Sunday, March 29, 2015

What my books are NOT about....

My books are not about myself. They are about the courageous men and women from across the planet who have fled war, torture, famine and genocide. They come here with hope. They dare to hope that they can once more live in peace. They dare to fall in love again, dare to make babies again and dream of providing a better life for their families.

They come from every country and background imaginable; from Africa, Asia, the South Pacific, Mongolia, Burma, Europe and South America. Against all odds they have landed here, bringing absolutely nothing with them... but hope.

My books are not about my life. They are about these amazing survivors starting over, from scratch. They invite me to witness some of their most intimate moments, like the birth of their
babies. My job is to help them navigate the impossibly complex world of the American medical system. With each one I try to create a safe environment for them, so that they can access their
own power and wisdom from within in order to birth this particular child.

My books are not about me. Yes, I get to be part of their lives and rejoice with them. I often get to visit their homes, eat their food and kiss their beautiful babies, but this is not about ME. Sometimes I also cry with them. The last time was when I accompanied a woman from Ghana into the operating room for a C-section. Her twin babies were showing signs of distress. They needed to be born NOW. 



Two plump beautiful brown baby girls who both carried a rare genetic syndrome; the incidence is only 1 in every 15,000 births—and they both have it. They will be disabled for the rest of their lives, but their brave parents love them dearly.

My books are not the story of my life. So why has Ma Doula: A Story Tour of Birth been allowed to be listed in the Barnes and Nobel catalogue as biography and memoir? They should be under transcultural medical care, intercultural communication, childbirth, doula, midwifery, health, and parenting. I have sent this letter to my publisher to get to the distributor to fix it. 

Stay tuned! Ma Doula will be ready to order on May 1st. You can order through Barnes and Nobel or Amazon, though they don't have the cover we decided on in the end, or North Star Press, St. Cloud, MN.




Tuesday, February 10, 2015

Books! Books and More Books!!!! The Journey, At Last

There is light at the end of the tunnel. I have a publisher! (See: https://www.northstarpress.com/about-us.html) And an agent! AND an editor (who is also my fairy godmother. Who else makes dreams come true?) Though she would cringe if she saw how many exclamation points (!) I have used so far.

Fairy Godmother takes an edited version of my manuscript of birth stories to her publisher friend. I don't know her well enough yet, the publisher lady, to know if she is also a Fairy or a Goddess, or what, but they appear related, somehow. She is something, I know that much. She/they live in a straw bale house between a goat barn and the sheep pens. I also noted guinea hens, ducks, dogs, cats, chickens, and organic gardens. I may just rent a 24-square-foot postage stamp-size patch of the lower 40 field and move my tiny house on wheels up there and write for the rest of my life.

The first book is called Ma Doula (See the blog for the title story, posted April 29, 2014) and will be out in May, 2015. There were actually too many stories for the first edition, so another collection of birth stories will follow the first book later on, perhaps also in 2015. Stay tuned....

I often talked about another book on the blog that I call Stone Age Babies in a Space Age World; Babies and Bonding in the 21st Century© which Fairy Godmother is editing as I write. Hopefully we will see that in hard copy in early 2016. Stay tuned for that one, too....

Fairy Godmother has mentioned several times that she knows there are more books inside of me, though I was unaware of that. So, in an effort to discover them, I have continued writing and they are indeed in the first trimester of gestation. 

As soon as I have a front cover finalized, I will post it here for all to see.

Blessings, love, and all good wishes go out there to all of my readers and all of their babies.
Stephanie


Saturday, January 31, 2015

An Ethiopian Baptism and The Pope on Breastfeeding

I feel like I've just returned from Ethiopia. In a way I have. I spent the day at an Ethiopian Orthodox baptism. It was held in Minneapolis, Minnesota, but nothing inside the church all day could hint at any place other than the old country. Much like Roman Catholicism in the Western World, the Orthodox Church traditionally baptizes infants, rather than adults. A custom no doubt reflecting the high infant mortality around the world, where baby boys die even earlier than baby girls for a whole host of reasons, Ethiopian baby boys are traditionally baptized when they are 40 days old, and baby girls, who are often stronger at birth, at 80 days. Perhaps the thinking goes something like this: “Let’s get these boys baptized sooner and maybe some of that grace will rub off and cause more of them to live longer….”
A study published in a recent issue of Proceedings of the National Academy of Sciences  of infant mortality in 15 developed countries, including Australia, found that baby boys are 24% more likely to die than baby girls. This is down from a peak of 31% in 1970. "The marked reversal of historical trends indicates that at an age when males and females experience very similar lives, they are very different in their biological vulnerability," says co-author Professor Eileen Crimmins at the University of Southern California Davis School of Gerontology. "As infant mortality falls to very low levels, infant deaths become increasingly concentrated among those who are born with some weakness." However, it is still double the rate in the days before the development of vaccines and public health measures, such as improved sanitation, dramatically improved infant mortality rates.

The male disadvantage begins in utero. Girls have a stronger immune system while boys are 60% more likely to be born prematurely and experience respiratory problems.
Boys are also more likely to cause difficult labor because their body and head sizes are often larger than girls. When poor sanitation and nutrition weakened all mothers and babies, the male disadvantage was less noticeable. Today (2014 findings), look more like this:
5.7 deaths per 1,000 births in the U.S.; 70 deaths per 1,000 births in Ethiopia, 98 deaths per 1,000 births in Somalia, Iceland has only 3.14 deaths per 1,000 births—even better than the U.S. as does Greece at 4.7 deaths per 1,000 births, Cuba at 4.6, Ireland at 3.7, Sweden at 2.7, and Monaco with only 1.8 deaths per 1,000 births; however, in 1990, the infant mortality rate in Tibet, according to a study in the Chinese Journal of Population Science, was 92.5 deaths per 1,000 live births, roughly triple the national average for China. I am still sending out antennae, hoping to find backing for a trip to Tibet in the near future in order to get some real data on the situation there and hopefully some answers, too. In Tibet, the death rate of women in childbirth in 2012 was 174 maternal deaths per 100,000 births, compared to about 28 maternal deaths per 100,000 births in the U.S. Something needs to be done.
But back to Little Ethiopia in Minneapolis. The invitation said 6 a.m. Really? I was there. As the doors closed behind me, I smelled incense. I noticed shoes lined up by the door, too, off to one side. I removed mine and stepped into the church. Even the priest was standing up front reciting the prayers, clad in ornate gold vestments, in his stocking feet. The church was very traditional Orthodox with icons filling the walls and a gate at the front closing off the actual altar. Colorful tapestries and rugs covered the floor, the steps up to the gate, and the aisles. Heavy satin and velvet maroon curtains hung over the gate and across the front of the sanctuary. Giant sequined red and gold ceremonial umbrellas were lined up off to one side of the sanctuary next to 2 huge drums, also opulently decorated.
The women were all standing in the pews on the right of the church and the men on the left. A tiny girl, not more than 3 years old, with an impish smirk on her face, wandered up and down the center aisle, stopping to visit with different ones who invited her over. She was dressed in a miniature copy of the richly embroidered dress and veil of the older women, though her tiny pigtail tufts held her veil up at a funny angle which made her even cuter. All were dressed in white linen. No one tried to hush her or the other children in the pews. All the children were held or cuddled or left to wander around, unlike many churches in America where children are expected to sit still and remain perfectly quiet. Except, I now recall, the Amish services I have attended, 
despite their strict rules and old fashioned religiosity. At one point during a particularly long service, great big cookies were passed out to keep the children happy and they were free to come and go should they need to use the outhouse out back. Hutterite services were definitely different, however. The littlest children are expected to fill the front-most pews, the next group in age taking the next rows, and so on. Men and women sit on opposite sides of the meeting house, filling up the middle and back pews. This arrangement makes it possible for the parents to watch their children during the services and should there be anything out of the expected behavior in church, it will be taken up later at home. Babies and toddlers go to the kliene shul (little school) or daycare during services.
An aside here, I was happy to read that before a baptism recently in Rome, the Pope made a general announcement that during the service it is perfectly alright to breastfeed the babies there that day. Good for him. You rock, Pope Francis!
Against one of the walls to the right of the pews about 30 sticks were hung up like brooms in a janitor’s closet. They looked like broom handles or crutches. Maybe shepherd staffs. I couldn’t guess what they were for.
So we stood. The first hour went by quickly. So much was new to me, and the icons were beautiful, some framed with embroidered white scarves. The next hour was getting harder. How could they stand for so long? One older grandmother left her pew at one point, took one of the broom handles from the rack on the wall and returned to her place. She held the top handle of it with both hands, closed her eyes and leaned in against it. It was a crutch! You could prop yourself up with it and rest awhile.
           
So went the next hour. Prayers, hymns, incense, bells, responsorial prayers where the congregation answers the priest, all in Amharic. Not one word of English so far. The next hour dragged on. Then all of a sudden two gold-robbed deacons with matching gold brocade fez-like hats started filling up the baptismal font from two huge tea kettles. It was a brass caldron-like affair. The two families in the first pews started undressing their babies as I wondered if they had given them chamomile tea or something to quiet them. They hadn’t cried at all during the service so far. The priest then produced a huge ledger and wrote down the babies and parents’ names in the book, having the mothers check the spelling of the names before he closed it.
At this point the dads from the men’s side came over to hold their naked babies. A blanket was thrown around them to keep them warm until it was their turn at the font. Dozens of cell phones and cameras stood ready.
Then the priests, deacons, acolytes, and the two families moved forward to the water. More hymns and prayers for a while and then the priest signaled to the first dad to hand the baby to him. The tiny girl was wide awake but completely quiet. A deacon held the baby above the water as the priest scooped up a handful of the water three times and trickled it over the baby’s head. Then the priest took the baby from the deacon and dunked her three times, careful to only submerge her up to her armpits. She still didn’t cry. Another man was ready behind the priest with a towel. Then the priest did same thing again with the baby boy. Still wrapped in their respective towels, the priest blessed the babies with holy oil. Returning again through the gate, the priest along with the whole entourage proceeded with the Divine Liturgy. Oh, I almost forgot. After the babies were baptized, the people came out from the pews up to the steps of the sanctuary and the priest splashed water from the font onto them, group by group as they came up. Then they returned to the pews, making room for the next group to get splashed. I was pushed along by the wave of women in my pew and similarly, liberally doused.
Toward the end of the fourth hour I was standing with my eyes closed, listening to the beautiful eastern melodies when someone touched my sleeve. It was one of the deacons with a large book. He was holding it out to me. I panicked. What was I supposed to do with it? I winced and looked straight at him, hoping for a clue. Was I being invited to recite the next reading? Smart man, he whispered, “You may honor the gospel”, which is a custom I was familiar with from my monastery days—and that is another story altogether. At least then, usually at Easter, a cross or a bible was brought to the people to venerate. This one was an ancient, leather-bound tome with an orthodox cross embroidered on the cover. I touched my forehead to the book and then kissed the cross. I must have done it right because he moved on to the next person. It must have taken him another half hour to circulate through the whole assembly. When he returned to the priest, he read from the gospel for that day, and then afterwards, the bible was brought around again for all the people to kiss.
After the reading, one of the deacons came straight down the aisle and turned into my pew. Oh, no. Had I done something wrong? He opened a book he had under his arm and pointed to the verse the priest was reciting at that moment. There were three columns of writing on each page, one in Amharic, one in Oromo, and the last in English. Oh, good. Now I could somewhat follow what was going on.
So this was what Sundays are for. It is the Sabbath, and these people took that very seriously. If you can’t work, you might as well spend the day at church, praying, worshipping and singing. I started composing this story in my head as we neared the beginning of the next hour. Then my cell phone went off. EEEEKKKK! How could I be so stupid? I grabbed it out of my purse and tried to muffle it against my chest. I quickly turned it off. No one turned to admonish me or even glare at me. A minute later someone else’s phone rang, so I didn’t feel so completely mortified.
Two more grandmothers and a grandfather from the other side of the room retrieved crutches during the next hour. Then the umbrellas were opened and marched over to the tabernacle where the bread and wine had been consecrated, and the entire entourage processed back through the gate to the people who were lining up for communion. The newly baptized babies were presented first. The priest dropped a miniscule crumb of the bread onto a silver spoon that contained a drop of the wine and fed the babies their first communion like that. They still had not fussed at all. After all of the people received communion, the umbrellas were put aside and the priest delivered a sermon. It was all in Amharic, so I sat quietly and went back to composing my notes in my head.
As soon as the sermon was over, four young people dressed in blue headdresses and robes came forward, each holding a staff or crutch. Then one of the deacons took off his outer vestment and picked up one of the drums. The air was instantly electrified. The women started clapping and swaying as he began a low, slow, deep boom boom boom beat on the drum. He slowly marched in a little circle in the center of the sanctuary as the people in blue—two young men and two young women—marched toward each other and then back again. All of a sudden the beat picked up and the staffs were whacked on the floor with the beat and the drumming got louder and louder and on some cue that I couldn’t discern, all the women did some kind of trilling with their tongues, all in unison, and then stopped, all together, something I had heard in African music before, but never live. It was all so amazing! 
Even the littlest children were dancing and clapping. I remembered then that in the Old Testament King David had danced before the Arc of the Covenant (II Samuel 6 and Psalm 132) and wondered when we in the Western World had lost this part of our worship and had become so very serious. Dads were holding their tiny children dancing between the pews. At one point the drummer turned his drum over to another deacon who started right away with the faster beat, much to the agreement of his audience who trilled and clapped and kept dancing. Then things settled down and the priest walked up to the lectern to deliver another lesson. I guessed it was on a secular subject because he had removed his gold vestments before mounting the steps up to the podium. We all sat at that point. I wasn’t looking at my watch anymore, resigned that this was what I had committed to for the day, so it no longer mattered if he spoke for 15 minutes or an hour. When he was done, it was obvious that the service was indeed over. People stood up, the staffs were all returned to the broom rack on the wall and people were wading through the piles of shoes in the back looking for their own pair. As all of that was happening, the two acolytes were passing out paper cups of water. I was handed a cup as a girl asked me, “Do you drink holy water?” I said yes and gladly drank it, but within another moment wondered to myself if somehow we were consuming the water that the priest had blessed and both naked babies had been immersed in. Oh, well. I just chocked it up to another new experience.
People were slowly making their way to the bottleneck at the front doors and on down into the church’s basement, and then just as quickly coming back up with huge chunks of homemade bread. Then they broke pieces off and handed them out to everyone else still on the steps. It wasn’t the same bread as the communion host, but most likely, I imagine, something to hold everyone over so they wouldn’t faint on the way home. In many faiths, people fast from food from the night before they wish to receive communion, so if that were the case, these people had had a very long wait until now. It was past noon.
I greeted the priest on the last steps leading down to the street. He offered his hand to me to shake. Unlike our Muslim friends who never shake hands with the opposite sex, these people always did. Even hugs were not verboten here. I only realized as people flooded out of the church that I was the only white face there. The thought had not occurred to me until then. The priest took my hand and immediately apologized that the service was only in their language, “No English, I am so sorry.” I told him that it was beautiful, that the reverence and joy came through loud and clear. I told him I enjoyed attending their worship and felt blessed by it. He said he had heard from Selassie that I had been helping her during her pregnancy and he thanked me. I told him that Selassie has appointed me as the baby’s American grandma, and that I wouldn’t have missed this day for anything. He agreed. At that moment she found me and shuttled me over to their car. It is still winter in Minnesota, so we were anxious to get the babies and little children into the cars quickly.
Back at Selassie’s apartment we all fell into the plush sofas and finished off our bread. It was wonderful, though unlike any bread I had eaten at their houses before. It was definitely sweeter. Soon more and more people were arriving with hot and cold dishes and the kitchen was humming. I had waited to hold little Kelile all day until now, and I finally got to play with him. He seemed to know me right away, though I had only been checking in less than once a week since the birth. He looked so good, so happy and filling out. We had concerns in the beginning. One of the specialty children’s hospitals here has checked him over and put in place a care plan to address the concerns. He will be fine. An emergency C-section didn’t help Selassie worry any less about him. Her husband Yonas was still back home in Africa, plodding through the immigration process. The latest fly in the works is a new requirement from the U.S. visa department. Selassie had to come up with $600 and have the baby’s DNA tested and then send the file to a hospital in Dolo Odo, Ethiopia and have her husband’s tested too. If he proves to be his father, then he might still get a visa, on the condition that he meets all of the other requirements. I have worked with many women from Africa who come here, either pregnant or with small children, find work and housing, and then proceed to try to sponsor their husbands. If the whole family applies all at once, they are not always granted permission to immigrate.
I went into the kitchen after Kelile made it very clear that it was time for him to eat, and Selassie disappeared into the other room with him. I was hoping to help with the preparations, but they were mostly finish. The last ingera pancakes were being rolled and stacked on a huge straw platter and the buffet was ready. Stews and various curries sat steaming: red curries, yellow curries, curries with chicken, curries with hard boiled eggs swimming in the sauce, yellow rice, barbequed ribs, steak strips in another pan, all elegantly arranged. Trays of sodas and coolers of bottled water and beer were being brought out to the tables. All of us were being ushered then into the kitchen to pick up our plates and drinks. The food and people too kept coming and going all afternoon and into the evening as Kelile slept. 

Monday, January 5, 2015

Guinea Pigs and Doulas

We received a request at work from an instructor at one of the local colleges requesting a volunteer doula who would be willing to act as a laboring woman during several nursing courses covering birth and delivery and the nurse’s role. Of course I was intrigued. I had never done anything like it. Why not? The instructor herself had played the part until this year, which wasn’t easy as she was simultaneously showing them how to chart stages of labor and prompting her students to ask meaningful questions of their patient. And, no, I did not have to submit to pelvic exams. I sat next to a very sophisticated manniquin (woman-quin would be more accurate) who had a “baby” in her tummy, a too big hairless (I know, shaving is “in”) pale pink rubber vagina that flopped open when you parted the lips, and a cervix that the instructor could dial up from 1 centimeter all the way to 10, effacement and all.  (By the way, I looked it up and these models cost about $54K per mannequin!) So while Ms. Jones lay on the bed, I answered for her.
First I introduced myself by saying that I am 61. I knew they would be thinking ‘this lady is too old for this part’ but I went on to tell them that in the 1990s there were over 194 documented cases of women over 50 giving birth, some for the first time and that one woman in India was 74 years old; Another lady in Spain was 66.
What do you wear as an actress simulating a patient? I arrived in my long flannel nightgown and hospital slippers with the rubber treads on the soles. The class was divided into two groups of 10 students. While one group went to an overflow room and watched birth videos, the other half of the class stood around the bed and asked their questions. We had one hour for this birth.
Student #1: “Have you been having contractions?”  
Me: “Yes.”
Student #2: “Since when?”
Me: “Three a.m.”
Student #3: “Is this your first baby?”
Me: “No, my third.”
Student #4: “How close are your contractions?”
Me: “About 5 minutes apart.”
Student #5 to teacher: “So, if they are 5 minutes apart, when will the baby be born?” He was dead serious!
Instructor: “When do you think?”
Student #5: “Well, is there a formula to figure out the time, you know, just approximately?”



Instructor: “No.” 
He looked quite perplexed, and asked, “like… well… how will we know, then, when it is time?’
Next student: “When did you last eat?”
Me: “Last night, supper.”
The teacher assured me she would send a signal when I had sufficiently progressed through early labor. Now it was time to go into active labor mode.
OK, I can do this, I thought. So I stood up and paced around the bed, bending in half, bracing my arms on the bed and commenced slow breathing. One student bashed a folding chair up against the back of my knees encouraging me to sit down. I ignored him until the contraction passed and remained standing. One student suggested I go to the bathroom, so I complied and sat at one of the nearby desks, while I breathed through another “contraction.” Another student gently suggested I go back to bed, but I refused, and closed my eyes, saying it felt good being on the toilet and asked for a pillow for my back which another student ran to get while another one brought me a drink.
So it went for a while. I got back up and paced around a bit more, leaning against the wall during contractions, ignoring questions while I concentrated on my breathing. I got a wink from the instructor to ramp up first stage, so I went into serious active labor:
Me: “I can’t do this!”
Student #4: “Yes you can, you are doing great!”
                                                      Me: “I need something for pain NOW!”
Student #3: “You can do this! You are so strong!”
Me: “F&@#! I need a break. I am so tired. I WANT AN EP-I-DUR-AL!”
Student #9: “You wanted to try this without meds. Maybe we should try the tub next?”
Me: “OK.”
I relax and breathe in the “tub,” two folding chairs off to one side of the room, asking if my doula has come yet and if she can pour water over my stomach. I agree it feels good.
After a bit I announce that I have to throw up, which jolts the two students closest to me into action and they drop their clipboards and produce two trash cans at the same time. I “vomit” and announce that I feel better now. I have never acted before, but this is easy. I get out of the tub, I throw off my towel and try the birth ball, then hands and knees, and then ask for some help with back pain. Someone jabs all of her fingers into my middle back and another student does a hip squeeze on my rib cage. I gasp and grab their hands and place them on the right spots. Geez! I guess I really am their very first guinea pig.
I throw up again, ask for water, ask for meds, get a wink from the teacher and proceed to lay it on thick. One student suggests they check my dilation at this point. So they go back to the manikin on the bed and all ten students glove up.
Student #1: “Ms. Jones, I would like to check your dilation and see where we are at this point.”
Me: “Can you just wait until after this contraction?” (Breathe, blow, breathe….)
Student #2: “Ms. Jones, I would like to check your dilation and see where we are at.”
Me: “OK, just hurry up.”
Student #2: “You will feel my touch… a bit cold here….”
Student #3: “Ms. Jones, I am Jody, your nurse and I would like to check your dilation if that is OK?”
Me: “OK.”
Student #4 approaches the bed. He is from Kenya, studying here while hoping to go on to medical school eventually.
Student #4: (in his lovely clipped British accent) “Ms. Jones, I am going to check your dilation now….”
Me: “Oh NO you are NOT! My doula said I didn’t have to have any men in the room. It is in my birth plan! I was sexually abused as a teenager and have trauma issues.”
The class fell perfectly silent at this, eyes wide open, a few open mouths. A couple of them looked over at the teacher as if to ask, ‘is this in the script?’ She smiled and nodded at me.
I explained: “You will get this as male nurses, you two especially. It is a huge issue, actually. You can agree to find a female nurse for her, or you can try to explain that the floor is short on nurses tonight, and if her doula is right there, would it be OK if he checks you if he promises to be super gentle? Or you can just wait until her midwife shows up. What would you do if she were Muslim and also would not let you touch her?”
Student #5: “You are at 9 centimeters! Good job! Let’s try the birth ball again, shall we?”
Me: “I want something for the pain, I can’t do this anymore!”
Student #6: “You ARE doing this. Do you feel like pushing yet?”
Me: “No. I am going to throw up….” Then I take a sip of juice and as another “contraction” comes on, spin around to the handsome guy from Kenya and grab around his neck and lean into him, panting furiously. I get light headed; I didn’t know I could hyperventilate with fake rushes. Male student #2 shoves a chair against the back of my knees once again, encouraging me to sit down, which I couldn’t do at this point even if I tried with a baby about ready to crown between my legs. Mr. Kenya freezes in place, not knowing what to do for me, and tries to peel my hands off his neck, but I pull his hand down to my hip and show him where is hurts. He complies. Some of the students are quietly tittering. Poor guy, why does she keep picking on him? Frankly, I like him.
I detach myself from him and hit the wall, take a deep breath and try a tentative grunt. They all freeze. I do it again and say, “I have to PUSH!” and two students jump forward to maneuver me back toward the bed. I lay down and close my eyes and snore. The instructor moves over to the manikin and directs my pushing during the next contraction, checking for a cord as the head is born, then tells me to push again and I am done, reaching for my baby and telling everyone I couldn’t have done it without them. Then the instructor stops the delivery to point out this circle of bonding happening above my waist and how crucial it is not to disturb that. As long as baby is breathing and pink they have to honor that space and not interrupt what is going on with bonding. "Good girl!" I silently cheer. She is checking the cord for a pulse before inviting “dad” to cut the cord. She delivers the placenta, narrating as she goes. She presses on Ms. Jones’ tummy while looking for bleeding, assuring me that my fundus is nice and firm.
It is 10 a.m. and the next class assembles as I take a quick real bathroom break. Then the instructor and I do it all over again.
After class Mr/Dr. Kenya comes up to me, all smiles, and offers his hand. We shake. I ask him if he will work here in the U.S. or go back. He explains that he is considering medical school after he gets his RN. I ask if he has heard about the free medical school in Havana, Cuba, which he hadn’t. He has a brother already in med school here and marvels at the costs involved. I give all of the students my card, encouraging them to check out my blog and feel free to stay in touch.
I didn’t realize it at the time but there were other instructors observing the class from the back of the room. They introduced themselves afterwards, thanking me and telling me what a great job I’d done. I was hoping I didn’t come across as a total nut case. They seemed to have really enjoyed it.

The next day I received a Thank You card in the mail, signed by every student that was at one of our classes. 
Stay Tuned! This and other stories will be available in my book, Ma Doula coming out in May 2015!

Thursday, January 1, 2015

Soshi

Another referral. Another homeless lady. Another not-too-sure-what-just-hit-him father-to-be who is deciding if this is something he can try to do or just another hit-and-run accident that he can run from. Like right now. Another baby on the way. Drama, drama, and more drama. Not an ideal way to start a family, but it appears to be more and more common. At least here in Minnesota, and I suspect elsewhere, too. How many young men and women end up being adults by default only? Thrown to destiny without a lot of thought going into the process? Is this pre-ordained? Is it all supposed to be so random? My philosopher-self wonders about such things. Then they puzzle how come life has become so complicated. I would wager they either grow up real fast, give up the kid stuff and take responsibility, probably much like their own parents did, or else they cling to the kid stuff, try to make a go of it in spite of all the odds stacked against them, and fall further and further down the rabbit hole with few resources on board to get them out of it and back on a path that even resembles normal.
We meet and talk about birth plans and housing options, where to get maternity clothes cheaply or free, and her relationship with her parents and whether they can help out at all. Baby will take a back seat in most of this. The priorities right now are finding a safe place to stay that will allow her to bring her baby back after she is born, and after that, connecting with the services that will help her find more permanent housing and childcare so that she can finish school. The services are all out there, but I have found that it takes an advanced degree in law to wade through the system and the myriad hoops that are in place. I often wonder while I attempt to help someone with the paperwork if there isn’t someone sitting at a big oak desk somewhere at the top of some government building whose sole job is to calculate how to make the process as intimidating and impossible as possible in order to discourage the vast mass of humanity living below the poverty level from accessing their services and overwhelming the system which has already experienced their own budget cuts for the year. They have to keep a ceiling on the hordes that might otherwise stampede the system should it prove not such an obstacle course. A certain portion of those applying will give up frustrated and rather join the ranks of the homeless than sift through the unintelligible verbiage, submission deadlines, and required unobtainable accompanying paperwork. Even I don’t have records from my first job 45 years ago.
What I have seen in the past decade only confirms my hunch: that the welfare system does not make it easy to get help—on purpose. I bet they even have a pie chart with the statistics on how many people give up at each step or point of application. Put another wrench in the works come the next fiscal year and they can manage to (barely) run the department with the same number of social workers as they had the year before without having to cough up any more money. Won’t the governor love them then? That is how we end up having families living in tents under the Mendota Bridge in the middle of winter in St. Paul. With their baby. We brought them to a Catholic Worker house where they stayed for a week before disappearing again, determined to avoid child protection services at all costs.
Soshi was born in the Middle East and came to Minnesota as a child when her family immigrated. She went through the public school system and like many children of immigrant parents, rejected the “old ways” of doing things and adopted the status quo of their new country. In her case, Soshi rejected all of the “old ways” en masse, including her family’s religion and values. The proscribed women’s dress code was the first thing to go once she reached high school, traded in for skinny jeans and designer T-shirts. She liberated her hair next, throwing away the entire drawer of color-coordinated hijab. Dating was forbidden in the old country, instead parents arranged marriages for their children with like-minded friends and relatives from their own strata in society. What Soshi couldn’t get away with out in the open, she found alternative ways of accomplishing.
I have watched Soshi’s generation over the past twenty years as they assimilate into their new country. Many have the attitude, “Now that we are in an educated country, we can throw out the superstitions and make this a new time. All the things that were forbidden before and are allowed here, well, we don’t see the Americans suffering for doing these things.” And before long, drinking, birth control, movies—the list is endless—all the forbidden fruits of this new land find a way in and a whole culture feels it is being threatened. This occurs over and over again with each culture, every wave of new immigrants coming in contact with a more modern, opposing culture that puts their very existence at risk. My own grandparents went to their graves shaking their heads, watching their own children and then us grandchildren embracing a world they would and could never understand. My wise old father told me before he died, “Just remember, you can’t live their lives for them” when my own teenagers were writing their own declarations of independence.
So, it was no surprise that her parents disapproved when she brought home American boyfriends. The lectures and warnings went unheeded. Like me, when I was her age, I did what I wanted, ignoring my parents’ wisdom and threats alike. And like me, Soshi became pregnant at 16.
We met at the shelter every week to hash out the list of needs and priorities. One by one we ticked off the items on the list and life started having a pattern and not feeling completely random. We applied for programs that could offer her housing, child care, and a high school diploma. We hit the thrift stores on senior discount days (I am a senior) and found enough items that could pass as maternity clothes. We collected used baby clothes and even found time to enjoy a trip to the mall together.
Christmas was quickly approaching and several churches asked our group of doulas if they couldn’t gift some of our moms this year. We wrote down their sizes and wishes and submitted them anonymously. That was an interesting discussion.
Me: “Well, there is this church that wants to buy gifts for some of our moms. Can you tell me anything you’d like to ask for?”
Soshi: “What I want more than anything in the whole world is a Princess Tiana blanket for my baby girl.”
Did I hear her right? Is she 18 going on 12 or what? OK, I think I get this. She is still a teenager, and she wants what all the other girls have, or something like that.
Me: “What is that?”
Soshi: “Well, she is Disney’s first Black princess and I just love her!”
Me: “OK. Do you need a crib or maybe a snow suit for the baby? Or do you have a flannel nightie for yourself?”
Soshi: “Yeah, but I really want anything with Princess Tiana on it.”
Me: “OK. I will see what I can do.”
So I called all of the fabric stores within a 50-mile radius and found out that the Disney designer fabric is not even out online yet. I will have to call back in a week. Which I did, and found out that I could get it in a fleece for under $10. Now Princess Tiana was on the top of my wish list too! Yikes!
The next order of business was a belly cast. We scheduled it for the following week when I could get the room to ourselves where we do them. She was tickled with the results. It is one way of zeroing back in on baby, which is what this is supposed to be all about anyway. Between our modern, materialistic society’s expectations for our babies to have all the latest designer clothes and equipment and our unspoken wish to keep up with the Jones’, we forget the most elementary, basic, amazing, truly awesome fact that we have created a living baby! who most likely never existed before, and will now soon grace the earth with its being on an unforeseen day and hour. It will be the most important event at that moment in the entire cosmos! And yet most of the world will slog on with their mundane consumeristic lives.
When we were barely at 34 weeks Soshi called me one night after midnight. She was having contractions. We met at the hospital and watched as the monitors confirmed our worst fear: she was indeed going into preterm labor. Babies’ lungs are not mature enough yet to survive without a respirator which often cause adverse side effects. This was just too risky for our liking. We really wanted to keep this baby in as long as possible. The doctors suggested some IV medicines which miraculously worked to slow the contractions. By morning they were gone. This pattern was to repeat itself every two or three days until her due date. The meds continued to postpone a premature birth until week 40. Then we got no rushes or contractions. Week 41 was approaching and this baby was making no attempt whatsoever to be born. Neither of us could believe it when the doctors scheduled an induction. For this baby?
So we settled in to a birthing suite on the appointed day. We were excited that finally we were going to meet her baby. I teased that she was going to be just as stubborn as her mama. My own mother had once tried to curse me in a similar way: “I hope your kids are just as obedient as you were!” (To tell the truth, they were, and more!)
The OB tried one medication after another over the next 12 hours. Nothing worked. No contractions. We rested then for a few hours, me in a lounge chair and Soshi zonked out in bed. Six hours later she woke up to mild but regular rushes. Yay! At one point Soshi asked about pain meds and started on an IV medication. It didn’t do anything at all. I wasn’t surprised since the earlier doses also had not worked to induce labor for her.
At one point Soshi’s boyfriend, her baby’s father arrived, followed by one of his home boys. I realized immediately that Dad’s eyes were red, that he smelled of something stronger than 7Up and headed right for the lounge chair without even asking her how she was doing before flopping down in it and closing his eyes. The Homie sat in the only other chair in the room and commenced to nervously tap out a percussion piece on the bedside table with both hands.
So we breathed, and walked up and down the halls, stopping during the rushes and then walking some more. Finally she wanted to go back to bed and rest a bit. The Homie had gone home by now and Daddy was sawing wood, passed out on the futon in the corner where the nurse had brought it in during the night.
The nurse asked if they could check her and shocked us by announcing that she was 7 centimeters! We were going places now. Soshi again asked for more IV meds but I explained that she seemed to be nearing the end of the first stage and that they would hesitate to give her anything that might make the baby sleepy, and we probably didn’t have time to get the meds and have them wear off before her baby would come. The last thing you want is a sleepy baby at birth, drugged so much that he might forget to breathe and need resuscitating. She asked the nurse anyway, if she could have something—an epidural, anything—but the nurse repeated what I had just told her. I told Soshi that I was confident she could do this and that the nurse was going to get the anesthesiologist to discuss an epidural, but that if she continued to dilate quickly she could be holding her baby soon.
So we breathed, and tried groaning low cow-like sounds, tried the tub again, then the birth ball, and before she could be checked again, started pushing. The nurse became a bit panicky at this and called the doctor who I realized had been sound asleep in the doctor’s lounge. She gowned up and sat down at the foot of the bed on an exam stool and promptly closed her eyes. I took that as my cue that I would be directing her breathing and pushing which we had pretty well down pat by now. As the nurse tucked sterile sheets around and under her, Soshi asked the nurse to please try again and wake up lover boy who was still snoring to beat the band in the corner of the room. She tried her best, calling his name, yelling at him to wake up, even bumping his sneakers with her clogs several times. We didn’t get even a glint of recognition from him. He was out cold.
Five minutes later, Soshi again asked me to try to wake him up. I knelt by the body on the floor stretched out on the futon and pushing the dreadlocks out of the way, called his name. Nothing. I patted his cheeks with both hands, sort of like the old Laurel and Hardy films did it, and got nothing. I patted harder, slapping him by now, incredulous that even that didn’t wake him up. Damn it, you. Wake up! Nothing. I gave up and went back to the head of the bed.
On the next push her baby’s head was born (and the doctor opened her eyes in time to check for a cord around the baby’s neck.) Soshi reached out as the doctor passed her beautiful big baby girl to her. The nurse brought over blankets to cover her with. I was amazed and pointed out to Soshi that her baby was already lifting up her head and rooting.
Soshi was crying and kissing her baby, telling her how much she loved her, and then begging me to try to wake up what’s-his-name again. I was giving him plenty of my own names by now: Turkey, Turd, Looser, Toad, SOB. So I knelt down again by the futon and slapped him a bit. I was afraid I’d get punched if I did it any harder, so I stopped. I grabbed his shirt collar in both hands and hauled him up to a sitting position. His cargo pants had migrated down to his knees while he slept. I yelled in his ear, “Hey, dude! Wake UP! I want you to see your baby!” That worked. He shook his head, blinking a few times, and I said, “You have to see this amazing super Mama here” to which he replied as he stood up, towering over me, “Oh, there really aren’t any super mamas, only super Papas!” (I gagged.)
He walked over to the bed and took his daughter as Soshi handed her to him. He sheepishly smiled at me and the nurse, gave back the baby to Soshi, and headed for the door as he scooched up his pants and took out a pack of cigarettes from his leather jacket pocket. Then he was gone.
When I went back to the hospital the next day they were busy packing up and getting ready to be discharged. “Meat head” as I was referring to him--to myself only, of course--was hauling suitcases, knapsacks, and IT’S A GIRL! balloons out to Soshi’s car. She had driven herself to the hospital the day before. She handed me baby Fayga as she put her coat on. Dad came back to the room at that point. I thought to myself, “It’s either now or never.” I had been awake most of the night wondering what I could say to this guy. Could I say anything that might, possibly turn him around? What future would Soshi and Fayga have with him? Was there any hope at all?
So I tried. I was still holding baby who was snuggling into my shoulder. I loved this baby. I love all of my babies. And I had fallen in love with Soshi, too. I saw so many similarities in her that I could see in myself at her age. I cleared my throat.
“Can I talk to you guys?” I ventured.
“Sure” she said. He looked up.
“I am not your doula now. More like a grandma, really. I love this baby, and I love Soshi. I really care about what happens now. I don’t want your baby growing up without a dad. I don’t want her to have a totally absent father. You have one more chance. Are you listening?”
I got a grunt from him as he stood there, rather petrified, with his eyes wide open, wider than I had ever seen them.
“Look”, I said. “You have one year to turn this around, OK? No more dope, no more drinking. You need to clean up your s&@#! You need to get a job. This is it. You have a family now. Do you get it?” 

He nodded. This was not what he expected. I meant it, though. Every word of it. I tucked Fayga into her car seat and hugged Soshi good bye as he slinked out of the room. I have added them to my prayer list. My oldest daughter was shocked that I had even attempted The Talk. She said I was lucky I didn’t get a broken nose out it. That had not occurred to me as a possibility. If only they could live happily ever after now, like Princess Tiana and her Prince Charming.

Stay Tuned! This and other stories will be available in my book, Ma Doula coming out in May 2015!

Tuesday, December 30, 2014

It Takes a Village

I was filling out Tiana’s paper work as I was signing her up for our doula program and at the same time gathering some information about her wishes for this birth that would eventually evolve into a proper birth plan. I asked her who she wanted to be at her birth. She answered, her mom, her step mom, her mother-in-law, her brother, her husband, and her husband’s sister. I put my pen down and gave her my little canned speech about not inviting everyone because you might end up feeling like you’ve got all these people watching and waiting for you to ‘perform’ rather than just making the birth room yours, essentially owning it; a sacred space wherein to welcome a new little soul to earth. I have also learned from experience that sometimes relatives are not all that helpful. Often, during labor, they will start telling all of their own birth and labor horror stories—definitely not helpful—or start suggesting interventions, like an epidural, that they used and thought was the best thing, while you are trying your darnedest to at least try to go naturally. I have even had one family set up a bar (BYOB, and not Bring Your Own Baby) and begin the celebrations before the little man even arrived! Other mothers-to-be have been asked by their mother or best friend or mother-in-law if they could pleeeeaaaaasssseee come to their birth, and they aren’t assertive enough to say no, and, well, if she comes, and I don’t let his mom come, then she’ll be mad at me… and soon you have an entire congregation attending.
So, I had my say, for what it was worth, and finished up the paper work. That done we watched the DVD called, “Doula” made locally here with many of the doulas I’ve worked with. The interviews with the midwives, doctors, new parents, and doulas in the film are wonderful, but even more importantly, I like to have first-time moms especially see all the diverse families and what they wanted for their births and how your doula tries to create that birth experience for you. There are home births with siblings present; home water births with dad in the pool, too; hospital water births; hospital medicated and un-medicated births; au natural births and moms dressed in their own clothes; unplanned Cesarean births and planned C-sections.
So, now empowered with all this information, I ended our first meeting and encouraged them to read as much as possible and suggested checking out some of the videos on my resource handout, pointing out the starred ones that I was designating as their homework for that night.
1    1. *You Tube: Breast Crawl by UNICEF ` A MUST SEE!
      2. Breastfeeding Resource Pages – La Leche League International: www.llli.org/nb.html

      The following is the connection to an amazing group in Canada with seemingly endless information – all excellent. IBC is composed of three departments: the Newman Breastfeeding Clinic, the Centre for Breastfeeding Education, and the Centre for Breastfeeding Studies:  http://www.nbci.ca  You can call them for help anytime, too: PH: 416-498-0002
3.      AskDrSears.com – valuable advice on breastfeeding and parenting (my personal favorite)
4.      Google on YouTube: “Extraordinary Breastfeeding,” real food for thought!
5.      *You Tube: “The Dramatic Struggle for Life” – very amazing footage from Bali
5.      *And here is one for your partner: https://www.youtube.com/watch?v=ws3MoSZrb58
7.      *YouTube: see https://www.youtube.com/watch?v=OPSAgs-exfQ
8.   *on Netflix see “Doula”
Our next couple of meetings went well as we were getting to know each other. Zion had some really insightful questions about birth and labor and was really getting “charged up” as he put it, for birth. Tiana was less vocal. I wondered if she was just plain scared. Most of her answers to my questions about how she was preparing for their baby were all monosyllable answers, “yes,” “no,” or “I dunno.”
Then as week 38 was quickly approaching I gave her a sample birth plan and suggested she change it to fit her expectations. She never worked on it, which was also OK, but I had been hoping she would take a more active role in her birth. I did learn that her mom had four very fast, natural births, so she thought she would try that. We were at her 39th week appointment when she asked if she should just show up at the hospital on her due date and wondered how they “start it up.” The midwife we were seeing that day laughed and said, “Remember when we went over the signs of labor starting? Well, we wait until your body tells us it is ready. You will see some spotting, though that doesn’t always have to happen first, or your water breaks, or you have contractions that don’t go away when you try to rest.”
Tiana thought about that a minute and then frowned. “You mean I gotta wait for that? It ain’t jus’ gonna all be over on my due date?” Whoops. I thought we had been preparing for this all along. Tiana was still in high school and at one appointment had told me about the birth classes the school also had for young moms, so I had thought we had plenty of childbirth ed going on here, but I was wrong. The midwife went over the basics of early labor again and reassured Tiana than this was all perfectly normal and that often first babies decide to arrive after their official due date, which is in fact only a guess date. There is no magic formula to predict when each baby will be born.
“Shee-it!” was her response. Tiana was tired of being pregnant. She was tired of heart burn and swollen ankles, uncomfortable nights and constipation, all normal side effects of pregnancy. She had been all geared up for this pregnancy to be done with on The Day, which was now one week away. Her mom was going to come up to be with her on that day and needed to go home shortly afterwards. She got dressed and left, a very disgruntled mama for sure.
A week later we met again. As soon as the midwife came in the room and started to measure her belly, Tiana asked if she could schedule an induction. The midwife asked why?
“’Cause I want this baby to come while my mom is here.”
“I can’t do that. Your baby will come when he is ready.”
“But if I am really overdue you could induce me, so why can’t you now?”
Patiently the midwife tried to explain that there has to be a good reason to induce babies and that her mom being here for a short time isn’t one of them. This did not sit well. Tiana left shaking her head while Zion practically danced out of the clinic singing a little made-up rap, “I’m gonna be a daddy, YES! I’m gonna be a papa….”
That night I got a call from Tiana asking if there was anything she could do to bring on labor. I explained that she could ask the midwife what she thought about what we call “stripping the membranes” where, if her cervix has started to dilate, the midwife can sweep a finger around the cervix while gently separating the bag of water from just inside the cervix. Sometimes this will trigger the uterus into thinking it is time for early labor. I also told her how I had gotten on a bike one day and rode for an hour up and down a dirt road when my twins were due and I couldn’t eat or hardly go to the bathroom anymore because I had two big babies inside and no more room left and that it helped start labor then. 
I also said that some midwives suggest that having an orgasm, with or without sex can also trick your body into thinking contractions have started. Some suggest that the male hormones from the dad during sex help labor start. Nipple stimulation can also trigger contractions. Then she told me she heard that using Pitocin helps but that it makes the contractions super painful and unbearable. I explained that that used to be the case, but what I have seen more recently is that smaller doses are used just until active labor is established and that often the Pitocin is turned down or off when the uterus responds well. Again I said that they have to wait to induce for a true medical reason. I also encouraged her to keep in touch with her midwife who might have other suggestions or tricks up her sleeve.
Well, the Guess Date did come and then go. Then two days later at 4 A.M. the phone rang. YAY! We had contractions. I said she should call the midwife and let me know if they wanted her to come in. She called me back and said they wanted her to wait until she had contractions for two hours that were five minutes apart. She told me they were already unbearable and I suggested she get in a hot tub or shower and keep me posted. An hour later I received a text that she was on her way to the hospital. I was off, too.
Our hospital has a Triage unit where moms first go to be assessed. Too often women come in very early labor, only one or two centimeters, and are encouraged to return home where they can labor in familiar surroundings and rest and eat until labor is truly established. When moms come in too early they often end up with interventions that could have been avoided. In Triage the baby and the contractions are monitored and if everything looks good they can be reassured that they are doing well and that labor will pick up exactly at the right moment, and that they should not be discouraged. My twin birth in 1982 seemed to have kicked in one night with some whopper contractions and I was slowly dilating, but suddenly they stopped. After another hour without any appreciable contractions I was sent home where I went to bed and did not have any signs of labor after that for five more days—until the day I got on the bike, determined to have my babies then and there. They had understood the eviction notice. That night they were born after a 58 minute labor. Finally.
The midwives assured Tiana that her body was getting ready, that this was all perfectly normal for a first-time mom, and that her baby sounded great, but that this early labor could go on for another day and they really thought she would be more comfortable at home. Zion, however was not phased. He was shimmying around the room with another original rap about his son who he couldn’t wait to meet. Tiana’s step mother, Imani, was helping her dress to go home when we all heard a tiny wet splat or plop. Tiana looked down and exclaimed, “EEEEEUUUUWWWWWW!!!” There on the floor was her mucus plug and water was running down her legs, filling her slippers.
“That’s so damn GROSSSS!” was her next expletive. I laughed and said, “Your water broke! Congratulations! See, your body knows exactly what to do.”
Her reply as I grabbed some gloves and paper towels to wipe it up before anyone slipped was, “EEEEEEEEEEEEEEUUUuuuuuuuWWWWWWWWGROSS!!!”
Imani steered Tiana into the bathroom to clean up as I cleaned up the floor, skirting Zion as he tiptoed around the room humming his little song like a big Black Pooh Bear. I told the nurse that it appeared that her water just broke. She went back to the nurses’ station and got a test swab to confirm that it indeed had. By the time that Tiana had dressed the contractions had picked up appreciably and the nurse put her back on the monitor. We weren’t going home or anywhere else for that matter. We were going to have a baby.
Soon we were roomed in a proper birthing room. I got a birth ball and filled a pitcher with ice water. Zion had texted his mom and sister and before I knew it I was being introduced to the whole tribe: her mother-in-law Alexi, her brother Naveah, her husband’s sister Jayla, her sister’s cousin Kiara, Tiana’s sisters Trinity and Onieda, and cousin Melida. Then her brothers arrived, Shay-shay and Diamond. As we got settled and hung up coats and collected more folding chairs from the other rooms around the hallway, I found a quiet corner and parked on an exam stool to update my paperwork. Everyone got comfortable while Zion wrestled with the lounge chair, trying to figure out which nobs to pull to turn it into a day bed. He was ready for a nap, having been up since 3 A.M. I poked around the cupboards in the room until I found some sheets and a pillow and helped him make up the bed. As relatives continued to arrive and greet one another, I tried to get near the bed. I wanted Tiana to know everything was going really well. The contractions were picking up and their baby sounded wonderful. I reminded her to breathe slowly and remember to relax her face, and throat, then shoulders and legs. I massaged her hands during the next contractions and then as her mother-in-law took over the hand massages on her own I moved down to her feet. 
She said that all helped relax. During the next hour Tiana asked to just be allowed to rest in bed. They had been up since 3 when the contractions started.
At shift change I wiped the white board in the room and updated it with our new nurse’s name, the new midwife’s name and under the title “Goals” wrote, “Have Baby Boy!” I invited Tiana’s sisters to fill in the rest of the box marked, “Companions.” They managed to squeeze them all in: Zion, Imani, Jayla, Alexi, Kiara, Naveah, Trinity, Onieda, Melida, Shay-shay, and Diamond.
One of her cousins busied herself with Tiana’s make up. She wanted her to look her best for the pictures they all planned to take. She suggested only above the waist photos for before baby comes and maybe a few as he is crowning. Tiana wasn’t sure about that. They continued discussing pictures while Tiana had her eyebrows sculpted. Lip gloss completed the procedure. I noticed how relaxed she was while being made up; no complaints about the contractions or rushes. Hmm. How could I tap into this and get her to relax?
Suddenly about 6 cameras started clicking and flashes started going off, now that the star of the show had on her makeup. It looked like a scene on the news of some diva rock singer showing up for her debut as she steps out of her limo, mink coat trailing, in front of the night’s venue. I had been wondering when her midwife would comment on the sheer numbers of people in the room and now she did.
“Maybe you can put away all the cameras and phones for now, at least until the baby is born, so we can work around the bed and help Tiana relax.” Very diplomatic.
I sat next to the bed and encouraged Tiana through each rush. After another hour she asked how much longer this could go on. I explained that for a first baby we expect about 1 centimeter dilation every hour, or sometimes every 2 hours and that is perfectly normal. I also said that she would feel a whole lot better doing anything other than being on her back in bed. We finally helped her up and walking down the long halls with Zion. I demonstrated with his cooperation how to lock her hands behind his neck and hang that way during the rushes and that moving her hips from side to side and in a spiral or circular motion would also help the baby move down.  

After one lap around the fourth floor she was back, heading for the bed. I grabbed the birth ball and firmly but gently suggested she stay upright awhile longer sitting on the birth ball at the edge of the bed which I then raised up to her shoulder height once she was seated, and positioned a pillow in front of her on the bed so she could really rest in between rushes. After a while, though she admitted it had helped, she asked about pain medication. I suggested she call the nurse and discuss her options together. The nurse told her it was still pretty early in the labor, and strongly urged she try a hot bath. They discussed this back and forth for a while until Tiana agreed to try it. Once she was ensconced in the tub with the lights out and tiny pin lights glowing around the edges of the tub, she relaxed. I got a pitcher and slowly poured a little stream of water over her belly. After a few minutes, I asked Zion if I could show him how to do this. He bounded in humming a new little hum and quickly got the hang of pouring a steady stream of water over Tiana. They stayed like that for almost an hour. When she got out and the nurse checked her she was at 3 centimeters. Not too fast, but definitely progress. We tried the birth ball again at this point and I had Zion behind her on a chair rubbing her lower back with a massage ball. I assured her that the back pain was a good sign that her baby was moving down into her pelvis. He was still sounding wonderful when the nurse intermittently checked his heart tones with a Doppler.
While Tiana was in the tub the sisters had gone down to the cafeteria, returning with covered plates of full of eggs, sausages, biscuits and toast and passed those all around. Another sister came back with a tray of a dozen cups of coffee in paper cups. They seemed to know how to do this—feed a crowd. This tribe knew how to “do family” I thought as I watched in wonder. I had also been figured into the breakfast count, bless their hearts!
Another aunt came in during breakfast and announced that since this was such an auspicious day, the day of their little man’s birth, she had gotten lottery tickets, the scratch kind, and passed them around. Someone was sure to get lucky today, she explained.
As breakfast was wrapping up, Zion went around the room picking up all the paper wear and cups and generally tidying up the room. About this time Tiana, smart girl that she is, asked one of the nurses if they might have an even larger room available than this one. The nurse left to check and soon came back saying that one other mom had just gone home and they had called housekeeping to clean it right away. Within an hour we moved into our new, bigger temporary home.
I thought I had a lot of people at my twins’ birth. We had gone to The Farm in Tennessee to have our twins in 1982 and agreed that all of the midwives there should feel very welcomed, so we had 13 midwives, two Farm doctors, and the camera man (we had also agreed to let them film our birth since a natural twin birth was becoming so rare.) There were also several nurses on hand to help with the babies should they need anything. At the time I didn’t feel cramped or crowded at all, only deeply grateful for the chance to have a natural birth surrounded by so much love, and care and expertise. There were even women in the kitchen in the clinic starting the pancakes I had wished for afterwards. They had thought of everything.
At one point Zion was talking on his phone and seemed to be taking orders of some kind. He yelled across the room, “Yo, Stephanie. Want anything from Cub?” (Our local supermarket.) I said a bottle of orange juice would be nice and put in my order, which he refused to let me pay for when it arrived.
While we continued to breathe through the rushes, we could overhear the older women talking about Thanksgiving and who should make what dish. One of them turned to me and asked if I had to cook the whole dinner for my family this year besides working and I explained that I didn’t have to do anything this year, that our sister-in-law was making it. She asked if I would at least bring a dish along and what I would make. I said I liked to bring stuffed acorn squash halves, filled with wild rice, currants, and minced onions sautéed with a pinch of cinnamon and cumin, and walnuts.
Sometime around 5 centimeters Tiana decided that she wanted an epidural. When the anesthesiologist arrived, I took the lead and announced that we all had to leave so he could set up and promptly escorted the crowd into the hall where the conversations continued.
It was just 5 P.M. Then, as if we had not sufficiently filled up the room, her Aunt Precious showed up with her two daughters, Faith and Charity, who were toting bags of fried chicken, dinner rolls, bottles of soda, chips and I don’t know what else. Oh, yes I do. Now I remember: bags of Halloween loot. I took a short break by the bedside to get some more ice water and on the way out the door passed the cousins and brothers, all big macho guys, Zion still happily humming, with lollipops in their mouths!
Only a few minutes later as Zion dug into the chicken, the nurse announced that Tiana was 10 centimeters and we were going to set up the bed for the delivery. With his mouth full of chicken, he looked at me with a pained expression and asked, “You can’t even eat fried chicken?” Earlier in the day, I had declined the burger and fries he offered explaining that I am a vegan and had brought snacks with me. I laughed and said, “I think Tiana needs us over here just now.”
Zion gulped down some more chicken and stood by Tiana’s head wiping his fingers off on a napkin where I had suggested he go and hold her hand. I was by the head of the bed on the other side, showing her how to hold her legs behind her knees. The baby warmer was turned on and the sterile pack of instruments was being unwrapped at the other end of the bed. About eight ladies were lined up behind that, cameras and cell phones ready. I looked over this scene and thought in my mind, “What is wrong with this picture?” I left Tiana’s side and walked to the end of the bed suggesting that the ladies might want to stand closer to the windows on this side of the room and give Tiana a little privacy at the end of the bed where the nurses were helping her position her legs on two trough-like stirrups. The epidural had rendered her legs numb and as heavy as tree trunks.
I returned to my position and encouraged Tiana during the next rush. She did not have an urge to push, the epidural blocking any sensations there, but the midwife was ready to offer directions from down below where she was now stationed. I was too far up near the head of the bed to see what was going on down there but could tell from the midwife’s response that things were going very well and she could see the baby’s curly black hair even after just the first push. I whispered to Tiana that she could rest now and when the midwife says to push, I will help her take a deep breath, let it out as the contraction builds and then, taking another deep breath, put her chin down to her chest, hold it… and… push… and again…. And then baby’s head was out. Just like that. It was the shortest second stage in a first-time mom I had ever seen. The midwife said the same thing. Another push and he was out. The ladies had migrated once again to the end of the bed during this time (it was nearly impossible to keep the paparazzi away) and the flashes started up again nonstop. The ladies were crying and hugging each other. I looked up and Zion was daubing his eyes and shaking his head in disbelief. One lady moved over nearer to me and said, “I am twenty-nine years old and I have never seen a birth before. This is so AWESOME!” It really was. I whispered into Tiana’s ear, “You did it! I knew you could! You are so amazing and I am so very, very proud of you, my dear!” She was crying too. As soon as Zion cut the cord the baby was put onto Tiana’s chest and a fresh warm blanket was laid over him. She instinctively held him there with both hands and noticing his warm little bum sticking up under the blanket she proceeded to pat it with both hands. She couldn’t say anything yet but just looked over at me beaming, tears rolled down into her ears. Her makeup was still perfect.
The family continued taking pictured from every angle, including the end of the bed where the midwife was waiting for the placenta. Oh, well. I don’t know how I could have managed crowd control any better. Tiana seemed completely unperturbed by it, so I just let her lead the way. I had let her know early on that she could let me know if at any point she wanted me to thin out the audience and send a few people out but she said it was all good. She had such an amazing family and support network. They were really good at this. I could certainly learn something from them.
The next day I emailed a friend/RN/aspiring CNM in St. Paul, asking her what her hospital’s policies were when it comes to families. She wrote back: “Our hospital does not have a specific number, but leaves this to the physician and nurses’ discretion. If the room is big enough, and the family is respectful, we can allow many people to stay. If they have a big family, I try to lay a ground rule early on that only two or three people fit in the room, and appoint a gatekeeper of another family member to do crowd control. There have been times we have needed to invent a unit-wide rule for the sake of getting obnoxious and unwelcome family out of the room, but only if they are truly interfering or causing a safety risk- there are even times we have had to call security to crowd control for us when there are 20 family members trying to take over a room. If we can't get a bed past them out to an OR, or a neonatal crash team in to the room, it's not safe and they need to move. If they are making unhelpful comments or being rude to myself or any of the identified birth team, I'll boot them.”
She continued, “I had a time once with a teen mom where I was certain that the six people she had identified on her birth plan to come would cause me grief all day. They were loud, discussing sports or their own births, and kept repeating untruths about birth and reproduction. I resolved that I would need to thin the crowd as she moved to active labor. But then her friends and family moved to interact with her, every one of them taking a task and becoming the most beautiful team of doulas I have ever witnessed. They all stayed as the baby was born, and they were sensitive and respectful, aware of the space I and the physician needed to work, and quietly efficient! Loved it!”
Another friend, C wrote back also: “Each hospital sets their own number. Here in New Jersey it is 5. You know the saying: the more people in the room the more dysfunctional the family. Much love. C”
But, back to my family. After the birth while Tiana was being cleaned up and wrapped in pre-warmed blankets and her baby boy was nursing like a real pro, I packed up my things from all around the room, quite ready to catch up on missed sleep. The room had thinned out appreciably and I assumed the family had started going home, too. I was wrong. It was time to eat again. They all came back in, this time toting Submarine sandwiches for everyone. As I prepared to leave after hugging everyone goodbye, I made my way down to the hospital lobby. The one group of brothers and boyfriends of sisters and cousins who were not with the sandwich crowd were just coming back into the hospital as I reached the front doors.
“I thought you all left?” I asked. Zion answered for them, “No, we just went out for a smoke.”
I hugged him goodbye as I whispered in his ear, “I hope you can give this up—smoking—it’s not good for your baby, even second hand smoke is really dangerous, you know.”
All I got was a half-hearted, “I know.” I tried.
I came back the next day. The crowd was less today. One of the aunties was changing their baby’s diapers. I mentioned that I had just run across a new gadget for babies that they just must see. I got out my phone and got the website for http://www.amazon.com/Beba-Bean-Pee-pee-Teepee, a soft little cover that you can order to put on your baby boy’s penis while you are changing him to protect his clothes and yours from any unexpected geysers. They thought that it was the funniest thing they’d ever seen!
I finished up my paper work and hugged Tiana goodbye. I will miss this big, loud, loving family, each and every one of them. It will take a village to raise this baby, whether he wants them or not. Lucky kid.
Stay Tuned! This and other stories will be available in my book, Ma Doula coming out in May 2015!