Eating Disorders and Postpartum Depression

Researchers appear to have found a strong link between a history of bulimia and postpartum depression. An easy-to-understand article summarizing the survey results is available here and the results themselves are available in the International Journal of Eating Disorders.

Obviously doulas can mention this to their clients, particularly if you know your client has a history of binge eating. Few clients will disclose that, however, so it can also be included in a general discussion of the many factors that can elevate one's risk of PPD.

Let It Bleed

I've been thinking for a few days about what, if anything, I have to say about the idea of using contraception to cease menstruation completely. My immediate reaction is that there is something fundamentally wrong, something of playing god, with putting an end to monthly bleeding, especially for no other reason than convenience. I tend to stand by the idea that evolution has honed our bodies to a darn fine point and we really should not try to modify that.

But then I've never had menstrual cramps. Nor anemia. Nor bleeding that lasts for more than a week. Any of these conditions would no doubt color my view.

If, however, one's primary motivation for manipulating their hormones is to stop the inconvenience of monthly bleeding, then I do not support it. Feminists might say it is liberation from one of the curses/emblems of women's reproductive imprisonment. But is it not also feminist to bleed and be proud of it? To see monthly blood as a mark of distinction? After all, when are women most at their peak of power and ability? Not as pre-pubescent naifs. Nor as aging (however gracefully) crones. My guess is that 95% of women moving and shaking our world are in the midst of their menstruating years.

I think a lot of the "inconvenience" of periods -- at least routine ones; I'm not talking about the debilitating cramping and bleeding -- is cultural, and much of it is dated. When our mothers were younger, it must have been unpleasant to wear the elastic and metal belts and pads. [Indeed, women who deliver babies at one of the local hospitals get to experience this "retro" style after delivery, when the nurse comes in with the belt and pad]. They had to refrain from swimming because their blood would still flow.

But what of it? It is only the social horror at a bleeding woman that would make swimming without a tampon distasteful. For that matter, why not just "flow" all the time? Why sop it up with rags? Practicality, yes. But also something more. A shame, a need to keep it hidden.

If we were truly liberated about our periods, we could walk around with blood stains on our thighs and be self-conscious only to the point of pride. "Yes. I am a bleeder. As my legs show."

Imagine actresses walking up the red carpet at the Oscars advertising their youth, vigor, fertility with a tiny trail of blood.

In such a culture, if women still felt it was necessary to stop their periods, I would be more sympathetic. Then it would be about their physiology, not their society's cultural norms.

Not above Tooting My Own Horn

I ran a 5K race today and was pleased to clock a finishing time of 26:48. It was good enough to put me just barely in the top 10% of finishers overall and ninth in my age group. It did not put me in the studly company of the 69-year-old woman who ran 9:48-minute miles or the woman ten years my senior who ran it a full six minutes faster than I. But for someone who wasn't sure if she would finish in less than 30 minutes, it was enough to keep me chattering happily for the full ride home.

Honorary Birth Support Dream Team Member #4

If you don't, as my Brooklyn-raised father-in-law says, "know from" Bruce Cockburn, go educate yourselves. As to why he should join the ranks of my birth support possee (here's info about members 1, 2 and 3), just listen to the man's music.

I was once at a birth where the mother's friend came and brought a lyre harp with her . The woman played FOR FIVE STRAIGHT HOURS! Talk about friendship. It was so beautiful to have this sweet music in the room with us as the mother labored along and brought her baby into the world.

If that sweet music was coming from Mr. Cockburn's guitar? Well let's just say there'd be a lot less need for pain-relieving medication.

This past weekend Cockburn (that's "co-burn;" not "cock-burn," which is the pronunciation the sad woman introducing the session used) was in town, along with Cathleen Falsani, whose book The God Factor was recently released. Falsani interviewed Cockburn during a session at the Ann Arbor Book Festival. She interviewed him about God. And about god. And spirituality, and worship.



Not my usual cup of tea, but if Bruce Cockburn is a Christian, I at least needed to hear his views on the subject. Perhaps his Christianity was one I could buy in to.

Though the interview did not make Christianity, or even Bruce's Christianity, any clearer, I still appreciated his thoughts. I was not disappointed in my assumption that, whatever his beliefs, they are open to revision and inquiry. That his path has included exposure to/study of Buddhism, Kabbalah, Sufi texts, yoga and meditation as well as the Bible, gives him a lot of credibility in my book.

But I'll be honest. I went simply to see Bruce Cockburn in the flesh. My husband and I have a shared adoration of the man. We have seen him perform several different times, driving 2-3 hours each time to do so. We own six or seven of his albums. We occasionally talk about how he should hold a summer retreat or camp, which we would attend, where there'd be lectures on various humanitarian topics and a nightly campfire sing-along. With Bruce, of course.

I had not realized this, but when you've only ever seen an entertainer on stage, you simply can't imagine her or him anywhere else. So to look a few rows up in the lecture hall and see Bruce Cockburn standing there -- no security guards, no stage elevating him over the rest of us, no curtain keeping him hidden until the last minute -- dissolved all the mystique. Not all. He's still an amazing talent. But suddenly I could imagine having him for a neighbor and seeing him shuffle out in a beat-up robe to pick up the Sunday paper. Or being a dad on the elementary school playground, politely chatting while keeping an eye on junior. I didn't, but I could have easily gone up to the front of the auditorium (short walk -- I was already in row 3) and, like, hung out near him. Asked a question or two. Told him how much I loved his music. Stupid stuff like that.

Instead, I harassed Falsani, who was very patient and quite thoughtful about her own spirituality.

[I know this post is completely rambling and really without a point, but bear with me. This is big emotional stuff to process, this almost-meeting someone you hero-worship!]

He was so humble and human and accessible that I stood outside the building for a good ten minutes debating whether to walk back in and invite him and Falsani to dinner. My guess is there was a 50% chance they'd come. My husband was not going to do the asking, but he didn't say I SHOULDN'T ask. So we stood in the drizzle and pondered what to do.

The more we discussed it, however, the more we felt like there was a good chance that even if they accepted the offer, it would still suck. Remember the Chris Farley Show on SNL? It would be like that:

Me: Bruce? You know that song? Lovers in a Dangerous Time?

Bruce: Yes?

Me: That song is SO COOL!

Husband: And what about the recording of it with you with Rob Wasserman? That's awesome! Didn't you record a version of "Cry of a Tiny Babe" with, like, Lou Reed? Lou Reed KICKS ASS!

Me: And, hey? Don't you totally care about the environment and human rights and stuff?

Bruce: Yes, I do.

Me: Wow. Me too.

Husband: So, Cathleen? You just, you know, got a book published?

Cathleen: Yes.

Husband: Excellent. I totally want to do that, too.

Me: I'm a doula, Bruce.

Bruce: Mm-hm.

Husband: I'm a graduate student, Cathleen.

Cathleen: Mm-hm.

Me and husband (to Bruce): We think Canada is pretty cool.

Husband (quickly): And Chicago, too, Cathleen. Bruce? What about Jack Layton. Why didn't you vote for him?

You can see why we decided to just fade into Ann Arbor anonymity. The risks were too high.

Which does not mean that we DON'T have interesting thoughts of our own about spirituality or that we COULDN'T carry on lively conversation with an internationally renowned musician and an up-and-coming author/journalist. We just need a little practice first.

Instead we met our friend, also a thoughtful poet and musician -- great for practice, for a delightful tapas dinner.

Abuse and Healing

Last week the Center for the Childbearing Year offered another great presentation in its "With Women" series. This one was on working with women who are sexual abuse survivors. All new terrain for me and so sad to confront. What stuck with me most was this factoid: Of all the things a woman is at risk for in pregnancy -- gestational diabetes, preeclampsia, etc. -- what ranks highest is physical abuse. Can this be true? More women are abused during pregnancy than confront any other "complication?"

The presentation covered a lot of ground. The most useful "take homes" for me were:

• If a woman discloses past abuse, don't put her back in that time ("Oh how awful that must have been...what a bad person he was...); rather, focus on what you can do in the present to support her through labor and avoid or minimize her triggers.
• To the degree possible in our mobile, home-visit profession, create at atmosphere that conveys support to abused women: include information on how to report and get help for abusive situations in your handouts, use a canvas bag or display buttons that condemn violence against women, etc.
• Ask a woman in a safe time and place whether she has been or is being abused. Honor her response, whatever it is. Some women may not be ready to confront past abuse. You can not and should not try to coax them into a "confession" they are not ready to make.
• Remember that doulas are trained in labor support not counseling. Aside from honoring the woman's history and present situation, we can also provide referrals to individuals trained to help abuse survivors and victims. Having a pre-made contact list for area counselors, the SafeHouse and other support options is a must.
• Remember confidentiality: just because a woman has disclosed abuse to you does not mean her doctor, family, partner know about it. Before talking with anyone about this, ask her if you have her permission to do so.

After all this heavy material, I was all the more happy to end my night on a high note. Also in attendance at the session was the nurse who was my hero at this birth. This is the nurse who stood up to a horrible doctor to protect my client's integrity, not to mention birth sanctity. Afterward I went up to her to say how she's been in my heart these two years. I was ready to retell the story, but as soon as she saw me, she broke into a smile and gave me a big hug. We didn't need to say anything. We both knew which memory united us.

In the parking lot we revisited the birth a bit and updated each other on the cast of characters. As with good fiction, some individuals grow and learn. Others do not. My client is seeing midwives for all her OB/GYN care now. She is an advocate for doulas, for good nurses and for the midwifery model of care. The doctor from the birth continues to practice as she was then: alone and unsure of women's ability to give birth.

And the nurse? She is studying to be a midwife through the Frontier School, having decided any training she'd get around here would be too clinical. I couldn't have imagined a better ending.

Male doulas: the few, the proud

Here's a nice article on a "dude"la. Nothing new on what he does, just that he does it with a pair of testicles.

PSA from the Center for the Childbearing Year's Fundraising Chair

If you live near Ann Arbor and want to direct a few dollars to the Center for the Childbearing Year, please patronize these businesses, which have committed to donate a percentage of sales from customers mentioning the Center:

NICOLA'S BOOKS
Donating 5% of sales
Monday, May 8 — Wednesday, May 10
2513 Jackson Road, Westgate Shopping Center

NORTON'S FLOWERS
Donating 10% of sales
If ordering by phone (734-434-2700), mention code "CCY"
Note: cannot be combined with other offers.
Wednesday, May 10 — Saturday, May 14
3 locations:
2900 Washtenaw Avenue
2577 Jackson Road, Westgate Shopping Center
2709 Plymouth Road, Plymouth Road Mall

LEARNING EXPRESS
Donating 20% of sales
Monday, May 8 — Thursday, May 11
2465 W. Stadium Blvd., Westgate Shopping Center

Better yet, print out this document [PDF] and share it with friends and family!

Birth of a Doctor (of Philosophy)

Yesterday I had the pleasure of attending a former client's dissertation defense. Better still, its subject was middle class American women's experiences of pregnancy.

[caveat: I am not an anthropologist nor familiar AT ALL with anthropological theory. What follows is my lay-person interpretation of her and her committee's comments]

In particular, she looked at pregnancy through the lens of kinship theory (i.e. family-making writ large). Apparently there are several ways kinship is established, or hypothesized to be established. One is biology and biogenetics, commonly thought of as shared genes or bloodlines. Family is family because they share lineage.

A more interesting approach, however, is the substance of kinship as developed in shared rituals, customs, interactions, etc. In this way, pregnancy can very much be a vehicle for kin making. Pregnant women may ask for advice from other family members, receive gifts from the family, invite an extended family to the birth and in other ways bring the baby into the fold of its kin.

One thing that arose in this woman's research was the centrality of one's own body and bodily experiences to the process of kin-making. From "belly talk," when pregnant women and their partners talk to the growing fetus, to sensations of fetal movement felt internally by the gestating mother and externally by her partner and larger family, the body becomes the conduit for relationships.

The committee was extremely positive about the dissertation. They called it "ground breaking." Apparently American pregnancy is not well-studied, at least in an anthropological sense. And especially pregnancy as a joyful and empowering experience, not an experience of subjugation by the patriarchy. The committee compared this research to that of Robbie David Floyd (!) and said it would make a great book with contributions to the Anthropology of Reproduction, Medical Anthropology, Gender Studies (not least because fathers' experiences were included) and the Anthropology of Consumption (because we Americans are so good at incorporating "stuff" into the process of becoming parents).

What a treat to see one woman at the peak of two creative events in her life: her child's birth and her dissertation's defense.

Even more encouraging is the fact that a fellow student in her department is looking at breastfeeding and infant bonding through a similar bodily analysis.

Our pregnant lives and bodies are entering the academic literature as objects of power and strength, givers of life, sources of joy. Thank you and congratulations Ms. Newly-Minted Ph.D.!

When doula work, running and knitting converge

Some time back I asked someone to design bedsheets for reading, that have sleeves in them to keep one's arms warm. Well since I have begun knitting I have starting thinking about a garment that would be half blanket, half sweater and would serve the same purpose: keeping one warm while sitting up in bed and reading.

Most of my thinking about the design of this item takes place at night or when I am running.

Last night I had a little Eureka! moment at about mile two. I realized this garment could also be made with nursing slits in it! I always froze when I brestfed in the night. This would keep the body and arms warm while providing the baby access to her food! Brilliant!

I am on a self-imposed boycott of all yarn stores until I visit my in-laws in June (my MIL is a knitter and has promised to both let me raid her huge stash AND take me to a great yarn store in the Adirondacks). I discovered I was spending A LOT of money on yarn. So for now I am sketching plans and contemplating optimal yarns for "Bed Jacket Nouveau," as I'm calling it.

If it can successfully knit one, I'll be sure to print the pattern here (I'm all for free patterns) as well as the "leche" version.