From “Natural Childbirth” Devotee to Doula | What I Learned As A Young Mother

I once was a “natural childbirth” devotee. I was teaching Lamaze classes before I’d even had my own children. I fit the perfect prototype; grew up in the 60’s (minus the drugs), vegetarian since sixteen, attended Hampshire College at the beginning, wore only sweaters that I knit myself and raised my black lab, River, before I became pregnant with my first.

I approached my labor as serious training. I had danced professionally for a living so I took ballet class every day, swam a mile and ran through my fifth month of pregnancy.

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 with everyone in the room that there would be no drugs.

I never made it past three centimeters after all that work and ended up with a C Section for “failure to progress”. I’ll never know if I had tried an epidural as a last-ditch effort to avoid a C Section if I would have slept and dilated. If only someone had helped me connect the dots that I would ultimately have an epidural for a C Section so why not give it a try beforehand?

Dogma. I learned so much about my own dogma from my first birth. My dogma around no drugs left me without being open to utilizing a tool that might have prevented my C Section.

Lisa Gould Rubin and her first Child IndyFrom then on, when helping people prepare for their births, we talk a lot about staying flexible in order to make decisions that are aligned with your goals, especially when things aren’t going the way you imagined.

I refer to what I call the “leaving no stone unturned” question. Ask yourself – when you are in labor, what does leaving no stone unturned mean to you around what you are willing to try in order have the birth that’s right for you? It also means trusting yourself to know when you feel you’ve tried enough for you.

Another way to look at it is this: if you were able to have hindsight in advance of your birth and ask yourself “what would have happened if…?”, and then try to take care of your “if’s” in advance. It helps to alleviate second-guessing yourself at the other end.

What would one of your “ifs” be?

Peace on Maternity | Newborns and Dogs

From the time he was a puppy, I knew Peace had the perfect temperament to be a Therapy Dog and so many years ago, we certified as a Therapy Dog Team.

Peace, a certified therapy dog He loves his visits with the children on Pediatrics at UVM Medical Center. As soon as I take out his Therapy Dog bandana, he gets excited and heads for the door.  He knows exactly where we are going.  I have to give us at least twenty minutes or so just to get from the parking garage up to the fifth floor because so many people want to pet/hug/admire/love/take a picture of Peace as we make our way through the hospital.

He is an enormous Golden Retriever; weighing in at about ninety pounds (down from one hundred given his eleven years, size and proclivity to arthritis).  We say he is a Golden channeling “Newfie”.  If I had a dollar for every time someone remarks on how huge his paws are, I’d be inordinately wealthy.  The answer I’ve come up with to the question I get more often than not – “Why is he so big?” – is to say that Peace needed an extra-large body to house a heart as big as his...

It had been a dream of mine forever to pioneer a Therapy Dog Team on Maternity.  Where else would a Doula and her Dog want to be?  So, after some research around protocol and the support of the midwives and nursing staff, Peace and I began our visits to the Mother/Baby unit.

Once we announce ourselves at the Nurses Station, the staff come from everywhere to love on Peace.  Then we begin our trip down the hallway, knocking gently, opening the door a crack and ask “Would you like a visit with a Therapy Dog?”

Almost always, the answer is a resounding YES PLEASE! For the mothers who have delivered and miss their dogs they have left behind at home, Peace brings much-needed comfort.  For the first-time mothers who have left behind their “firstborns”, the dogs they have raised before giving birth, Peace helps them allay the anxiety around going home and introducing their human babies to their dogs.  They have the chance to practice right then and there, lifting their new babies for Peace to smell and nuzzle.  We visit with the mothers who are on bed rest for preterm labor, have experienced miscarriage and loss and recovering from surgery. Mothers have sat on the floor hugging him and sobbing into his fur.

Peace is always gentle and kind and knowing.

One Doc said it right; Peace is the best medicine in the hospital.

Doesn't it just make sense to have Peace on Maternity at every hospital?

My firstborn daughter has given birth to her firstborn daughter

Baby Lena made her way in at 2:25 pm on January 7, 2019. I was there as MotherDoula.

Everyone gushed about how excited I must be to become a grandmother. I was really excited that I finally was going to have a “take my daughter to work day”! But I couldn’t really know what it would feel like to become a grandmother. I’d never been one. What I did know was that in my lifetime I deeply hoped for the opportunity to usher my three daughters into motherhood.

Right from the beginning of Indy’s pregnancy, I realized that there was an inherent conflict in our circumstances. Indy wanted my support, guidance and expertise as a doula and as her mother. Yet I know both professionally and personally that daughters need to separate from their mothers in order to become mothers themselves.

As a birth worker, these roles are inextricably intertwined.  Doula IS mother.  I am, essentially, a professional mother; mothering mothers.  How would I gracefully navigate this very tricky space; a nuanced combination of input and no-put and know when to do which.

I started to learn that when there was pushback, I needed to let it go; sometimes with palpable frustration and sometimes with grace.  And as a professional, responsibly follow up with articles and research, signing off with “let me know your thoughts”.

When Indy wrestled with getting an epidural in labor, she said in a moment of frustration, “Just tell me what to do, Mom!”.  As her mother and her doula, having been asked this very same question many times over the decades, minus the “Mom”, I gently, knowingly and lovingly told her, “I cannot do that, Ind.  Only you can make that decision for yourself.”

Knowing how terrified Indy was of getting an epidural, I knew from that very deep Mother place exactly what I needed to do. I went out to the nurse’s station, where they were all sitting around. I had specifically decided not to wear scrubs as I always do to show up as mother.  One nurse swiveled in her chair toward me and asked in that tone I have heard too many times throughout the years; the one that implies you are a nuisance and why are you interrupting us? (Interrupting what is debatable…). “Can I help you?”. “Yes”, I said nodding my head slowly, “Yes. You can. The patient in room four; she’s my daughter.  And I am also a doula of thirty-five years. She is waiting for her epidural and she is absolutely terrified of the procedure.  I don’t know who is on for anesthesia tonight and I am not sure what the policy here is for support people in the room, but I cannot leave my own young without either me or her husband to help her through it.  So, I am asking all of you, as a mother and as a doula, to do whatever you need to do to make that happen. Please.”
Both Dave and I were in the room to help Indy get her epidural.

After Indy gave birth and was resting, she asked me if I wanted to know the baby’s name.  She and Dave had kept it secret.  I get this because I did the same thing with Indy and her sisters. I wasn’t interested in hearing people’s opinions about their names for nine months.  In fact, the girls were given the honor of being the first to hear each sister’s name whispered into their ear just after birth and then announce it to all those gathered.  Only this time, twenty-five years since the last sister was born, the name Indy was sharing was her daughter’s.
Lena

I wept.  After keeping it all together to navigate Indy’s glitchy birth, the baby having to go to the NICU and Indy requiring medication that would keep her bedridden for twenty-four hours, I lost it.

Lena was my mother’s mother’s name.   My mother had to leave her parents in the middle of the night when she was seventeen.  With the help of the Jewish Underground, she escaped Nazi occupied Vienna, but she never saw her parents again.  My mother didn’t have her mother to help her become a mother…

Lena is amazing ?!    And, she is a joyous reminder of the extraordinary gift that Indy, Lena and I have been given; that we are all here, together.  We get to experience and hand down motherlove, learning how to balance loving and letting go, a life-long process that begins at birth, from mother to daughter, new mother to new daughter and grandmother to granddaughter.

And this was just my first “take my daughter to work day”…

Altered States…

I am now being invited to attend the births of my eldest daughter Indy’s friends.

Wow.

These are the same girls (now women) who sat at my kitchen table in high school eating homemade chocolate chip cookies while we discussed birth control and heartache.

Those who come to the house for Good Birth Class (instead of meeting online – I DO work with Millenials) now sit pregnant, on the very same couch they made out on. Talk about altered states…

Last month, I had the honor of helping to usher in baby Jack. Jack’s mama, Molly, has been Indy’s best friend from the time Molly was 18 months old. I helped Molly’s mother labor 27 years ago to bring in Molly’s brother.

Again, wow.

In the midst of all of this, I am keenly aware that we are currently living in an altered state…

What keeps me afloat in these unsettling times are the babies; the reminder of this continuity over millennia, of the repetitive renewal and infinite possibility that comes with each birth.

I need to say this. We need to protect our mothers and babies. We need to safeguard their health and their passage in our communities, our country, our continents and our cosmos.

Birth is sacred and it preserves our humanity. It is the key.

Peace on earth really does begin at birth. I see it there every time…

Let me know if you want to talk or have coffee. I am here.

My Mother’s Day Dream

I dreamt early this morning that I was having a baby. I knew it was time for me to go through the closet where everything is stored to get what is needed so I could wash and dry it, fold it and put it in the baby’s room. It had this wonderful, familiar feeling of that ritual that I have done so long ago now, just in the days and weeks before birth. Which is what I am about to do…

What a beautiful feeling to have on Mother’s Day before giving birth to
The Good Birth Project – on Labor Day!

In my world, every day is Mother’s Day.

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.)

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.