All the Right Tools at Birth

A plethora of debate surrounds home birth. And there are good reasons that some people choose to birth in the hospital and some people choose to birth at home. I respect them all. I'm grateful for the choices I had.

But sometimes, women don't have those choices. They live in countries without adequate health care systems. They live without adequate sanitation, clean water, or even services such as electricity - all of which I take for granted as I drink my icy cold water, sitting in my cool, air conditioned, well-lit home.

So rather than spend time debating about the business of birth as we seem to do a lot of in this country, women do what has been done for generations. They birth where they live - without question. They do it in unsanitary conditions, with only minimal assistance tools. And they do it with skilled midwives, who bring so much more than a birth bag to the table. (For a first hand account, you can read about my friend Marya's midwife who frequently works in Haiti.)

It was so inspiring for me to read a novel that included the passage of midwifery from grandmother to granddaughter. In the book, Tiny Sunbirds Far Away, the protagonist of the story finds herself in the midst of culture shock as she is first forced to leave her home in the city to live with extended family in a rural area without so much as indoor plumbing and then forced to leave formal education because there simply wasn't enough money to educate her. But she finds herself far from lost. Her grandmother takes her under her wing and passes down her trade - a trade that brought so many healthy babies into the world and continues to do so.

Although she had the bare minimum of physical supplies, she carried some of the same tricks my own midwives carried. For starters, she learned to be a compassionate person who could sit with a woman in labor. She learned to help women trust themselves and push when it was time, and hold back when a cord preventing safe passage into the world needed to be unwrapped. She learned to look past the pain that accompanied birth and find the joy. Most of all, she learned how to hold a birthing woman's hand and be present - something that still makes me grateful to both of the midwives who caught my babies. She even learned how to flip a slimy little baby onto its mamas chest, and then help both mother and baby start nursing.

In the midst of insanity all around her, she brought perfect calm. And though my own births took place under very sanitary conditions, with access to all sorts of back-ups if need by, these midwives in Nigeria had what I found to be the most helpful tools at my own home births. It was so inspiring to read yet another tale of women doing what needs to be done, in whatever way it can be done.

Elaine

As a member of the From Left to Write book club, I received a free copy of the book Tiny Sunbirds Far Away, by Christie Watson. That book inspired this post. But there is oh so much more to the story. I definitely recommend it. And, if you're the first person to email me that you want it, I'm happy to give my copy to you. You can even read the first chapter here.

Pregnancy and Birth, Remembered

It's no secret. I loved being pregnant with Connor. I loved my appointments with my midwife that allowed for time to talk about how the baby had grown, how my life was going, and anything else that seemed to come up. I especially loved when my belly started getting big enough for people to notice and then later, when I was so enormous I almost felt like a cartoon.

I also loved being pregnant with Helen, though it was a completely different experience. For starters, I wasn't as well rested, I wasn't in as good of shape, and for a reason that has never been fully explained, pregnancy with Helen was accompanied with a lot of bleeding - which was just stressful, even after a sonogram confirmed it was nothing to worry about with respect to Helen.

But most of all, I loved the moments that each of my children were first put on my chest. In Connor's case, my midwife performed this crazy move where she flipped him onto my chest seemingly the moment he emerged from my body. That's the convenience of being in a mostly horizontal position while giving birth. Helen was more handed up to me, since I was nowhere close to a bed when she emerged.

Magical. Just Magical.

A few nights ago, I was heading back from a trip to Tahoe. The whole time I was in the car coming from the airport, I just knew my friend HelenD was in labor. I actually tried to sleep a little in the car, in preparation for what could be a long night ahead. And when I got home, I was not disappointed. On my answering machine was a message that she was in pretty intense labor asking if I would come over. But, because HelenD is the nicest person in the world, she of course said "but I know you're just getting back from vacation, and it might be too much...". But what I was thinking is, OMG, she waited to have the baby for me. (See how nice she is?) So then, I had to do a bit of detective work because I never bothered to set my answering machine to the current day and time, so my machine noted the call came in on Thursday at 2:13 AM. It was Saturday around 11:00 PM. Ed (he's so smart), noted that I could simply push the clock button on the machine to see what time the machine thought it was now, to determine whether it was likely HelenD was still in labor or not. So I did. And Holy Cow! The machine said Thursday at 4:31 so I looked at Ed and said "I want to go? Do you mind?" and he said "Let me empty the car" and so it was that I was running around looking for HelenD's address, Ed was throwing out a week's worth of vacation gear onto our driveway, and then I dashed into the night.

And I made it.

And it was incredible.

HelenD's home birth was memorable in a million ways, but these are my two favorites. When HelenD hit a bit of a wall (apparently labor had been in full swing and stalled sometime between when she placed the call to me and when I arrived and that was really depressing) her husband looked at her with the confidence that can only come from true love. One look from him assured me at least that everyone was going to get through this.

And the second moment I want to remember is when Dahlia was coughing like crazy and placed onto HelenD's chest. Again, Helen's husband looked at the two of them as if life were perfect in that moment. Perfect.

This all made me think - that while I spend a lot of time thinking about how everyone who wants it should have access to a home birth, not that many years ago, hospitals did not even allow dads to be in the room when babies were born. And the lesson? Birth practices can change radically, and in my mind, for the better relatively quickly.

So I remain completely hopeful about the state of home birth. And I am so impressed that the birthing community has come so far that dads are now included. Because that birth on Friday night? It wouldn't have been nearly the same without the dad there.

Thank you for letting me be there HelenD. You rock!

Elaine

Disclosure: I was given a free copy of the book Exploiting My Baby, by Teresa Strasser as a member if the From Left to Write Book Club, which inspired this post. I read the book in one evening, as I sat in the ER waiting for my kidney stone to be diagnosed. It's not my style of book, because I loved being pregnant, and this author felt otherwise.

Strangest Night of My Life: Health Care, a Kidney Stone, and more!

As mentioned, I went ice skating last Sunday with the little people, followed by skiing the next day. Only, I didn't really ski because I spent my time passed out in the lodge in lots of pain. The pain came and went in waves, until finally, on Thursday, I called my primary care physician.

Only, even though I am part of the insured elite with one of those really great federal health insurance plans, I couldn't get in. Apparently - and I did not know this - if you don't see your primary care physician at least once every three years, they dump you. Because I go to my midwife for all my well-women care, and I am rarely sick enough to require a doctor in my zip code, I don't go to a primary care doc. Instead, I call my brother-in-law's excellent diagnostic phone service. And here, I should mention, if my brother-in-law regrets becoming a doctor, it is totally my fault because I am always calling him for free medical advice. If he's not immediately available, my sister tells me what to do because being married to a doctor is just about the same as being a doctor - or at least she thinks so.

Anyway, on the advice of my brother-in-law, I went to the ER. And actually, I went to the Urgent Care clinic first because I felt guilty about going to the ER, even though my brother-in-law told me that my problems needed to be attended to in the hospital, not a clinic. (Apparently I don't always take his advice.) The urgent care clinic sent me to the ER. See how smart my brother-in-law is?

After arriving at the ER with book in hand and a full bottle of water, I settled in to start reading. It was, unfortunately for me, a busy night. I finally got seen by a doctor and after I spent a few minutes apologizing for being in the ER and explaining how I didn't have a primary care doctor, blah, blah, blah, the doctor spent a few minutes apologizing for my wait. Of course, I was all - hey - I'm a mom of two. I haven't sat and read a book cover to cover in years. This was the most relaxing night of my life.

Well, at least after they loaded me up with pain meds it was relaxing. About this time, Ed called me to tell me a stabber was loose in our neighborhood, so he was locking the door and I should be careful when I came home. Yes, he was totally calm about this. I had visions of being stabbed in my driveway looking for my keys because my jerk husband decided to lock the door so he could go to bed while I sat in the ER.

One CT scan later and with three prescriptions and a referral to a urologist in hand, I was released from the ER with the knowledge that I had a 7mm kidney stone. For the record, most people complain about a little 2mm or 3mm stone. So, mine is like the mother of all stones. The ER doc couldn't believe I'd made it so long before coming in, until I informed him I gave birth at home and had a pretty decent pain threshold.

I went to the 24 hour pharmacy, and my night got even weirder. On my mind, of course, is the knowledge that there is a stabber loose in my neighborhood. I pulled up to a very empty area of the pharmacy parking lot that was well lit and glanced around to see if there were any people between my car and the front door.

All Clear.

So I got out of my car and immediately, a guy called out to me - and he was on the passenger side of my car and here is where I about lost it completely. Because, uh, stabber? Hello? He told me a long story about his dad and a heart attack and Raleigh and I have to admit, I wasn't thinking that clearly, so I asked him if he was trying to get directions to North Carolina because I really am not good at directions.

No, no directions needed. He needed gas money. At this point he was within a few steps of me and it was so strange, and nothing added up, so I reached in my wallet, gave him $20 and figured he would leave me alone and I would live to tell the story. (Which I have, obviously.) Only, he then asked me who else I knew in the neighborhood that he could get money from and I looked at him and said "It's midnight, dude. People are sleeping." And he explained to me that he needed a tank and a half of gas and I actually stood there for a minute trying to figure out how many miles away Raleigh, North Carolina was and tried to then convert my $20 into gallons of gas, and then convert that into miles he could drive, to see how close he'd get, only I have no idea how far away North Carolina is, nor do I know how much gas costs because Ed's job is to fill the gas tank, not mine!

Anyway, the strange parking lot guy kept asking me for advice, and I was busy performing math in my head and finally I sputtered out  - "Why don't you get in your car and start driving?" and I high tailed it into the pharmacy, after assuring him that I was not going to give him my name and address because he really did not need to pay me back and if he felt he must, he should just donate the money to a needy organization.

Once inside the pharmacy, I replayed the conversation a few times, and it kept making less and less sense until finally I decided that he would be standing outside the pharmacy, ready to murder me and take my prescription drugs and money. And now, rather than being a helfpul gas-money giver, I was actually an ENABLER of some bad drug habit, which made me feel really guilty. So I thought about calling Ed and waking him up to ask him to come escort me the 15 feet from the front of the pharmacy to my car, only then another customer was leaving and I just pretended like we were best friends and tailed it out with her, but not before putting all but $5 in my front pocket and tucking my drugs safely away because I somehow convinced myself that maybe I would just get mugged instead of murdered, and this way it wouldn't be so costly.

I got to my car, drove the few blocks home, and then once again sat in the car and looked around for the on-the-loose stabber and cursed Ed because he actually turned the lights in the driveway off before he went to bed. The man leaves lights on all day long when he is not even in the house, but manages to turn them off after alerting me to the fact that a stabber is on the loose in my neighborhood. Go figure.

Somehow, I evaded capture, and tried to relate this all to Ed when I got home about how lucky he was that I was still alive, and by the way, I'm having surgery in a few days for the mother of all kidney stones, and the next morning? He remembered nothing.

Tomorrow is the big day that that little stone will be lasered out. Ed will actually bring me home this time, so I don't have to worry about strange encounters in the pharmacy parking lot and stabbers on the lam in my neighborhood.

And that's why I didn't post anything for homemade Friday this week. It shall return next week - and it might just be a picture of my kidney stone!

Elaine

Happy Thanksgiving: 2010

One nice thing about Thanksgiving is taking a moment to breathe in, look around, and give thanks. Here goes.

This year, I'm thankful for 5 year olds and good grooves, because for several months now, Ed and I have both been waiting for the other shoe to drop. Connor is just a happy kid. And he can (and does) dress himself (albeit mostly in sweat pants) most mornings and he even celebrated daylight savings recently by sleeping in until 8:00 the day before daylight savings started. It was awesome. Regularly, he hops up to his chair at breakfast, consumes a big meal, and then starts smiling and bubbling with excitement. It's contagious. Of course, there are still the occasional tired, very emotional days, but those are few and far between. And hey, I have them, too.

I'm also thankful for Helen. She is truly a pain in the rear end many days, saying "no" before considering any other answer, jabbering away non-stop, and recently taking to waving her arms, clapping, and shouting "Hey, Elaine!" when she wants my attention. But she also brings joy with her almost everywhere she goes, and she continues to be the snuggliest child in the world. And that is such a gift.

I'm thankful for healthy children and a partner that celebrates them with me.

I'm thankful for sleep, when I get it, and am hopeful that these last few nights of sleep are going to turn into a string of many, many nights of sleep. It's not the kids waking me. I think it's just the memory of waking often several years ago and never quite being able to kick the habit.

I'm thankful for a Democratic Senate that will hopefully hold the line in this next Congress and that we're getting closer to universal health care (though I continue to hold out hope of single payer). I'm thankful for the midwives that assisted me during pregnancy and that caught Connor and Helen. I still wouldn't do it any other way and I look forward to my annual visits with them. I wish the healthcare legislation would've provided more protections for midwives.

I'm thankful for no longer having to carry diapers when I travel.

I'm thankful for new recipes, dinners that get eaten by everyone (which happens occasionally), and that our local grocery store has started stocking Chincoteague clams. Everyone in my family loves those delicious, salty morsels. The last time we had them, Helen had 23, Connor had 23, and Ed and I had 1 apiece. Two didn't open.

I'm thankful for grandparents that come on ski trips, come to visit, and always agree to take morning duty when they visit. I'm also thankful for grandparents that allow me to drop my kids off for a week - or at least I hope to be someday (hint, hint). I'm also thankful for grandmas that never stop reading books.

I'm thankful for full-length musicals and lots of great, local children's theatre. Even more, I'm thankful that Connor and Helen seem cut out for the role of theatre buddies for me. Hopefully they'll wheel me into the theatre when I'm drooling on myself in my old age so I can see just one more show.

I'm thankful the Chiefs are winning again. It's been a long time.

I'm thankful for date night, HR57, and the proliferation of cupcake stores and high-end chocolatiers in the greater DC area. I'm thankful for good open mic nights at Iota, old friends returning to the States, and being back at Miriam's Kitchen. It's been a long time. I didn't realize how much I missed it. And along those veins, I'm thankful for Kevin Crowe's lecture at the Foundry this year.

And finally, I'm thankful for friends and family that inspire me daily. I believe in the power of positive energy. Thank you for sharing yours so freely.

Home Birth - It's Really Not That Scary

A great article in the Huffington Post made me smile when it came across my inbox today about choosing home birth and asking questions about why one-third of babies are delivered in US hospitals - by Cesarean - and whether that might be a risky choice. Don't get me wrong, I understand that c-sections can be a very good thing, lifesaving, even. But it's major abdominal surgery that comes with risks to both mother and child. I'm not sure it ought to be extended as often as it is. Indeed, most well-developed countries with birth statistics better or rivaling our own don't extend it as much.

But what bothers me more is the idea brought out in the beginning of the article, that the images that surrounding birth are scary, and may just make women lack confidence in their ability to do anything but give birth with lots of assistance, and possibly surgery.

"For many of us who haven't yet been through childbirth, there's an image we have of what it's like: A woman is rushed to the hospital in a taxi; she gets put in a wheelchair and is rolled down the hallway in dire emergency; then we see her screaming, and yelling in pain and then... there's the baby.



"Sadly, this is the image that a lot of television shows have put into our minds, and have led many of us to believe: Birth is scary. Birth is dangerous. And it might be better if we just numb out through the whole experience.


"Because so many women don't have an image of what a natural, empowered birth looks like, there is a lot of fear surrounding the act giving birth. Accordingly, the majority of women give their inner authority over to doctors in their birth process. They trust the doctors more than themselves. The problem with this is that many women aren't aware that the majority of her doctor's medical decisions are being made today for monetary and legal reasons, and not necessarily for the good of her and her baby.


"Here is the reality: Hospitals are businesses. They want those beds filled and emptied. They aren't really interested in having women with long labors hanging around. And there is something else you should know: Having a baby in a hospital might not be as safe as you thought."

Occasionally, I find out a co-worker or playgroup mom had a home birth, and it's usually after the birth, and if that's the case, they tell me "I wish I'd known you had your children at home while I was planning my birth. Everyone I knew was against the idea." And this always bums me out because a lot of people know I had home births. And I'm happy to talk about those births. I still count them among my best two days, ever.

I don't expect the numbers of home and hospital births to change that much. But I do wish the information out there was delivered on a fair playing ground, so that people who choose out-of-hospital birth don't have to feel like they're some sort of outcast. I also wish people didn't feel like they had to choose between a hospital birth and the birth they imagine. Seems like there ought to be common ground available.

DCMM: Hey AAP: Ready to Reverse Course on Male Circumcision, Too?

I run in a pretty “crunchy” crowd. Or rather, I used to run in an ultra-crunchy crowd. You know - the kind that grows vegetables in the backyard, argues about the conservative media bias, and generally considers Birkenstocks to be perfectly acceptable for the office. I never seriously considered a hospital birth because I knew from the start I wanted my babies born at home if at all possible. But I knew when I was a new mom I needed to flap my social wings a bit. I found myself socializing with other mamas, if only for the reassurance that my son’s (remarkably poor) eating and (remarkably poor) sleeping was normal. (It was). Imagine my surprise, then, as I sat with a group of moms at a Friday jazz program at the National Gallery of Art when the conversation turned to circumcision.

One of the moms of a girl asked the group (which formed from a lunchtime gathering at the Breastfeeding Center of Greater Washington) about whether folks had their sons circumcised and at the point when I was about to say “of course not, I’m friends with the author of the MGM bill, and he has convinced me the procedure is unnecessary and potentially harmful”, I was interrupted and another woman answered (and I do not think I will ever forget this) “Of course I did! I don’t want my son to be a freak! I want girls to like him!”, and then the next woman spoke up about her son’s bris, and a third chimed in about how her son didn’t even blink during the procedure which clearly showed it wasn’t painful (though others would argue her son might have been in shock). At this point, I looked down at my glass of wine, blinked back a tear, and took it as one more sign that life as I knew it before a baby was gone. If I wanted to have some mommy friends, which I desperately did, I was going to have to take a step to the right and bite my tongue. Or at least bite my tongue.

I was reminded of this conversation a few weeks ago when the American Academy of Pediatrics (AAP) put out a position statement —which they subsequently reversed—regarding female circumcision, or female genital cutting (FGC). After a loud public outcry, the AAP has reaffirmed their opposition to all forms of FGC, noting that it is forbidden by federal law in the United States.

But I wonder, what will the AAP say in the revised policy on male circumcision that is due out later this year? Currently, the AAP’s policy indicates that circumcision is not essential to a child’s health and furthermore, scientific benefits of the procedure are not sufficient for the AAP to recommend that all infant boys be circumcised. Yet, at least in this country (though few other Western countries), circumcision remains the norm (though that majority is getting slim). Contrast this with Canada, where fewer than one-third of infant males are circumcised. And that’s true of many European countries as well.

How did I make the decision? I thought about a few things. My son could only reasonably expect to be able to reverse my decision to not circumcise. A choice to have him circumcised would be a lifelong one. My husband and I thought this decision ought to be his. As a mom that often looked like a deer in headlights, I often go back to the mantra “first, do no harm” – and this pointed me in the direction of not having him circumcised. I dismissed the argument that my son wouldn’t “match” his peers the same way my mom dismissed me when I used this logic as a girl “If Suzy jumped off a bridge would you follow her?”. But most of all, it just never made sense to me. The routine removal of a body part wasn’t something my husband or I could justify. And so we didn’t. I'm crossing my fingers that when the AAP's new policy statement on male circumcision comes out, they agree with me.



This is an original DCMetroMoms post. Elaine writes about less controversial topics at Connor and Helen!


These were the original comments on the post:

Jessica C./Claire Jess said...
This mama of an intact boy says thanks for writing!

Reply June 14, 2010 at 05:44 AM Tiffany said...
Oh, I know that feeling. Making non-mainstream decisions regarding your children puts you in a veeerrryyy awkward position in mommy groups. Comments like the ones you heard make me cringe as well. It saddens me that the choice to remove a normal healthy body part is based on the desire to look good for the girls.....Gah!

Reply June 14, 2010 at 05:57 AM ElaineMM said in reply to Tiffany...
How girls may or may not perceive my son is not - and hopefully never will be - grounds for a decision like this.

Reply June 14, 2010 at 07:02 AM Rebecca said...
Great post. I am a mom four uncircumsised boys. I'd like to think the woman they pick to marry would look past that part of them to the men they will be. (In answer to your friend's reasoning.)

Reply June 14, 2010 at 06:26 AM ElaineMM said in reply to Rebecca...
Me too. In all the conversations I had about this, how a woman would perceive my son never came up.

Reply June 14, 2010 at 07:01 AM Marilyn Milos, RN said in reply to Rebecca...
Any woman who understands the importance of the foreskin and recognizes how much better sex is with an intact man will thank their mother-in-law for protecting her son! My grandson and his wife have both thanked me!

Reply June 16, 2010 at 10:47 AM Robin (noteverstill) said...
We're Jewish and religious(ish) and my son had a bris. We never considered otherwise - I just can't turn my back on a multi-thousand year tradition and what we are taught is God's commandment. I wonder, though, if I wasn't Jewish... I think I probably would be against it for many of the reasons you describe. My first two kids were girls and I never had to think about this. With #3 it was only a philosophical discussion because we do feel religiously obligated, but it was an interesting philosophical discussion to pursue. I so understand about biting my tongue re: parenting opinions. I hope those of us who circumcise for religious reasons, at least, don't make you uncomfortable with our decisions. I think the most important thing is that you're putting so much thought into how you'll care for your son - that's what will make him turn out right.

Reply June 14, 2010 at 06:31 AM ElaineMM said in reply to Robin (noteverstill)...
Because I'm not Jewish, I never had to think about it, so it's hard for me to truly be in your shoes. I do, however, appreciate that thoughtful parenting will go a long way. And yes, biting tongues. Always biting tongues in new crowds.

Reply June 14, 2010 at 07:00 AM Marilyn Milos, RN said in reply to Robin (noteverstill)...
I suggest you read Marked in Your Flesh: Circumcision from Ancient Judea to Modern America, by Professor Emeritus Leonard Glick, MD, PhD, in which he discusses how circumcision was inserted into the Bible in Genesis 17 by the priests (P text)about a thousand years after Abraham allegedly lived. The original covenant was Genesis 15, which said nothing about circumcision. Many Jews today are now welcoming their babies with a bris shalom, a celebration of peace, a naming ceremony, without the cut. It's not being circumcision, but being born of a Jewish mother that makes one a Jew.

Reply June 16, 2010 at 11:01 AM Marilyn Milos, RN said in reply to Marilyn Milos, RN...
Oops, that should be been "It's not being circumcised but being born of a Jewish mother that makes one a Jew."

Reply June 16, 2010 at 11:02 AM Kiki La Roo said...
Good for you, from a mama of an intact boy.

The "I want girls to like him" excuse kills me. My daughter has seen her brother's parts many a time...it will be normal to her, when the time comes.

It's the penis owner's choice in my book. The end.

Reply June 14, 2010 at 06:41 AM ElaineMM said in reply to Kiki La Roo...
This is the reason that kills me most as well. Seriously? I like to think I would not have cared about this, even as a 20-something. GAH!

Reply June 14, 2010 at 06:59 AM Vickie said...
Hmm. I have no memory of this conversation, but I can sympathize with the tongue-biting.

T's circumcised. We never thought he wouldn't be, because where we come from, ALL boys are circumcised (or at least, all catholic/christian boys are; am not sure about the Muslim population). In his dad's time, it's a rite of passage, typically done before setting foot in high school. Most families nowadays have it done soon after their boys are born, though.

We always thought we'd be headed back home within a few years, so it made sense to me that T ought to resemble what I thought would be his peer group. I don't think anyone thinks twice about this back home. I've also never heard any stories of circumcisions gone wrong back home. I did read that book about twin boys in the midwest where one was mutilated during his procedure and his parents decided to raise him as a girl with horrible consequences.

Reply June 14, 2010 at 10:28 AM ElaineMM said in reply to Vickie...
You read the most interesting books, Vickie! I can tell you more details about the conversation. I remember a lot. But I do not remember you being there, so possibly you weren't. It really bummed me out at the time, and I didn't have the confidence to engage anyone in a debate about it, so I just sat there quiet and stunned. Now, I wish I had challenged the person in question a bit.

That's interesting that the procedure used to be rite of passage that took place at a time when a boy could understand what was happening. I wonder what motivated the change to it being an infant procedure.

Reply June 14, 2010 at 02:25 PM Vickie said in reply to ElaineMM...
Haha! The book was nonfiction (and I am too lazy to google it now) but I remember the impression it made on me--back in the 60s when the mutilation happened the thinking among psychologists that gender identity is tied to genitals. But the boy who was forced to become a girl grew up unhappy and aggressive and not comfortable in his own skin until he found out the truth. As an adult he decided to be who he really was (a man), got reconstructive surgery, etc. and last I heard had a family.

Quite possibly I wasn't there--I don't remember making NGA Jazz until T was older, and never with a big group.

In the less urban areas back home, I think this is still a cusp-of-teenage years ritual for many boys. (Who don't even go to a doctor for this--sometimes it's a barber, sometimes a faith healer.)

I think as people become more affluent, they make the decision to have it done early to spare their sons the spectacle of spending the days after the procedure wearing their sisters'/mothers' slips or skirts. And they may rationalize it by saying that the baby won't remember the pain.

For us it was also an insurance decision! Circumcision is covered completely when performed within a certain number of days following birth, but my brother-in-law found out the hard way that if you wait till your boys are teens or tweens AND you live in the US, it costs minimum $700 per kid.

Reply June 14, 2010 at 08:00 PM Deni said...
This is a personal choice and we all need to allow it to stay out of the list of things we judge! I am the sister of 6 brothers (dad and brothers not circumcised) mother of 6 (4 boys all circumcised) our decision was because we had seen a friends boy that had to have it done at 4yrs old for medical reasons and thought better to prevent with it done early. We realize that it is the exception to have issues either way and left the decision for our 4 grandchildren to their parents without judgment!

We are all free to be individuals so just base your decision on who you are not what others think!

Reply June 14, 2010 at 10:57 AM ElaineMM said in reply to Deni...
That's true often, right? We ought to base our decisions on who we are, not what others think. Now that's a lesson I'd like to figure out how to pass on successfully. Could apply in a lot of contexts.

Reply June 14, 2010 at 02:26 PM Marilyn Milos, RN said in reply to Deni...
Now we're beginning to understand circumcision as a human rights issue, so we've begun to recognize that it is not our right but a choice that actually belongs to the person who will live with the loss and consequences of a decision made by someone else.

Initially, we didn't understand how the pain, trauma, or harms of circumcision affected our sons but, during the past 30 years, thousands upon thousands of men have voiced their complaints. They describe their scars, skin bridges, missing pieces, the problem of premature ejaculation in the early sexually active years, and the problem of sexual dysfunction leading to impotence later. Form cannot be altered without altering function. Circumcision disturbs the normal sex life of both the male and his sexual partner.

Believe me, I am not sitting in judgment, I have three circumcised sons. But, after witnessing a circumcision when my sons were 10, 17, and 20, during which the baby screamed horrifically and the doctor looked into my tear-streaked face and said, "There is no medical reason for doing this," I devoted my life to bringing an end to non-therapeutic genital cutting of non-consenting minors, whether they are boys, girls, or intersex children.

Now, I have four intact grandsons, so we learn.
Reply June 16, 2010 at 11:19 AM ohslowburn said...
Thanks for this - I wasn't aware the AAP had reversed it's recommendation, something I care and blogged about (whole other subject!).

As for the male circumcision thing, I take comfort in something my husband said when we decided not to have our boys clipped - "honey, no one will say a thing, it's really not like men walk around looking too closely at one another's shlongs." Okay then. :P

Furthermore, if he really really wants to "be like the others" he can choose to do it later in life. I imagine it's an ordeal, but at least he'll have a choice and will go into it with his eyes open.

Reply June 14, 2010 at 11:07 AM ElaineMM said in reply to ohslowburn...
Wow! Those are some powerful posts. A friend and I went down this same debate road right after the policy came out. It is all about protecting young people, in the end. And wouldn't life be easier if we knew exactly how we could do this best? Thanks for writing! You've given me more to think about.

Reply June 14, 2010 at 02:32 PM Jenni said...
Mom to two intact boys. We never even considered it. We just felt like the foreskin is there for a reason and we did not feel comfortable with the procedure.

You know, I heard that the AAP is actually going to alter their recommendation to the "for circumcision" category as some studies show it may reduce the spread of AIDS. I can't help but think that teaching our sons to practice safe sex would go a lot further with regards to AIDS prevention.

Reply June 14, 2010 at 11:32 AM ElaineMM said in reply to Jenni...
I know about the study that made a big splash in Africa about AIDS prevention. Two subsequent studies had the opposite findings, and of course, you point out that there are more direct ways in the US we can think about AIDS prevention. I'm definitely curious about what the AAP is going to say.

Reply June 14, 2010 at 02:19 PM Marilyn Milos, RN said in reply to Jenni...
You're absolutely correct that safe sex practices would go a lot further to protect against AIDS. In fact, the spread of AIDS has been curbed in Thailand, Senegal, and Eastern Uganda because those governments took a strong leadership role, educating about the dangers of HIV/AIDS, with a new campaign of "100% condom use 100% of the time!" Then, they distributed free condoms.

The African studies, done by researchers who were promoting circumcision for other reasons before they used AIDS as the excuse, are suspect!

The horror is the vast numbers of men who are being circumcised in Africa now because they've bought into the hype. Our NOCIRC of Kenya director, Prince Hillary Maloba, reports that Kenyans who have been circumcised to prevent AIDS are wondering now why they've acquired it, even though they were circumcised. How many more will be harmed, have their sex lives diminished, or die because of this misuse of funds. In addition, those men who think circumcision will protect them may very well be even more promiscuous because they're circumcised, believing they're protected.

Education, not amputation!

Reply June 16, 2010 at 11:26 AM Jenni said...
Glad to hear they retracted that bogus position on FGC, though. Ridiculous.

Reply June 14, 2010 at 11:34 AM Ladybug Crossing said...
My husband and his brother both had to have circumcisions at the age of for medical reasons. Trust me, it was not pleasant for either of them. When our son came along, both my husband and my BIL were adamant that our #1 get circumcised as an infant. I absolutely agreed. Genetics were not in our favor for leaving things alone.
Do I care if you circumcise your boy? No. Will I tell you what happened to my Mr. and his brother? Sure I will. But, when it comes right down to it, the choice is yours.
LBC

Parental Rite of Passage: Trip to the ER - Completed

If you asked me which of my children was most likely to end up in the ER, it would - hands down - be Helen. She is constantly stretching the limits of her little body trying to do what Connor does, and this is often completely frightening to watch - and impossible to halt. In fact, when I called my parents last night and told them I had been to the ER, both guessed it was with Helen.

But I was wrong. Yesterday, we went on a bowling outing arranged by a mom's group I'm part of. I took Helen and Connor there, got Connor set up, and then Ed arrived. I went to the snack bar to get Connor and Helen a treat (mostly because I needed a good distraction for Helen since this is one of few activities that I really think even she couldn't figure out a way to participate in). While I was at the concession stand, I heard a very terrible scream. In my head, I said "Wow, I'm glad I don't have a kid that screams like that" assuming it was some child protesting leaving the alley. But then my friend Laurie rushed up to me and said "Elaine - get some ice, that was Connor!" and I was totally stunned, and then I saw Ed carrying little dude, blood everywhere. It took a moment to get it washed up enough to see what was going on, but as has been pieced together for me, Connor picked up his very heavy ball, and then tripped. But because his hands were full of bowling ball, he couldn't use them to break his fall, and so his chin caught the edge of the alley with a fair amount of force.

It actually stopped bleeding pretty quickly, but as soon as the physician's assistant at the ER saw it, she proclaimed he'd be needing stitches. I asked about a magic glue solution another mom told me about, but his cut was apparently way beyond the wonder of this stuff. As it turns out, he needed six stitches. He was an absolute champ, only letting us all know after four stitches "I'm all done now. I'm ready to go home.".

The PA thought I had a career in medicine because I was so calm as I held Connor. She told me children only do as well as their moms. She then asked if I'd been through this a lot and I told her "no", Connor's never been in the hospital except to have blood drawn. He wasn't even born in one. She said "wow, that must have been awesome. I think it's the reason you're so calm. Seeing blood must not bother you at all." And that's just another reason to be a home birther (though I don't believe it myself at all, I think I'm just a calm person when I know I need to be).

Elaine

Someday, I may be mainstream

In college, as I was sorting through the discount book bins, I came across the book "In Labor". The book chronicled the move of birth from inside the home to the hospital, and with it, the displacement of midwives. This, by the way, is a unique feature of the US medical system. In other countries, as birth moved into the hospitals, so too, did midwives. But here, OBs had a rather forceful campaign against midwives as they sought to "professionalize" what they did. Apparently, OBs used to be sort of the bottom run on the medical profession totem pole, and part of this lack of respect came from them doing "women's work". Never underestimate the power a book can have in a young person's formative years when the phrase "rabid feminist" would not be at all too harsh.

When Ed and I first decided we'd have children, I went to the bookstore during lunch one day and was flipping through the pregnancy books. The one that caught my eye? "Baby Catcher" a lovely book with many vignettes about primarily home births, but a few hospital births as well. It's a midwife's tale of her practice in CA, at what she considered to be the height of the home birth movement.

When I became pregnant I knew I wanted a midwife attended birth, so I went to my insurance provider's website and searched for a midwife, and BirthCare came up on the list of approved providers. I went to their website and OMG, I discovered that they attended births at home, and this was just the coolest thing ever and I knew right away I would have a home birth.

And then I told Ed my plans.

He wasn't completely convinced of the sanity of my plan, but I had a few reasonable sounding arguments that appealed to him like - the last time I was in a hospital my ex-boyfriend was dying from leukemia, and frankly, I don't have a lot of happy memories there - and doctors like to do things their way, and if that's not my way, we already know who will lose (and there may be rational reasons for this in our litigious society) - and this may be our only child and I would hate to miss out on this opportunity, because I just know in my heart I am a homebirther - and by the way, did I mention how high the c-section rates in this area are and do you really want to see me cut open because I will totally make you watch the surgery. And by the end, Ed agreed to read this book, and I told him how I'd already made my first appointment and he should come with me.

At BirthCare, Alice (one of the midwives and a cofounder of the practice), interviewed us to see if I was a good candidate for home birth. At one point, she asked me why I wanted to have my baby at home and after I told her, she turned to Ed and asked how he felt and Ed responded "I don't actually have a full voting share in this matter" and Alice laughed and said "I think that's true a lot of the time, but most husband's don't usually tell me that". And after I'd been examined, I was officially a home birth candidate.

I told everyone about my plans and my friends who know me well often said "that's so cool, I want to hear all about it" and then, of course, there was a story about a home birth where the woman ended up delivering a breech baby and wow, was that scary and painful - but everything was fine, and then of course my sister told me I was nuts and my mom somehow knew this was sensitive territory to tread on, so she maybe said something like "it's not what I would choose", but that was about it - if even that. I think she knew my sister would do everything she could to talk me out of my decision so what was the point in her ganging up on me (thank you, mom). But by the end of my pregnancy, my mom had met another home birth grandma on the golf course and this was possibly the best day of my entire pregnancy because all of a sudden, my mom appeared totally zen about the idea.

I have only second guessed my choice twice - and that was moment before each of my children were born. Apparently, this is a classic sign of transition, when a woman has serious doubts about her ability to give birth. What possible biological function this serves I cannot even fathom.

I am intensely curious what Connor and Helen will think about when they learn they were born at home. Will they think I was crazy? Will Helen someday have her babies at home? Will Connor be the dad of kids born at home?

It's been a rough year for home birthers. ACOG and the AMA keep hammering their unfounded point that home birth is unsafe. My only guess as to why they care so much is because if insurance companies in the US ever figure out what a cost savings they could enjoy if they promoted midwifery care, many OBs could find themselves unemployed. After all, presumably c-section rates would fall more in line with the rest of the world and the need for those specialized surgical skills would just be a lot lower. They'd still be needed to handle anything out of the norm and high-risk pregnancies, but pregnancies like mine would never make it into the hospital (or woudl only be there for a few hours if a stubborn baby was lying transverse too close to her due date and needed to be turned downward - like Helen!).

Today though? Today was a good day because rather than reading another story about how midwives are getting the shaft, I read a story in the
New York Times that says home birth is coming back - and I love it!

Elaine

In celebration of life

January 25, my friend Laurie gave birth to her second daughter, Mia.

February 3, my cousin's daughter, Sadie, died.

Laurie lives only a few blocks from me, and gave birth at home. As it turns out, the same midwife who caught Connor caught Mia. During Laurie's labor, her husband called to see if I would come over just to bring a different energy to the atmosphere. I had told them both before the birth that I would be more than happy to be involved in any way Laurie thought would be helpful. To make a long story short, it was really cool.

I arrived at Laurie's after she had been in labor for a few hours. Connor and Helen were both in bed and I told Ed I'd probably only be there for an hour or so because I wasn't sure how long she'd want me there. Truth be told, it was awful timing for me. Connor had been sick and a true grump, Ed and I were both on edge, and we were feeling really overwhelmed. But I wasn't going to tell a man with a wife in labor that I couldn't come after they had been so good to pick-up Connor around 7AM the day Helen was born to care for him, and so I went. Plus, I felt at least partly responsible for Laurie being in labor at home without meds since I had told her how great giving birth at home was about 1 million times. I was also very excited that Scott had called because I thought I could be helpful and really wanted to be there.

I could never possibly describe it fully, but seeing a woman in labor is incredible. The moment it starts, everyone knows what the ending will be - a baby will be born. But nobody knows how long it's going to be, what twists will happen, or how many special moments will be recorded along the way. I should point out, that I'm one of those people who thinks it's just amazing that a tiny seed can be planted in the ground in May and a couple of months later a tomato will be there. So you can imagine how amazing I think a little human growing inside a person is.

My mom gave me some great advice about weddings one day. She told me that there was so much hulabaloo leading up to a wedding, that by the time it comes, it can go by so fast that the actual day doesn't end up being nearly as glorious as it seemed it would be with all the planning. I'm not sure she would remember saying this, but it was at the time my sister's wedding was being planned and I remember it. When my own wedding came, I decided I was going to take my mom's advice (which I believe was to focus on the event, not the details) and enjoy that day to the fullest. After Ed and I hired people we thought would make a good contribution to the day, I refused to manage any small details. The day of the wedding, we were having photos taken at the reception site and the maitre'd asked me a couple of questions about details (I believe they had to do with placement of salt and pepper shakers, and possibly about when the bar would be open). I remember telling him "I'm sorry, I'm not going to answer any questions. Ed is in charge of all wedding day details. I'm sure your instincts on this are better than mine anyway." I said this not because Ed cared at all about any detail (except that the bars be OPEN at all times), but because I knew there was no way the maitre'd was going to bother Ed, so I was freeing the maitre'd up to do his job, and he wouldn't have to worry that I was going to have a meltdown because some tiny detail wasn't perfect. It worked perfectly. The maitre'd never asked Ed anything, and by avoiding concerning myself with any particular detail, I have no memories of anything going wrong, and I have a ton of fabulous memories about the day. I wouldn't change a thing. Not because it was perfect, but because everything important turned out perfectly. I really felt like a guest at my own wedding rather than feeling the need to orchestrate anything.

A child's birth is also something that should be remembered like a wedding. And similarly, you spend a lot of time planning for it - both in the conception phase and then during pregnancy. The problem is, you can't offload caring about details - particularly when you give birth at home. In short, your partner can do an awful lot, but he's not the maitre'd of the event. He can help make sure there is adequate food and liquid in the house. But only the laboring woman knows the right time to call the midwife and birth assistant. Most importantly, nobody can labor for you. In short, I would've loved to be a spectator at both of my births, but I was so focused on conserving energy and getting through the pain, that I couldn't really sit back and take in all the little things. Other people could, and did, but I was working really hard. Certainly I had a few moments at the beginning to be in awe "holy cow! I'm having a baby!", but once the serious business of labor began, there was no pause button.

So to have the opportunity to watch someone else's labor was very cool. I got to really marvel at all the little moments, but I wasn't in pain. I could provide support for Laurie and Scott, but after the contraction happened, I didn't need to start gearing up for the next one. Instead, I could sit back and say "wow - that's amazing. Your body is really working hard." I am so grateful for that experience. I finally understand why midwives do what they do. The hours are terrible, it can be hell on a family, and I suspect the pay is mediocre - but catching babies is meaningful work. And, my own bias is that doing this in a home setting is the most meaningful of all because the midwife, birth assistant, friend, whomever the laboring woman invites - enters the room with the laboring woman on her terms. So the contribution of being the midwife at a home birth is really crucial. She might be the only person with substantial medical knowledge around.

I went home to feed Helen once during labor, and then when it was getting really late, there was a moment when all of a sudden Scott went from sort of being on the outside worrying about Laurie to totally getting what his role was, and at that point, I went up to Laurie and told her everything looked great and I went home. Scott called once more when apparently Laurie was screaming at the midwives and had definitely hit a wall. I was feeding Helen though, so it took me some time to get over there. I waited to make sure Helen was all the way asleep before I headed back, and this was a mistake because I missed the actual birth by 4 minutes. But, it was still so cool to have been there earlier and to share a few moments with Laurie right after she'd given birth. I will treasure these memories always.

The next day, I told Ed I needed to be a midwife. I told him there was a 3 year Masters program at Georgetown for folks who weren't already nurses. I was totally ready to sign up. Ed is a very smart man. He would never tell me "you cannot do that". After all, he knows that I can be stubborn. Possibly my sister telling me I could never give birth at home is what kept me there when I had serious doubts with Connor and for a few moments, buried my head in a chair and thought to myself that I was never going to make it because it was SO.PAINFUL. But as soon as those thoughts entered my head, I knew transferring to a hospital would mean my sister was right and I was wrong about giving birth at home. I wasn't about to call her up from the hospital and tell her I was waiting for a baby to arrive while my anesthesiologist gave me an epidural. Nothing wrong with hospitals and epidurals - but I had told my sister they weren't for me and I wasn't backing down. So instead of telling me he wouldn't support me becoming a midwife, Ed said perhaps I should give it a little time, maybe become a birth assistant or doula first. I still think about it, but I am not nearly as convinced as I was that I need to be a midwife - though I do think I would be good at it and if I knew what I know now back when I was choosing careers, I would be a midwife now. The high of witnessing birth, was really high.

And then came the cruelest low. My cousin's daughter, Sadie, died after a two year struggle with cancer. Kids are not supposed to preceed their mom in death. It is not right, on any level, and there is no possible explanation that I will accept for this tragic event. If you find comfort in the thought that your god has some grand plan and this is all part of it, then your god is not nearly as merciful as my god. My god would never have a mission to prove something by ending a child's life. Which is just a very direct way of saying that I am unable to gloss over this loss with any supernatural explanation. I am, however, very hopeful that the next dimension will be much kinder to Sadie than this one ended up being.

I often wonder how my cousin manages to get through each day because I'm not sure I could handle losing either one of my children. I did not know Sadie well - only met her a few times at family reunions. My cousin kept folks updated on what was happening with Sadie, and I certainly cheered when good news came and sent all the good karma I could muster toward her when bad news came. The image I hold of Sadie is this unbelievably gorgeous Christmas card my cousin sent that featured 3 super cute photos of her 3 kids before Sadie was diagnosed with cancer. I often think of those photos when I think of Sadie because for me, it just shows how fast things can change. Nobody who received that card could've guessed that they wouldn't be receiving a similar card every year until the kids were teens and too concerned with their image to be the focus of the family Christmas card.

The take away lesson from both of these experiences? Kids are amazing. My kids are particularly amazing. I worked from home one day a few weeks ago and when I went upstairs for lunch, I looked out back to see Connor and the au pair playing in the sand and Helen sitting under the magnolia taking it all in. All I could think about was that I had no idea how many more days like this were going to come. My very flexible employer allowed me to cut my hours back again. I asked to do this because I don't want to miss too many days with my kids while they still think I'm really groovy. Ed has adjusted his hours, too, and he's home almost every day by 4:00. I don't know how long this will last, but I'm going to enjoy it while it does.

Elaine

Happy Three Month Birthday!

Dear Connor,

Today, you are three months old. That means you have been living outside of my body for 92 days - and I assure you I can hardly recall what it was like before you came. That's the beauty of learning how to get along with a minimum amount of sleep and having my heart find out how much it's possible to love someone. My brain functions at a minimum necessary level from the sleep deprivation and my emotional state is one that focuses on what a great person you are. The other day, I even heard myself telling a friend how childbirth was easy - at which point Ed looked at me like I had gone completely insane. I guess that's something else a mom's body does as soon as possible - forget the pain it takes to bring babies into the world. By the way - it's painful, though in my case is didn't last too long. And hey, I was at home surrounded by love.

You celebrated this 3 month milestone by abstaining from naps today, despite near heroic efforts on the part of your dad and me. Finally, I slept with you, but even then you only made it about an hour. At present, I'm attempting to nurse you to sleep which usually doesn't take that long, but who knows when you will finally drop tonight. I guess this is what everyone was talking about when they said that much of parenting was two steps forward, one step back. Hopefully tomorrow you will remember how you are a much happier baby when you sleep!

You've learned to make a new sound - it's a high pitched squeal (not associated with pleasure) that your dad told me about but I didn't actually believe until tonight. Wow - that'll get attention every time. Your dad also claims you winked at him today, but I'm not sure I believe this either. You have also started pooping on a daily basis - which is OK, but frankly your dad and I were getting used to and enjoying your 6 day cycle that you have been on since week 4 when Mims and Pappy came to visit and I couldn't believe that you didn't poop for a whole week. Both pediatricians in the practice we go to assured me this was normal, as does the Baby Handbook that Heather sent me. But still, once a week? But I guess all good things come to an end because you've pooped daily for 4 days now. Still better than the babies who poop after or during every feeding, but the 6 day pattern was great once I stopped worrying about it.

Today's photo shows those hands of yours. When you couldn't get your own fingers into your mouth earlier today, you pulled my thumb in. You seemed to enjoy sucking on it for a while. And hey, I thought it might inspire you to sleep so I didn't mind it. No such luck, but it was worth a try.

We tried the stroller out again today, but you still prefer to be carried. And, this doesn't seem too irrational to me since you're stuck looking at the sides of the stroller laying on your back until you're big enough to sit upright in it. Maybe next month...

You're drifting off to sleep now, so hopefully you'll sleep once I drop you in bed.

Love,
Mom