Monday, February 28, 2011

Give birth with a smile… WITHOUT epidural

While browsing the Shabbat newspapers, I came across a new column in “Besheva”, by Dr. Hannah Katan. Hannah Katan is a well-known Orthodox Jewish ob\gyn and a mother of 13 children. Generally speaking, I highly esteem Dr. Katan’s opinions as expressed in various articles I have read so far, but this time I beg to humbly disagree here on the blog.

The column was titled “give birth with a smile” (translation from Hebrew) and spoke with high praise of “the invention of the century” – the epidural anesthesia, which is highly recommended by Dr. Katan to all birthing mothers “in order to stay calm and happy, and save the husband from being traumatized.”

Those who have been visiting my blog for some time know that I’ve experienced, so far, two beautiful natural births. My second birth experience was less satisfactory, but not because it lacked the miraculous epidural, but due to insensitivity on part of the medical staff. I take issue with the epidural for two main reasons: one, that it carries a host of risks but is advertised as something totally harmless. And two, that women are brainwashed into thinking they can’t give birth without it.

“Years ago,” writes Dr. Katan, “the L&D room was a place of loud voices, and sometimes screaming and crying. But since the epidural was invented, there is usually peace and quiet… which the nurses like very much.”

I would like to point out this reference to the medical staff, instead of the laboring women. Labor and birth are not about what is convenient for the doctors or midwives. Of course they have more peace and quiet thanks to epidurals. But what have epidurals done to reduce risk during birth and contribute to the health of mothers and babies?

“I tend to recommend the epidural anesthesia, which is entirely harmless (what about all the possible risks mentioned in the form of consent the women are required to sign?) and turns birth into the most natural experience in the world.” I’m sorry, but this is just backwards. Even if you are a raving fan of epidurals, surely you can’t call them “natural”?

“The woman is in full control.” No, she is not. She can’t feel the contractions, she can’t control her bladder function, she can’t get off the bed, walk around, or assume positions that will enhance the birth process. If you call this full control, I beg to differ. “Her mind isn’t occupied by the contractions or by trying to get over the pain, she can read through the book of Psalms during birth, pray for her friends and family, chat with her husband and her mother, and enjoy a truly spiritual experience.” During labor, the woman is supposed to be concentrated on the contractions, and if she is in no state for chit-chat, that is all natural. When she is in tune with her body, it helps her to do things that advance the progress of labor.

From my experience so far, it was also entirely possible to pray between and even during contractions, but if a woman can’t do that, the people who love her and are present can pray over and for her.

“The epidural anesthesia can also prevent the father’s trauma. While on duty, I was often called to take care of the laboring woman’s husband, who was lying on the floor unconscious and chalk-white.” How inconvenient. Well, it is time to remember that our sages wisely prohibited the husband from watching the birth process itself, and with good reason. Many men are not up to being present during the delivery at all, or can’t bear to see their wife throughout the contractions. It is understandable and doesn’t make them bad husbands. Does it mean the woman should consent to an epidural so that her husband can watch the birth? If the husband doesn’t feel up to being present during the delivery, a woman can get emotional support, instead, from her mother, a sister, a friend or a doula.

In the last section of her column, Dr. Katan speaks highly in praise of the custom prevalent in Charedi circles, of new mothers going to a health resort for a couple of days, to rest and recuperate. “A few days after my last birth,” she writes, “I went to a new mothers’ health resort for two days – without the baby, who was left in the expert care of his father and big sisters. My youngest was the only one who refused to nurse…as if saying, Mom, you’re too old for that.”

Logically, if a woman is young enough to give birth, she is also supposed to be young enough to produce milk for the baby. But even if nursing isn’t possible, for whatever reason, it doesn’t change one bit the newborn’s basic, all-encompassing, irresistible need to be with his mother.

So far, with both my daughters, I was told I should let my babies stay in the hospital nursery while I’m there, so that I can “rest”. I insisted on keeping them with me, and slept so much with them by my side that I was actually bored. They would wake up to nurse and slept peacefully on. If something disturbed my rest, it was the incessant crying of those babies left in the nursery, who wanted their mothers so badly. My room was right opposite the nursery and I could hardly bear hearing the babies, even though mine was right next to me. When I mentioned this crying to one of the other women during discharge, she clucked her tongue sympathetically and said, “That is why I always ask for a room as far from the nursery as possible – I can’t bear to hear the crying and think my baby might be wanting me too.” I will make no comments on that one, except to wonder why such a simple solution, of keeping the baby close, isn’t thought of by more women, as opposite to getting out of earshot.

Granted, I am a young mother still and there might be countless situations I haven’t observed, but the chief of my experience so far has taught me that caring for a newborn, although time-consuming, is not very complicated, and generally includes nursing and changing diapers, which can both be done without leaving one’s bed. If a woman were given the opportunity to sleep all the while her newborn sleeps, she could be very well-rested.

What really puts a strain on the mother is having, in addition to the newborn, her other children, if she has any, and her household duties to attend to. The natural solution is not to break up the family and have the mother go away, certainly not to leave the baby behind – but to obtain household help. The husband can take some days off work, Granny or a sister or a friend can come and stay a few days. If nobody is available, household help can be rented for a while, and thus enable the woman to recover in the privacy and comfort of her home, and still be with her children and allow them to see the baby and get used to this new addition to the family.

I can’t help but feel that such attitudes as expressed in Dr. Katan’s article promote detachment – detachment of a woman from her body and from her newborn baby, and detachment between the children. It doesn’t feel right, and I hope that I was able to show, in some small measure, that there might be another option.

Thursday, February 24, 2011

The potential importance of a birth doula

I received a question by email asking my opinion about hiring a doula to attend birth. Different women may all have different accounts of their experience and you are all welcome to share yours, however, the following is what I think.

I believe a doula can play a very important part in a woman’s feeling of comfort during labor and birth. In a hospital setting, perhaps the most important part a doula plays is being a sort of buffer between the woman and the medical staff, advocating the woman’s rights to avoid procedures she is not interested in and guarding her privacy.

During my first birth, I was supposed to be attended by a doula in training, who was going to be there with me throughout the birth without any financial reward, as part of her practice. However, I went into labor in the middle of the night and our phone call failed to wake her so we went without her.

In retrospective, I can say that my husband provided all the necessary emotional support during the birth of both our children so far, and took it upon himself to assert to the staff that I’m not interested in an epidural. He also insisted that they wait until my waters break naturally, instead of doing it in an artificial procedure, something I almost consented to simply because I was in that stage when you become too confused to think properly.

However, not all husbands are as knowledgeable as mine is about natural birth, and some become distressed when they see their wives going through labor (for which they cannot be blamed), so it can be highly useful to have someone around who will be supportive without being too emotionally involved.

For Orthodox Jewish women, especially, who can’t have any physical contact with their husbands starting from a certain stage of labor, it might be very important to have a doula for physical measures of support and pain relief, such as massage and reflexology. I was lucky enough to have a volunteer who did that during my first birth. I think that is why the profession of a doula is becoming increasingly popular among Orthodox Jewish women. I recently had the pleasure of discovering that a very sweet lady who lives nearby is a doula. I inquired her about the challenge of always having to be on call, especially during the night, to which she replied with a smile that she loves the night shift best because it enables her to leave while her family is sleeping without having to worry about additional arrangements.

I wouldn’t want anyone from the family, apart from my husband, to accompany me during birth, but some feel comfortable to have their mother, sister or friend with them, and one of them might do the part of a doula. In fact I believe that the contemporary professional doulas have their origin in the past, when birth was a family event and the mother was attended by other women, mostly experienced ones.

On an unrelated note, I’d like to please remind everyone that though I’m doing my best to keep the blog running, my husband is the one who posts for me through his work computer - I have very infrequent access to the internet myself, so while I still read my emails and try to answer all of them, it can easily take weeks for me to even see your message. I love hearing from you, but it might take me a while to reply. Thank you so much for understanding.

Saturday, February 19, 2011

Tragedies do happen

I have received several comments and emails from ladies who told me stories that were truly heart-wrenching, about husbands that abandoned their families and left their wives to fend off for themselves, or husbands who unexpectedly died. The bottom line in all such recollections was that a woman must study a degree and hold on to a career throughout her life in order to secure her position, should something terrible happen to her husband.

I do not deny that tragedies happen and sincerely wish that neither I, nor anyone I know should ever suffer the loss of a husband, an illness, or other dire circumstances. I’ve never had to face such a situation so far and therefore am not the most suitable person to give advice on how one should conduct oneself when something like this happens, but I do have a general view, which could be summarized as following: we cannot allow ourselves to be led by fear, for that would be like spending our whole life in a bunker, out of concern that war might break out – and never seeing sunshine or smelling flowers. I think that would be a terrible waste.

If a woman’s dearest wish is to be a stay-at-home wife and mother, but she feels she ought to keep up with a demanding career at the expense of her family, just in case something might happen, I think something must be backwards here. It’s also worth mentioning that not all university degrees are practical, and certainly not all guarantee high-paying jobs (I think I have mentioned earlier how my ex-fellow students work for a meager salary). Also, having a job doesn’t guarantee you won’t lose it.

I think it’s perhaps worth to dedicate some thought to “what would happen if” (though certainly not allow all life decisions to be based upon it), and look what could be done. Ideas I can come up with off the bat is to have a good insurance, which would allow the family some financial “breathing time” in case of an emergency, and launching a home business which could be kept on a low burner and promoted further, if need be, to generate higher income. Of course I realize this isn’t always possible for everyone.

There are also professions which can be acquired in a relatively short period of time, through a course of practical studies, and which often pay better than college-degree professions, though they might not be very prestigious – and many of them can be pursued from home. Our local women’s hairdresser, for example, enjoys working from home while also spending time with her children. Investing in such a course of studies can be an option for a woman who suddenly finds herself in a situation when she has to fend for herself, in fact I know a woman who is doing so at the moment. She is in pain and confused, but doesn’t regret one bit the time she spent with her child while she could.

It’s not very pleasant to think about possible tragedies, however, I think that whatever happens in the future, I will never regret the time I spent as a stay-at-home wife and mother so far. These past years were very dear to me, and I think I grew and learned more than I did throughout my entire previous life.

Wednesday, February 9, 2011

Snippets of time

I don’t have an excess of time (like most mothers with young children at home, I guess), but recently I realized I do have some time when I’m not doing much and could be doing more – only it comes in very small snippets, of perhaps five to ten minutes, and the trick is to utilize these short periods of time to do something useful.

Right now, most times I can’t dedicate a whole uninterrupted hour to cleaning, cooking, ironing, whatever. Most likely, ten minutes won’t pass before I have to change a diaper, clean up a mess, attend to a kid who’s simply claiming attention, or sit down to nurse. It slows down everything, but that’s how I work these days, because otherwise I might as well give up and allow the house to sink into mess.

The solution is to complete small tasks (such as wiping the stovetop) in the rare free minutes that come up during the day, and split up the bigger tasks into small parts and do them as well as I can, during that free time that means five minutes here and ten minutes there. Otherwise nothing will ever get done.

I draw some comfort from the words of older and wiser women, who tell me no period of their life was as hectic and time-consuming than when they had little ones at home, none of whom was yet old enough to lend a helping hand or at least take care of themselves some of the time.

So sometimes I feel as though I’m not good enough. And sometimes I feel as though I’m not even remotely adequate. But at least I’m trying, and not letting go of the simple, beautiful and so important things I’m striving to achieve – happy children, a good family life, a reasonably orderly and clean home. Such simple things, yet not attained as easily as it may sound.

I don’t know whether you’ve been in situations when you visit a home that is so orderly and beautiful (even if it’s not large or luxurious), and say to yourself, “oh, I’ll never be able to have a home like that.” It has happened to me. Most of the times these weren’t the homes of young mothers, though. :o) I’m not sure anymore whether it’s possible to attain any level of orderliness at all, when you have toddlers around. Well, at least my furniture isn’t turned upside down. Yet. :o)

Tuesday, February 8, 2011

Ecological breastfeeding, revised

I’ve always been skeptical about ecological breastfeeding, especially the part of it which involves co-sleeping, but this time ended up more or less doing it anyway – mostly because I feel I don’t have a lot of choice. The baby isn’t hungry, she isn’t uncomfortable – she just doesn’t want to be alone at night, and that’s it.

On nights when I didn’t give in, none of us got any sleep. Once I took the baby to bed with me, my husband is able to sleep and I can at least nap with the baby next to me. I can’t say I’m a big fan of it, though. I know some families say co-sleeping goes very well with them, but this isn’t the case with me. I miss the good deep refreshing sleep I’m not getting when I’m afraid to roll over the baby or when she looks for the breast all through the night. I miss the privacy of our bed.

I do realize this is a stage the baby will eventually grow out of, but I’m just so tired, all the time. Because I get so little sleep at night, I tend to get up very late the next day and then it simply feels as though there isn’t time for anything. I miss the days when I was able to get up before the rest of the family, spend some quiet time, be refreshed, and do a good portion of the chores before everyone else was up. I maintain that is definitely the way to go. But right now that is not what is happening around here.

I’ve had some suggestions that perhaps my baby would be better off with a pacifier, and perhaps we could all get more sleep. I’m not sure I exactly have a logical reason for why I haven’t given a pacifier to either of the children so far, except that I always simply disliked the way it looks, and also my feeling that it tends to be overused (I’ve seen 4-year-olds using it, and heard parents say they can’t get rid of it – and I don’t like the prospect).

I suppose I wish I had a bit more control over my life. But this just isn’t happening. So far, every day is a mad battle against tiredness and against time that is running out. I do keep up with the basics but that’s about it. I haven’t ironed a single item since Tehilla was born, although ironing is still on my to-do list – I’m not giving up. Not yet, at least.

Well, at least we have a happy healthy baby, and that’s what matters. Tehilla is growing very well, despite her tongue-tie. I suppose that is the most important thing for now, and the rest shall pass.

Wednesday, February 2, 2011

Excessive consumerism and waste of space

I used to buy much more stuff than I needed (mainly clothes), and I think I didn’t even realize just how “too much” it was, until I was married and we moved to where we live now – a tiny place where pretty much the only shopping venue is the grocery store. After a little while, I realized that not only I don’t miss buying stuff, I’m happier with less shopping opportunities and save money, time and (very important in our little home) storage space this way. 

When there is a chance (and it doesn’t happen very often), I still like to go and look at shops, but I have no urge to buy everything I see. In most cases, I know what is really missing and I’ll buy it if I see it at a good price, or I won’t buy anything at all.

I saw a sure sign of reduced consumerism in our home when I went through the closets recently, and didn’t find nearly as many things to give away as I did in previous years. It made me very pleased.

Here are a few questions you and I might ask ourselves before making a purchase:

* Does it save work or create more work? By this I mean all the kitchen gadgets which are supposed to save manual work, but take so much time to put together, take apart and clean, that they end up unused and fruitlessly take up storage space.

* Does it have a place in my home? I don’t know about you, but I’m fighting a constant battle to free up space and get some more air to breathe. I don’t want things that will clutter my home, even if I can get them for free.

* If you buy something on clearance, were you planning to buy this product anyway, or did you decide to buy it just because the price was so temptingly low? Because if it is the latter, it means we end up paying money we didn’t intend to spend.

* Do you pay for brands, and for what reason? Is it because the quality is genuinely better, or just because you are used to it? In most (not all, but most) cases generic products work just as well.

In our last meeting at the home ec classes group, we had a discussion about buying where it is cheapest vs. buying at local stores and supporting people you know and care about. We didn’t come with a clear-cut answer, and I’m not sure there is one. Theoretically I’m all for supporting local economy, but when I walk into the local store and see ridiculously high prices, I don’t think it would be fair to pay so much for something I can get so much cheaper elsewhere. Also, I have no way to know whether the products are priced so high because otherwise a small local store can’t afford to keep them, or simply because the store owner wants to earn more and expects people to pay because his store is the only one in the area.

Overall, I believe excessive shopping comes to fill in certain social and emotional gaps (buying presents to “make up” for not spending enough time with people you care about, buying treats for yourself because you are tired, frustrated and “deserve it”). A full, busy and peaceful life does not encourage a surplus of unneeded purchases.