Seattle Yogini

My Line in the Sand

This week’s hoopla over Rush Limbaugh’s outrageous statements regarding a female Georgetown law student has really gotten under my skin. I know, I know, that was his intention - to stir the pot, so to speak. There’s a lot of important discussion arising from this media stunt, and I think it’s awesome that so many people have come to Ms. Fluke’s defense (including President Obama and the President of Georgetown University).

BUT...

What Rush Limbaugh’s statements have made clear is that there continues to exist a segment of our society that sees women’s sexuality as something to be controlled or, if uncontrollable, then vilified by men. The word “slut” is meant as a derogatory comment about a woman who is known or believed to have sex - sex outside of marriage, in particular, but also women who have “lots” of sex, or “lots” of sex partners. There is no male equivalent for this term (people have, however, begun to use the word to comment on both sexes’ behavior). The word is at the forefront of misogynist language.

It is unacceptable that in this day and age we still have to argue that women have every right to a full and satisfying sex life, regardless of our relationship status. Women who use birth control for contraception are using the best tool available to them to control their reproduction regardless of their partner(s) willingness to contribute to the effort. (I think/hope it is clear by now that hormonal contraceptives have many health applications aside from contraception, and that many women take them for health concerns other than contraception.) Sexually active women cannot rely on male partners to “protect” them from unwanted pregnancies. That is why the pill is so popular as a woman-controlled contraception option. This makes women more responsible, not less. This makes women more mature, not less. This makes women more aware of the calculated risks of sex, not less. Being on the pill has no bearing on a woman’s morals, ethics, or sex life. It is a life-changing (and sometimes life-saving) drug.

We know that the number one contributing factor to whether a woman will get more education, have a better-paying job, and generally do “better for herself” in life is whether or not she has children, at what age, and if she is a single parent. Birth control facilitates women's potential to have full, satisfying lives that include sexual intimacy, while lessening the risk that an unplanned or unwanted pregnancy will prevent her from attaining other goals in her life.

And so it is that I once again find myself gobsmacked in the face of such blatant sexism. I am flabbergasted by the political rhetoric that seems hell-bent on pulling our society back into the mid-20th century. Aspirin between the knees? Public use of the word “slut” to describe...anyone? Genetic screening as a mere invitation to abortion? Women AND men who feel that such comments are an insult to adult women (and our families) must take a stand in the face of this recent, public wave of misogyny.

I have drawn my line in the sand. How about you?

What's the difference between a Doula and a Licensed Midwife?

There seems to be a lot of confusion about the difference between a midwife and a doula. It's simple, and very important:

A doula is a professional labor support person who offers physical, emotional, and mental support to the laboring woman (and oftentimes her family) from as early in labor as the woman wants it until the new family member is settled in and nursing. This is a great job and a wonderful service that improves birth outcomes (studies show this to be true).

A licensed midwife is a professional, licensed healthcare provider who can carry and administer some drugs (i.e. Pitocin to stop a hemorrhage, Penicillin, IV bags), perform some minor surgical procedures (such as sutures if the mama has a tear) and, of course, "catch" the baby or help mama or papa to do so.

The midwife, like the doula, offers emotional, physical, and mental support BUT in addition s/he is the professional person who is responsible for the health and wellness of mother and child. The midwife does all routine antenatal care (tracking vital signs, watching for signs of increased risk that may require a referral or transfer of care to an OB, counseling regarding nutrition, exercise, and whatever else the woman needs to discuss, labor progress checks, as well as newborn care through 6 weeks postpartum). Essentially, a licensed midwife offers routine antenatal care to healthy women having a normal, low-risk pregnancy in a way that encourages the woman to trust her instincts and remain "in charge of" her body and her childbirth process.

I am proud of my work as a doula, and being a doula should not be seen as merely a stepping stone to becoming a midwife. Being a doula is a time-honored profession of its own. Now that I am a student midwife, however, I find that many people seem to equate a doula with a midwife. Because a licensed midwife is a healthcare provider, the education, training, clinical skills, time, and experiences required in order to get licensed is exponentially more than the training required to become a doula. That isn't because one is better than the other, but because they are two very different circles of responsibility that, granted, have some overlap. What doulas and midwives certainly have in common is a desire to support women and families as they forge the new version of their family - with blood, sweat, tears, as well as laughter, smiles, and joy.

 

Living Alongside the Pain

Me in August, about one week after

I've been debating whether to write about this. Debating whether it's too personal, or too "much", or just plain TOO. It is a lot, what I am about to write. It might be a lot to read. I hope, however, that it can give some insight into the processes of grieving and healing...into what it's like to live through something to which few people can relate.

Six months ago today I almost died. Within the span of a few short hours I went into shock (due to internal hemorrhaging), found out that I was pregnant, that my baby was dead, and that I would die too if I didn't have surgery immediately. I signed consent forms and kissed my husband goodbye, because we really didn't know if I would come through surgery.

That's a lot.

Sometimes it feels like little bits and pieces, rather than one giant, traumatic event. The little pieces are easier to swallow, and to share: "I had a ruptured ectopic pregnancy." It sounds so clinical, so unemotional. Or this: "I had a salpingectomy." With that statement I can reduce the experience to the removal of a body part. It doesn't even seem as if another life was involved, or that mine was at risk.

Today, however, all of the pieces came together and the full reality of the experience knocked me over.

The grieving process is unique to each person, but the common thread is that it takes as long as it takes. And then, the process may be done, but like a scar the grief remains part of you...a part that rises up again sometimes - perhaps to remind you of your own strength. I'd like to think so.

Because that's the thing about grief - it doesn't go away, exactly, it changes quality over time. At first mine was raw and huge like a force of nature. My body ached with grief. Feeling as if I would burst, I wanted to roar. Sometimes I did roar. I came to understand the stories of women tearing their hair, their flesh. The grief was consuming.

Now it's like an irregular geyser, it springs up from my depths with no warning, refusing to be contained for another minute. It is still consuming, but only when it rises. I have learned to give it my full attention, even though every fiber in my being just wants it to go away, be over, be quiet, stop harassing me.

Some people like to say that life events such as these are "blessings in disguise". If that's the case, then all I can say is that the Universal Costumer should be fired.

Pain like this may, in fact, redirect our lives. Faced with such shock, one is likely to reevaluate a great deal. That still doesn't make it a "good" thing to have experienced. Calling it a blessing "in disguise" belittles the fullness of the experience and the complexity of human emotions. There is no kernel of good that was wrapped up in my fallopian tube bursting open because my baby didn't implant in the right place.

HOWEVER, like a wounded bird who flies once more, I know that good decisions have been made since going through this experience. And of course there's still good. I am alive, for one thing. My husband is not a widower. I am thankful to be alive.

There are many wonderful things happening in my life right now, but they are not because of my ordeal this summer, they are in addition to it. They do not erase the pain, they live alongside it.

Early Signs

Before the emergency & before the trip to Ireland, I completed a knitting project.  The details must remain secret until it is gifted, but I can tell you that the yarn I used was 100% cashmere.  You should be sighing right now.  Seriously.  Sighing.

Anyway, there was a little bit of the yarn leftover, and it isn't the kind of yarn a knitter can allow to go unused.  At the time, I was preparing to be a friend's doula, so I decided to use the nugget of leftover cashmere to make a baby hat for her newcomer.  It was as soft and delectable as you would imagine, and was received quite graciously by mama and papa.

It was also the start of a knitting spree.

To date I have knit ten baby hats.  Hats with pompoms.  Hats with stripes.  Hats with little dots of color.  Hats with a wee "umbilical cord" knot on top.

At the time I joked with family and friends that they shouldn't jump to conclusions - I wasn't pregnant, I was simply industrious, and possibly a little bit obsessed.  I had lots of small portions of leftover yarn, after all, and I was happy to put it to good use.  It only takes me 2 - 3 hours to knit a baby hat, so the instant gratification index was high.

When I was about six hats in, Rob asked what I planned to do with all of them.  We talked about opening an Etsy shop where I would sell only hats.  It'd be like the Etsy shop version of that glass cup lady here in town.  I would just sell the one item, but in many colors and with little embellishments.  I thought that perhaps I would open the shop once I had a baker's dozen.  Now I'm really not sure.

I'm not sure about a lot of things.

I knit each of these little hats with love in my heart, pouring through my hands.  A love for babies.  A love for knitting.  A love and gratitude for the skill I have developed over the years.  I had no specific baby in mind, and no idea that a life was trying to grow inside of me.  For my first two babies, I knit specific items:  a luscious yellow blanket bag for our first baby, a sweet little pair of socks for the second.  This time, though I was knitting up a storm, I didn't make them for my own baby.

It feels so strange - to know after the fact that I was pregnant - that I am no longer pregnant - to not have known the fact in its present moment and for it to be completely lost to me now.

It's strange to grieve the loss of something I didn't even know that I had.  As I mentioned on Monday, I feel grateful for that ignorance.  Since I wasn't temping and charting, I had no symptoms of pregnancy or pain to indicate the impending trouble, and I even had what I thought was a period at the right interval.  I really had no notion that I was pregnant.

And yet, I feel the loss so keenly.

Lost and Found

Saturday a week ago I woke up feeling like I still had a little bit of the indigestion I'd suffered on Friday afternoon.  It was much lower, though, and sharper, so I thought maybe I had really, Really bad gas.  Within an hour, though, it was clear that something much worse was happening inside of me.  I started to lose color, my lips were ashen, I was becoming listless and I was doubled over in gut-wrenching, stabbing pain.

Rob rushed me to the emergency room.

I was seen quickly, whether that was because I was showing obvious signs of shock or because I vomited gloriously while Rob filled out paperwork, we'll never know, but we were both thankful when I was called to triage right away.  My blood pressure was very low, and my pain so great, that I was put on an IV with anti-nausea and painkiller meds before any further tests were run.  It was around 9:30am, and after that things are very foggy.

I remember looking to Rob with tear-filled, knowing eyes when the doc came back with the first of my many blood tests:  blood serum pregnancy test was positive.  We were dumbfounded.  I'd had what I thought was a normal period just two and a half weeks earlier.  We weren't even "trying" anymore, not really.  I mean, we aren't trying to prevent pregnancy, but I'd given up on temping and charting and ovulation testing years ago.  We'd finally reached a feeling of reconciliation with the likelihood that we would never have children.  A positive pregnancy test, combined with this now-familiar pelvic pain could only mean one thing: another ectopic pregnancy.

I was rolled off for an ultrasound.  The tech was wonderful - kind, careful, very gentle, but my situation was so severe that the slightest pressure was excruciating and I remember trying to hold myself together as I gripped Rob's hand and cried out in pain.  It must have been horrible for him, and for the tech.  I knew that it couldn't be helped, I just had to endure.  I was so relieved when she said "Okay, I've got everything we need, I'm not going to put her through anymore of this."

We found out when the consulting OB came in to introduce herself and tell me that I was being prepped for surgery (nice to meet you, too, doc!) that there was a good deal of fluid in my upper abdominal cavity and what looked like an 8cm mass on my right ovary.  We'd treated my first ectopic pregnancy (same side) with a drug called methotrexate because I wanted to keep my fallopian tube and avoid abdominal surgery if at all possible.  Not only was that not an option this time - the mass was too big ("mass" apparently is easier for people to say than baby & placenta) and the tube had ruptured.  Even if that hadn't been the case, I would have chosen surgery this time because it was the second ectopic in that tube, and I just couldn't see going through the 6+ weeks of recovery that methotrexate treatment demanded of me last time.  I wanted the tube out.

So I was wheeled to the surgery floor with Rob at my side.  We were given horrible worst-case scenarios, asked to sign lots of papers, and ensured that they would do their best to leave as much of me intact as possible.  They just weren't sure what they would find when they got in there, or how much blood I'd already lost.  What was planned as a laparoscopic surgery to remove just the right fallopian tube might have to become a full abdominal incision to also remove scar tissue and/or a damaged ovary.  I might need a blood transfusion.  We didn't have many options, though, but to trust that the staff would continue to do their best, that God was watching out for us as always, that all would be made right and we would find a new normal.

Rob and I kissed, and tried to give each other reassuring smiles as I was moved into the OR.  They weren't messing around; things moved pretty quickly.  Once I was transferred to the operating table the nurse smiled kindly at me as she put the oxygen mask on my face, telling me to take deep breaths while the anesthesiologist put the "sleeping med" into my IV line.  That stuff works fast.

I woke up in recovery, with nobody there but two nurses.  The surgeon came and assured me that things had gone well.  She showed me some pictures of my insides, but I was really out of it and wasn't wearing my glasses, so I mostly just wondered why she was waving some fuzzy pictures of white blobs in front of me.  At some point I came to understand that the laparoscopy had been enough, I had three small incisions and one less fallopian tube, but my ovaries were both intact.

Rob was fetched at some point, either while I was transferred to my room or once I got there, I don't really know.  We were so happy to see each other.  The surgeon had already spoken with him, so he had the good news.  Now the nurses went to work getting me settled, assessing my condition, and managing my pain.  They were wonderful, and we felt so grateful that, as much as we try to avoid medical care, we have access to some really amazing technology, medical staff & facilities just a 5 minute drive from our home.

I stayed overnight, getting regular checks from the nurses & aids.  I'd been pumped with so much IV fluid that it had seeped into my lungs.  So I was given a drug that gets it out of the lungs so that it can be peed out.  My lungs cleared up pretty quickly, but as promised I had to call for the bedpan every half hour through most of the night.  Still, I preferred that to coughing, which was difficult and painful, to say the least.

This past week has seen a steady improvement with plateaus.  I came home on Sunday afternoon and we managed my pain with Percocet, which worked a lot better for me than the Vicodin I was given with the first ectopic.  The sofa was my daytime bed, so that Rob could easily keep an eye on me, help me to the loo, etc.  Also, I knew I'd get lonely lying upstairs in our room.  I was fairly out of it until Wednesday or so, but by Thursday afternoon I felt well enough to cut my dose of painkillers to just one (rather than two) every 4 - 6 hours.

It was around Wednesday that I started going for little walks outside.  I held Rob's arm and shuffled down the street, happy to feel the warm air and sun, the refreshing breeze.  Exhausted after one block, Rob steered me back home to my sofa station.  By Thursday I could stand a little more upright.  By Friday I didn't feel the need to hold one arm across my belly, as if holding my innards in.  By Saturday it was no longer a shuffle, but a slow, steady (albeit ginger) walk.  Today I got to go out for lunch.

I get to see the surgeon for a follow up next week.  I'm making a list of questions, which - thanks to my area of study - is extensive.

As with so many of life's events, this experience is full of contradictions.  We suffered some obvious losses:  the loss of an unexpected pregnancy, and the loss of a fallopian tube.  What has surprised us, however, is what we have gained.  I have an enormous sense of gratitude, not only for things like excellent emergency medical care, but for life itself, for MY life.  I also feel relief, that I never have to go through an ectopic pregnancy on my right side again, that we now know the cause of the ectopic pregnancies (it appears that the tube developed improperly), that my left tube looks healthy and good.  I feel sad that another baby was lost, but very grateful that this time we were blessed with ignorance, which didn't offer us any time to get attached.  For the first time in years, I feel hopeful with regards to pregnancy possibilities.  The whole experience was shocking and violent but we received tender, compassionate care.  We feel utterly alone in our grief and yet our loved ones are showering us with so much support and love.

We're doing our best to focus on what we have found through this experience.  What we have found within ourselves and what we have found in other people - strangers and loved ones.  After all,  we all must choose where to focus our attention, and I believe in focusing on the positives.

Trimming Waaaay Back

During the many years of trying to conceive, I purposefully allowed my body to become "fluffy".  I feathered my nest, so to speak, wanting to not only have a healthy amount of body fat but also because I felt that, for me, a slightly softer, rounder figure was more welcoming to the energy of "mother".  I have a history of heavy-duty exercise and even a short period of my life during which I starved myself.  Coming to a decision that would allow my body to expand and soften was a very big deal.  Indeed, much of it had to do with letting go of the need to monitor and control my body so very much - particularly since the baby-making efforts (temping, charting, vitamins, surviving and healing from two lost pregnancies, etc.) were exhausting in much the same way that dieting and over-exercising are.

While our hopes for a baby have not completely waned, our participation in the baby brigade has.  No more temping, charting, and I only sometimes remember to take the folic acid (gasp!).  Life is good, and we're slowly but surely feeling better and better about our shift in focus and energy.  We both have time off this summer, and we're using it to rest, recuperate, and reinvent ourselves after five years of baby focus.

To that end, on the first day of summer I cut off all of my long, beautiful hair.  I grow a great head of hair - it's thick but not coarse, wavy and easy to curl.  It was a few inches past my bra-line, and it hadn't been dyed or over-styled.  It was beautiful, but truly felt that it was no longer serving me.  One of the reasons I'd grown it out was this feathering of my physical nest, which no longer felt applicable or appropriate.  Cutting it all off and starting fresh was an easy decision, as was donating it to Locks of Love.

The before pictures (click to embiggen):

  

The during pictures:

              

The after picture:

Each ponytail was about a quarter in diameter.  That's a lot of hair for a child's wig, and I'm so glad that it can be put to such a good use.

The final style is a pixie (not the bob you see above), but I don't yet have a good picture of it.  So you'll have to use your imagination and be patient.

This reinvention also involves a serious return to fitness activities (not merely the "making do" that I was doing during the school year).  To that end, I will post a weekly wrap-up of my dedicated work-out time at the end of each week.  I'm good at being accountable to myself, but I'm also proud enough that I don't want to have to share a lame list at the end of each week.  Making myself post it here should help me stay on track.  If you want to join with some reinvention of your own, I'm using the book, The Female Body Breakthrough, which - having weight-trained for many years - I highly recommend.

 

Cross Post

Have you ever wondered what support a doula can offer during a cesarian birth?  I've written about it on my birth-related blog, Prenatal Yogini.  Check it out!

Pregnancy and Neck Pain

Today's post is on Prenatal Yogini, where I've offered some recommendations to alleviate neck and throat tension during pregnancy, and insight into why a relaxed throat is so important as labor draws near!

Standing Poses During Pregnancy

I posted on Prenatal Yogini today.  Learn how to take care of yourself (or your pregnant students) during a standing pose practice!

A Baby Catcher is Born

 

One of the realizations I made during my springtime quietude was that it is time for me to become a midwife.  On some level I have known this for a long time, but I didn't want to know it.  I thought it was the forgotten dream of an ardent eighteen-year-old, no longer applicable to my life.  It was at that age that I first learned about some of the common interventions used in childbirth.  I was appalled, and outraged that birth seemed to have become something that happens to women, rather than something that they themselves do.  I wrote a paper for school entitled, "The Dangers of the Medicalization of Childbirth" (this was in 1995) and learned about the midwifery model of care, which views pregnancy and childbirth and normal and healthy.  Then I realized that I didn't actually know any midwives, it was illegal in many states at the time, and I had no idea how one became a midwife.  I wasn't interested in becoming an activist, I wanted to be a midwife.  I shrugged off the fleeting dream of what I might do when I grew up and continued going about the business of being a college student.

And yet...my course of study continued to focus on women, empowerment, the body, health, reproductive issues and rights, sexuality education, and eventually Purna Yoga, specializing in prenatal yoga, and becoming a doula.  This move to become a midwife feels like a development of, not a diversion from, my current work.

This morning on our local NPR station the topic of the 9am show is Natural Childbirth.  The ad stated that less than 1% of couples choose a non-medicated, little to no-intervention birth (they didn't state whether that was local, state-, or nation-wide).  That means that less than 1% of childbearing women have faith that they can do this thing that our bodies are, with few medical exceptions, perfectly capable of doing with zero "help".  What has happened to our sense of strength, our power, our confidence?  What keeps the other 99% of women from choosing a way of giving birth that maintains the sanctity of this journey, the well-being of the infant, and the mother's sense of unmitigated confidence in her abilities**?

I want to become a midwife because I believe in birth, I believe in women, and I believe in babies.  My path holds challenges, to be sure, but I am finally, happily, ready to face them.  I will be the change I wish to see in the world.  I will be part of the movement to ensure that families have choices when it comes to where, how, and with whom they welcome new little people to the world.  I will be an activist, if that's what it takes.

You can follow more about this particular journey at my sister-blog:  Prenatal Yogini

** Disclaimer:  I am thankful that we have so many choices when it comes to prenatal care and labor/delivery options.  My bias is clearly toward "natural" childbirth, but please do not take that as an indictment against those who choose other methods of labor/delivery.  I am not judging those women.  I may, however, judge the practices that have become so commonplace - often in spite of clear scientific evidence that they are not safe or effective.