The Next Book! Excerpts...

PUSH! The Sequel is finished!

Here are some juicy parts, pre-publication:

Dedication

This book is dedicated to the brave, revolutionary young families of the Muntele Rece district of Cluj-Napoca, Romania. Against all odds they are taking back control of their lives and the lives of their children after Communism all but dictated their very existence. They are choosing to have their babies at home, later home schooling them, and discovering autonomy for themselves.

I have only the highest respect and regard for this tiny movement among them. They are slowly winning midwives, doctors, and others over to their side. It reminds me so very much of the 1960s and ’70s in America when radical hippies like Ina May and Stephen Gaskin began to question the status quo. They deserve our deepest respect and support.

Preface: What my books are and are not about

They are about the courageous men and women from across the planet who have fled war, torture, famine and genocide. They come here with hope. They dare to hope that they can once more live in peace. They dare to fall in love again, dare to make babies again and dream of providing a better life for their families.

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

My books are about these amazing survivors starting over, from scratch. They invite me to witness some of their most intimate moments, like the birth of their babies. My job is to help them navigate the impossibly complex world of the American medical system. With each one I try to create a safe environment for them, so that they can access their own power and wisdom from within in order to birth this particular child.

My books are not about me. Yes, I get to be part of their lives and rejoice with them. I often get to visit their homes, eat their food and kiss their beautiful babies, but this is not about me. Sometimes I also cry with them. The last time was when I accompanied a woman from Ghana into the operating room for a C-section. Her twin babies were showing signs of distress. They needed to be born NOW. Two plump beautiful brown baby girls who both carry a rare genetic syndrome--the incidence is only 1 in every 15,000 births—and they both have it. The rest of their lives will be challenging, but their brave parents love them dearly.

Above and Beyond the Call of Doula

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 six 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, one living child, one stillborn, due in September, single birth. This would be my third homeless mom in four 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.

“The knowledge of how to give birth without outside interventions lies deep within each woman. Successful childbirth depends on an acceptance of the process.” ~ Anonymous  

Some facts about homelessness in Minneapolis:

The shelter where Shavonne was staying is the largest in Minnesota. They served an average of 1,187 homeless families a year for the past several years. 59% of guests were children and 34% are under the age of five years old. The average age of a child there is six 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 eight 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 staged a one-woman silent vigil there for several nights that winter, in protest.

   

“People who say they sleep like a baby usually don’t have one.” ~ Leo J. Burke

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 almost thirty 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 anyway. 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—the 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 six 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 five 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 succeeded in avoiding 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. Shavonne planned to bring it to her baby shower that a friend was hosting for her and have everyone write blessings and messages on it.

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.” ~ sss

 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, allowing him to nurse exclusively. 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 things. Within ten 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.

“Babies are such a nice way to start people.” ~ Don Herold

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 had 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 beautifully 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 in. It was very different from the last shelter she had been in before the birth. Here 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.

“A perfect example of minority rule is a baby in the house.” ~ Anonymous

So Shavonne settled in and spent the next few weeks trying to access the county services and find 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 child care 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.

 Stay tuned for more chapters from PUSH! The Sequel

The Tattooed Lady

I am going to veer off from my usual topics here and post a very personal story that I want to share.

The Tattooed Lady

or We Are Survivors!

This year marks 50 years ago that I survived childhood sexual assault. I was 14 at the time. Two men assaulted me throughout the night, leaving me half naked in a corn field at 4 in the morning when they were done.

In my very immature 14-year-old brain, I figured I would rather kill myself than wait for them to come back and find me and carry out their threats. Of course, I had to tell the sheriff what happened. Yes, I could identify their house. Yes, I could describe them. Yes, they were caught.

In the 1960s we didn’t have victim services--at all. No one knew what to say, so no one said anything at all. After my suicide attempt my parents sent me to a state mental hospital (after not talking about what happened or its suicidal aftermath) which is where the psychiatrist said I would be safer than left to my own devices. I didn’t meet with the psychiatrist or any other health care professional during my entire sojourn there.

Where I spent two years pacing the halls and crying. But I survived. I eventually left. I finished school, worked, travelled, grew up.

My life had all the ups and downs every life has. Then mine became decidedly richer: I found the love of my life, had five amazing children, continued to travel, was awarded a fellowship to return to school after the children and received my state midwifery license in 1989. I wrote a book* and became an author, a grandma and an artist all at the same time. Life is still full and busy and, like brandy, my husband only gets sweeter with age. I am blessed and deeply grateful.

* Ma Doula: A Story Tour of Birth, North Star Press, was released on June 1^st, 2015. In 2016 Ma Doula won as a finalist in the 12-state Midwest Book awards.

Continue forward to this year, 50 years later. I’ve moved on. I tried to forget. I stuffed all of the rage and shame and fear down so deep I hardly knew it was there, but every time I looked at the white slash marks up and down my arm, I was reminded. I hated my arm. I wore long sleeved blouses all of my life. I didn’t want anyone to see my past carved out there so clearly.

Then the miraculous happened: about seven years ago I was at a doula workshop and during our lunch break, as I was wandering around, taking in all the vendors there for the day, I happened upon Victoria and her henna booth. Cool, I thought. She invited me to sit down and have a henna tattoo done. They were so beautiful and magical. When I was settled, she gently reached out to take my arm which I quickly drew back. “Not that one. It’s ugly. Do the other one,” I said. I could actually see a shift in her eyes as she carefully continued to pull my left arm onto the little table by my chair. As she took in the 12 inches of my own handiwork she said, “Then let’s make it beautiful.”

I was stunned. I couldn’t say anything. I let her paint as my mind was swimming with this new paradigm on the whole of my arm’s life. She not only completely covered the scars, but it was elegant and beautiful. 

  

After that I bought some tubes of henna and learned the art by drawing over Victoria’s patterns as they began to fade. This experience had really opened a whole world of possibilities, short sleeved shirts being one of them. It definitely stopped the horrified looks every time I went to the doctor or had my blood pressure checked.

Fast forward (back) to my 50^th anniversary this year. What appeared to be a grave error on the part of my medical practitioner turned into a miraculous teaching and healing that would direct the next ten months in particular, and then the rest of my life. This was also the year I turned 65.

The whole saga is being written as a book called Elopement Risk so I won’t go into details here other than to say that as I was being weaned off a mild anti-depressant, I was prescribed Trazadone and by the 5^th day on it, was into a full-blown psychotic episode where I was hallucinating, had stopped eating and sleeping and my mind was convinced I was on an epic religious crusade, complete with Satan stalking me from behind attempting to thwart my successes along the way. Yes, to say it was bizarre is an understatement. It was like going on my first LSD trip at 65. It took two whole weeks in a psych ward for the effects of the errant drug to leave my system and once again get a good night’s sleep.

The miracle, however, is that I had the opportunity for the first time in my life to talk about the past and all the things that had bubbled up during the last two weeks in the hospital.

Even when I went home, I was required to continue psychotherapy (having been diagnosed with PTSD) and found a wonderful woman who actually understood what I had been through. After several months with Janice I was invited to join a 10-week workshop/group therapy program called, “In the Wildflowers” with five other survivors of childhood sexual abuse. What an eye opener. I had never heard any other woman’s story. I could share mine and each time I did I remembered more and more details and was able to work through the pain. It was freeing. It was amazing. God had found a way to heal me, even at 65.

About this same time I stumbled upon a website for women who had survived mastectomies and chose instead, rather than reconstruction and breast augmentation surgery, to cover the scars with beautiful tattoos.

I was awestruck. Such brave women, and they were all around my age! What a revelation! I could permanently cover my scars with something beautiful. This idea ‘blew my mind’ as we would say back in the ’60s.

So, I got my first tattoo. I designed it and found Nora, a budding artist who has perfected the art. 

I love it. I even love my arm, after 50 years. I thank God and Janice and Victoria, and Nora and all the amazing women who have blessed me this past year. I am grateful.

Stephanie

On Censoring the World For Our Children

On censoring the World for Our Children

Most of you reading this are parents of very young children, I suspect, but I have been wondering about several things that I am guessing we began when ours were little and elaborated on as they grew. We based our early years of homeschooling on one quote alone by John Holt, the guru of home schooling or UN-schooling as some call it. He said that all that children need to learn is an environment consisting of "an extravagance of creative space." I didn't need to stand up in front of them, all relegated to individual desks, and pour (or shove) information down their throats. I could step back and let them discover the world at their own pace. Each one would be free to explore and exhaust each new thing they chose to study or work with. I didn't even have to offer various topics. I could trust them to be curious about the world around them and give them the freedom to delve into whatever interested them without my interference. When did adults decide that children would only learn from us and not from what they could taste, see, smell, hear or touch?

So, I would begin each day doing what chores I needed to do. Sometimes one or the other child would follow me around and even help, doing whatever I did. Other times I would find them picking up where they left off the day before and continue playing in the stream, creating a whole world out of twigs and mud and acorns, little cities with bridges and castles and whatever else they imagined, often things taken from books we had been reading to them at night, or things they heard us discussing. I was careful not to clean up their projects at the end of the day; I couldn't bear to destroy all that hard work. I would clean the house around them, reminding them if we were expecting visitors and suggest they move to "help" me cook or bake, sometimes getting helpers, sometimes not.

I realized as they grew that perhaps some if not all of the problems with American teenagers stemmed from them not being genuinely needed. If we look at other cultures, both third-world and so-called first-world, children were and still are desperately needed to help on the farm or help support the family, though often, unfortunately, to the extreme of child labor. But they were depended on. They didn't have to check a roster on the refrigerator decorated with stars and stickers, relegating the daily nominal chores: dishes, laundry, garbage, walk the dog, clean your room. They need to be needed more than that. There must be another dimension, perhaps spiritual. They belong to a larger unit. They aren't little pawns waiting to be launched, putting in their time, dreaming of the next adventure. Rather, each one has gifts that we have to discover and put to use, to make us all better, stronger.

A very wise Quaker granny once told me that the promiscuity we can observe in American teenagers is a direct result of the lack of affection bestowed on them at home. If they are no longer cute and little and cuddly, do they suddenly not deserve hugs and pats and kisses? My granny friend said, "You just watch. They will find their hugs elsewhere if not at home."

High school presented the biggest challenge for me yet. Books were coming into the house at an alarming rate, faster than I could approve them while other moms in our church were daily adding banned titles to their lists. That didn't quite jive with me. If they are banned at home, and we request alternative assignments from our children's teachers, how do we justify that to the kids? Is it OK because I am an adult to filter everything they see, but get to read whatever I want? Are the arguments worth it? Won't they just sneak the banned books, curious to see what all the fuss is about? I know I did when I was their age, though my parents were intellectual atheists and trusted (or allowed) us the freedom to decide for ourselves what or what not to read. I certainly didn't want them to lose their innocence as early as I did. 

In the end we came up with a plan. I got to see what they were reading in school and would read it too. Then each night we'd see where the other was in the book and discuss it - all of it. I could give them my take, why I thought something was sad or racy or whatever, and they could share their thoughts. It only brought us closer and I hope helped me retain some respect in their eyes. 

They all still read voraciously. I even get books in the mail from New York and California with little notes: "Ma, you'll love this one!" (I hated it but didn't tell them that.) But some are really winners. I think it helped keep the lines of communication open. I am glad.

Welcome to Parenthood

Once upon a time... we got out the calculator (before computers) and figured we had not slept through the night once in 11 years. We also deduced that I had been pregnant or nursing or both for 9 straight years. I usually smelled like a dairy, or a barn, or both. I had not had an uninterrupted hot cup of coffee in... well, I couldn't remember when the last one was. I wasn't remembering much, actually.

But I do remember making challah bread with my children and picking off the cat hairs from the dough after Isaac dropped his little braided loaf on the floor on its way to the oven. And I remember the day they named the kittens. The kids held the equivalent of a world congress from which I had been banned while they debated. The verdict they arrived at was "Orangy" for the tiny calico, and "Little Fuzzy Fur Feet" for the black one. I will never forget the day Hannah asked me, "Who puts the eggs under the chickens for me to find?" Or when they wanted to know if they were born in the shell or out of the shell.

The joys outweighed the sacrifices. We didn't do everything right. I am sorry if my past blogs gave the impression that it was all bliss. No, it was all trial and error. Year after year. Nothing from all those years of school prepared us for parenthood, but we are so very blessed because of them. I wouldn't trade those years for anything. And now they are gone, only memories that I cling to.

What I am left with is five confident, beautiful adults, all seeking their place in the world, all caring, curious, insightful, independent, very unique people.

~ Grandma Stephanie

Tribes and Everybody Loves Babies, the movie

Filmmaker Thomas Balmès criss-crosses the globe to observe and record the first two years in the lives of four infants and their families. Ponijao is the youngest of nine children and lives in a village in Namibia. Bayarjargal's family lives in Mongolia. Hattie is a San Francisco couple's first child, and Mari is the first child of a couple living in Tokyo.

What are we seeing, then? Two so-called first-world families and two (supposedly) third world families. I am quite sure the photographer wasn't intent on observing bonding styles or even measuring maternal responses to the infants' attachment cues. But this film gives us the rare opportunity to glimpse just that. 

There is virtually no narrative in the movie. We just watch the four babies at various stages of development from birth, to their first steps, their first words, interaction with others and their play.

But I am instantly struck by the vast differences in the various parent's interactions and the link between that and the baby's responses; sometimes bored, whiny, frustrated or downright opposition to the proposed activity. In San Francisco Hattie wants nothing to do with a drumming circle nor a dip in the jacuzzi. In Japan Mari is left to play alone with numerous toys and throws herself down in utter misery at her failure to occupy herself. 

Then we see the contrast in Namibia where toddlers are perfectly content and given the freedom to explore their world free from distractions. They are even content playing with sticks and rocks. We see a similar response in Mongolia. Two boys and two girls. Fate has brought them to four very different families on opposite sides of the world. We get to travel with them. We get to form our own conclusions. 

We have a rare opportunity to observe bonding at every level by looking into the lives of these babies. Every time I watch the movie I am struck by the obvious, to me at least: more is not always better.

Make your own conclusions.

Screen time and relatives with opposing values

Screen time and relatives with opposing values

For an ongoing discussion on this and other topics go to:

http://www.continuum-concept.org/forum/index.html

I've been mulling over this one for a while. Many wrote in to the Continuum blog with their suggestions and unhappiness with relatives who are not on the same Continuum Concept wavelengths. Looking back over raising our 5, there were many times we'd encounter grandparents and others who were definitely not on the same planet as us as far as values, i.e., home birth, extended breastfeeding, co-sleeping, homeschooling, you name it!

But, without condoning it, we allowed it. Yes, the kids came home hyped up on Grandma's sugar cookies and begged for a TV like Grandma's, but we stuck to our beliefs at home. I think it is far more important than giving a list of no-nos to outside family or alienating them by restricting contact with our children, that we showed love and compassion to others who were different from us. As the children grew older, we could explain these differences and they could understand where our empathy grew from. Our living example of not judging others taught them far more than any legalistic lists could. There could be more un-peace in that than living our beliefs, often without using words. We didn't want it to be us against the world. 

We let them play with neighborhood children later, which presented many different cultures including the American pro-military stance. I didn't tell them they couldn't play with children from those families, but I did draw the line and didn't allow war toys or guns on our property. I had a little lecture I gave to the new kids about leaving their weapons in our mailbox at the end of the driveway where they'd be safe until they returned home. The kids complied. Perhaps it was their first introduction to pacifism. 

We didn't have smart phones or computers either, so screen time wasn't an option. They had them in high school, but it wasn't some forbidden fruit that they went wild with. They have all grown into extremely different, creative, loving adults. Ultimately they know we did the best we knew how, mistakes and all. 

Birth Trauma and who is to blame

As a midwife, I have a strong conviction that the feelings of shame and guilt  in oneself, thinking you are weak and 'caved in' at the end if your birth ending up with interventions, namely an epidural, forceps, vacuum, or C-section, and the resulting disappointment is the result of the medical community and where the blame should lie. I feel that it is a grave disservice to all women that the medical community, first of all, in general, though some are the exception, has a long history of fear, that birth is a set of horrific problems waiting to happen, and at the other end of the spectrum, that as a midwife, I (or collectively) might have given my clients the false impression that I expect a 100% natural, easy, basically unassisted birth, and anything short of that is failure.
In fact, I am in awe of all of my moms from over the past 35 years that did their very best first to educate themselves and then find the best providers for themselves. That said, I have seen women who have experienced so many things that they might not even be able to admit to themselves, that color much of our make up: childhood abuse, substance abuse, failed relationships, hurt, neglect, gender issues, a lack of confidence, the list is virtually endless. 

If we lived in a perfect world, yes, none of those things would affect our births, but we don't. We have a whole lot of baggage to work with. That is why, when I find myself in an operating theater for a cesarean with one of my moms and we have just heard her baby cry, I whisper in her ear, "Sweetheart, you've done it! You are brilliant!" and I kiss her. I can't judge her. In some cases, if we had been in Venezuela, or Zimbabwe, she and her baby might not have survived.  I am grateful we weren't.

Blessings,

Stephanie Sorensen

Midwife, Author

Breasts of the World Unite!

A Voice for Babies!

U.S. (the Trump administration) Opposition to Breast-Feeding Resolution Stuns World Health Officials 

Full article found in NY Times: https://nyti.ms/2J0WJuV  By Andrew Jacobs

July 8, 2018 Wesley Tomaselli contributed reporting from Colombia. Reprinted here without permission.

 A Brooklyn mother unable to nurse fed her child donated breast milk. The $70 billion infant formula industry has seen sales flatten in wealthy countries in recent years.

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.

Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.

Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States.

Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States.

“We were astonished, appalled and also saddened,” said Patti Rundall, the policy director of the British advocacy group Baby Milk Action, who has attended meetings of the assembly, the decision-making body of the World Health Organization, since the late 1980s.

“What happened was tantamount to blackmail, with the U.S. holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health,” she said.

In the end, the Americans’ efforts were mostly unsuccessful. It was the Russians who ultimately stepped in to introduce the measure — and the Americans did not threaten them. The State Department declined to respond to questions, saying it could not discuss private diplomatic conversations. The Department of Health and Human Services, the lead agency in the effort to modify the resolution, explained the decision to contest the resolution’s wording but said H.H.S. was not involved in threatening Ecuador.

“The resolution as originally drafted placed unnecessary hurdles for mothers seeking to provide nutrition to their children,” an H.H.S. spokesman said in an email. “We recognize not all women are able to breast-feed for a variety of reasons. These women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.” The spokesman asked to remain anonymous in order to speak more freely.

Although lobbyists from the baby food industry attended the meetings in Geneva, health advocates said they saw no direct evidence that they played a role in Washington’s strong-arm tactics. The $70 billion industry, which is dominated by a handful of American and European companies, has seen sales flatten in wealthy countries in recent years, as more women embrace breast-feeding. Over all, global sales are expected to rise by 4 percent in 2018, according to Euromonitor, with most of that growth occurring in developing nations.

The intensity of the administration’s opposition to the breast-feeding resolution stunned public health officials and foreign diplomats, who described it as a marked contrast to the Obama administration, which largely supported W.H.O.’s longstanding policy of encouraging breast-feeding.

During the deliberations, some American delegates even suggested the United States might cut its contribution to the W.H.O., several negotiators said. Washington is the single largest contributor to the health organization, providing $845 million, or roughly 15 percent of its budget, last year.

The confrontation was the latest example of the Trump administration siding with corporate interests on numerous public health and environmental issues.

In talks to renegotiate the North American Free Trade Agreement, the Americans have been pushing for language that would limit the ability of Canada, Mexico and the United States to put warning labels on junk food and sugary beverages, according to a draft of the proposal reviewed by The New York Times.

During the same Geneva meeting where the breast-feeding resolution was debated, the United States succeeded in removing statements supporting soda taxes from a document that advises countries grappling with soaring rates of obesity.

The Americans also sought, unsuccessfully, to thwart a W.H.O. effortaimed at helping poor countries obtain access to lifesaving medicines. Washington, supporting the pharmaceutical industry, has long resisted calls to modify patent laws as a way of increasing drug availability in the developing world, but health advocates say the Trump administration has ratcheted up its opposition to such efforts.

The delegation’s actions in Geneva are in keeping with the tactics of an administration that has been upending alliances and long-established practices across a range of multilateral organizations, from the Paris climate accord to the Iran nuclear deal to Nafta.

Ilona Kickbusch, director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, said there was a growing fear that the Trump administration could cause lasting damage to international health institutions like the W.H.O. that have been vital in containing epidemics like Ebola and the rising death toll from diabetes and cardiovascular disease in the developing world.

“It’s making everyone very nervous, because if you can’t agree on health multilateralism, what kind of multilateralism can you agree on?” Ms. Kickbusch asked.

A Russian delegate said the decision to introduce the breast-feeding resolution was a matter of principle.

“We’re not trying to be a hero here, but we feel that it is wrong when a big country tries to push around some very small countries, especially on an issue that is really important for the rest of the world,” said the delegate, who asked not to be identified because he was not authorized to speak to the media.

He said the United States did not directly pressure Moscow to back away from the measure. Nevertheless, the American delegation sought to wear down the other participants through procedural maneuvers in a series of meetings that stretched on for two days, an unexpectedly long period.

In the end, the United States was largely unsuccessful. The final resolution preserved most of the original wording, though American negotiators did get language removed that called on the W.H.O. to provide technical support to member states seeking to halt “inappropriate promotion of foods for infants and young children.” “We’re not trying to be a hero here, but we feel that it is wrong when a big country tries to push around some very small countries, especially on an issue that is really important for the rest of the world,” said the delegate, who asked not to be identified because he was not authorized to speak to the media.

He said the United States did not directly pressure Moscow to back away from the measure. Nevertheless, the American delegation sought to wear down the other participants through procedural maneuvers in a series of meetings that stretched on for two days, an unexpectedly long period.

In the end, the United States was largely unsuccessful. The final resolution preserved most of the original wording, though American negotiators did get language removed that called on the W.H.O. to provide technical support to member states seeking to halt “inappropriate promotion of foods for infants and young children.”

The United States also insisted that the words “evidence-based” accompany references to long-established initiatives that promote breast-feeding, which critics described as a ploy that could be used to undermine programs that provide parents with feeding advice and support.

Elisabeth Sterken, director of the Infant Feeding Action Coalition in Canada, said four decades of research have established the importance of breast milk, which provides essential nutrients as well as hormones and antibodies that protect newborns against infectious disease.

A 2016 study in The Lancet found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

Scientists are loath to carry out double-blind studies that would provide one group with breast milk and another with breast milk substitutes. “This kind of ‘evidence-based’ research would be ethically and morally unacceptable,” Ms. Sterken said.

Abbott Laboratories, the Chicago-based company that is one of the biggest players in the $70 billion baby food market, declined to comment.

Nestlé, the Switzerland-based food giant with significant operations in the United States, sought to distance itself from the threats against Ecuador and said the company would continue to support the international code on the marketing of breast milk substitutes, which calls on governments to regulate the inappropriate promotion of such products and to encourage breast-feeding.

In addition to the trade threats, Todd C. Chapman, the United States ambassador to Ecuador, suggested in meetings with officials in Quito, the Ecuadorean capital, that the Trump administration might also retaliate by withdrawing the military assistance it has been providing in northern Ecuador, a region wracked by violence spilling across the border from Colombia, according to an Ecuadorean government official who took part in the meeting.

The United States Embassy in Quito declined to make Mr. Chapman available for an interview.

“We were shocked because we didn’t understand how such a small matter like breast-feeding could provoke such a dramatic response,” said the Ecuadorean official, who asked not to be identified because she was afraid of losing her job.

Tribes and following your heart: Continuum Concepts

Tribes and following your heart: Continuum Concepts

Every parent interested in tribal peoples and natural parenting must see Babies, also known as Baby(ies) and Bébé(s), a 2010 French documentary film by Thomas Balmes, who in fact did not have an agenda or even know about Continuum Concepts when he produced the movie.

An interesting review written by Roger Ebert on the 2010 French documentary unwittingly touches on the fact that the babies seen in the movie from the poorest parts of the globe appear the happiest. He writes:

"Babies is the perfect film for anyone who has never had the opportunity to interact with humans at an early age. You may never have had one, held one or baby-sat one, yet remained curious about the infants you see in a park, on the beach, or in baby carriers at the mall. Now a French documentarian has traveled to Africa, Asia and America to bring back charming footage of babies in their natural habitats.

If, however, you've raised children and/or grandchildren, or had little brothers and sisters, the movie may resemble 79 minutes of unpaid baby-sitting. When Baby Mari starts screaming, you're wishing you could turn on the TV and use something bright and noisy as a distraction. But no, you're at a movie. However, maybe “Babies” may be fascinating viewing for babies, just as many dogs and cats have their favorite programs. The babies are cute. Well, all babies are cute. That's just as well, because how could filmmakers audition a baby and wait six months to give it a callback? It's not a baby anymore. The director, Thomas Balmes, has found exemplary babies in Namibia, Mongolia, Tokyo and San Francisco, and observes them lovingly as they nurse, play, doze, poke kittens and happily hit one another. The movie is really about the babies, not their parents, and in most cases, we only see those parts of the parents ranking highest on the infant's interest scale: nipples, hands, arms, and male and female chests. Not all of the nipples are real, but the babies don't discriminate as long as they work. 

Two of the babies come from poor parts of the world, and two from rich. They seem equally happy and healthy. The Japanese and American babies are subjected to an awesome array of baby training strategies so they can begin climbing the success ladder as early as possible. I have no argument against baby yoga classes, but I have never known a baby who wasn't naturally able naturally to contort itself into alarming positions and get lost in meditation on the spur of the moment.

The African baby, Ponijao, lives in a forest hut with an earth floor, but this is Home and here is Mother and there are sticks to play with that may not be made of plastic and ornamented with Disney creatures but are excellent sticks nonetheless, and satisfying. Bayarjargal (nicknamed Bayar), whose family lives in a yurt in Mongolia, passes time by becoming expert in sibling rivalry.

Mari, from Japan, and Hattie, from America, are surrounded by a baffling array of devices to entertain them, serve them, shelter them, protect them and help them grow up big and strong. Can the epidemic of attention deficit disorder be explained by the First World's lack of opportunities for babies to be bored? How can babies concentrate when things are forever being jingled and dangled at them? Is there too much incoming? 
I dunno. What I do know is that babies are miraculous. From a sprawling, bawling start, they learn to walk, talk, plan, scheme, play and figure stuff out. Generations of scientists have hurled themselves at the question of exactly how babies learn to talk. They must be getting so frustrated by the fact that the babies just go ahead and do it with no training." 

***

From my book, Ma Doula: A Story Tour of Birth: In the late 1970s, after the Vietnam War had displaced them, thousands of Hmong people immigrated to the U.S., Minnesota absorbing the bulk of them: 35,000 in the first years. I decided to befriend them. And I watched and listened.

Like Jean Leidloff (The Continuum Concept, 1971) whom I didn’t read until many years later, I was not seeing babies who resembled our American babies. These babies hardly fussed, never seemed to cry, were carried most of the day only being put down on straw mats on the floor when they were sleeping, but were otherwise scooped up at the first peep and tied onto whomever was the first adult on the scene. Babies were nursed on demand until the next newborn came along. Then that toddler became the charge of Grandma or an Aunt who would carry, feed, sleep with, entertain and care for him so that the little person would not feel left out for one minute by the tiny intruder. Children were constantly milling around the grownups wherever they were congregating. The men would gather before and after a meal, often sharing a bamboo hookah, babies or toddlers on their knees or in their laps, older children quietly playing and listening to the conversations while their moms and sisters cooked, cleaned and took care of the household.

During the first years I was with the Hmong, I never saw a baby crying uncontrollably, or left to cry behind a closed door. I never saw a tantrum when a parent said no. I didn’t see whiny or clingy children in stores demanding this or that dry cereal or toy. I also didn’t see parents entertaining their little charges, rather, they were simply brought along throughout the day wherever their parents or aunt or grandma needed to be engaged. Toddlers were looked after by the whole extended family. It did take a village to raise each child. Everyone, even the oldest grandpa’s lap wasn’t off limits to a grazing toddler. Grandpa just kept talking or telling a story to whomever was listening (or no one.) Spoken Hmong is a preliterate (unwritten) language, so there is a very rich oral tradition of story-telling. Stories are told and retold. Stories are sung over and over. Stories are even sewn into intricate, elaborate quilts and wall hangings. You can find story quilts telling the story of a particular family’s exodus from Laos or the layout of the clan’s farm and animal herds before the war.

I also saw toddlers wielding knives and machetes. Adults didn’t admonish the children, or grab the tools away but quietly hovered nearby, letting this be an educational moment. Children hardly more than toddlers themselves would comfort a smaller child if he fell down. There were no toys as such in those early days, but children would share or patiently wait for a turn with an empty juice bottle ‘doll’ wrapped in a rag that another child was playing with.

This was continuum bonding. After 9 months in utero, being totally surrounded by everything he needs a baby’s care isn’t suddenly completed, like an assembly line product, popped out at birth. The complete circle of touch, smell, sounds, taste and comfort must be continued 24 hours a day. ‘In arms’ he will continue to be held, fed, jostled, rocked and hear and see everything around him that he will slowly learn from. That is stimulation enough. We don’t have to constantly entertain, provide educational toys, teach, hang mobiles, come up with unique experiences, schedule play dates, put on classical music, and play CDs of foreign languages, ad infinite. Our babies will process as much as they are able at each appropriate stage without our perpetually thinking that they won’t learn or be smart if we don’t personally fill each teaching moment by offering them multiple options. Our daily lives already provide the social and physical requirements for our brain development.

Fast forward to 2018. I am now seeing 3 generations later, an entire society emulating our American lifestyles, values, and so unfortunately, our parenting styles. Most have lost sight of the continuum model I saw in the beginning of their assimilation. I would bet, though, that I would find that model again in Laos should I return to visit those that stayed behind. 

Blessings,

(Grandma) Stephanie Sorensen

Midwife, Author

Email: ssskimchee@gmail.com

Blog: callthedoula.blogspot.com