What Did Your Doula Do For You?

Giving Birth with Confidence has launched a blog carnival focusing on doulas! I’m psyched about this, because I love doulas, and this is why. It’s an older post, but it still is really the best way I can express what my doula did for me, and why I am such a huge believer in this kind of labour support.

Like Cara at Giving Birth With Confidence, Ialso want to shout, “Every woman deserves a doula!”  Doulas are awesome. And I’ve been learning a ton about how many different kinds of doulas there are over at The Radical Doula. I used to think it was just birth doulas and postpartum doulas, but I’ve discovered that there are full-spectrum doulas who attend women through a variety of experiences including pregnancy loss and termination, doulas who work with women in custody, and so many more who provide women with much-needed personalized support. 

So if you are pregnant or know someone who is pregnant, or going through a pregnancy-related experience and need support, consider finding a doula. If you can’t afford to hire one, there are often student doulas who are happy to provide services free of charge in order to gain needed experience. You can find a doula through DONA International among other professional organizations, or by asking your doctor, midwife or other birth professional.  If you’re local, ICAN Cowichan Valley keeps an up to date list of local birth and postpartum doulas, so comment here  if you need help finding the right support person for you.

Simple

It all really just comes down to this:

Stop pathologizing my body.

Prenatal & postpartum weight: giving up and giving in

“All new moms worry about losing the baby weight.”

How’s that for a major generalization? 

True, many new moms worry about this, maybe even most.  But all is a troubling superlative, not only because it’s almost guaranteed to be untrue (find one exception, and the hypothesis crumbles) but more importantly because it reinforces the cultural imperatives for women to be thin no matter what, and to put weight at the top of their list of concerns at all times. Statement:  All new moms worry about losing the baby weight.  Subtext:  If you aren’t worried about this, you should be because everyone else is.

Note that the article linked above, about so-called “mommyrexia” (could there be a more infuriating term?) invites women to share their methods for “stay[ing] slim in pregnancy or los[ing] weight after giving birth.”  I’m all for women sharing their experiences, but I find this formulation troubling. Surely there are better and less sensationalist ways of acknowledging women’s fears about the changes to their bodies during pregnancy.

As a pre and postnatal fitness instructor, obviously I have a vested interest in helping women maintain their health during and after pregnancy. This includes promoting healthy weight gain while growing a baby, and appropriate weight loss in the months following.  But I won’t do it in a way that upholds the paradigm in which weight plays a disproportionate role in determining a woman’s worth or which shames women whose bodies don’t conform to current weight and shape ideals.  Yes, exercise burns calories and can reduce body fat; no, we won’t talk about that in my classes.

I work to support prenatal and postpartum women’s health, not to help them police the size of their bodies.  Body size and weight are only two variables among many that indicate a person’s level of fitness and capacity for activity, and the jury is still very much out when it comes to conclusions about the relationship between weight gain, weight loss, health and pregnancy. Science and Sensibility’s recent series on maternal obesity demonstrates this beautifully.

Different women gain different amounts of weight during pregnancy for reasons that often have less to do with food intake or exercise than you might think. This can be scary for a lot of women. Larger women have reason to fear being treated as if they’ve done something wrong if their weight continues to increase during pregnancy, and they are likely to be categorized automatically as high risk and subjected to a variety of  prenatal and birth interventions as a result. Smaller women may have their own set of fears, especially if they usually go to herculean efforts to keep their weight at a certain level or maintain a particular shape. It’s hard to drop that mentality and to weather the pressure not to ‘let yourself go’ just because the stick has turned blue. 

But what does ‘letting go’ really mean?  There is some implication that it means giving up, giving in, and that these are inherently bad things to do.  But we could re-frame the concept as giving up our culturally-determined beliefs about how our bodies should look. And rather than giving in to the TV-land stereotype of gluttonous-pregnant-woman-eating-for-two, how about giving in to pregnancy, which is designed to ensure that women gain the fat and fluid they need to carry a baby to term, and have the energy necessary to labour and birth a healthy baby.

In this framework, giving up and giving in are important steps toward good mental and physical health, and they are perfectly congruent with staying active and eating a diet of nutrient-rich foods in amounts that satisfy hunger and thirst.  This framework promotes health for all women, all of the time, without prejudice or judgment about size and shape.

The more we learn to listen to our bodies during pregnancy, to explore how they grow and change and to support their new needs, the more likely they are to respond appropriately to pregnancy’s demands.  And the happier our bodies are during pregnancy, when we’re feeding, moving and resting them well, the more likely they are to recover appropriately in the months that follow.

Birth community and a little update

A while back I posted about wanting to generate a birth network here in the Cowichan Valley.  But the crazy few months that followed meant that that wish never got too much further than a blog post and a couple of discussions with friends.  So I was super excited when I was invited to join a circle of women at the new Matraea Centre in Duncan, called together by Sarah Juliusson of Island Mother, Dancing Star Birth, Birth Your Business, and other cool projects. Sarah took the initiative to bring a group of people whose work supports pregnant and birthing families for a Birthing from Within training for professionals and discussion about our local birth community. 

I was tired and rushed last night, and had had one of those days where it’s lucky I work mostly from home because other humans would not have appreciated my mood.  But I made it to Matraea nonetheless, and am so glad I did.  I already knew some of the women there including the midwives, and a postpartum doula (aka goddess) who founded the New Mom Centre, and I met some others whose services include pre and postnatal yoga, and prenatal dance and art.  It was amazing to be sitting in a room full of so much excitement–excitement about Matraea, excitement about building connections in this community, excitement about sharing a common enthusiasm for supporting women and families. 

It was exciting and also educational.  Sarah took us through an exercise designed to help us examine the way we listen and respond to women when they talk about pregnancy and birth.  We worked in pairs to practice not only reflective listening but also body language that shows our clients that we are ready to ‘meet them where they are.’  I took away the message that we need to really hear what women are saying, recognize the validity of their position, and work with them so that the choice they make is truly theirs and not an empty reflection of our values.  This process focuses not on the outcome–not on what a woman ultimately chooses to do–but on how she gets there.  Does she feel supported?  Does she feel confident?  Does she believe that she is the most important person in the equation?  Does she own her own pregnancy, birth, and body? 

Tomorrow I’m going to start going to one of Sarah’s Mama Renew groups.  I’m not sure I’ll be able to do the whole session; I may have a scheduling conflict, but I won’t know for a while.  So, in the meantime, I’m going and I’m really curious about what it’s going to be like.  I have pretty much no idea what to expect!  But I hear it’s an awesome group of women (8 or 10, I think), so I figure it can only be good. 

Tonight is the first ICAN meeting here at my house for the Cowichan Valley chapter.  I’m nervous, which is funny because there’s really nothing to be nervous about.  I’ve wanted to do this for such a long time, as I think a group like this can really make a huge difference in a woman’s life, if it’s there for her at the right moment.  So, even if no one comes, just spreading the word and waiting so that ICAN is available for any person who may need it at any point in the future is good enough.

Q: Why make such a big deal about birth? A: Feminism

People often ask why I invest so much energy in birth activism, and why I care so much about how women have babies.  After all, babies are born every minute of every day, all over the world.  Why make such a big deal about it?

I started caring about pregnancy and birth when I started linking it to my identification with feminism.  I’d always known about both:  for the duration of my childhood, my mother was a family doctor with a busy obstetrical practice, and she was (is) a feminist.  I don’t recall her linking the two explicitly, at least not to me.  (Although we did have a book about Judy Chicago’s Birth Project on our coffee table, and I understood without any doubt in the 1970s that the fact my mother was a doctor at all was because of this feminism thing that she and her friends sometimes discussed.)  But I knew from the time I could be conscious of anything that supporting pregnant and birthing women was worthwhile and that feminism, defined very simply as empowering women to do whatever we wanted to do, was good.

I got that birth mattered, and that women deserved to be treated with care and respect.  I remember little things like my mother’s answer when I asked why she had short nails without nail polish:  so she wouldn’t scratch her patients when she was delivering their babies.  That made deep sense to me as a child, illustrating in an utterly comprehensible and practical way the things we can all do to make women more comfortable when they are vulnerable and in need.

Birth mattered and it also seemed absolutely mundane, and often annoying.  I was not amused as a child by having trips to the park and the pool interrupted because my mother was on call and some lady was having a baby.  I did like making pictures with all the colourful tape at the nurse’s station in the hospital where I sometimes had to wait for my mother while she worked.  But I didn’t like having to wait. And sometimes I was impatient:  I once told her to “just do a c-section” when a patient seemed to be laboring for an awfully long time, interfering with whatever it was I wanted my mother to do for me.  Yeah.

It was all very matter of fact until after my first baby was born.  I realized then that birth might be common but it’s actually never mundane, and that all the care and respect that I received as a pregnant and laboring woman—that I took for granted from a family doctor who my mother had trained—was not necessarily the norm.  I learned after the fact that I was lucky to have grown up believing the things I believed about women and to have had the kind of birth I had, and that my total, unfailing trust in my doctor and my mother’s medical angle on birth might be worth questioning, even though they believed in the medicine they were practicing and my outcome was good.

My daughter’s birth almost fifteen years ago radically altered the way I understood women’s relationship with medical approaches to childbirth.  The high I felt after giving birth, the incomparable sense of accomplishment and power, was so incongruous set alongside my unquestioning willingness to let my doctor manage my pregnancy and to accept—even anticipate—interventions simply because they were ‘normal.’  I began a long process of reframing and rethinking, asking questions, demanding justifications, searching out evidence of benefits and risks, wondering what ‘normal’ even meant and why anyone automatically believed, in the context of intervening in pregnancy and birth, that it was good.

It didn’t take long for me to recognize that the framework for my analysis was feminism.  Feminist thinking made it possible for me to de-center medicalization without demonizing individual doctors, and to explore other approaches such as midwifery without romanticizing them.  Feminist thinking encouraged me to look at pregnancy and birth first from the perspective of the women who experience it, and consider the ways in which ‘normal’ pregnancy and birth are constructed by particular social, historical, political and economic contexts.  Feminist thinking made it impossible for me to look uncritically at any action that interfered with women realizing or being supported in realizing the unhindered potential of their bodies, and allowing their bodies to take up space, and be noisy, messy and inconvenient.

It probably comes as no surprise that this has all led to some *cough* interesting conversations between me and my mother.  We agree on the fundamentals:  birth is not a medical emergency, interventions should be kept to a minimum, and women deserve respect.  We agree on many critical points, including a shared sense that today’s skyrocketing caesarean rate is a problem and the importance of supporting all women in making truly informed decisions about their own reproductive health.  But then there are other topics, such as the relative safety and advisability of homebirth, where the discussion gets a little more complicated and I have to remind her:  intentionally or not, you raised me to think this way.

Believing in women’s bodies and their capacity to grow, birth and feed babies without undue intervention, and in women’s right to control their own reproductive labour—not only whether they give birth, but how they give birth—is central to my belief in women’s capacity to be agents in their own lives and effective political actors.  I don’t reject medical intervention when a woman needs it.  I do reject the dominant medical model that says intervention is almost always necessary.  And I reject the notion that just because birth is common we shouldn’t care about it or that birth activism makes mountains out of molehills. Minimizing issues that are unique to women is a time-honored tool in the war against us.  And it’s often in the struggle for autonomy in our everyday lives—including what some consider the mundane, uninteresting work of pregnancy, birth and mothering—where we discover what power really means.

ICAN of the Cowichan Valley

Forgive me, readers, for it has been many months since my last post.  I took a little professional detour (can you detour from an already diversified path? hmmm…).  It was interesting, and among other things, gave me an opportunity to reevaluate my values and priorities. 

And now that I’m back from my sojourn, I’ve re-prioritized my work around birth advocacy.  To that end, I’ve (finally!) gotten around to doing something I’ve been talking about for years:  I just started a new chapter of ICAN, the International Cesarean Awreness Network, here in the Cowichan Valley.  ICAN of the Cowichan Valley, like other ICAN groups, will offer resources and information about cesarean sections, and provide support to women who are recovering from a c-section or trying to avoid an unecessary surgery. 

After I had Annika, I attended one ICAN meeting down in Victoria.  But for a variety of reasons, including distance (it was a 2-hour drive, round-trip), I never managed to get to another one.  I’ve always regretted that, and wished I’d had a practical option beyond suffering in isolation with the aftermath of her birth.  I did have a wonderful circle of online friends who helped me through those years, but there is a lot to be said for face-to-face, local connections, especially in the postpartum phase.  And there is also a lot to be said for a specialized group like an ICAN support group.  It’s often hard for women to talk about their experiences with surgical birth, as many people still trot out the ‘but you have a healthy baby!’ dismissals, and unecessary c-sections have become normalized in our society.  ICAN groups can offer a safe place for women to connect with others who are likely to empathize, and willing to listen without judgment to their stories.

I’m still in the process of getting the group up and running–it was only officially registered yesterday, and I have yet to plan any actual events or meetings!  My hope is to find a central space where we can gather, perhaps beginning in late May or early June, and go from there.  So, local folks, please help to spread the word and encourage people to contact me at icancowichan@gmail.com.  Local and far-flung, like our Facebook page. Thanks to all of you for helping me let people know about this important new resource.

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