Thursday, November 20, 2008

Individuals can make a difference after all

I was pleased when Ricki Lake released "The Business of Being Born." But I had more reservations than many of my birth colleagues, who seemed to think the movie would spark a renaissance in attitudes toward labor and delivery in the U.S. Surely the movie would draw a crowd of converts like myself instead of women unsure about or wholly skeptical of non-medicalized birth paradigms. Surely an Obama rally would draw only the Democratic faithful.

Or would it? We have a liberal president for the first time in 8 years. And apparently home birth rates are up in New York. Not only that, they're appealing to new classes and cultures of women. Says the article, "Home birth professionals in New York City have been the fact that the increase is coming not so much from the dyed-in-the-wool back-to-nature types as from professionals like lawyers and bankers."

Moreover, "One reason for the change, it seems, is “The Business of Being Born,” a documentary produced by the actress and former talk show host Ricki Lake, which ran in only a few theaters during its theatrical release in January but has become an underground hit among expectant parents since coming out on DVD. "

I stand corrected. Ms. Lake, I apologize for my cynicism. You made a movie to "educate[ ] people and empower[ ] them to really know their choices in childbirth." Darned if it doesn't appear you did just that.

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Tuesday, November 11, 2008

More personal recriminations

Last Friday I went to a fundraiser for our local volunteer doula program, Doulas Care. It was very nicely done. I am hugely impressed by the amount of work that went into it. I know most of the employees and volunteers, so my gratitude is quite specific.

The evening was a delightful mix of socializing with birth colleagues , browsing silent auction items, and tasting wine. They had live music and a caterer. There were twinkle lights everywhere in the renovated barn where the fundraiser was held. It was quite enchanting.

I left with a high, great feelings for the increased awareness I've seen about doulas and birth in the last 5-6 years. I felt a sense of unity with these women and men who are committed to the same cause. I was affirmed by shared stories of births gone well, and women empowered.

By the next day, I was thinking again of this article a friend posted on his Facebook site. It's about maternal mortality and the persistence of high death rates among women in poor countries. The article has an accompanying slide show.

Between the images of spartan delivery rooms and descriptions of deaths that would be so easily prevented in developed countries, I realized how different the global issue of birth is from what I confront here in this little corner of Michigan. Yes, we have poor women here. Yes, women start labor without a minute of prenatal care. But there are places where they can be brought for safe delivery and recovery.

Insurance is, of course, its own issue. But if someone is hemorrhaging in this community, she will be given a transfusion at a hospital.

I was reminded again of a midwife friend who left the area saying she was "tired of these Ann Arbor women and their fancy birth plans." It sounded so cynical at the time. These were the women who were seeking her out for the amazing birth experiences of which she was so often a part. We needed desperately needed her and her birth philosophy here. How dare she leave.

She went on to work in rural Latin American countries and on American Indian reservations. Her patients were not concerned with whether or not they could birth in the squatting position. They were hoping, especially in Central America, simply to survive the experience and return home with their child.

I've thought about this before and come down hard on myself. On doulas generally. Aren't we all just birth junkies fortunate enough to have found this mechanism for getting to be present at birth?

Hopefully the answer is no. I think it is no. I think we want women to have a positive birth experience. Thankfully, in much of the developed world, fundamental questions of survival are largely taken for granted. We doulas arrive on a scene that has the luxury to focus on the smaller details: informed choice, minimal psychological trauma, enhanced bonding. But I suspect that if we were in a culture where birth was a dicier proposition, we would do what we could to assist on that level: lining up blood donors for each woman in advance of birth, helping women get to care, providing care to families in the event of loss.

It is a spectrum. We are fortunate to be on the more luxurious end of it. But we would serve even if we were not. Wouldn't we?


Monday, November 03, 2008

Paying a Premium to be Female

An editorial in today's NY Times called attention to the fact that women often pay more than men for the same health care insurance coverage. They are also excluded from eligibility by conditions that are uniquely female: having had a c-section for example.

The editorial mentioned that women fortunate enough to obtain coverage may find that maternity care isn't covered. I would add that even those policies that cover maternity care do so only when it's provided in a hospital. Ixnay on the omebirthhay.

This type of information is rarely surprising. Last week our office was buzzing about a study that said heterosexual marriage added seven hours a week of work to the woman's load and decreased the man's by two hours. My colleagues appreciated confirmation of what they felt to be true, but no one found the study enlightening.

Similarly, are we surprised health care is a little harder to get or pay for by the women in our society? Sadly, no.


Sunday, November 02, 2008

More grounded, no less busy

Time flew. My self-imposed hiatus is over. I found four items to flag for my "doulicia fodder" favorites folder. I got my legs under me at the new job (and what a pleasant new place it is!). I saw a doctor about my sore Achilles tendon and received a diagnosis of tendonitis, for which I begin physical therapy this week. I spent a gorgeous evening passing out Halloween candy from our front step and watching bats swoop over our house.

Now, November. A work colleagued had a baby, her first, last week. She called to say everything went "really, really well." I haven't heard the details of what that meant to her, but I am glad for her happiness.

Another colleague told me she was pregnant last week. We have in common a friend, who is also a former client. Small world.

This Friday I'll be going to a fundraiser for the Doulas Care program, our local volunteer doula service for low income women. I'd like to say I'm generous enough to be one of the volunteer doulas. I'm not. At least not for now. But I have served on the board of Doulas Care's precursor organization, and provide what financial support I can.

I'm eager to post and reflect on the issues I flagged. For now, I'm just getting back in the groove. Hi.