blindness. It is treated with steroids; unfortunately it tends to be recurring. The vet gave me a 75% chance it will come back. Each time it comes back, it is harder to treat. Eventually, he believes, she will be permanently blind.

I am somewhat devastated by this diagnosis. She's only 10 months. The vet thinks she will have about five years of sight before blindness.

However, I am grateful that she will have five years -- or will possibly be the 25% that doesn't have a recurrence! -- and the blindness is not life-threatening or painful. She will adapt -- probably faster and easier than I will! It sucks, but I'm still glad that I know a little more about it and how to deal with it if or when it recurs.

Jeannie, a local Cardi-person and dog trainer, is willing to work with me privately to ensure that she is well-trained and well-behaved before she loses her sight. And even if she keeps her sight, I want her well-trained and well-behaved! We're going to meet once a week. I'm also still in Beginner Obedience with her, and plan to start Rally in March. I joined a Yahoo group for owners of Blind Dogs, and someone sent this to me. I think it's wonderful:

How to work with a newly blind dog!!

Jester, our 13 year old frisky boarder collie mix went blind in three days. He has diabetes and at this point, he is not a candidate for surgery. We had two other border collies, Maggie, 14, was blind in one eye since birth (didn’t know it till we did a check up) and Cosmo, who died at 16 and was going blind for awhile.

Anyway, when Jester went suddenly

blind, his eyes literally changed in front of us, we were blindsided, so to

speak. We were trying to learn as quickly as we could how to deal with our “new Jester”. I am not sure what Jester thinks is going on, if he thinks the world is just dark or if it’s him. It doesn’t matter, really, it is what it is to him, and I help him make it work.

It may seem daunting at first, but the “rules” are simple, and pretty soon having a blind dog will be second nature. Jester did sleep a lot a first, but I knew that wasn’t good, so we just went for it, fumbled along and he is now my protector.

First bit of advice, and is almost the most important, is to have a great attitude. When we told people he was blind, and they sounded sad talking to him, his tail went down like he was a bad boy. But if we and others said, “wow, he’s doing great”, his tail was up, and his body language changed. It is really important that you are positive, and that your dog doesn’t think you feel sorry for him.

I realized working with Jester was like working with my daughters when they were young. If they fell, I just helped them back up and moved on. If they got confused, I let them get a little confused and work their way through the problem. You must let your dog be a dog, and let them find their way in their new darkened world.

Don’t carry them up the stairs.

Don’t put food under their noses. Don’t lift them onto sofa or into car. Let them feel their way. Sure, they will get frustrated, but most dogs won’t give up. They want to do it. Jester bumped his nose many times trying to get into the car. He slid down the stairs. It was okay. Pat the sofa and maybe guide them up, or help them half way.

Here are some simple tips and advice to get going. The sooner you get back to “normal” the happier your dog will be and the more progress you will make. Jester goes on leashed walks, unleashed walks and to off-leash dog parks. We go to several places, but try and walk the same routes once there.


Use very simple language. Pick

one word, ie TREE, to warn dog if they are going to bump into something. They actually need to bump into something for the word/warning to mean anything. It needs to be one word, no matter the obstacle. We use TREE, so I say TREE TREE TREE, and he knows to slow down and veer left or right. When we were walking I had to let him walk into a bush or door slowly so I could give the warning. It didn’t take long before Jester knew that when I said TREE he needed to slow down and veer to the side. If he still bumped into the object, I just said, oppsy, and moved on. They will still bump into things, but by giving warning, they will slow down and little damage will be done.

We also have lots of stairs in our home. I put treats on the stairs and as Jester found the treats and tried to go up, I said STAIRS STAIRS STAIRS. Just the one word. And that was for up or down. I would sit on the stairs and coax him down with treats, saying stairs the whole time. Pretty soon, at home he was going up and down no problem. In the park, I just give him a warning, STAIRS when we get close and he lifts his little paw higher and finds the steps.

Dogs have great physical memories and can do a lot more than we give them credit for. Jester remembers the different textures of the ground and adjusts. He can sense if it’s a hill- up or down- he senses the change from sidewalk to street to gravel to dirt to grass.

Keep your home simple. Remind people not to leave backpacks on the floor, items on the stairs, etc. Keep water bowl in same place. When feeding dog, put bowl on floor and call dog to dinner. Tap the bowl or keep picking it up and putting it down. Tell your dog dinner and encourage them to go to the bowl. It gives them a sense of independence and pride.

In the house, chat to your dog, say hello, ask how they are, let them know when you are leaving room and when you are coming back. You should do this a lot initially so your dog will connect the sounds to your movements.

I use Jester’s name, but also say Dude to him. If I say jester, he may feel he needs to come and respond, and if he is laying in the sun, or doing his “biznezz”, I don’t want to disturb or disrupt him. By saying Dude, I am right here, he knows I am there but doesn’t have to come over right away. This is important on off-leash walks, if Jester has gone to explore and I sense he needs to know I am still there. When we first started taking walks, I carried a radio so he would know where I was. I would also just chatter away to myself, so he could hear my voice. Now, I don’t have to so much as he follows me, and his other senses are more tuned in.

We had a dog that would sneak up on Jester, and when he went blind, it was an unfair fight. So Maggie got a bell put on her collar. And that bell was really helpful for walks. If you don’t want to deal with a radio or chatter, carry a bell with you and jingle it.

When we encounter a lot of dogs at the dog park or on the sidewalk, I say Puppies!!! Puppies!!! to give Jester some warning. He does fine, he likes to smell other dogs and get smelled. Sometimes, if a dog suddenly starts barking and then other dogs join in, Jester is unsure if it’s a fight or just playing, so I let him know it okay.

Most people can’t tell he is blind until they look at his eyes or he walks into them. I tell people he can’t see anything but that he loves getting petted, and to go ahead. If I stop to talk to people, I remember to “include” Jester, so he knows I remember he is there. Sometimes people will put there had out for him to sniff before they pet him, I let them know its okay and he loves the attention, so massage away.

When its treat time, I toss dry little

treats on the kitchen floor and Jester smells his way around and finds the treats. I don’t hand feed him. He works to find the treats and feels good about it when he find them.

The best piece of advice I can give you is to be positive. Don’t sound sad. Imagine if you went blind and everyone sounded like you should be put down, or sounded like they wanted to cry or didn’t think you could do anything anymore.

Jester always barked when the postman came by, I thank him now for letting me know the mail is there. He loves car rides like he did before. Sometimes, I can see a bit of frustration when he wants to sniff another dog and that dog moved away and Jester is trying to follow him by scent. That frustration quickly passes. He loves to take walks, smell, say hello and still be Jester.

We have a back yard with a doggy door. Initially, he was unsure going through in once he couldn’t see, but after some coaxing, he uses it just fine. I also made a point of taking him out at night down the sidewalk to pee. It gave him a sense of adventure and a chance to relearn the neighborhood. We go for walks three times a day, and he gets so excited. He finds his way to the car, by following me, he feels his way along the car or listens to me open the door and finds his way in. I pat the seat. At first, he wouldn’t get in, but after a few attempts, he knows that it’s a safe place to op into and if he falls behind the seat, he can just feel his away to sit on the seat.

At the park, we walk the same routes and he recognizes the ground. If we are on the path, he knows when he is going off the path to smell something, and then finds his way back. I am talking to him or one of our other dogs, or just saying, “Right here Dude” “Hey, good job” just making that verbal connection. I don’t use his name unless I want him to come closer, because I learned when I said Jester, he stopped smelling around and came to me. I needed him to know I was just letting him know I was close, but he could keep sniffing away.

At home, we have a few dog beds around the house. He can easily find one to lay down in. This morning, he walked around feeling for the sunny spot on the floor.

You don’t need to have baby gates up everywhere, its better to teach your dog how to navigate your house. They can and people need to let them. By putting up barriers, you are telling the dog they are no longer welcome in much of your home and treating them like they did something wrong, they didn’t. Spend time now with your dog and soon they will get around just fine.

Be upbeat. If they bang their

noses, go Caboomy or something silly and move on. If you say TREE and they successfully dodge the obstacle, say GOOD JOB, so they know they dodged something. Warn them about steps and stairs. When stepping off or up a sidewalk, I say step. That’s it. If he slips, so what? Your job is to pay attention to your surroundings, be upbeat, give warnings, give praise, let others know and remind them your dog is amazing. They will bump into things, they will get nervous, they may snap at a dog who is too pushy, that’s okay. Just pay attention, and let your dog still be a dog. They can do this and we need to let them. Don’t do for them, re-teach them how. Its like working with a toddler. Find the right balance of protecting them and letting them be who they are. They need that.

Friday, January 8, 2010

In which Tour de Birth 2010 starts

I wrote this blog about 10 days ago but then things got crazy with more births, and Maizey's optic neurtis, so I am just now getting around to posting it.

The new decade is but 8 days old and I've attended two births. Two awesome births, to be exact. (And after that I missed one with Leigh because the labor started just after I got home from the second birth, which had been a 24-hour marathon. Thanks for letting me recover, Leigh!)

Both moms had beautiful natural births in comfortable environments and I was honored to be a part of their experiences.

Being a labor support person in any role can be challenging, whether it's as a doula or an apprentice. I try to make sure that before my doula clients go into labor, they know that they can say anything to me; they don't have to sugarcoat it if they need me to STFU during labor.

But first time moms are the most difficult because they've never labored before; they don't know how they'll feel or what they will need during labor. If they're having an intense experience, they might not be able to put their needs into words. And of course, I don't want to interrupt their rhythm by asking a bunch of questions. So it's a challenge.

Many labor support professionals have certain things that they have found that work with most clients. Leigh once grabbed a laboring mom's feet and she loved it. After that, the mom would say, "Feet! Feet!" as a contraction was starting.

A few days later, I attended a birth and grabbed the mom's feet during a contraction and she shrieked, "Stop touching me!"

It takes all kinds.

I used to take a lot of "stuff" with me to births. I'd have a Birth Ball, a rice sock, a tennis ball, a small massager, some positive affirmations or a birth book or two. However, after reading Spiritual Midwifery by Ina May Gaskin, I decided that the most important thing I can do is express love for the mom. Yes, that sounds really cheesy, and no, I don't love every client. But I can express my love for what the mom is doing, my belief in her and her body, my compassion and empathy for her, and my encouragement. And that's all I usually need. If she wants other stuff, she can get it for herself.

That leads me to something that someone said to me recently, which was that a doula can do too much for the laboring mom. Honestly, I'd never thought about that. I always want to make a laboring mom as comfortable and happy as possible. But, once in a while I see a mom whose labor takes a long time because she's just not willing to get to that uncomfortable place. Labor can be very uncomfortable. It doesn't have to be painful, but there's usually some amount of discomfort involved, and if the mom isn't feeling any discomfort, she's probably far from giving birth.

Achieving a medication-free birth is a feat; it takes hard work, it takes perseverance, and it takes a lot of support. But in the end, only the mom can do it. I can't take it away from her -- and I don't want to. I love this blog which compares preparing for a medication-free birth the way one would prepare for a marathon. I have never run in a marathon and I don't plan on it. But if I did, I wouldn't want to be carried across the finish line, even if I were uncomfortable and in pain and wishing I'd never signed up for this stupid marathon in the first place. Anybody can be carried across the finish line. Not everybody can actually step across it.

Friday, January 1, 2010

In which I share Sydney's home birth story

This is a very brief version that I wrote out for my local mommies group. It's just the labor and birth/info. At some point, I hope to write the longer version.

My water broke with my fourth baby on October 12. Just like with my previous labor, I slept through it and woke up in a pool of water. I called my midwife, who had traveled from Louisiana to attend my birth. We did not have any homebirth midwives in my small town in Arizona, and the closest midwives were over three hours away, in Phoenix or San Diego. I have a history of short labors – a blessing and a curse! – and I didn’t feel comfortable with a midwife who was that far away. My midwife had arrived when I was 39 weeks pregnant. She was staying in a nearby hotel with her two children. I had done my own prenatal care. I was now 41 weeks pregnant.

So, my water broke… and nothing happened. For two days. Over the course of those days I drank castor oil, tried an enema, used the breast pump, and took blue and black cohosh. Still I felt nothing, not even a twinge of contractions. I was practicing good hygiene, taking vitamin C, and listening to the baby’s heart tones by Doppler. And waiting. Finally, after a day and a half, I talked to my midwife about my options.

I wasn’t worried about my water being broken for so long. I was more worried that she’d want me to go to the hospital. I’ve given birth in a hospital with an epidural, to my twin boys in 2003. I’ve given birth in a birth center with a shot of stadol, to my girl in 2005. For this birth, I wanted to be home.

I called her, and told her I needed 12 more hours. If, after 12 more hours, I still hadn’t gone into labor, I’d go to the hospital; I’d get the dreaded pitocin (and probably an epidural and a series of other interventions).

As soon as I hung up, the contractions began. It was like my body needed me to verbalize that I trusted myself before labor would start. The contractions started coming quickly and without much of a break. I remember thinking, “This is absolute misery.”

I asked my husband to fill up the birth tub. I got in, and I said, “Wow, this is so nice,” – until I had another contraction. At some point my midwife arrived, and my best friend who was acting as my doula.

I wanted absolute silence and darkness. It was around 1AM, and my three older children were asleep. Everyone tiptoed around, and I shushed them. At one point the midwife tried to get heart tones, but I shooed her away. She said something about it, like, “I am not taking the baby’s heart tones, are you alright with that?” I nodded. The baby was moving like crazy, and I knew she was fine.

After that I felt the urge to push, but my brain was telling me it was too soon. I started to get out of the tub so my midwife could check me, but I just couldn’t leave that warm water. Instead, I reached down and could feel the baby’s head. I pushed a few times, grunting loudly, and felt her head come out. I remember saying, “Her head is out. Now what do I do?” I really could not remember what would happen next.

My midwife said, “Push the rest of her out.” So I did. I pushed her out and brought her to my chest. She had a nuchal cord, and seemed to be around 8lbs. She was perfect, and I was exhausted! Sydney was born on October 14, 2007 at 1:32AM. She was 8lbs 8oz.