Thursday, June 13, 2013

A Day in the Life of a Doula: Baby Parties!

Every culture has their customs. Some are dictated by religion, some by superstition, or just plain wanting to have a good excuse for a party. In many cultures that have come out of primarily Third World Countries, the infant mortality rate is high – higher than ours, so you have more babies than you planned for, often as many as you can manage to make, because statistically, a certain percentage will not survive. A new report by Save the Children finds that India leads the world in the highest number of babies dying within the first 24 hours of their birth, more than 300,000 a year. The international non-governmental organization sounded the alarm this week with its annual State of the World’s Mothers report, which says India accounts for 29 percent of all global first-day deaths. The three major causes of newborn mortality are pre-term birth, severe infections, and complications during childbirth. Save the Children said these three conditions alone account for 80 percent of all newborn deaths worldwide. (And I cannot help but wonder if reports of killing unwanted baby girls is not being added officially to these numbers.)

As of this writing the best countries to have a baby in (and ensure its survival) is Finland, Sweden and Norway. The worst are the Democratic Republic of the Congo, Somalia and Sierra Leone (Save the Children’s Mother’s Index.) Tibet isn’t far behind with not only its high infant mortality rate but rates highest or number one on the charts for maternal deaths. Many studies have been done in Lassa, Tibet at the
hospital there on high blood pressure, anemia and altitude considerations as the possible cause, but according the Tibetan diaspora in Minneapolis, which is the 2nd largest next to New York in the U.S. when asked, they universally site the cause as the calculated Chinese genocide on the Tibetan population: A family brings a woman into the hospital because of complications during labor and the all-Chinese staff does little or nothing – intentionally. (Does anyone want to fund a watch-dog trip to Lassa? Let me know!)

A recent CBS report reveals that the United States has the highest first-day infant death rate out of all the industrialized countries in the world. About 11,300 newborns die within 24 hours of their birth in the U.S. each year, 50 percent more first-day deaths than all other industrialized countries combined, the report's authors stated. The 14th annual State of the World's Mothers report, put together by the non-profit organization Save the Children, ranked 168 countries according to where the best places to be a mother would be. Criteria included child mortality, maternal mortality, the economic status of women, and educational achievement and political representation of women. Worldwide, the report found that 800 women die each day during pregnancy or childbirth, and 8,000 newborns die during the first month of life. Newborn deaths make up 43 percent of all deaths for children under five. Sixty percent of infant deaths occur during the first month of life.

So I was not surprised when my friends from Laos explained that they will not celebrate the birth of their new baby until she reaches her 1st month birthday. We are not supposed to mention that she is cute, or adorable or strong, much less her name which the parents have not said out loud even once yet, lest the bad spirits hear of these things and come to spirit her away or make her sick, which is basically the same thing in
their history. The Ethiopian family that I recently was doula for asked me to attend their new daughter’s Orthodox baptism when she reaches 40 days of age. Boys’ baptisms take place on day 30. They could not tell me where that comes from, but I can only guess that in their experience in the past girls babies were stronger than boy babies, so they chose to move up the date for boys to somehow absorb a little extra grace so they might have a better chance at survival. In many cultures the baby won’t receive gifts until the proscribed ‘wait-and-see-if-he-lives’ period is over.

Adam Katz-Stone writes in an article in The Jewish Federations of North America newsletter:In Jewish tradition, baby showers were taboo. Neither Halakha or Jewish law forbids gifts for an unborn child, but custom effectively prohibits them. Such gifts once were thought to draw the attention of dark spirits, marking the child for disaster. To this day, many Orthodox Jews will not so much as utter the name of a baby until that baby is born, for fear of inviting the evil eye. In liberal Jewish circles, however, attitudes are more relaxed.
"I don't think there is anything wrong with giving gifts," said Rabbi James S. Glazier of the Reform Temple Sinai in South Burlington, Vermont. In his view the traditional reluctance to hold a shower "is based more on superstition than anything else. It's all Ashkenazik medieval superstition. I don't denigrate it, but on the other hand I don't put a lot of stock on it either."

While the rabbi and his wife had baby showers for both their children, they deferred to tradition in so far as they did not decorate the nurseries until after the babies were born. Like many modern rationalists, Rabbi Glazier said he respects the psychological imperative behind the custom of not holding a shower – a custom that arose in a time when infant mortality was high.

"I can see where you don't want to have a whole room waiting, in case something terrible should happen," he said. "Today people have concluded that since infant mortality in childbirth is so infrequent, they think every child will be healthy. I don't agree with that. In our case we didn't want to be faced with a complete room before the baby came home healthy."

At the Conservative Temple Beth Shalom in Mesa, Arizona, meanwhile, Rabbi Bonnie Koppell said her mom warned her against buying "so much as a receiving blanket" before her first child was born. The rabbi went shopping anyway, but she agrees that full-scale pre-natal nursery design may not be appropriate.
"My sense is that preparing a whole suite of furniture and decorating the room might be a bit much," she said. "However, a few receiving blankets, onesies, and diapers--G-d forbid, if the infant does not come home, these few things won't make terribly much difference in the face of such overwhelming grief." Yet there are many in the observant community who will not buy so much as a sock. Some say that the tradition of shunning the baby shower is not just ancient superstition: it serves a deeper communal need.” It's not just about the couple having the baby, they say. It's about all the other couples that can't. Rabbi Jay Yaacov Schwartz and his late wife wrestled with infertility for years before adopting. When they did begin the adoption process, "we didn't even tell people when we had an adoptive opportunity, because we were afraid of ayin hara -- of bad energy," said the rabbi, a spiritual leader at the Orthodox synagogue Young Israel of Oceanside in New York. Rabbi Schwartz was not literally afraid of demons. He feared waking the cosmic wheels of action and reaction that he believes return to us just what we give out. In this case, he knew that his happiness might cause pain for some childless couple, and their unhappiness would someday come back to bite him.

I have also been to Hmong baby parties for my friends from Laos. One time I was told to come to a certain address by 8 a.m. It was a good thing I didn’t have any other obligations that day. We didn’t eat until 7p.m. or later. Really. The pig was still running around in the basement when I arrived. He would be ritually sacrificed sometime during the day to drive away all bad spirits from the baby and his family. A shaman sat on a sawhorse upstairs and played his bamboo raj nplaim or tsaaj nplaim flute and communicated with the Other World, asking the bad spirits what they would require in order to vacate the premises.
More often than not, they would request a pig feast and the family would butcher the animal that just happened to be in the basement that day. A host of relatives (meaning up to 200 minimum) would be invited and the preparations would begin. The men would prepare the meat and bring it to the kitchen where all the aunts and grandmothers would be squatting at large round cutting boards that looked like small tree stumps, each wielding a huge machete or knife and would proceed expertly hacking and chopping it. Periodically during the day, a large dishpan would be brought around with the ‘appetizers’: whole scrubbed cucumbers or hard boiled eggs or apples and oranges. Thick, sweet syrupy hot instant coffee would be passed around, too. This would suffice to stave off starvation until we could feast later that night.

I usually had one or more of my children with me when I did home visits, always at least one or two was still nursing (See: Twin Birth on The Farm with Ina May Gaskin at this blog under the April posts.) So I would wander around the house visiting with the other moms, or talking with the grandmothers. One of the favorite activities among the girls was taking turns brushing my hair. Unlike their straight black hair, mine is brown and kinky curly (a true ‘Jew-fro’.) So I sat on a couch and submitted to the ordeal while nursing a baby or two just to pass the time. Then I would wander into the kitchen and watch the cooking. It was fascinating watching Grandma Moua Lee hacking perfect little broccoli flowerets for one dish with a giant machete and Great Aunt Mee Thao slicing pigs ears into what looked like long rubber bands. Fresh pig liver was frying on the stove and ground meat was being mixed with hot peppers and cilantro in another giant pot (see: Cauldrons of rice were steaming on the stove while another auntie was pounding raw, sweet rice in a mortar for sticky rice cakes or Hmoob Jiang that would be wrapped in aluminum foil and steamed in an electric rice cooker. Cases of Mountain Dew and Coke were piling up as each new car pulled up to the building in the housing project. Teenagers were visiting out on the lawn smoking cigarettes while the oldest grandpas shared a hookah in the back yard.

Finally, the dirty dishes and cutting blocks would be cleared away, the floors all swept with little handmade brooms and babies collected from all the mats on the floor. We all gathered around the new baby and her parents as the shaman began the ceremony with prayers and good wishes for a long, prosperous life. He burned some gold paper called joss or jin (below) which represents money to placate the ancestral spirits.
He tied a cotton cord onto one of the baby’s tiny wrists as he spoke the last blessing and announced her name. Then all of the grandpas and uncles tied their white cords onto the baby’s wrists with a blessing, also repeating her now-public name. Little Pah (which means ‘a flower’) slept through most of the ritual. Another uncle continued to pass out more pre-cut white cord to all of the guests down to the children. After a while both of Pah’s arms were full of strings and I noticed that some relatives had started attaching them to her ankles too. Some of the guests also pressed large bills into the parents’ hands, more often than not 50s and 100 dollar bills. Perhaps the money would be saved for her dowry, but it was explained to me that this way her extended family was ensuring that she and her parents would never have to go hungry. The strings would be left on little Pah until they literally fell off, at which time she would be much stronger and not in need of the prayers that had been attached to her arms and legs with the strings.

Next, all of the men and boys in attendance sat at the many card tables that had been brought in or stood around those sitting at them and ate from the communal bowls stacked around the center. Little children were already smacking their lips on sticky rice cakes. Meanwhile, the women kept their eyes on the bowls of stews and soups, refilling them
as soon as they emptied. When the men finished and roamed back out to the hookahs, all of the cracked Melmac dishes were snatched up and washed in the kitchen and the tables set once again which us women and girls descended upon.

Hmong etiquette requires one to eat until you are ready to burst. Perhaps this grew out of years of wars and occupations where you never knew if this might be your last meal for a very long time. And hostesses make sure you are told at least three times, “noj kom txog rau thaum koj muaj tag nrho” (pronounced: naw-maw choe-PLAH!) or literally, “eat your stomach FULL!) When my husband came along with me to these parties he had no trouble complying. He loves Hmong food. The Hmong grandmas and grandpas would sit around him, watching in awe as he filled his bowl over and over with food, commenting that they thought Americans didn’t like their food; after all, none of the doctors or social workers they had invited to a meal since they first arrived in the U.S. had ever once come to their homes to eat with them.

At one party we were at a young Hmong dad had sat down next to David with two cold beers, handing my husband one of them. At the previous party this father had noticed and obviously admired David’s boots and had gone out shopping until he found an exact replica. As they sipped their beers in anticipation of the meal, 
Jou Zhe Yang pointed out his new boots to David while grinning from ear to ear. He could not speak English yet.

I went to a Vietnamese Coming Out Party last weekend. It was amazing! The mom is required by tradition to stay in her room for a month. This is a tradition in many cultures suggesting that she needs time to once again become ‘pure’, or recover, (or I like to think establish a good milk supply.) It gives the family a chance to ‘mother’ the mother, which we could do a whole lot more of in our society in the U.S. She gets to rest for a whole month and doesn’t have to shop, cook, do laundry, care for other children, or think about her partner’s needs. She is waited on hand and foot!

Tuyen’s* midwife hosted the party at her home, inviting family and friends of the new mom and also quite a few of her own family. Her interpreter from the birth attended with her husband too. This was a first for me, so I wasn’t expecting to being invited to help with the cooking when I arrived. Maya,* the midwife, with the help of a niece had already shopped for just about everything listed in their Asian cookbook and were half way through a recipe for Green Papaya Salad when I arrived. I have seen this in Hmong and Thai restaurants and love it, so I was glad to see it here, too. It is a very spicy salad made with julienne slices of peeled green papaya mixed with cabbage, tiny dehydrated shrimp, raw green beans, fish sauce, sugar, carrots, red Thai chilies and a host of other ingredients.

While we were tasting that and adjusting the spices, turmeric-coconut rice was simmering on the stove, ground shrimp Pops on sugar cane sticks were cooking on the barbeque, catfish in caramel sauce was bubbling on the stove in another pot, and Maya was finishing up the rice and peanut sauce for the Pops and
a sweet chili sauce for the fried egg rolls. Spring roll ingredients were arranged on the buffet: rice ‘skins’, warm water for dipping them into, rice vermicelli, fresh mint, basil and cilantro leaves, lettuce, shredded carrot and cucumber slices.

All this time, little Ngoc was being passed around as she slept, oblivious to the festivities. Tuyen had dressed her in a tiny plum colored satin dress with matching booties fit for a princess. Finally when all the cooking was done a couple of hours later, we all sang Happy Birthday for Ngoc and then dove into the meal. It was
exquisite! Tuyen had brought all of the ingredients for quail egg drop soup and had been making that on the stove while we were all finishing making the last of the other dishes. I have eaten some very interesting things during the past 30 years that I have worked with refugee and immigrant communities, but this was a new one. I hesitated, thinking back to my son's little pet quail who died of a heart attack one evening as Isaac was holding him and a huge truck backfired as it passed our house, scaring the little guy to death. Literally.

After the meal, at which Tuyen ate more than any of us had ever seen her eat before -- all 85 pounds of her -- we opened presents. Baby clothes have gone to a whole new level since I had my babies in the early 1980s. She received the cutest little dresses, sleepers and shoes. She was given checks with which to buy things she may need for herself and her baby. It was a wonderful party, and a real encouragement to her in her new country.

*all names, dates and identifying characteristics have been changed.

STAY TUNED... This and other stories will be appearing in one of the books, Call the Doula! a diary© or Stone Age Babies in a Space Age World:§ Babies and Bonding in the 21st Century,© pending by Stephanie Sorensen

§This phrase was first coined by Dr. James McKenna, used here with permission and gratitude for his work. 
A world-renowned expert on infant sleep – in particular the practice of bed sharing, he is studying SIDS and co-sleeping at his mother-infant sleep lab at Notre Dame University. He is the author of “Sleeping With Baby: A Parent’s Guide to Co-sleeping,” 2007, Platypus Media, Washington, D.C.

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