Monday, November 24, 2008

Why Can't We Be Friends? Doulas vs The Medical Community

NBC's Today Show segment (I apologize for the poor quality, but thank the person who put this on youtube for others to see.):

What a horrible story!  First of all, why interview a doctor?  Shouldn't they be interviewing a doula or someone from DONA international?  From my experience most physicians do not like people who encourage their patients to question their recommendations.  And I can certainly understand why they would feel that way.  After all, doulas are not trained to deliver or provide medical care for babies.  However, most physicians are also not trained for normal birth, they are skilled surgeons trained to look for reasons to intervene with a normal process.  The common thread here is that they both work for the expectant mother and along with the nurse they are part of a team whose goal is to give the mother and baby the best outcome possible.  

A doula sister of mine recently attended a hospital birth at supposedly "baby-friendly" hospital with a new maternity wing.  The first thing the OB did was to point at the doula and tell the laboring mother that she shouldn't influence her decisions.  After laboring for only six hours and getting clear to seven cenimeters open the doula was asked to step out while the medical staff spoke to the parents.  She was allowed back in and a short time later asked to step out again so that the staff could discuss with the parents their options.  My friend waited outside the room and the nurse came out with her things and told her it would be best if she went home.  My friend was shocked.  She left only to find out later that her client had an epidural, the baby's heart rate dropped, and her client ended up with a c-section.  It was the doctor's third c-section that day.  Later she found out that the nurse lied to the parents, telling them the doula had errands to run and that was why she left.  The nurse had simply come back in to get her belongings and bring them to her.

I have heard of doula horror stories, of course, where doulas pressure unwilling clients into natural birth when perhaps that wasn't what the mother wanted or it was a detriment to the outcome of the labor.  In any profession there are going to be those who need to find another line of work.  This would be an example of someone who has crossed the lines of doula support.

So what can doulas do to help build a sense of teamwork in the maternity ward of a hospital?

Before I walk into a hospital birth I encourage clients to inform their doctors that they will be hiring a doula.  That way they aren't surprised by my presence.  I come in with the mindset that the staff might have had bad experiences with other doulas.  I do my best to put them at ease by greeting them with respect and appreciation for being there.  I try to avoid interjecting while the staff is speaking and if I feel something needs to be addressed I will ask the mom if she wants to ask her doctor about the procedures discussed by using the B.R.A.I.N. acronym.  That empowers her to ask about the benefits, risks, and alternatives to any procedure.  Then we talk about what her intuition is telling her and ask if the intervention has to be done now.  Then she has the power to make an informed consent.  With this technique I avoid the temptation to tell her what I think she should do, which keeps me from crossing the line from empowering to pushing.  I do my very best to be the gentle voice in a roomful of people and while I am not hiding in the corner I am also not dominating the room and drawing negative attention.  If I want to suggest a change in position with the nurse in the room I will ask "I have a birth ball that I brought, do you think we would be able to use it?"  In my head I know that it is probably okay but in this manner I am respecting their "turf."  If they seem hesitant I try to find out what they are worried about, and we can often compromise "How about we keep it right by the bed so she can still be monitored?"  That way both parties get what they want.  I offer to do all of the running for the mom instead of asking the nurse for things I can easily get.  I am also sure to use the nurse's first name and always use a positive tone.  At the end of a birth I am sure to thank everyone involved.  If you think the nurse was great, praise her up and down!  Nurses sometimes work under crappy conditions and they experience burn-out pretty easily.  If the OB has an office I send a card thanking him/her for being great to work with and add a few business cards. 
Now I realize there will be situations like the one I mentioned above where the nurse was really out of line.  This sort of behavior needs to be brought to the attention of her supervisors.  Lying, manipulating, or removing a patient's right is never okay and should not be tolerated.  Just as we are advocates for our patients through labor we also have a greater responsibility to address issues that affect the well being of our clients. 

While our first priority is to our client we also have to realize that serving our client also means being respectful and fostering good relationships with the medical staff.  If we all get along and keep a peaceful and positive energy around the laboring mother can you imagine how much better the outcomes could be?    

Saturday, November 22, 2008

Welcome Our Newest Family Member!

Daisy melted our hearts the moment we saw her.  Right after church we went outside to chat with our friends and Midge ran off to the grassy area to play.  Someone from our church had brought puppies and Daisy went right up to Midge and tried to hide under his legs.  Of course he is all of two feet tall so he was unable to keep his balance.  She was so sweet, curling up underneath us to keep cool. 
At our shop we have a watchdog named Dusty.  He has been a bit lonely lately so we figured this would be a good playmate for our Dusty Dog.  She's been such a great addition to our shop.  She keeps Dusty busy and they both seem happy.  At first I was wondering if we had made a mistake taking a puppy home on a whim but it's been wonderful.  She has a fantastic personality and we think she and Dusty will be lifelong friends.  

Sunday, November 16, 2008

Motrin Can Kiss My Crunchy Patootie

What on earth were the half brained people in the marketing department thinking when they decided to come out with this campaign?  Click the link below to see:

Here is the ad, in case it is removed, (which I suspect it will be very soon):

Wearing your baby seems to be in fashion.

I mean, in theory it’s a great idea.
There’s the front baby carrier, sling, schwing, wrap, pouch.
And who knows what else they’ve come up with. Wear your baby on your side, your front, go hands free.
Supposedly, it’s a real bonding experience.
They say that babies carried close to the bod tend to cry less than others.
But what about me? Do moms that wear their babies cry more than those who don’t?
I sure do!
These things put a ton of strain on your back, your neck, your shoulders. Did I mention your back?!
I mean, I’ll put up with the pain because it’s a good kind of pain; it’s for my kid.
Plus, it totally makes me look like an official mom.
And so if I look tired and crazy, people will understand why.

For those of you out of the babywearing loop let me bring you up to speed.  Babywearing is not a new trend, but a cultural practice where a mother, father, or others close to the baby "wear" the baby in a carrier, sling or wrap.  Babywearing has been long documented among other cultures and studies suggest babies who are worn cry less, which is good for both mom and baby.  One physician, Dr. William Sears, has written much about babywearing and it's benefits.  Overall it's a practice that makes sense when you think of how moms and babies bond and what makes babies happy.

I had never even heard of babywearing until after my Nee Nee was born seven years ago.  She was known as the Velcro baby because she never wanted to be put down.  Being a mommy to a high needs child like her was nothing less than draining.  One day another mom suggested I wear her in a sling.  Lo and behold...she was a happier baby and I was a happier mama.  This picture of us was taken when she was five months old.  You can see she is happy and I am smiling!  For me babywearing was the only way I could keep my sanity!  I wore all three of my kiddos and I still wear Noah when he has his cloth diapers in a bunch or when he won't sit in the cart at Trader Joe's.

So here's my response to Motrin:

Dear PR People At Motrin,

In theory your marketing campaign may have seemed like a great idea.  I mean, let's take something that millions of women have done for thousands of years, find the downside and add a plug for your pain reliever.  Viola!  The Motrin should be flying off the shelves, right? 

So if I am understanding you correctly I only wear my baby because I want to be fashionable and regardless of how much pain it puts me in I will suffer for supposed benefits that are good in theory?  Sounds like the fixings for a nice case of post-partum depression to me!   

First of all, babywearing's "supposed" benefits have been studied for years and have actually been proven and documented.  Secondly, I don't know what the heck a "schwing" is but if you are trying to sweeten your insult by using a Wayne's World  catchphrase I think all of those anti-inflammatories have clogged your brains.  Lastly, any carrier that is causing you pain is being worn incorrectly and it needs to be adjusted.  All those babywearing maytrs who have "suffered" for their children for years before Motrin was even invented must have been tired and crazy!  As long as I look like official mom, I should be okay though.  Because appearance is everything and nobody could ever tell you are a mom unless you have a baby strapped to you.  *eyeroll* 

Before I end this rant...errr...commentary I just want to add that the side effects of Motrin are as listed:

Abdominal cramps or pain, abdominal discomfort, bloating and gas, constipation, diarrhea, dizziness, fluid retention and swelling, headache, heartburn, indigestion, itching, loss of appetite, nausea, nervousness, rash, ringing in ears, stomach pain, vomiting.

So let me insulted me with your ignorant statements, you poke fun at my parenting style, then you offer me all these great side effects?  Where can I sign up?


Saturday, November 15, 2008

Funny Nunnies

Last night I was at my mom's house with Midge, enjoying some quality family time with my parents, sister, and my niece "Boo" who is almost three.  Midge and Boo worked at learning to play nicely with each other throughout the evening. 

Midge has finally gotten the hang of asking to nurse:  "Nunnies, pes."  It's really sweet to see how much he loves being next to his mommy getting his snack of choice.  Plus I get to sit down instead of chase him around and I always welcome that break.

So I am nursing little Midge on my mom's sofa chair and Boo comes up and asks if Midge can play with her.  I tell her after he is done drinking his milk.  She looks a bit confused and asks me where his milk is.  I tell her it is inside me and he is drinking it (pointing to my breast).  She is just mystified now.  "In your chi-chi?" she exclaims.  "Yes, I have leche (milk) in my chi-chis," I explain.  Now she is genuinely excited by this idea.  Her happiness was just peaking at this point.  What a miraculous discovery for Boo...milk inside your body that comes out when you want to drink it!  Her big brown eyes look right at me, her face all lit up and she smiles sweetly and asks, "Can I drink some?"  Her sweetness made it was hard to tell her no.  I gently explained that only babies drink milk from their mommies and that big girls like her get their milk from sippy cups.  She was disappointed but she went up to my sister and asked to drink her milk.  My sister explained she didn't have any for her.  Boo persisted a bit longer but finally accepted that mommies make milk for babies, and Boo's milk was stored in the fridge.

On the bright side of Boo graduating out of being a "baby" she earned herself a ice cream princess cake for going poop in the potty.  Personally, I would take the ice cream cake anyday!

Tuesday, November 11, 2008

The Toddler With The Iron Fist

In Clarks Nutritional center I made an urgent call for direction to the homeopathic remedy drops that help calm a toddler that has been like a little raging bull for the last two days. Poor Midge has been completely out of control the last few days, and it has been a nightmare. He's not ill and not tired, but just trying to understand the way fairness and life works and it's not agreeing with him.

He learned the word "mine" and according to him everything should be stamped with his name. It's really hard to explain to a 17 month the laws of ownership. So to accompany this unwillingness to share is his right hand swinging at people about every minute or so. I have had to sit with him near other children because once I see that face scowl and those eyebrows furrow I know the hand of wrath will fly within about .2 seconds. To make matters worse he seems to enjoy hitting with toys in his hand. Most remarkably a steel car on the head of a child of someone I had just met. Oye! I was horrified.

Today I took it upon myself to write him a prescription for lots of Mei Tai carrier time and as needed doses of chamomilla tablets. Oh, and lots and lots of re-enforcement of the "no hitting" policy. So far he seems calmer and a bit more relaxed. I just hope we can turn Midge's frown upside down before he makes me crazy!

Thursday, November 6, 2008

Three Bean Chili (my own recipe)

2-15oz cans dark kidney beans
1-15 oz can pinto beans
1-15 oz can black beans
1-15 oz can sweet corn (the crunchier the better!)
1 bottle vegetable juice (like V8, I use Trader Joe's Low sodium Garden Patch)
1 medium onion, chopped
1 clove garlic, minced or eqivalent dried garlic
1 tbsp cumin
2 tbsp chili powder
2/3 cup brown sugar
2 tbsp dried oregano
salt and pepper

Add bottle of vegetable juice to crockpot. Drain beans and corn and add to crockpot. Add in onion, garlic, cumin, chili powder, brown sugar, dried oregano and stir. Salt and pepper to taste.Cook on low setting for 4-6 hours. Serves a large crowd or a family with some leftovers!

**I recommend using low sodium vegetable juice and organic ingredients whenever you can. Makes for a much healthier dish!

Wednesday, November 5, 2008

I Must Have Done Something Right!

So yesterday's breaskfast fiasco left me questioning my tactics. Of course the job description of "Mom" includes the occasional self-induced guilt trips, so I tried not to beat myself up over it. I stuck to my guns...meals are eaten in the high chair and I'm not running a diner. You eat what you are given when you are given it or you have to wait until snack time or the next meal.

Lunch yesterday was much better. He sat in the high chair and eagerly ate a slice of pizza. Dinner was met with equal success. As I was making lunch today I told him "Go sit in your highchair" and he walked over to it and waiting for me to scoop him up and sit him down. Dinner tonight was a huge success. Again he obeyed me and went to his highchair and sat down. I gave him a new meal, Three Bean Chili and a slice of cornbread and he started eating it! Not only that but he used a spoon and didn't toss the bowl over the side of the tray onto the floor. Not only that but he drank from a big boy cup and didn't spill! He ate really well and was good about not throwing food, a habit we have been trying to break forever.

But gets better!!

Today while I was at work he went into the diaper bag and grabbed me a clean diaper and handed it to me. Had had done a #2 and wanted changed! Oh my gosh! He's never done that before. He took off his diaper before bathtime again tonight and squatted down so I decided to see what would happen if...

Nothing came of it, but he thought it was funny that I tried to instruct him with grunts and gestures and the word "poo-poo." Ah well. He's still a bit young, but it was funny to see him up there hanging out like a big boy.
I'm glad there are days like this. It makes me feel like all of my hard work and endless hours of repeating myself do pay off.

Tuesday, November 4, 2008

It Sounds Easy

Feeding your child breakfast should be a fairly simple task involving making a meal, putting child in high chair, feeding your child, cleaning their hands and face and viola...mealtime is over!

That doesn't happen here.

Midge has decided that he doesn't want to sit and eat. He doesn't even really want to stand and eat. So I feed him two bites of yogurt standing up and he runs off to play. I am tempted to chase him but I am not about to teach him that mommy is not his portable feeding machine. We go to Jazzercise after breakfast and after an hour he bursts out of childcare clamoring at my feet with his hungry pant that sounds remarkably like Bill Cosby's imitation of lamaze breathing. We only live a couple blocks away so I opt to take him home and feed him what is left of his breakfast. The entire way home he is falling apart. When we get home I stick him in his high chair and go to get his yogurt. When I turn back he has wiggled out of the chair and is squatting on the tray. I try to place him back in the chair he throws a tantrum.

At this point I decide that he needs to learn that if he won't sit then he won't eat. I have to make one of those pivotal mommy calls where I either have to break down and try to feed him on the go or suck it up and allow him to experience the reprecussions of his actions. It was a tough call because he's still a young toddler but I decided that I had made every effort to feed him and I had to let it go and let him be unhappy. I offered him another bite, but he ran off so I left the room.

Within a minute he came back to me crying. I mean, he looks pathetic and all but by this point I just shake my head. By 11am he has taken two bites of yogurt. He is hungry and refuses to sit down and eat. The sheer ridiculousness of the whole breakfast ordeal has lasted until lunch now. Look at this face. I hope he can duplicate it's pathetic-ness for grandma or maybe even the CPS agents when they come out for a malnourished child report.
Gotta make lunch with a screaming toddler at my legs. Maybe I'll sprinkle some Valium on my pizza today.

Sunday, November 2, 2008

And Just When I Thought He Couldn't Get More Fabulous...

My very dear friend Jered managed to land himself a spot in history with his Halloween costume that was featured in the Associated Press. He was the Wicked Witch of Wasilla, aka Sarah Palin. This was taken at a party in West Hollywood.
Let me guess where his vote lies...

Halloween 2008!

Stephen and I, along with our sock puppet Midge, Gothic Countess Nee-Nee, and Ninja Bear were able to recover from the flu bug in time to get some trick-or-treating done.  It was great to see the kids feeling up to par again!  Especially Nee-Nee, who I had not seen smile in several days.  Midge was facinated by all of the costumes.  He even chased a little boy about his age who was dressed as a lion. 

All in all it was a good night.  I feel like things are normalizing again as far as being sick goes.  Hope everyone else had a great Halloween!