MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Merry Christmas Everyone!

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It’s finally here!  The 12 Days of Christmas are now begun; time to celebrate!  We had a lovely day with good friends, Eric, Marilyn and Roxanne joining us for dinner late in the afternoon.  The morning hours were spent opening presents and relaxing in the blessing of being a family.  We spent, as we typically do, most of Christmas Eve at Church.  Mary was a sheep in the Christmas Play at the early “Family” Mass and then I sang the beautiful Charpentier Messe de Minuit pour Noel ( Midnight Mass for Christmas Eve )at the late service with Orchestra and full “bells and smells” which will be meaningful to any of my Anglican/Episcopalian and Catholic readers!  I spent the two hours between services rehearsing with the orchestra and choir and so that made for a long day but what a beautiful way to spend Christmas Eve.  If you can find a nice recording of it, it’s worth a listen. I’m going to try to see if I can find a YouTube of at least a portion of it for you to listen to and post it here for the “Season”.  Tomorrow my husband’s brother and his family will be here from Boston for the next week or so; always a great time!  So, much to look forward to.  Blessings on all of you, enjoy the next few days of Christmas…….Peace.  

Kneelingwoman.

"The Mall" ~ The Audacity of Hope Vs. Despair and Happy Birthday Hugh!

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Christmas is almost here; Advent nearly past.  I have spent it contemplatively, reverently and with devotion to the “True Meaning” of this season of Holy expectancy.  Until yesterday. Yesterday, my disciplined and tranquil structure was rudely interrupted with the reality that I have done absolutely no holiday shopping of note as yet.  Advent had to take a temporary ( and I do emphasize “temporary” ) back seat to the necessities of the “Holiday Season”.  Yesterday, I had to make my one, yearly trip to “The Mall”.  I do it at almost the same time every year and every year I am shocked and dismayed at the fact that once again, I have to do something I hate more than almost anything.  Sometime in the  last few days before Christmas, without fail, I finally have to concede that there is something I need from such a place that I am not going to get anywhere else.  My denial firmly engaged, I have put it off as long as I can and so, yesterday, Ben ( my husband ) and I decided that the time had come.  I have a whole routine that must be followed to the detail regarding heading to “The Mall”.  First, I have to stop for coffee at my local, favorite coffeehouse where I will spend longer than I need to complaining to whichever of the darling coffeehouse kids’ is working that “I have to head to ‘The Mall’……and I hate it.  I don’t want to go.  I will need every drop of this espresso to energize me for the trip and to sustain me whilst I’m there.  I will need you to tell me that it won’t be nearly as bad as I think it will.  After I’m done there, I will need another cup of coffee and I will need you to listen to me tell you that it was AT LEAST as bad as I thought it was going to be and I will require your sympathy, including looking soulfully into my poor, sad eyes and nodding your head affirmatively all the while telling me that I don’t have to do it again for a WHOLE YEAR and really, I probably just need a nice meal of take-out Chinese food and a bottle of dark beer and ALL WILL BE AS IT SHOULD BE once again.”  I will need all of that and I’ll ask for it too!  I HATE GOING TO ‘THE MALL’!!!!  

My more cheerful and willing “consumer” friends will tell me that I’m making a tempest in a teapot about this ( and they tell me that every year while making themselves a stiff drink because they have to listen to my annual recitation ) and that I should lighten up and just “go with it”, meaning, I take it, that I should quit being such a frugal zealot and just go a little crazy at Christmas and spend, spend and spend.  In truth, it isn’t the spending so much that upsets me, it’s the people.  It’s the fact that when I am at “The Mall” I find myself rapidly losing any confidence or hope for our civilization.  I watch people who are already in debt spending more money that they don’t have on cheesy, cheap and imported- from- China junk while equally plastic, electronic “Holiday” muzak streams through everyone’s conciousness, as hundreds of little kids, many with runny noses and horrible, consumptive-sounding coughs stand in an endless, snaking line to sit on the lap of a Santa – suited person of undetermined moral rectitude while telling him what they “wantforchristmas” which has become the only point to the holiday for most of the population.  Everyone around me seems to be eating or drinking something sprinkled or dipped or covered in whipped cream.  None of them look healthy, or happy.  Everyone has a sort of exhausted, depleted look about them.  None of them seems to care at all that a miracle is happening in the midst of all this muddle; a Holy miracle and something that, if they could but even sit still for two minutes and listen for it, could change their lives.  Thoreau said that “most men live lives of quiet desperation”, this salient observation made while he was living alone on Walden Pond but, for me, this truth is most evident when I am walking numbly through “the Mall” three or so days before Christmas.  I feel my vital energy sinking into the cement beneath my feet and my infrequently displayed bad temper rising as my poor husband, equally distressed and dispirited at finding himself in such a place, pulls his sulking and espresso-maddened wife along by the hand, trying to get through the ordeal as swiftly as possible and I watch this deflated multitude of humanity pass by me and  all I want to do is kill someone with my bare hands!  Merry Christmas!
Well…….we found the one thing we “needed” from “The Mall” and headed home.  I had my dark beer (no Chinese food though; my poor attitude requiring some kind of penance, I decided to deprive myself of take-out ) and thought to watch some television news for awhile.  On every cable news channel, I was confronted with still more human depravity and evidence that we are, as my father used to say ( about nearly everything ) “Going to Hell in a Handbasket”.   Amid what someone determined to be appropriately heartwrenching and funereal music, we see the running video stream of little Caylee Anthony, the Florida toddler murdered (probably) by her mother, Casey.  Her Mother……..
I saw Caylee Anthony’s mother at the Mall……lots of them.  Women in their very early 20′s with a baby on one hip and a toddler being dragged along by the hand while the young mom talks on her cell phone and then screams at the toddler to “shut up….I can’t hear” while jerking the child’s arm roughly.  I see them in the clothing stores, carelessly shoving little kids onto a row of seats while they try on party clothes and choose sexy underwear and spritzing perfume on wrists and all the while, the ubiquitous cell phone conversations go on and on, interspersed only with texting and impatient and angry retorts to whining, crying and tired little children who will be left, later, with unwilling grandparents, or a friend, to be “babysat” while mom goes out partying.
I don’t think that anyone will find out that Casey Anthony, mother to a murdered child, suffers from some kind of particular personality disorder, or psychological pathology.  I think that she is as sane as any of us.  She suffers, in my opinion, only from the distracted, materialist and consumer lifestyle that shuns quiet, or solitude, or the building of relationships of the kind which foster intimacy, genuine friendship and support and that encourages fragmentation, disengagement and complete disconnect from other human beings; in short, she suffers from modern life.  Modern life kills people.  It kills relationships and creates shallow, self-serving relationships of convenience and whim.  Casey Anthony, if found guilty of murdering her little daughter, will not understand why she did what she did.  She will know, only, that she wanted to have fun and the “little snot head” as she called her, was in her way.  Of all the young women I saw at the Mall yesterday, any one of them, I am convinced, could become the next Casey Anthony simply by having a bad few weeks where there is no babysitter, and the boyfriend turns out to be another loser, or her own mother lets her down and then she loses her cool job and how far is it to get to “this kid has got to go”.  At least twice yesterday, I overheard one of these young women say something to the effect of “I just can’t HANDLE this anymore” in despair to someone on the other end of the cellphone.  It isn’t a big leap……..
People are fascinated by these stories not because they believe that they “could never do something like that” but because they secretly fear that they could.  So much neglect and abuse of children is a matter of degree.   The news program showcased a young mother with a 3 year old little girl held on her hip, explaining to the journalist that, after all, her own little girl looks “so much like Caylee, and has so many of the same interests and activities, and ( sobbing ) I just look at my child and wonder how could someone DO that to a little girl like this ( nodding at her own toddler who is now watching her mothers face in fear, lip trembling, eyes tear filled ), to just murder your own child……”.   She never even looks into the face of her “own child”.  She doesn’t notice her daughter’s anxiety or fear.  She doesn’t have any awareness of the human person she was just seconds earlier using as a prop.  She has brought a toddler to a murder scene to participate in something larger and more dramatic than her own life.  She, like Casey Anthony, doesn’t view her child as a person with rights or needs of her own.  She sets her daughter down to wander as pictures of the murdered Caylee alongside this child are broadcast so that we, the viewing audience, can do our own comparisons about how similar they are and be drawn into the perverse and false pathos of a too common tragedy and shake our collective heads in silent condemnation of the horrible, “bad” mother who would do what we are so sure we never could!
The little girl wanders around, alone, looking frightened and uncertain while her mother continues to talk into the air with the video cameras rolling………unaware of her own neglect, disconnection and lack of concern for her child’s welfare as she sought to put the focus on herself and her own need for attention and self-affirmation by coming to the place where a little girl’s skeletal remains had been scattered and letting her own child walk around on ground where Caylee Anthony had been buried in a plastic garbage bag!
Christmas celebrates the birth of the Christ child and all of us struggle with an interior sense of despair, at this time of year, because of the mockery our culture makes of this Holy time.  We participate, in varying degrees, in this yearly excess and only rarely do we stop and watch and listen with our hearts to what has been happening around us.  Everywhere are frustrated and angry young mothers’ who are moments or days away from doing something to a child because they just don’t have a clue what to aspire to in their lives and they have such deep needs that they can’t name and can’t meet…….they need mentors, and friends and someone wise and caring to open a door to a larger life to them.  They don’t need other women, other mothers, to use them only as counterpoint to their own sagging self-esteem, to comparison shop in the land of “Mommy Wars” and “Maternal Competition”.  Women and mothers need love, friendship and support.   The “crime” of Casey Anthony, from a sociological and cultural perspective, is that she isn’t unusual.  She isn’t all that rare.  She’s just one of millions who fall through the cracks, who give in to desperation, a shallow sense of priorities, and poor judgement.  She’s probably not a nice person; fine.  I’m sure I wouldn’t like her; ditto.  But she’s probably not insane, or truly evil.  She’s just young, angry and uncertain what, if anything, matters.  And what does our culture tell her “matters”?  Shopping.  Spending.  Getting things.  Getting men.  Getting what “I” want……
Going to “The Mall” is an annual torment for me primarily because it takes me outside my self-imposed serenity and peaceful co-existence with my wonderful family and extended “tribe”.  I am forced to really understand that things are not so lovely for everyone and there is a lot of work to do.
I hope that the balance of the Advent season is used by all of us to reflect on our cultures values and how we listen to the stories of others.  Does our news media exist for us, or we for it?  Is it enough to shake our heads in disapproval over the story of another mother who murders her child, or should we be asking hard questions and then putting our hands to the plow to do something positive to help women and families?  Is our hope in our new President-elect that he will “make everything good for everyone” or that he will empower us to get creative and to think outside the box to look for solutions to problems ourselves?  Is is really so audacious to hope that next year, next Christmas, the Christ-child will be born in our midst and we won’t be so busy multi-tasking that we miss it?  Is it possible that we can find a way to just sit in the quiet of our own hearts and offer up something that feels like peace to a very weary old world?  
Over the next few days, find a few minutes alone and be grateful for all the blessings of this life and this year.  Today is my son Hugh Edwin Wilbert’s 14th birthday.  After a very serious health threat early last year, he has spent this last year growing, thriving and “becoming” a lovely, funny young man of intention, giftedness and loving kindness.  Happy Birthday Hugh…..enjoy the day!  
More tomorrow. 
Kneelingwoman

Advent Retreat ~ Thoughts and Feelings

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Hello Everyone!  I’ll be once again on “Retreat” , beginning tomorrow afternoon, until Sunday night.  I’m looking forward to it and to spending time with this wonderful group of fellow “interns” and the marvelous, cagey, intelligent and aware Jesuit Priests who lead our group!  As most of you know, I am not Jesuit, nor even Roman Catholic; I’m wholeheartedly Episcopalian/Anglican and very attached to my “roots” in that denomination. It has been an enormous pleasure and blessing to me to experience such an ecumenical and open educational and spiritual experience in a Jesuit community that is so accepting and loving.  Our group is truly a miraculous and amazing bunch of people all trying to learn the art of “Holy Listening” with others.  I’ve been profoundly moved and affected by this process and, with still more than a year and a half left to go; I expect to be still more drawn to a deeper sense of understanding and working with the “true self” and to helping others to find the same.  It is in “living true” that we find our peace, and genuine happiness.  I’ve found this whole process to be the most life-giving and affirming of anything I’ve done.  A wonder, truly!

So, I will continue this process of becoming a Spiritual Director with yet another Retreat, and a challenging one at that: we will be focusing on the “Discernment of Spirits” which sounds very spooky but isn’t at all; just complex!  
On Monday, we will be observing the third anniversary of the death of our 10 month old son, Samuel.  He was born 4 February 2005, and died on 15 December 2005.   I am hoping to put something up to honor him; I’m considering posting my best picture of him, as none of you have ever seen him.  There are only a few people, actually, who were graced to have known him and fewer yet who actually held him, touched him or spoke to him.  They deserve special mention on Monday and they’ll get it too!
I have found this particular anniversary to be the most difficult and sad so far.  I don’t know why.  I’ve found myself in tears over small things, and I feel almost lonely, even though I am surrounded by family and friends who love me and who’ve already been sending their love and support via phone, e mail and invitations to dinner!  I suppose that losing a child creates a space in one’s heart that is somewhat unreachable? It isn’t that I’ve any desire or need to shut others out.  I’m very grateful for every remembrance from everyone!  But there is a corner of my soul that is reserved for this loss, and others and finding myself enveloped within that place reminds me that we are, inescapably, alone in this world at particular moments and for specific reasons.  It’s not a bad thing; just hard.
Everyone asks me what I “learned” from Samuel ( and Paul and Mary ) and all I have to offer is some idea that love is the important and crucial measure of our lives–how willingly we love; how passionately and how hard we try, and keep trying, to touch the hearts and souls of those we profess to love.  I know, too well, that I failed in so many ways, to love Samuel as I should have.  I was nearly overcome by the difficulty, fear and stress of caring for such a fragile human being.  But he and I had moments that were simply, completely “soul to soul”.  I have had a few of those moments in my life; with only a small handful of people and I treasure every, single one for the magic and depth that they brought into my life.  In those few moments with Samuel; I experienced the completion and pain, of the deepest kind of love ~ that which knows that time is a thief and will take it’s toll and none of us have a surplus to waste!  We have such a brief time to be kind, loving, compassionate and tender ~  don’t lose a minute!  If there was any “lesson” in the experience of Samuel; that was it.
So, the Advent season moves apace.  Enjoy the weekend and blessings and peace to you all.
Your Kneelingwoman.

December Midwifery Rules Committee Meeting

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It has been a while since I blogged about the legal issues relating to midwifery in Utah, but it is time for an update.

As you may recall the Utah Medical Association launched another bill last year attempting to restrict the births that Licensed Direct-Entry Midwives could attend.  They claimed that the midwives had asked to do only low-risk births at home, but they were attending births that the doctors considered too high risk to be done at home.  (Don’t worry your pretty little head about what the mother considers high risk.)
The bill was incredibly restrictive in its original inception and would have eliminated nearly all home births, but we fought back.  Compromises were struck and most of the restrictions were removed, but the real sticking issues were breech births, twin births and VBACs.  All three are considered ‘high risk’ by the medical community, breech births are basically an automatic c-section and twins are most of the time too.  VBACs happen in some hospitals where they have the resources to care what they considered a high risk birth.  VBACs are generally not available in hopsitals outside of the Salt Lake valley, those women will have to have a repeat cesarean or travel to Salt Lake. 
The midwives conceeded twins and breech, they are fairly rare anyway and unlicensed midwives will still be able to attend them if the women really are intent on a home birth.
VBAC though just has to stay.  The difficulties that women run into getting a VBAC birth at the hospital, especially a natural, intervention-free birth, are just so great – they need home birth.  I did, for lots of reasons, but a big one was the requirement that women be monitored constantly while they labor.  Depending on the provider you might run into a whole lot more requirements, it isn’t uncommon to hear that to doctor requires the woman have an epidural.  Or other times they get to 36 weeks and the doctor tells them that if they’ll go ahead and schedule the c-section for their due date because if they haven’t gone into labor by then the’ll need to have the “elective” repeat cesarean (ERCS).   If a woman truly wants to avoid having another cesarean and wants to improve her chances by staying unmedicated, off the pitocin and upright, she may have no alternative besides home birth.
Fortunately midwives were able to keep the wording in the bill that allows VBA2C, but another consequence was that the Rules for the Licensed Direct-Entry Midwives must be rewritten, this time allowing the UMA to select the doctors who sat on the board (I’m not sure why there aren’t any midwives on the Medical Board).  The bill dictates the basic guidelines but the fine details of the rules that midwives must follow in their practice are to be hashed out by the Rules Committee.  The bill does have language give the Rules Committee license to further restrict the VBAC births that LDEM requires but it does not mandate exactly which births.
So far there have not been any real surprises about the changes made to the existing rules.  They were required to change the things necessary to match the new bill and that has been done for a number of issues.  There has been much discussion about everything but nothing terribly offensive or restrictive has made it into the new rules.  On the agenda at yesteday’s meeting was the discussion of the VBAC portion of the rules.  The requirements written into the law state the midwives can do vaginal births after 2 sections, but the woman cannot have had a classical, J or T type of incision.  (Basically those are variations to the way that the obstetrician actually cut into the uterus during the caesarean surgery.  Most women get what’s called a low transvere incision, which everyone agrees is the most safe type to have had when attempting VBAC.)  The women are also required to get an ultrasound to verify that their placentas are implanted away from the scar.
Dr. Lamb, one of the doctors on the committee, came prepared with a number of proposed changes to the rules.  His first proposal was to require that the midwife must verify the incision type and if she can’t, then the woman must be transferred, no exceptions.  There was much debate to this idea because it can sometimes be difficult to get those records and if a woman transfers into midwifery care late in pregnancy they may not show up until after the baby is born.   Even if the woman is sure her surgery was low-transverse, and her external scar is low and there isn’t any reason to believe otherwise, she still couldn’t have her VBAC at home if she couldn’t produce that piece of paper.  
Considering that the hospital is the entity that needs to give you that piece of paper, but they are also going to lose your business if they give it to you.  You think that they aren’t going to stall or accidentally lose something?  Sorry, maybe I’m cynical but it is oftentimes quite difficult to get medical records and it doesn’t help when they really aren’t motivated to want to give them to you!
The midwives refused to add this requirement to the rules, they were willing to require that they try to get the operative report, and have the woman sign another informed consent document that she understood the risk of not knowing what type of scar she had, but they weren’t willing to make it a requirement!  The doctor basically said that he wouldn’t vote to approve it  the way it was.   The other doctor didn’t say, but likely she won’t vote to approve the rules either, which is fine unless the nurse-midwife won’t vote for them either.  She either approves or the vote is tied.
The discussion  moved onto whether the rules should allow the midwives to attend women who are having a vaginal birth after having two prior caesareans.  The docs adamantly oppose this, and the only doctor who came as a member of the public, a retired doctor, that has come to watch the last couple of meetings had plenty of commentary.  He told us how it is their job to protect the 1-5% of babies that are going to be harmed when there is a bad outcome (hello, what study did that number come from?).  
This is where my blood pressure was really starting to rise.  His implications were very upsetting and his opinions were outdated and completely opposed to everything we believe.  It is offensive to be told that your not qualified to decide where or how to give birth, that only the doctors should make that call.  He also said we should be required to have an IV, that there must be a blood supply on hand, and that after every VBAC that it should be required for the midwife or doctor to reach up inside the woman and verify if the scar is intact.  That is an invasive and barbaric procedure, and there is absolutely no evidence that it is either safe or beneficial.
Later when he got the chance to speak for a few more minutes he shared more of his opinions.  He felt that the rules should dictate who should be allowed to attempt VBAC based on his criteria for who is a good candidate.  He said that women who had prior c-sections for a large baby shouldn’t be allowed to try if their second baby is large too (well how exactly do we know that until the baby is born?).  If I understood correctly he was okay with women having a VBAC at home if they had a proven pelvis, in other words if they had given birth before.   That would eliminate the VBAC option for so many women, especially if they had a c-section for their first birth, then the only place available to do the first VBAC is the hospital and we’ve already talked about how restrictive that can be.
When time ran out it was a stalemate and I guess that is fine.  No votes to allow any rule changes were made, so nothing really changed.  It may draw out the process, but so far no change is a good thing.
It is frustrating to have a system that gives the medical community such an elevated status in society that they are allowed to dictate how everyone else should manage their medical care (or lack thereof).  I’m a fierce libertarian, so I know that my beliefs are pretty radical and I think that a woman wants to give birth in the woods attended by only a shaman then that is her call, just like a person with cancer can choose whether they will have every surgery and drug known to man or no drugs and no treatment at all.  We allow Christian Scientists to do have autonomy over their medical decisions, even when know that it is a high risk thing to do, I’m really not clear on why anybody else shouldn’t have the same right.  
I know the answer my critics will give, because of the baby.  They feel entitled to intervene because they need to protect the baby from what they believe is a bad choice their mother might make.  Who are they to decide which choice is right or wrong?  How can we ever really know beforehand what will be the best course of action….  Have an ERCS and give birth to a baby with breathing problems who later develops asthma and suffers from severe, even life-threatening allergies or have an ERCS and zero problems, there isn’t really any way to know for sure which it will be.  Even for the mighty Obstetrician, he just can’t know, so why isn’t it my call to decide how I will handle my birth.  As Michelle says, “My Body, My Baby”