September 27, 2008

The Birth Partner

I actually had a hard time believing that I hadn't read this book before. It looked really familiar, but I realized as I delved into it that in fact, this was the first time I'd read this material.

The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth (2nd Edition) by Penny Simkin, P.T. is terrific. There's so much practical information packed into a very readable text! One thing I really like is the illustrations of different labor positions. I'm pretty familiar with them, but it is helpful to have pictures to look at with a mom instead of having to get into each one to demonstrate them all when time is short. There is a chart showing what medications are in which kinds of commonly offered anesthesia options, when these are usually administered in labor, and benefits and risks. Since I am not a medical professional, this is very helpful information for me when I ask "what kind of epidural are you offering my client?" and the doctor says "blah blah blah yadda yadda yadda " (i.e. names of medications I have no previous experience with.)

Probably the most interesting and challenging part of the book for me is the Pain Medications Preference Scale. This is a scale from 10 to -10: 10 means a mother would prefer not to feel any pain at all, getting anesthesia before labor begins. -10 means a mother would prefer to use of pain medications under any circumstances, even in the case of a cesarean birth. Both of these extremes being nearly impossible to put into practice, most women will fall somewhere in between. The Scale also shows what a birth partner needs to do to help a woman with this preference. The idea is for the mom and the birth partner to each identify their own preferences and support each other appropriately. That is the kicker for me. I know what my personal preference is and I know that many of the women I work with will have a different preference. So far I think I have done okay with that. I really don't feel any urge to judge any one's decision to (or not to) choose pharmaceutical pain relief when it is different than what I think I would decide for myself in a similar situation. But I find that I have sometimes reflexively justified a mother's choice as being one that I would make for myself in a similar situation. And although on the surface that may not cause a mother to feel judged or invalidated, on a deeper level, comparisons are odious. It doesn't matter what I would do if I were the mom. My judgement of that question is irrelevant to what is happening in the moment at a birth, and in the long run, I can see that it could be harmful to impose my judgement, offer my justification for her decision. It matters what I do do as one of her birth partners. My role is to validate her decision making process. What matters is for her to make a decision that is justified in her mind by her own values and preferences. It makes me so mad when a doctor or nurse says, "I would do this for myself/a family member, so it's the right thing to do." Just because it was right/would be right for you doesn't mean it's right for me. I don't want to say that - even subtly and subversively - to the women I am caring for.

The flip side of this is that Penny Simkin is one of the few birthy authors I have read who is really trying to be almost completely value neutral about the "big issues" in the birth world. In this book, at least, she is valuing caring support by a birth partner for a pregnant woman, but she is not expressing any kind of opinion herself about the birth industry and how it functions. While I think this is good in that it makes this book useful for a wider spectrum of people than many other books, I also think that I'm not sure value-neutral is where I want to or can be about the birth industry. Non-judgement of the people participating in the birth industry by having babies isn't the same as non-judgement of the system for me. I need to leave those judgments of the system aside when I enter the birthing space or even the educational space; but I (at least for now) think it's also important for me to recognize the judgements of the system I do hold as I lay them to the side when that's what's needed.

Okay, this one got long. Good stuff!

September 23, 2008

The Doula Advantage

I read this book, by the way, while labor-sitting with a wonderful couple who had a very long, very slow labor followed by a very fast 2nd stage and birth.

The Doula Advantage: Your Complete Guide to Having an Empowered and Positive Birth with the Help of a Professional Childbirth Assistant is by Rachel Gurevich. What I found most interesting about it is that it's written from a very different perspective than most "you should have a doula" books: that of the consumer. The author isn't a doula or a midwife or a childbirth educator. She's an editor at a mom-focused website - and a mother. So this is kind of a "consumer reports" version of why and how to have a doula.

I like that she lists a wide variety of doula certification organizations (including Birthing From Within) - so many sources just say "find somebody certfied by DONA". DONA is great, I'm sure, but I have no desire to certify through them. And I am learning a LOT through my certification process with Birthing From Within!

On the other hand, this seems like kind of a "lightweight" book to me. I guess because it's focused on ONLY doulas and why you might want one and how to get one. There is so much to learn and think about and experience around birth besides a doula that it felt strange to read a book that really doesn't address (in any depth) the kinds of choices and experiences a doula is supposed to help a woman negotiate.

One little thing that struck me as odd was her injunction against meeting with a doula you're thinking of hiring in your home. She really doesn't say why she thinks this is a bad idea, and honestly, I think it's a good idea assuming you've screened the person ahead of time (by talking to her over the phone, etc.). It's harder to have a conversation that's more than superficial in a public location, and I don't know that I'd want to hire or be hired based on a superficial conversation.

Would I recommend this book to clients? Maybe - I mean, it wouldn't go on a "waste of time" list like some other books I could (but won't) name - but it wouldn't be at the top of the "read this now" pile, either.

September 8, 2008

Mentoring: the Tao of Giving and Receiving Wisdom

I read Mentoring: the Tao of Giving and Receiving Wisdom by Chungliang Al Huang and Jerry Lynch slowly. It's not a long book, and it's also not a dense book - the main portion of the book consists of four-page sections for each of the "Virtues of the Heart" and "Virtues of the Soul". The first page shows the Chinese character for each; the second page describes its poetic meaning; the third page shows translations epigramatic wisdom from Chinese classics on the subject; and the fourth page describes the virtue's application to mentoring relationships. I tried to read one virtue at a time, several times a day, because I wanted to relax and savor the lovely calm and gentleness of them.

Being assigned to read this book felt like a gift. Tao means "way", and the way this book describes being in relationship to others is, in most ways, exactly how I would like to be in relationship with all the people in my life. Of course I am not all of the time in all of the ways with all of the people who are important to me. But this book isn't about "should," it's about "could" - "you could choose to behave more this way when a situation arises" rather than "you should do xyz when this happens!"

And I guess that's what I want to keep most from reading this book: offering those I mentor (clients, family, friends - the authors describe how mentoring is a model for all kinds of human relationships) and myself coulds instead of shoulds. This book models that possibility beautifully.

September 4, 2008

Homeopathy for Pregnancy, Bith, and Your Baby's First Year

I loved reading this book, and I'm so glad I couldn't find it through the library so that I have my own copy to keep. Miranda Castro, the author, is a homeopath who has worked extensively with women and children, including herself and her own, and her purpose in this book is to empower people to prescribe homeopathic treatments for non-critical conditions for themselves and their family members.

I learned a lot I didn't know about homeopathy. I've always been told, "well, there's nothing really in homeopathic remedies, so try it - it can't hurt you and it might help." And I've read the indications on the remedy bottles and guessed at something that might be appropriate. And sometimes, it's helped. Castro explains that in fact, using the right remedy for too long, or using the wrong remedy, CAN cause or exacerbate the symptoms you are trying to treat or other symptoms; that you should not take most remedies for more than a few days or doses at a time; that it is usually not a good idea to combine multiple remedies; and that a dose is a dose - it doesn't matter if you take 3 of those little granules or 5 of them.

She also explains in detail how to choose a remedy - when you have lots of time, or on the fly in an emergent (though not emergency) situation. The book includes a "materia medica" list of a wide variety of homeopathic remedies and what they are good for to help you in this task, something I've not encountered before. Although this sounds like it would be boring, it was actually pretty interesting reading, since each remedy is linked to certain emotional and character traits. I read it "looking" for myself and other family members - and I found us!

Today I looked up a remedy in this book for a doula client facing an induction next week. (This was simple as there is only one suggested remedy for labor not starting in a timely fashion.) I didn't prescribe it, of course - I think I'd need some formal training of some sort to feel at all comfortable prescribing even relatively benign homeopathic treatments to anyone outside of my immediate family - but I did share the information with my client. I have no idea if she'll use it - but I'm sure I'll use this book again with clients and for myself and my family.