Thursday, June 6, 2013

On Birthing Books: Or, How does a book get born, anyway?

I don’t know about other books, but this is how this one was first conceived. I was trained as a midwife, but not to deliver babies, mind you. My primary instructor in 1989, Valerie El Halta, who supposedly retired a few years ago, but who is now ‘catching’ babies for Mormon mommies in Utah, made it clear from day one in school that midwives don’t deliver babies. In fact, we actually don’t ‘catch’ them either.
What she wanted to teach us first was to learn so well what Nature already knew how to do very well. Then she wanted us to see that babies and mothers knew what to do also, if we let them, and that we could approach birth with respect. We saw birth after birth after birth until we learned -- and some of us had to un-learn quite a bit, too -- what normal birth really was, and what natural birth really was. Only then were we trained to know when we were seeing something that didn’t fit in the picture. Then we were trained to know when it was time to take charge or how to help, but not with instruments. Instead we learned to use our hands, and ears and eyes, or perhaps a mother’s body in a different position, to get things back on track. Sure, we studied all the obstetrical pathology and I am still fascinated by new discoveries, but normal came first. Always.

I did not realize how well I had internalized Val’s lessons until over 30 years later when I was getting to know the Somali refugee community in Minneapolis. My husband and I had worked with refugees since just after the Vietnam War when our family had sponsored Hmong families as they arrived in Minnesota back in the 1970s and ‘80s. (Over 50,000 Hmong eventually came to Minnesota.) We got to know several extended Hmong families and became close friends, staying in touch for all these years, attending births, giving their babies American names when they asked us to, attending weddings, and translating for funerals, as I learned to speak Hmong. My children actually spoke Hmong before English, having been with Hmong children as they grew up and being watched by various grandmothers while I worked with their moms.

David and I had gone into mission work after our children were grown and found ourselves  in England. At one point we returned to the States on a sabbatical to visit our now grown children and grandchildren in Minneapolis. The civil war in Somali had continued to escalate and displaced families were flooding into Minnesota by the early 2000s. As I write this there are over 70,000 African refugees in Minnesota, the majority Somalis, trying to start over and live in peace once more. I was as curious, it turned out, about them as they were about us. I didn’t have regular work, so I began hanging out every day at the Somali women’s bazaar. I’d give an English lesson here and there, and they would paint my nails with henna and ask about life in the U.S. We’d compare everything: what we were each making for supper that night, where we bought our skirts, where our kids were going to school, what natural remedies were better than prescriptions. But the longer I was there, the more troubled I felt about … something.
I could not put my finger on it at first. I knew that the Somali immigrant community had the highest incidence of autism in the state compared to every other ethnic population. I started snooping around and found out that the Hmong had the lowest, lower than the average for us other Americans which is about 1 in 110 to 150 infants.  The Somalis had 1 in 28! and rising, according to SAAF, the Somali American Autism Foundation. This is unacceptable! As I listened and observed I became more and more convinced that my mind was switching into the ‘Valerie mode’ I had learned in 1989; in other words, what is wrong with this picture? There is something very not normal here. I puzzled and wrestled with it from every angle I could think of until it dawned on me, one of those little ah-ha! moments: they weren’t bonding with their babies! Since I began observing Somali mothers I had seen only 1 baby being worn in a baby carrier or wrap on the mother -- in 8 years! They had been all worn back in Somalia. However, I continued to see strollers, cell phones, blue tooth phone ear attachments, Walkman with ear plugs poking out of every other hijab I saw; mothers driving cars (Hmong women did not drive until much later assimilation), and already owning their own businesses. 
The babies in the strollers were wearing new clothes, using pacifiers, drinking formula from propped up bottles, and playing with toys from local department stores. Many of these women were so economically successful that as of this past October 2010, they had already attracted the attention of a delegation of businessmen and women, led by Dr. Benny Carson from Sweden, who flew to Minneapolis (where Somali women own a shopping bazaar called Karmel Square) to learn from them how they had become so business savvy so soon, with the hope of replicating this in Sweden where there is also a large Somali population who have not been as successful there, though they blame the Swedish business laws for much of the delay. And I found out also that Sweden has identified the Somali population there as having a similar autism epidemic. I believe I am seeing a group of fiercely independent, assertive women, but, unfortunately, by adding our 21rst century, technological culture to this mix, we have women unconsciously multi-tasking during the earliest bonding opportunities, eager to rejoin or compete with other Somali women in their new-found freedom, social status, and economic independence. I have even had nurses at the University Hospital ask me how they can get the moms to room-in with their babies.

To top this off, in 2007 the Women’s Coalition on Breastfeeding in Minnesota declared breastfeeding a “disaster in the Somali community with no one nursing past 3 months”. In the same year, neither WIC nor the La Leche League in Minneapolis had been able to identify a Somali woman who had nursed past 6 months and thus could act as a breastfeeding peer. (WIC has done a phenomenal job since then in educating and supporting immigrant women to successfully nurse their babies.) 

To me, at least, it was critical that someone compare the Hmong and the Somalis and figure out what was causing the problems, not just with autism, but with the many emotional and developmental problems that they told me they were dealing with and had never heard of in Africa. As I waded further and further into this puzzle it became very clear that many of the doctors and people doing research were forming several ‘camps,’ some thinking vaccinations were the culprit. Others were sure it was genetic, and would not be swayed by any other arguments. Still others were already treating children with diets devoid of wheat and dairy, often prescribing and replicating the foods their parents ate in their home country. A lack of vitamin D is being investigated, and hotly debated, too. Then it also became apparent that there were different sides even within the Somali community: political, religious, medical. It was getting so very complicated with different factions blaming the State, or the U.S., and demanding compensation from the government, and then even the universities and hospitals here in Minnesota were vying for the research money that began trickling in. But the children continue to suffer. The National Institute of Health, Washington, D.C., in collaboration with Autism Speaks, New Jersey, is finally tackling the research needed here in Minneapolis in collaboration with the University of Minnesota.

I am continuing to meet with Somali mothers and fathers and sharing, where I am able, the need to bond with their babies right from the time before birth. Together with a Somali grandma, Fadoomah, and a Somali mom, Fatima, both who have become close friends and fierce bonding advocates, we have produced a DVD in Somali about bonding which Somali TV, radio, and newspapers have expressed a great interest in.

But back to my book, which is still very pregnant and waiting to deliver. I still felt that the biggest disparity between the refugee groups that I have worked with over the past 30 years, and more recently in many American moms I see also appears to be in maternal-infant bonding. I blame our fast-paced technology, rampant consumerism, and our perception of evolution that includes materialism and the death of the extended family for our present levels of bonding and non-bonding behaviors that have become acceptable to an entire generation. I cannot blame any one individual mother. Without seeing examples of good bonding in past generations, is it any wonder women haven’t learned how to bond, do not recognize their instincts and have become so out-of-touch? So I continue to hope that a book about bonding in the 21st century will address a much bigger problem than just autism in Minneapolis, though that remains paramount. This book is actually the culmination of years of observation, friendships, research, study, and just plain wondering. Some answers are given, others remain elusive. I am hopeful that this book will encourage all new parents everywhere and those who help care for them to bond deeply with their children in our modern age of technology and materialism. Something must change and I believe it begins with the recognition that we are producing instinct-driven newborns who have not evolved along with modern technology, even though we treat them as if they have.

"Women today not only possess genetic memory of birth from a thousand generations of women, but they are also assailed from every direction by information and misinformation about birth." ~ Valerie El Halta

*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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