Witnessing Birth

Breastfeeding in public causes traffic jam!!!!

2011-12-27T18:06:00.002-06:00

Buns in the oven.

2011-12-24T02:07:00.003-06:00

As any wise baker will warn you, timing is everything. Say, for example, you're making a delectable holiday treat. Maybe vegan macadamia nut snickerdoodle cookies. Or old-fashioned molasses crinkles. Deliciousness is about to ensue, you've read over the recipe and have all the ingredients. Alright! Everything gets mixed perfectly and sweet mounds of dough soon cover the baking sheet. Into the over the soon-to-be cookies go...and now the waiting begins. Ugggggg! Patience is hard work! Today, especially, it's difficult because you're REALLY hungry and haven't had a yummy dessert in what feels like forever. Your stomach growls and all you can think about is cookies. After a few minutes, you decide the anticipation is too much to handle and pull the treats out. Just to take a look. Maybe a bite. Or two. Three four five. Soon all the cookies are gone. Devoured. And, though they tasted alright, you realize you missed the satisfaction of a crunchy, fully-cooked treat. The poor dollops were unable to reach their most awesome potential because of impatience. Discomfort. Hunger. Darn.

On a deeper level, this metaphor can be applied to childbirth and the seduction of induction. A baby is meant to live in the womb for around 40 weeks. Now, some kiddos choose to come early and others arrive late. Two weeks on either side of a due date is considered kosher and often babies born in this bracket are healthy and ready to greet the world. However, when a baby's date of birth is chosen before it is ready - namely, before 40 weeks and without the spontaneous onset of labor - the risk of undercooking arises. Like the cookies, babies need to be fully-baked. In the last weeks of gestation, important brain growth and physical development is still occurring. Arguably, the best place for these changes is in the womb. Once born, a baby has soooo many other tasks to focus on, such as breathing and eating, that other all-important but less vital aspects take a back-seat. In the end, the baby who's born before he or she is completely ready is given an almost-cooked start to life and runs the risk of increased illness, decreased success with breastfeeding, and a whole host of other problems. The solution: exercise patience, don't induce labor without a serious medical justification, and keep them bunz in the oven till they're good and ready! And check out 40 Reasons to Go the Full 40 Weeks.

Coooooooows!

2011-12-21T18:38:00.001-06:00

Just a sweet babe nursing from mum's teat.

These cows live at Bells Bend Neighborhood Farms,
and I loooooove their gentle presence.

Just don't forget to shut the gates to the gardens
or they'll eat all the vegetables and then some!

Run-run-a-running and pregnancy

2011-12-21T17:43:00.000-06:00

I've been thinking about writing a post on exercise for what seems like ages and finally decided to sit down and make it happen. Thanks be almighty, it feels BIG these days to steal time from school and friends and farming and everything else to blog. When I do decide to write, sometimes I get lost imagining the possibilities. Do I write about my life as a student midwife? Or peruse the internet for interesting birth-bellies-babies stories? And what about plants? And dancing? And celebrations? And food creations? Ohhhh, what do I write about today???

It's a good problem, rest assured, I know I'll never be bored so long as this blog is part of my life. I could probably type and type and type till my fingers tire and won't punch another key and still have plenty more to share. So, preface and all, I'd like to talk about aerobic activity and pregnancy...namely: running. Jogging. Speeding. Sprinting. Galloping. Charging. Whatever you want to call it, I started moving my body methodically in a forward motion for the purpose of exercise almost two years ago. And I haven't looked back. Surely, it was slow at first. And rather cumbersome. I felt so bouncy and uncoordinated. The more I kept running, though, I realized I'd found a sense of exhilaration, peace, and joy that was unparalleled. No other type of physical activity made me feel quite as embodied and alive. To this day, some of my greatest epiphanies and most creative moments arise when I'm running. I work through the jubilant and the complex parts of life via moving my body, one leg at a time.

When I think of pregnancy, childbirth, and parenthood, I envision a proverbial ultra-marathon. It's a long-distance race, to be certain, one that requires pacing, rehydration, lots of support, and stops along the way. Running in real life can be viewed as a training ground for this mother of all marathons, preparation for the bumps and humps of parenting. Not too long in the distant past, though, exercise was discouraged during pregnancy. Women were cautioned not to overexert themselves for fear they would deprive their unborn babes of oxygen and other necessary nutrients. Nowadays, exercise is recommended before, during, and after pregnancy. As it turns out, regular physical activity is healthy for both mom and baby...now, pregnancy is not the time to start an intense exercise routine...rather, the key is not to overdo but rather work out at a moderate level. But go mama go! Obesity-related issues such as gestational diabetes, large babies, high blood pressure, high cholesterol, and complications during labor and delivery carry far more risk for mom and baby than exercise.

A few months ago, I ran the Women's Half Marathon in Nashville, TN. It was a wonderful experience, my first half marathon, and I loved running with ladies of all shapes, sizes, backgrounds, and fitness levels. The support was stellar, I knew I'd finish the race if only by the cheers and high-fives of my fellow runners and the crowds that lined the streets. Sometimes I wanted to stop. Peel back. Grab a smoothie and say "Seeeya!" When I ran across the finish line, though, I felt such a surge of relief and confidence I couldn't stop smiling. I did it! I did it! I can do anything! It's these moments in life that reinforce in me the idea that women are strong and we can do whatever we want...birthing babies included, of course!

Later, some days after the marathon, the director of my midwifery program sent my classmates and I an article about a women who gave birth shortly after running the Chicago Marathon. Wowza!

Cinco de utero!!!

2011-12-09T10:10:00.006-06:00

It's decided. Midwives throw great parties. This past week, the students in the midwifery class ahead of mine returned from their faraway clinical sites to wrap up the semester and end their schooling as midwives. How exciting! To celebrate their work and graduation, my class prepared a brunch feast. A fiesta, actually.

The theme: Cinco de utero. Complete with a uterine pinata, pin the IUD on the uterus, and a build-your-own-burrito bar, it was a super-duper success.

Now, sometimes I think of my heart as a giant pie. Maybe chocolate mousse or pumpkin. Or good ol' apple. Regardless, I imagine an infinite number of slices and, depending on the day, I can cut it any way I choose and give pieces to whomever or whatever tugs my heartstrings. Often, I split the pie halfway down the middle and offer mutual affection to birth/bellies/babies and food/plants/gardening. These are my two loves of life. Not surprising, I think it's great when they tie together. For the fiesta, I made fixins' for the burritos using Bells Bend Neighborhood Farms sweet potatoes (the same ones I helped dig back in August!) and Jeff Poppen's potatoes.

So we gathered. And we ate. And we smiled. And we sang and held hands and swayed. Welllllll...not quite. Though I never mind the Kumbaya spirit, not every midwife is interested in flowers, earthly colors, and hugs. Myth-bust! In fact, many of my midwifery classmates are wonderfully modern, with serious style and sass. Stereotypes about midwifery abound and the typical visual image of a midwife is someone who's old(ish), a flower-child of the 60s, with braids and knitting needles in tow. Though there ARE midwives who fit the stereotype, there are many others who don't. My classmates and their eclecticism help me remember the diversity present in midwifery and reassure me there's a midwife for every woman!

Special thanks to Maggie and Amy, two of the frontline organizers for Cinco de utero.

A picture is worth a thousand words...

2011-12-01T18:55:00.000-06:00

Seriously. Check out National Geographic's 2011 photo contest, particularly this picture...and this one too. They are simply stunning. I'm especially inspired by their clarity and focus because the birthing process is not always easily captured via photograph. The moment of exit from womb to world can happen in the blink of an eye, before anyone has a chance to grab the camera, adjust the lens, turn on the flash, find the right angle...and many positions that women naturally assume make it awkward for picture-taking, such as under the water, on the toilet, in a deep squat, or on hands and knees. Both photos, though, present the moment of birth in such real, raw, up-close and personal glory I feel as though I'm in the room too! Yes, yes, yes, I love witnessing birth.

Teen midwives to the rescue!

2011-11-27T20:46:00.000-06:00

As someone who has not experienced childbirth personally, I sometimes wonder if it's legitimate to become a midwife. Especially in the early days, when I first began attending births as a doula, I felt very aware of my lack of childbearing. I didn't think anyone would want me to be present with them during labor and wasn't sure I had much to offer. And, I felt waaaay too young to provide assistance to women in their late twenties and thirties...after all, I was only 21 when I attended my first birth as a doula. Luckily, the woman I worked with was uncertain if her husband would be present at the birth and ended up being completely grateful for any and all support. Age, it turns out, is not all that important. Check out this story about the work Afghan teen midwives are doing to curb alarming maternal & infant mortality rates.

After witnessing five, ten...fifteen...thirty...seventy (and on upwards!) births, I now believe I bring a rich base of experience (and an increasing amount of knowledge) to the table as a birth attendant. It's remains true that I have yet to go through the physiological birthing process myself. Therefore, I can't empathize with a pregnant woman about the sensations of labor. I don't know what the urge to push feels like. Nor have I nursed a sweet babe at my breast. However, I can attest to giving birth psychologically to ideas and creations. I understand the birthing process is one that requires trust, surrender, and a belief in the spiraling nature of manifestation. A birth, on whatever level, happens on its own time and, though some details can be controlled or planned, each idea/baby/project arrives to the beat of a wonderfully unique drum.

Abundant Thanksgivings.

2011-11-24T01:15:00.003-06:00

Today I am thankful for
two feet to stand on upright and tall
cornbread baking moist
ovens and pots and pans and wooden cutting boards
carrots straight from the ground
dirt
the purple hue of sunset
hundreds of blackbirds dancing the sky into dusk
bellies and babies
the purr of kittens snug against my chest
spinach and kale and everything green
friends
family
mason jars and sweet potatoes
the last of summer's tomatoes turned ketchup
relics of the past
books
music and dancing and celebration
a warm kitchen
polka-dotted spandex
hips, lips, curly hair, and beards
but
most of all
I desire
want
thank
need
feel
am
a life shared with others and filled to the brim
with love.

Bells Bend Neighborhood Farms Fall Harvest 2011

A gush of fluid but no labor? What now????

2011-11-17T20:06:00.002-06:00

Last Friday, while harvesting vegetables for the Saturday farmer's market, I listened to a fellow gardener's birth stories. She has two kiddos and I enjoyed hearing her speak of their adventures entering into the world. It's always nice when my interest in plants coincides with my passion for birth and babies. The way we were talking, I could've kept bunching kale and turnip greens all the live long day! When I asked how labor began, she mentioned her waters releasing with her first child and no contractions following.

Termed premature rupture of membranes (PROM), this occurs in as many as 1 out of every 10 pregnancies. My friend wanted to give birth to her son with minimal medical intervention and so chose to stay at home, monitor her temperature and vaginal secretions for signs of infection, and wait for labor to begin. Well, as it turns out, over 24 hours passed with nary a contraction. Ultimately, when she noticed meconium in her undergarments (meaning the baby had passed its first stool while still inside her uterus, possibly as a result of being stressed due to the lack of amniotic fluid surrounding him) she went to the hospital and her labor was artificially induced with medication. A loooooong, slow, hard labor followed, and ultimately the baby's heart dropped too low and an emergency cesarean section was called to remove him from the intrauterine environment quickly. A healthy, wholesome baby resulted, thank heavens, but my friend recounted the story with dread. What an uncertain, tumultuous process!

When faced with PROM, a pregnant woman has two options: expectant or active management. She can have her labor initiated with medication immediately or wait a while to see if contractions begin on their own. Which type of management is better? Unfortunately, the answer is more grey than black or white and a tossup exists amongst birth attendants over which plan of care to support. Recently, an article in The Washington Post looked at this very issue from multiple perspectives. Well-written, engaging, and, what's more, one of my instructors at Vanderbilt University is featured as an expert in the piece. Hurray for indecision!

Tits. Cha-chas. Honkers. Whimwhams. Breasts.

2011-11-10T19:17:00.002-06:00

Celebrate, it's National Breastfeeding Month! Errrr, actually, August was the REAL month for mammary recognition. Whoops. However, I'm a definite breast fanatic and am always on the lookout for lactivist opportunities, ways to spread the good news about breastfeeding. Did you know breastfeeding can lower a woman's risk of breast and ovarian cancer, postpartum depression, and type 2 diabetes? And that breastfed babies are less likely to be sick, and have a lower risk for many illnesses and diseases (such as asthma, SIDS, and type I diabetes) than formula-fed babies? Check out the U.S. Department of Health and Human Services Office on Women's Health's website for more breastfeeding stats and information on why breastmilk is the perfect food for a new babe.

Birth as Performance Art

2011-11-09T00:04:00.000-06:00

What is art? What does it mean to perform? To me, performance art is the expression of beauty, truth, and realness. It's an embodied tapestry of creativity and curiosity, a way to connect individual thought with collective consciousness via physiologic movement of the body. I have always loved dancing and acting...as far as performance art goes, it's a real thrill to take the stage and know a watchful audience is waiting to explore whatever I'm about to express. Arguably, anything can become an act of performance, a piece of art. The free, accepting nature of performance art invites a certain amount of undeniable rawness not often seen in other forms of artistic expression. Essentially, artists can do whatever they want and people will watch. And, hands down, doing something to a human body in real time in the presence of a group of people can be quite spectacular. And informative. And render the onlooker inquisitive and awed. Sooooooo...how about birth as performance art? Recently, an NYC performance artist did just that! Check it out...and then, I suggest, why not go create your own piece of embodied art? After all, the point of life is to live it, and live it full of expression, right?!!

!!Upright Birthing Pumpkin!!

2011-11-02T18:52:00.002-05:00

Shortly after I posted the supine birthing pumpkin picture and lamented about the woe's of a woman giving birth on her back my doula friend Katie sent me a message saying "You wanted an upright, birthing pumpkin...I have just the thing." Check it out! Is this pumpkin empowered, in charge, and oh-so-sassy or what?!!!

BOOK REVIEW: Birth: The Surprising History of How We Are Born

2011-11-02T18:41:00.001-05:00

In Birth: The Surprising History of How We Are Born, author Tina Cassidy blends personal experience with historical research to present a unique narrative on modern-day childbirth. A journalist by trade, Cassidy begins by explaining the book’s impetus as multi-factorial: after hearing childbirth horror stories from the women in her family and enduring a challenging birth herself, she became curious about how women around the world and throughout time have given birth. A lack of literature on the history of childbirth deepened her interest. The nagging question she seeks to answer is if there’s a better way than that which the current maternity system presents to pregnant women for a child to be born.

Additional questions that appear seemingly simple and straight-forward - such as where to give birth, with whom, and with what level of medical intervention - prove difficult to answer as Cassidy teases apart the details. Luckily, her humor propels Birth: The Surprising History of How We Are Born forward and tempers the dry, fact-based material that might otherwise make reading dull. Instead, Cassidy presents an easy read on a tough topic ripe with complexity. She strives to depict the discourse and varied opinions surrounding birthing practices and targets the development of obstetrical interventions over the past fifty years as a particularly influential change in maternity care.

I rate this book with 4 ½ stars out of 5. It provides a near exceptional account of the history of childbirth, with particular emphasis on the last fifty years of obstetrics in the United States. I appreciated Cassidy’s extensive research and was engaged in reading from first glance. She offers historical gems and obscure information not widely found in other literature. I couldn’t put it down! My caveat is her slight bias towards “natural” birth, though she provides the reader enough insight into the iatrogenic causes of childbirth woe to warrant her angst about unnecessary intervention and encouragement of wise, cautious, use of medical and technologic intervention.

As Cassidy emphasizes throughout her book, it is imperative to know the history of childbirth in order to contextualize and understand current obstetric practices. Indeed, it seems every generation develops its own view towards childbirth and the extent to which pregnant women and their families should or should not be participatory agents in the process of bringing new life into the world. Differing perspectives surrounding pain relief and comfort during labor, cesarean section, choice of birth setting and birth attendant, presence of family members, breastfeeding, and childbirth in general render being pregnant an intricate process deeply influenced by cultural, sociological, and political beliefs.

Looking back, it is not too long ago that birth occurred primarily in the home setting with community-trained midwives or family doctors in attendance. Very few, if any, drugs and medical interventions were used, partly due to lack of access and development and also because birth was viewed collectively by society as a commonplace, normal occurrence – albeit potentially dangerous and not always positive in outcome - in the lives of many women. These days, childbirth in Western countries is predominantly hospital-based and often assisted with technology. These shifts reflect the development of new attitudes towards childbirth. As Cassidy puts it “Twilight Sleep is in. Twilight Sleep is out. Forceps are in. Forceps are out. Episiotomies are in. Episiotomies are out. What is state of the art one year is outmoded and unfathomable the next…” (Cassidy, 161).

Much like the actual process of giving birth, society’s views of childbirth are ever-changing and largely unpredictable. Ultimately and hopefully, though, a baby is born. The understanding that women have been giving birth since the beginning of time is the only constant, amidst a spiraling evolution of thought and practice. Reading Birth: The Surprising History of How We Are Born I felt relief to be alive today, surrounded by medical advances and new knowledge that are utilized every day to keep mothers and babies healthy. On the other hand, Cassidy’s writing makes me determinedly steadfast to work to create a system of maternity care that promotes and respects the normalcy of childbirth and the authoritative wisdom pregnant women themselves bring to the table.

Cassidy, T. (2007). Birth: the surprising history of how we are born. New York, NY: Atlantic Monthly Press.

Birthing Pumpkin.

2011-10-30T21:32:00.000-05:00

Ever seen a pregnant pumpkin in a hospital gown with carrot fingers? What about a baby pumpkin straddling the edge of womb and world, ready to make its grand entrance through the birth canal? Check out this photo...I don't know where it came from and who's responsible but it's been circulating the internet these past days and I couldn't resist. It's pretty great, right?!! Salutations to the artist's imagination and creative effort. Kudos aside, I'm not so sure about the supine, back-lying position for birthing a baby. I mean, come on, that looks terribly ineffective and uncomfortable. As it turns out, gravity gives women the extra oomph needed to bring their babies into the world with ease and strength. And, squatting increases space in the pelvis. Next year, I might could be inspired to create a follow-up art piece in the vertical plane. Now THAT is something I could get on board with...full speed ahead!

Pear-picking

2011-10-26T23:15:00.003-05:00

Did you know the non-pregnant uterus is the shape of a pear? It sits beneath the bladder deep within the pelvis, awaiting growth and transformation. Even without the implantation of an egg, the uterus undergoes cyclic physiologic changes each month. After menstruation ends, the follicular phase begins and the body secretes the hormone estrogen to build the uterine lining - also known as the endometrium - into a delicious cushion for new life.

Mid-cycle, ovulation occurs and an egg is released from the ovaries into the uterine tubes. At this point, the body begins to slow its secretion of estrogen and increase production of another hormone called progesterone. Over the rest of the cycle, progesterone peaks and then declines. Somewhere around 28 days from the last menstrual period, progesterone decreases enough to stimulate the uterine lining to shed and the cycle begins again. That is, unless fertilization of an egg by sperm occurs. If this happens, the body increases its output of estrogen and progesterone significantly to maintain the pregnancy and provide a nourishing, comfortable space in the uterus for the lil' embryo to grow grow grow.

By about 12 weeks gestation, the pregnant uterus will be able to be felt just below the superior border of the pubic bone. At 16 weeks, the uterus is midway between the pubic bone and bellybutton. At 20 weeks, it's found at the umbilicus. And onwards and upwards the uterus grows, along with the baby, until it reaches approximately 40cm from the pubic bone to the top of the uterus. After this point, the baby typically moves down deeper into the pelvis and the measurement decreases by several centimeters. Soon thereafter, the babe makes its entrance into this wide, wondrous world!

Today I thought a lot about the amazing uterus as I picked pears from a friend's tree. Several bushels into completing my task, I realized with reverence the similarity between the lifecycle of a fruit tree and a pregnant woman. Both incur remarkable changes in their unique, respective seasons: from Spring to Fall, a tree blossoms, blooms, builds fruit...and finally lets it fall. From fertilization to birth, ovum to blastocyst to embryo to fetus to baby, a woman's body supports the incredible growth of another being.

I notice some trees are particularly productive, like the one I picked from...fruit practically grows on every limb and spare inch of space! These trees stand ready, open, and fresh, awaiting transformation. The sweet and abundant fruitfulness makes growing look easy! It makes me think of human pregnancy and wonder if we ought not take a lesson from the trees. If the prenatal journey is wanted, welcomed, and celebrated, might it confer an easier and more efficient pregnancy? And might this positive mentality engrained during pregnancy carry onward into labor, birth, and parenthood? I'm inspired by the pears who beckoned and called me forth to explore the day and, in the process, encouraged me to reflect on such fine pear-shaped lady wisdom!

My Sister, My Self

2011-10-23T14:16:00.001-05:00

From The White Ribbon Alliance for Safe Motherhood, "This short film communicates women's joy in birth and motherhood, as well as their sorrow over the loss of babies, the deaths of sisters, daughters, friends, aunts and cousins. Its vibrant contemporary soundtrack reflects both women's courage and pain."

My Birthing Celebration!!

2011-10-22T02:04:00.005-05:00

Ohhhh, life. Although the blogosphere is captivating and posting in this forum often feels wonderfully reflective, I take it as a good sign my lack of recent updates. Now, believe me, there is SOOOO much to write about. I'm backed up with ideas and articles and rants and raves. Seriously. The arts and crafts bin next to my bedside has become the prime resting place for "oh, I need to write about that" stuff. I always think I'll have the energy and zest to post before going to bed...unfortunately, that doesn't usually happen these days. I'm too tired by the time I decide to sleep to do much else. WHY am I exhausted??? Well, I'm experiencing an abundantly full life, that's why!!!

Jumping from here to there, school to dancing to farming to preserving food to sharing meals with friends to riding my bike...tonight, though, is different. A friend sent me several photos from my birthing celebration last weekend and I'm so smitten I decided I had to share. I think the day a baby is born is just incredible and should be remembered as such with all the gusto in the world on each anniversary. Not surprising, my birthday has always been important to me. One of my favorite ways to ring in another year is with a party.

Have I mentioned my love for all things cylindrical? And the fanaticism I feel for birthday parties? It was only a matter of time before the two coincided...and, in this case, became a wild ball-themed fiesta. The evening started with a ballz potluck:

Later, we played four-square and basketball outside...all for the sake of play and roundness. Who doesn't love bouncy balls???!! And I put on a fire hula-hoop spectacle:

As the night wore on, I couldn't help but dance when friends started playing good tunes...look closely, I'm in the background hootin' and hollerin' and stompin' and clappin':

When I no longer felt my eyes stay open, I slipped to dreamland amidst pillows, blankets, and friends. In the morning, we made merriment with music, food, swings, balloons, and human sculptures (!!!):

Tiny, cell, divide, quick, grow, strong, body, healthy, warm, loving, liquid, contract. Small I started and out I came into this wide, wondrous world. And, after such a special celebration, I believe I'm ready to circle the sun during my 24th year.

Pssssst! Check out the vegan raw cheesecake birthday ballz Nathalie made:

Like whoa!!!!!!

Pregnant ground = full-term taters.

2011-10-12T17:17:00.001-05:00

Oh, learning. It happens everywhere, all the time. In fact, I think I learn the most when I'm not in the classroom...and when I haven't set the intention to gain specific knowledge. Amidst informal conversation with friends, while creating kitchen concoctions, on long (and short!) bike rides, and in the fields farming, learning sifts through the cracks. Sometimes life lessons appear subtly...I stumble on new knowledge meditatively or glean insight after reflection of the day's work. For example, last week I dug sweet potatoes at Sulphur Creek farm and remembered how incredible it feels to connect with the earth. Sweet and simple. A quiet realization of interdependence.

Other moments I am hit with epiphany. Kablam! Like, whoa, did that tuber just emerge from the ground and can I really eat it????!!

Certainly, being in an academic program provides the space and opportunity to dive into particular material quickly. This semester, my schedule is pushing me to gain information about birth, babies, and women's health faster than if I were left to develop my own learning plan. Golly, if I weren't in school I'd probably not know how to insert an IUD, perform endometrial biopsy, complete a pelvic exam, counsel a women experiencing bacterial vaginosis, and look intelligently at cells underneath a microscope. This is how it goes: awesome, intelligent reproductive anatomy and physiology teacher asks, "Ever wanted to know about fetal development?" I answer "Oh yes! Tell me more." Teacher says "Here. Now. Learn. Lots. Read these chapters, watch this lecture, study these cases, then process and regurgitate." Next topic: fetal nutrition and oxygen transfer. Then..."Ever wanted to know about placentas?". And onwards. No doubt about it, I'm on the fast track towards becoming a midwife. And I loooove all I'm learning. Some days, though, I really struggle with being part of a program that operates on a fixed schedule I didn't construct. Sometimes, I just want to be on my own, doing the day's work and learning as I go.

Another pumpkin picture!

2011-10-10T14:39:00.000-05:00

My fantastically artistic friend Nathalie sent me a picture of the pumpkin she carved last October. We share a love of the female body and women's health...more often than me, however, Nathalie conveys her interest via art. When I look closely at her work, I often find sperm and eggs hidden amongst other depictions. Yes!!!

The Birth Facts

2011-10-02T08:20:00.000-05:00

Check, check it out! Perinatal Education Associates, Inc. has a superb website for mothers, midwives, doulas, and all others involved in pregnancy and childbirth. The Birth Facts serves as a clearinghouse for evidence-based information related to childbearing. Topic headings include "Doulas: Birth & Postpartum", "Nutrition in Pregnancy & Beyond", "Induction of Labor", 'Teen Pregnancy & Birth", and "Water Labor & Waterbirth". Within each category are user-friendly links to research articles, studies, and practice guidelines that relate to the topic at hand. A midwife friend passed the link along and I've been perusing the content like wildfire. I appreciate The Birth Facts because it compiles information I seek regularly into an easy-to-navigate format. Now, hear me out, I think perusing PubMed and other scholarly search engines is loads of fun (yes, that's right, nerd alert!)...however, it's also all-consuming and can easily eat up an afternoon's worth of work. Sometimes getting lost in cyberspace is A-OK, especially if it's raining and chocolate is involved. But, for those moments when I'm looking for a specific piece of research and don't have a lot of time to waste, The Birth Facts is a great place to begin!

Babe in a pumpkin.

2011-10-02T08:01:00.000-05:00

A classmate sent this picture to me, her cousin is the artist. Amazing!

Withdrawaling before ejaculation: friend or foe?

2011-09-28T18:24:00.000-05:00

A recent New York Times article examines the efficacy of the withdrawal method of birth control and posits it may be only slightly less effective than the male condom. With a pregnancy rate of 18% for the withdrawal method and 17% for condom use, it appears withdrawing the penis prior to ejaculation is a viable option worth examining. Now, this method is inherently challenging because it relies on the man to be sensitive towards impending ejaculation and maintain a steadfast commitment to removing his penis when this occurs. He must be aware of his sexual response and able to pull out before he reaches the point of no return when ejaculation cannot be held back or postponed.

Not all men are astutely tuned into their bodies during intercourse and some are unable to sense when emission - the passage of semen into the posterior urethra - happens. Thus ejaculation, which follows emission, may take the sexing duo by storm without a clear warning. And, unfortunately for those couples trying to prevent pregnancy, ejaculation usually occurs with orgasm. Now who wants to stop doing something that feels good, especially when the excitement has built to a peak? Not I, no thanks.

Furthermore, the withdrawal method does not prevent sexually transmitted infections from passing between partners and is miles away in terms of efficacy from other forms of contraception - the IUD boasts a 1% pregnancy rate, Depo-provera injections 3%, and pills 8%. All this said it's good to know the withdrawal method is at least somewhat effective. It's free, always available, non-hormonal, and doesn't have any side effects (aside from unintended pregnancy, should it occur!). And the study's lead researcher, Rachel K. Jones, makes a valid argument: namely, if a couple is going to have unprotected sex and does not want to get pregnant it makes more sense to use the withdrawal method correctly than not use anything at all.

Davidson County Residents: Pregnant or Planning to Be?

2011-09-28T17:24:00.000-05:00

Calling all Nashville pregnant ladies!!! A friend forwarded me the following information about a research study that's taking place in our area through Vanderbilt University. It seems to be a straightforward, non-invasive opportunity for pregnant women and their children to influence the future of health care.

...................................................................................

Are you or is someone you know currently pregnant or trying to become pregnant, >18 years old and <49 years old (unless currently pregnant), and living in Davidson County? The National Children's Study is a federally-funded research study that will examine how we live, work and play can improve the health of children. We are currently recruiting 1,000 women, who live in Davidson County, and will follow children from birth to age 21. To learn more about the study call us toll free at (866) 346-2684 or send an email to childrensstudy@vanderbilt.edu with your name, phone number and times that you can be reached. We will not share your email address with anyone outside of the study.

Visit http://DavidsonCounty.NationalChildrensStudy.gov for more info.
Participants will not need to change what they do and there will be no changes to routine prenatal visits or care. At this time you will answer questions by phone, online, mail or in person during home visits.

You will receive about $25-100 in cash or gift cards to thank you each time you complete a study visit or questionnaire and other items such as a tote bag, picture frame or other small thank yous.

Lil' radish babes

2011-09-25T09:15:00.001-05:00

When I'm not thinking about birth and babies, vegetables are usually on my mind. I'm a fanatic. Most any veggie has a place in my heart...big or small, red or purple, yellow or green, mushy or firm, old or young. Tomatoes? Total winner. Winter squash? Yes please. Kale, Collards, Parsley? Sure. Okra? Mmmmmmgood. Sweet potatoes. OMG. Beets? More, more! Even Turnip greens are beginning to taste delightful. Always it seems there's a decadent meal hiding behind every vegetable, just waiting to jump at the first opportunity for culinary creativity. This past Friday, I helped harvest and wash 101 bunches of newly gestated radishes at Sulphur Creek farm. In many ways, being involved in the growth of veggies deepens my appreciation for life. Plants begin their lives as seeds, full of potential, and grow vibrant as the days pass on. For me, gardening is an affirmation that life works. Birth works. We work. And we, like the vegetables, are growing, one leaf at a time.

BOOK REVIEW: Sisters on A Journey

2011-09-25T08:54:00.002-05:00

In Sisters on A Journey, editor and midwife Penfield Chester presents an insider’s perspective on midwifery as told by 27 American midwives. Throughout each narrative, sentiments of struggle, joy, frustration, and empowerment abound as individual midwives share their views on midwifery, childbearing, and the past and current states of maternity care in the United States. The uniqueness of this book resides in the inclusion of diverse stories, told by women who arrived at midwifery via different educational paths at various times in history. In her book, Chester presents the narratives of apprentice-trained midwives, community midwives, granny midwives, nurse-midwives, and certified professional midwives, and includes stories from notable midwives such as Penny Armstrong, Helen Varney Burst, Anne Frye, Ina May Gaskin, Gladys Milton, and Sister Angela Murdaugh.

Although differences in clinical practice, background, politics, and spirituality are apparent when reading their stories, the gaps that threaten to separate one midwife from another appear to close as each midwife affirms her call to be of service to women. Coupled with adherence to the tenet of normal birth and an intrinsic trust in the power and strength of women, their tales begin to blur together and form a coherent, collective identity. Written for the lay audience and birth professionals alike, Sisters on A Journey is an accessible, enjoyable read and presents an oral history of the modern-day complexities of being with women and providing female-centered health care.

This book receives four stars out of a possible five. Chester supports each midwife’s narrative with a portrait photograph and short biography, thereby nestling their stories in context and enabling the reader to better understand various perspectives within the midwifery movement. Additionally, Sisters on a Journey is laid out in a straightforward format, with one interview per chapter and medical terms described in parentheses, such that reading is easy, interesting, and friendly for the least to most seasoned childbirth aficionado. Certainly, highlighting diversity in midwifery is a cornerstone of Chester’s book; one caveat, however, is the lack of inclusion of stories from midwives working in places in North America other than the United States and narratives of men who practice midwifery.

In the book’s introduction Chester emphasizes the importance of recognizing the threads of connection between midwives. Across history, midwifery care has existed in direct political and practical opposition to the medical model’s predominant devotion to disease, science, and technological intervention. Given its holistic, body-centered emphasis and incorporation of varying forms of knowledge, midwifery is a cultural and sociological deviation from past and current gynecological and obstetric practices in the United States. Ina May Gaskin, in examining the birthing culture of the United States, states “What we have in our culture are two very sharply opposed ideas of childbirth. One of them is the traditional Earth Mother…then you’ve got birth as probably the most frightening experience awaiting you...” (Chester, 1997). Other narratives echo similar thoughts and contrast between the midwifery and medical models of care.

In Sisters on a Journey, many of the midwives express experiencing adversity and feelings of inadequacy because of their rejection of cultural norms surrounding childbirth and women’s health. Midwife Rondi Anderson narrates “I hate dealing with a medical profession that isn’t supportive of me. It makes me crazy.” (Chester, 1997). Likewise, their narratives reveal political strife in the form of certification and licensure regulations, a lack of state recognition to practice independently and to the fullest extent, and internal struggle within the midwifery community itself. In the end, Chester asserts midwives heed remember their connection to each other while traversing bold, unconventional territory. Despite differences in education, certification, and practice, Sisters on a Journey suggests midwives reach out for support and solidarity if they are to remain committed and passionate about continuing the hard work of humanizing birth and women’s health experiences.

Chester, P. (1997). Sisters on a journey: Portraits of American Midwives. New Brunswick, NJ: Rutgers University Press.

I passed!!!!!

2011-09-15T18:29:00.000-05:00

Thank heavens, I passed the NCLEX. Yippee!!! Unfamiliar with the exam? So was I until I started nursing school last fall. Ultimately, the extent of work, knowledge, and skill as a student nurse is tested with the national licensure exam, also known as the NCLEX. Indeed, it's a heavy load for a multiple choice test to carry. Not to mention the questions are quite tricky. Going into the exam, I was nervous but confident because school prepared me well. Coming out, I felt like an ambiguous blob, not certain if I passed or failed. So many questions seemed to have at least two great answers. Which one to choose?!!! The real challenge was waiting for my results...it took a grueling, stomach sickening 48 hours for them to be posted. I felt so impatient and worried and stressed to the max. At one point, I went to the gym and worked out on the elliptical like I've never done before. Forty minutes later, with sweat everywhere and an exhausted smile spread wide across my face, I wondered if passersby thought I'd lost my marbles. That night, I slept rotten. I woke up, couldn't even do my morning yoga, and sat in bed watching the minutes tick by. 7:42...7:46...7:51...come on...when 8:00 rolled around, I logged onto the computer to check and wah-la! "PASS" read the screen. Pass? Pass!!!! NOW I can dive whole-body deep into midwifery.

Midwifery, studenthood, and the turn of summer to fall...

2011-09-03T21:56:00.001-05:00

A week and a half has passed since school began again. With the first year of my program out of the way and all the precursory nursing business aside I can now officially call myself a student midwife. It couldn't come soon enough. Alas, good gracious, the material I have to learn is outstanding and kind of intimidating. There's just so much and it's all very interesting and new and big. Truth be told, I'm a bit overwhelmed. Not certain how to dive in, I've decided to approach learning via multiple angles...last week, I put an important textbook near the toilet for easy reading and organized lecture notes on a prominent table in my bedroom. My hands stay busy during dull moments knitting a true-to-size pregnant uterus. I'm committed to eating, breathing, and sleeping with midwifery. Literally, books about pregnancy and birth have taken cozy residence in my bed.

Wow!! It doesn't quite feel real yet, and, truth be told, I still have to take the national exam to become a registered nurse before I can advance completely in my studies. I sit for the exam this week. Yikes. It's scary and I feel ready some moments...others I lose steam and confidence. I keep quizzing myself with practice questions and am thinking a lot about how to prepare mentally for the test. Affirmations fill my head. Yes, I can do this. I know the material. I use my brain. I listen to my intuition. I have prepared all year to pass this exam. I am a nurse. I breathe deeply and search inside for the answers. I walk with strength and passion to pursue midwifery. In the end, it's all about serving moms and babes. Yes, that's my motivation, I remember now. I can do this!

My other interests - namely spending time in nature with plants, dancing, and eating with friends - are co-conspiring to keep me quite busy in between schoolwork and studying. I spend my free days volunteering at a farm outside of Nashville called Sulphur Creek. The community is fantastic and I experience loads of warmth and love when I help with the harvest, plant new crops, or provide support in some other way. Being involved with gardening makes the turn of summer to fall feel more intimate. Over the past month, I've watched the tomatoes come in full force and slowly dwindle. I remember when, back in early August, I lost myself in a patch of juicy reds for over two hours. That day, I think over 900 pounds were picked. Aye!! Now, the flood of ripe tomatoes has reduced to a trickle and only a bushel or two comes from the fields on harvest day. At the same time, the ground has been sown with fall crops - kale (!!!!!!!!!!!), turnips, beets, onions, arugula, sweet potatoes...and the cycle continues.

Awwwwwww.

2011-09-03T20:25:00.000-05:00

Her First Calf
by Wendell Berry

Her fate seizes her and brings her down.
She is heavy with it. It wrings her.
The great weight is heaved out of her.
It eases.

She moves into what she has become,
sure in her fate now
as a fish free in the current.
She turns to the calf who has broken
out of the womb’s water and its veil.

He breathes. She licks his wet hair.
He gathers his legs under him
and rises. He stands, and his legs
wobble. After the months
of his pursuit of her, now
they meet face to face.

From the beginnings of the world
His arrival and her welcome
have been prepared. They have always
known each other.

How much do women REALLY know about childbirth?

2011-08-14T22:49:00.000-05:00

An interesting article appeared in the Los Angeles Times in June 2011 regarding a recent study that examined the knowledge women have about childbirth. Dr. Michael Klein and researchers surveyed over 1,000 women to assess their knowledge about childbirth options such as intermittent vs. continuous fetal monitoring, unmedicated childbirth vs. cesarean section, perineal tearing vs. episiotomy, and breastfeeding vs. formula. Unfortunately, their results reveal fewer women and their partners are prepared to make decisions about childbirth than in times past. These days, childbirth education classes are being replaced by information gleaned from the internet, friends, and books. This would be fine with me if the switch in resource acquisition correlated to an increase in women's understanding of the risks and benefits of various obstetrical procedures. However, Klein's research showed many women held uncertainty about childbirth options late into pregnancy, a finding he stresses in concerning because it "affects their ability to engage in informed discussions with their caregivers". The pearl in the oyster of the study is women receiving care from a midwife "tended to be more informed about their options compared with women receiving care from a medical doctor". Yahoo, that's right! The midwifery model of care stresses education as a cornerstone to effective care that empowers women to make the best decisions for themselves and their children. And, in my experience, women who are actively involved in their care during pregnancy become fierce birthgivers and strong mothers invested with deep interest in their offspring's wellbeing. Now, I don't know about you, but those are the women I want running about this wide, wondrous world!

Father-daughter sketch comedy on menarche

2011-08-13T15:20:00.000-05:00

The Frantics-Her First Period - watch more funny videos

Ina May Gaskin: "Birth Matters: A Midwife's Manifesta"

2011-08-08T00:02:00.003-05:00

A friend called me the other day to report listening to a fantastic interview on The Diane Rehm Show with Ina May Gaskin, midwifery forerunner and birth extraordinaire, about home birth and the future of bellies and babies in the United States. I listened to the interview while processing tomatoes and it sure helped me pass the time. Ten quarts of tomato sauce later, I was a happy camper, full of inspiration and vigor to start a birth center in Nashville. Or somewhere. At the very least, I wish to be involved with out-of-hospital birth during my life as a midwife. My experiences thus far with home birth and birth centers as a doula have cemented my desire to help women birth their babes in a less medically intrusive way. Birth, innately, is not an illness, but rather a celebration that usually involves little if any complication. With a skilled birth attendant to guide and watch over the process, out-of-hospital birth is a safe, viable option for pregnant women. Lest we forget, all life begins with birth. Trust the process.

World Breastfeeding Week 2011 Flashmob Dance

2011-08-01T18:42:00.004-05:00

Top 5 reasons why I love menstrual cups.

2011-08-01T13:41:00.001-05:00

Ever heard of a menstrual cup? Some have, many haven't. I first learned about this alternative to tampons and pads several years back during my time at Warren Wilson College. The school happens to be home to a savvy group of young ladies who question conventional standards about health, beauty, and being a woman. As may be imagined, I bloomed at Warren Wilson College. Fell into my womanhood. Learned to love my body (some days are still tough). Became a feminist.

So what, you may ask, is a menstrual cup? In fact, it's like it sounds. A menstrual cup is a small device that fits in the vagina around the cervix to facilitate the catchment of blood during menstruation. In some ways, it's similar to a diaphragm in size and placement in the body. I think it looks like an eyewash cup. While bleeding, the menstrual cup is inserted, left in place anywhere from several hours to overnight, removed, emptied, rinsed, and reinserted. It's that easy. After menstruation ends, I sanitize the cup by boiling it in water for 15 minutes and then put it in a cloth bag in my medicine cabinet, ready to be used again. There are three types of cups sold in the United States: the Keeper, the Moon Cup, and the Diva Cup. Others exist in Europe and elsewhere, if you live abroad. I use the Keeper, because I like that it's made from natural gum rubber (latex), which is a renewable resource. The Moon Cup and Diva Cup are made from medical grade silicone, making these options ideal for women with latex allergies. Honestly, I could go on and on about menstrual cups because I appreciate them tremendously and want to spread the word to women worldwide that an alternative exists to tampons and pads. Here are the top 5 reasons why menstrual cups have my heart:

1. Less bulk: I never got the hang of tampons, they always felt strange and I didn't like knowing that most contain toxins such as dioxin and other carcinogens due to manufacturing practices. Yuck. No thank you. I don't know about you but I've got enough external, environmental cancer-causing pollutants to deal with and would prefer not to stick a toxic wonder wand in my yoni. Pads, though, are equally discouraging. Even my cloth pads, which feel much more comfortable and are reusable, make life cumbersome. Riding a bike with a pad? Watch out, it may just shimmy to the left or right or up your bum to high heaven. Pads are bulky and warrant frequent readjustment. The menstrual cup is a viable alternative, because it fits inside the vagina - eliminating the bulk of pads - and contains no toxins.

2. Environmentally friendly: The menstrual cup is reusable and packaged minimally. The manufacturers, it seems, are as committed to green practices as their customers. And the monthly disposable tampon/pad stock-up is no longer necessary. Goodbye packaging and throw-away materials. Less buy-in to the industrial consumer system = happier, healthier, more harmonious life.

3. Go anywhere, do anything: I don't worry these days when I am bleeding. When I wore pads, I was constantly concerned about being near a restroom so I could change my pad as it became saturated. During the first days of my cycle, when it's quite heavy, it felt as if I was switching from one pad to the next every hour. I just wanted to stay home, for convenience's sake, and sit on a giant towel to soak up the flow. Aye! Not to mention swimming, one of my favorite pastimes, had to be placed on the back burner for later. The menstrual cup allows me to stay active and keep doing what I love with much less concern about getting blood everywhere. On days 1 and 2, I still use a pad as back-up because some leakage from the menstrual cup occurs when my flow is heavy. After that, I go back to my usual panty-less lifestyle without fear!

4. Cost-effective: The upfront cost of a menstrual cup is around $40, which may seem like a lot to spend initially, but in the long run it costs pennies per period. And, the average life of a menstrual cup is 10 years. Amazing!!!

5. Increased body awareness: To use the menstrual cup, it's necessary to become intimate with the body. First, I fold the cup to collapse it and enable easier insertion. Then, I spread my labia, find my vagina, and introduce the cup into the canal. In the beginning, this was easier said than done. I bought a menstrual cup and had it for 2 years before I worked up enough courage to actually try it!! It looked scary. With a friend's teaching, I overcame my fear and, in the process, became more aware of my body. There's no denying I am a woman when emptying the Keeper requires that I pull the cup from my vagina to the outside world. And, for that matter, it's impossible not to notice I have a yoni. For some, this may be a new frontier. Welcome, the body is incredible.

Dear Sesame Street, thanks.

2011-07-14T12:11:00.005-05:00

Tee Renovation

2011-07-09T21:57:00.000-05:00

At the beginning of the school year, I bought an oversized t-shirt from the class ahead of mine. The students were fundraising for the annual American College of Nurse-Midwives meeting by selling gear for midwives. Since that time, I've worn the shirt just barely because it's too large. My body disappears when I put it on. Recently, however, I became inspired to renovate my bulky tee collection. I decided gathering dust would not suffice anymore as an occupation for my t-shirts. The result? Check it out. With my midwifery tee, I took the sleeves off, cut the collar for a loose fit, and brought in the sides. Overall, it was an easy sewing project and took about 30 minutes from start to finish. I love creative endeavors like these! I feel empowered with my success. And, my new t-shirt has moved to the top of the list with regard to clothing selection. A win.

Yo, Doulas!!!

2011-07-06T18:18:00.001-05:00

A childbirth educator, doula, and PhD student is completing her doctoral dissertation on the role of doulas in the culture of the childbirth and reproductive justice movements in the U.S. To do this wonderful work, she needs doulas to fill out a survey...it takes about 15-30 minutes and is fairly straight-forward. I just finished. For me, the survey carved a space in my day to travel through memories of past births witnessed and sweet families celebrated. It was refreshing and comforting to remember my doulahood amidst nursing school. Indeed, wherever I go and whatever I do, I will always be a doula. Even when I'm a midwife. And a mother. A farmer. Abroad providing primary health care to underserved populations. Always, I will advocate for the people I care for and support their preferences with regard to medical decisions and health. Being a doula taught me to listen carefully to the people I serve and ask questions to better understand their unique situation and needs. As a doula, I sit with women, families, and babies at a time of great mystery and hold the door open to surrender to all that is unknown. Doulaing is a passion, an art, and a calling. It envelops me and will forever be a hat I wear.

Babies are AMAZING.

2011-07-04T20:58:00.001-05:00

Q & A with Midwife Tonia Moore-Davis

2011-06-30T10:08:00.002-05:00

Call me cheesy, but I like most health-oriented media. Give me the choice of watching a documentary about influenza or the latest episode of The Bachelor and I'll go for the first option. Coupled with a good cup o' tea and a nerdy friend or two, and I'd venture to declare the viewing amazing. Hands down. I can't help it, I get sucked in, and my brain always wants more information. "Feed me!!!!", it screams with excitement and fierce command. Ok then, I will.

Enter Vanderbilt Nurse, Vanderbilt University School of Nursing's quarterly magazine with news and stories related to health care and the profession of nursing. I like it. The current issue often finds its way to the bathroom - which is, as a matter of fact, my favorite place to read. It's an oasis. A place to let loose. Anyways..........

I especially like the magazine when it includes articles related to midwifery and families. Always, these grab my attention, and I tend to bypass everything else initially to read the mama-baby-birth stuff. Let me at it! To my excitement, the Spring 2011 issue includes a great interview with certified nurse-midwife Tonia Moore-Davis about Vanderbilt's nurse-midwifery faculty practice. It's an easy, quick read and presents good insight into the future of midwifery in Nashville.

I liked reading about the Franklin Road Women's Health Center - the newer of Vanderbilt's two midwifery clinic sites - and it was refreshing to learn its establishment has been a success. Towards the end, Tonia posits the creation of a birth center in Davidson County to serve low-risk women wanting an out-of-hospital birth experience. Supposedly Nashville had a birth center not too long ago...stuff went awry, though, and it was closed. Tonia seemed to be advocating for a new venture into the out-of-hospital realm, and I couldn't agree more. I think Nashville's ready for a birth center again. Bring it on!!

STEPP Outreach

2011-06-25T17:25:00.002-05:00

Several weeks ago, the STEPP coordinators and I spent a few hours posting fliers around Nashville to advertise the program's prenatal services. It seems a key issue facing underserved and uninsured pregnant women in the area is having a lack of knowledge about organizations that exist to help them navigate the maternity care system. Consequently, they end up entering into prenatal care late in pregnancy or foregoing care until birth is imminent. In addition, concerns regarding finances and citizenship appear to keep some women from seeking care. Many believe they don't qualify for assistance or may feel guilty about asking for help. Whatever the situation, it is unfortunate to realize a number of women in Nashville do not receive prenatal care.

STEPP aims to make a dent in the number of women who enter into prenatal care late in pregnancy or not at all. To do this, the organization has identified community outreach as an avenue down which to wander and strengthen. Our first flier posting was a success, with most materials on-hand disseminated by the end! For the next mission, we plan to reach out to more religious organizations and focus on areas of town with high Hispanic populations. I'm excited about the direction STEPP is headed, and can't wait till our next outreach extravaganza!

Myself and Sarah Morrow, 2011 STEPP coordinator showcasing fliers.

Bilingual STEPP fliers!!

2011 STEPP coordinator Kim Grelli and I are jazzed about community outreach.

Introducing: STEPP

2011-06-23T23:05:00.001-05:00

Recently, I began volunteering as a Spanish language interpreter and nursing student with an amazing organization in Nashville. Shade Tree Early Pregnancy Program (STEPP) is an outreach mission of Shade Tree Clinic, a free clinic run by medical students. STEPP’s mission is two-fold. Firstly, the program exists to connect pregnant women from underserved populations with early prenatal care, community resources, prenatal education, and social resources. Additionally, STEPP’s mission is to train medical, nursing, and midwifery students to provide holistic prenatal care for vulnerable populations by addressing their physical and psychological needs as well as their social needs.

Overall, the population of women who receive prenatal care through STEPP is diverse. Individuals served through STEPP include women in the Nashville area who are undocumented immigrants, uninsured, homeless, living in poverty, and non-English speaking. An estimated 1/2 of STEPP's clientele are Hispanic, Spanish-speaking women.

Basically, STEPP is a starting place for uninsured and underserved pregnant women in the Nashville area who need prenatal care. The program provides free services including an initial prenatal physical and pelvic exam, PAP test, ultrasound, laboratory tests, prenatal education, and social services consult. Anyone can contact STEPP and make an appointment. Each monthly clinic has the capacity to serve up to twelve patients.

Follow-up prenatal services are provided by certified nurse-midwives at Franklin Road Women’s Health Center (if patient is low-risk) or Vanderbilt OB/GYNS (if patient is high-risk). STEPP coordinates with care providers to schedule appointments and ensure patient records from STEPP are received.

Per conversation with 2011 STEPP coordinator Kim Grelli, 130 women have been helped through STEPP since its inception in 2009. Preliminary data released in Shade Tree Clinic’s 2010 Report showed STEPP helped over fifteen pregnant women in acquiring medical insurance, medical care, and social services during 2009.

The agency continues to reach out to community organizations, emergency departments, and free clinics to identify and care for more at-risk pregnant women. I look forward to continuing to be involved with this evolving, growing organization. I'm inspired by the work of my colleagues as well by the women who seek STEPP's services.

A poem for Father's Day

2011-06-22T23:38:00.001-05:00

"Dad" by Heather Sevcik

Inspiration has many faces,
I see her in the dawn as you ride
through the opening sky
to greet the day, wind blow breeze
mixed with sleet and snow
hurling you towards desperate resolve
to bike no longer in wild weather.
But the next day you do it again.

She hides in the backyard, amidst
honey bees and tomato vines growing up
in obvious oblivion to all life's hurts.
Time stalls in simple abundance as you tend
the ground made fertile by four score and six
years cultivation. Roots cast down
and spread w i d e, I sense
solidarity.
It is no wonder
in your garden a reckoning
exists between human and plant,
God and Heaven on Earth.

Dad, some days I feel your nurture seep
past my skin through muscle into bones
to reconcile all those pangs, worries, obsessions, and regrets
that lie deep within.
Calling forth what rots, you help me turn
the compost of my soul.

Will you still be in the sacred shape
of compassion when I no longer need
authority on matters of logistic
and faith? Where does a father go when
his daughter emerges from childhood chrysalis
and starts aflutter to find her way in the world?

Wherever I go, whatever I do,
I will never tire
of you and I sharing the view atop a mountain high
eating watermelon in summer sun,
and later picking raspberries
in brambles multiplied
by hands of determination and love,
all the while listening
to every word you say.
Some things
never
change.

Especially during the month of June
I celebrate you, Dad, and all that you are.
How'd I get so lucky?

Quote of the Day

2011-06-11T00:04:00.001-05:00

I found this quote in the comment section of an article about homebirth that appeared in The Washington Post:

"Obstetrics is just like an antibiotic - I'm very grateful it's there for that rare instance where I might get a bacterial infection, but most of the time it's just a common cold..."

Well said, I agree!!

Latest stats on home birth show increase

2011-06-08T00:01:00.002-05:00

According to an article released at the end of May 2011 by the Associated Press, the percentage of home births in the United States has risen over the past four years by 20%. The number of women who choose to give birth at home is still low, overall, but government findings indicate an increase. Interestingly enough, the statistics reveal significant differences in birthplace across race. In 2008, 1 in 98 Caucasian women had their babies at home, as compared to 1 in 357 African American women and 1 in 500 Hispanic women.

Why? Some suggest Caucasian women are more interested in low-intervention birth in a familiar setting than women of color. I'm not sure about this rationale. In my experience, most women prefer to receive medical treatment when it is indicated and avoid unnecessary intervention when childbirth occurs normally. And, a home-like, cozy birth environment seems enjoyable to many laboring women...across race, creed, and culture. I mean, come on, who wouldn't want to labor in a softly-lit room with a rocking chair and soft music, as opposed to a sterile white environment with an uncomfortable bed? And who doesn't wish to avoid an episiotomy or cesarean unless medically necessary?

However, women of color have a history of neglect with regard to the medical system. Often, they are the recipients of inadequate and unethical care...more so than their white counterparts. Though it may not be as overt as in the past, prejudice and racism appear alive and well in our society; just look at the racial disparities in health care. The infant mortality rate for babies born to women of color is sky-high in comparison to that of babies born to white women. Given the disparities, I imagine it might appear appealing to a woman of color to birth in a tertiary setting if given the opportunity. In the hospital, she will be certain to receive medical care (even if it is unnecessary)and will have access to technology and skilled surgical care...components of the medical system that were once reserved for white upper- and middle-class persons. Women of color, particularly those living in poverty, used to be forced to give birth out-of-hospital; home birth was the option because they could not access care in the hospital. Consequently, however, some of the most skilled birth attendants in the United States were African American granny midwives of the deep South. This, I find inspiring.

Given the history, home birth may be seen by some women of color as a form of oppression and a reminder of inaccessibility to formal health care. This saddens me because I know how transformational giving birth outside the hospital can be for a woman. Often, it is a perfect catalyst for empowerment and esteem. Women who birth their babies in an undisturbed and non-invasive manner become fierce mothers capable of taking on the world. For the well-being of all women, I wish the dawning of a new age free of racism, full of choice with regard to reproductive health care, and without the social and economic ties that dictate who should give birth in what setting.

This is beautiful.

2011-05-29T18:58:00.002-05:00

"Gas and Air" at Vanderbilt to Take Edge Off Labor Discomfort

2011-05-25T22:44:00.000-05:00

Alright!! Soon, Vanderbilt will become the 3rd hospital in the country to begin using nitrous oxide. Recently, an ICEA childbirth educator and doula interviewed one the Vanderbilt Nurse-midwives about nitrous oxide and wrote an informative blurb on the website Nashville Mama. Check it out!

It wasn't too long ago I wrote about nitrous oxide on this blog. A safe and effective alternative to IV narcotics and epidural analgesia, nitrous oxide is widely used in other industrialized countries such as England, Canada, and Sweden. You may know nitrous oxide by its lay name "laughing gas", and I venture to say many have experienced its effects while in the dentist's chair. Once upon a time it was also used in the United States to ease discomfort during labor, before the epidural came along.

What I like most about nitrous oxide is that the woman herself controls the amount of medication, as opposed to being dosed by a nurse or anesthesiologist. Using a face mask, the woman chooses when to breathe in, and can alter the amount of gas inhaled from moment to moment. Plus, the effects are rather quick. A feeling of euphoria and relaxation should descend after 2-3 minutes of breathing nitrous oxide. Anxiety relief and taking the edge off contractions seem to be the most common benefits. Unlike IV narcotics and epidural analgesia, a woman receiving nitrous oxide can still move around during labor and will remain aware of all that's happening. Furthermore, when a woman decides she does not want any more gas, she can simply stop breathing it and the effects will wear off between 3-5 minutes as the body clears the medication.

Now, I think I will always have a heart for unmedicated, undisturbed birth. There is nothing quite like it. However, in the interest of presenting women a full array of options when considering pain relief during labor, I am thrilled to know that Nashville's pregnant mamas will have another choice besides IV narcotics and epidural analgesia. The more options, the better; let's help women make the best, most informed decisions for themselves and their wee ones!