Prenatal Qi (Chi)

Qi (pronounced CH-EE) is often translated as 'life force', a sort of subtle energy that penetrates and influences each person in myriad ways. Qi permeates the universe, it can be seen in the rising of the sun, the flowering of the bud, and in the buzz of bee's wings. There are different types of qi, but the one that fascinates me, is prenatal qi.

Inherited from our parents, prenatal qi is sort of like the Western concept of the genetics we inherit from our parents, this is what we nourish throughout our life. Similar to genetics, prenatal qi can thrive with a good quality diet, air, water, and without it it can wither, or flare and cause problems. Given a good dose of strong, healthy prenatal qi, babies and children thrive in their childhood and beyond.

Other types of qi, such as lung qi, spleen qi, etc... can be improved upon, but prenatal qi is like a seed that cannot be replaced, it can only be nourished. Mothers however, can improve the quality of their health, thereby improving the prenatal qi that they pass on to their children. Dr Randall Neustaedter, says in his book, The Holistic Baby Guide, " In Chinese terms, a deficiency of Prenatal Qi is one of the primary causes of immune-system weakness and susceptibility to external pathogens. A mother who seeks out the care of a Chinese herbalist before and during her pregnancy is more likely to have a robust and healthy baby." He says that according to Chinese Medicine, a Prenatal Qi deficiency is one of the leading causes of asthma in children.

Gestating, delivering and nursing a child depletes the prenatal qi that the mother has available to pass on to the next child. Practitioners of Chinese Medicine believe that the different qualities and quantities of Prenatal Qi passed from mother to child account for the sometimes vast differences of energy and health between siblings. In order to avoid passing on any deficiencies to her baby, between and during subsequent pregnancies, it would behoove mothers to nourish and replenish these spent stores. Here are some great ways to do that:

• See an acupuncturist. Regularly. This is an excellent way to nourish yourself as a mother. Often they prescribe herbs that also replenish and build qi stores. If the cost of acupuncture is prohibitive, look for local clinics that provide these services in a group setting at a reduced rate. Such as this. If you are local, here's my beloved acupuncturist.
  
• Eat a whole foods diet. Eat real food. Broths, fermented foods, grass fed meats, organic fruits and veggies, and unpasteurized dairy, heal and nourish a body better than most things. Nutrient dense food is also great for mothers who often have no time to eat, or if pregnant, can't eat much at one sitting. Make each bite pack a nutritive punch.
• Eat lots of fish, or bump up your Omega 3's through supplements. This essential nutrient becomes especially depleted through nursing children.
  
• Drink herbs. Nettle, red raspberry leaf, oatstraw, lavender, chamomile. Drinking an herbal cup of tea each day is also a calming, relaxing way to nurture oneself.
  
• Exercise. Get some fresh air, swim, hike, yoga and strength building exercises can all be important in regaining vitality and building health. As a busy woman who doesn't have time for a yoga studio, I love Yogaglo for home practice.
• Take time for yourself. Don't let motherhood deplete you. Let it be your path to nurturing and health, for you and your family.
  

Birthrights

Birthrights is a wonderful new series premiering on Al-Jazeera English. It is a "series exploring maternal health and the power, politics and poverty that impacts it around the world.". The following three episodes are some of their first. The first one is about Hungarian OB turned home birth midwife, Agnes Gereb, and her imprisonment for attending home births in Hungary, a country where it is legal to choose your place of birth, but illegal to attend birth at home if you are a licensed practitioner! The second episode follows the lives of women who have undergone obstetric fistula repair surgery in Ethiopia. Obstetric fistulas are holes that develop, usually due to the prolonged pressure of a baby's head, between the rectum or vagina, leaving women incontinent of either urine or feces, rendering them also socially isolated. These injuries come about largely due to unskilled birth attendants, and a lack of resources. The third episode here follows a group of midwives traversing Ethiopia hoping to change that by either creating birth centers, or training traditional birth attendants, who have no training. Great series, I can't wait to watch more. Enjoy!!

Newborn Needs

When my son was about four weeks old, one of my favorite uncles came to visit. I was feeling stronger and excited to show off my new bonny boy! I took him to one of my favorite Afghan restaurants. What a mistake, it was so loud, bright, and busy in there! I had never noticed this before and my son was not having it. He screamed at the top of his little lungs until I walked him outside back and forth, back and forth, weaving lullabies into the cool night air. Meanwhile, my husband and uncle were talking about all sorts of interesting topics, undisturbed by the heavy handed kitchen staff, or the glare of the overhead lights. This was the first of a slow learned lesson, restaurants and our baby did not mix.

I later came across a possible explanation. Ayurveda believes that mothers are in a state of psycho-physiological transition for six weeks after the birth of their child. That after pregnancy, birth, and lactating, the first six weeks their system is transitioning back to a new normal. It is such a rapid and profound time of growth and change, that nothing really matches it. Except the rate of growth and change in a newborn. When I experienced the loudness, brightness and bustle of the restaurant, something that had not occurred to me before (and to be fair, not after my kids are older either), I was simply in tune with my baby. Newborns need stillness, quiet, softness, love. Restaurants might offer the latter, but rarely any of the rest.

It is important for both mother and baby to honor this need for stillness, rest, and beauty. It can be done in all birth settings. Recently, I came across a beautiful example of a mother going to extraordinary lengths to create this for her newborn. Meg, of the Sew Liberated blog, knew that her second son Lachlan was going to be born with a heart condition that would require nearly immediate surgery upon birth. It would require him to be in the NICU (neo-natal intensive care unit) and separated physically from her. Well, this crafty and beauty loving mama, did not let that stop her. She hatched a plan to bring softness, black and white prints, breezy mobiles, and warmth to her son. You can read about her post, Every Baby Deserves Beauty -Thoughts of a Heart Mom, and then check out the lovely Lachlan, surrounded by softness and warmth here. Having spent my fair share of time in NICU's with babies, I know that all of this effort must have muffled much of the noise and beeping that incessantly happens in these units. The babies who need the most quiet to grow and thrive get the least of it. I hope Meg's example inspires others to take control of their baby's surroundings from day one!

The following quote from Cynthia Aldinger founder of LifeWays North America powerfully sums up the needs of a newborn. By taking care of newborns in this way, we will be meeting the needs of ourselves as mothers as well. Say no to the restaurants, the trip to Target, the mall, wherever. Bring sunlight and nature into your space. Celebrate your baby's stillness and tranquility, in stillness and tranquility.

" However, I do want to say something about the first three months. Some refer to it as the fourth trimester, and I feel it is worth noting that it is a time that is completely different from the development we see taking place in the months following. If it were possible to wrap an extra layer of care around these little newborns, that would be wonderful. As a kangaroo mother keeps the newborn in her pouch, I wish we could provide more protection around the child from birth to three months. If you have ever been in a situation where you have had to adjust to an abrupt change in your life, perhaps that experience can build compassion for the newborn’s adjustment from womb life to outer life. Even more than the adjustment from womb to world, I feel it behooves us to consider the transition the individual is making from spirit to matter. Imagine being pure spirit, held in the arms of the angels, so to speak, surrounded by heavenly sounds, then being tucked into the womb for nine months with its own special sounds and warming rhythms, then emerging into the mechanistic, materialistic, ever-moving and somewhat cold and loud world of modern life. Certainly nurses, midwives and many parents know that swaddling helps to mitigate the dramatic change in physical existence for the newborn. If we could imagine taking similar protective measures in regards to the type of lighting, the sounds, and the activities to which they are exposed, most particularly in the first six weeks, gradually expanding their worldly experience over time, that would be a real gift."

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!

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.

"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

pleasure!

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

inductions

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.

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"