The Starfish

There once was a young boy who went to the beach for a holiday with his family. He was sad to see that every day as the tide went out hundreds of starfish were left to dry up and die on the beach. Each day he would run along the tide, looking for starfish and throw them back into the water. His parents, frustrated that he was not building sand castles and splashing in the water as they expected, tried to discourage this behavior. As they walked along the beach with him, searching for starfish, his mother said, “Why are you doing this? When we go home, there will be no one to do it. What difference does it make?" His father added, “You are wasting your time. Think of all the starfish that get washed up on beaches all over the world every day. You can’t possibly make a difference.” The little boy stubbornly picked up one more starfish, threw it back out to sea, turned to his parents and said, “I made a difference for that one!”

Belly Casts, Babies and Negasi’s Birth

“It's not just the making of babies, but the making of mothers that midwives see as the miracle of birth.” ~ Barbara Katz Rothman, Sociologist, Author

Last week Miruts** came in for her last prenatal meeting before her due date. We had signed up for the Belly Cast Room for a slot early in the afternoon. We offer this as part of our doula services for our expectant moms.

            Everyday Miracles in Minneapolis is my home base. (see: www.everyday-miracles.org) About 25 doulas from several nationalities meet moms and their families here for prenatal classes, yoga, car seat clinics, and general support especially for low income mothers. We have doulas who are Hispanic, Somali, Hmong and a melting pot of Americans. Sometimes our clients are single mothers, teenage moms, or recent immigrants to the U.S. We see women from the whole metro area in the Twin Cities and attend their birth at any one of the hospitals in the area. As a doula, we also follow up with a postpartum visit to ensure that they are doing well and that mom and baby are getting the hang of breastfeeding.

            I am not sure when this art form called Belly Casting came into being. It is one way to help an otherwise overwhelmed young woman bond with her baby before birth. Some call it taking pride in their changing body or bonding with their Bump. However you put it, there is an awesome transformation taking place here: a little human being is growing, soon to make his or her momentous appearance on Earth. Part of the job of a doula while she tries to emotionally support a mother-to-be is to help her fall in love with her baby. There are numerous distractions threatening to obliterate this fragile connection. A young woman often has to face questions of employment, schooling, even where she will live with her baby. Relationships often become brittle as the reality of a baby sets in. The responsibility for a new little person can affect all the different parts of a woman’s life.

            Sometimes our job is to try to find ways to gently steer attention back to this connection or bond with her baby. We try to find ways to celebrate the life that is growing within each new mother. One way is to create a belly cast toward the end of her pregnancy. It is also a chance for the doula and the mom to share some special time together before labor and delivery. We will be working together once labor starts and will need to know each other quite well to work as a team.

            When we create a belly cast we first put a tarp down on the floor to catch any drips. Then the mom takes off her blouse and bra and using Vaseline or lotion coats her belly, chest, under her arms and down her sides. I tuck Saran wrap along the top of her skirt or pants to protect them from the plaster. We use plaster coated gauze sheeting that comes in strips that used to be used to cast broken limbs. You dip a sheet into warm water and layer that on until her whole belly and chest up to her collar bone is covered. I usually lay on 2 layers. Within 10 minutes it dries and pulls away from her skin. We gently lay it down on the tarp to finish drying while she washes off with fresh warm water and soap.

            Many women paint their belly cast. Some decorate it with henna patterns. Others bring it to their baby shower and have everyone write wishes or blessings on it. The possibilities are endless.

            Miruts was not due for over two more weeks, so I was surprised when Tamirat called me at 5:30 a.m. two days after I had done a belly cast for her. He was quite upset as he explained that his wife was bleeding and they had called 911. I asked if she was having any contractions and he said no, none. I asked if it was a little, like spotting or a bloody show and he said no, it was all the way to the bathroom and back again and on the bed. I stopped breathing. All I could think of was, why them?

            They had come to the U.S. less than a year before from Ethiopia, with a stop in Sweden until they could get U.S. visas, seeking a better future for their children. They were learning English and working hard to assimilate. They have a beautiful little girl named Selam, who is sixteen months old. I had really enjoyed getting to know this little family and looked forward to this baby with them these last few months.

            I raced to the hospital, praying the whole way. I don’t know if we can alter a divine plan, if such a thing exists, by prayer, but I was going to try anyway. All the causes of early bleeding were racing through my mind, placenta abruptio (also called an abruption) being uppermost. This is when the placenta begins to detach from the inner wall of the uterus before the birth of the baby. Sometimes just a portion of it comes off causing bleeding and the remaining part is still able to deliver blood and oxygen to the baby through the umbilical cord, but should it completely come away from the uterus, that oxygen is cut off and the baby cannot survive. It is one of the causes of a stillbirth. Another possibility could be placenta previa, where the placenta has attached to the uterine lining near or over the cervix itself, close to the opening of the uterus.  Occasionally we see a uterine rupture, where there is a tear in the uterus at a weak spot, though this is more common, although still rare, when there has been a previous C-section, and the strength of the contractions stress that area. That can also cause bleeding, even hemorrhage.

            At this point, all I knew was that I was scared, more scared than I have been in a very long time, and I could hear Tamirat’s fear too. When I arrived at the hospital Miruts’ midwife was watching the baby’s fetal heart tones on the monitor by the bed. They checked out OK, which was a huge relief.  The monitor also showed us that there were contractions coming at regular intervals, though Miruts wasn’t feeling them yet. When the midwife decided to check to see if she was dilating, this produced a fresh gush of blood – not a good sign. The midwife left to call the obstetrician on duty that morning. I tried to let Miruts know that the baby still looked good, and that they did the right thing coming in so soon. She was not panicking up until now, but when the midwife left to call the doctor, that alarmed her very much and she started crying.

            When the doctor came in he first reviewed the read-out from the monitors and agreed that the baby was still doing fine, though the heart beat was fairly unchanged throughout, what is called non-variable. He ordered an ultrasound hoping to get a look inside the uterus and maybe get a clue as to what was going on, but the baby appeared to be toward the front of the uterus, covering a posterior placenta, meaning it was attached to the back wall, or closest to the mother’s back which made it impossible to view; he also couldn’t tell how high or low it was either.

            Then the doctor suggested breaking the bag of water. His rationale was that this would inform him further if the baby was feeling stressed in which case he might consider a C-section or if baby was OK we could continue to wait a bit longer. When babies are not doing well or feeling stressed as might happen if less oxygen was being delivered to them, they often poop in the water before birth. Then the amniotic fluid turns green or dark, sometimes with dark particles. Artificially rupturing the bag of water at this point could also possibly help hasten labor along. The doctor explained that the baby needed to be born sooner rather than later today, and though he or she looked fine now, he was continuing to weight the options left to him. He could do an emergency C-section, but the risks of major surgery were a serious consideration, especially if the mom is bleeding already. The baby was still doing OK so ideally a vaginal birth was still an option and might pose less of a threat to the baby. This doctor was weighing the pros and cons minute by minute and you could visibly see his concern. He spoke about using Pitocin should the contractions not pick up or the baby’s status change. But first he went ahead and broke the water – a simple procedure that the mom doesn’t feel. An amnihook, a sterile plastic probe is used to snag the amniotic sac. A small hole will allow the fluid to seep out a little at a time if the baby’s head is not entirely engaged. Care must be taken not to try for too aggressive a tug which could tear a larger hole in the bag allowing for a more forceful gush of fluid which has the potential of bringing the umbilical cord down with it. Then the baby’s head could conceivably pinch off the flow of oxygen before birth.

            Usually we don’t like to see this or any other intervention used, and a couple could refuse it, but in this case and at this time it seemed warranted. When births unfold as this one was doing, parents often turn to me and ask if what they are doing is the right thing. Many have planned an un-medicated natural birth and had never even entertained a thought otherwise. When our births don’t go as we planned -- and remember, we don’t always have complete control over our births -- and we find ourselves on a totally different planet, when I am asked what I would do in this case I pull out my Welcome to Parenthood Talk. It goes like this:

            “Welcome to Parenthood! You must find out what is right for YOU, not me, not the doctor or midwife, not your mother or mother-in-law. You must go into your hearts and together find out what is best for you, for your family. You’ll make lots of mistakes along the way, but it’ll be like this for the next 18 years or so. This is only your first test. You can’t ask anyone else what to do. You have to decide this one for yourselves. And you will know. And we will support you.”

            Fortunately, the fluid was clear, indicating that at the moment at least she or he was not exhibiting any signs of stress. At this point Miruts’ husband, Tamirat asked to see me in the hall. He was beside himself with worry. Their first baby had been born in Sweden the year before, in a birthing room with a midwife, a natural birth lasting only 5 hours. This was so very different and he was losing it. First, he didn’t understand why he wasn’t being consulted on every decision that was being made, and he didn’t understand the reasons why a C-section was being mentioned at all. In his country, he told me, an elder or at least a husband would be consulted by the doctor, and the patient rarely advised on all the aspects of her condition, partly to spare her worry or concern and also since she may not be in the best position to decide these things.

            I explained that in the U.S. we have innumerable laws giving the patient complete rights over her own body and subsequently her own treatment and then only when she agrees is her husband or partner or family brought into the discussion. His English was adequate, but there was the whole cultural barrier that he was trying to bridge here. We were able to go over each point that the doctor was concerned about until Tamirat was satisfied that everyone really was trying to find the very best course to take for his wife and baby.

            Very soon then, the contractions picked up, which often happens after the water breaks and triggers a hormonal response in the brain. This was a good sign, and the baby continued to tolerate the stronger contractions very well. I couldn’t give Miruts juice or even water since they were still leaving the Cesarean option as a possibility, but I did succeed in getting her nurse to give us some ice chips, which was better than nothing at this point. Miruts was breathing well with the rushes and getting up to the bathroom. She was dilated to 5 cm. the next time the nurse came in and the bleeding seemed to have slowed down, all good news. The nurse left us alone at this point. She had other patients and of course could follow our monitors back at the nurses’ station should anything change. The next time she came in she surprised us when she announced that the cervix was now at 8 cm. It had only been about half an hour since the last check. She scurried out to let the doctor know. I took one look at Miruts and knew she was already thinking about pushing. I hit the nurses’ light on the bed rail as I put on a pair of gloves and sure enough, Miruts took a deep breath and gave it all she had with the next rush. I helped her slow down her breathing just a bit as the nurse ran in. She started to put on a glove as the little head crowned. I picked up the other glove she had dropped on the bed and held it open as she shoved her hand into it, barely in time to catch a very plump little baby. The doctor walked in just then. I saw that the nurse was trying to un-wrap the cord which was around the baby’s arm and then her chest, so I moved in and held the baby by the hips so she could unwind the cord. At the same moment the doctor came up behind me and gently told me to hold the baby’s hips higher which I did, basically turning the baby head down which would drain any fluids, extra blood included, before she or he took a breath. Then the doctor gave the nurse the umbilical clip and hemostat clamps and handed the scissors to Tamirat. All this had taken place in complete silence. At that moment, the baby let out a huge screech. When he heard his baby, Tamirat started sobbing, so relieved that his wife and baby were out of danger. He blinked back tears as he cut the cord. Then the nurse turned to him and asked, “Well, what is it? A boy or a girl?” Earlier I had clued in the nurse that they didn’t know the baby’s sex, and I thought it would be nice if we left it to Dad to announce.

            With the advent of sophisticated ultrasounds today, we rarely don’t know the baby’s sex, so when this happens, I let the father or partner have the honor of making this announcement. I did this last year with a couple from Kenya. The midwife had caught their baby and in one fluid movement plopped it onto the mom’s stomach. All that the father saw was the backside of their baby, but thought that was enough. He started dancing around the room yelling, “I have a boy! I have a boy!” He even called the relatives in Kenya with the announcement during the next 20 minutes or so. Finally the mother asked me to take the baby so she could sit up and get cleaned up and when I did, I noticed something different. I nudged her and whispered, “Look here,” and she laughed out loud. They had a girl! He had never seen a baby girl it turned out, and just assumed baby boys looked like that, from behind at least. He had to call Kenya back.

            The placenta followed right away with hardly any more bleeding. It was over. We all breathed a huge collective sigh of relief. Tamirat went from kissing his brave wife to thanking the doctor and nurses, to crying, and kissing his wife again. Of course the nurses offered to weigh the baby right away, but we had already discussed this and put it in our birth plan that they preferred to just bond and put off everything else for a couple of hours. I find that nurses are generally relieved when they hear this; it takes the pressure off of them to hurry through the list of things they are required to do before the end of their shift. They simply chart, ‘mom refused’ and they are let off the hook.

            They needed time to take everything in, first of all. It had been intense. It was only 3 hours from the time they had come in by ambulance. This labor was even shorter that their first baby’s had been. It is called precipitous labor when it goes this fast, very overwhelming for mom especially. We wrapped her in warm blankets and I went to get some juice for her. Finally she could drink. She would need to replace all the blood she had lost and regain her strength. She was soon feeling much better and talking to her sweet little girl. Tamirat checked again as I replaced the baby’s damp blankets and hat with fresh warm ones and confirmed that they indeed had another girl. Little Selam would be pleased. They named her Negasi. I think we were all still stunned that she was here, that she and her mommy were OK.

            Tamirat asked if I would stay on while he went home for clean clothes and to get the car. He had come with her in the ambulance and didn’t have their hospital bag or anything. We relaxed and ordered a huge breakfast that was delivered shortly afterwards. Miruts told me she was actually feeling good, even after such a traumatic morning. Tamirat soon returned with roses and a big pink balloon with IT’S A GIRL! written on it, and a teddy bear, “for Negasi to give to Selam when she visits” he explained to me. And then he handed me a small brown bag with organic dates and a soy milk shake from a nearby coop. I was stunned! He had remembered what I had carried with me and ate a month earlier when we had met over the lunch hour one day on a home visit.

            The next day I went back to the hospital. We again talked about the birth. They were trying to process all that had happened. It takes time to take it all in and consider how it could have been different (it couldn’t, really) or better (we were very, very fortunate).

            During our prenatal visits I often brought my laptop along and shared some of the DVDs I have on baby-led breastfeeding or labor or natural birth. The last one I had shown Miruts was filmed in Brazil, I believe, about a midwife there who has discovered a way to foster the gentle birth continuum by her method of gently bathing newborns. It is at my blog for March postings, callthedoula.blogspot.com under the heading, The Best Baby Video Yet! It really is amazing. Since I first saw it I have been introducing this to new mothers and have the same results with each and every newborn baby. Miruts was anxious to try it, so we did – right there in the hospital the second morning, and just like in the video, her baby loved it, closed her eyes and actually went to sleep while floating in the tub! Some of the nurses asked to come and see us bathing Negasi and I am sure that was a first for them, too. Gone are the days that we subject newborns to the bed bath, scrubbing them from head to toe with a rough damp wash rag, taking extra care not to get the umbilicus wet (never mind it has been submerged in water for the last 9 months anyway) or her ears (ditto). We patted the umbilical stump dry and didn’t put anything else on it.

            And like in the video, Miruts massaged her baby slowly with almond oil while still on her towel. She enjoyed that, too, though decided it was time for lunch NOW, so we wrapped her in a dry blanket without any clothes and got her mom dry and back in bed, also without a gown (she had climbed in the bath first.) Negasi fussed until she was latched on once more and then blissfully went back to sleep. She even smiled for us at this point!

            Take a moment and think: we are the only mammals who dress our babies after birth. We are also the only mammals who ask ourselves, “Where will my baby sleep?” and “what should my baby eat?” Last year I found a wonderful talk by my favorite U.K. midwife, Carolyn Flint, (see: http://www.youtube.com/watch?v=PXCorYbsVfM)

who tells us that we “….should go home, if we aren’t already there after the birth and take all of our clothes off, and all of our baby’s clothes off (nappies or diapers allowed) and go to bed for 10 to 14 days with our little mammal.” Just consider: this gives mom time to recover and rest; baby can establish a good milk supply by nursing on demand; that bonding is optimum when there is uninterrupted skin-to-skin contact and the family can bond in the sacred space they have created in their bedroom. 

                       

** all names and identifying characteristics have been changed.
Stay tuned... This story is one of many that will appear in one of the upcoming books, Call the Doula!© and Stone Age Babies in a Space Age World: Babies and Bonding in the 21st Century©      both pending, by Stephanie Sorensen

Can We Afford Another Baby?

The French have an old saying that goes something like this: every baby is born with a loaf of bread under each arm. 

            Our Rachel cost us $25. Really. The year was 1984. We were living in St. Paul, Minnesota. She was our 4^th child, born 2 years short of 5 weeks after our twins, Isaac and Ruth. The twins were born 2 years minus four days after our eldest, Abraham. I had breastfed all of them well into their second year. We had decided I should stay at home while they were babies, even if the extra money would have helped, had I been working. This was our investment: the effort, time and attention our children needed, especially in the vital first year of life. It is like going into business. If you don’t seriously invest all of your energy into them, the end product will fall short of perfect (or at least the very best you could do.)

We were actually living below the poverty line at this point in our lives, by choice, to avoid paying taxes that would funnel into the military which we opposed, but the children didn’t seem to notice. Or mind. They had the raspberry patch they would breakfast in before the serious work of the day: PLAY. They would continue whatever scenario had begun the day before: building miniature birch bark tee pees for their coffee can menagerie of tiny dolls, farm animals, plastic men and women, and little hairy rubber trolls, (no little soldiers or guns allowed); or a wedding for the cats, acorns being collected and thrown in lieu of rice. On rainy days they stayed indoors, stringing buckets of buttons, or learning to braid little loaves of challah bread, reading stories, building log cabins for the trolls.

We had gone against the stream of the American way of thinking for many years already, so when we considered another child we knew we wouldn’t be fitting in anyone else’s box as far as numbers went, but we did find out what the latest statistics were projecting the cost of raising a child in the U.S. in the 1980s. The Consumer Expenditure Survey by the U.S. Department of Labor recommended $124,800.00 as the minimum amount that you should project for the cost of raising one child from birth to 18 years old. We figured that at that rate the human race was doomed to become extinct, so us poor people might as well help populate the planet because no one else would after considering those figures.

As a first-time mother in 1980 I had wondered at all the things my friends thought were absolutely necessary when they were expecting their first baby: a crib, a fully furnished nursery room with matching sheets and curtains, blankets, a little bath tub, room monitor system, mobiles, toys, powders, creams, lotions, baby shampoo, paper diapers, outfits, clothes, shoes, playpen, windup swing, stroller, pacifiers, bottles, bibs, Sippy cups, sterilizer for the bottles, baby spoons and warming dishes, baby food grinder, nipples and bottle rings, breast pump, nursing clothes, nursing bras, and the list goes on and on and on. And on.

Before we began our family, David and I had volunteered to teach English to Hmong refugees as they began arriving in Minnesota in the late 1970s. We would pick up families at the airport when they landed, (with practically no luggage, we noticed), find housing, and then help them through the myriad appointments: the Public Health Department, ESL classes, job readiness training – you have to have been through it to know exactly what I am talking about.

We noticed that our Hmong friends’ babies, when awake, were tied on with cloth carriers to mom, dad, grandma or aunt, it didn’t matter who. They had no cribs in the beginning, so their babies were carried or played with until they walked, it seemed, or laid down on a straw mat on the floor when sleeping. They nursed whenever they were hungry and quickly grew fat and sturdy; we called them ‘juicy’ babies, or the kind you like to pat and pinch. Our time with our Hmong friends all during the 1970s and into the 80s made us seriously rethink our American way of raising babies. They certainly didn’t have all the stuff other Americans had and their babies were beautiful, and were growing into confident, happy little people. Maybe they really didn’t need what the TV was telling us we couldn’t live without. (Maybe we didn’t even need a TV. We did eventually get rid of that, too.) Maybe there really was a better way. What did the parents in Africa, China, the Eskimos, or parents in South America, have? We Americans tend to think we are so intelligent, informed, and educated. Well, sometimes that kind of thinking becomes so arrogant that it blinds us to common sense and distorts our view of reality, I believe.

Ultimately, I felt that the trend in the U.S. to buy all these things was a great distraction on another level, a very important one, a spiritual one. By refocusing on what is actually happening to us as a couple, that we were becoming a new family, we were able to reflect on a deeper level and tune in to this new being. He already had a consciousness. He was aware. Did he know how much he was wanted? Did he know how much he was already loved? Could we talk to him and tell him these things before he was born? Would he hear us? Did he recognize our voices already? Would he enjoy hearing lullabies already? By bonding with an unborn baby you are beginning a relationship that will last the rest of your lifetime. You need not wait until labor and delivery with all the emotions that flood in surrounding the event of birth. Instead you can and should be preparing for his arrival in far more important ways than materially.

So, as we wondered how much we could actually do without, and how little we could get by with, we discovered some very interesting things. First, we discovered that we weren’t the only people questioning the status quo, or the way things are generally done. We found lots of other people who thought how we did, and didn’t care what other people thought of them, either. We were still a minority, these daring, radical parents, but there really was an underground-type  movement in American that we realized was gaining strength during those years. In spite of negative comments from friends and relatives, we breastfed our babies. Not only did we breastfeed, but we continued until our babies told us they were ready to be weaned, well into their 2^nd year sometimes. I knew they would soon be talking and asking to nurse, so we only talked about nursing in Hmong, also called Dao or Meo, (a Mongolian-Chinese language, one of 24 distinct Chinese languages, each with own multitude of dialects). That way Grandma, or any of the other relatives, wouldn’t have a clue that we were still nursing, and I wouldn’t have to repeatedly battle the negativity. Abe would ask, “Goo yoo-ah naw-me” – I want some breast milk. I could answer, “pay loo-jay”, when we get to our house. Only rarely would he fuss: “Goo yoo-ah yoo-ah yoo-ah!” I want want want now! And I would put my foot down and insist, “Chee-yaw kaw-naw”, not here just now. “Pay mo loo-loo-fy ee plee-ah”, we’re going to the car soon.”

We didn’t buy baby foods either in all those years. At all. We waited way beyond the recommended 4 or 5 month start-them-on-solids-and-cereal stage that was popular at the time, and only when we saw baby teeth did we begin offering solids. Then they were ready for soft finger foods like bananas, cubes of avocados, cheese, tofu or potato. When we breastfed we didn’t first look at the clock to see if was time, but when our babies were hungry, they ate. And they grew. And grew. When I ran into problems or questions I would find a grandmother who had nursed her babies and would always find the support I needed.

There is a Jewish proverb that says: Two Jewish grandmas are better than one pediatrician.

            They slept with us*, too, and I never had to get out of bed at night to nurse them. As long as I rested when my kids napped, ate well and took care of myself, I had plenty of milk. We shared baby clothes with relatives and friends, offering them to other new moms when our kids out-grew them. I made all of our diapers out of cotton from a bolt of diaper fabric** and never used disposables, which have become a huge environmental problem in our country.  

As they became older, and they still seemed to be thriving and happy, we began to question the educational system in our state, and after meeting with other families who felt the same way, began homeschooling our children. We discovered that we were part of a very large network in America, and of over 20 families in our district that chose to homeschool. The school district in our town even recognized the benefits and opportunities the families could offer each other within our network and supported us with supplies and equipment from their schools.

Three years after Rachel was born Hannah arrived, our biggest baby, weighing over 10 pounds. She was the easiest baby yet as all her siblings adored her and entertained her constantly. They are all grown up now and we are grandparents. The time really does fly by. We did not always find the right way with each child as this or that one tried to find their own independence. Some were more rebellious than others, and looking back we see things we could have done differently, but we are proud of each one and who they have become. And I am sure we didn't spend anywhere near $124,800.00 to raise one or even all five of them. P.S. And, by the way, I spent the $25. before Rachel's birth on a package of Chux to protect our bed during the birth (which I didn't use since I decided to squat on the floor at the last minute) and the rest on maternity size sanitary pads for the time after the birth. There are actually cloth ones now that you can make or buy and eliminate disposable waste concerns all together. 

A Quaker friend once posed this question to me: why is breast milk so good? 

Answer: Because it is always warm, it’s always ready, and it’s up high where the cats can’t get it!

* The Family Bed: An age old concept in child rearing, by Tine Thevenin, 1983, Minnesota

also see: “Sleeping With Your Baby: A Parent’s Guide to Co-sleeping”, by Dr. James McKenna, Notre Dame University 2007, Platypus Media, Washington, D.C.

**cotton diaper fabric and rubberized flannel to protect mattresses can be ordered from Gohn Brothers. Write for a free catalog or call: Gohn Brothers, P.O. Box 1110 Middlebury IN, 46540 Phone: 574-825-2400 Call Toll Free: 1-800-595-0031 (Website or e-mail not available.)

STAY TUNED... This and other stories will be appearing in the book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21^st Century,© pending by Stephanie Sorensen  

Above and Beyond the Call of Doula: Shavonne’s* Birth

"I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel." 

~ Maya Angelou 

She walked into the lobby where we had agreed to meet for our first prenatal appointment. My first thought was, “She’s BEAUTIFUL!” And it wasn’t just her pregnant belly. I have this thing about tummies. I have been a midwife for over 30 years and work as a doula now, when I am not an author or a Grandma or Mom to my own 6 kids. They are all grown up but you always call them ‘the kids’.

            I had been given her referral a few days earlier. It painted a grim picture: homeless, FOB (father of the baby) involved, 1 living child, 1 stillborn, due in September, single birth. This would be my third homeless mom in 4 months. As a doula my job is to accompany and support low income women during their pregnancy, birth and postpartum time with education about birth, labor, delivery, breastfeeding and newborn care, and emotional and physical support. This often spills over to include helping them find services in their community like free clothes, food shelves, employment agencies, social services, subsidized housing, counseling and treatment facilities, etc. 

Some facts about homelessness in Minneapolis:

            The shelter where Shavonne was staying is the largest shelter in Minnesota. They served 1,187 homeless families in 2011. 59% of guests were children and 34% are under the age of five years old. The average age of a child there is 6 years old. The number of families rose 18% in 2011, with an average of 347 guests per day. 37 days was the average length of stay for a family in 2011. 250,398 meals were served at this facility in 2011. 24 hour front desk service supplies diapers, formula, warm clothing and other basic needs. And a bit of trivia about homelessness in Minnesota: During the winter of 2002 - 2003, 70 homeless people died of exposure. That same winter, the Twin Cities Winter Carnival spent $5 million that was privately raised on the Ice Castle, an extravaganza built out of huge blocks of solid ice complete with light show, turrets and a drawbridge, but roped off and patrolled all night by local police so that no one would go inside of it, much less attempt to sleep there, the reason being that they didn’t know if during a thaw before it was disassembled it might create a hazard and someone could get hurt. The Dorothy Day Center across the street from the Ice Castle didn’t have enough beds to accommodate all the homeless. Each night they would have a lottery: take a ticket and wait in line and at 8 P.M. sharp they would call out numbers, like at a Bingo game. Some got in, some didn’t. I wanted to know why the city couldn’t put some of that $5 million toward adding another floor for a dorm above the one story Dorothy Day Center? I even held a one-woman silent vigil there for several nights that winter in protest.

            The lobby was alive with kids that morning: kids with knapsacks waiting for school buses, kids crawling under the bench I was sitting on, kids running in circles around a mom or dad who was waiting in line at one of the numerous desks lined up against one wall where staff were issuing free bus passes or other services for that day. The noise level was up there with my memory of the last rock concert I attended about 30+ years ago. I looked at Shavonne and asked if she could leave with me for a couple of hours. She signed out and we took off.

            We found a nice coffee shop nearby. I asked her if she had had any breakfast. She hadn’t. She had missed the half hour time slot to go down and get cold cereal and milk and couldn’t take anything back to her room. So we ordered breakfast. She kept telling me how good it all was as she was eating. I wondered at the quality of the food at a huge shelter like hers. Fresh fruit? Vegetables? Or government surplus institutional food -- sodium, sugar and MSG contents would be just right for a pregnant woman, right?

            Over the next two months we met every Monday at the coffee shop. I often brought my laptop and we would watch YouTube videos on everything from water birth to natural birth in Russian tidal pools at the ocean, twin home births, animal births (a great way to see how Nature intended birth to be),** and the latest out on breastfeeding (see UNICEF Breast Crawl on YouTube.) Most of this midwifery or natural model of care was new to Shavonne. Our meetings became an oasis in the midst of a very stressful period for her: a tentative relationship with the current boyfriend, her homeless situation, a fragile relationship with her family, a job she was struggling to keep right up to the time she would birth this baby and the chaos of the shelter with its own dynamics of unstable, often mentally ill roommates, and rampant theft. She was in a dorm room that housed 6 pregnant women. Talk about drama!

            Her first birth had been a C-section after her baby began showing serious signs of distress during labor. He is 5 and living with his dad in another city. Her next baby was carried to term and unexpectedly died only days before his due date. With this history, her present doctor was reluctant to let this pregnancy go to term or attempt a VBAC or TOLAC, Vaginal Birth After Cesarean or Trial Of Labor After Cesarean. Neither precaution he suggested has been proven as best practice or been able to avoid a poor outcome, much less without carrying their own multiple risk factors.

            One fun thing we did together was to make a belly cast just weeks before her due date. (See Belly Casts, Babies and Negasi’s Birth at this same blogsite due April, 2013.) Shavonne had planned to bring it to her baby shower that a friend was hosting for her and have everyone write blessings and messages on it. Unfortunately, she had stored it in a plastic bag under her cot at the shelter. When she opened it later, it was covered with mold; it had not had enough time to completely dry.

          We continued meeting for our Monday breakfasts until she called one morning after a prenatal visit. The doctor had scheduled her C-section for the following week. She was not happy with this option at all, but her family insisted that it was for the best. It is not my place to referee these events, nor am I being asked to override a physician’s position. Shavonne knew by now how I felt about natural birth and believed she could do that, but her last baby’s birth was still painful enough to make her doubt her own reserves of strength. I also let her know I would be there to support her no matter what she decided to do.

This may be the hardest part of being a doula. You have found that inner power and have seen it work a hundred or more times, but you cannot make that journey happen for another woman, no matter how much you love her.

            We reworked our birth plan to include baby-led breastfeeding in the operating room or in recovery as soon as possible. We made it clear that baby would be rooming-in and that he should not be given water, formula or pacifiers. Shavonne also wanted her partner and doula there. So we went to the hospital on the appointed day ready to meet little Ra’shon. I asked the nursing staff if I would be able to join her in the O.R. before the epidural was started and was able to talk her through that. I was given one square foot to the right of her head by the table where I could hold her hand and talk to her without getting in the way of the anesthesiologist and her assistant. I felt like if I moved an inch I would be sitting in one or the other’s lap! It was a tight squeeze, but they were all very nice about it. Her partner was positioned on a chair to her left. A large sterile curtain cuts off the surgical site from all of us at her head and shoulders side of it. Within 10 minutes the surgery was begun. I was able to tell her what was happening each moment and warn her when there would be pressure and tugging. I could see when they were ready to lift her baby up and as I was telling her about all of his black curls he let out a huge squall. At that moment she started crying, big tears running down her face into her ears. Her arms were full of IV lines but I had a tissue handy and wiped her eyes while we listened to her baby who was finally here sounding very healthy and strong. I whispered in her ear, “You did it! I am so proud of you, sweetheart!” More tears.

            Within minutes little Ra’shon was wrapped up and in his daddy’s arms. He brought him back to where Shavonne could see and kiss him. It was so beautiful. Only this perfect little baby could make her whole world worth living in again. Shavonne was overwhelmed with relief and joy that he was finally here and healthy. All she had to do now was get stronger and hopefully the rest would fall into place – a better place than it had been for the last several months.

            Shavonne asked a friend if she could bring the baby home to her house when she was able to leave the hospital. That seemed like a better option than going back to the shelter, so it was arranged for the following week. Within two days she called me back. The ‘friend’ was an alcoholic and the situation was impossible. In the meantime, the housing advocate at the shelter had found Shavonne an apartment. When she went to see it, she found it more than filthy: it was overrun with cockroaches. She told the worker that there was no way she would bring her baby there. The worker returned to the shelter and filed a report that Shavonne was not cooperating with the shelter staff and refused the apartment. The next thing she knew, Shavonne received a notice that she could not return to the shelter for refusing to cooperate within the program. She was homeless. And now the shelter closed its doors, too.

            I often volunteer at another shelter for homeless pregnant women run by Mother Teresa’s Missionaries of Charity in Minnesota. I fill in as ‘house mother’ when the sisters are invited out. I often make breakfast and lunch and hang out with the women for the day. It is housed in a beautiful renovated building, bright and immaculately clean. There was room there, so a friend and I picked up Shavonne and little Ra’shon and brought them to their next home. Shavonne couldn’t believe it when we walked into the new house. It was very different from the last shelter she had been in before the birth. She had her own room with a crib and the nuns made hot meals, too. A bowl of fresh fruit was frequently refilled and sat on the kitchen table.

            So Shavonne settled in and spent the next few weeks trying to access the county services and arrange a more permanent arrangement. She could not stay with the sisters indefinitely. Finally her time there was up, too. Friends outside of the city had a room in their house and offered her that space. Her former employer let her know he was holding her job open for her. Now she was just waiting for the county worker to sign a voucher that would cover childcare so she could return to work. Finally things were coming together.

            That was the last time I heard from Shavonne. I don’t know if her phone is still working or if she simply could not pay for the next month’s minutes. I think of her often, another young woman whom I grew to love and had to let go. I never forget them. I pray for all of them. I think that must be part of my job as a doula.

*all names and identifying characteristics have been changed to honor privacy.

**See The Dramatic Struggle for Life – Bali, and Chimp Birth Attica Zoo at YouTube.

STAY TUNED... this and other stories will be appearing in the book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21st Century© pending by Stephanie Sorensen

Ina May: Remember this, for it is as true as true get...

“Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth as well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.” Ina May Gaskin, Ina May's Guide to Childbirth, 2003

From the Diary of a Doula

February 13^th I guess there is always a first: I went to a birth at 11 a.m. the other morning, a sweet immigrant couple having their 2nd baby. Their toddler is a little girl and they knew this was a boy. So, I taxi over to St. Paul, help her relax all day, do back massages, hip presses, help her labor in the tub for a few hours – she liked that, walk the halls together, show her how to be on a birth ball, (with gravity helping baby to labor down.) She'd wanted a natural birth, so I was there to support that. Finally it is time to push around 7 p.m. and she started screaming that she wants a C-section RIGHTNOW!!! - though it is too late for that anyway, so I go into ‘take charge’ mode as we doulas call it, and have her open her eyes and look right at me while we breathe together until she gets the urge to push and all of a sudden she has a 9 lb. boy in her arms who comes out, also screaming, and Daddy is kissing Mom, and she looks over at me and says, “Is it really over?” I nod and we are all happy.

            I usually stay for 2 hours postpartum and make sure baby is breastfeeding OK, so David, my husband, picked me up at 9:30 p.m. We got home, I shower and fix my supper, we visit awhile, I check my phone that had been off and out of range anyway, and see that another mom has been calling. So I call her hospital first to see if she's been admitted and sure enough, she went into labor early. Two weeks early, which isn't really too early, but whenever I don't plan for such an eventuality, it usually happens. They had planned a C-section a week before her due date for the next day because of serious problems, thinking she wouldn't go into labor that early, but she did. So we both change back out of our night clothes and I whip out another set of clean clothes and David drives me to the second hospital - not in the suburbs, at least. And I get there in time to go into the operating room with her, help her relax and tell her how well she is doing as they start the anesthesia and let her know what is going on the whole time. They have this surgery down to 30 minutes. Baby cried right away, mom starts crying when she hears baby crying, Daddy kisses Mom, I kiss Mom and tell her how amazing she is and I am mopping up her tears while they are still sewing her up because her arms are still attached to all the IVs and she crying. Her little girl has so much hair it looks like fur! A beautiful little Hispanic doll! ¡Muey bonita! So I go to recovery with them and get baby breastfeeding - only 7 lbs. and she latched on like a pro! I didn't do anything! She was still slurping and sucking when I left 2 hours later. Got home and fell into bed. No one due this coming week. The only bad thing was that I missed the baby shower for one of our doulas yesterday having her first baby soon. I am sure it was quite the grand party. They were bringing in a Henna artist to decorate her belly and do our hands, too. And the food must have been stellar! So, that is a glimpse into my week. Hope yours wasn't quite as exciting and that you managed to get more sleep than I did. I caught up this morning and rolled out of bed at noon.

Stay tuned.... this story is one of many in the upcoming book, Call the Doula!© by Stephanie Sorensen

On How NOT to Bond

"What’s done to children, they will do to society." ~ Karl Menninger

          Isaac: my gifted, hyperactive, smart, wise-for-his-years Indigo child. All the other kids went along with the program, all except Isaac. At 4 he was already listing on his hand all of his grievances with my method of discipline, which was mostly time out, and a sad face from me asking in a controlled voice, “Why would you want to punch your sister, anyway?”

     His tantrums were over the top. He would rip cupboard doors off the kitchen cabinets if I wouldn’t stop what I was doing and walk him down to the mailbox -- it was too early for the mail – which was a ¼ of a mile down the hill. It did not occur to me that he was jealous of his little sister Rachel, who was still snuggling and nursing every night before bed. It did not register in my mind that he was not OK with weaning (along with his twin sister Ruth) 6 months earlier when I was already pregnant with Hannah and still struggling with morning sickness. I had tandem nursed them when Rachel came along, but I was pregnant again, and three seemed to be too much. Once I decided I needed a break I weaned them rather quickly with plenty of protests, but I stood my ground. If only I had known then what I know now.

     The day started like any other. The four children wiggled out of their shared futon and various quilts, dropping any damp pajamas on the stairs on their way down. They wouldn’t bother to dress. Why should they? It was summer and we lived on the top of our own mountain. They would first head for the raspberry patch and gorge themselves there before settling down to pick up wherever they left off in their play the day before. I never put away the serious creations, like the Lincoln log castles or the troll villages. I knew they would eventually come down and I could clean that part of the house or yard while I waited for the other half to become unoccupied once more.

     I called them in for a common bath. I had a galvanized feed trough that I found at our local farm store set by the woodstove where I could tip hot water into the tub from a huge canning kettle and mix it with cold water from the hose connected to our gravity tank upstairs. The bath over, I sent them upstairs to dress, never quite sure what combinations they’d come down with: plaids and stripes, flip flops and woolen scarves, it didn’t matter. No one would see them anyway. Why sweat the small stuff? I worked on breakfast until they came tripping down the loft stairs.

     I cannot remember what issues Isaac had bristled at that morning. It just went from bad to worse. He was strutting up and down the length of the log cabin’s kitchen, yelling and crying about this and that and yesterday and the day before. I couldn’t even remember what happened then that he was taking issue with now. Pretty soon I was crying and trying to hug him and getting brushed off and yelled at some more. I finally babbled, “But, Isaac, what do you WANT?” He instantly stood still, brushed himself off, raised himself to his full height of 3-something feet tall, and said, “I just want to nurse!”

     I couldn’t believe I had been reasoning with him all this time and actually never asked him what was wrong before. Incredulous, I asked, “Is that all?” And he answered, “Yes.” So I sat down on the floor, my hands covered in flour, my apron covered too with a dusting of whatever it was I had been kneading and he happily lay across my lap, oblivious to the huge belly crowding him just slightly, and he nursed. After a few minutes I said, “Are you getting any milk?” because I didn’t think I had much, even though Rachel still pacified herself at the breast before bed. He unlatched and said, “Nope. You’re all dried up,” and reattached himself and resumed sucking. I thought about that a minute and then asked, “But you just want to nurse?” Without letting go this time, he nodded and kept nursing.

     So, that is how Isaac got to nurse whenever he wanted to for the next year. He weaned himself first from daytime nursing and later from the fall-asleep-with-the-boob-in-his-mouth bedtime sessions. The tantrums abated somewhat, with some changes in basic strategies coming from Mom and Dad. We stopped what we were doing sooner than we previously had and tuned in to what he was getting upset about before we had a full-blown battle going. We asked and listened better, I think, too. Looking back, I know I could have made fewer Shoo-fly pies, and fewer quilts, and just enjoyed my little kids more, spending more time with them doing nothing and playing with them. We spaced them all two years apart using breastfeeding alone as contraception*, but I think now I didn’t realize that I didn’t have to be so very busy all the time doing things. I was constantly frustrated, wanting to do this or that, but bonding should have been number 1, and it wouldn’t have taken all the energy I was using up doing things either. The time went all too quickly, though back then I could not see the end of the tunnel. Now I believe all those who knew it would be over all too soon and tried to warn us. But do we ever believe them? I think not.

     So, those are some of my regrets. They did grow up, even Isaac. They are wonderful caring people, amazingly bonded to each other in ways I have not seen in many other siblings, and Isaac is still my Indigo child: intense and wise beyond his years and I love him just the way he is.

*See Breastfeeding and Natural Child Spacing: How Ecological Breastfeeding Spaces Babies by Sheila Kippley, 1999, Couple to Couple League

Stay tuned... Stone Age Babies in a Space Age World: Babies and Bonding in the 21^st Century,© pending by Stephanie Sorensen  

Evolution and Babies

"Many Western doctors hold the belief that we can improve everything, even natural childbirth in a healthy woman. This philosophy is the philosophy of people who think it deplorable that they were not consulted at the creation of Eve, because they would have done a better job." ~ Dr. Kloosterman, Chief of OB/GYN, University of Amsterdam, Holland

Dr. Ala Alwan, World Health Organization (WHO) Assistant Director General for Non-communicable Diseases and Mental Health said in April, 2009, "It is a deep concern that the global burden of disease attributed to mental disorders continues to grow, particularly in developing countries. It is essential to prioritize, implement and fund projects on autism spectrum disorders and other mental disorders in children in developing countries."

Guess what? The U.S. is also the 46^th in the world in order of infant mortality. 45 other countries have healthier babies at birth than we do: Singapore, Hong Kong, Malta, Slovenia, Czech Republic, Portugal, Gibraltar, Cuba, Taiwan, and Macau, to name just a few. Our mothers’ chances of surviving childbirth fare just as poorly here as well: 38 other countries are ahead of us in that too.

But as I write we are being told that now, since 2011, women have surpassed men in the Western World in holding more post-graduate degrees than ever before. Finally, we (women) are smarter, more advanced, more intelligent, and more insightful on all levels in mathematics, engineering, medicine, the sciences, and in all other areas than ever before in history. Aren’t we clever? Yet we have more problems with our infants and young children than many/most other places in the world. What is wrong? How did this happen? I believe we have somehow, quite falsely, assumed that our offspring would or could evolve along with us in direct ratio to the fast forward we have plummeted ourselves into in the race toward the 21^st century. We must stop here and take a few things into account before considering such assumptions.

Have you ever wondered why we as humans have such large brains? This one is obvious: we are smarter than any other animal. But our babies are more helpless than other mammals at birth. Have you ever wondered why? Part of the reason is that, yes, we are the most intelligent species, but our babies are born unprepared for survival. Our brains grow so fast before we are born, and into the first year, however, that if they kept growing until the rest of the body caught up and was as mature as, say, a calf is at birth, their heads would be far too large for the birth canal they must pass through. Since our brains are so advanced, they grow faster in the first year than the brains of any other species. If we waited another 3 months to deliver our babies, their heads would be too big to fit our frames. So Mother Nature had a toss-up: make mothers’ hips even bigger than what we have now (Horrors!) or have babies born sooner than they are in reality ready for. So, this makes it clear that they are not as mature as other little mammals and do need us constantly, even more than the offspring of other species. Nature knows this. Babies know this. Do we? We don’t act like we know it.

"Natural childbirth has evolved to suit the species, and if mankind chooses to ignore her advice and interfere with her workings we must not complain about the consequences. We have only ourselves to blame." Margaret Jowitt

It is actually an illusion to imagine that our man- or woman-made time machine should likewise affect our babies, but we in fact do believe this. The truth is, our babies are just about as immature at birth as our fore-mother Lucy’s were 3.18 million years ago. Consider Lucy (who currently resides at the Ethiopian National Museum in Addis Ababa, Ethiopia), whose babies had to be carried and in constant contact with her, 24 hours a day, day and night, for at least 2 years or until they could walk. He (I am just guessing it was a firstborn son) had constant skin-to-skin contact; was in constant proximity for eye contact with his mother or whatever member of the clan his mother was interacting with throughout the day – at an adult’s eye level, incidentally, and not lower as in a crib or stroller where faces suddenly appear to loom above his and just as quickly disappear.  He nursed on demand.  He had no need to cry. A grunt or his reaching for a breast would be enough of a sign. His mother had enough time connected to him that she could already easily ‘read’ any signals coming from him. He listened to his mother interacting with others all day long. We don’t know when she began speaking directly to him, though. Perhaps it began when he spoke first, having listened to adult speech and figured out how it worked. 

We now know that bonding is reciprocal.  Even into the 21^st century, however, we can read from some authors who are still considering bonding a mother-led phenomenon, whereas it is actually reciprocal.  When a baby searches his mother’s face, he is seeking her gaze in return. If her gaze is not there more times than it is, she has also given him a clear message: this is not how we humans interact, though she gives him no alternative solution. When he reaches out to touch her, he expects his hand will be held or caressed. When he first coos, a rewarding sound from his mother will encourage more early speech. If parents are engaged elsewhere either mentally or literally, while interacting with a cell phone or texting, for example, and those overtures from your baby are ignored, that, too, is a message: he isn’t being answered. Perhaps his voice may not be the best way to communicate after all. He’ll have another try at it first: cry louder, perhaps, to get the needed response. Or do something, anything, to get your attention.

Sounds familiar? But back to Lucy. Bonding was the way to survival. Had she put her babies down, they would have been mauled or eaten. And we would not be here today.

The most basic factors that influence bonding are touch or skin contact, smell, eye contact, attention, and sound or hearing. We don’t know yet which factors in what order affect an infant’s earliest development, i.e., whether touch is primary, or if language comes on the bottom of the ladder, though one study of deaf mothers of hearing children regarding a lack of vocal speech did not appear to negatively influence their babies’ overall well-being during the first year or later on. We don’t know if 100,000 words in a given time frame are required to ensure normal, adequate development, or if only 5,000 will do, though a recent 2010 study has shown that more educated mothers do directly address their children more than poor or less educated mothers, and the long term outcomes are notably better. We don’t know if 40 hours of skin-to-skin contact in the first month is enough to guarantee a proper level of bonding or if 400 hours of some form of touch is required.  Breastfeeding already offers skin-to-skin contact every time your baby feeds, but mothers who choose or need to bottle feed their babies can supply the same skin-to-skin contact, too. We don’t know what the exact formulae is in combining these factors that are necessary for successful bonding, but what I have been observing is that somewhere between the high levels of all factors in one of the refugee communities I was able to observe over a ten year period, and the present poor connection on all levels of all the factors* that I have been observing more recently in a second refugee population, there is a threshold that is being left far behind.
Another analogy would be to consider how little food a person needs to survive. We can guess that X amount of calories represent the barest minimum and less than that is simply not sufficient to sustain life.  The same is true in the realm of child development. If we could only know how much of each factor is needed at minimum, or what combination of what levels of all the factors as we know them, is necessary, then, I believe, we would know the mystery behind all child development problems. But we cannot measure hugs and kisses, caresses and bedtime stories, nor do I believe we should ever have the technology to do so. What I do believe, though, is that we should be intelligent enough to grasp the simple fact that as technology has advanced, and as we have moved forward in intelligence and knowledge, our newborns have remained immature, helpless little mammals who need to bond with us, need us to bond with them, and that the rules of Nature really have not changed in a very, very long time. We are giving birth to Stone Age babies in a space age world. And we must rethink our present responses, and our often gross lack of appropriate responses to their Stone Age needs. Until recent, western historic periods, no human parents ever asked: Where will my baby sleep and how will I feed my baby? Most human parents still wonder!

(See also This Emotional Life, DVD, and the work of Dr. Seth Pollak at the University of Wisconsin, Madison, on bonding.)

* I am currently writing an assessment tool for rating bonding, similar to Apgar or Latch scoring to help chart this and be able to identify at-risk mother-baby couples sooner. See the Bonding Grid in Appendix I in the upcoming book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21^st Century,© pending by Stephanie Sorensen  Stay tuned....

Doctors Deliver Babies But Shouldn't*

“The midwife considers the miracle of childbirth as normal, and leaves it alone unless there's trouble. The obstetrician normally sees childbirth as trouble; if he leaves it alone, it's a miracle.”  ~ Sheila Stubbs

         
            I cannot take credit for this chapter’s title. It was coined in the 2^nd half of the 20th century in England, and later written in Maternal Bonding, by Dr. Wladyslaw Sluckin of Oxford, U.K., 1983. He writes: “The basic pattern of social behavior in human babies lies in maternal-infant attachment. She has carried her child in her womb for about 266 1/2 days, which is actually the average from conception to birth, not delivery. Babies get themselves naturally born in most cases, and that child is looking forward to a continuation of the life that it had in the womb. The temperature and pressure are constant, no work is required, and he or she is looking forward to a continuation of this. What they are looking forward to is a "womb with a view". But they are expelled rather roughly and usually taken away from their mother, which is wrong. It's physiologically and psychologically wrong. Both baby and mother need each other more at this time than they ever will again. The baby should be put to nurse at his mother's breast whereupon it induces an enormous number of wonderful changes in the mother, such as an arresting of the postpartum hemorrhage, which no obstetrician can do under the circumstances, but a baby can do. Which indicates that there is more intelligence in the upper and the lower lip of one baby than all the brains of all the obstetricians put together.”

Happily, many medical schools and physicians since Dr. Sluckin’s time have re-considered our modern approach to birth and are very concerned about how we bring babies into the world. Since his book, we also know that bonding is reciprocal, that baby also initiates cues, though this idea has not been accepted yet by all researchers, scientists, and medical professionals.

We now have birthing rooms at most hospitals and rooming-in options. Many doctors have since educated themselves and encourage exclusive breastfeeding. Many studies have been done and are continuing to prove the effectiveness, if not cost saving, benefits of change, and the increase in patient satisfaction. But above and beyond hospital cost considerations and patient ratings, what can we learn from the past about what is best for your baby?

We have seen over past centuries how the pendulum of thinking dictates what we do or don’t do, or do for a few years and then deliberately don’t do, often to the detriment of our children. Here is but one example of this: For centuries cradles were used to calm babies to sleep. All of a sudden, about a hundred years ago, a physician warned parents of all sorts of overly indulgent behaviors, in particular that cradles were a ‘crutch’ that they would never be able to wean their children of – have you ever seen a six-foot long cradle in a college dorm? – and that they must train their children to sleep without it, even if that means a period of adaptation from being comforted to sleep, to sleeping alone and that only ‘soft’ parents would not allow babies to cry themselves to sleep during this period. Well, many parents bought this theory, threw out their cradles and thought themselves better parents for having trusted an ‘expert.’

There are numerous other examples of where we ‘thinking’ parents throw out our instincts in favor of doctors’ or educators’ views. First we should stop and ask, do these people have children? Then we should find out if what they have just published earned them a degree.

            We must test these theories and decide for ourselves what will work best for my baby, not what ‘they’ say is best for all the other babies in the world. Only then will we collectively see what is good for babies. And then we can initiate change that is solid, now called ‘best practice.’ In turn it will attract the attention of doctors and hospitals and educators and much of the mainstream whom I must believe also want the best for their babies, too. It takes time, often years or decades, but it does happen. Thirty years ago I had to fight to have my twins born naturally. I had to defend myself against society for nursing both of them without supplements. Then I had to explain why I thought I could nurse them into their third year. (I also found myself guarding our bedroom like a mama tiger lest people realize we didn’t have any cribs.) Later I found myself defending our choice to homeschool. This idea of following our instincts is further complicated by our society’s eagerness to blame: later problems are blamed on extended nursing, or child-led weaning, or bad mothering (or fathering) in general. (See “Bad” Mothers: the politics of blame in twentieth-century America , Ladd-Taylor, Molly and Umansky, Lauri, New York University Press, 1998, chapter 11, essay by Jane Taylor).

 “This wouldn’t have happened if you hadn’t let him sleep with you… you should never have started….” Or, “you are starving that baby…” or, “you are spoiling her…it’s good for their lungs to let them cry.”

Actually, what you are teaching your baby when you let him cry and don’t pick him up, is  to cry more. Babies are not born with our level of reasoning, though we act as if they are. None of my babies, at least, could reason like this: “Let me see now, if I am dry and fed and had my nap, let’s see what would happen if I cry and if anyone will spoil me and pick me up.” A baby cries for a reason. These are some of them: he is hungry, he wants skin contact, he wants affection, he needs reassuring, he is cold, he is too hot, he has a burb, or something hurts. These are all valid needs. And he is definitely not figuring out how to manipulate us. We project our ideas on our children much too early. Our instincts should tell us this, but if your mother or mother-in-law or someone else who has in turn been warned not to follow their instincts tells us to, “be careful you don’t spoil him…” we are simply perpetuating a myth by ignoring our hearts. 

In the end, our lack of confidence in our parenting skill is also undermined. Never before in history has parenting been as difficult. The world outside our homes is falling apart on many levels.  There are wars, famines, natural disasters, epidemics, and unprecedented violence. We must not despair and decide we can’t make a difference. We can make a significant difference if we each choose to, every day. We must begin with our children. Mother Teresa, whom I lived with in the 1970s, continually exhorted people, “Start in your own families. Love each child there first. Do not come to India. You have work to do in your own homes. If everyone did that, and it spread, there would be no hunger or loneliness or need.”
 If we begin our families with an unsure foundation, not confident that we can know what is best for our children, then that shaky beginning will translate into a lack of security for our babies. Instead, when we have educated ourselves the best we can, thoughtfully discussed and tested each new idea with our partner and agreed on what feels good and right for us; that we are doing our very best, that we may make mistakes but know we can learn from them and move on, then we can have the assurance of knowing we will be the best parents we can be and have happy, secure children.

"I think one of the best things we could do would be to help women, parents, families discover their own birth power from within themselves, and to let them know it’s always been there; they just need to tap into it". ~ Karl Menninger

*Stay tuned... This chapter is one of many that will appear in the upcoming book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21st Century©             pending, by Stephanie Sorensen