Wednesday, February 23, 2011

Wisdom From the Crone

In this quarter's California Association of Midwives newsletter there is a wonderful new section entitled, "Wisdom From the Crone". This month's featured crone was the beloved midwife, acupuncturist and woman extraordinaire, Raven Lang. She talks about how midwifery, when she was coming of age as a midwife in the 1960's and 1970's, was yet to even have a name. That women felt a strong calling to it, to be held in sisterhood with other women, a vocation that often went unpaid and unsung. They followed their passion with great energy and drive, sometimes at the cost of their personal lives, such was their commitment to serving women.

I have a well loved, dog eared, highlighted, ancient edition of Myles Textbook for Midwives. In midwifery school, I relied on this book more than any other for guidance and explanation. I would (and still do) run home after a birth to look something up or confirm an explanation floating through my brain. More than any other book, I found the British no nonsense, cut and dry approach to midwifery refreshing and without dogma. We Americans tend to be a sentimentalizing bunch, midwives included. Myles's book was just birth plain and simple.

Which is why I was so dumbfounded to read how a few years before I was born, the midwives here, did not have access to this great midwifery text. Raven talks about how this type of global midwifery knowledge was just unavailable to the midwives at that time, some of whom didn't even have a phone line! I find this incredible, and quite humbling. To actually learn from birth itself, from women and babies, what a thought!

What a great debt we owe our teachers and the phenomenal women who have come before us. They have smoothed the path for all who have benefited from midwifery, students, midwives, women, fathers, babies, etc... Here are some more choice quotes from Raven Lang in response to being questioned about what we could do to help the Earth as midwives:

  • Grow one's own garden and help others do the same
  • Eat whole foods, buying them from local sources, and to shun corporate foods and packaging.
  • To remain connected to the moon and the power and integrity of nature.
  • To stay deeply connected to the cycles and power of the earth and its place in our universe.

How's that for career advice? She also advises young midwifery students:

  • To put their family on the front burner and their profession on the back
  • To work in pairs or teams so as to avoid burnout.
  • To continue learning and never stop teaching.
  • To strive for personal balance daily.

A midwife midwife-ing midwives. Now that's a midwife!

Thursday, February 17, 2011

In Celebration of the Birth of the Prophet

It's that time of year again, the celebration of the birth of the Prophet!!This is a reprint with some added goodies (in bold at the end). Hope everyone is enjoying the celebrations, and all the rain! What a mercy.

Prophet's Mosque - Medina, Saudi Arabia by Shabbir Siraj.

"And when Aminah was pregnant with him
She did not complain about anything that befalls (pregnant) women

For Gentleness from the Lord of the heavens encompassed her
And Barred from her all harm, worry, and sadness

She saw (in a vision), as was narrated to us
That the Guardian (Allah) was going to Honor the Creation

Through the pure one who was in her womb, so she Rejoiced!
And the time for labor drew near, so she was filled with

And the lights emanated from all directions
For the birth of the one given intercession had arrived

And before dawn, the Sun of Guidance emanated
The Beloved became manifest, honored and protected"

An excerpt from "The Shimmering Light" compiled by the great scholar Habib Umar

Ustadha Eiman Sidky (May Allah protect her) is a treasure house of knowledge and goodness. Her accounts of the life of the Prophet (peace be upon him) are intimate, compelling and fascinating. She teaches a seerah class for women online each Saturday. In honor of the upcoming mawlid, she recently enlightened us on the pregnancy of the Prophet's mother, Aminah, and about some of the secrets of his birth. To think of our blessed Prophet in the womb of his mother and the stellar impact of his birth, is moving and awe inspiring.

  • During her pregnancy, Aminah felt a light within her and one day it shone bright enough for her to see the castles of Bostra in Syria. Again before her delivery she also saw this intense light, light all the way to Syria.
  • Once, while pregnant, Aminah heard a voice say to her, "Thou carriest in thy womb the lord of his people; and when he is born say: 'I place him beneath the protection of the One, from the evil of every envier'; then name him Muhammad"*
  • When it was time for the labor, Aminah did not feel pains.
  • At the time of the birth of the Prophet (peace be upon him) there were no impurities; no blood or other impurities that normally occur at a birth.
  • The midwife who delivered the Prophet, Shifa'a, was the mother of 'Abd ar-Rahman ibn 'Awf (May Allah be pleased with them both).
  • The night of the mawlid Shifa'a was sleeping, dreaming of a full moon that was about to fall into her lap. She was awakened from the dream by a knocking on the door, it was some one sent to bring her to Aminah so that she could help with the birth of the world's last prophet.
  • When the Prophet was born, he was born in sajdaah. Shifa'a said that he smelled of musk and was the most beautiful baby she had ever seen. She knew that this baby would become something grand.
  • When he was laid on the bed, he clutched his blessed little, newborn fingers into fists, all but the index finger of his right hand. La ilaha ila Allah from the time of his birth!
  • Every animal in talked on day of birth - they said she is carrying rasool allah and he is lord of ka'aba
  • Every bed belonging to a king was flipped upside down
  • All of the statues were upside down, a sign that the worship of One God would reign
  • The year of his blessed birth was a year of opening, year of happiness. It was very green, as there was lots of food and rain, after years of drought

*Exact wording taken from "Muhammad: His Life Based on the Earliest Sources" by Martin Lings

Saturday, February 12, 2011


The other day I realized that I now mark time in terms of babies born. July 2008 brought Maryam, Omar, Julian, and Sofia. If I want to think back to say November 2009, I think of Asiya, Malachi, and Caroline. Living in a season-less California, births mark times and seasons more concretely than weather can. It would be a lie to say that they always arrived at the most convenient times, when my cold was gone, on the weekends when babysitting is free, or at a civilized hour. No. Babies come when they are meant to come. As much as I would like, I have no control over when that hour descends. Even now as I write this, a sunny weekend approaching, I am hesitant to make plans as I am waiting on a baby.

If I were another type of practitioner, maybe I would consider inducing this client. It would be nice to have it out of the way, with a free weekend sprawling before me. If so, I wouldn't be so off the mark. In 2007, a large study of 18,000 deliveries found that 9.6% were early births ('early' was not defined in this study), and the reasons for them being early were non-medical, i.e. practitioner or patient convenience. Indeed according to the Center for Disease Control sources, the average length of pregnancy has fallen by seven days since 1992!

No one really knows what kicks off labor. What I understand is that their is a complex interplay of mother and baby hormones that each tell the other that the time is near. Mom's cervix softens, telling baby's lungs to mature. Baby's lungs mature and mom's uterus develops more receptors for oxytocin, the hormone that makes the uterus contract among other things. Like all other bodily processes, it is hard to isolate it from the whole, and interference often shows up in other ways later.

This thought provoking look at early elective births by California Watch looks at the reasons why inducing early for non medical reasons is now thought to be contributing to poor maternal and infant mortality rates in America. There is a reason babies play a major role in deciding when they are born. A 2009 New England Journal of Medicine study found that elective cesarean sections resulted in respiratory and other adverse outcomes for neonates. The brain, eyes, and nervous systems all are formed in the third trimester. According to California Watch babies born early through C-section and/or induction are nearly twice as likely to spend time in the neo-natal intensive care unit.

How can women prevent this scenario? Show any of the above information to your doctor. Like an old college friend of mine threatened with induction at 41 weeks asked, "How can I go nine months with perfectly health pregnancy, and NOW all of a sudden I'm high risk?!" Good question. She answered it by delivering at 41 and a half weeks, a perfectly healthy baby girl, au natural. Here are some tips for preventing post-dates.

  • Drink lots of red raspberry leaf tea throughout the pregnancy. I can't say enough on this wonderful uterine tonic. It provides all of the minerals a healthy uterus needs to do it's job.

  • Walk, especially hills. I'm not sure what it is about hills, but many women claim that this helps them deliver a baby. Being fit, a side effect, may be what helps to prevent post dates.

  • Have sex. Yes, as the old adage goes, what gets the baby in gets the baby out. Semen contains prostaglandins which help soften the cervix. An orgasm cannot occur without oxytocin, once again, the hormone which causes contractions.

  • Visualization can help relax you and allow your mind to turn off. Sit in a quiet, undisturbed place and visualize a head down baby, distending the cervix and rotating down and out of the pelvis.

  • I haven't seen research on this, more of a hunch, but I think that adequate healthy fat intake in the third trimester can cook a baby just right! We know that healthy fats are needed for baby's brain development and that the most brain development happens in the waning weeks of the third trimester. It would seem to me that if baby is getting what he needs in terms of development, there will be no need to leave early, or hang on too late in order to soak up the nutrients. Eat lots of eggs, fish, meat. Supplementation of fish oil will do in a pinch, but best to get it straight from the source.

Sometimes inductions are unavoidable, even necessary. I suggest these final things only as a means to naturally induce labor when an induction is unavoidable. Use with wisdom.

  • A homeopathic induction of Cimicifuga and Caulophyllum is a gentle way to start labor. Take one remedy every half hour for three hours, alternating the remedy each half hour. Do this every morning until labor commences. The strength should be 200C

  • Herbal inductions can be used as well. Black and blue cohosh along with cottonroot are a potent mix of uterine stimulating herbs. A half dropper of each every hour for three hours. I have heard some herbalists comment that this isn't enough because our bodies metabolize herbs quickly. Consult with a person who knows if my recommendation isn't enough.

  • Acupressure points that you can squeeze yourself are also effective. The two I like are located in the webbing between your thumb and index finger and the other four finger widths above the inside of your ankle bone.

  • And finally, there is the dreaded castor oil. This is a last ditch resort. Castor oil makes for a messy birth. In fact, that the whole reason it works, it irritates your bowels, thereby irritating your uterus, or so the theory goes. I have seen it work many times. A castor oil milkshake is one way to tolerate it. 2oz of castor oil, some ice cream, and some juice. Drink it up!

As the Bible says (I'm paraphrasing), to everything there is a season, this includes babies. I rather like that my years and seasons are marked by a soul's entrance and not by my vacations or plans. Inductions can have long lasting effects on mother and baby. It's best to wait for the dance of hormones to begin. Just like we can't force the long days of summer, or rush the chill or winter, neither should we unduly force a baby's birth. To everything there is a season. I can't think of a better reason to put off my plans than a birth, so for this weekend, I'll stick around here and maybe next year I'll think back to February 2011 and remember the particular way the sun fell as a baby, for now nameless, was born.

Thursday, February 3, 2011

Radical Homemakers

As a midwife one gets lots of phone calls, quick questions, and requests from pregnant women. Mostly, these women are not my clients. They ask about how to turn their baby, does their weight gain sound normal, what's a gestational diabetes test, etc....Most of these questions don't come from my clients because we discuss these things, they are out in the open, transparent for the both of us to grapple with and resolve. The fears of a pregnant woman are nothing to be dismissed, in fact the further they are buried, the more likely they are to rear their ugly head at inopportune moments (i.e. labor). It often leaves me wondering how as a people we have become so out of touch with the flowering and bearing fruit of our species. Or perhaps we know too much, the technologies peeking into hypothetical drawers not meant for our eyes. Once opened though, we can't forget the drawers contents. In the past did women really worry about 'back labor' in their fifth month of pregnancy? Did midwives need an ultrasound machine to tell them which way the baby was facing? Who had a scale?!

I found a piece of the answer in Shannon Hayes's book, Radical Homemakers. In it she talks about how so many of our basic skills and economies have been usurped by corporations thereby swapping what she dubs 'a life serving economy' for ' an extractive economy'. She implores us to switch back. What is midwifery if not life serving? Do I dare say that obstetrics(think almost a 35% national cesarean rate) is extractive in the true sense of the word?! I found Hayes's book compelling. It offered reasons why so many women who choose the cookie cutter model of obstetrical care are often the ones calling me with burning unanswered questions. Like food, clothing and even education, the art and science of obstetrics has been co-opted by economic interests. Discussing with a woman how to possibly influence her GBS status, how to avoid a posterior labor, or even what constitutes a good baby growing diet, would not serve an extractive economy. It would take too much time and wouldn't pay so well.

When I get these queries from women who often see a new doctor at each visit, I feel for them. They are not blossoming from the care they are receiving.Rather their trust in themselves and their bodies, is literally being extracted. Doubt often creeps in. Midwifery on the other hand is life sustaining for both mother and midwife. It is a personal relationship with someone in your community who shops at the same grocery stores you do, who breathes the same air, plays at the same parks. This is the soil upon which new life is brought forth. It begins with a family and folds into community. It is an honest relationship brokered on trust. Just like we are discovering that local food is superior in terms of quality, environmental impact, and even taste, I hope that sentiment spreads to mothers and babies. Look for local, sustainable midwives and birth. Build a real community for your baby from day one.

Radical Homemaker is a fascinating read with lots of history of how we got to where we are in terms of a largely consumer society rather than producing to meet most of our needs. Here are some quotes I liked from the Radical Homemaker:

  • ..."the homemaker who simply learns to cook dinner, keep a garden, and patch blue jeans will probably not find deep fulfillment, either. Those who do not seriously challenge themselves with a genuine life plan, with the intent of taking a constructive role in society, will share the same dangers as the housewives who suffered under the mystique of feminine fulfillment; they face what Freidan called a "nonexistent future".

  • "In order to revive our culture and create a vibrant society that does not depend on a consumer driven and ecologically rapacious economy, more of us need to look homeward to create a life-nurturing alternative."

  • "The simplest and most sensible start for Radical Homemakers departing the extractive economy and building the life serving economy were the elemental practices of thrift, frugality and debt avoidance....The defining principles: are including everyone in the economic picture; capitalizing on available resources; minimizing waste; becoming net producers of goods rather than net consumers; bartering; spending money where it matters most; and understanding the concepts of "enough".

  • "Healing remedies were once standard knowledge for homemakers, right up until the industrial revolution"