Sunday, November 10, 2013

Hakima Midwifery is now Homemade Families!

Homemade Families provides comprehensive midwifery and lactation support in the Bay Area.  Please contact me at 408-464-1441 for more information or by email shannonstaloch at gmail dot com.

I'm still blogging away over at Homemade Families. Let's continue the conversation and bring midwifery care to even more mamas and babies.  See you there!!

Friday, November 9, 2012

Lion Hearted

Photo Credit

"For every disease, there is a cure." 
Prophet Muhammad 

At four weeks postpartum, I was bending over cardboard boxes, deciding which books I would need for the next year, and which I could part with.  As I straightened up, I tightened the knot on the belly wrap designed to put my fragile insides back together.  To help me pare down my closet, I needed a dear friend, and the unwavering opinion of my fashion sensible midwife.  I guess plaid is out, who knew? The fragile moments of the first couple of weeks post -birth, already seemed like another lifetime's dream.  By the time my mother came to meet her newest grandchild, her only daughter was in need of some ibuprofen and a shoulder to cry on. Not to mention the help I needed washing the dingy curtains, and packing those aforementioned books. (Note to self: A Kindle is warranted until you buy a house!) It wasn't an option to take a back seat.  My husband accepted a once in a lifetime opportunity to study with a respected teacher and continue his academic studies.  One short month after meeting my son, it was LA or bust.  I was tending towards the latter. 

If this were a movie, I would roll the credits first, because without the support of family, friends, and community, none of this would have happened.  It was an outpouring of generosity like no other.  Each night I found freshly cooked food at my doorstep, or steaming from my table.  Clothes for the baby, and even my daughter arrived unbidden.  One talented and creative friend sewed bags filled with activities for the older ones, and baked the best sugar-free, grain-free snacks a gluten sensitive mama could hope for.  My son went to the zoo, and Fairy Land, with an ice cream stop to boot.  The last baby I delivered before I had mine, even made an appearance. And I would be remiss not to mention the presence of a fellow midwife, who truly midwifed me through one of the hardest days of my life.  She was born to do this work. God bless her.  It was awe inspiring and bittersweet, for soon I would be leaving this nest of community and warmth. But first, I'd have to put the Boppy aside, and pack up the entire house.

It's hard to follow your own advice, though I endeavored.  I rested in bed for two weeks, stayed warm, gave myself warm oil massages, ate the best darn food I could. Hell, I even gave myself moxa treatments.  But the looming move crept in and all of my best laid postpartum care plans shrank in response.  STRESS became  a real and unwelcome guest.  Oh, did I mention 'the shooting'?  There was one, in front of my house, at dinner time.  We had the luxury of leaving that night.  May God help and raise up those mothers who don't.  It seemed stress was everywhere I turned.
Evidence of my herbal medicine nesting!

There was however, one burst of nesting which became my postpartum savior.  In anticipation of the move,  my settled pregnant self dove into herbal medicine making.  It was a way to hedge myself against what I knew would become a harried postpartum. Sitz bath herbs, nursing teas,  arnica and St. John's Wort oils, valerian root, motherwort and echinacea tinctures were all brewed up and bottled before I delivered.  It was a gift to myself and a sure stroke of intuition, for I needed these herbs even more than I anticipated.


The move, turned out to be a minor blip in the scheme of things.  My husband and I had to be separated, all told for over a month. (The LA rental market turned out to be less than friendly to a family of 5!)  My little ones and I lived with the most generous brother and sister in law you could ever ask for, for one month.  It was an epic postpartum I tell you.  It was going to take more than some nursing tea to get me through. It was going to take the heart of a lion.

Luckily, I had the closest thing I could get, the plant called motherwort , leonurus cardiaca, Latin for lion hearted.  Brewing this tincture many moons ago, I had anticipated using it for the afterpains.  Motherwort, or mother's herb,  is an antispasmodic and a uterine tonic.  And for those first few days, I was taking it every half hour or so to quell the crushing afterpains.  However, motherwort is more than that, it is also a nervine and sedative and often used in the treatment of stress and nerve related disorders.

This is what the respected herbalist Susan Weed has to say about this herb:
Another of motherwort’s uses is to improve fertility and reduce anxiety associated with childbirth, postpartum depression, and menopause. If used in early labor it will ease labor pains and calms the nerves after childbirth. Take motherwort only once soon after giving birth as consistent use before the uterus has clamped down may cause bleeding to continue. Use one to two times a day in the weeks following birth for easing tension and supporting a woman through the feelings that come with new mothering.

One lonely morning,  as the two year old was melting down, the baby was crying, and my poor six year old looked just plain apathetic, I found the full bottle of motherwort tincture waving at me from my  bathroom bag.  I  took two full droppersful.  My shoulders instantly dropped from my ears.  A plan of action soon formed in my mind (calm the two year old first, always!), and the overwhelm seemed to diminish.  The courage to pluck on grew in this delicate new mama heart.  Throughout the next month, motherwort became my green friend.  I took it morning and night, and whenever the two year old decided to dig in her poopy diapers (yes, you read that correctly.  A habit she developed once moving into the pristine enclave of my in laws!) Motherwort, take me away!  Two droppersful and I could exhale again, feel the ground hold me up, and march on. 

It's been three months since then.  Ya Sin is four months old, just rolling over, and charming us all with his easy going grin. My 8 ounces of motherwort tincture is long gone.  There are many mornings or mid afternoons, where I could still use it to be sure, but I find myself brewing that nursing mother's tea now. "For every disease there is a cure", said the Prophet Muhammad.  While my postpartum was not a disease,  it was excessive and warranted a cure of its own.  I believe in medicine of all kinds.  Each tupperware filled box cooked for us was medicine.  Every phone call or text message to see how I was, was medicine.  For everyone who joined me on my couch and listened, I healed.  These were all cures for my state.  But motherwort certainly lived up to its name as a mother's herb.  It was the cure for this mother during a less than ideal postpartum. 

I once heard that the medicine you need, is always with you, you just have to be open to it.   That was certainly the case with me and motherwort.  May you always find the medicine you need, when you need it.  Thanks for your patience.  Want to know how I made these tinctures without alchohol?  Stay tuned, I have a post coming up!!

Saturday, July 14, 2012

Ramdan - Fasting with Child (ren)

This is a re-post from last year's Ramadan. The information is still the same and insha'Allah of benefit to some of you. Thank so much for all of your well wishes. Ya Sin and I are enjoying our lie-in. I hope to return to this space more regularly soon!  An early Ramadan Mubarak to all of you. Please keep us in your du'as. 

Ramadan's many lights and gifts will be here in a matter of weeks. One of the questions I am often asked by pregnant and nursing women is whether or not they should fast in Ramadan. This post is not meant to encourage or discourage women from fasting, rather it is to provide information that can help mothers stay healthy if they decide to undertake even a few days of fasting.

Many women say that they would rather fast when everyone else is fasting instead of making their fasts up later. If you are one of those women, I hope this can help prepare you physically for the fast of Ramadan. Studies conducted about pregnant women fasting in Ramadan have found no adverse outcomes in the baby's birth weights, length, and head circumference. The fast of Ramadan also has not been found to adversely effect milk supply in lactating women, although it can alter the content of breast milk, but without affecting infant growth.

Pregnancy can be a challenging time to fast depending on when the fast falls in your gestation. Nina Planck, a real food expert and author, has written a wonderful book called Real Food for Mothers and Babies that breaks up pregnancy's nutritional needs by trimester. Planck says that in the first trimester, when the organs of your baby are developing, your embryo needs minerals to become a strong fetus. The bones and muscles are doing most of the growing in the second trimester, so your baby needs calcium and protein rich foods. In the third trimester, the eyes, brain, and nervous system are rapidly developing; fats high in Omega 3's will aid this growth.

If we base our Ramadan diet on Planck's demarcations, what are the best foods to nourish you and baby in each trimester? Fasting in Ramadan offers us only a few exchanges with food, so we need to make each of these encounters nutrient dense and filled with what our growing babes need. You will notice a theme throughout my recommendations and that is good fats and protein. Good fats include, coconut oils, olive oils, fish oils, butter, and tallow. Your baby's development needs cholesterol. You need good fats and protein to support this. This duo also supports mother's in their health and well being through pregnancy, therefore you will see multiple mentions of healthy fats and proteins.

In the first trimester many women often need to eat constantly to keep nausea at bay. Others do better with no food. Either way, your baby has to grow. If you choose to fast during this time, I really like a few foods to help you out. Much of nausea comes from hunger. When you eat, eat foods filled with protein and good, healthy fats. For the suhoor, the morning meal before dawn, try any of the following:

  • Smoothies with egg yolks, coconut oil, milk, and yogurt and lots of fresh fruit. The fruit will give you plenty of the micro-nutrients which your baby's organs need and the yolks, oils, and yogurt will give you good fats and proteins for fuel throughout the fast.
  • Eggs are a great suhoor meal for pregnant women. Make an omelette with lots of vegetables -- again this will give you a mix of micro-nutrients and protein.
  • Oatmeal with lots of butter, cream, milk, or coconut milk. Add nuts and fruits for a complete suhoor.
  • I do recommend eating at least three times a day in Ramadan, the suhoor meal, an iftar meal, and then again about an hour before going to bed. This still provides the same caloric intake, albeit not at the regular times you usually eat.

The first trimester is a big adjustment. Take it easy and don't push yourself to exhaustion. Read my post on the first trimester, where you will find many tips that you can do while fasting. I personally think essential oils, like lavender, ginger, and geranium go a long way in helping with nausea, fasting or not. Also, fresh air can alleviate nausea for many women. Get out and go for a walk right before you break the fast.

When Ramadan falls in the second trimester, it is perhaps the easiest time for you to fast while pregnant; the nausea has mostly passed, and you have regained some of your energy but don't yet feel uncomfortable from the weight of your baby. Here are some general tips for fasting and breaking your fast in the second trimester.

  • If you can, try to switch your nights and days. During the day, stay inactive and rest as much as you can. If you need to do anything active, like clean or cook, wait until shortly before the sun sets so that you can eat and drink soon after.
  • Try fasting every other day.
  • Do gentle exercises like yoga, tai chi, or walking shortly before the sun sets.
  • Don't skimp out on sleep! This is hard in Ramadan, especially during the summer months, but try your best not to exhaust yourself.
  • Because protein and calcium are important this trimester, be sure to include lots of protein rich foods in your meals. Meats, broths, eggs, and lentils are wonderful and healthy choices.
  • Calcium rich snacks can be eaten between iftar and bedtime. Almonds, warmed milk with cinnamon, ginger and a pinch of sugar, yogurt with fruit.
  • Dates, the traditional food to break the fast with, are an excellent way of revitalizing the body after a day of fasting. High in potassium, iron, anti-oxidants, and other minerals, they are also perfect as a second trimester treat.
The third trimester is perhaps the trickiest time to fast. There have been studies that have found that fasting in late pregnancy causes a state of 'accelerated starvation.' We should know that our bodies are working hard during this time; the baby's nervous system is developing connections between neurons, its brain folds are forming rapidly, and its gaining more and more motor control each day. All this while it is packing on half a pound every week. All of this requires an enormous amount of caloric input, so it makes sense that this trimester would be a difficult time to abstain from food. Also, labor could begin at any moment in this trimester. Beginning labor with a caloric deficit is adding an extra challenge to the challenging physical task of labor. Despite that, some women will fast. Whether or not you fast, here are foods that help build healthy brains for your baby:

  • Try eating fish when you break your fast. Fish is easy to prepare and full of healthy fats well suited for growing noggins. Check out Seafood Watch for more information on which fish is best for you and the environment.
  • I love herbal infusions in pregnancy. They are especially great for women facing the great task of birth, and subsequent mothering. Alfalfa, red raspberry leaf, nettles, and oatstraw are wonderful third trimester choices. Drink them mixed or separately. They contain an amazing amount of minerals and micro-nutrients, all of which saturate your tissues and muscles with nutrients that help them work efficiently in labor.
  • Egg yolks, butter, whole fat milk, and all other foods rich in cholesterol can be considered brain food. So go ahead and have eggs and toast with lots of butter for suhoor. Your baby will be smarter;)!

Staying hydrated is actually a bigger concern than caloric intake for fasting pregnant and nursing women. Abstaining from water all day can be a real challenge while pregnant and/or nursing. I suggest that when you eat in the morning and in the evening, drink an electrolyte drink, preferably not Gatorade as it has tons of sugar and other undesirable preservatives. Try this mixed in your water. Coconut water is another refreshing way to replenish your electrolytes. Vitamin Water and Re-Charge are also good choices. Electrolytes help the water replenish and hydrate you. Without them it often seems that the water just rushes through you!

Nursing and fasting is often more difficult than pregnant while fasting. That is simply because while nursing, you also have to change diapers, push the stroller, and carry and nurse the baby. There is more work involved! All of the above recommendations can apply to nursing women. Along with a few of these:

  • Add one tablespoon of coconut oil a day. You can eat it directly off the spoon. Lauric acid is the main ingredient in coconut oil. Lauric acid is a medium chain fatty acid, the primary component in breast milk. This can help keep your breast milk full of the nutrients your baby deserves.
  • Focus on hydration. You will feel thirsty due to the hormones of breastfeeding, primarily prolactin. When you are not fasting, always keep a bottle of water with you and electrolytes are a must. The above mentioned studies have found that lactating women hydrate more than non-lactating women in Ramadan. Remember that and drink to thirst.
  • Stay away from the fried offerings always so present at iftar gatherings. Often they are fried in unhealthy fats full of trans-fats. Trans-fats are easily transferred to breast milk. Be mindful of healthy fats and fulfill your fat cravings in other healthier ways such as butter, meats, fish, and eggs.

Ramadan, however, is not only about the physical fast. Fasting also takes place on the spiritual plane. Fast from the fast-paced world for your baby's sake. Slow down and retreat deep into the stillness of spiritual practices and a beautiful remembrance. This more than anything is what nourishes mothers and babies, whether or not they fast during Ramadan. I pray you all have a blessed month full of vast openings and a renewed closeness to God. Please remember me in your prayers.

Friday, June 29, 2012

Eat, Drink and Be Content - My Birth Story

The gray area of when labor starts is rarely heralded by a neat "5 min apart, lasting 1 minute, for at least 1 hour", otherwise known as 511, but, shhh, don't tell my midwifery clients.  As a midwife, I can tell it in the puffed faces of my beautiful mothers, their mental desperation and physical distress at a state that is starting to feel timeless. As a mother, I recognize it in myself when I start to burn things in the kitchen, consistently, each meal is somehow derailed, for days.  My mind is incredibly present, but not.  It is the outward manifestation of the internal contradiction, in the the invariable discomforts of late pregnancy, I somehow find myself yearning for escape though the rhythmic pain of contractions.

I have just felt three contractions in a half hour.  They squeeze my middle, forcing me to sway my hips and breathe.  The baby even pauses its passes at my ribs, seeming to wonder at the new sensations too.  I call my husband at work, wanting him to be on alert in case he has to come quick.  The kitchen is inside out with half finished projects, coconut date balls need to be rolled and dipped in coconut, salsa needs to be chopped and bottled, there's milk cooling for yogurt, beans bubbling for tonight's enchiladas, and a sink full of the evidence.  It's at least an hour or two of work, and my labors rarely last that long.  My mind is swimming between before and after. Now, I'm a pregnant mother preparing her family for her postpartum rest. After, I'm on the other side of this great battle called labor.

I've been advised by many to listen to Surah Maryam (the Chapter of Mary) during labor.  It is what fits right now.  I plug in my phone to the speakers.  "Kaf Ha Ya Ain Sad" rings out of the dainty speakers and reverberates through my entire being on such a physical level, that I  grab the counters edge and sink down to the kitchen floor.  The soothing words and rhythm continue to wash over me melding the before and after of this fragile expectant mother.  I am reminded that if I die, I am a martyr, receiving the same spiritual status as a holy warrior.  I weep for a forgiveness I didn't know needed forgiving. It feels like the shedding of a self, one that needs to yield in order for a momentous event to occur.

My son overhears the weeping and asks, "Are you having contractions?"  Yes, I answer him, noting mentally, that no, I haven't felt them since I called my husband half an hour ago, but there is no other explanation for my unraveling in the kitchen, so I do what most mothers do and opt for expediency.  I hear him tell his sister that the baby is coming.  I am once again grounded by my sweet children.  The dates need to be pitted.  I hit 'translate' on the Qur'an app on my phone.  The ayah (verse) that is playing at that moment, that pops into my phone's screen, is like a Divine answer to my misgivings, "So eat and drink and be contented".  My heart swells with belief, and I am back on the staircase weeping.  Allah is al-Hayy, the Living, I am not alone in this undertaking.  The kitchen can wait, I finish listening to the surah before resuming my work.   I imagine that this is what a soldier feels like before battle, humbled ego, and steadied heart.

After having three labors, there are some individual patterns that can be etched out.  I can now say that not only does my water break before my labors, but that it does so at the beginning of the morning prayer.  It's an odd pattern, but I like it.

I'm lying in bed as my husband is rousing for fajr, when a contraction hits me so hard, I reach out for his arm.  And then with a great release, the soothing warmth of amniotic fluid gushes between my legs, a message from the other side, my babies habitat for the past nine months revealed.  Instantly,  I am shivering and moaning through contractions.  It's odd to be a midwife and a mother in labor.  The contrast between the head and the heart is somehow clearer.  I'm noting from a distant place, that I am in transition, right now.  I tell my husband to call the midwife, but tell her not to come, the heart is wanting privacy.  I am playing that mind game that mothers in labor play.  We tell ourselves that this is only the beginning in order to have mental stamina for the end, and in some ways, labor really is only the beginning.

The morning prayers are said, and we are descending the staircase so these moans of "Ooooopppppeeennn" do not wake the sleeping children.  By the time we make it to our living room, the birth room, I am nauseous and hot.  I want a wet washcloth, and a woman's knowing touch.  My beloved midwife lives less than a mile away.  "Call her", I tell my devoted husband who is fumbling with the birth tub pump.  She answers and says, I'm already on my way, did we think she was waiting for another call?  Oh midwives, the good ones capture that difficult place between knowing and unknowing with such skill and wit.

I am sending each contraction into circles of movement, from hips to cervix.  I can't imagine not circling my hips. "Ya Latif", O Gentle One, I mutter weaving this sentiment into these circles.  I am connected to my Muslim sisters from Afghanistan to Senegal, who have uttered this Divine name through their contractions for centuries.  They become my companions through these giant, urgent waves.  I can do this too.

The birth tub is inflated, but dry, as I am feeling the first urges to push.  There is no time to fill it.  I have never done this without the tub and I am nervous.   How do I push outside of the tub?   The answer soon becomes clear, you just do.  Twenty minutes later, my nine pound baby boy is born.  We have named him Ya Sin, a name without direct meaning, yet fraught with Divine mysteries and meanings.  It is what I felt throughout this pregnancy, and the earliest twinges of  labor, a knowing beneath the surface, that if trusted and sought, will open up worlds of understanding.  May Allah bless him, and all babies and mothers everywhere. Our children truly are here to teach us, from their conception, to adulthood.  I am grateful to learn.

Post Note: We wanted to say a special thank you to our other stellar midwife Lael, who not only made the birth hours before leaving on vacation, but brought us a dozen eggs from her chicken to nourish us and continue the cycle.

Sunday, June 24, 2012

The Prophet Muhammad as a Baby

Photo Credit

In honor of the Islamic lunar month of Shaban, traditionally touted as the month of the Prophet (peace be upon him), I am sharing some really sweet notes on the development of the Prophet Muhammad as a baby.   These notes are from a class I attended about six months ago with  Ustadha Eiman Sidky.  I wish I could find the book from which she took these pearls, but alas, my notes are lacking the text. If anyone knows, please leave it in the comments, so I can add it! They detail his development from turning over to talking, and as always he was exemplary and above the curve.  I love thinking of his blessed babyhood, and how he was as an infant.  Enjoy!

  • At two months of age he was rolling over already.
  • By four months he was cruising, as in cruising along tables, and other furniture to move from one place to another.
  • He was walking at five months. Can you imagine!?
  • At nine months he was speaking Fus'ha, the elegant and elevated form of Classical Arabic. It is the form that the Qur'an was revealed in. 
  • At ten months, he was able to accurately shoot a bow and arrow, a sign of his piercing intelligence and unwavering focus. May Allah bless him!!
  • And always, before he touched anything, even as an infant, he would utter a 'Bismillah"
Enjoy this month, may it bring you closer to the Prophet and prepare your heart for Ramadan!  Remember all the babies of the ummah in your du'a!

Saturday, June 2, 2012

What Gets the Baby In...A Birth Story

"What gets the baby in, gets the baby out"
-Ina May Gaskin - founder of modern American midwifery

"...sexuality is a whole.  The same hormones are involved in the different episodes of sexual life such as intercourse, childbirth, and lactation....The final phase of each sexual event is always an 'ejection reflex': sperm ejection reflex, foetus ejection reflex, milk ejection reflex. 
-Michel Odent from The Farmer and the Obstetrician

I was awoken at around 2 am by a phone call from Kim (you can read her awesome rendition of giving birth here)  Expecting her second baby any day, I was waiting for her phone call.  

"I couldn't sleep so I had sex.  After we were done, my contractions started coming every five minutes.  I swear, I wasn't trying to bring on labor!"  Kim laughingly told me. I listened through a couple of contractions then told her to change positions, maybe try a shower and call me in half an hour to see if things slowed down, or picked up, or what.  I was thinking that things would peter out after her hormones calmed down.  Oh, how I love to be proven wrong.

My somewhat rule is that if the dad calls you during labor, it's go time.  About twenty minutes later, the phone rang.  Mike's Irish lilt turning serious told me that things were picking up and it looked like labor.  I could hear Kim moaning through a contraction in the background. Wonderful!  I told him to call the doula, and that I would get myself and my things together and head over.   

As  I was approaching the lights and wonder that is crossing the Bay Bridge in the wee hours, the doula called.  My other somewhat rule (because can birth really have rules?) is that if the doula calls, I better step on it.  Britt informed me that Kim was indeed active and that they just wanted to make sure that I was on my way.  Yes, I was, ten minutes I said.  I went as fast as feels safe over a bridge and through city streets.  

It was a lovely night to be born, a chill, crisp March evening.  Entering Kim's birth space was truly magical.  Kim is an artist. She makes each and every thing she does an act of beauty, creation, and meaning.  From our first visit her birth space and how it looked was of utmost importance to her and her husband.  She came through.  The tub had been moved into their living space. Candles, with inspiring collages and quotes from Kim's myriad friends, filled the room with love and light.  Music, which I never would have pegged as birth music, but suited the moment perfectly livened the mood.  Kim was on the bed hands and knees.  I threw my things down to say hello and have a quick listen.  As soon as I did that Kim let out a deep, sonorous yet guttural sound signalling that the power of birth was moving through her. My midwife ears heard it and I peeked at her perineum, indeed it was bulging with a soul determined to take it's place in the family, and soon!  

Kim made it clear that she wanted in the tub.  She was so relaxed and in control, yet totally surrendered. She had a vision of her birth, and she was going to make it happen if at all possible.  We moved her into the tub with the head sooo low! It was the perfect ending to a whirlwind labor.  The contractions slowed a wee bit, just in time to wake big sister.  Kim moved to hands and knees in the water.  With a couple of pushes, her son's head was out, witnessed by all in attendance, including her two year old pajama footed daughter.  I reached down to help with the body and sweep him through to mama's waiting arms.

And just like that, it was done, a circle of love completed.  Truly Kim's birth was an illustration that birth is not separate from sexuality, that it draws from it, and intimately relies on it.   It was an honor to see, and a privilege to so clearly observe a truth about women's bodies and their hormones, we are indeed vessels of love. 

Sunday, May 20, 2012

Wendell Berry on Birthing Lambs!

Photo Credit
 “When you are new at sheep-raising and your ewe has a lamb, your impulse is to stay there and help it nurse and see to it and all. After a while you know that the best thing you can do is walk out of the barn.” -Wendell Berry as quoted in a recent NYT article.

This quote couldn't describe midwifery more elegantly.  Most of the time the hardest part of our job really is to just "walk out of the barn".  Birth works, babies are born, mamas give birth, just like the moon rises at night and stars set in the morning.  The intense, powerful energies at birth are often contagious and we just want to jump in and soak it up, but it is not meant for us.  Center stage is for the family, we must quietly exit stage left. Unless of course we are needed, but mostly, we can take five, and mother and baby are more than fine.  I love this post at Progressive Parenting about three things we need to stop doing to newborns. Here's a clue, stop Hatting, stop Patting, and stop Chatting! I mean look at that sheep mama above, does she need any help raising her adorable lamb?  It looks like she's got it under control to me!