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The Big Letdown: A Book Review

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It’s been a long time since a book has hit the scene that really resonated with me to the point of wanting to discuss or promote it. The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding, by Kimberly Seals Allers, is the first book in a while that not only chronicles the path taken to where we are, but also lays out a plan for next steps.

The first part of the book covers history, politics, and science and is well researched. The middle of the book really gets to the heart of structural barriers, racial disparities and lack of meaningful support for breastfeeding.

I find it interesting that some of the negative reaction to the book I have seen is rooted in the notion that being a feminist means that you are not allowed to look at how women are approaching issues of equity and decide that there are new ways to approach it. Women need to continue to demand the same opportunities, pay and influence as men have. Of course we need and want more and better and longer paid family leave in the US so that (all) parents can take time off to care for a new baby or a sick relative or themselves if they have an unexpected health issue. This would most definitely ease the burden on those who have just experienced childbirth, or adopted, breastfeeding or not.  Addressing policy is the first point that Ms. Sears Allers invites us to focus on next. Yet at the same time, we need to push the needle forward on valuing things such as breastfeeding and mothering.

Valuing mothering does not mean devaluing fathering or parenting or grandparenting or dictating a strict set of rules for how to parent. This passage from Chapter 5, Nipple-omics and the Value of Motherhood, sums it up: “In a world where we are fixated on time and overwhelmed with overscheduling, breastfeeding is framed as confining and restrictive because it works best unscheduled. Instead, we should challenge why we have no freedom to be temporarily unstructured or unscheduled or made to feel like less of a woman for exercising this freedom.” I agree. Not everyone wants to choose an unstructured and unscheduled path, but as a person who supports new parents, I sure can’t keep up with the inquiries from new mothers who wish they did not have to return to work so soon or would like to relax and slow down as they adjust to parenthood but just don’t know if it is ok to do that.

The book challenges whether or not aspects of the feminist movement have helped mothers. It’s a fair question. Is choice really choice as far as breastfeeding goes when there are so many obstacles? Just like with health care, is it really impossible to have health care for everyone or does America just not value that? Is it really impossible to make breastfeeding easier for people or are we just not willing to ask the questions or have the conversations that seek to support the idea that breastfeeding is really valuable. Not just nutritionally, but societally.

Ms. Sears Allers outlines a set of seven starting points for taking action. The time is right for moving the needle forward and these areas to focus on are clear and well articulated. No doubt the task at hand is a challenging one, and complicated! There is a lot to consider in discussing how society, politics, and women themselves, intersect to create the current lactation landscape. Yet I am inspired and motivated by reading her perspective and I urge you to get a hold of a copy and consider how you might be able to incorporate some of her ideas on the way forward into your work.

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Wild Feminine Circle

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Hello Friends!

I am sending out this email to let you all know of an exciting new offering I am putting out into the world with Carla Orr. After reading this, if you know of anyone who may also be interested, please feel free to forward this email.

As you may know, I am very interested in working with women of all ages to tap into their own personal power and then go on to use the resulting confidence to make authentic and satisfying choices for their lives.

Carla’s work combining art with energy healing has been informed by training she received from Tami Lynn Kent, a pioneer in women’s holistic health. Tami wrote the book Wild Feminine so that all women would be able to access their own medicine and give them the tools to bring joy, balance, spirit, and creativity into their lives. This book is so full of useful and insightful information and has helped me in so many ways.

Carla and I have decided to form a Wild Feminine Circle that will meet monthly for women who are also interested in connecting to their core and exploring the full range of their wild feminine landscape. Have any of you been wanting to venture into some possibly unknown, unfamiliar but rich inner territory with others in a safe, nurturing circle? Well, now’s your chance!

Each month we will be going over one chapter in the book. The circle will be a place to discuss and share our thoughts on the given topic. Meditations, creative activities, and other things that naturally move us will also be part of the circle. We will also provide light refreshments.

Questions? Want to take a peek at the book before you join? Want to meet the two of us and see if this is something you might want to do? Come to our Free, no-obligation Info Session next Sunday, November 9th at 4pm to find out more!

We will gather at my house in Wenham. If you would like to join us, please let me know and I will send you my address, or fill out the form here. Exact details with dates are also on this page. Books are available to purchase for $15, each session is $15, or you can pay for the 7 months in full for $75. We will be circling the second Sunday of the month, from 4-6pm, starting in December.

I am looking forward to hearing from you and am happy to answer any and all questions you may have. And thank you, too, for passing this along to anybody else you believe is a Wild Woman at heart!

Sincerely Yours,

Maureen

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MicroBirth Screening 9/20/2014

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If you are in the Boston North Shore area, here is your chance to attend one of the world premiere screenings of the documentary MicroBirth. Birth Philosophy is hosting a showing of the film at the awesome Cinema Salem (voted best theatre on the North Shore!) in Salem, Massachusetts on September 20, 2014 at 10am.

How the human microbiome is formed and/or compromised is, without a doubt, a huge HOT TOPIC these days. Toni Harmon and her husband Alex Wakeford are the filmmakers at One World Birth are are exploring questions about how birth affects the microbiome seeding of a newborn baby. The way a child is born and whether or not they  are breastfed or have skin to skin contact immediately with their mother all play significant roles in this highly complex process. A person’s immune system is either helped or hindered based on all of these factors. The documentary features a large number of experts from around the world who share some really fascinating information and opinions about an incredibly important topic for public health.

I invite you to come on over to the theatre to watch this extremely interesting film. More information and ticketing link here. And if you are not in the area check out the trailer and website to see if there is a screening near you!

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Birth Story Slam

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The second Birth Story Slam event is on the near horizon and will be held on Sunday, April 27th in Somerville, Massachusetts at The Burren starting at 5:30pm.

I had the pleasure of participating as a teller in the first Birth Story Slam which was held last spring in Jamaica Plain. It was amazing to hear all of the accounts that ranged from touching to inspiring to hilarious! This article in the Cambridge Day has a link to the trailer for this event featuring clips of  some of the stories from last year. Take a look!

Advance tickets are available here and tickets will also be available at the door. People of all ages are welcome, including babies of course!

The description of what the Birth Story Slam is all about from the BSS Facebook Page reads as follows:

“This event aims to highlight stories that too often remain hidden in hospital rooms, to challenge the stereotypes of those who seek an alternative, to bring together women, men and their community to realize the shared experience of childbirth.

We strive to unpack the joyful, ordinary, and devastating experiences that define childbirth in the U.S., to open up the conversation, and serve as a launch point for action.

A story slam is a contest of words held in a supportive space featuring both known and undiscovered talent. All are welcome.”

This is a unique event in a comfortable and fun setting. There will be table service so that audience members can have a drink or a bite to eat while they listen to the stories (each 5 minutes).  Men, women and children enjoyed the experience of sharing some incredible stories of birth.  We all have a birth story to tell! Taking the spoken word story or poetry slam model and applying it to this theme is a brilliant idea. Audience members will vote for their favorite teller and prizes will be awarded. While both of the Birth Story Slam events have been based in Boston, event organizers hope to expand to other cities in the future.

If you are out of the area and miss this event, go to the Birth Story Slam YouTube channel to listen to the stories from the first event.

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Spotlight on Rebecca Dekker and Evidence Based Birth™

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Working through the multitude of childbirth care options and decisions during pregnancy and labor can be a daunting task.   Pregnant women and their families can often be overwhelmed when faced with some of the various tests, suggested procedures or interventions that are offered or recommended to them prenatally or while laboring.

Rebecca Dekker, PhD, RN, APRN is one of those women whose first time through the gate left her feeling uneasy, so she started asking questions and seeking answers.  Rebecca felt that some of the restrictions that were in place during the birth of her daughter had not worked in her favor. She began to wonder if they had truly been needed.  Was it really imperative that she not be allowed to eat or drink during labor? Was the risk of cord prolapse great enough to justify the bed rest that kept her from being more upright and active during labor? Being a researcher and a nurse herself, Rebecca set to work investigating the basis for some of the recommendations that she took for granted were based on clear evidence. It turns out that the evidence was scant for some of the policies and procedures she had assumed were necessary and that realization prompted her to do things differently with her second child.

Armed with new information based on the all of the good quality research she could get her hands on, in her second pregnancy, Rebecca placed herself firmly in the driver’s seat and sought out care that was supported by medical evidence. After her son’s birth, she felt the opposite of uneasy, and instead, she felt she could do anything!  She followed her gut and turned her newfound bursts of inspiration into something that would help others gain information to more easily navigate the birth care maze. Rebecca’s story is not uncommon. Many women have their minds and hearts jostled a bit during their first birth experience when things either don’t go as planned, or the overall experience is not what they had envisioned. As a long time postpartum support group facilitator, I have personally seen countless new mothers do a lot of rethinking of the choices they made, especially in regard to interventions or care they felt they had no choice about or did not quite understand the real risks or advantages of.

All of this questioning and examination usually yields good results.  And, fortunately, for all of us out there who care about improving maternity care and providing pregnant women with quality information to help make decisions about their care, Rebecca used her experience, skills and research and took big action. Her website, Evidence Based Birth™ , is a virtual treasure trove of birth related research, distilled down into forms that the non-researcher can easily understand and utilize.

The EBB website offers, a long list of articles in Q & A blog format, printable documents, video-based online classes that include continuing education credits and a newsletter. Subjects are well organized and can be accessed using an alphabetized topic list.

I had the opportunity to speak with Rebecca on the phone and was able to ask her a few questions about her new venture, which has garnered a fair amount of attention in a short amount of time since she launched the site in 2012. Some of the recent or upcoming topics she is working on which include Vitamin K for newborns, moxibustion for turning a breech baby and the oft cited ‘failure to progress’ as a reason for birth interventions.

When asked what she felt was one of the best things a pregnant woman could do with the content available on her website as far as taking action, Rebecca said that using the data and information to choose a care provider that they feel will provide evidence-based care was at the top of the list. I agree wholeheartedly with this because a woman who exercises her power to purposefully choose a care provider that supports the vision she has for her birth is a key element to a positive experience.  In addition to birthing women, Rebecca’s EBB website resources are highly desirable and useful to childbirth educators, doulas and other birth and medical professionals in the work they do with clients prenatally, during birth and postpartum.

With less than stellar maternal and infant mortality rates here in the US, there is much discussion in the birth world about finding ways to improve these results. It is challenging finding a balance between expecting the maternity care system to take responsibility for ensuring, quality, evidence-based care for all while simultaneously urging pregnant women to take responsibility for learning as much as they can in order to make informed decisions about who and how they are cared for when they give birth. Both of these things are important.  I love that Rebecca has made it easier for all of us to access and understand the research that is out there in order to get a clearer picture of the path that seems best for a woman in her own unique situation.  So if you are trying to find your way (or help others) to the birth you desire and feel lost and uncertain about which way to go, bring your questions to Evidence Based Birth™

and you may just find the answers you are looking for.

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Note: My interview with Rebecca was the inspiration for an article I recently wrote for Peggy O’Mara’s website about evidence based medicine as it relates to birth.  Click here to read it.  As the long time editor of Mothering magazine and founder of mothering.com, Peggy has been a tireless advocate for women and families as well as the author of several wonderful books. At her new self-titled website, she continues to curate and create great content about natural family living, social justice and making healthy choices. I highly recommend this site as a place to spend time reading about and digging into issues that are near and dear to all of us who want to live well and support positive change in the world.

 

 

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A Whole Different Side to Birth

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It is time for another installment of the Birth Philosophy Young Voices guest blog post series. In this piece, we hear how a global perspective can help to mold, shape and even change our impressions of birth. This account is written by Kristen Green, a Yale School of Nursing student.

As a future midwife, it embarrasses me to say that I can remember a time not too long ago when my friends and I bemoaned how we never, ever wanted to have babies. We decided that labor was simply too long, would hurt too much, and we also agreed that a human coming out from down there was just, well, scary. Granted, just about the only visual frame of reference we had for all this was some inadequate high school sex education and the episode of Friends where Rachel gives birth to Emma. As an only child, this fear was reinforced with stories my mom told me about how excruciating and awful labor was (i.e., two episiotomies, an ineffective epidural, and a male OB yelling at her that the pain couldn’t be that bad) – as she often put it, that’s why she just had me.

Despite my fear of birth, I was also secretly fascinated. I wondered how so many women go through labor – let alone women who don’t have access to hospitals, pain meds, or personal support systems. I simply couldn’t wrap my head around it.

In the fall of my junior year of college, I studied abroad in Ghana, and it was there that my ideas of pregnancy and birth were completely changed. I was able to intern at an HIV clinic and on my very first day, an expectant mother came in. She sat in the waiting area for hours, not knowing that the entire clinic staff was in a meeting across the street. When a nurse finally came back and noticed her, the woman explained that she was in labor, but, unfortunately, the clinic wasn’t equipped to deliver babies. The mom-to-be, already significantly dilated, merely laughed at her mistake, remained calm, and was prepared to take a tro-tro to the nearest hospital, which was a considerable distance away. This situation was nothing close to what I pictured real, live active labor to be like. I was absolutely floored by the woman’s composure and strength. I imagined that if I were in her place, I would probably have run (or quickly waddled) out the door in panic. However, the clinic doctor paid for her to take a taxi to the hospital and thankfully mom and baby ended up just fine.

Throughout my time in West Africa, I began to notice that most women treated their births as normal – even exciting – life events, and, from what I could tell, had far fewer thoughts of birth anxiety despite the fact that Ghana has a higher fetal and maternal mortality rate than the U.S. (not that our numbers are anything to be proud of either). It made me see how important it is for expectant moms to do their own research, if they can, and to have meaningful conversations with their care providers (and other women!) so that they can take charge and make informed choices.

Since returning from Ghana, I’ve seen several births and have done a fair amount of reading and internet searching, trying to find out all that I could on topics from morning sickness to epidurals to home birth to VBACs. I learned about the wonders of midwives and doulas, professions I never even knew existed. It was the culmination of my experiences – seeing the strength of so many women throughout such a physically and emotionally demanding time – that made me appreciate how natural, normal, and amazing birth actually is. It also, despite how cliché this may sound, made me realize just how much energy and power we all have inside of us – that our bodies can mold and hold another being for nine months and can create and endure the forces of contractions. It’s truly incredible.

I began to see that there is a whole different side to birth – a side that I feel is still largely hidden from so many women in the U.S. or maybe just more often dismissed as unorthodox, even unsafe, despite evidence to the contrary. Right now we live in a society that largely treats birth as a means to an end – something you have to endure in order to have your baby. We talk about the “ring of fire” as the baby crowns, the sleepless nights, and the emergency C-sections. But pregnancy and birth are more complicated and layered than that. The beauty of it is that it truly is different for every mom with every baby, and that’s why it’s so important for people to know what the possibilities are. It’s incredulous to me that what we discuss about birth is still largely veiled in fear, but I fully believe that the more we talk about the nuances of birth and the options that are available (the earlier, the better!), the less frightening and more empowering it will be.

KGREEN

Kristen Green graduated in 2012 from New York University with a degree in Social and Cultural Analysis as well as Public Health and Policy. She is currently in her GEPN year at Yale School of Nursing and is 6 semesters away from becoming a Certified Nurse Midwife and Women’s Health Nurse Practitioner. She is incredibly excited to be joining a profession that helps women and their families through some of the most challenging and joyous times in their lives.

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Mammals Suck…Milk! at Harvard with Katie Hinde

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Breastfeeding is one of the most politically hot topics of our day. The subject cuts across some touchy areas: breast milk v. formula, work v. stay-at-home, how long is enough? Oh, and don’t forget breastfeeding in public or breast milk selling and sharing. Weigh in on any one of these discussions and you are pretty much guaranteed to piss-off at least a few people in any setting, no matter your point of view.

So…what if there was a way to consider breastfeeding without so many of the usual political or personal filters put on the topic? Well, earlier this month at the Harvard Science Center I was pleased to sit in on a lecture about lactation that seemed, to me anyway, to have done just that. The presentation was given by Katie Hinde, PhD, Assistant Professor in the Department of Human Evolutionary Biology at Harvard University, and it was a lay-persons review of some fascinating scientific studies digging into what we know and most notably, what we don’t know, concerning the way in which mammals breastfeed their young and the value of the milk (and the mother-infant interaction) to the development of the young.

In her presentation Katie discussed research on how the composition and quantity of rhesus macaques monkey milk varied depending on the sex of the baby monkey, analysis on the purpose and effect of various milk components such as oligosaccharides, cortisol and bacteria. We learned that the mother naturally creates different types and amounts of milk for sons and daughters and that the components in mammal milk are widely varied, vast and largely unknown. Throughout the presentation it became clear that the extremely limited knowledge we have today about what these components are and what they actually do is only the tip of a fascinating iceberg.

Some of the other interesting aspects of the research Katie was highlighting included the intertwined elements of nutrition and socialization for the monkeys. One point, which jumped out at me, dealt with the scientific research process itself. In that, to study the natural behavior of mammals such as the macaque monkeys it is impossible to separate the socialization and the feeding. I found that a notable reminder that there is more going in with infant feeding than simple milk transfer. It was also really thought provoking to consider the various resource trade offs that were occurring for a monkey mother based on the age and size she was at each of her pregnancies.

Overall, I came away with a renewed sense of wonder about how closely linked maternal and child development really are and how little we understand about the dynamics in play. I am in no way fluent in human evolutionary biology so I am not going to try and break down this awesome science because that would be really embarrassing for me. Do, however, go and check out Katie’s blog posts on sex biased milkmilk and behavior, the Comparative Lactation Lab, her chuckle worthy twitter feed @Mammals_Suck, or any of her published research if  you want to geek out on this stuff as it is well worth a look. And don’t blame me if you get hooked on it because I am warning you, Katie makes things really fun and interesting. I mean, who can resist the competitive challenge of filling out your picks and cheering on your favorite mammals in a basketball bracket style twitter game of Mammal March Madness? Trust me, this is a blast and educational to boot so keep your eye out for the 2014 version that will launch in, you guessed it, March of 2014.

It was fascinating to consider how all this works in nature and for an hour or so to strip out a lot of the noise contributed by the modern human response to the topic of breastfeeding. I look forward to following Katie’s work as well as keep my ear to the ground for other, similar research underway – sometimes, just maybe, mother nature is the best teacher, after all, she has had millions of years to perfect her lesson plans.

A special shout out to Diana Cassar-Uhl, IBCLC for initially introducing me to Katie’s work!

Katie and I at the end of her talk which I will link when the link is available.

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Great Day Spinning Babies

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Spinning Babies Workshop – Easier Childbirth with Fetal Positioning

On October 7, 2013 I had the opportunity to attend one of Gail Tully’s Spinning Babies workshops, it was sponsored by BACE/NMC.

What an event! Gail’s workshops are very popular and the attendees universally rave about them, so I knew that the information and format of the event would be good.  The focus of the day was on fetal positioning, a comprehensive look at how to support optimal positioning, and the best methods to assist a mother in making space for her baby to ‘spin’ into a better position for birth.

Anatomy, posture, exercises for releasing ligaments, muscles and fascia,labor patterns, real life stories, aids and tools, complementary body work suggestions and related research and were all part of the discussion.  To be honest I was blown away by the vast amount of really useful information I had never heard before and it was clear that Gail is in command of her subject!

To give you a sense of it, here are a few things that stood out to me in regard to why this was such a quality continuing education offering.

Gail had a very approachable presentation style that really showcased her extensive experience and high-level knowledge.  Although it was clear that she has done the day-long workshop many times, Gail worked through her material like a talented musician would give a concert.  She moved in and out and around her script and adjusted the presentation to the attendees in the room and the questions presented with ease and kept us engaged.

Gail also is clearly a creative thinker so her talk was filled with really well though out visual aids and props that were an amazing part of her ability to convey (and help me to easily visualize and remember) what she was explaining.

There was also a noticeable element to Gail’s overall outlook and approach to birth that included a strong dose of intuition and recognition of the mother’s emotional state as a crucial element of all that is in play when a woman is laboring.  Being someone that feels that it is essential to look at physiologic birth in a holistic way, this resonated with me.

I was thrilled to get this great photo of Gail and I at the end of the day.

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You can check out Gail’s program here.

To summarize: If you are out there helping mothers birth their babies and haven’t been to one of Gail’s workshops, run, don’t walk, to the nearest upcoming event And for anyone interested in learning more, take a look at all the great content on her website including this great article on belly mapping.

 

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Keeping Current With Online Continuing Education

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More and more quality online continuing education offerings are popping up out there and I wanted to highlight a few coming up that look really worthwhile.

  • Evidence-Based Care for Suspected Big Babies: 

Rebecca Dekker, PhD, RN, APRN of Evidence Based Birth has launched her first video-based class entitled Evidence-Based Care for Suspected Big Babies.  This is an in-depth course with several video lectures and handouts that is worth 2 nursing contact hours. More offerings are slated for later in the year so keep an eye on her site or sign up for her newsletter if you want to be in the know on what the upcoming topics will be.

  • Social Media for Lactation Professionals:  Skills to Maximize: 

Praeclarus Press has two webinars coming up in October, 2013.  The first is Social Media for Lactation Professionals:  Skills to Maximize featuring Lara Audelo, CLEC author of The Virtual Breastfeeding Culture:  Mother-to-Mother Support in the Digital Age 

  • Welcoming African American women into your practice: Seven steps to creating a culture of respect and inclusivity: 

The second offering from Praeclarus Press is entitled Welcoming African American women into your practice: Seven steps to creating a culture of respect and inclusivity with featured speaker is Sherry L. Payne, MSN, RN, CNE, IBCLC of Perinatal ReSource 

  • An Integrative Approach to Tongue-tie, Lip-tie & Breastfeeding: the Interdependent Roles of the Lactation Consultant, Surgeon & Bodyworker: 

Another interesting offering is with Jennifer Tow, BFA, IBCLC, in collaboration with Larry Kotlow, DDS scheduled for October 21 and 22, 2013. This two part webinar is called AnIntegrative Approach to Tongue-tie, Lip-tie & Breastfeeding: the Interdependent Roles of the Lactation Consultant, Surgeon & Bodyworker

 

These are just a few of the online lectures, courses or webinars that I have seen available Fall 2013.  I love in person conferences and seminars but the internet makes hearing the latest info from leading professionals out there easy and convenient. Check them out!

 

 

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