Birth from the perspective of a midwifery student (conference presentation)

A month ago I had the honour of making a presentation at the Ontario Student Midwives Conference at Ryerson University.  As a midwifery student, currently on maternity leave, it was a great opportunity to reconnect with old friends, and meet in-person virtual friends.  It was also a tough place to be given the tenuous position I have as an actual student (more on that another time), and given my topic.  I had submitted two proposals and both were accepted.  One, was an editorial piece I've been working on for a while but a presentation I didn't actually get a chance to make due to a mini family crisis when my 3 year old dislocated her elbow! The other, was this piece below, one that I cried when writing but somehow managed to get through without crying.  Though, I made many of my fellow classmates tear up. Keep in mind, this was written to be spoken, and to be listened to for about ten minutes so it is long and the tone may be a little different from my "blog" writing.

Being a midwifery student is hard work.  Maybe harder then we thought it would be.  Maybe not.  Those of us who are mamas have so much to re-learn, how to see things from the other side, how not to interject every five minutes with “During my births…in my pregnancy…when I was breastfeeding’  and those who aren’t mamas have to learn that they are not at a disadvantage so stop feeling like that and move on!  I do remember, in my first year, during With Woman actually, thinking, how amazing it would be to have all of this information before having a baby.  To be able to tap into all of these extra resources, and wealth of knowledge.  Um, yeah, not so much.

As I was preparing to write this presentation I spoke (aka, Facebook’d) with a few mamas from the program.  They had vastly different experiences from me and from each other.  Planned home birth.  Planned hospital birth.  Things went according to plan.  They didn’t feel like they’d had any amount of pressure or expectations as an MEPer.  Maybe it was just me then? And then I read an amazing paper by one of my classmates.  She had looked into the experience of giving birth as a birth professional.  Of the women she had surveyed, all of them a birth professional of one kind or another, many had felt that there was a certain expectation around the kind of birth they were going to have, felt that there knowledge both helped and hindered them, and that it was hard to not be in control. 

Now, I’m a planner.  To a fault.  But I had worked really hard at not having a birth plan, though every one does to a certain extent.  I felt I had learned a lot about myself, my body, the way I give birth, and my babies during my first two pregnancies and births and during this pregnancy.  Unbeknownst to me at the time, I would come to learn a lot more about myself.

My girls...and Mark like to dress up as Superheroes. And as a mama you feel like one. I obviously have an innate power, two really: the ability to incubate and nurture a human life inside my very own body and the awesomeness that is lactating boobs!

So when things went a little sideways with my planned home birth I felt like Supergirl faced with kryptonite. Actually no, I wasn't on the ground squirming in pain, I was more like WonderWwoman being harnassed by her own lasso. In case you don't know, that's her main weakness.

  

I initially though of this analogy to bring some humor to my story, keep myself from crying, but the more I thought about it the more accurate it seemed. As a mama-midwifery student aka Wonder Woman, it was my own knowledge that was tying me up and forcing me into the ambulance and to the hospital. From a midwifery student perspective, that was the ultimate villain's lair. But from a regular mama perspective, it was the extra knowledge, the extra help from fellow students, the "extra" that was tying me up and imprisoning me in my decisions.

You see, non midwifery types, still amazing mamas of three, Breastfeeding, baby wearing, loving their kids mamas, they did not understand why I was so defeated at having given birth in a hospital and having stayed there for 23.5 hours. They understood that it had not been part of the plan; but these women, whom I didn't know all that well, simply said " but you made the right decision for your baby. You didn't really have a choice. Not one where one or more of the outcomes would have been acceptable.". My friends, the students, they all had a lot of different things to say. Sympathy instead of empathy, sorrow instead of support, shock instead of agreement.

So why didn’t I have a homebirth? Poop.  I suppose the more appropriate way to say it, is that there was meconium.  A lot of it.  Thick, pea soup sludge seeping into the birthing pool. 

And the reason I had to stay at the hospital was a GBS positive screen with insufficient amount of antibiotics administered prior to delivery. And here’s what I have to say to my fellow midwifery students:  Stop.  Stop thinking about the odds ratios, the research, the facts, the myths, and the alternatives.  As your classmate, I know now, and knew then all of that information. But what I also knew, was that the institution I gave birth in had a mandatory 24-hour stay policy for mamas and newborns with a GBS positive screen or they would call CAS. 

CAS.  These three little letters.  Letters every parent – good or bad – dreads hearing.  Imagine, if you will, having just given birth to a beautiful, perfect little girl.  A beautiful birth.  An emotional high.  Conflicting emotions – the “wrong” kind of feelings are bubbling below the surface but you are pushing them down as you stare into the eyes – are they hazel?  Are they brown? – of your daughter.  Your midwives doing post partum things.  Your partner, leaning over you and your babe, kissing your head, pushing back your hair.  And all of a sudden arrangements are being made for you to stay overnight.  It doesn’t matter that the odds of your baby being affected by GBS are 1 in 300 to 1 in 1000.  It doesn't matter that you had some IV antibiotics.  You are free to go.  But if you check your beloved newborn out against medical orders, you will awake to Children’s Aid Society at your doorstep.  Now, consider again all of the informed choice, research, self-rightousness, strength, mama-bear protectiveness of not just your two older girls sleeping soundly at home, but of this new life you have never been away from.  And imagine, for a full minute, the idea of a stranger holding that baby and seriously considering that you are unfit.  

Being a midwifery student can really screw with your head and your heart sometimes and this was one of those times.  I knew my baby was fine, and safe.  I knew what to look for.  I knew the odds.  I knew my rights.  And I knew that my girls were going to wake up and be surprised at best, heartbroken at worst, that I wasn't there with the new baby.  But none of that compares to the even the most remote possibility of having to deal with CAS bureaucracy within the first 24 hours of my newborn’s existence.  I mean, honestly, I wasn't planning on letting the grandparents in the door!

As I prepared for this presentation I was searching for images and I came across the cover for a children's book about homebirth. And I came across gorgeous waterbirth photographs including ones of mamas with all of their children clambering to look at the newest sibling. And looking at these images, breaks my heart.  Every. Single. Time.  And there is no excuse for it.  When I speak to my partner, when I go over my story, when I speak to other mamas who aren't in the midwifery circle, it’s not really a big deal.  I had a beautiful labour.  I had a beautiful birth.  But most importantly, I had a beautiful baby girl.  But the fact that I read that damn book every single night for months, watched homebirth videos, and practiced birthing sounds and positions with my girls – all for nothing, that breaks my heart.  And, you can argue that they are young so they are fine.  To which I say, my middle monkey, she had to be reminded that we got to keep our baby.  And my oldest monkey who saw the middle one born, was also heartbroken and angry and we had a good long cry about it together. It’s hard to hear about other people’s wonderful water births with their children present because I didn't get that.  But that’s the midwifery student in me.  The mama in me, is grateful for having three healthy daughters.

 Sometimes I think that I’m not going to ever fully get over disappointing my girls by not having a homebirth for them.  And then, Mark reminds me that my girls are six and under and that sometime much sooner than I would like I will disappoint them in what appears to be a frivolous way to me – like, saying no to an Abercrombit Fitch sweatshirt, or to party they want to go to – and that will be the moment that sticks with them not that they missed Baby C’s birth. So, while many mamas probably dread the conflict of the teen years, I say, bring it on, it will totally  help me heal!  

So what does it mean to give birth while an MEP student? And what doesn’t it mean?

• Maybe because I wasn’t in Clinical Skills with my peeps, it didn’t result in numerous belly palpations, pulse takings, fundal measurements or fetascope listenings.
• It did mean that during Bruce’s lecture when he put up the graph of oral contraception – the one explaining why you have to take your pill at the same time every morning – even if you just hosted the end of the year party and your children aren't home to wake you up - that 50% of the class will turn around to shoot you a knowing look, and laugh.
• It does mean that at least twice you will be told you are huge and you will wonder how a future midwife feels like that’s an okay thing to a pregnant woman
• It does mean that you have a plethora of information –far more than even a well educated mama
• It means that you have expectations of being with a midwife, most likely a doula, that you will not freak out, that you will not request pain relief,
• It does mean when you go for your ultrasound and the technician makes assumptions about your sexual orientation, your desire to have the baby, the man in the suit being your husband, you hear Nadya’s voice in your head gently reminding you how you should never ever make those assumptions.
• It may or may not mean that you will cook and serve a delightful vegan meal for a dozen or so of your closest friends and family who all invade your house immediately.  Personally I came home and crammed my belly full of braised pork shoulder curry and rice.  And a Strongbow. And didn’t let anyone in the door for 48 hours.
• It means that when you are stuck in the hospital bed checking your facebook, one of your school friends will notice that you are at the same hospital she is making rounds in and will be the first to visit you.
• It means you can argue with the pediatrician and convince her to let you leave the hospital early.
• But it also means the L&D nurse will call you “one of them” for not letting her bathe your baby.
• It means that when you are forced to make a quick decision, it’s no longer impulse nor even informed choice that is guiding you, but information overload, and graphic visuals, anecdotes,  facts and figures clouding your brain.  And that no matter which way you lean, someone you go to school with, will offer their unsolicited opinion telling you that it was a misinformed decision.  And they do so because of the information in their head, not as a judgment, but it comes out very much as a judgment and a sentence “Guilty of not fulfilling the MEP student edict of perfect home birth!”  "Guilty of allowing the institution to dictate what you could do!"  "Guilty of submitting to the will of non-midwives!” 
• It doesn't mean that any of your decisions would have been different. Because you are a mama first.
• It doesn't mean that you are at a disadvantage.
• It doesn't mean that you are being judged.
• It doesn't mean that you failed in some way.  Unless you know, you actually failed.  But despite my hormone addled brain, I managed to pull off decent to hey-not-bad grades in my courses!
• It does mean that you will receive lots of love from wonderful women who will make the trek all the way to Mississauga just to visit you and your girls.

Baby C is my baby Hulk.  That is to say, she’s a happy baby, until she's not.  (And you don't want to make her angry.) Which is to say she is perfectly healthy.  Ultimately, there is no guarantee that she would have been had I stood my ground and not gone to the hospital.  But just looking at her, while she nurses, or laughs, or yells at the floor for not letting her defy gravity, I can’t say that I would make any decision differently except for – and this is the most contentious issue – maybe, just maybe, planning on a hospital birth.  If I’d planned a hospital birth with my girls present then they would have been there for the birth.  But, that wasn't really the images and experience I wanted for them, for me, for us.  R has one homebirth under her belt already, and while L will never get to see a sibling being born at home, neither will Baby C just by being the baby.  But, I figure most of my friends and classmates are younger then me and a few of them will probably have babies of their own one day – so hopefully, they can witness that.  You don’t mind do you ladies? 

Back to School

I'm a self confessed back-to-school shopping addict. I recently returned to school and unabashedly hit the school supply sales stocking up on fun colored pens, post-its, highlighters, and of course fancy notebooks and an even fancier pencil case. I then voided the need for all of these by purchasing a netbook!
Even though I'm taking a year off to hang with Baby C while she's still a baby, I couldn't help but sneak an AC/DC backpack into the shopping cart this week for myself. (What? Don't judge. It was very cool!) It was a very efficient shopping expedition and that was a result of some planning in our part.

To get ready for R's return to school on a budget, here's what we did:

• went through all the school supplies in the house and ran a web search on what might be needed for grade one. As it turns out, if you are in Edmonton you need a whole lot more then here in Mississauga. We created a short list of what we still needed and what we were going to ask Dumboo (aka my dad) for as he likes to take them shopping.  We ended up not needing very much but we did pack three pencil cases:  one for each girl (sorry Baby C, maybe next year) plus one for R to take to school.  Take away message: Save all those fancy pencils kids get from teachers, classmates, and lootbags.  We had over a dozen!  Parcel out new supplies mixed with old ones.  Don't set up the expectation of brand new stuff every year.  R happily used the same backpack for two years; the girls fight over who gets to use my old pencil cases and all of my fancy pens.  Plus, I find a little extra purchasing when a box of pencil crayons is 93 cents and a pack of paper 17cents to be more than worth having to keep it in storage for later as compared to paying full price mid-school year.  

• tried on all of last years fall/winter clothes. Very little still fits R but she has plenty of tshirts, hoodies, and a couple of pairs of pants plus her shorts that will get her through the early part of the year. September is generally still summer like. We compiled a list of what we needed: a couple of pairs of pants,   a few long sleeve shirts, new shoes, and rain-boots. We then hit Joe Fresh and the online sales at Old Navy. The clothes aren't the best quality but they aren't awful either like some less expensive places. While you could argue that paying a little more for better quality might be worthwhile as there are two more girls to grow into them, it doesn't quite work out for us for a few reasons: Despite the fact that R takes good care of her clothes there just isn't much left to them by the end of the school year (regardless of the brand);  L is a completely different body type so she will never fit into R's old stuff and so far, Baby C is her own size and shape.  Take away message::  Pick one or two stores/brands. I've got three girls who are in car seats or boosters including a baby who despises being in the car and stroller.  It is far more economical for us to just pick up what we need at one or two places then spend a day at the shopping centre or driving from place to place, comparing prices and sizes (heaven forbid you need to return something!) .  My time - and my sanity -  is worth more than saving a couple of dollars.  But saving more than that? A necessity with three girls so I never shop Old Navy (or even Gap) unless there is an email coupon code;and I generally shop online so that it's shipped to me free and there are no distractions of other unnecessary items and /or lunch!

• had R write out all of the things she would like to eat for snack that does not come in a box or other packaging.  This gave her the chance to make some decisions, we talked about nutrition, she practiced her printing, and it was really helpful.  We have a litterless lunch policy at school so I can't send things in wrappers or disposable containers otherwise they come back home generally making a mess of the lunch bag first (open yogurt container - ugh!).  While this may sound inconvenient, it's actually a super economical way to go.  We don't bother with any single sized snacks like mini yogurts, string cheese (is this actually cheese?), or granola bars which either seem to have nuts - a big no-no; marshmallows (not even trying to be healthy); or are so healthy they are both expensive and tasteless.  Take away message:  even if you don't have to go litter-less.  Try it!  Portion out yogurt in small containers; cut up cheese yourself;  and dole out kid sized handfuls of crackers or other crunchy things in containers as well.  You can be as healthy or not as you choose and still save money by not paying for all that packaging.
• sorted the winter accessory bag.  Yes, it's really hard to look at, never mind, touch, wool, flannel, and fleece when the humidex has spike at 38 degrees but if I don't sort through hats, scarves, and mitts now, when it does get cold there is a scramble to see what fits who and who needs what.  Take away message:  deal with wardrobe issues for the entire school year in August.  
• decide where to spend the big money.  I know mamas that drop some serious coin on expensive backpacks, that are looking good and going into the third year of use.  I know mamas that invest in really expensive footwear that only lasts a season or two, but their reasoning is "It's my kids only pair of feet!  And others who are all about clothes.  Backpacks, well, I still haven't learned that lesson to invest in a good one.  Last year I fell for a backpack from a reputable clothing store.  Apparently, their backpacks are crap!  This year we went super cheap, and may live to regret that, but honestly, the budget is creaking from being stretched. We buy our girls good shoes, fun shoes even, but at Dixie Outlet or Winners. We spent a pretty penny on their winter jackets/ski parkas last year.  But not only were they on sale, not trendy, had sleeves that could extended and waists that could drop - they were warm!  My kid has to be outside for 45 minutes at lunch time, I don't want her to get wet or freeze her butt off.  Summer shorts - cheaper the better.  Winter jacket - bring on the Christmas present money!  Take away message: Spend the big money on items you know your kid won't outgrow quickly,  can't lose easily, and what they really need for comfort. Take a risk on cheaper items when and where you need to.  There's no point paying more interest on your credit card than buying another of something if it tears or breaks, would cost.
• lunches - R and I talked about what she wants for lunch.  And aside from making it clear that I'm not letting her get pizza every week for pizza day, we're good.  But I'm lucky, she likes a variety of food and while sometimes I feel pangs of guilt for breaking otu the dim sum, pasta, and frozen perogies on a weekly basis, I figure, it's lunch and the rest of the time she's eating homemade food.  But there is not way in hell I'm making her a quinoa-sprout-tempeh puppet to play with and then eat because every other article out there says kids will love it.  No she will not and no I do not have the time to build things out of your food.  It's food - eat it.  Take away message:  I am the wrong mama to give you advice on what to feed your kid and the most budget friendly thing I can suggest is make sure it is both something your kid will eat and relatively healthy. Much like the snacks, if you steer clear of the pre-packaged stuff, you are doing your budget - and your child - a world of good.  But there is nothing wrong with a cold cut and cheese sandwich - just go for real cheese and not the plasticky kind okay?