Life Is Lifey

Managing The Polarity Of Parenting

On July 13th, I put my 20 year old on a plane, which would ultimately take her to Sydney, Australia. Australia, just so you know, is geographically on the absolutely other side of the world from our house. It exists in the Pacific Rim – a term that makes me feel as though she might as well be in another dimension. Sydney is fourteen hours ahead of our time zone. What that means is that often I close our Blackberry messenger text conversations with “let’s ‘speak’ in your today, my tomorrow”, which is more for my calculations than hers and helps me wrap my head around the fact that we literally exist for portions of each day in two different dates.

As timing would have it, Hallie needed all four of her wisdom teeth removed before she would leave, another ritual of emerging adulthood. This is my child who doesn’t get ruffled by medical procedures and copes stoically through physical pain but because she ended up with a “dry socket” (where the clot doesn’t hold, leaving the bone exposed, just fyi), her post op pain went from not good to really, really bad. We spent the week of her recovery symbiotically immersed. My life was pretty much on hold as I took care of her, just like when the kids were little – shopping, preparing and inventing things she would or could drink or swallow, managing her medications, helping her get up in the morning and settling her on the couch downstairs for the day, helping her get to the bathroom, change her pajamas, bathe her. We even slept together, either in her bed or mine. I thought it was just easier for me to take care of her in the night, but she whined the first night I slept away from her.

The week before Hallie left, she was nearly impossible to live with. It isn’t rocket science. In times of transition, Hallie’s behavior is not unlike the toddler she once was –lashing out in anger rather than talking about what is going on for her. Much of the time, she needs her space. Some of the time, she needs me to set my boundaries so she can still bang up against them, not unlike finding the ropes in a boxing ring. But all of the time, she still needs to know that I love her and always will.

We arrived at Newark Airport before much of it was operating. As we made our way to her airline, I found myself casually on the lookout for other kids with their families gathered around them who looked as though they might also be heading off for junior semesters abroad in the Pacific Rim, in hopes of finding her a “buddy”. This wasn’t unfamiliar. I used to “pimp” for the kids when they were little – trying to round up someone to play with at the beach on vacations, at the playground, on the first day of nursery school.

We checked her baggage. Hallie didn’t want me to stick around. She made it clear that it would be easier for her if I just left. We hugged tight and I drew in her scent as deeply as I could, committing it to sense memory, like an animal.

Managing the polarity in parenting is code for learning both when to hold on…and when to let go.

Cesarean Section Is “Up” Again

Cesarean Section is “up” again. Up in numbers, “up” in that it is an issue. Again. Wasn’t it just 1983 when “The Silent Knife” was published?

I’ve decided to share excerpts of a letter I wrote back to Anna Quindlen in 2006, who had just written an endorsement for my book (The Birth That’s Right For You), which I will always hold enormously dear.

This is my story of my first pregnancy and birth. What I experienced then informed an enormous shift not only in my work, my thinking around Cesarean Section, but also in my personhood; laying the foundation for what would evolve as “my dogma around no dogma”.

………I, too, was a “Natural Childbirth Nazi”. I was teaching Lamaze classes before I’d even had my own children. I fit the perfect prototype; grew up in the late 60’s (minus the drugs), vegetarian since sixteen, attended Hampshire College at the beginning in 1972, wore only sweaters that I myself knit (sick, really) and raised a black lab named River for practice before I became pregnant with my first.

I was hardwired for survival. My mother is a Holocaust survivor, fleeing Vienna on her own in 1938 at seventeen. I approached my first labor like I was in serious training. I had danced professionally for a living. I took ballet class every day and then swam a mile in the pool at the Y.

It was in the locker room after my swim, just at the end of my fifth month, during the daily ritual of applying cream and loving my new body, when I noticed the lump in my neck. Two weeks later, with a team of doctors at my belly for the baby and a team of doctors at my neck, I underwent a five-hour surgery for malignant thyroid cancer that had gone hog wild in pregnancy. I had biopsies, ultrasounds and even a CT scan. The technician took one look at me and asked, “Do they know you’re pregnant?” to which I replied, “It’s kind of hard to miss”. I lay in that chamber with three lead aprons “protecting” the baby and a very full bladder for an hour.

But I still held out, even after surgery, refusing post-op pain medication in the ICU, trying to hold on to some vestige of keeping the baby drug free where I could. Thank God for one ICU nurse who said to me in the middle of the night, ”I know what you’re trying to do…But you aren’t doing the baby any good when you’re fighting pain.” That somehow got through to me and I finally took something to help me sleep.

Three months later I labored for thirty-six hours, the last ten of which were driven by Pitocin. I made it through every contraction, fighting my way through the pain. This was familiar. Give me any physical challenge and I could and would make my way through it. But I was adamant that there would be no drugs. I ended up with a C Section. I never made it past three centimeters after all that work. I’ll never know if I had tried even a half dose of pain medication and/or an epidural as a last ditch effort to avoid a C Section, if I would have just slept and dilated. The irony is that I ended up with an epidural anyway for the surgery.

I was such a “breastfeeding fascist” that I put off the radiation treatment for my cancer, which should have been done right after surgery, but at the time, I was six months pregnant. I wanted to pump and store enough breast milk until I could go back to nursing. There wasn’t a whole lot of research on breastfeeding and nuclear medicine then. I had to give my daughter formula before I was irradiated to make sure she would take it in case I didn’t have enough stored “clean” breast milk to last until my irradiated breast milk came down to nearly the same measure of “rads” as before I was treated. That’s right. You’ve just read “rads” and “breast milk” in the same sentence.

I’m happy to report that despite the CT scans, anesthesia, surgeries, post-op pain medicine, radiation and formula, my eldest daughter, Indiana, has just turned twenty-one, finished up her junior year at Connecticut College, made Deans List and has a really great sense of humor!

Here’s what I know. Life is life-y. I learned that there is no one “right” way and, in your words, “one size doesn’t fit all”…….

(BLOG update – Indy is now 25 and in a doctoral program for psychology, at the end of which she will be able to fully document just how this experience is responsible for all of her issues.)

Mothering the Mother. For My Mother…

My birthday is in February. It was a Thursday and as I drove my daughter to school, I found myself trying to work out – is it my champagne birthday if I’m turning 55 and I was born in 1955? Or was it my champagne birthday when I turned 18 on the 18th, which was in 1973?

We chatted for some of the forty-minute commute we have each morning to school. Given that our local high school is five minutes away, you might ask why in God’s name did we say yes to the request to attend this high school, which may as well be in Zimbabwe for the miles I put on my car doing drop offs, pick ups, trips back down for parent nights, high school dances, evening basketball and weekend football games. That is for another story.

After dropping my daughter off at school, it suddenly came to me what I needed that Thursday morning of my birthday. I drove to the assisted living complex where my mother lives, which happens to be five minutes from school and where I grew up.

I knew my mother would still be sleeping at 8:15 am. In another time, when I was a child, there was hell to pay for waking my mother. But this morning, I parked, walked into the building, climbed the stairs to her floor, walked down the hall and knocked lightly on her door. Her aide let me in, surprised to see me there so early and whispered that my mother was still sleeping. I told her I figured as much, walked into my mother’s bedroom and climbed into bed with her. My mom opened her eyes, looked at me sleepily and said with pure joy, “Oh, it’s you!” She rolled over to make room in her twin hospital bed, wrapped her arms around me and pulled me close. I began our ritual, asking her which “you” I was (my mother has five “you’s”). She answered in her Viennese lilt and feigned aggravation, “Don’t be ridiculous!” I cajole and remind her that I am her Lisele, just so she doesn’t have to grapple with remembering names. I also remind her that as long as she doesn’t call me Fritz, the family German Sheppard (of course) now long gone, we’re o.k.

But I know she knows exactly who I am to her as she holds me close and kisses my forehead. She asks what am I doing here so early in the morning and I tell her, “Today is my birthday”. She pulls back a bit to see me better and make sense of this. “It is?” “Yup. It is. Fifty-five years ago you gave birth to me. And I’m here so my mommy can wish me a Happy Birthday!”

Which is what she did, the way she always has, in German, “Acchhh, Happy Geburtstag, my dahhling.” She pauses, then asks, “If you are fifty-five, how old does that make me?” When I share with her that she is ninety, she takes that in and responds simply and pragmatically, as she always has, with “Vow….”.

And so, on my 55th birthday, I climbed into bed with my mother and the gift she continues to give me at nearly ninety-one is her unconditional love. This, I have come to believe, is what enables me to mother my daughters with unconditional love, whom I hope in turn will then be able to mother theirs from this same place.

I am struck by the notion that maybe this is what is truly meant by the definition of “Doula; mothering the mother” – teaching love this way from one generation to the next, over and over and over again.

My Black Panther Days of Labor and Delivery Are Back

I’ve seen childbirth in this country go through some real changes. By the time I got involved, the childbirth revolution of the 60’s and early 70’s had already established (in most places) that women could have their husbands or partners with them in labor and delivery and they could choose not to be drugged; the birth of (forgive me) Natural Childbirth

In the later 80’s and 90’s, we childbirth educators were teaching expectant couples to beware the pitfalls of routine procedures like IVs, continuous fetal monitoring, artificial rupture of membranes, laboring in bed, pushing flat on one’s back, episiotomy, repeat cesarean section, and how to advocate for themselves.

The birth plan was created. We encouraged people to list their “preferences” around which birth procedures they wanted and which they wanted to avoid in advance of labor and delivery. Seems reasonable, right, not to have to have some discourse on the nature of episiotomy while you’ve got a human head pressing on your rectum?

Couples were hiring me as an advocate then; to make sure that the things they didn’t want done weren’t and that the things they did were. And I endeavored to do so without creating any conflict in the labor room, which was an industrious goal given hospital politics.

And while we worked so hard for and won the opportunity for women to create the childbirth experience of their choosing – doctor, midwife, hospital, birth center, home birth, unmediated, medicated and VBAC (vaginal birth after cesarean), there are a ton of mixed messages out there – from all sides.

In this medical/legal climate, we tell OB’s “We’re hiring you to give us a perfect baby and a perfect mother and if you don’t, we’ll sue you”. (This is partly how we all have come to make some sense of the fact that the practice of obstetrics in this country has become so industrialized and full of interventions.) The inherent message to expectant women is that the OB’s are not to be trusted.

The prevailing message from the childbirth community to expectant mothers is that natural birth, now referred to as “normal” birth, is the “best” birth. We’ve gone way beyond the great, International Childbirth Education Association’s (ICEA) slogan, “freedom of choice based on knowledge of alternatives”. The pressure on a pregnant woman today is to do so much research on childbirth before she has her baby that she could write a doctoral dissertation. And if she doesn’t, she is not being responsible. A woman needs to know all the risks and benefits before she makes any decisions (otherwise she can’t make an informed decision and that’s bad). She is to advocate for herself, even if she is not sure what she is to be advocating for or knows how to do so. A woman is irresponsible if she has a planned cesarean section or chooses an induction or an epidural, no matter how she arrived at that choice. We judge each other for how we give birth, how we parent, whether we stay at home or go back to work.

Here’s what I’m protesting now:

It’s unfair to presume that evidence based medicine means that it’s best practice for every one of us. It’s unfair to presume that every woman is in a place where she needs or wants or is capable at that time of “physiologic birth”. It’s unfair to presume that every woman needs or wants the “journey” and is better off for it. It’s unfair to promote that the best way to give birth is “normal” birth. Normal according to whom?

If we are really going to make a difference in maternity care in this country we have to ask and listen to what each individual mother needs to feel safe and secure. We need to respect each woman’s own perception of her threshold for pain and not presume that if she had only done enough research and/or had the ”right” support, she would do without medication. We need to meet each woman just where she is in her life and not dismiss her choices because she just doesn’t know how empowering a “normal” delivery is. We would emphasize that it is “better” to do whatever – breast feed, bottle feed, practice attachment parenting, let your baby cry it out, stay at home, go back to work, have your baby in daycare or in-home childcare, better to do anything because that individual mother has come to determine that it is better for her. We’d empower each woman by helping her figure out what she wants for herself and support her efforts to get there, not presume that we know what is better for her because we have the evidence based research to prove it.

We have to really listen. And to truly listen, I believe, is to do so without agenda, judgment or dogma.

The new revolution? It’s not really any different than the old one – it’s still about tolerance, respect and trust.