asking for normalcy

It doesn't take very long to know that I am pro-breastfeeding. My support of breastfeeding doesn't include shaming those that don't. Just as I believe that women should be supported in their choice to nurse their babies, I believe women should be supported who choose to formula feed. There are many reasons not to breastfeed. This post isn't about that. I know and respect those reasons. This post is about a cultural attitude that I cannot ignore. It is about human rights.

The breastfeeding rates in the US are on the rise, and that is encouraging (according to the CDC the rate of babies breastfeeding at 6 months of age went from 35% in 2000 to 49% in 2010). Even though more women are doing it, there still hasn't been a cultural shift to "normalcy" yet. There is still vehement opposition to breastfeeding, specifically to the act in public. Breastfeeding in public is protected in federal buildings as long as the woman is legally allowed to be there; the law doesn't not differentiate between using a cover or not. According to the National Conference of State Legislatures, "forty-five states, the District of Columbia and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location" (http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx). Breastfeeding is encouraged by the Centers for Disease Control, World Health Organization, and American Academy of Pediatrics. It is legally protected both at the federal and state level. Yet why are we, as the American people, so offended by it? 


Like I said before, our country's opposition to public breastfeeding is not universal, but a cultural attitude. The front of the passport for Gabon features a woman breastfeeding, the opposite breast exposed. Talk about normalcy for the Gabonese! One American woman took to the internet to vent about being discriminated against for breastfeeding. An Australian woman replied, "I don't understand your country's problem with breastfeeding! Us Aussies do it without anyone bothering us. It's just a part of life." I find it odd that human beings all over the world can go about their business feeding their babies without opposition, that no one bats an eye, yet we can be utterly disgusted and enraged over breastfeeding in the United States. 

Let's just look to social media for a minute. There is a page that I follow on Facebook that is attempting to support all women throughout pregnancy, birth, breastfeeding, and parenting. It repeatedly gets pictures removed of breastfeeding mothers and bans are placed on the page for "violating the user terms." Women who simply post pictures of themselves enjoying a nursing/snuggle session with their little one often get the same results. The images are removed. Yet, soft porn images are not removed. Women giving life is not allowed, but women as sex objects are. For me, this is the core of the issue. Our society is okay with the sexualization of the female form, but not the nurturing, life-sustaining one.

 *warning! graphic images!*

Let's just look to social media for a minute. There is a page that I follow on Facebook that is attempting to support all women throughout pregnancy, birth, breastfeeding, and parenting. It repeatedly gets pictures removed of breastfeeding mothers and bans are placed on the page for "violating the user terms." Women who simply post pictures of themselves enjoying a nursing/snuggle session with their little one often get the same results. The images are removed. Yet, soft porn images are not removed. Women giving life is not allowed, but women as sex objects are. For me, this is the core of the issue. Our society is okay with the sexualization of the female form, but not the nurturing, life-sustaining one. 

*warning! graphic images!*


This photograph, and many like it, has been removed from Facebook. 

This photo, and many like it, is allowed to stay on the social media site.

 

Here's the thing:

We do not have a problem with breasts in this country. We love boobs! I mean, who wouldn't? We simply have a problem with breasts being used for anything but sex. We can't possibly understand that something has more than one function. It bothers us to see an innocent baby sucking on something so sexual in nature. And this is where the women's rights issue comes in. A woman's body isn't only for sex. It has other purposes and functions.

My mouth has many functions. It can be used to eat and communicate. It can also be used for sex. We don't have a problem separating the two. When the mouth is used for sexual purposes it is expected to be done in private. However, I don't have to keep my mouth hidden when I'm using it for nonsexual purposes, such as eating. I am not denying that breasts aren't sexual because they are. I'm just denying the looney idea that our minds can't possibly separate the two acts- sex and breastfeeding. What you do with the body part, whether it's your mouth or hand or breast, defines its function. 

(I understand that someone will try to use my analogy to say, "Then if I'm not using my penis for sex, I should be able to whip it out anywhere." I understand that the example isn't flawless. I'm just asking you to think differently for a minute. I'm attempting to challenge your perspective.) 

I've heard several arguments. I've heard "I don't have a problem if you breastfeed, I just don't want to see it." or "I do not want to walk into a restaurant and watch someone do that while I'm trying to eat. It's disgusting." or "I don't want my son to see that." I get it. I'm not trying to disrespect anyone's feelings. What I AM trying to do is to challenge you to forget that mindset for just a second. What if your son grew up seeing women breastfeed? What if his first experiences with breasts were that of nurturing? What if he saw a woman's body doing extraordinary things like make milk and sustain a life solely with her own body? What if he grew up learning that breasts are more than sex objects? What if from the beginning of his life he saw the act as an innocent way to feed a baby and not something sexual and perverse? What if YOU grew up that way? Imagine yourself for a moment being from another culture. Imagine that you saw your mom, your neighbor, your sister, your friend all breastfeed. Imagine that it was a normal part of life and no one had anything to say about it. Imagine no one ever asked a woman to cover up, sit in a dirty bathroom, or hide out in a sweltering hot car to feed her baby. It wouldn't be so bad would it? If you grew up seeing it, everyone around you did it, and no one had any objections to it... you probably wouldn't think it was gross/odd/perverse, right? 

Or just imagine you and your child enjoying this Mister Rogers' Neighborhood episode from the 60's. Or this Sesame Street episode from 1977. Our country hasn't always been so against breastfeeding, which gives me hope that us Americans can once again begin to see it as normal. We won't ever get past the sexualization of breastfeeding unless we take down these cultural attitudes that limit breasts to sex. And women will never be free unless they are supported to do what their bodies are meant for. Let's stop the shaming. Let's stop the ugly stares. Let's stop the banning of these images from our society. Let's stop the discrimination. Breastfeeding may be legally protected and encouraged by reputable health organizations, but cultural norms are always more powerful than laws and expert advocacy. 

And please, women, it starts with us. If women won't support other women, who will? 

they call me sissy

"So where did 'Sissy' come from?"

It's a legitimate question. A Canadian midwife in Haiti wants to know why a grown woman is telling other adults, "My name is Carsen, but you can call me Sissy."

It started out the usual way: my siblings- and there are many of them- started calling me Sissy when I was very young. Then my parents did foster care and over the course of four years, 28 different children were in our home and I was Sissy to them too. When my parents decided to expand our family more by doing an overseas adoption, the name spread to Haiti.

My junior year of high school, I flew to Haiti for the first time to meet my siblings. My mom introduced me to them and the nannies overheard and thought "Sissy" was my given name. I tried to correct them once, but soon found out that "Carsen" doesn't sound quite right in Haitian Creole, so "Sissy" stuck.

I like to joke that my parents "take in strays." People that are lonely or in need of a family unit always have seemed to find their way into my parents' home. It doesn't take long for the nickname to become a part of the vocabulary of those who become family along the way.

That little orphanage where I met my brothers and sister became a home for me at the age of 19. I was already known there as Sissy and so it became the name that I went by for the 8 months that I lived there. When I return to Haiti with other organizations, I always introduce myself as Carsen. However, it still seems to be a name that is difficult to remember or say to Haitians, so I generally offer "Sissy" as an alternative. Somehow, the name has sticking power.

For me, however, it is an identity. For some sweet ones "Sissy" isn't enough and it becomes "My Sissy". I am a sister to many. I'm a shoulder to cry on, a hand to blow noses with, a back to climb on, legs to run with. Someone once said, "I like Sissy because she can make her face look like a monkey." I guess I'm good for that, too. I might come with a lecture or two- or maybe I'll just be there to listen about how unreasonable the adults are being. My heart has been broken into a million pieces as the phases of life require changes that little ones don't understand- like why I don't live with them anymore. "I want my Sissy!"- and my heart breaks with each tear as he tries to figure out why Sissy has to leave all the time. I reminisce about the days when my makeup-wearing sister was small enough to bathe in the sink. I miss when my 6 foot tall, nearly 200 lb brother was small enough for me to carry around in a backpack. As they each grow to tower over me, the relationship changes. These large, hairy, hormonal beings no longer want me to read them bedtime stories. However, I may be good at changing my voice to act out each character's part, but I'm also good at talking about periods and dating and sex.

With the name comes a badge of honor. It is a privilege to be Sissy to each one of them, even if only for a short time. I'm blessed to have these sweet souls in my life. Even more, I'm blessed that they call me Sissy.

keep on

ZIIIIIIIIPPP ZZZZOOOOOOM *phew* Life is moving fast and I barely have time to process it.

In seven short longest-of-my-life months, I will graduate nursing school and will hopefully be an RN shortly thereafter. That statement alone makes my eyes spin a little. It's hard to write a blog when your eyes are spinning, which may explain my absence. 

Life is a little bit CrAzY right now. While I'm busy memorizing things like electrolyte levels, John has been busy with work. With an impending promotion and the increased responsibilities of that, as well as an intense training schedule, John's eyes are spinning too. You should see us. We look like cartoons. 

We are at this awkward place in our life. Half of our friends are having babies and the other half are single and partying it up. We are somewhere in between. Some of our friends are young professionals and making good money with few obligations. We are close enough to that reality to dream about extra money someday soon, but we're still eating ramen noodles every now and then. You can't beat 25 cents worth of sodium and cardboard. We also have been married long enough that the delirium of honeymoon bliss is wearing off. I am happy to report that we still love each other, and most days we even like each other. It's just that this is the longest time we've spent in the same country and that comes with some new challenges. Once again, we are in an awkward place: the elated daze of the first few months of marriage is gone, yet we haven't quite found that secure niche that comes with several years of a solid marriage. The ever-changing dynamics of our relationship coupled with perpetual exhaustion leaves us wanting to go out dancing with our fun, single counterparts, but usually ends with us watching TV until our brains ooze out of our ears and we go to bed at 9 pm. I'm sorry I'm not sorry. 

It's a lot of work. All of it. Nursing school, Army life, marriage, finding laughter and spark in the mundane parts of life - it takes work. I wish I had some words of wisdom to offer, but I'm kind of up to my spinning eyeballs in the muck of it all. However, I've heard from those who've been-there-done-that that it's all worth it in the end. So I'll hang my hat on that and keep on keepin' on.

choose life

This week is National Suicide Prevention Week. I've always thought that suicide is the most selfish thing someone could do. I've always thought it was an easy way out that only made the person committing suicide feel better but left everyone behind hurting. I've always thought that it was a detestable thing to do. I've always believed suicide was pain that just created more pain. And then there I was in the midst of more despair than my soul cares to share, staring at a ceiling fan wondering if it could hold my weight.

I began to wonder if we had any rope. I thought about how painful it might be if the fan base couldn't hold my weight and I ended up just crashing to the ground. I wondered if I would feel my neck snap. The thoughts were ever so brief, and they left as quickly as they came, but the fact that they even entered my mind scared me. However, even though it was tempting to fantasize about ending my pain by ending my life, I knew that I would never do it.

I knew that I would never commit suicide because I know how deeply I am loved. Even though there was so much hurt, I knew there was that much more love. I knew that if I were to act in my darkest moment, that it would only give birth to more darkness. I knew that I would be causing pain to the people that I care about, and I decided I never wanted anyone that I love to feel this visceral, unbearable pain I was feeling. So I chose life. And I know that there are people that are very glad I made that choice, even if they never knew those thoughts had crossed my mind.

This experience made me think about the people that don't know that they are loved in that way, the people that have doubts about if anyone would miss them. I thought about those who didn't choose life because they didn't know how dearly loved they were. To those of you who don't have that tangible love to lean on, to those of you in your darkest moments, to those of you with the rope already around your neck, listen to me: I love you. You. are. loved. Do you hear that? Someone, somewhere loves you. Even if it's a girl miles away who never met you... you are loved by someone. It will break someone's heart to lose you. You are valuable. You have a purpose. It will get better. The fog will lift and there will be light again. The sunrise is coming... you know what they say, it's always darkest before dawn. So, please, dear loved one, take the rope off from around your neck, put the cap back on the bottle, get rid of whatever nasty thing you want to use to bring more darkness to the world. Take a big deep breath and feel my love for you. Now get up and go choose life.

The Road Home

I decided to go for a walk this morning. The fresh air and morning sun could do me some good. I left early to avoid the scorching Texas heat. By 8:30, I had completed the route I had set out to take. Enjoying the exercise, I decided to continue on. Though it was heating up considerably and I was sweating more than expected, I was in deep conversation with God and lost in my thoughts. I then realized that I was in a neighborhood I did not recognize. I was lost. Should I go back the way I came from and retrace my steps? The problem was that I wasn't even sure how I got there. The street names didn't look familiar. I stopped in the street and looked at the sun. I wasn't sure exactly where I was, but I had an idea of the direction of my home. Should I cut through all these residential streets and move in the direction of where I want to go? I wasn't sure if those streets went all the way through or if they were a clear shot home.

I decided to continue on the route that I was on. I thought that maybe I would discover something along the way. I decided to make it an adventure instead of anxiety-producing. I don't move that fast, so I knew I couldn't be far. And I still had confidence that I knew the direction of my home and an inkling that this street I was on would lead me to one that would take me straight there. After a couple of twists and turn, my surroundings started to become familiar again. I wasn't lost at all; I knew exactly where I was! And my intuition was right, this street lead me to the one I was looking for, the one that would take me home.

Isn't life like that sometimes? You wake up and look around and have no idea how you got to where you are. Your current situations are confusing and full of uncertainty. You aren't sure what path to take. Do you go back? Do you keep going? Do you take another route entirely? Your surroundings are unfamiliar and there may be some uncomfortable twists and turns. Do you choose anxiety or adventure? Perhaps looking up at the Son will remind you of where your home is. Though it may feel like it, you aren't lost at all. The road home is just around the corner.

I need a doctor

It was a month before my 16th birthday. My mom was taking me to Haiti to meet my siblings who were currently living in a Haitian orphanage. I wasn't a stranger to poverty. I grew up serving meals at the local homeless shelter. My parents had taken in foster children in the middle of the night who were malnourished and scared and ate the warm food past the pain of their rotting teeth. I had gone to Costa Rica. There I saw regions of people displaced from other countries trying to make by in small huts and tents. I wasn't a completely naive, young American girl.

However, I had never seen anything like Haiti and I wasn't yet desensitized to the shocking reality of poverty. The local homeless mission is vastly different from the poorest country in the Western Hemisphere. As I gazed out of the back of a truck, wide-eyed and nervous, down my first bumpy Haitian road, I had no idea how this little country would impact me. I had no idea that it would be here that I would hold a little one as AIDS took his life. I had no idea that I would learn enough of the language to argue with nurses and advocate for babies in Haitian hospitals. I had no idea that it would be this place that helped to decide on a career in nursing. At just 15 years old, I had no idea that I would wrap a stillborn baby up in a blanket and hand it to a man with a wheelbarrow to take for disposal. As I road in that truck, with the smog in the air sticking to my pale but freckled face, I had no idea that someday I would live in this country.

In fact, it wouldn't take long before I decided that I really wanted to go home. My mom stayed with me the first week of my trip. I stayed behind another three weeks to help around the orphanage and learn a thing or two about humility. In the process, I contracted a parasitic infection and lost 11 pounds in the month that I stayed there. By the end of the month, I was exhausted, ill, and homesick. I couldn't wait to get as far away from Haiti as possible and into a warm American shower. I happily packed my bags and was dropped off at the airport in Port au Prince. I had never been so excited at the thought of getting on a plane.

When I arrived at the airport, I had to first make a stop at the bathroom, a frequent necessity when harboring a parasite. As soon as I exited the restroom, I noticed it looked a lot busier than I expected. I got in line and began to wait. The line wasn't moving, but it was growing and growing until there was no more room in the small Caribbean airport. I began to grow incredibly anxious. I had arrived at the airport two hours before my flight, yet I wasn't even checked in yet. As I began to realize that I wasn't going to make my flight as I had been waiting in line for two hours, the crowd began to rumble. Angry protests, pushing, and yelling began. Any sense of personal space I once had was completely gone. An American man told me that the power had gone out in the airport and all of the computers and other equipment was down, and the backup generator was apparently not working.

The airport staff eventually set up tables to manually check each bag since they had no x-ray machine. Other staff members were trying to handwrite boarding passes and communicate without telephones or overhead speakers. It was the most chaotic thing I have ever experienced. My bag was in front of me. The shoving began to get so intense that I flipped right over my bag onto the floor. That's when I decided I had had enough and could no longer just stand in line while other people shoved me. I observed the baggage checking process. When the staff members were done combing through everyone's bags, they put a sticker on the bag to signify it was clear. A lover of rules and order, I have no idea what overcame me, but I have a feeling it had something to do with holding in diarrhea for the last three hours while getting shoved to the floor. I crawled on the ground in the middle of the Port au Prince airport and found a sticker. I put that sticker on my bag and went to the people guarding the ticket counter. They asked if my bags had been checked. I pointed to my "tactically-acquired" red sticker on my bag. They let me through.

The agent at the counter informed me that my plane had left an hour ago. I forcefully said that I didn't care where they sent me, JUST GET ME TO AMERICA. She told me all flights were booked. I gave her a death stare. She wrote out a standby ticket for a flight to Fort Lauderdale and checked my bag. She told me to go to the gate and find the person working there and tell them I am on standby. I did just that. The woman told me to just stand here and wait for her. I didn't. I followed that woman everywhere she went, even to the bathroom. I told her that I will get on a flight. I stared her down as she began the boarding process for the flight I was on standby for. After everyone was boarded, she turned to me and said, "There's a seat available. Go." "Which one?" I asked. There were no jetways. There were several planes on the tarmac with passengers boarding via large ladders. She pointed to one and told me to hurry. I ran and waved and screamed at the people getting ready to close up the plane and remove the ladder. They waited for me.

The flight attendant was completely confused at my handwritten ticket that simply said "standby" and my name. She found me the last seat on the plane. I sat down and cried. A young Haitian boy was sitting next to me eating crackers and offered me one. I smiled, ate a cracker, and collapsed into a deep sleep. I woke up as the attendants were preparing for final decent. "American Airlines welcomes you to Miami." Miami?! I was supposed to be on a plane to Fort Lauderdale! I checked my bags to Fort Lauderdale! I got off the plane, and through customs, and finally called my mom. In a weary voice, I tried to explain all that had just happened. I had no connecting flight, since my original one was long gone, and the only thing the Port au Prince agent booked me for was a flight to Fort Lauderdale, but I ended up in Miami. While my mom was trying to figure out getting me a ticket home from her end, I went to the American Airlines desk. I explained everything to the agent. She was my angel and found me a flight to Dallas with a connecting flight to Sacramento. But she looked at me and said, "They already started boarding. Can you run?"

And run I did. I called my mom out of breath to tell her I was getting on a flight and that I would be home soon. As I came down the escalator of the Sacramento airport, I saw my family at the bottom. My lip began to quiver. I walked straight into my dad's chest and began to sob. My dad took my backpack off of me as I just stood there. My mom kissed me. I looked at both of them, wiping away my cleansing tears, and said, "Hi. I need a doctor. And a bathroom."

OB, Midwife, Doula... what's the difference?

Well, hello there! I'm back into full swing of nursing school- the final 10 months! I'm taking a break from studying about mental illness to talk about something I really love- women's health. (I just don't have any interesting "love" or "camo" topics so I'll bore you with the "other stuff.") I get asked these questions a lot- "What's the difference between an OB and a midwife?" and "What's the difference between a midwife and a doula?" It can be really confusing at first, so I'm gonna break it down for you.

Obstetrician
An obstetrician (OB) is a physician who is inherently a trained pathologist and surgeon. This means OBs are specialists in pregnancy-related diseases, complications, and surgery. An OB first earns a four year degree, then goes to four years of medical school. After those eight years of college, the now MD goes on to more speciality training in his/her field- obstetrics- usually for another four years. (That's a total of 12 years.) They do learn about low-risk, "normal," vaginal birth, but what they are really good at is the high-risk, complicated pregnancies that often necessitate interventions such as medication and surgery. Because OBs have been trained to treat diseases (and fear litigation if they don't act soon enough), care with an OB tends to be very medicalized and full of routine interventions (medications/actions that are done to every woman, whether she needs it or not). Most women in the US see obstetricians for their care even if they are not high-risk. This system is unlike most other countries in the world. Most other industrialized nations have a system in which everyone sees a midwife first, and if her pregnancy is high-risk or complications arise, she is referred to an OB. We have this system for every speciality except obstetrics. For instance, if you have high blood pressure and a heart murmur, your general physician can prescribe medication and monitor your murmur. That may be all the care you need and GPs are generally very good at what they do, even though they are not "specialists" in cardiology.  However, if your GP feels that your heart condition is beyond her scope, she will refer you to a cardiologist. Obstetricians see patients for their prenatal and postpartum care usually in an office, and attend births in a hospital.

Midwife
In the US, there are two different kinds of midwives- direct-entry midwives (Certified Professional Midwife) or midwives that were nurses first (Certified Nurse Midwife). Both are master level degrees, however some states do not allow CPMs to practice midwifery. I will be mainly speaking about Nurse Midwives, however midwives who were not nurses first have just as much merit and worth as CNMs.
CNMs first complete approximately two years of college courses to qualify them to enroll into a nursing program where they become Registered Nurses. After completing a bachelor's degree in nursing, an RN then goes on to becoming an advanced practice nurse with a focus in midwifery. This master's degree gives the RN a new title- Certified Nurse Midwife. The scope of practice for CNMs vary throughout each state, but are generally the same. CNMs have the same level of degree as Nurse Practitioners, but have specialized in the care of pregnant women. Midwifery tends to be more hands-off than obstetrics- waiting until there is an actual problem to act and tailoring care to each individual need instead of routines for all women. Appointments with midwives tend to be a bit longer and have a more holistic focus. This means that midwives put an emphasis on nutrition, exercise, emotions, and thoughts, as well as the basic assessments such as blood pressure, weight, uterine growth. Midwifery tends to be more low-tech, relying more on skills than technology. For example, using a measuring tape and feeling the uterus to estimate fetal size rather than using an ultrasound machine. Midwives tend to be more trained in "normal variations" of vaginal birth. For instance, midwives tend get more training in vaginal breech birth (buttocks or feet first instead of head first), whereas an OBs "go to" for breech birth is cesarean section. (I have a friend in medical school. He told me that his training for breech birth was watching a 20 minute video in class. After the video, the instructor said, "Well, you don't really need to know this anyway because you'll just section.") Midwives appreciate the mind-body connection and understand that things like fear and anxiety can stall labor. Midwives also tend to try least invasive alternatives first, such as upright pushing to use gravity, instead of an episiotomy (an incision to the vagina/perineum). CNMs work in hospitals, birth centers, and attend home births. CPMs attend births in out-of-hospital settings, such as birth centers and at home. Ideally, midwives work closely with OBs in the event that transfer of care is necessary. Midwives are trained how to deal with complications that may arise such as neonatal CPR, administration of emergency medication, how to control a hemorrhage, and suturing tears.

*Disclaimer: These are broad generalizations. Every practitioner is different. There are many OBs who are hesitant about routine interventions and do more individualized care. There are many OBs who strongly support natural childbirth, avoiding surgery if possible, and advocate for a woman's right to make her own decisions about birth. You will also find CNMs who are highly medicalized, do not respect autonomy, and perform many routine interventions. It is always important to interview multiple providers to find one who is a good fit for you.

Doula 
A doula is a non medical person whose sole purpose is to comfort and support a laboring woman. A doula does not do internal exams, check blood pressure, run tests, clamp the cord, etc. There are lay doulas (one without a certification) and certified doulas. There are various certifying bodies, but the training is about the same. One must read a handful of books about birth and breastfeeding, write a paper about the books, attend a certain number of births with a certified doula, attend a childbirth education class for pregnant women and their partners (such as Lamaze or Bradley), take a test, and pay a fee. Those that are not certified have typically done many of these things as well. A doula does not replace family members/loved ones, but is a birth professional who supports, encourages, and comforts before, during, and after labor. Most hospitals do not include a doula in their "count" of people allowed in the room (if hospital policy states only two people can be in the room, it usually means two family members plus a doula.) Most doulas understand the importance of loved ones being involved in the birth and will encourage them to stay engaged and focused on the laboring mother. Generally, a pregnant woman and her partner will meet with a doula 1-2 times before the birth. These meetings including becoming comfortable with one another, sharing information about possible interventions so a woman can make informed decisions, and making a birth plan- talking about the goals and desires for birth and ways to achieve those goals. For instance, if avoiding pain medication is really important to the woman, she and the doula will talk about other pain management options and establish a code word to use if the mother changes her mind during labor. The doula's goal is to help the woman have the birth she desires, no matter what that looks like for each individual client. Doulas are a source of information and bring to the birth a calmness, assuredness, and peace. Doulas tend to manipulate the environment to make it conducive for a happy, relaxed, and healthy birth. She may do this by dimming the lights, playing soft music, or using aromatherapy. Doulas help manage discomfort by giving massages, suggesting position changes, using therapeutic movement, encouraging hydrotherapy (warm bath or shower), and offering food and drink. Doulas also recognize the mind-body connection and help women to discuss their worries and fears and use supportive, encouraging words. A doula's job is to trust a woman's innate ability to birth her baby and helps a woman to have the same confidence in herself. A doula stays with a mother through early labor, active labor, pushing, birth, and initiation of breastfeeding (she will stay to support a woman usually up to two hours after the birth.) Doulas go wherever their clients labor and deliver. Studies have shown that this continuous support leads to fewer complications and interventions, higher breastfeeding success, and a more satisfying experience. Some hospitals are noticing this effect and are starting to implement their own doula programs. The rates for doulas vary widely depending on the area and actual doula; the range can be between $400-$1,500.

where she wants

In the United States, there is a certain attitude in our birth culture that hospital policy and physicians always know best. It seems that we've forgotten that women know how to give birth and that the laboring woman is no longer the authority of her own body. Just look at the language: "They won't allow me to eat in labor." "My doctor let me move around." "I can refuse that?" Without really knowing it, women often judge their birth experience based on whether they were allowed to follow their own intuition or not. A woman who gave birth over a decade ago told me that she wanted to be upright and moving during her labor but the hospital staff actually forced her to stay in bed. Unfortunately, this is still happening today. Many women are also not taking personal responsibility by becoming informed about their rights.  (In all fairness, there are many doctors, midwives, nurses, and hospitals doing excellent work to bring autonomy back into the birth world. There are those who are advocating for individualized care instead of blanket routines. There are those who understand that no one delivers babies, but that women give birth. There is also a shift among women as they are becoming more informed and vocal about their options and rights.)

As a doula in the US who has only done hospital births, much of what I do is to help a woman achieve her goals and maintain her rights. Without a voice reminding a woman that she has every right to get up and move around as she pleases, it can be difficult to not just automatically fall into a cascade of routines. There have been situations when my only role as a doula was to comfort and support the mother because the hospital already honored her wishes, but often times my role includes reminding the family of their right to refuse unnecessary interventions. When I was in Haiti working at the birth center, I watched midwives function completely different than what I'm used to in the American hospital culture.

For the three births I was in attendance for, there was only a total of three internal vaginal exams performed. One woman didn't have any, one had one, and the other had two checks. The midwives' view was that internal exams are invasive, can introduce harmful pathogens, and that a woman's progress often can be just as accurately determined by assessing things like her behavior. There was also a sense that having a woman lay down and be in such a vulnerable, unnatural state, would slow or impede labor. We often forget this in the hospital. I had a client in the states whose obstetrician came in early in the morning. The woman had finally relaxed enough during the night to get some sleep and was still asleep when the OB came in. The OB opened her legs, and broke the woman's water before she was ever fully awake and able to consent to what was being done to her (another person's hands in her vagina with a hook that looks like a crochet needle). As people in the medical field, we often don't think much about how a patient might view these things because we are just doing our job. However, the patient's experience, privacy, autonomy, and individuality was not lost in this small Haitian women's clinic.

The first woman who gave birth while I was there was walking around the waiting room in pretty active labor. It was late in the night and no one else was there except two other patients in their own rooms. As the contractions got more intense, she ended up on the floor in the waiting area. It became difficult for her to move and I could see that birth was very close. I asked the Haitian midwife, "Should we help her move into her room and get her on the bed?" The midwife looked at me and said, "She can give birth where she wants. If this is where she's comfortable, we will bring the stuff out here." Where she wants. If she is comfortable. Clearly, giving birth in a waiting room in a hospital isn't feasible, but it's her attitude that surprised me. It was surprising to finally see what respect for the woman's choices looked like in action. The staff of the clinic quickly got the birth supplies and a stool out into the waiting room. The midwife sat on the hard tile floor. The woman was upright and in a position that felt natural to her. She wasn't forced to move for the convenience of others. Her labor wasn't impeded by invasive and unnecessary exams or interventions. Everyone around her trusted that she could do what her body was meant to do. There was skilled personnel quietly nearby to facilitate and act in the case of an emergency, but to only intervene when necessary- a model that has proven to work in many countries. It was so refreshing and honoring to be a part of culture that so respected and empowered the women that it served. Those three words have stuck with me, the epitome of the type of culture cultivated at Olive Tree Projects: where she wants.

my wednesday-friday in Haiti

I was at the apartment getting ready to go out for Alex and Nicolette's last day in Haiti (they've been in Haiti for a month). We got a text message from Sarah saying that a woman called her saying she was bleeding and that her water broke. As we were getting ready to walk to the clinic, a tropical downpour rolled in. It was raining so hard that our tin roof was leaking. We picked up everything off the floor and put cups under the leaks. We were trying to wait for the rain to pass, but it was clear that it wasn't going to stop for some time. We made the decision to run down the two blocks to the clinic in the rain. I wrapped up my valuables in some scrubs and put them in my backpack. I put the backpack on first and then a big t-shirt over it. 

We were soaking wet and muddy when we got to the clinic. Sarah had already finished the assessment. There wasn't much bleeding and no signs of labor so they decided to monitor her overnight and reassess in the morning. We went back to the apartment after an hour or two of doing vital signs. Sarah and another midwife, Ninotte, stayed with the woman. We woke up early the next morning to go back to see if labor had started. When we arrived, Sarah told us that another woman had called to say her water broke at 3 am and that she was going to stay home for a little while and come in later. The first woman still hadn't started labor. We tried walking, acupressure, nipple stimulation, and herbal tinctures to see if we could induce labor. None of it was working. Sarah performed an internal exam to see if she could see fluid and test it to confirm that her water broke, and to assess the state of her cervix. Her cervix showed signs of infection and it wasn't obvious that her membranes had ruptured or that her cervix was ready for labor. We decided to treat her with antibiotics and keep her for 48 hours for observation. 

The second woman came in early labor and we set her up in one of the birth rooms. Just as we had finished, a third woman called to say her water broke four days ago. She came in and we began IV antibiotics. She also wasn't showing signs of labor. We tried the same natural induction methods on her. They produced some mild contractions and she was 3 cm dilated and soft. Because she was getting prophylactic antibiotics and not showing any signs or symptoms of infection or fetal distress, we decided to wait to see if labor would increase naturally. Meanwhile, the other woman began to shows signs of active labor.

The woman in active labor started to have high blood pressure. Our priority was to vigilantly assess for other signs and symptoms of problems like eclampsia and to try to get her blood pressure down. We gave her valerian root to see if it could help her relax and therefore lower her blood pressure. It did lower is some, but not as much as we would have liked. We did several urine tests and frequent assessments. She did not have any other symptoms and while her pressure was higher than normal, it wasn't so high that we felt we needed to transport. She began to show some signs of transition (opening the last few centimeters), such as vomiting, a change in behavior, bloody show and the shakes. Sarah did an internal exam. She was only 4 cm but her cervix was paper thin and the baby was pressing right on it. A few hours later, she began pushing on a birth stool. At 1:23 am, a 9 lb baby boy was born. His heart rate was good, but he was having difficulty breathing and didn't have good muscle tone. We (mostly, they) worked quickly to stimulate him and give him a few breaths. He pinked up right away but was very sleepy. We put him on his mother's chest and after a few minutes he began to cry. After the placenta was delivered, another midwife and myself went to assess the baby. I had to suction him a bit more. He had a little bit of a rough start, but things resolved quickly and mother and baby are healthy and doing well. 

I went back to the apartment to sleep for a few hours. The woman whose water broke a few days ago was started on pitocin. I came back to the clinic this morning and continued to do vital signs for both the laboring woman, the postpartum woman, and the newborn. Sarah showed me how to do a complete newborn assessment. It was interesting to learn the things a midwife looks for and how they determine how many gestational weeks the baby actually was. With a variety of assessments, it's possible to determine just a week's difference in gestational age. Because mother and baby were both stable, the attention turned to the laboring woman on IV antibiotics and pitocin. Her pitocin was slowly increased because she hadn't made much progress from the night before. If that didn't help progress her in a few hours, it would be necessary to transport her to the hospital. However, her labor became active and she began to respond well to the increased pitocin. She's currently six centimeters dilated and we are playing the waiting game. 

~~~~~

A 7 lb baby girl was born Friday night at 10:19 pm. The mom worked beautifully at moving and using gravity to help bring her baby down. Birth seemed to come very naturally to her and she followed her intuition. I went into her room around 7 pm to take vital signs and as soon as I walked in, she asked me to give her a massage. She was having a lot of back pain and counter pressure on her sacrum seemed to really help. First, she was sitting backwards in a chair, leaning forward. Her husband was sitting in another chair next to her, as I sat behind her doing hip squeezes and back massages during her contractions. Other than a few breaks to eat and use the restroom, I stayed massaging her for the rest of the birth. She had turned the chair around and I noticed she kept scooting her bottom farther and farther off the chair until she was barely sitting on it. I suggested trying a birth stool which has the middle cut out of it and may be more comfortable since she was feeling so much pressure on her bottom. She began pushing when her body got the urge while the midwives waited quietly and followed her cue. There was no counting or telling her when and where she had to push. Sometimes she only pushed a little, sometimes very hard, but it was up to her to determine what she felt was right. It was a calm, quiet, and peaceful birth. Once the head had emerged, the rest of the baby and a lot of water came out very quickly. The baby was doing well and just needed a little stimulation to get some big, strong cries. The sister in law of the woman said, "The mom didn't cry and neither did the baby." It was true. Mom had stayed very calm throughout the birth and her daughter came out with a similar disposition.

Day 1

My day begun at 2 am. I had to be at the airport at 4. I got there on time and there was already a line forming at the check-in counter, but there were no employees there yet. A man in front of me left (presumably to go to the bathroom) and left a small duffle in line. The woman in front of him starting getting very anxious, saying "it don't take that long to pee!" She tracked down a TSA agent to tell him there was an unattended bag. They didn't seem to care. This increased her agitation. She told three other people and was saying things like "Well we are all gonna die if it's a bomb!" She was starting to scare a little girl in the line. Someone announced that check in outside was available and she bolted out of there. The bag still sat there. A TSA agent finally approached the bag right as the man returned. He said, "Don't leave your bag." And that was the end of that incident.

I finally got to the check in desk at 5 am. A friend of mine purchased my plane ticket using miles earned with her American Express. When I had tried checking in online the day before, it told me that I needed to present the credit card to check-in. My friend called Delta and they told her it wouldn't be a problem when I came to the airport. When I tried to check-in at the airport, the agent told me I needed the card. I explained to her that my friend had already gone to her airport to have to card swiped and called twice to make sure it wouldn't be a problem. She called over her boss. He said to her "Why does it say card found? Was it reported stolen and then they found it?" I interjected and explained the situation (since the first agent hasn't said anything to him). He told her to go ahead and check me in and print my boarding passes.

I finally got to my gate and right before they began boarding they announced that the plane was actually parked at another gate. We all got up and moved. The flight was also overbooked so they were asking for volunteers to give up their seats. We started boarding, but the computer wasn't working so the agent had to tear off everyone's bar code and then scan it at another gate. Surprisingly, we took off only about 10 minutes late. 

Once I got to Atlanta, I had enough time to eat and change my clothes into something more fitting for Haiti weather. I would be catching a ride with a group from Alabama that was heading to the same city as me. That's all I knew about them, but in case they were also flying through Atlanta, I started asking everyone if they were from Alabama. None of them were. I met a nurse who was going to Carrefour to work at a clinic and do home visits. We had fun observing the Christian subculture of missions teams. Who decided bright matching shirts tucked into belted khaki pants is what one is supposed to wear on a missions trip? This nurse, Benjamin, turned out to be a great help when we got to Port au Prince. He had a small issue at customs and I was able to help him out of it. Then he watched my stuff as I used the restrooms and waited with me as I asked every passerby, "Are you from Alabama?" Eventually, someone said yes. My next question was, "Are you headed to Jacmel?" When they said yes, I said, "Great! I'm getting a ride with you." They looked very confused about this random girl inviting herself into their van.

I still wasn't sure if I was on the right van, but if I at least got to Jacmel, I knew I could find someone that knew Sarah and could get me to her. The 2-3 hour drive was gorgeous. During the drive through Port au Prince, I saw how the city had changed since the last time I was there. The last time I was in Haiti was a year after the earthquake and there was still a lot of rubble and tent cities. There was less of that this time. The Presidential Palace is completely gone now. Once out of the city, we took a windy road up and over the mountain ridge. It was gorgeous. Up in the mountains it got cool enough for me to put on my sweater. It started to rain lightly and we saw a rainbow over the green hills. 

We arrived at the organization the team was working with. When we got out of the van someone asked me if I was Carsen and told me Sarah was on her way to get me. I made it to the right place! She took me to where I'm staying: a small upstairs apartment about a block from the clinic and her home. She then gave me a tour of the clinic. We quickly drove down to a neighborhood soccer game to support a boy who put the game together. I had street food for dinner and we watched a movie. Falling asleep was difficult. I'm no longer acclimated to the heat, humidity, and noises of Haiti. I finally fell asleep around midnight and was up with the morning sun and roosters. I fell back asleep for a little while until the sounds of Haitian church, shouts of Hallelujah, came in through my windows. 

My trip

Tomorrow very early in the morning, I'll be getting on a plane to head to one of my favorite places: Haiti. I'm going to be working with an organization called Olive Tree Projects in Jacmel. I've been to Jacmel once before and loved its laid back atmosphere. This will be my first time working with Olive Tree. My plane arrives in Port au Prince late Saturday afternoon. I will then catch a ride to the other side of the island with a team working at another organization in Jacmel. The last time I went to Jacmel, my family took a tiny plane for a scary 13 minute flight over the mountains of Haiti. The drive will be much longer, but I'm looking forward to the adventure (as long as I don't get car sick).

Drinking out of coconuts in Jacmel, 2006

The main function of Olive Tree is to provide safe and loving maternal healthcare. They also work alongside Haitians to improve the community through adult education and girls' soccer. While I'm flattered by people's kind comments of how wonderful I am for doing this, I have to be honest: this trip is purely selfish. One day I want to be a Certified Nurse Midwife and possibly own a birth center/home birth practice. Because I'm an American going into midwifery from the medical model (as opposed to a direct-entry midwife who was not a nurse first), the majority of my training will be in a Western hospital setting. This trip gives me the chance to work with a Canadian midwife in a third world country. Midwives are known for having hands-on skills that may be lost in the obstetrics model due to the technicalization of birth, i.e. the standard is breech babies are born via cesarean surgery and few obstetricians have ever delivered a vaginal breech baby. Midwives, especially in an out-of-hospital setting, tend to rely on things like measuring the uterus with a measuring tape to estimate fetal growth instead of using ultrasound (which tends to be inaccurate as the pregnancy progresses.) If there is a natural disaster in the states and we lose all the technology we depend on, what do we turn to if we don't have the basic skills of assessment and palpation? I am so excited to be a part of the daily norms of this maternity clinic for that reason. It will be a different perspective and set of skills that I look forward to experiencing early in my nursing career.

Short term trips do little to improve the lives of the people they intend to touch. My goal is not to make a difference in the day to day lives of Haitians. My goal is to learn and grow and be a better person and eventual clinician. My goal is to bring needed supplies and also the little things like mascara and chocolate to the woman who carries the burden of this ministry on a daily, long-term basis. My goal is to provide company and friendship and refreshment to the people doing the difficult work and actually making the difference. The type of missions that work are the ones that build relationships and intimately know the community's needs because they are a part of it. I'm simply attempting to come alongside those people, learn from them, and hopefully be a blessing to them.

There are six babies due in the month of June. I'm praying that some babies are born during my ten day stay. Not only for my own learning, but also so that it works out that Sarah, the midwife, has an extra set of hands around. I'm also praying that my travels are smooth and safe and that I can easily meet up with the people I'm getting a ride with. I'm praying that going through customs is uneventful and that none of my items get taken. I'm praying that my bags and all their contents make it to their final destination. I'm praying for health and energy while I'm there (no malaria, please). Will you pray with me? I don't know how much internet access I will have, but I will do my best to post updates and pictures. Thank you for your support!

Holding a half French, half Haitian cutie on the beach in Jacmel, '06

military dictionary

Having a family member in the military means having to learn a new language.
I've complied a short list of some commonly used acronyms or terms.
Disclaimer: These definitions are what I know of the terms and may not be absolutely correct. My husband is in the Army, so these may not apply to other branches.

ACUs- Army Combat Uniform, the basic camouflage uniform that soldiers wear on a day to day basis, and while deployed
ASUs- Army Service Uniform, also known as dress blues. The class "A" uniform is the more formal uniform. Class "B" is the less formal uniform with a white short sleeve shirt.
PC- Patrol cap, AKA the hat that goes with the ACU
MOS- Military occupation specialities. Basically, your soldier's job. His/her MOS is usually a number and a letter like 11B, which means infantry.
Basic training- (The term "boot camp" is not used in the Army.) The initial training a soldier receives. Where it takes place and its duration depends on the MOS.
AIT- Advanced individualized training. This training phase is often combined with basic training for one lump of initial training or takes place shortly after basic. It is specific training geared toward the individual's MOS.
PT- physical training. "PTs" is used to describe the uniform to be worn during PT.
FRG- Family Readiness Group. This is usually run by the Captain or the Captain's wife, if he is married. The FRG can be a great source of information about upcoming events on post, training schedules, and important dates. FRGs often host meetings and events for spouses and families. At its worst, it can be a way for people to gossip and complain. At its best, it can be a way to meet new people, get involved, and be informed about the happenings of the company.
Px/Bx- Post exchange/base exchange. This is a store on post/base. (An Army instillation is a "post." "Base" is used by the Air Force and Navy.) What they sell varies from store to store, but it's kind of like a Walmart. You can sometimes find cheaper prices here than at a civilian store.
Clothing and Sales- Another store. This one specifically sells uniform items- boots, patches, ribbons, shirts, pants, socks, etc. You can also often find gift shop items like "Proud Army Dad" shirts and bumper stickers. This might be a place visiting family members would want to check out.
Commissary- grocery store on post
DFAC- dining facility, most often used by soldiers who live in the barracks
Barracks- dormitory-style living facility for single, lower-level enlisted soldiers
Deployment- period of time in which a group of soldiers leave the country for the accomplishment of a specific mission, typically in a combat situation (or in support of one)
"Outside the wire"- when soldiers leave their combat outpost during deployment to go on patrol or some other function/mission of deployment
"In the field"- When service members are "in the field" they usually are quite literally out in a field conducting some sort of training exercise
PCS- Permanent change of station. A fancy way of saying "moving."
CQ- charge of quarters. 12-24 hour shifts to guard the front of the barracks. This includes doing random barracks checks/patrols and signing in soldiers who have to check in every hour due to disciplinary actions. Mostly, it's a lot of sitting around and a glorified "rent-a-cop" duty for the barracks.
Staff duty- Similar to CQ but at the battalion level instead of the company. Battalion secretary/rent-a-cop
BAH- Basic Allowance for Housing. An allowance given to those who live off post. The amount is based on rank, whether or not the soldier has dependents, and the cost of living of the general area.
BAS- Basic Allowance for Subsistence. Part of income for those who live off post, specifically for food. It is in place of having access to the DFAC.
LES- leave and earning statement, AKA a pay stub
Tricare- health insurance for service members and their family
DEERS- Defense Enrollment Eligibility Reporting System. I'm not sure of the full function of the DEERS office but this is where you go to get your military ID and enroll for health insurance. It's about as efficient and pleasant as the DMV. Making an appointment online will help shorten your wait time. To get a dependent military ID, the active duty service member must be present (unless the service member is deployed and you have a power of attorney specifically stating you can act in his/her place at the DEERS office) and you have to have all required paperwork (usually a government issued picture ID like a driver's license, social security card, sponsor's active duty military ID, and a marriage license).
MyCAA- an education grant provided for military spouses. If you meet the criteria, you can receive up to $4,000 in grant money for college

One of the hardest things for me to remember was how a group of soldiers was organized. I learned it best starting from the biggest group down to a smaller, more specific group. However, if you ask a soldier what unit they are in, they will usually say it starting from the smallest to largest entity. Here's how it works from biggest to smallest:
Division > Brigade > Battalion > Company > Platoon
It breaks down ever further into sections and squads in some units. If you look at an address for a deployed soldier it will usually read like this (or something similar):

Rank Last Name, First Name
 --- Co (company), ---- (a number which represents the battalion), --- BCT (brigade), --- DIV (division)
The name of the post/base
APO, AE and a zip code

Sadly, this is a very short list of the terms one must learn to understand the military world. I don't know that I'll ever be fluent in "Army" but I hope this list helps some new family members!

last minute

It's 8:40 pm and my phone rings. It's my husband. I haven't seen him in six days. I'm laying on the couch in my pajamas, hair up in a messy bun, with the day's make up smeared under my eyes. He says he's on his way home. They released him last minute. "Yay! So you have tomorrow off?" "No, I have to be back at 0800." Awesome. Less than 12 hours off after working six days straight. Sigh. I'm thankful that he's on his way home and decide to make a night of it. I quickly brush my hair and change my clothes. I'm sitting on the edge of the tub, one hand shaving a leg, the other brushing my teeth.

We have this routine down to a science. I tell him I don't care that he hasn't showered in six days, I still want a hug and a kiss. He empties his ruck and I get laundry going while he showers. I ask him from the shower if he wants a beer or a margarita. Margaritas it is and the blender is going by the time he's out of the shower. I ask him if he wants to stay in, get take out, or go somewhere to eat. It's already past 9 pm, but we have to make the best of the time we have. He packs up his ruck with new socks, boxers, and undershirts and moves his uniforms to the dryer while I finish getting ready. It is boring day to day stuff but we are a team and know how to run the system efficiently. It's morning and he's gone again before I know it.

Everything is last minute with the military. There is no planning ahead.

 "Will you be able to visit for Christmas?" "I don't know." "When will you know?" "Probably not until November or December."

"Can we let you know the day of if we are coming or not?" "Can you let us know by Friday? Having a baby makes it hard to plan last minute." "I understand. I will let you know as soon as possible."

"Let's go on a double date!" "Well, I can come, but I don't know if John will be home or not."

"Hey! It's good to see you! Where's your husband?" "He's in the field."

This is the military life. I often go to functions solo. My answer often is that I for sure will be there and maybe John will. John tells me to plan on going to things despite his schedule because he doesn't want me to miss out on things. Most of the time I do. However, sometimes I'm also the girl who stays home at the off chance that he'll come home because I don't want to miss the few precious hours he will get.

Thankfully, it's not like this all the time. Gunnery, a big training exercise, is going on all month so it's more crazy right now than it usually is. However, the military offers a lot of opportunities for spouses to be very independent. It often means not seeing your spouse for days, weeks, months, or even more than a year at a time. It means packing up the entire house alone and living apart for awhile. It sometimes means having a baby without the father present. When John got back from deployment, someone at church asked if he was my boyfriend. Being a military spouse sometimes means that people think you're single.

It also means that sometimes you look like an unreliable flake because you can't commit to plans. Naturally, I'm a planner. I plan dinners for the week and have things on the calendar months in advance. I like details and don't appreciate big surprises. I want to be prepared. I've had to learn to be more flexible. I've had to learn that I can't just freak out and say, "but I'm not ready!" Now I just say that I'm happy and run frantically to the bathroom to shave my legs and brush my teeth at the same time like a champ.

pregnancy courtesy 101

Because I'm a woman in my mid-twenties and have worked as a doula, I've had lots of pregnant women vent to me about things that were frustrating during pregnancy. A lot of the complaints have to do with family and friends. Most of these lovely ladies would prefer to not saying anything directly because they fear hurting a loved ones' feelings isn't worth laying down some ground rules. Since I currently know approximately 76.3 pregnant women, I thought I'd compile a list of some common complaints and general rules my pregnant friends might like you to follow.


1. So you just found out your friend/daughter/sister is pregnant? That's so exciting! However, unless she explicitly says she wants you to tell someone, keep it to yourself. She loves you and is excited to share the news with you, but don't ruin that trust by blabbing the news. Perhaps she hasn't gotten ahold of a family member just yet and doesn't want them to find out through the grapevine. Maybe they've had a history of miscarriage and don't want the news public until the second trimester. You are excited and that's great, but it's their news to tell, not yours.

2. Stay off social media. Boy, do we live in a world of over-sharing! I'm just as guilty. Social media is a great way to keep in touch with relatives from afar, but we often forget to honor each other's privacy. If you are privy to information such as the gender of the baby, possible name choices, that the mom is in labor, the baby has been born, or you were there and have pictures, again please keep all of this to yourself unless she asks you to post the information on Facebook. Some moms appreciate having one person head up the spreading of the news so she doesn't have to, but many do not want it plastered all over the internet. Yes, this point is almost the same as number 1, but I feel that it is important to make it it's own point. We post pictures of our dinner and other trivial things- sometimes we forget what should go online and what shouldn't.

3. So your friend has decided to have an elective cesarean section/induction/no pain medication/home birth/whatever and you think that's a horrible idea. Maybe even a foolish or dangerous one. Guess what? It's none of your business. Trust that your friend/daughter/niece/sister is a wise and informed woman. Trust that her choice was based on research and guidance from a professional. If that's not the case, and you have a close and personal relationship with her and are concerned about her choices, politely ask questions. Maybe you don't know the whole story. Maybe she knows more about what is right for her and her family than you do. For some reason, pregnancy seems to be a time when everyone thinks they have a right to influence decisions or offer advice when they don't. Support and respect your loved one; she needs that more than your advice.

4. Ask her about things other than her pregnancy. She is more than an incubator. Ask her about politics and what she's been reading. Ask about her marriage and work. Just because it's growing to the size of a watermelon, doesn't mean that she is only a uterus. There's a good chance she wants to vent about heartburn and constipation, but maybe she also wants to tell you about her dreams and plans for the future.

5. Leave the cute outfits and accessories to the grandparents. Be the boring friend that buys diapers, wipes, soap, and organizer bins for her baby shower. Get her a cloth diaper cleaning service and throw in some hemorrhoid cream. She'll love you forever.


6. Once the baby the is born, make yourself useful. Don't show up without food. Pick up a broom. Do some laundry. Don't stay long and expect to be entertained. She just pushed out a tiny human that poops, cries, and eats every few hours. It's not about you.

7. If she chooses to breastfeed, don't be offended if she asks you to leave when she needs to feed the baby. The first couple of weeks can be tricky and trying to add in modesty makes it more difficult. Feeding her baby comes first and if she can't be comfortable about whipping out her boob in front of you, you gotsta go. And no she can't just give the baby formula this one time so you get to feed the baby. She didn't choose to breastfeed to make you feel left out.

8. If you're sick, stay away. It's kind of ridiculous that I even have to say it, but it seems that people need to hear it. You seeing the little one who will probably just lay there and sleep isn't worth potentially infecting the vulnerable baby for your few minutes of pleasure. Don't be that guy. It can wait until you are healthy.

9. Keep your horror stories to yourself. Her mind is already flooded with fears of arms growing out of foreheads and perineums ripping in half. If it's not helpful, assume it's hurtful. There is plenty of drama and scary birth scenes in our media; she doesn't need your input about how awful birth/breastfeeding/parenting might be. Encourage her instead. Remind her that she is strong and capable. She's probably totally freaking out right now; don't add to it.

10. Babies are not milk; they don't expire on a certain day. Due dates are simply educated guesses based on a lot of different averages. Sometimes babies are healthily and naturally born at 38 weeks, sometimes 42 weeks. If mom, baby, uterus, and placenta are all healthy.... everything is healthy! Please don't text her everyday asking if she's had the baby yet. Sometimes babies come too early or need some help coming out, but most of the time they come when they are good and ready. Everything will be okay... deep breath...


So what say you? Anything else you'd like to add to the list? Have I spoken well for you pregnant ladies? Can we all agree to follow theses rules?

allies

Hey newlyweds. I don't have much wisdom to share about this whole marriage thing because I've only been married two years. I'm still figuring it out, and I'm not always doing it very gracefully. I have learned a thing or two, though, and I'd like to share something with you. I think it's important and wise and helpful, so you should listen, mmkay? Are you ready for this?

Choose your friends wisely.

I know your mom already told you that 20+ years ago, but please hear this not as a motherly figure, but as someone who is still learning all this stuff too. Only certain people in your life should have authority over you. That's a part of establishing boundaries. Not everyone gets a say in how you live and act. In fact, most people shouldn't have a say. As you become an adult, that authority usually shifts from parents to peers. You get to decide who influences you. When it comes to important things like marriage, it would behoove you to choose those people wisely.

Here's the thing; as awesome as your partner is, he/she will one day be the most excruciatingly annoying and exhausting person you have ever met (and you will be the same for them). And you are going to turn to someone pissed off, tired, ready to dramatically throw your hands in the air in defeat. This person needs to be someone who is for your marriage. You might say some things you don't mean about your spouse. You probably will disrespect him/her out of your anger. You can choose to confide in someone who will agree with you- "Yeah, what an asshole!" Or you can choose someone who will honor your marriage and not stoke the fire - "I know you don't want to right now, but I'm going to pray." You need to select a few chosen people who have the authority to say, "I love you, but you are being the jerkface."

When you are angry, it feels good to have people agree with you. Our natural reaction is to turn to people who will feel the same way and shake their fists with us. However, you need to have allies in your corner; people who will listen and not minimize your feelings, but who will also give you wisdom and be for you and your spouse. These type of friends know that being supportive of you and your marriage also means supporting your spouse. They are allowed to be upset if you're hurting, but choose the ones who will put aside their own feelings to help you reach unity and resolution with your spouse.

When you have a fight and you want to call someone, stop and think, "Will this person help me to be more angry or to find grace for my spouse?" If your goal is to continue to feel righteous in your own anger, go ahead and pick the first type of person. However, if peace is your goal, choose a peace-loving person. Trust me, things can get pretty wonky in marriage; you don't need someone to help you be annoyed with your totally awesome, lovable, worthy spouse.

bel peyi

Everyone knows Haiti is poor. I knew it before I went there, yet I was shocked by my own shock. As a privileged white teenager, I snapped photos of burning tires and frail children. I was taken aback by trash in the streets and the overwhelming smell of urine. I wanted the kids at my school to see how other people live. I wanted to wake them up from their frivolous conversations about prom dresses and boyfriends. I wanted them to see. I wanted to make them see. You know it's poor, but do you really know how poor? I wanted to scream to all of them, they don't even have clean water to drink! Screaming, as if I knew all about it, yet just trying to wrap my own head around the things I'd seen. I saw desperation. I wanted to do something. I wanted to be a hero and save the poor black people with my education and intelligent plans.

This place fascinated me and gave me a sense of purpose, but a selfish one at that. I wanted to do good because it feels good. I liked neat, tangible successes. I painted an orphanage wall. I did crafts with those cute orphans. I never consciously felt superior, but I did feel like I had something to offer. But then I started to get to know the people. I began to feel the weight of their lives. The fixes were no longer easy. "Just leave him!" I told her. I thought it was absolutely ridiculous for her to stay with a man that sleeps around and treats her poorly. "But he pays for my daughter's education," she shrugs. "If these women would just stop sleeping around, maybe there wouldn't be so many infections and uncared for babies," I thought. And then someone lovingly explained to me that it's not that simple. Sometimes women don't have a choice about having sex. Wall after wall, notion after notion, they began to crumble and humble.

Then I saw the beauty. I had slowly begun to know the people. I knew their names and their hopes and they became my friends. Then the country came alive with color and life and burst out with so much beauty. I became fascinated in a new way. I no longer wanted to be a hero and wanted to just soak up all that Haiti had to offer me. I began to smell the salty ocean air and sos pwa bubbling on the fire. I had been seeing in black and white, distanced, shocked. Once I began relationships with Haitians, I started to see all the titillating and dangerous colors, so many shades of them that once again I was overwhelmed by what I saw. The photographs I took changed, though my perspective is still a work in progress. Rolling hills, clear blue oceans, smiling faces, the silhouette of couple dancing to kompa; I saw life. And now I find myself screaming again, but something different this time. Don't you see that she is so much more than poor? Yes, there's poverty. That's a truth that remains amidst the beauty; one doesn't cancel out the other. Visitors come and take pictures of the poverty and share with their churches the tangible things they've done. Those that live and breathe in Haiti get to know the beauty within the hero-less, intangible work they do. And maybe they'd like you to stop taking pictures of the trash and the sickness. Maybe they'd like you to stay long enough that you stop thinking you are a hero. Maybe they want you to stop offering all your crisp white ways and just take in what Haiti has to offer you. She has a lot give to the soul that is willing to receive the weight of her friendship.

six weeks

Lots of people have had these moments. Each story is different, but the actual moment isn't all that unique. Sitting, waiting the 5-10 minutes. Emotions flooding, nerves shaken. Some people want it, others don't. A positive or a negative, two lines or one. Waiting, watching the window, praying another line appears or hoping there isn't one. Whatever the story, many people have been here before.

Enough time elapses and only one line appears. My husband lets out a sigh of relief. I am unconvinced. I know there is something different about me. "Are you disappointed?" No. Disappointed is the wrong word. I just don't believe it. I decide I need to take another test, this time first thing in the morning when the sample is more concentrated. It might be too soon to tell, but I know.

I know, but I'm in denial and choose to not get another test. It's almost Christmas and family will be here shortly. I don't have any typical symptoms, but I am different on the inside. Something has changed within me. Two weeks later I wake up tired, ill, and achey. I had injured my back recently and decided it was that which was causing me pain. This pain was different though. It started out like a dull, annoying pressure. As the day went on, it was getting less easy to ignore. It became sharp and moved from my low back into my pelvic area. I had lost my appetite. I was trying to not ruin the family outing, but by lunch I insisted on going home. I laid down with ice on my back, silent tears running down my face as it became more intense. Now I could feel it in my thighs, every few minutes becoming increasingly more difficult to bear. The pain would come in waves. It would start in my lower back, come around to the front, deep in my body, and reverberate down my thighs.

I must see a doctor; they don't give me a choice. Silently I think to myself that this feels a lot like how I've imagined labor to feel. Still in denial, I did not verbalized what I thought was going on. The ER doctors speculate appendicitis; it is ruled out. They then turn to the possibility of a pelvic infection; the labs say otherwise. I assume they do a pregnancy test and since nothing is mentioned to me about it, I assume it's negative. My body is still violently trying to get rid of something. The morphine does nothing. They seem uninterested with my case and admit me for pain control. A doctor tells me my cervix is dilated, but no one answers my questions about why. They send me home with pain medication on Christmas eve.

My follow up appointment a week later does not lend much answers, except that in the ER they did a urine pregnancy test, which the lab said was inconclusive. They should have then done a blood test, says my primary physician. She is worried about a life-threatening ectopic pregnancy. I'm sent for more tests and that is ruled out. I finally have the courage to ask what had been on my mind: was this an early miscarriage? I'm given a political "we can't say that for sure" answer. No one wants to give potentially bad news when they aren't sure. I'm given the sense that because there is no life-threatening condition and that they can't definitively say, they want me to just drop it and not concern myself with the ugly "m" word.

I go home and share with a few select people what I believe. It's difficult for me because I believe in science and medicine and like things to be black and white. This situation isn't and it makes me uncomfortable. When I mention miscarriage, my family is sensitive and asks how I feel. I tell them I'm indifferent. I don't have the right to feel anything because I know nothing. I question if I'm trying to fill in the blanks to make myself feel better.  I wonder if I feel this way just because I didn't get answers about what was going on with my body.

When I can't get it out of my head, I begin to do research. I reach out to other women. I listen to their stories. Slowly, I allow myself to believe my intuition. I take in all the information and give myself permission to feel the things I'd been holding back. First it's relief that I'm not pregnant. And then shameful guilt that I felt that way. Then, quietly the sadness creeps in. I go through all these cycles alone, never mentioning it to anyone except a few anonymous women online. I process it all internally, sometimes resisting and fighting with my inner dialog. Two months after the incident, I finally confess to my husband all the things I'd be going through. He tells me I don't need a doctor or labs to give me the answers; I already have them. He gives me the confidence that I know my body better than anyone else. He tells me to talk to someone about it.

I do. I talk to a friend who also had a miscarriage. She helps me find peace. She tells me that the wide range of emotions are normal. She tells me her story and that makes me feel less alone, less awkward, less silent. I am reminded of the old saying, "A woman becomes a mother when she becomes pregnant. A man becomes a father when he sees his baby for the first time." For some reason I feel like I should be more like a man; that because I didn't see or know this child, I shouldn't have such strong feelings. Sweetly my friend says, "You were a mom for six weeks." And that's what I need to hear. It all makes sense and comes together for me. I was a mom for six weeks, my heart and body changed. For whatever reason, it was for only a short amount of time, yet the change still happened. Although I am feeling like my normal self again, for six weeks I was a different woman because of the life growing inside of me. I may be forever changed because of it, but it's a change that probably only I can detect. It was my secret, my intimate six weeks with a life only the most intuitive parts of me knew existed.






Late edit: I began to share this post privately among friends. I was overwhelmed at the amount of friends that have had similar experiences. Early miscarriages are very common and it seems that many women deal with them silently. The reactions also seem to be similar: flippant attitudes from the medical community, women dealing with a wide range of emotions from relief to grief, and difficulties between husband and wife because of a huge difference in how men and women experience the situation. It was because of this response from other women that I decided to post this publicly. Perhaps the sharing of my story may help others find peace.