Musings of a Midwife-to-Be: Homebirth and Home Visits


One of my duties as a nurse at a birthing center is to go to our clients’ homes a day or two after they birth to examine them and their babies, answer questions and offer support. It’s always an interesting thing to me after seeing someone in the office for 9 months, on my turf so to speak, that I then get a glimpse of them in their own surroundings.

There is a complete change in in the caregiver/client relationship when the interaction occurs in the home rather than the clinical setting, a shift from being in charge to being a guest. I imagine that home healthcare and hospice nurses experience this every day, but it was a couple years into my own career as a nurse before I understood how going into someone’s home to provide care required a different mindset.

The biggest problem I had working in a hospital was the long list of rules to follow, especially in the labor and delivery arena which is so personal and special. There just wasn’t a lot of wiggle room to make each family’s experience unique to their needs and wishes. Often, because of hospital policy we do things that may not exactly fit the situation our clients find themselves in, and most people don’t know that they can be firm about what they want and don’t want regarding interventions in birth.

And really, it’s the same for any hospitalization. Hospitals have to set a standard of care, and develop policies for providing it, which is designed to fit the masses and not any one individual patient. The open gowns, IVs, round the clock vital signs, and any number other of interventions make patients feel like a cog in the wheel of hospital machinery instead of a person with specific needs and desires for care.

In a person’s home, they wear what they want, rest where they want, eat what they want and generally make the rules. No “Nurse Ratcheds” allowed, thank you very much. As caregivers, we must become partners with and be respectful of our clients, their space and their individuality. It is a relationship of equality. Sometimes this is a challenge, of course. There are instances where I know I’d like to be in more control of a situation, but that is not  how healthcare is meant to work, and I really do wish we could provide care more like we used to with lots of house calls and less reliance on hospitals.

 Because of my specialty, I notice this difference most when comparing a home birth and a hospital birth. I started out my career in a busy labor and delivery department, then moved to an in-hospital birth center. My L&D floor had a laundry list of rules from continuous monitoring, to ubiquitous IVs, to taking the baby to a warmer before letting Mom and Dad hold him/her. There was less of that in the Alternative Birthing Center and I figured that home births were probably similar to birth center births, but I was very much mistaken. There is a subtle but meaningful shift in care when you go into someone’s home to provide it. The first time I assisted at a home birth I was amazed, and surprised at the intimacy and respect it required. (And by the way, for those of you who have never seen or been part of a home birth….it is not what you’ve seen portrayed in movies of weird hippy types burning incense, banging on a drum and making placenta stew afterwards……you know you were thinking it.)

So much is learned by being in the home. You see how partners interact with each other, what kind of art they like, what kind of music they like, are they cat people or dog people…or even iguana people….all those seemingly small things that changes a patient from facts on a health form into a real person.

Photo by: Happy Birth Happy Baby Photography. Used with permission.

(Just a note on the picture above: The woman pictured is actually only moments away from giving birth at the time of the photo. In a gorgeous, light filled bathroom, with the windows open so we could hear the breeze rustling the trees and the birds chirping. Utterly peaceful and in surroundings that suited this particular couple.)

Now I know that home birth isn’t for everyone, either for safety reasons or reasons of choice, but that isn’t the point I’m trying to make. While I know its not likely due to time and financial constraints, I really do hope that healthcare can become more personalized again. That we can train more nurses, nurse practitioners, and general practitioners to allow for more home healthcare, not only for pregnancy and birth, but throughout the lifespan. Can you imagine what it would be like to go back a bit in time and have a family physician who makes house calls? To only utilize hospitals (and their expenses) when it is a true emergency?  To feel, as a patient, that you are an equal in making decisions about your health? We have strayed so far from that model of care that I wonder if we can find our way back.

That All Too Brief Time When You and Your Parents Are Friends


My parents were 19 years old when I was born which makes them much younger than most of my friends’ parents.  As young as they were, they were very old fashioned when it came to raising children and they never tried to be friends with me and my brother when we were growing up. As a teenager, I often lamented about this and was envious of my friends who seemed to have more of a friendship than a parent/child relationship with their parents. My mom told me many, many times when I was young that she was my mom, not my friend which hurt my feelings as a kid.

I know better now, with the benefit of experience. In fact, when I reflect on my own kids I find that my worst parenting mistakes often come when I’m trying to be a friend instead of a mom. That is not to say that I don’t hope for friendship in the future; I actually think (hope!) I’ll be great friends with my son and daughter when they’re adults. So while I’m knee deep in the jungle that is parenting teenagers, and waiting for that future friendship to begin, I have moved on to a great friendship with my own parents.

While we have the usual bumps in our relationship, we have moved beyond them for the most part. Many of you many have lost your parents at a young age, some of you have relationships that are too difficult emotionally to continue, some of you have hurt that is too deep to reconcile, and so can’t get to the point of true friendship with your parents. Because my parents and I don’t have that kind of baggage, we have been able to become friends and I know that that makes me very lucky.

They came to visit this weekend and it was a blast. You know you’re in a new phase of your relationship when you spend 4 days drinking and laughing, playing games and having deep conversations. Now that I’m in what I guess is early mid-life, and my parents are in late-midlife we have a lot to talk about and we’re more like peers. After a particularly relaxing day today, I was thinking to myself how precious this time really is.

There is only a small amount of time when your mom can ask what you’re reading, have you answer 50 Shades of Grey, and have her answer, “Ooh, how is it? I’ve been dying to start reading that one!” There is only a small amount of time when your husband and dad can talk about the challenges of raising a family over golf, drinks and cigars like buddies.

Eventually, our relationship will change again, and the roles of childhood will reverse. I will be watching out for them, acting as a protector, or advocate, perhaps I’ll turn into the caregiver. But for now, during this fantastic time, I will relish having my parents as my friends.

Time Magazine Overload


Are we all sick of this story yet? Are we done ranting about one side or the other? I don’t know about you, but I’m exhausted.

I’ve spent more time thinking about everything I’ve seen and read over the last week, than I will admit publicly, (I would diagnose myself as OCD, but looking around my less than sparkling clean house I know that’s not the case.) and there are two things that I keep coming back to.

  1. The comments of people who disagree with me.
  2. Why we’re collectively spending so much time arguing about whether or not a particular person is too affectionate/nurturing/attached to her kids when there are so many horrific cases of actual child abuse in the news, not to mention every other thing that’s wrong with the world we’re living in.

I’m not averse to people disagreeing with me, generally speaking. (My kids would scoff at that statement I’m sure….and perhaps my husband too) I didn’t have a problem with any thoughtful comment from people who had obviously taken the time to get the facts but had a differing opinion from my own. What I didn’t understand, and am not sure I will ever understand, is disagreeing without hearing the other side of the argument. Basically just putting your foot down and saying, “I think that’s wrong, so its wrong.” Or sticking your fingers in your ears and saying “La, la, la, I can’t hear you.”  I guess there’s no arguing with that sentiment, but I still want to.

What I spent most of my time thinking about however, was deeper. I found myself wondering about the topics I blog about and whether I feel like I’m part of the problem or part of the solution. I started blogging to add a voice I wasn’t hearing in my day to day life and with the best of intentions…….but you know what they say about good intentions….

The road to Hell

So I had to take an honest look at myself and say, am I just like everyone else out there with a keyboard and an opinion? Am I jumping on the pop news bandwagon? Why do we get fired up about a person we’ll never meet, or a celebrity, or a sports figure? Why do these seemingly trivial things end up on the front page and then taking the internet by storm? Surely there are more important things to discuss and pour our energies into.

As luck would have it, in the midst of pondering all of this, a new post from a fellow blogger appeared in my in box giving me the answer I was looking for, at least to the question of why we pay attention to seemingly small stories while essentially ignoring the bigger picture.

It was called “Everything’s a Circle” by True Stories: http://jessicavealitzek.com/

In it the author talks about the phenomenon of “psychic numbing” and how in today’s climate of 24 hour news coverage our minds get so overloaded with information, we can’t process all of the difficult subjects we’re faced with, and the greater the problem, the more likely we are to tune out. Seems about right to me; not right in the sense of okay, but right in the sense that that kind of behavior is just plain human nature. Unless we’re confronted with an “in your face” crisis, there are just too many worthy causes clamoring for our attention and we don’t know where to focus, which means, I guess, that we will focus on the easiest target.

Alternative parenting techniques, gay marriage, politicians’ thoughts on gay marriage, Kardashians, flesh eating bacteria, Jessica Simpson‘s pregnancy weight gain,  the war on women, Fifty Shades of Grey….and on and on it goes.

And, yes, I guess I have to admit that I do get caught up in the emotion of the sensational news stories of the day, but what I’ve noticed, is that my best writing and my best reader responses come when the story du jour aligns with the things I’m most passionate about, like the breastfeeding cover, the debates on birth choice and women’s healthcare. So I will keep looking for things to talk about and pick carefully those topics which mean something to me. It may mean that my blog starts going in a different direction than I originally foresaw, but I will endeavor to never have to wonder again if what I’m blogging about is worthy of putting out there.

Kreativ-ity: Who Knew I Would Be Considered a Creative Blogger?


This has been a week full of surprises.

I started writing more as a form of therapy than anything else. I needed a chance to express how I really feel about things from politics, to birth to religion and thought I’d explore my writing abilities. Having never written before, except for school, I wasn’t sure if I could write anything that would  be interesting to anyone but me, however the response from everyone has been overwhelming and very gratifying.

My Time Magazine posts, seem to have jump started my readership in a way I really never expected, and then to top it all off, a fellow blogger, Jessica Vealitzek, nominated me for the “Kreativ Blogger Award”. Thank you Jessica! Jessica has a wonderful blog which I follow called True Stories (http://jessicavealitzek.com/), where she uses real life stories to illustrate important truths about life. I love it every time I see a new post in my e-mail.

So what is the Kreativ Blogger Award? Well, it’s an unofficial blogger to blogger award, which is a validation that someone out there thinks your writing is entertaining and worthwhile, a great chance to learn some personal facts about the blogger, and chance for one blogger to share their favorite blogs with their readers.

The rules are as follows:

  • Thank the person who nominated you.
  • Share 7 interesting things about yourself.
  • Share 7 of your favorite blogs for others to check out.

I like it. Gratitude first. Thank you again Jessica!

Seven interesting things about me……hmmm……that’s a little bit harder, but here goes:

  1. My husband and I met when we were 14, started dating at 16 and are about to celebrate our 18th anniversary. They don’t make many couples like us anymore.
  2. At the ripe old age of (just about to turn) 40, I have had my mid-life crisis and am going back to graduate school to become a Certified Nurse Midwife (The opportunity for blogging material from this new venture is pretty exciting.)
  3. I was tricked into vegetarianism by reading Skinny Bitch 4 years ago. I sat sobbing on the couch, reading the book and vowed to never eat meat again…..but occasionally I succumb to the temptation of bacon.
  4. When asked what makes me interesting, my son said, “The fact that you’re not scared to talk to us about adult things like sex and stuff.”…….I must take a moment here to give myself a little pat on the back.
  5. The closest I think I’ve ever come to dying was on a flight from Philadelphia to Dallas which should never have taken off due to bad weather. We then had mechanical trouble, an aborted landing attempt back in Philly, followed by a shaky voiced captain telling us we were going to divert to Pittsburg, all the while not telling us what the mechanical problem was. The hour and a half from Philly to Pittsburg was the longest of my life and half the plane burst into tears when we landed. (I still love to fly though.)
  6. I am not as domestic as I’d like to be as evidenced by my piles of pictures that are not in scrapbooks yet, my crocheted blanket that I have been working on for 4 years, cross stitches I’ve left incomplete for 16 years and the fact that I have a cleaning service avery other week. I’d rather be reading.
  7. I can’t wait to travel the globe. I have a deep yearning to visit as many places on earth as possible before I die. I have always felt that if I need to give an accounting of my life before God, He/She won’t ask me about my sins but why I didn’t explore this great big beautiful world when I had the chance.

My seven nominations for the Kreativ Blogger Award……much easier:

Time Magazine’s Breastfeeding Cover…A Rant in Two Parts (Part 2)


First of all, thank you to everyone who checked in to Friday’s post! It was a record-breaking day followed by a record-breaking weekend for my little blog, and I appreciate the time you took to read as well as the opportunity to hopefully shed some light on the real scoop behind breastfeeding, and especially extended breastfeeding.

Stepping back for just a moment, to truly discuss this article, we need to understand the myths and facts about Attachment Parenting (AP).

Myth: AP is the latest in a long line of parenting fads.

Fact: The ideas that make up AP are a return to more “primitive” ways of parenting, and have been studied for the past 60 years. While applying all of the ideas of AP in modern life presents difficulties, it’s not because AP is new and unusual, it’s because our hectic lives have outpaced our biology.

Myth: AP is for moms who have a pathological need to keep their children dependent on them.

Fact: The whole goal of AP is to raise independent, yet empathetic children who are capable of forming healthy attachments later in life. The guiding philosophy of AP is that by having a consistent caregiver available to young children they will develop security and trust in their parents which will allow them to then explore their world without fear and become more independent.

Myth: AP requires moms to give up their own lives to cater to their children.

Fact: While AP is very labor intensive, especially for the mother, one of the principles of AP is that there is balance between parenting and personal self care as well as nurturing the relationship between the parents. In fact, the mom at the center of all of this Time Magazine controversy blogs about her experiences with Attachment Parenting and her “about” page states that her goal with the blog is to help other moms figure out how to parent without losing themselves.

Now, here’s the thing, I think there is a knee-jerk reaction to regard AP as being ridiculous, or extreme because the principles involved are different than what most of us grew up with. It’s easy to dismiss and scoff at something we don’t understand, and it’s easy to make pronouncements about AP instead of keeping an open mind and learning about it before forming an opinion. However, I saw a great quote on another blog (Mommy OM at newhealthom.com) which applies here, and reads:

The highest form of ignorance is when you reject something you don’t know anything about. – Wayne Dyer

So, what are the basic principles of Attachment Parenting?

  • Beginning before birth: taking care of yourself, and preparing yourself for parenthood before delivery.
  • Feeding with Love and Respect: This means breastfeeding if possible, paying attention to the baby’s hunger cues, and letting the child wean when ready.
  • Respond with Sensitivity: Meaning when babies cry, comfort them, provide physical contact. No “crying it out” or, in older children, telling them to toughen up.
  • Use nurturing touch: Almost constant physical contact for infants, lots of hugs and cuddling, no physical punishment.
  • Ensure Safe Sleep, Physically and Emotionally: Safe Co-sleeping or at least having children in the same room as the parents.
  • Consistant Loving Care: Having a consistant caregiver almost all of the time, this is usually the mom.
  • Positive Discipline: Have a good understanding of the child’s developmental stage so that parents don’t have unrealistic expectations of what behaviors to expect from a child. Praise good behavior and redirect bad behavior without physical punishment or verbal abuse.
  • Strive for balance in Personal and Family Life: As discussed above. This includes taking care of yourself physically through good diet and exercise, and mentally by making sure to indulge in activities that are personally meaningful

I’m guessing that if you’re new to AP philosophy, that as you read this list there were at least a couple of principles that made you roll your eyes. I get it. It seems like a lot of work, and it is, but then again, any parenting that does’t involve outright neglect is a lot of work. Dr Sears, who is probably the best known proponent of Attachment Parenting, is also pretty clear that while the AP principles have good reasons behind them and work together, that each family and each family situation is unique and parents need to figure out what works for them. No guilt. No finger pointing, and certainly no mommy (or daddy) one-upmanship.

I was not an AP parent. I wasn’t really aware of Attachment Parenting when I had my kids, and if I had been, I probably would have felt guilty because I couldn’t have followed all eight precepts. I prepared pretty well before birth, I breastfed, I loved wearing the kids in a sling because it was a hell of a lot more comfortable than carrying around a baby in a car seat and I could get more done than carrying a baby in my arms. However, I also got desperate for sleep and “Ferber-ized” them (do parents do this anymore?), I have been known to yell, and I slapped the occasional hand and swatted the occasional butt. Balance….not so much. I did the best I could with what I knew and was capable of at the time, and my husband and I parented the way that felt right to us….learning as we went.

Now, finally, on to the second part of my Time Magazine Rant. Here is a confession….I didn’t like the cover photo either, just for different reasons than most people.

I should stop for a minute and give the people at Time Magazine who put this picture on the cover a standing ovation. Their job is to generate buzz about their magazine and boost sales. Mission accomplished. Seriously, when was the last time you were this interested in a magazine story? However, in picking the most provocative picture, they missed the boat on the essence of Attachment Parenting. AP is all about closeness and nurturing, but the cover photo does’t show that at all. Mom‘s face looks defiant, playing into all of the ideas/fears that the general public has about parents who practice AP, or just breastfeed past infancy that they think they are superior to the rest of us. She and her son seem disconnected, in spite of the fact that he’s actually breastfeeding at the moment the picture was taken.

I really wish that they had chosen one of the other mom’s they photographed for the cover. Either picture was more representative of the bonding and closeness that I think AP moms are striving for, but even at that, I kind of hate that they are staring out at the camera, and I really, really hate that they are all thin and gorgeous (but maybe that’s just my hang up).

I think this one is my favorite.

Love the way the older brother has his arm wrapped around the baby too.

Which brings me to my final point, the title of the article, “Are You Mom Enough?”….to which I say, “Are you Kidding Me?” That is precisely the type of inflammatory language that gets moms all defensive and upset. As discussed in some of my previous articles, parenting is so personal, and none of us get to know ahead of time what type of child we’ll have, what our feelings will be or what circumstances will surround us. We just plug along the best we can, trying our damnedest to not screw up so badly our kids can’t afford the therapy bills.

Attachment Parenting is a theory, with some good evidence behind it. There are many other theories of parenting with good evidence behind them. What is better for one family may not be better for another, and that’s okay. As always I feel like as long as we keep an open mind and are willing to learn about all kinds of lifestyles, and parenting choices (whether or not we use them ourselves) that is how we’ll move on in a supportive sisterhood of moms.

Ask questions first, then make up your mind. And no mommy wars allowed!

Time Magazine’s Breastfeeding Cover….A Rant in Two Parts (Part 1)


There are times when I forget how sheltered I am working at a birthing center where most moms choose to breastfeed. Then there are days like today.

My Facebook page has blown up with various threads of comments regarding the oh-so-controversial Time Magazine cover depicting a mom breastfeeding her 3 year old son. Now I looked at the cover first and I had some definite thoughts, which I will discuss in part 2 of this post. Then I started scrolling through the comments and really started to feel sick.

There was a mix of disgust, shock and derision. The picture was categorized as pornographic, and the mom as emotionally needy and selfish. Some comments equated extended breastfeeding with the sense of entitlement today’s kids seem to have and some comments equated extended breastfeeding with a right wing conspiracy to keep women at home and out of the workforce.

Sigh.

What all of those comments say to me is that the general public is still in serious need of education about breastfeeding, its benefits to children, and what it is and isn’t.

Before I get to my explanation, let me say once again, like I’ve said before, if you chose to bottle feed or breastfeed for a few days or a few weeks or a few months, I completely support your parenting decision. This is not about vilifying anyone who isn’t nursing their 3 or 4 year old. I “only” nursed my kids 13 months and 15 months, and that felt right for me; I don’t feel guilty about not nursing longer. That said, there is nothing “gross”, “disturbing” or “abusive” about nursing an older child. It’s unusual in our society, but that doesn’t mean it’s wrong.

Here are a few points everyone should know about breastfeeding. (I know its long but PLEASE, PLEASE take the time to read.)

1.) Breastfeeding isn’t sexual. At all. – I don’t understand why this is such a hard concept. Yes, breasts are sexy; they are also functional. Women who have nursed understand that their breasts have two separate uses, both important. Can nursing be pleasurable? Yes, of course. There is a whole cascade of hormones that are released when nursing which cause a sense of well-being in the mom, no doubt an evolutionary mechanism to ensure babies got fed long before there was such a thing as formula. However, and this is a big however, a baby or child suckling is very different than when done by a lover. Breastfeeding is not sexual for the mom and certainly not sexual for the child. Seriously people, how many of you are turned on by your mom’s breasts?….I’m guessing the answer is no one, yet to someone at sometime, your mom’s breasts were sexy. I can see some of you gagging out there, but you know it’s true. Different relationships, different functions.

2.)Breastfeeding past infancy while not the cultural norm in the United States is normal and how our bodies are designed. –And until we, as a society, stop and look at the scientific evidence for breastfeeding and realize that there is value in supporting moms who want to nurse for whatever period of time works for them and their children, new moms will continue to have a high failure rate and “fringe” moms who breastfeed beyond infancy will feel shame and keep the practice hidden. Yet according to most, if not all, health organizations, breastfeeding can and should be encouraged, even beyond 2 years.

  • The American Academy of Pediatrics recommends that “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child… Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother… There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.(AAP 2005)
  • The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that “As recommended by the WHO, breastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement. It has been estimated that a natural weaning age for humans is between two and seven years. Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment, and having a sustainable food source in times of emergency. The longer women breastfeed, the greater the decrease in their risk of breast cancer.” They also note that “If the child is younger than two years of age, the child is at increased risk of illness if weaned.” (AAFP 2008)

3. Extended breastfeeding has a measurable impact on the mother’s health as well as the child’s health.- There hasn’t been a lot of research into breastfeeding past two years, however the research that has been done so far shows that the same immune system benefits that babies receive while nursing continue throughout the nursing relationship. In the US where we are lucky enough to have decent healthcare and infection prevention, this may not seem like a big deal, but in other parts of the world extended nursing can save lives. In fact, the World Health Organization estimates that 10% of the deaths of children 5 and under would be prevented by continued breastfeeding. As if that weren’t enough, the longer a mom breastfeeds in her lifetime the lower her risk of breast, ovarian and uterine cancers.

In case you don’t know, the woman on the right is wearing a nursing cover up.

4. Women who breastfeed in public are not trying to make you uncomfortable or make a statement.-Women who breastfeed in public are simply feeding their babies. I would love for someone to tell me why it’s acceptable for young girls to run around the mall in skimpy tops, but if a mom wants to nurse she should cover up or go to a bathroom because “no one wants to see that”. Most moms I know who nurse in public are very discreet, and don’t want to attract stares and attention. I have never in my life seen someone in public whip out a breast and leave it exposed for any amount of time. For the most part, a baby covers up far more of the breast than today’s fashion does. When a baby needs to eat, it needs to eat, and any mom should be able to feed her baby in any place without fear of reprisal. Personally, when I see a mom nursing in public I try to give her an encouraging word or smile because every time a mom nurses in public, it makes breastfeeding less out-of-the-ordinary and begins to normalize it.

5.Extended breastfeeding is not some new age-y parenting concept.-Actually, it’s the idea of breastfeeding only during infancy that is relatively new in the course of human history. From the La Leche League website:

In a study done of 64 primitive cultures in 1945, it was found that only one culture weaned their children as young as six months. Mothers in China and Japan still nursed their children for four or five years well into the 20th century. During World War II, Burmese children nursed until age three or four. Up until 1950 in Kenya, mothers nursed until five, and in Mongolia mothers nursed until two or three and sometimes as old as six and seven. In New Guinea during the 1960s, children were nursing freely up until two, three, and sometimes four years of age (Bumgarner 2000).

As explained in A Nursing Mother’s Guide to Weaning, Margaret Mead and other anthropologists discovered that mothers wean in the way and at the time that their cultures prescribe and that peaceful, cooperative societies tend to wean later using gentler methods. Furthermore, it has been estimated the median age of weaning throughout the world is between ages three and five. That’s years, not months.

Here’s the thing, we know that in modern society we’ve figured out how to survive without extended breastfeeding, but what we don’t know is what the lasting effects are. We may have guesses or opinions but in the absence of research, it’s all just conjecture. So what gives anyone the right to speak authoritatively about the detrimental effects of extended breastfeeding, telling moms they need to stop what they’re doing, or that they are damaging their children, when really it looks like the opposite may be true, contrary to our social mores? The answer I guess is that anyone has the right to say anything….but that doesn’t make it right.

Whew…..that’s a lot of information, and if you’re still with me I appreciate you taking the time to perhaps get a new perspective. Please share this post so that as many people as possible can hopefully learn something new. On Monday, I have a lot more to say about the picture that Time used, and especially the title of the article. See you then!