I am looking forward to presenting my "Dare to Care" workshop in Saskatoon in November. I am going there anyway to speak at the Canadian Association of Midwives 2014 conference. I will be speaking about about the good sense of requiring midwifery applicants to have experience as volunteer doulas, in an organization such as Montreal Birth Companions.
When I decided I would indeed be going back to Saskatoon (I was there ... 40 years ago as a young hippie girl), I contacted my virtual friend Lisa Wass, a Birth Keeper who is director of Birth Rhythms. Birth Rhythms is the kind of place you would imagine finding in a large metropolitan city, but there it is in Saskatoon, changing women's, babies' and families' lives for the better every day (and every night - Lisa is also a doula who attends births).
I am very honored to be presenting my workshop there - it is a little bit of a transition time for Birth Rhythms and Lisa's community has banded together and shown their absolute support for this amazing organization.
"Dare to Care" is a workshop that focuses on the healing power of birth, and on self care and pleasure for the Birth Keeper. We will be exploring different approaches to healing, and we will be playing together with some body mapping techniques and storytelling.
For more information, head over to Birth Rhythms and look at their calendar here.
Thursday, October 2, 2014
Wednesday, October 1, 2014
Just say no? Of course not!
Drugs save people's lives. Antibiotics, antiretrovirals, opiates, anesthetics, statins .... the list goes on and on. Every day, millions of people are kept alive by modern medicine and by appropriately prescribed medication.
In obstetrics, however, as in psychiatry, medications are overused and used inappropriately. The other day I heard a story about a woman who needed surgery like she needed a hole in the head. She is alone, poor, and anxious. She was going to have a difficult entry into motherhood without major surgery, dealing with the stress of a newborn along with the continued stresses of poverty and cultural isolation.
She was scheduled for an induction and her uterus reacted too strongly to a Cervidil insertion and started hyper-contracting. Baby went into distress and surgery was needed to save the baby.
I would need a crystal ball and a full-on fortune telling kit to figure out if this particular mother-baby dyad would have needed surgery if left alone. But it is true that "Care providers need to consider that induction of women with an unfavourable cervix is associated with a higher failure rate in nulliparous patients and a higher Caesarean section rate in nulliparous and parous patients" (SOGC).
Why are we giving drugs to laboring women? I took a picture of this drug the other day. It is called synthetic oxytocin. It can save women's lives if they are experiencing a serious postpartum hemorrhage. But it is used much too often to speed up or stimulate labor in cases where a good dose of patience is all that is called for.
This is a high risk drug!
Another cocktail of drugs that is commonly administered is the epidural cocktail. The components vary from hospital to hospital. You can find detailed information on the most common ingredients here (page 20). Most epidurals do contain Fentanyl (see below), which is an opiate. I have never heard an anesthesiologist ask a laboring woman if she has a history of substance addiction, but most recovered addicts I know would not willing put an opiate into their bodies unless they really had to.
Which leads me to the next question, which is: when is it necessary to give pharmaceutical medication to women in labor? And I would like to suggest that the answer should be: when the pharmaceuticals are directly involved in saving the life of mother or baby or both.
We simply do not know the long-term effects of epidural medication on the baby. And no, I am not speaking from a pedestal of wonderful candle-lit home births here, either. I have experienced my fair share of birth trauma. And yes, I am fully aware that taking an epidural during labor is often very important for the woman's emotional and psychological well-being, and her sense of empowerment. But these drugs are becoming normalized and their effects minimized. I would like to see the brake put on this candy store mentality where we are offering dangerous drugs to women and newborns.
Here is a brief description of one of these candies:
Tuesday, September 16, 2014
I just found out that another student graduate of the MBC Doula School has been accepted into Ryerson midwifery school. She will make a wonderful midwife and I truly believe that the experience she has had volunteering for Montreal Birth Companions has given her the groundwork that she needs to start her midwifery education with confidence and compassion.
I have been involved in maternity care since I was thirteen, which as my youngest son likes to point out, was a very long time ago! For years, when my four older children were small and I was running an organic subsistence farm, I studied Clara Hartley's "Apprentice Academics" long-distance midwifery courses, and so I gained my theoretical background for woman-centered care. When I returned to Canada, I chose to attend births as a doula and I continued to learn from every woman I accompanied, and from every professional I met.
I have been part of programs that offer midwifery internships to students in parts of the world where midwives is scarce and hospitals are under-equipped and expensive. This phenomenon morphed into programs in the southern US that provide midwife-based maternity care to Mexican women, and it also became a popular way for student midwives from the US to "get their numbers" for the Certified Professional Midwife program administered by NARM. This practice has now been discontinued because of ethical considerations, which makes it even more difficult for midwifery students from North America to have contact with women from cultures outside of their own.
Midwifery programs in Canada are not apprentice-based, and the university programs that teach Canadian midwives do not expect students to go to the community to gather their birth experience. Practical experience is combined with theoretical study to provide the students with a grounding in midwifery in Canada.
The requirements for graduation vary slightly from province to province, but generally a graduate midwife must have attended "a minimum of 60 births, acting as primary caregiver for at least 40 births in home and hospital settings." (http://www.ryerson.ca/midwifery/overview.html)
A student midwife can learn a lot from participating in the births of 60 babies. As every birth is different, the student will see, hear and learn about many variations to the tune of giving birth. If she is primary caregiver for 40 births, hopefully she will attend ten home births, and possibly have to transfer one of those to the hospital.
But I propose that prospective midwifery students in Canada and around the world can greatly benefit from a foundation of learning and experience that they will find by volunteering as doulas for needy women.
First, volunteering as a doula can teach a midwifery student about an important aspect of midwifery, an aspect that is not taught in class and can only be learned in practice - and even better in doula practice! This is the art of sitting on your hands: "Don't just do something - sit there!" is one of the golden rules of being a true Birth Keeper. Doulas working in hospitals alongside medically trained professionals need to be able to keep their opinions to themselves. They need to learn how to act diplomatically in all sorts of situations. They need to learn how to comfort, how to heal, how to facilitate natural birth with only the lowest technologies. They learn how to measure cervical dilation with their eyes and ears. They can distinguish between normal pain in labor and suffering. They are adept at hearing the little catch in the breath at the peak of a contraction that means that a woman is nearing the pushing phase. They can sense the difference between the "6 cm rectal pressure" (when a woman probably just needs to have a poo); and the fully dilated deep pushing urge.
Why are these skills important for a midwife? Because the art of midwifery rests on a foundation of physiological childbirth. And the more a midwife knows about how NOT to disturb the birthing process, the easier her task will be. Then when she starts her midwifery classes, which teach her the skills that doulas are not trained in, she will already have the very basics of birth attendance.
Secondly, as a volunteer doula with an organization such as MBC, the midwife-to-be will come into contact with women from many backgrounds. She will witness birth experiences that will be as different from each other as every woman's story. She will find herself listening to women's stories from around the world, and she will learn about herself as a woman and as a birth companion. She will learn about professional boundaries, and about the challenges that women face when they are marginalized.
As a Birth Keeper, I have witnessed many births and I have been part of many more, as coordinator of MBC, as shoulder to cry on, as mentor. I have learned from books and from my teachers (Basia, Ibu Robin, Heather, and others). I have learned what NOT to do from other teachers - and those I won't name - but I have witnessed midwives, nurses and physicians who have treated birthing women with disrespect and brutality.
But the most I have learned has been from the birthing women I have served. And this is why I believe that volunteering with an organization such as Montreal Birth Companions should not be an aid to midwifery school acceptance, but a requirement.
Wednesday, July 30, 2014
I have been the director of Montreal Birth Companions for over ten years now. We are at a very exciting point in our life as an organization, and I compare it to that time in a child's life when he (I have only sons so forgive the gender specific pronoun) leaves home to find his way. Our organization is now becoming mature and I will have to relinquish some of my hold on it and let it become what it needs to become.
So now I have a new baby, and that is the MBC Doula School. I have been teaching doulas since 2003 and I want to expand my (and my students') horizons, and to that end I have created a school which is based partly on my basic courses (Levels One and Two), but also is based upon guest teachers who come to MBC Doula School to share their knowledge.
I have been working hard to bring this program to reality and things are coming together nicely now. I have invited several wonderful guests to lead us on our learning path and I have had lots of enthusiastic feedback from prospective students. To those of you who are far away, I am working on a web-based program that will retain the friendliness and community of our in-house classes.
Tuesday, July 22, 2014
I have always loved to read and study and write. I have been asked to provide reading lists for my doula courses and I always tell my students just to read everything on paper, online, about birth, women, and healing, and to think and discuss.
This is actually the kind of advice that is too wide and vague to be of much use, so I am trying to pin down my reading list and make some better suggestions. I have created a list here for the MBC Doula School students. It's on Goodreads, so you can make suggestions and add your comments and reviews.
I hope you enjoy the list, and I am looking forward to hearing suggestions, critiques and reviews.
Friday, July 11, 2014
Interested in doula training in Montreal? MBC Doula School provides a comprehensive doula training with hands-on experience throughout, as the students volunteer with Montreal Birth Companions (visit us here).
Level one is starting September 8, 2014. Follow the link below to find out more about a future in birth work!
Thursday, May 29, 2014
|Mama and son in Barbados|
Mama was happy.
This story is about burnout. About that feeling you have when you have so many worries and brightly colored post-its stuck inside your head that you mainly just walk around your house looking at things.
My particular form of burnout started in December, when my mother came to visit with a large parasite on her neck. Cancer is weird that way. This thing just grew and grew and grew until it just sucked her away.
I made her a party for New Year's:
Then I got back to work. In January, I organized a big doula workshop with my friend Debra Pascali-Bonaro. It was wonderful, all things doula, all the doula students ... the hotel was crap, I learned my lesson about cheap hotels. The food was great - having a chef for a son is a bonus (yes, I paid him).
I also attended five births that month. I realized during some of those experiences that I had to stop attending hospital births for a while. I couldn't bear to see unnecessary things done to women by people who had not bothered to educate themselves about the birth process.
I studied like crazy for my CPM written exam. When my second son (the boy in the picture!) was born 28 years ago, I realized I wanted to become a midwife. Not because I had a wonderful birth experience but because in fact I was horrified by the approach and the touch of my birth attendants, and I was drawn to treating women with love.
I wrote my exam, and I passed!!! Now I am a Certified Professional Midwife.
Then the parasite on my mother's neck took over my life, from February until March when she finally passed away, I was caring for her, sometimes from a distance, sometimes right by her side.
Home death isn't all its cracked up to be. Death can be pretty awful, really. I've seen death and its never so nice, but my mother's death was hard.
And so to mourning and grief. In the Jewish faith, you just sit for a week and don't do anything. This is good. Then for another three weeks your activities are limited. This is also good.
I have taken good care of myself over the past month. I realized that some of my big disappointments over the past few months are really little - the rejection slips piled up, so? So I started running again, back up to 4 k, and working on it. I want to get to ten by the end of the summer. I eat well. I try to do fun things. I cherish my kids and my family.
What is the cure for burnout? Be gentle on yourself! This means being able to walk around the house and look at things. To stand in the middle of a room and think for a few minutes. To have a piece of chocolate.
It also means saying no when you need to. Not always, but when you need to. It means making sure you have a couple of friends you can call when the going gets tough. It means not taking yourself too seriously. It means pushing yourself to get some exercise. It means starting slowly to get yourself back at work and play, but starting! Start off slowly if you need to, but you will need to. Burn-out can't last for too long, because then it becomes chronic tiredness and pain or illness. Treat yourself like a pussy cat for as long as you can, but when its time to get moving again, you will know it.
This particular pussy cat is so happy to be back from the edge! My energy is solid and growing. I am back in the birthing room, after some time away. I have my patience back. I am looking forward to an active and productive year, as the MBC Doula School blooms and MBC continues to provide service for those who are in need.
Thank you for traveling with me for these past difficult months - the list is long, you know who you are.
Wednesday, May 21, 2014
I found this beautiful broken robin's egg shell the other day. It reminded me again of how I miss going to births. I finally feel ready to go back to attending birthing women after having taken a couple of months off to attend my mother's death and to then mourn her passing.
When I had a farm, back in the days when I had four little boys under my feet; an acre of vineyard; a huge market garden and a wheat field ... not to mention needy Wwoofers and occasional building tasks (like hoisting chestnut beams for the roof) ... I digress ... when I had the farm, I used to pick coltsfoot flowers in February to make syrup for the next winter's coughs. Just last week, I found some coltsfoot on an abandoned lot in Halifax.
Spring is lovely. I am so happy that the sun has returned - I thought it never would. The darkness of winter 2013/14 was very, very dark, and I am grateful to be alive on this warm lively day.
Projects coming up: I am available for prenatal classes and to attend births; the new MBC Doula School is growing and expanding; Montreal Birth Companions, as always, is providing doula services for women in need.
Please contact me if you are interested in joining in any of these projects. I am always happy to share the love!
Thursday, March 27, 2014
Death brings into question all of your life. My dreams, my goals, my aspirations, seem so small when I remember what my mother was whispering about on her death bed.
I've always felt that my task on this earth is to try to do good; to try to be kind; to try to make the world a better place.
God knows I've failed, spectacularly at times. I have a temper, and I "shoot from the hip", and I have a devil-may-care attitude that upsets people. I seem stand-offish and arrogant to those who don't know how deeply shy I am. But, yes, I must admit, my ability to dance to the beat of a different drum has kept me alive, literally, in the past, and probably will continue to offend people in the future.
I first met my mother after I stubbornly refused to turn from breech and the obstetrician recognized that because of a short cord, a normal delivery would be dangerous for me. My mother had a cesarean, which back in those days meant a serious incision - no pretending that cesarean section wasn't major surgery back in the fifties. It gave you a scar to remember!
Two years later, she gave birth to my sister, and then another sister after that. Back in Uganda at that time repeat cesareans were NOT the order of the day, so my two sisters were born naturally.
My mother was a very sociable person. She was intensely creative and loved to see the world. She loved a party. She loved to talk to people. Her deafness was a real challenge to her, as she was a great and witty conversationalist. Two days before she died, my sisters both happened to be wearing pyjamas with polka dots on them. We were at her side constantly for the last five days of her life. That morning, she brightened up, looked at my sisters (both in their fifties and a little tired after having been up for three days) and said: "I could spot you girls a mile off!".
She wins the end-of-life, in deep pain, absolute pun prize.
She was always excited about my projects, no matter how zany they were.
She was brave. She left England in 1952 with my father to go to Uganda where she taught mathematics at Makerere University. In 1959 they decided to move to Calgary where she lived a very different life and was appalled by the backwardness and provincialism of the people there.
In her late thirties, with three daughters, one of whom was spinning out of control (yours truly), she decided to move from mathematics into art and she decided to take art classes. She worked very hard and created some absolutely beautiful works. She became an artist during this time, and continued to paint, draw and create up until very recently.
These are some works she did during and just after my father died.
Never to stay still for longer than a few years, my parents moved to Botswana in the late seventies where my mother created a silkscreen workshop that is still thriving, at a village museum:
My mother loved the desert. They would get in the truck and drive on to the pans and sleep under the stars. She loved the light.
My mother loved dressing up. She would mix colors magnificently, and she always made sure her hair was done. She loved jewelry, and perfume, and high-heeled shoes. She loved going out with me to buy a pretty dress.
She loved a party. She was always ready to celebrate! On her 80th birthday, she was with us in Italy and we drove to our favorite picnic spot:
It is a spot by the side of the road where we stop and eat supper and watch the sun go down into the sea. We didn't have a fancy picnic basket - just the usual - home made bread, tins of tuna, mozzarella, capers, beer, ... and then we stuck a lighter into a plastic plate of cookies and sang Happy Birthday.
After the sun went down we drove to the nearby town, walked on the boardwalk, and had a coffee. A perfect party!
She loved to knit and sew. With three daughters, she always had us dressed in matching dresses, at least until her oldest decided to wear only jeans, hiking boots and a small T-shirt.
She was a very skilled textile artist: This is the front of a sweater she knitted for me from a silk/cotton mix.
She loved music. She loved art. She was always enthusiastic about going to the Musee des Beaux Arts when she visited Montreal.
She loved to get presents.
She loved Italy. I moved there in 1985 and she visited whenever she could, which wasn't often in the beginning as she was living in Botswana. But a few years later, my parents bought a medieval tower in the middle of Umbria. It was, simply, a tower. No electricity, bathroom, kitchen, or much of anything. It had water. And it was in the middle of an Italian village.
They didn't live there, because they were still enjoying the Kalahari. So we moved in: two adults, two young children and pretty soon two more babies on the way. I don't know many kids who lived in a medieval tower for some of their childhood, but mine did - I suppose I must have inherited some of my mother's sense of adventure!
Just over a year ago, after my father died, my mother found out she was ill. She decided to forgo exploration and treatment and instead booked herself on an art tour to Italy:
This year, my mother spent the winter vacation with us, and she partied with her six grandsons well into the night on New Year's, 2014.
In loving memory of my mother who died on March 17, 2014.
Saturday, March 8, 2014
This International Women's day, I would like to hand a mimosa branch to each and every one of the people I love.
This day is about women, about peace, strength, the power of love.
We are not there yet, but I dream of a world where women can give birth with respect and honor; where we can all walk wherever we want whenever we want, a world where there is no hate, no war, no hunger.
"Se non ora, quando?"
If not now, when?
Please go out today and do one thing that will help bring peace.
Thursday, March 6, 2014
In Quebec, we are experiencing an interest phenomenon. A provincial politician is trying to be Le Pen. She is stirring up xenophobic and racist emotions rather effectively with some doublespeak that pretends to be about secularism and feminism. The target? Religious Muslim women. The fallout? Pretty well everyone who is not .. erm .. well, let's just say that anyone who looks a little different has experienced annoyance if not rage at this political acrobatics.
I am used to people using women's bodies as a battleground. From my days as a sexual abuse counsellor - and a direct action activist - to my days working in hospitals with birthing women, I have been witness to the phenomenon of the woman's body being argued over, manipulated, commodified, objectified, ground up and spat out.
And it has grown up, this violence against women. Back in the seventies, as a rape crisis worker, it was pretty clear what was happening. If you were a woman, and you were alone at night, or walking home from work, you were a target and you could be raped. If you were a prostitute or an indigenous woman, you could be raped AND killed. Simple. Violence against women.
But today, the violence is coated in pretty words. What do you call it when someone puts his hand into a woman's vagina without asking her or looking her in the eye? Its called rape. Birth rape. Doctors who manhandle and abuse women when they are giving birth say that they are saving lives. They are not. They are exercising their power.
Politicians who make silly rules about what women can or cannot wear may say that they are doing it "for the women" (yes, in South Africa they say that rape is "for the women" too, when they are raping a lesbian to convince her to change her preferences). They say they are doing it for the Muslim women's enlightenment and freedom.
They're not. They are also exercising their power.
I suggest we ban the type of clothing that overweight, middle-aged Quebecoise women wear, when they should know better. Oh, the tight T-shirt over a middle-aged belly! Oh, the tight jeans over hips that should be covered! Oh, the dyed blond badly-styled hair! The polyester double-knit suits! The shoes that Cinderella's sister wore!
But it's different, you argue. Those badly-styled garments do not speak of a deeper moral code - a code that oppresses women (we are speaking of Islam here). They are just off-the-rack, cheap garments, bought without a shred of moral judgement or thought. Yes, you're right. It heralds the victory of the mediocre fat lady; the no-brainers; the thoughtless violence; the amoral assholes who parade as sensitive do-gooders.
I went to a birth once with a lovely student of mine who wore a see-through spaghetti strap tank top and a fake leopard-skin miniskirt. It was a Montreal summer - hot and humid. In the greyish hallways of the hospital she looked like an angel from heaven - hot, sexy, and happy. The birth was a lot of fun: the birthing mother didn't take any shit from anyone and she gave birth on her hands and knees, even if the physician couldn't handle seeing her vulva "upside down". After the birth we ordered sushi.
Another of my fondest memories was a birthing woman who was dressed completely top to bottom: hat, wig, robe, undershirt, bra, panties, stockings and socks. She removed the panties and stockings to give birth but everything else remained. Her husband, who was not allowed to look at her, sang throughout her labor, and told jokes. She laughed that baby out. The room was full of love.
I have seen women's legs held down, women's bellies jumped on, women yelled at and berated. I have listened to doctors, nurses, and midwives tell women what to do; what to say; what to feel; how to move.
When will we rise up against this banal mediocracy?
Thursday, February 6, 2014
Here are some highlights from the Birth Companions/DONA workshop with Debra Pascali-Bonaro last weekend. We started out sitting around in a circle, with notebooks at hand, listening intently to what Debra had to say...
|Day One, Hour One|
The room started to get a little messier and we all moved in closer to Debra, and to each other, as we started to get into her words and the concepts we were exploring together.
|Debra explaining about positioning.|
As I was saying - Birth is Simple! An introduction to the concept of pleasure during the childbearing year.
|Working with the birth cards|
|I Love You|
Taking the time to treasure each other and ourselves.
|Shake and Lunge!|
This useful tool hangs on a door (make sure it's locked!!) and a laboring woman can pull on it as she squats.
Finally, on Day Four, our babies were ready to be born. Our doulas comforted each other through active labor and used all the techniques they had learned during the final role play. They used birth balls, rebozos, positions, physical comfort measures, and a lot of vocalization! The room was alive with woman sounds: moaning, yelling, sighing, and laughter!
Monday, December 30, 2013
Winter Birth Intensive
with Debra Pascali-Bonaro
Have a look at details here.
This training brings together Debra Pascali-Bonaro, one of the most experienced doula trainers in the world, famous for her dedication to joy in birth, and Rivka Cymbalist, author of The Birth Conspiracy.
Those who take the workshop do not need a professional background, but should have the following: fascination with pregnancy, childbirth, and newborn babies; a desire to work with women or couples during this most meaningful and demanding time in their lives; emotional maturity; stamina; and reliability.
The course will take place during four days (this includes the Introduction to Childbirth).
Dates: January 25 to January 28, 2014.
Introduction to Childbirth will start at 8:45am on the morning of the 25th, so it will be advisable to reach Montreal on the 24th.
The DONA International Birth Doula Training covers all the basics of doula care before, during and immediately after childbirth. This workshop has been approved by DONA International and counts for two steps toward certification. Please contact DONA for information about membership and requirements for certification as a birth doula.
WHAT IS THE COST?
Registration including accommodation US$875.00.
Montreal residents $700.00.
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