That's really all I have to say right now. 20 days after surgery, my body is working hard on becoming whole again. My 10-inch incision is shrinking as my belly slowly contracts back to what it was before pregnancy (is "contracts" an ironic word to use, when you don't have a uterus?) Every day I'm a little stronger, but every day something new seems to hurt. The pain of nerves waking up, ligaments knitting themselves together, cauterized veins and arteries casting listlessly around (I imagine) to find a new home.
I think healing is like that. The stronger we are, the more we can feel. For almost three years, I've regretted going into "denial" after my sons' birth. I lied to myself about my feelings and pretended that I was okay with it all. I wasn't. Anxiety and depression seeped under my door like a cold fog, chilling me with an insidious and demanding pain. It took months (even years) before I could look squarely at that experience and all those feelings. But in those early days, in the dark of winter with a newborn -- a new mother, with a new scar and a bunch of new problems -- was it so bad to blind myself? What's so bad about waiting until we're strong enough to feel it all?
So I don't know yet, what I feel about all this. I've tried to write about my daughter's delivery and surgery, but so far I can't even finish the Customer Service Survey I got from the hospital. I just don't remember -- or want to remember -- it all. So far I can say this: That I was hysterical with fear in the hospital admitting lobby. That both teams of surgical staff were poignantly sensitive-enough and conducted themselves professionally throughout the surgery. That I remained conscious, without crying or vomiting, for the entire delivery until I saw and heard my daughter (ten feet away from me under her own oxygen mask, because "she's early" and "her lungs didn't get cleared by a vaginal birth.") I remember saying "okay, Josh, I'm done," to the anesthesiologist (younger than me!) and awoke hours later asking to breastfeed my baby. That I did feed her, and fell in love so suddenly that it surprised me. That I hit unimaginable physical and emotional lows in the hospital, but came home, and started to get better.
That's all for now. The baby and I are fine. Having a newborn is demanding, but I remind myself that this is only "for now" -- my baby wakes up every three hours at night, for now. She nurses ravenously and then spits up in my hair, for now. She is sometimes unconsolable, sometimes precious. Sometimes her socks fall off and get lost because they are so tiny. For now. So we are fine. I find myself welcoming the challenge and not overwhelmed by the cold or darkness that I expected. For now.
Tuesday, September 04, 2007
Sunday, August 12, 2007
Ready or not . . .
I'm joking that, having done the newborn thing before, at least we're not naive enough to look forward to it. Of course it will be wonderful to meet our daughter. But I hear myself saying "I'm ready to be done with this insomnia . . . " Oops. I know what challenges are to come. But I know other things too -- like my baby won't die from a sloppy nail clipping. I know more about my own strength. That I can survive on less sleep and fewer meals than I'd like to. I have a two year old who likes to say, "I a baby bird. I love you, Mommy Bird!" So I'm starting to understand why I have children in the first place.
The cancer thing is getting hard to ignore again. When I got diagnosed during my first trimester, I was consumed by the urgency -- one doctor after another telling me I'd need an immediate hysterectomy, regardless of whether anyone was living in my uterus. Then the tumor was safely removed, and I was consumed by relief. And it was easy to forget how serious it is. So I've spent most of this year complacently enjoying my time at home and planning for the new baby.
My anxiety crops up unexpectedly. Hearing the question "when are you due?" when I have a planned surgery date (which I'd otherwise fight tooth and nail). Listening silently while other moms talk about breastfeeding challenges and birth control (there's not a whole lot out there on nursing under the shadow of surgically-induced hormonal arrest). Definitively sorting maternity and baby clothes because I know this will be our last child. I don't fit in with most pregnancy discourse, and it makes me nervous.
Last week we met with the surgeon who described the details of the procedure -- the "dissections," the incision, the transfusion risk, the bladder complications. Nothing too unexpected. I still found myself dizzy and choking back tears. Could this really be about me?
I want to focus on the positive: the healthy, beautiful baby girl who will be joining our family in a matter of days. But I don't want to ignore the pain and loss. It's inevitable to lose one's sense of self with a newborn around. And when that self is physically or emotionally injured, ignoring it doesn't help. Survivors of birth trauma can find it impossible to admit any regret or suffering about their baby's delivery. Our culture tells us to pick between grief and love -- as if caring about birth is a self-indulgence that we could overcome if we only appreciate our children enough. As if we must judge our feelings instead of listening to them. At least I know better now.
I want to focus on the positive: the healthy, beautiful baby girl who will be joining our family in a matter of days. But I don't want to ignore the pain and loss. It's inevitable to lose one's sense of self with a newborn around. And when that self is physically or emotionally injured, ignoring it doesn't help. Survivors of birth trauma can find it impossible to admit any regret or suffering about their baby's delivery. Our culture tells us to pick between grief and love -- as if caring about birth is a self-indulgence that we could overcome if we only appreciate our children enough. As if we must judge our feelings instead of listening to them. At least I know better now.
I'm listening.
Tuesday, June 19, 2007
Talk Softly
I keep meaning to type a quick update . . . after so much turmoil earlier in the year, everything has settled down to the point that I find myself without much to say. I'm spending the summer stretching my budget beyond previously unimagined limits (this turned out not to be the best time to find a new job), planting peas and building "railroad castles" with my toddler, and enjoying what I can about the third trimester of pregnancy. Our daughter will be here in the middle of August.
Sometimes I feel remiss in not writing more. But I'm discovering the freedom of living beyond words. After years of school and desk work, constantly typing up all my ideas and feelings, it's liberating to live life without stopping to imagine its narration. Or as our son reminds us, when we get too worked up in debate and analysis around here, "Too woud, Mommy Daddy! Talk softwy." And sometimes, the quieter we are, the more peaceful it is.
I'm hoping that this might help when the baby is here, in those early days when our family is reduced to its fundamental functionings of eat and sleep. When Malcolm was born, I struggled to explain and express every detail of my Parenting Experience. Even my paradigm of being a "more intuitive parent" was entangled in intellectual conviction and cognitive research. Even the most intimate aspects of my family's experience -- our cloth diapers, our breastfeeding, my cesarean scar -- I strained to mentally justify, to respond to counteraguments (imagined or real), to politicize. Of course, it was good to care about my choices and even to become an advocate. But it exhausted me. At one point I realized that I honestly could not count higher than "two." And ultimately, mothering a newborn is impossible to think your way through (or around).
So we'll try again. To move through this next big challenge while really letting go of explaining and documenting it. To languidly answer "I don't know" to doctors and nurses who quiz me about infant care. To doze in sunbeams like a cat. To talk softly. To touch and feel and care for my children. Without rationale, without explanation. Accountable to no one but them.
Sometimes I feel remiss in not writing more. But I'm discovering the freedom of living beyond words. After years of school and desk work, constantly typing up all my ideas and feelings, it's liberating to live life without stopping to imagine its narration. Or as our son reminds us, when we get too worked up in debate and analysis around here, "Too woud, Mommy Daddy! Talk softwy." And sometimes, the quieter we are, the more peaceful it is.
I'm hoping that this might help when the baby is here, in those early days when our family is reduced to its fundamental functionings of eat and sleep. When Malcolm was born, I struggled to explain and express every detail of my Parenting Experience. Even my paradigm of being a "more intuitive parent" was entangled in intellectual conviction and cognitive research. Even the most intimate aspects of my family's experience -- our cloth diapers, our breastfeeding, my cesarean scar -- I strained to mentally justify, to respond to counteraguments (imagined or real), to politicize. Of course, it was good to care about my choices and even to become an advocate. But it exhausted me. At one point I realized that I honestly could not count higher than "two." And ultimately, mothering a newborn is impossible to think your way through (or around).
So we'll try again. To move through this next big challenge while really letting go of explaining and documenting it. To languidly answer "I don't know" to doctors and nurses who quiz me about infant care. To doze in sunbeams like a cat. To talk softly. To touch and feel and care for my children. Without rationale, without explanation. Accountable to no one but them.
Thursday, May 03, 2007
Partly Sunny
This season of my pregnancy has been like a Seattle Spring. Moments of delicious, lilac-and-saltwater saturated sunshine, and moments of stark chill and darkness -- those times when we rush inside from the backyard to curl up under a blanket. Some days are sunnier, some are colder, but any given day could be forecast as “partly cloudy,” “showers,” or “partly sunny.” Which never really tells us what to wear, or how long we can be outside before coming in from the cold.
But most days really are partly sunny, if we‘re lucky and pay attention. And so I’m thinking of my life as “partly sunny,“ too. I’m expecting a baby girl, and enjoy the giddy relief of carrying her through the second trimester. I'm also preparing for a radical hysterectomy, as cancer treatment, when she is delivered this summer. Fear and thrill, grief and joy. It would be dishonest to say that the happiness outshines the anxiety. To pretend everything is fine is to lie -- and no more practical than wearing a sleeveless maternity dress on a day forecast for rain. Still, I’m inspired by what Elizabeth Edwards said, when asked whether encouraging her husband’s Presidential campaign, in the face of recurring breast cancer, is a kind of denial: that she will continue to deny cancer control over her life, every day that she continues to live.
So where's the balance? With luck and mindfulness, I can honestly immerse myself in sunny moments: The lush May branches arcing over our heads as I push my toddler’s stroller through the leafy streets of our neighborhood. His surprised exclamation that “we are FRIENDS!” as we cuddle before bedtime with his head on my growing belly. My daughter’s incessant thumping inside me -- already insisting on her own independent rhythm -- so much like the occasional bumping on the other side of the bedroom wall, as my son stirs in his sleep.
When I let myself rest in these sweeter times, I can feel the sun on my face and be fully thankful, in that moment, for all of our blessings. As my son sometimes says, looking around at his toys or our dinner table, “We have SO MUCH.” And we do. And when the clouds roll through -- when I’m temporarily chilled with the stress and fear of what’s to come -- I know better than to pretend it’s sunny. Sometimes, all we can wish for is a blanket to curl up under, and cry -- if we need to -- until the moment passes.
But most days really are partly sunny, if we‘re lucky and pay attention. And so I’m thinking of my life as “partly sunny,“ too. I’m expecting a baby girl, and enjoy the giddy relief of carrying her through the second trimester. I'm also preparing for a radical hysterectomy, as cancer treatment, when she is delivered this summer. Fear and thrill, grief and joy. It would be dishonest to say that the happiness outshines the anxiety. To pretend everything is fine is to lie -- and no more practical than wearing a sleeveless maternity dress on a day forecast for rain. Still, I’m inspired by what Elizabeth Edwards said, when asked whether encouraging her husband’s Presidential campaign, in the face of recurring breast cancer, is a kind of denial: that she will continue to deny cancer control over her life, every day that she continues to live.
So where's the balance? With luck and mindfulness, I can honestly immerse myself in sunny moments: The lush May branches arcing over our heads as I push my toddler’s stroller through the leafy streets of our neighborhood. His surprised exclamation that “we are FRIENDS!” as we cuddle before bedtime with his head on my growing belly. My daughter’s incessant thumping inside me -- already insisting on her own independent rhythm -- so much like the occasional bumping on the other side of the bedroom wall, as my son stirs in his sleep.
When I let myself rest in these sweeter times, I can feel the sun on my face and be fully thankful, in that moment, for all of our blessings. As my son sometimes says, looking around at his toys or our dinner table, “We have SO MUCH.” And we do. And when the clouds roll through -- when I’m temporarily chilled with the stress and fear of what’s to come -- I know better than to pretend it’s sunny. Sometimes, all we can wish for is a blanket to curl up under, and cry -- if we need to -- until the moment passes.
Tuesday, April 24, 2007
Robin's Cancer FAQ
Since so many people -- both strangers and my closest friends -- have learned about my cancer here, I'll provide a little more detail for everyone's information. I appreciate so much all the love and support shown by everyone throughout this whole time, even when I was not able to express exactly what was going on. Friendship, it turns out, takes more forms than I ever could have imagined.
What do you have?
I've been diagnosed with Invasive Carcinoma of the Cervix, Stage Ib1 (diagnosed as gross polyploid lesion less than 4cm), Squamous cell, Grade 3 (poorly differentiated), LVSI negative (no microscopic lymphovascular involvement within tumor), no lymph node enlargement visible on MRI, 1.5 mm of invasion with 6 mm of lateral invasive extent.
How did you find out?
I was diagnosed late in the first trimester of my pregnancy when I was examined for unusual bleeding. A visual exam revealed a growth on/in/through my cervix. At first the obstetrician assumed it was a benign growth, which apparently aren't unusual, but a subsequent biopsy showed that it was a Grade 3 (aggressive) cancer.
At 16 weeks of pregnancy, I underwent cervical conization surgery. While this was high-risk and not generally recommended for pregnancy -- the standard treatment for Stage Ib during the first trimester is immediate termination and hysterectomy -- it successfully removed the tumor and showed no involvement of invasion at the margins. Some noninvasive carcinoma (surface cells only) remains.
Are you okay?
The conization removed around 2 cm of cervical tissue. My pregnancy has been under close observation for early dilation due to cervical incompetence; so far everything looks fine. Because even microscopic cancer can spread quickly through the cervix and surrounding tissue, the safest treatment is a radical hysterectomy ("It's not your mother's hysterectomy.") Statistically, Ib1 patients treated this way have a 85-95% survival rate. Because of the success and positive indicators of the conization, I imagine myself to be on the high end of those numbers -- although the delay in treatment, due to pregnancy, has not been studied enough to know how that might affect the outcome.
How are you feeling?
In general, these days I feel . . . physically healthy, thankfully free of pain, surprisingly exhausted (I am fighting mild anemia and low weight gain as my second trimester comes to a close), conditionally grateful, and occassionally terrified.
This is so scary! Did you have any problems in the past that predicted this?
I had annual pap smears without fail between the ages of 18 and 30, and every two years after that. In 15 years, I had two occassions of abnormal pap smears: In 1994, I had some apparent dysplasia that resolved with no biopsy or further treatment. In 2004, when I was last pregnant, I had apparent "severe dysplasia" that either resolved after labor and deliver or was originally misdiagnosed. This appeared in a different location than my eventual tumor, which was found 16 months after my last (uneventful) exam and pap smear.
What do you think of the HPV vaccine?
That it is ridiculously politicized, commercialized and aggressively marketed for a preventative measure that might save 10,000 occurrences of cancer a year; If only our culture put this much emphasis into other fundamental women's issues. But I have no particular concerns and it appears to be as effective and low-risk as any new vaccine. Selfishly, I find it pretty annoying to have an illness that is the year's hot topic. It makes me self-conscious and clutters information resources for actual cervical cancer patients.
What's Next?
My daughter will be delivered by cesarean section immediately prior to my radical hysterectomy. This will involve about five hours under general anesthesia and about six weeks of serious physical recovery. If all goes well, this will happen in August.
No, I am not confident that this is best for the baby's health, due to the risks of cesarean delivery and disruption of breastfeeding. I am a little more confident that it is the better alternative for my own health, but deciding on how and when to be treated have been difficult decisions. I have not lost my trust in birth and my skepticism about medicine, just because because I'm a cancer patient. And because it's not up to my doctors to "let" me do anything -- delay treatment, go to full term, deliver vaginally -- the final responsibility for these decisions rests only with me. Which is a huge headache.
I will have a pelvic lymph node dissection which will give more information on whether the cancer has mestastized. If all goes well, I'll be carefully observed every few months for a matter of years, and might eventually be categorized as "NED" (No Evidence of Disease). If all doesn't go well, my remaining treatment options are radiation and/or chemotherapy. Which, I try not to think about much.
You Should Be Grateful! After all, all that matters is a healthy baby.
Okay, no one has really said this. Please don't, or I will have to kick some ass.
Friday, March 16, 2007
All That Matters Is . . .
It's almost ironic that, finding myself pregnant with cancer, I'm drawing strength from what I've learned as a fledgling birth activist. A staunch VBAC advocate, fighting for the chance at a 26-week cesarean? A family-unplanner, researching sterilization surgery? It's not easy to apply my old convictions to my new situation. But it's helping.
Tonight I'm thinking about gratitude. Survivors of birth trauma are haunted by the reprimand that they "should be grateful," because "all that matters is a healthy baby." Reading You Should Be Grateful, the groundbreaking essay by Gretchen Humphries, was the starting point for my healing after my son's delivery -- during those first months when I worried that I wasn't "grateful" enough for my healthy child to forget the pain of a lost birth.
And here I am, at another starting point. The first day that my doctor called with a cancer diagnosis, I found myself huddled under the covers in bed, bargaining with God. And I heard myself say it -- "Lord, I will give up everything -- all that matters is a healthy baby." But I knew this wasn't true. I knew might be forced to judge -- brutally so -- exactly how much value I placed on this child's life. But I also knew that, however my other priorities might fall into shadow, they would still always matter. And what else could possibly matter? I've made a list:
Strength and Mobility Matter. I'm scared of the prospect of being temporarily immobile, incontinent, and disabled if I have a hysterectomy with a newborn. I'm trying to imagine this as a slow and quiet season in life, expecting little of myself and others, thinking only of healing. But I know it will be frustrating. If it hurts, I will let it hurt.
Bonding and Breastfeeding Matter. A cesarean-hysterectomy can take over five hours. Pain and recovery can be compounded many times over, compared to a cesarean alone. But the more I'm in the hospital, the more I learn not to fight pain medication, catheters, and IVs when my body still needs them for healing. This means that the first hours, or days, of my child's life might be spent without me able to feed or interact with them. I will grieve this.
Fertility Matters. By the end of the summer, I look forward to having two beautiful, healthy children to call my own. I live a life of abundance, filled with more love that any one woman deserves. Still I choke back tears when I read Hop on Pop. "Father, Mother, Sister, Brother/This one is my other brother." My children will not have "another brother." My family destiny has always been a matter of spiritual and marital trust and enterprise. It's an open horizon, closing into finition for reasons beyond my control. I will grieve this.
Youth and Sexuality Matter. About half of hysterectomy patients show signs of early menopause. Yes, I hear everyone's mother and mother-and-law have been doing really well lately with or without hormone supplements. They are inspirational to us all. I'm just not ready to be them. Whatever happens to my body, I will cope -- proudly, and with all the dignity and grace I can. But I will grieve whatever I lose of my 33-year old body.
Birth Matters. I still don't know whether a cesarean will be my safest bet in this situation. If it is, I'll deal -- but I won't like it. I will grieve my lost birth. I will feel disappointment and anger. I will write, sing and share this pain until I am healed. I will do this knowing that it cannot -- ever-- compromise the love I have for my children.
I'll probably think of other things that matter, as I go. I don't do this to be negative. I'm so, so grateful for the chance to have a healthy baby. Having thought long and hard about our lives (and deaths), I know exactly what "matters" most about me and my baby. But even if I don't lose it all, I'll still grieve what I lose. To deny this would be to lie and cheat myself. To accept this is to accept life and loss -- and to gain the strength to move through pain, to eventually find something more.
Friday, March 09, 2007
Seeing Thestrals
Good news here -- Last week's surgery comfortably removed the tumor with room to spare. The pathology report indicated clean margins, no lympho-vascular involvement, minimal invasion, and other various happy things (all interspersed with the word "carcinoma," again and again). I spent yesterday getting MRI scans, and will still likely need a hysterectomy after delivering this baby. There is some risk in delaying treatment for a few months, but it's easily outweighed by the opportunity to carry the baby safely to term. So I can start saying "due in August" again, after all, without the catch in my throat that says "or so I hope."
Now after three weeks of waiting, the world seems so much brighter. I can take my boxed-up maternity clothes out of the attic. I can look at my son, and see him as the beautiful older brother he's going to be. But I feel a little like Harry Potter at the beginning of Book 5 -- when he's shocked to see that the magical Hogwarts carriages are drawn by skeletal winged horses that he's never noticed before. The beasts are called thestrals. Harry sees them for the first time because he's seen death.
I won't be melodramatic -- I live a lucky and luxurious life where I'm pretty much insulated from these things. Especially my own mortality -- me, a healthy, 33-year-old woman who has only been to three funerals, ever. But I think I'm starting to understand how it works. When I first got my diagnosis, I explained indignantly to my loved ones that I am FINE. This cancer cannot be a threat to ME, because the prognosis (when properly treated) has a stellar survival rate (as far as cancer goes). But really, I was trying to say, "you don't understand. I'm Robin. I'm right here. My life can't be at risk -- that's not the way it is."
But now I've had time to think about the way it is. In more painful moments, when my heart cried out "Why this? Why me?" the answer was too simple: "What the hell were you expecting?" How can I have a life-threatening illness? Because all of us die. Or as I've started flippantly saying, "we all have cancer." It's just a matter of whether we'll live long enough for it to slip out of the shadows and into our nuclei. All 6 billion people living on Earth will eventually die; I'm not particularly special, just because I'm looking it a little more closely in the eye.
The ugliness of this reality -- like the grotesque thestrals with their leathery wings -- can be overwhelming. But it's reassuring to see the truth that's been invisible until now. This life isn't magic. It's finite, even temporary. I'm not immortal. And this reality can make every little thing (and every big thing) -- the pregnancy, fresh tulips, a hug, toy trains, my family -- that much more delicious.
Now after three weeks of waiting, the world seems so much brighter. I can take my boxed-up maternity clothes out of the attic. I can look at my son, and see him as the beautiful older brother he's going to be. But I feel a little like Harry Potter at the beginning of Book 5 -- when he's shocked to see that the magical Hogwarts carriages are drawn by skeletal winged horses that he's never noticed before. The beasts are called thestrals. Harry sees them for the first time because he's seen death.
I won't be melodramatic -- I live a lucky and luxurious life where I'm pretty much insulated from these things. Especially my own mortality -- me, a healthy, 33-year-old woman who has only been to three funerals, ever. But I think I'm starting to understand how it works. When I first got my diagnosis, I explained indignantly to my loved ones that I am FINE. This cancer cannot be a threat to ME, because the prognosis (when properly treated) has a stellar survival rate (as far as cancer goes). But really, I was trying to say, "you don't understand. I'm Robin. I'm right here. My life can't be at risk -- that's not the way it is."
But now I've had time to think about the way it is. In more painful moments, when my heart cried out "Why this? Why me?" the answer was too simple: "What the hell were you expecting?" How can I have a life-threatening illness? Because all of us die. Or as I've started flippantly saying, "we all have cancer." It's just a matter of whether we'll live long enough for it to slip out of the shadows and into our nuclei. All 6 billion people living on Earth will eventually die; I'm not particularly special, just because I'm looking it a little more closely in the eye.
The ugliness of this reality -- like the grotesque thestrals with their leathery wings -- can be overwhelming. But it's reassuring to see the truth that's been invisible until now. This life isn't magic. It's finite, even temporary. I'm not immortal. And this reality can make every little thing (and every big thing) -- the pregnancy, fresh tulips, a hug, toy trains, my family -- that much more delicious.
Monday, March 05, 2007
The Audacity
If you haven't been keeping up with me, I'll warn you that things around here have turned serious. My life has entered into the Twilight Zone -- and not one of its happier edges where Santa Claus is real. I have cancer; I don't know whether my baby (due in August) will survive the treatment. I apologize, because I'm sick of dropping the depressing news on people who know me. But it's become ridiculous to pretend it's not happening.
So I'm learning about hope, and I'll title this along the lines of Senator Obama's book -- The Audacity of Hope -- because I feel absurdly audacious these days when I answer "How are you?" with a simple "fine." I'm not "fine." The past three weeks have been all about waiting. Waiting for doctors to call back, waiting for test results, waiting for surgery to be scheduled. Each time I wait, my life pauses for hours or days, and I can decide whether to be fatalistic (to avoid disappointment) or hopeful (and risk discouragement).
And "getting my hopes up" is something I've thought about before, in pregnancy. Pregnancy means "expecting." For months on end, we really don't "have" anything but heartburn, swelling, eventually some kicks and tumbles in our bellies -- nothing but the expectancy that this will lead to a day when we look into the eyes of our newborn child. Pregnancy is all about hope. And when it comes to the hard stuff -- whether to give birth naturally, whether to get your heart set on breastfeeding -- we're often afraid to hope for much at all. We tell ourselves, "I'm being flexible, so I won't be disappointed." As if it's the moment of letdown -- and not the actual loss -- that can ultimately hurt us.
So we protect ourselves with low expectations, and this isn't always enough. In my last pregnancy, I failed to prepare for natural birth (of course, not helping my chances) because I was afraid to admit I wanted it. I thought that, if I avoided conviction about birth, I would avoid disappointment. But the pain came anyway, even when I had so carefully avoided "getting my hopes up." How could I grieve something I tried so hard not to want?
Because some things suck. I decided, early in this pregnancy, that no matter how hard it is, I'd go ahead and hope for the best. That used to mean "insisting on VBAC" instead of "Maybe they'll let me have a trial of labor." Now things are crazy, but I'm hoping anyway. "Disappointment" isn't my worst case scenario any more. I have cancer. What do I have to lose by getting my hopes up?
Hope looks different around here, each day. Last week, I said out loud "I've decided that I'm fine," and ended up with my hopes crushed to tears after reading two more independent pathology reports. Yes, I felt stupid and embarrassed for having high expectations. I could have spent that week expecting the worst, and I wouldn't have any "hope" to be "crushed" when the oncologists came into the consultation room. Was I in denial, or just being optimistic? Was I feeling the pain of "crushed hopes?" Or just the pain of this damn situation?
This week, as I wait to hear whether last week's surgery got "clean edges" around a tumor, hope means shopping for baby clothes (just a few) without thinking too intently on when they might be worn. Hope means sending out job applications, without knowing for sure when I'll be available for work. Maybe this is delusional. But I can't clear a year off my calendar in case I end up unable to walk. I can't ignore the child wiggling in my tummy, when a few brief weeks of affection might be the most love I'll ever be able to give.
It's an awful, awful struggle. But I can't live as if I've already lost it. So, at the risk of "getting my hopes up" -- I'll go ahead and raise them high to shine in the sun. And see what happens next -- Maybe I'll even go for that VBAC.
So I'm learning about hope, and I'll title this along the lines of Senator Obama's book -- The Audacity of Hope -- because I feel absurdly audacious these days when I answer "How are you?" with a simple "fine." I'm not "fine." The past three weeks have been all about waiting. Waiting for doctors to call back, waiting for test results, waiting for surgery to be scheduled. Each time I wait, my life pauses for hours or days, and I can decide whether to be fatalistic (to avoid disappointment) or hopeful (and risk discouragement).
And "getting my hopes up" is something I've thought about before, in pregnancy. Pregnancy means "expecting." For months on end, we really don't "have" anything but heartburn, swelling, eventually some kicks and tumbles in our bellies -- nothing but the expectancy that this will lead to a day when we look into the eyes of our newborn child. Pregnancy is all about hope. And when it comes to the hard stuff -- whether to give birth naturally, whether to get your heart set on breastfeeding -- we're often afraid to hope for much at all. We tell ourselves, "I'm being flexible, so I won't be disappointed." As if it's the moment of letdown -- and not the actual loss -- that can ultimately hurt us.
So we protect ourselves with low expectations, and this isn't always enough. In my last pregnancy, I failed to prepare for natural birth (of course, not helping my chances) because I was afraid to admit I wanted it. I thought that, if I avoided conviction about birth, I would avoid disappointment. But the pain came anyway, even when I had so carefully avoided "getting my hopes up." How could I grieve something I tried so hard not to want?
Because some things suck. I decided, early in this pregnancy, that no matter how hard it is, I'd go ahead and hope for the best. That used to mean "insisting on VBAC" instead of "Maybe they'll let me have a trial of labor." Now things are crazy, but I'm hoping anyway. "Disappointment" isn't my worst case scenario any more. I have cancer. What do I have to lose by getting my hopes up?
Hope looks different around here, each day. Last week, I said out loud "I've decided that I'm fine," and ended up with my hopes crushed to tears after reading two more independent pathology reports. Yes, I felt stupid and embarrassed for having high expectations. I could have spent that week expecting the worst, and I wouldn't have any "hope" to be "crushed" when the oncologists came into the consultation room. Was I in denial, or just being optimistic? Was I feeling the pain of "crushed hopes?" Or just the pain of this damn situation?
This week, as I wait to hear whether last week's surgery got "clean edges" around a tumor, hope means shopping for baby clothes (just a few) without thinking too intently on when they might be worn. Hope means sending out job applications, without knowing for sure when I'll be available for work. Maybe this is delusional. But I can't clear a year off my calendar in case I end up unable to walk. I can't ignore the child wiggling in my tummy, when a few brief weeks of affection might be the most love I'll ever be able to give.
It's an awful, awful struggle. But I can't live as if I've already lost it. So, at the risk of "getting my hopes up" -- I'll go ahead and raise them high to shine in the sun. And see what happens next -- Maybe I'll even go for that VBAC.
Monday, February 05, 2007
Danger, Data, Drama
I've been thinking about how we learn about risk and safety. In a world of hidden threats, what is danger? How do we know what to fear? A car cruising at freeway speeds with sleepy children buckled in back. Pills prescribed by a trusted doctor. Invisible pollutants. Unprotected sex. These things can kill us -- but they probably won't. You can live a lifetime, unscarred by accident or disease, and never know whether you were safe and smart -- or just lucky.
It's through the collective wisdom of our community that we know about latent risk. I don't personally know anyone who's lost an infant in a car wreck. But I buckle my son in his five-point harness -- because I (and my government) have looked at the data and determined that, in the right circumstances, it could make a difference between life and death. I've done this with almost every parenting choice I've faced -- whether to supplement with formula; whether to vaccinate; what kind of medical interventions to accept during childbirth, and which ones to avoid.
And no matter what we disagree on, all moms seem to agree that this is exhausting. We face information overload. We go to great lengths to avoid "risks" like artificial growth hormones and latex balloons -- and at some point, we have to let it go. "What's the harm?" We say. "How dangerous is it really?" My sister and I used to wrestle around on the floor of our Grandma's backseat while she smoked cigarettes and fed us colored marshmallows in the car -- and we turned out fine. Can a little peanut butter and a few unsupervised bathtimes really be that dangerous for our own children?
So at some point, we turn away from the data and the studies. We remember that we are mothers who can learn from other mothers. We value the knowledge of our friends, our sisters and mothers, as if we crave a primal community where we learn by sharing anecdotes. "I was induced at 38 weeks/ fed him baloney/let him use the walker," they say "and he turned out fine." Or on the other hand, "I know someone whose cousin had a VBAC/left him alone in his highchair/ fed them a raw carrot -- and they almost died!" The closer we are to these kind of horror stories, the more power they have over us. It's as if we are living in the wilderness and hear of our neighbors being attacked by a wild animal. The nearer they are, the more real the threat can seem.
Of course we need to temper our parenting decisions with common sense. And good old-fashioned Mom Talk can be a great source of support. But the wrong anecdote can overdramatize safe situations -- or veil the risk of threatening ones. When I hear about a friend's cousin's uterine rupture, for instance, I need to keep in mind where she fits into the big picture. With a 0.7% rupture rate, for every woman who experiences rupture there are over 142 who do not. Of course, it would take too long to counter a single rupture anecdote with 142 relatively boring stories about uneventful VBACs. So the dramatic anecdote survives, and thrives, until ultimately it threatens to distort the true risk of the situation.
And some risks are only apparent when viewed relatively. A .177% infant death rate for cesarean deliveries seems low enough to ignore -- until you compare it to the .062% rate for vaginal births (in a study of almost 12,000 babies who died in a 3-year period) . So while it's accurate for me to spread the word that "I had a cesarean and my baby is fine" -- is it intellectually honest? Over 4,000 of those babies died for no other discernible reason than a cesarean delivery. Was it smart decision of me to consent to surgery? Or was I just lucky?
And why does it matter? We can't be perfect mothers. We all take risks the moment we leave the house. And we crave and require each other's support. Tell me I'm not a bad mom; Tell me I'm not alone. Don't judge me. But I wonder if we're so hesitant to "judge" each other that we've lost our ability to use critical judgment where it's needed -- in analyzing important information about our children's health and safety. What will it take to give us the courage and confidence again?
It's through the collective wisdom of our community that we know about latent risk. I don't personally know anyone who's lost an infant in a car wreck. But I buckle my son in his five-point harness -- because I (and my government) have looked at the data and determined that, in the right circumstances, it could make a difference between life and death. I've done this with almost every parenting choice I've faced -- whether to supplement with formula; whether to vaccinate; what kind of medical interventions to accept during childbirth, and which ones to avoid.
And no matter what we disagree on, all moms seem to agree that this is exhausting. We face information overload. We go to great lengths to avoid "risks" like artificial growth hormones and latex balloons -- and at some point, we have to let it go. "What's the harm?" We say. "How dangerous is it really?" My sister and I used to wrestle around on the floor of our Grandma's backseat while she smoked cigarettes and fed us colored marshmallows in the car -- and we turned out fine. Can a little peanut butter and a few unsupervised bathtimes really be that dangerous for our own children?
So at some point, we turn away from the data and the studies. We remember that we are mothers who can learn from other mothers. We value the knowledge of our friends, our sisters and mothers, as if we crave a primal community where we learn by sharing anecdotes. "I was induced at 38 weeks/ fed him baloney/let him use the walker," they say "and he turned out fine." Or on the other hand, "I know someone whose cousin had a VBAC/left him alone in his highchair/ fed them a raw carrot -- and they almost died!" The closer we are to these kind of horror stories, the more power they have over us. It's as if we are living in the wilderness and hear of our neighbors being attacked by a wild animal. The nearer they are, the more real the threat can seem.
Of course we need to temper our parenting decisions with common sense. And good old-fashioned Mom Talk can be a great source of support. But the wrong anecdote can overdramatize safe situations -- or veil the risk of threatening ones. When I hear about a friend's cousin's uterine rupture, for instance, I need to keep in mind where she fits into the big picture. With a 0.7% rupture rate, for every woman who experiences rupture there are over 142 who do not. Of course, it would take too long to counter a single rupture anecdote with 142 relatively boring stories about uneventful VBACs. So the dramatic anecdote survives, and thrives, until ultimately it threatens to distort the true risk of the situation.
And some risks are only apparent when viewed relatively. A .177% infant death rate for cesarean deliveries seems low enough to ignore -- until you compare it to the .062% rate for vaginal births (in a study of almost 12,000 babies who died in a 3-year period) . So while it's accurate for me to spread the word that "I had a cesarean and my baby is fine" -- is it intellectually honest? Over 4,000 of those babies died for no other discernible reason than a cesarean delivery. Was it smart decision of me to consent to surgery? Or was I just lucky?
And why does it matter? We can't be perfect mothers. We all take risks the moment we leave the house. And we crave and require each other's support. Tell me I'm not a bad mom; Tell me I'm not alone. Don't judge me. But I wonder if we're so hesitant to "judge" each other that we've lost our ability to use critical judgment where it's needed -- in analyzing important information about our children's health and safety. What will it take to give us the courage and confidence again?
Monday, January 08, 2007
For Reals
So, after months of debate, analysis and other attempts at finding "peace through argument" about childbirth, I find myself pregnant. (Okay, it's not as simple as one "finding oneself," but I'll skip that for today). And here I am again: in the middle of the night; alone in the car; huddled at my desk during the workday before I tell anyone at the office; Experiencing pregnancy as the fundamentally solitary, physical experience at the core of gestation and birth. Right now, it's much more visceral than verbal. So writing anything thoughtful about it seems, in a way futile.
Now that it's for real, I'm on a lonely journey. No matter how much "community" I sweep in around me, this pregnancy is mine and mine alone. Even my closest relationships -- my mother, my husband -- are satellites orbiting my own choices, and my direction. I felt this from the first moment I took a breath to announce my pregnancy. What to tell them? How to say it? It's all up to me. I am separate, relying on my words to connect me to everything outside myself. It's the same with my friends, with my journal, with support groups. It's as if, to be anything more than a lonely pregnant woman, I have to find out how to describe, explain and verbally connect with the outside world.
So far, this has meant lots of reading, talking, listening. Lots of theory, research anecdotes. And it's tiring, because meanwhile my body is growing a placenta and networks of blood vessels to support the little gummi-bear sized fetus who will zillion-tuple in size as it grows into the full-fledged person of my son or daughter. But in the meantime here I am trying to connect and learn as much as possible. Because I want this pregnancy to be different than last time. Healthier; more convicted; more confident. I keep thinking of my mantra from last fall -- With Love and Without Fear -- and honestly, these days it seems out of reach. So my new mantra is "courage." And Mark Twain said, "Courage is resistance to fear, mastery of fear - not absence of fear." So I know I will be afraid -- and do it anyway.
And what am I afraid of? Last time, I appreciated the value of natural childbirth, but I did little to prepare myself for it. I secretly hoped I'd be one of those women who found it "not that bad" and would end up saying, "by the time I asked for an epidural, it was time to push!" But I didn't commit to avoiding interventions. I didn't aggressively learn or practice other coping techniques. I went with standard OB care instead of a midwife, and didn't have a doula. Part of me, quite simply, didn't believe in birth -- and didn't care. This part of me was afraid.
I wasn't just afraid of the pain. I was afraid of disappointment; of wanting something that I wouldn't get. Of being one of those women who "thought they could birth naturally," but caved in, and turned out to be self-righteous ideologues who are no better than the rest of us. Looking back, I thought that disappointment was the biggest risk I faced. And by keeping my standards low, that I could avoid it. I was afraid to hope and afraid to care.
I was wrong. Now, I'm done second-guessing the medical treatment that surrounded my son's delivery. I've reviewed my records -- and yes I did have pre-eclampsia, and we all did the best we could with what we knew at the time. But what I can second-guess is myself. What if I had stayed mobile, without an epidural and could walk around or labor in the shower? What if I had more confidence in my body, and trusted myself to work with my contractions? I can't guarantee I won't have pre-eclampsia again this time. But there's a lot I CAN do to prepare myself, build my skills, and surround myself with supportive people.
I have a lot of other thoughts -- about whether regret is the mirror image of disappointment, and how they're really phantoms that distract from our actual fears. About where, and how, and with whom I'll have this baby. About my dreams for my family and my future. But that's a lot of words, for another day. So I'll stop talking, for now, and just keep listening.
Saturday, December 16, 2006
Santa? Snowflakes? Savior?
"Happy Holidays." I wrote this at the top of our "Annual Family Letter" to slip into this year's Christmas Cards. This is the first time we've done a letter, and I'm hesitating. I'm worried that it's not pithy and funny enough, but it seemed convenient to remind everyone where we work and how old the baby is. We're also sending everyone a picture of him. And like every year, I've bought three sets of cards. Religious ones (Mary and Jesus from Gerard David's The Rest on the Flight to Egypt), for religious relatives and art lovers with an affinity for Christian tradition. Wintery ones (snowflakes), mostly for Jewish friends. And Secular Christmas (a cat wearing a Santa Hat), for everyone else.
Every year I consider sending the Cat in a Santa Hat to our Jewish friends. Because the Santa Hat is not a symbol of the same magnitude as Christ on the Cross. They know I observe Christmas. But I know they don't. Not even the contemporary American, Santa Baby, Grandma Got Run Over By a Reindeer, "9 days til Xmas" Christmas. To those who are alienated by the mainstreaming of Christianity's Major Holiday, Santa is a symbol of their marginalization (as in the joke from the Simpson's, Santa Claus is beloved by everyone, "whether you're Christian, or simply not Jewish.") I know mixed-religion couples who have debated less about bris or baptism and more about whether they could ever have a Christmas Tree in their house. So, I skip it -- and anyway I don't mind the Un-Santa cards: I love snowflakes, or wintry cityscapes, or birds on snowy branches. In a way, it's an opportunity for me to broaden my experience of all that is festive about winter.
And of course, I don't send Mary and Jesus to everyone else. I do value religious worship as part of a community (one reason that I'm Catholic). But Within my Church, an image Mary and Jesus (She is feeding him grapes -- adorably evocative of my own relationship with my own toddler) is precious. Between us, the symbol says: Here is our Mother, and here is our Lord. Here is an painter circa 1510, honoring them with this artistic image. Here am I, sharing them with you.
But with non-Christians, I'm more guarded. Even though I'm fairly bold about sharing my faith, I see it as just that -- a personal faith, that in the context of my culture will always be subjective. I can't prostelytize. So when my Christian symbol might be heard differently, I keep them to myself. Because I'm not saying: "This is what I think Christmas should be about . . . .I am more religious than you . . . You should be Christian. . . I don't care if you don't agree with me."
I hate to make it political. And once you take your faith beyond your faith community, it instantly implicates politics. If I believe Jesus is Right, then it logicially follows that un-Jesus is not right. And what do we when everyone can't be right? How do we incorporate our various faiths into our legal and cultural symptoms? Who's in charge? What happens to minorities? All fascinating questions. I won't stop asking them for fear of being offensive -- and I won't use the phrase "politically correct" to describe anyone who would rather talk about politics than holidays -- But sometimes, I'd rather just say "Merry Christmas."
One of these years, I'll get too busy or bored, and it will be snowflakes for everyone. But for now, I have fun with it, and I have fun thinking about symbols. It's easy to analyze symbols pedanticly. For instance, does the origin of Christmas Trees in pagan nature worship, makes them less potent a symbol of American Christianity? Is "Santa Claus" less religious than "Saint Nicholas?" When people want to come together as a community, holiday traditions and symbols seem like a festive and inclusive way to bring people together. The debates about the removal (and reinstalation) of Christmas Tree display at the Sea-Tac Airport show how important this is to people -- but also remind us that, once symbols have become marginalizing (if not oppressive), their meaning won't go away so easily.
This reflects the core tension of the First Amendment: Free expression of religion and freedom from religious establishment. There's no easy way to respectfully celebrate holidays in a diverse society that values plurality. The reader board by my house ("Happy Holidays, to everyone not offended by the suggestion") is too snarky. But I don't care if it's not easy. If I know whether someone prefers a snowflake over the Santa Cat, or the Santa Cat to Jesus, I'll try to reach out in whatever way helps us celebrate what we share about the season. And when I don't know, one way or another, I might just say, "Merry Christmas." And if someone doesn't want to say it in return, I'll consider myself lucky if they tell me why.
Every year I consider sending the Cat in a Santa Hat to our Jewish friends. Because the Santa Hat is not a symbol of the same magnitude as Christ on the Cross. They know I observe Christmas. But I know they don't. Not even the contemporary American, Santa Baby, Grandma Got Run Over By a Reindeer, "9 days til Xmas" Christmas. To those who are alienated by the mainstreaming of Christianity's Major Holiday, Santa is a symbol of their marginalization (as in the joke from the Simpson's, Santa Claus is beloved by everyone, "whether you're Christian, or simply not Jewish.") I know mixed-religion couples who have debated less about bris or baptism and more about whether they could ever have a Christmas Tree in their house. So, I skip it -- and anyway I don't mind the Un-Santa cards: I love snowflakes, or wintry cityscapes, or birds on snowy branches. In a way, it's an opportunity for me to broaden my experience of all that is festive about winter.
And of course, I don't send Mary and Jesus to everyone else. I do value religious worship as part of a community (one reason that I'm Catholic). But Within my Church, an image Mary and Jesus (She is feeding him grapes -- adorably evocative of my own relationship with my own toddler) is precious. Between us, the symbol says: Here is our Mother, and here is our Lord. Here is an painter circa 1510, honoring them with this artistic image. Here am I, sharing them with you.
But with non-Christians, I'm more guarded. Even though I'm fairly bold about sharing my faith, I see it as just that -- a personal faith, that in the context of my culture will always be subjective. I can't prostelytize. So when my Christian symbol might be heard differently, I keep them to myself. Because I'm not saying: "This is what I think Christmas should be about . . . .I am more religious than you . . . You should be Christian. . . I don't care if you don't agree with me."
I hate to make it political. And once you take your faith beyond your faith community, it instantly implicates politics. If I believe Jesus is Right, then it logicially follows that un-Jesus is not right. And what do we when everyone can't be right? How do we incorporate our various faiths into our legal and cultural symptoms? Who's in charge? What happens to minorities? All fascinating questions. I won't stop asking them for fear of being offensive -- and I won't use the phrase "politically correct" to describe anyone who would rather talk about politics than holidays -- But sometimes, I'd rather just say "Merry Christmas."
One of these years, I'll get too busy or bored, and it will be snowflakes for everyone. But for now, I have fun with it, and I have fun thinking about symbols. It's easy to analyze symbols pedanticly. For instance, does the origin of Christmas Trees in pagan nature worship, makes them less potent a symbol of American Christianity? Is "Santa Claus" less religious than "Saint Nicholas?" When people want to come together as a community, holiday traditions and symbols seem like a festive and inclusive way to bring people together. The debates about the removal (and reinstalation) of Christmas Tree display at the Sea-Tac Airport show how important this is to people -- but also remind us that, once symbols have become marginalizing (if not oppressive), their meaning won't go away so easily.
This reflects the core tension of the First Amendment: Free expression of religion and freedom from religious establishment. There's no easy way to respectfully celebrate holidays in a diverse society that values plurality. The reader board by my house ("Happy Holidays, to everyone not offended by the suggestion") is too snarky. But I don't care if it's not easy. If I know whether someone prefers a snowflake over the Santa Cat, or the Santa Cat to Jesus, I'll try to reach out in whatever way helps us celebrate what we share about the season. And when I don't know, one way or another, I might just say, "Merry Christmas." And if someone doesn't want to say it in return, I'll consider myself lucky if they tell me why.
Friday, November 17, 2006
The Price of Discretion
So I've fallen behind, and still need to catch up the latest chilling news -- a women kicked off an airplane for breast-feeding. The buzz on this is already fading; In the time it has taken me to assemble my own thoughts, the airline has already apologized and a number of “nurse-ins” across the country are proceeding with little controversy.
But the message to me, and to women everywhere, is still sinking in. It’s a message about discretion and exposure – our social obligation to protect other people from seeing too much of our bodies. The woman kicked off the airplane (seated by the window with her husband on the aisle) was first asked to cover her child (and breast) with a blanket. When she refused (or failed), her family was ask to leave -- no small request for a family who has spent hours hauling baggage, stroller, carseat and gear through an airport's gates and crowds. Removal from a flight is a serious measure. A group of Muslim scholars removed from a flight out of Minneapolis yesterday have called for an investigation because of the humiliation (and presumably they needed to get where they were going, too).
But even among dedicated lactivists, the outrage and disappointment at the news never sounded like shock and awe. Because we’re not really that surprised. Even if we agree that it was wrong to kick the woman off the plane, we understand why it happened -- or at least we have the vocabulary to discuss it: was she "discreet" enough? Does it matter? We can debate it, but we knew this kind of thing could happen. As much as we rail against it, for years we’ve been hearing that same message about our bodies and babies: Be careful. Your breasts are dangerous, and feeding your child is risky.
And so, in its first apology, the airline expressed its support for breast-feeding women – if they are discreet. I’ll assume that, in light of national news headlines and a complaint filed with the Vermont Civil Rights Commission, even the first apology (later revised) was vetted by at least one team of lawyers, publicists and managers. All that expertise, all that consideration, came to the decision that it’s necessary to draw the line when a breast-feeding woman exposes too much of her body. In essence, they reiterated that women have a duty to protect society from an inadvertent view of our breasts.
I won’t be the first to point out how ironic this is, in an age of breast-intensive advertising and entertainment. If breasts are offensive, why are they everywhere? It’s not enough to blame the media – if mostly-bared breasts weren’t appealing to most consumers, they wouldn’t be plastered across billboards and beer commercials. Boobs are good. So then, we assume, the threat lies the prospect of “too much” breast – along the lines of local strip club ordinances that define "nudity" as including "the breasts below and including the areola." Therein lies the difference between an episode of BayWatch (appropriate) and the moment when I quietly shift my drowsy son off my breast and reach for my sweater (not). Is it all about the areola? Too bad for babies that the business end for milk is the same part considered the most taboo for display -- because it is usually not displayed (a tautology?) -- and therefore takes on a more private and forbidden association. As the argument goes, because breasts are obviously sexual, and sex is private, breast-feeding must be private.
But it’s really not the slight slip of nipple that instantly repulses an otherwise breast-appreciative public. In fact, it’s not the “breast” in the “breast-feeding” that's offensive – it’s the feeding. I think of this as the "don't ruin them for us!" argument: It’s the lactating woman, not the sexualized one, that must protect the world from her body. As observed by the characters on Friends, while watching a nursing mother, "It's such a beautiful and natural thing. . . / Yes, but there is a baby sucking on it!" Or comments like those of Ken Schram, a local news commentator who compared public breast-feeding to "urinating in the middle of the mall.” Boobs are pretty and sexy; Lactation is an intimate, even disgusting, bodily function.
In practice, I can tell you that discretion is no small challenge. It’s hard to nurse a busy and curious baby while maintaining the crucial inch of coverage that could change a peaceful and cuddly feeding into an offense, a confrontation, even a ruined cross-country trip. A slip of blanket or bra, a little distraction, and there we are exposed. Even with laws protecting public breastfeeding, many women feel too vulnerable to ever nurse in public. This is not simply out of modesty (I'd argue that anyone has the right to protect their body from view) but out of fear. What if we're next? Why risk it?
So we suffer a chilling affect. We hide ourselves in a safe “quiet” corner, cover up with a blanket, and spend hundreds of dollars on pumps, bottles and formula – all because we feel vulnerable. And what is our vulnerability? A nursing mother doesn’t shield her breasts out of fear that a sexual predator will notice and direct his violent attentions upon them. We’re really protecting our babies, out of fear that someone will disrupt the feeding. We protect the fragile eyes of the public from the uncomfortable truth of lactation. And in doing so, we complicitly agree that our bodies should be protected -- for someone else's prurient fantasy.
50-State Summary of Breastfeeding Laws
Militant Breastfeeding Cult
But the message to me, and to women everywhere, is still sinking in. It’s a message about discretion and exposure – our social obligation to protect other people from seeing too much of our bodies. The woman kicked off the airplane (seated by the window with her husband on the aisle) was first asked to cover her child (and breast) with a blanket. When she refused (or failed), her family was ask to leave -- no small request for a family who has spent hours hauling baggage, stroller, carseat and gear through an airport's gates and crowds. Removal from a flight is a serious measure. A group of Muslim scholars removed from a flight out of Minneapolis yesterday have called for an investigation because of the humiliation (and presumably they needed to get where they were going, too).
But even among dedicated lactivists, the outrage and disappointment at the news never sounded like shock and awe. Because we’re not really that surprised. Even if we agree that it was wrong to kick the woman off the plane, we understand why it happened -- or at least we have the vocabulary to discuss it: was she "discreet" enough? Does it matter? We can debate it, but we knew this kind of thing could happen. As much as we rail against it, for years we’ve been hearing that same message about our bodies and babies: Be careful. Your breasts are dangerous, and feeding your child is risky.
And so, in its first apology, the airline expressed its support for breast-feeding women – if they are discreet. I’ll assume that, in light of national news headlines and a complaint filed with the Vermont Civil Rights Commission, even the first apology (later revised) was vetted by at least one team of lawyers, publicists and managers. All that expertise, all that consideration, came to the decision that it’s necessary to draw the line when a breast-feeding woman exposes too much of her body. In essence, they reiterated that women have a duty to protect society from an inadvertent view of our breasts.
I won’t be the first to point out how ironic this is, in an age of breast-intensive advertising and entertainment. If breasts are offensive, why are they everywhere? It’s not enough to blame the media – if mostly-bared breasts weren’t appealing to most consumers, they wouldn’t be plastered across billboards and beer commercials. Boobs are good. So then, we assume, the threat lies the prospect of “too much” breast – along the lines of local strip club ordinances that define "nudity" as including "the breasts below and including the areola." Therein lies the difference between an episode of BayWatch (appropriate) and the moment when I quietly shift my drowsy son off my breast and reach for my sweater (not). Is it all about the areola? Too bad for babies that the business end for milk is the same part considered the most taboo for display -- because it is usually not displayed (a tautology?) -- and therefore takes on a more private and forbidden association. As the argument goes, because breasts are obviously sexual, and sex is private, breast-feeding must be private.
But it’s really not the slight slip of nipple that instantly repulses an otherwise breast-appreciative public. In fact, it’s not the “breast” in the “breast-feeding” that's offensive – it’s the feeding. I think of this as the "don't ruin them for us!" argument: It’s the lactating woman, not the sexualized one, that must protect the world from her body. As observed by the characters on Friends, while watching a nursing mother, "It's such a beautiful and natural thing. . . / Yes, but there is a baby sucking on it!" Or comments like those of Ken Schram, a local news commentator who compared public breast-feeding to "urinating in the middle of the mall.” Boobs are pretty and sexy; Lactation is an intimate, even disgusting, bodily function.
In practice, I can tell you that discretion is no small challenge. It’s hard to nurse a busy and curious baby while maintaining the crucial inch of coverage that could change a peaceful and cuddly feeding into an offense, a confrontation, even a ruined cross-country trip. A slip of blanket or bra, a little distraction, and there we are exposed. Even with laws protecting public breastfeeding, many women feel too vulnerable to ever nurse in public. This is not simply out of modesty (I'd argue that anyone has the right to protect their body from view) but out of fear. What if we're next? Why risk it?
So we suffer a chilling affect. We hide ourselves in a safe “quiet” corner, cover up with a blanket, and spend hundreds of dollars on pumps, bottles and formula – all because we feel vulnerable. And what is our vulnerability? A nursing mother doesn’t shield her breasts out of fear that a sexual predator will notice and direct his violent attentions upon them. We’re really protecting our babies, out of fear that someone will disrupt the feeding. We protect the fragile eyes of the public from the uncomfortable truth of lactation. And in doing so, we complicitly agree that our bodies should be protected -- for someone else's prurient fantasy.
50-State Summary of Breastfeeding Laws
Militant Breastfeeding Cult
Thursday, November 09, 2006
Waning Crescent: Birth Stories
I went into labor two years ago today. I've written tons about my labor and delivery -- in email, in a Baby Book, and all the journal entries, messages and posts in between. And now, looking back on it all, I can see how I've changed by the stories I've told. When my son was 8 days old, I wrote out a long timeline, hour by hour. Here's a quote:
Happy Life-on-Earth-day, Malcolm.
International Cesarean Awareness Network
Birth Truth
Phases of the Moon
Hour 22: Still at 6 cm. The doctor (new one on rotation!) came in and said we could deliver now by c-section, or we could wait and see if things changed. I had never thought about a c/s, no one in my family has ever had one, and my pregnancy had been so healthy and easy. The doctor said the baby wasn't in distress, but didn't say "get the c/s or wait for a vaginal birth." It was more like, do it now or do it later because all the pitocin hadn't worked and my water had been broken all day. They couldn't figure out why I wasn't dilated despite good hard contractions, whether it was the magnesium sulfate or what.
We talked about the c/s. They answered all our questions about breastfeeding, time together right away after the birth etc., and it sounded manageable. The doctor and nurses and my mom left the room so D and I could talk it over. We understood the risks and benefits of situation pretty well, it was just overwhelming to be faced with such a huge decision about our baby in such an exhausted state. We decided to go ahead with the c/s.
This is accurate, but I notice the tone. I was so careful not to place blame. The surgery was inevitable. At the time, I thought I was confident and competent. Now, I hear defensiveness and denial. When I wrote this, my son was so young he still had the stump of his umbilical cord. I had only felt a fraction of the pain the cesarean would eventually involve. But I insisted that I had "understood the risks." I had heard about women who were ignorant and manipulated into cesareans -- I was not one of them. I was better prepared. I chose. In these stories, I am savvy and empowered.
If anything, I told myself, I was unlucky -- I had been diagnosed with pre-eclampsia in labor, and was treated with magnesium sulfate. This made my labor both unpleasant (vomiting, sweats and chills, double vision) and slow (an effect of the drug). I'm the one who "failed to progress," but the deck was stacked against me. If I was sad, it was because it had been so bad. My writing began to emphasize all the difficulties, as if I need to justify my pain. I had never been hung up on childbirth (I wasn't some granola-cruncher who wore hemp maxi-pads.) I thought it was healthier to be flexible and not set my heart on natural birth. If my heart felt broken, it wasn't because I had set myself up for disapopintment -- I had low expectations in the first place. It must be because my labor was so very hard. I was one of those women talked about at baby showers with sadly shaking heads. In these stories, I am a victim.
But I knew women with “worse” trauma who weren’t as upset as I was, and I hate to feel competitive. I tried to move on -– but without much "blame" or "regret" to hang my hurt on, I became listless and conflicted. Whose fault was this? I had chosen a cesarean, but the memory haunted me -- the pounding, slamming anonymity that violated me, despite my consent and my numbness -– like a teenager who thinks she's "ready for sex," realizes too late that she's not, but tells herself she's okay and that she can't complain. So many, many other women had been through identical experiences and they were fine. I wondered why I couldn't get over it: Was I hypersensitive? Melodramatic? I read, wrote and argued with women who had cesareans and women who hadn't. In these stories, I am confused.
I began to doubt and wonder. What had I really done to prepare for childbirth? What if I had been more patient -- even let the epidural wear off, and sit or stand enough to let my son's head dilate my cervix? On the day I finally Googled "mild pre-eclampsia," I found a reputable medical source say that magnesium isn't standard treatment. Had my cesarean been avoidable? And if so, who was responsible? I ordered my 147 pages of medical records, sat down to read them, and wrote about what I found. In these stories, I am searching.
I face my son’s second birthday tomorrow. In the past, when anyone has asked me "what date he was born," I've had trouble answering. I had labored through the night and day of November 9; The nurses in the operating recorded his delivery as "00:50" on November 10th. But I didn't like that date – what kind of time is "00:50?” The middle of the night, or the early morning? The end of one day, or the beginning of another?
And this is how I felt about it all: A gap surrounding my son’s entry into the world. When I saw “State of Washington” on his birth certificate, I thought no, not my Washington. The "place" was a sterile operating room, forbidden to anyone not trained and scrubbed (or being cut open). When I hear “November 10,” I think no, it was not that day. It doesn't have a date. It’s taken me two years and thousands of words to help me articulate what the gap is. Maybe it wasn’t a birth.
So how can we commemorate that? Yes, we'll buy balloons and cupcakes, he'll open presents, and we'll all sing "Happy Birthday." But for me, it doesn't feel quite right. So I think of this: I recently told someone how my son loves the moon (he calls the outline of a naked pregnant woman on my "Birthkeeper" shirt a "moon and stars.") She asked if he'd been born at night. I flinched but said yes. Then I thought about it, did a little research, and here's what I learned:
If anything, I told myself, I was unlucky -- I had been diagnosed with pre-eclampsia in labor, and was treated with magnesium sulfate. This made my labor both unpleasant (vomiting, sweats and chills, double vision) and slow (an effect of the drug). I'm the one who "failed to progress," but the deck was stacked against me. If I was sad, it was because it had been so bad. My writing began to emphasize all the difficulties, as if I need to justify my pain. I had never been hung up on childbirth (I wasn't some granola-cruncher who wore hemp maxi-pads.) I thought it was healthier to be flexible and not set my heart on natural birth. If my heart felt broken, it wasn't because I had set myself up for disapopintment -- I had low expectations in the first place. It must be because my labor was so very hard. I was one of those women talked about at baby showers with sadly shaking heads. In these stories, I am a victim.
But I knew women with “worse” trauma who weren’t as upset as I was, and I hate to feel competitive. I tried to move on -– but without much "blame" or "regret" to hang my hurt on, I became listless and conflicted. Whose fault was this? I had chosen a cesarean, but the memory haunted me -- the pounding, slamming anonymity that violated me, despite my consent and my numbness -– like a teenager who thinks she's "ready for sex," realizes too late that she's not, but tells herself she's okay and that she can't complain. So many, many other women had been through identical experiences and they were fine. I wondered why I couldn't get over it: Was I hypersensitive? Melodramatic? I read, wrote and argued with women who had cesareans and women who hadn't. In these stories, I am confused.
I began to doubt and wonder. What had I really done to prepare for childbirth? What if I had been more patient -- even let the epidural wear off, and sit or stand enough to let my son's head dilate my cervix? On the day I finally Googled "mild pre-eclampsia," I found a reputable medical source say that magnesium isn't standard treatment. Had my cesarean been avoidable? And if so, who was responsible? I ordered my 147 pages of medical records, sat down to read them, and wrote about what I found. In these stories, I am searching.
I face my son’s second birthday tomorrow. In the past, when anyone has asked me "what date he was born," I've had trouble answering. I had labored through the night and day of November 9; The nurses in the operating recorded his delivery as "00:50" on November 10th. But I didn't like that date – what kind of time is "00:50?” The middle of the night, or the early morning? The end of one day, or the beginning of another?
And this is how I felt about it all: A gap surrounding my son’s entry into the world. When I saw “State of Washington” on his birth certificate, I thought no, not my Washington. The "place" was a sterile operating room, forbidden to anyone not trained and scrubbed (or being cut open). When I hear “November 10,” I think no, it was not that day. It doesn't have a date. It’s taken me two years and thousands of words to help me articulate what the gap is. Maybe it wasn’t a birth.
So how can we commemorate that? Yes, we'll buy balloons and cupcakes, he'll open presents, and we'll all sing "Happy Birthday." But for me, it doesn't feel quite right. So I think of this: I recently told someone how my son loves the moon (he calls the outline of a naked pregnant woman on my "Birthkeeper" shirt a "moon and stars.") She asked if he'd been born at night. I flinched but said yes. Then I thought about it, did a little research, and here's what I learned:
When my son entered the world, the sky was dark. That morning at 4:45, the sliver of a waning crescent moon rose for its short journey across the wintry southern sky. Imagining this, I can imagine those moments. I can remember that what happened did happen, and even if it will never be "okay," it will always be part of something bigger. Maybe that is what we will observe this year. Tonight I’ll take him outside and we'll look at the moon. He will say "Oh LOOK! The MOON!" like he does every time. I will think about the eternity and rhythm of its phases. We can live in the blackness, and we can live by a sliver of light. We can rage against loss, and love all of life with the same heart.
Happy Life-on-Earth-day, Malcolm.
International Cesarean Awareness Network
Birth Truth
Phases of the Moon
Tuesday, November 07, 2006
Hearts without Names
All over Seattle, there are billboards and buses showing bodies -- the insides of dead human bodies. This is not a metaphor; it is advertising for a science/entertainment exhibit of preserved cadavers called "Bodies: The Exhibition." It is hard for me to get past the "I see dead people" aspect of this, but on reflection it's pretty amazing.
The exhibition website describes it as an educational exhibit that tells the story of ourselves "with reverence and understanding." I would hope so. These are the real remains of real human lives: The muscles, bones and skin that grew with these people from childhood. Legs and backs that worked for a living. Lungs that breathed and brains that dreamed. Arms that held lovers and cared for babies. These bodies aren't just artificacts of life -- they were life itself.
In every culture, human remains are treated with some kind of ritual and reverence. Even when they are destroyed through cremation or funeral pyres, it is not because they are so much waste -- it is because they have so much relevance. For the people who became the "Bodies" exhibition (all former Citizens of China), their funerals consist of a transportation across the United States for public education and viewing. The exhibition is their final rest.
I love science -- in fact, I love anatomy -- and find myself staring in wonder at the complex interplay of tendons and muscles on display I see on the side of the Metro Route 15X bus. Perhaps the exhibit itself (like others, such as the display of ancient Egyptian mummies in Chicago's Field Museum) lists the dead by name and respectfully asks for prayers in their memory. But the advertising (which is everywhere) doesn't. I see a skull without a face; I see a heart without a name. I know science and education are public and social goods. But is this?
I'm happy to find, on doing some quick research, that it's not just me: The Seattle P-I has written a cogent editorial about consent; unlike human cadavers used in medical study (which I have seen, in educational settings), there is no evidence that the people exhibited intended to donate their remains to public display. The Exhibition has affirmed that it has a "contract with a Chinese university" which, while it apparently guarantees the bodies are not from political or religious prisoners, doesn't say much else about the source or intention of the remains. The Stranger's article, "Unrest in Pieces," includes an article written by an employee there who describes the moral and political ambiguities of law and death in China.
So at least it's a "controversy," in the headline-grabbing sense. Yet I'm still kind of surprised that this is this where our standards are: It's socially acceptable to display tastefully flayed dead bodies on billboards, as long as they weren't executed for political reasons by a totalitarian government. Apparently, under our American values system, the victims would be much more sympathetic if they were killed for exercising their civil rights. Perhaps it would be okay if they were criminals, executed for morally reprehensible crimes like rape or muder. Or best of all if they'd simply died "naturally" from malnutrition, disease, poverty or unsafe work conditions.
I wonder whether the cause of death even matters. Or is it that, in contemplating the specifics of individual human deaths, we must see these as individual human lives. And maybe the issue of "consent" distracts us from the real moral question of whether there are some things just too intimate to buy and sell, no matter who consents. Anna Nicole Smith, for instance, has apparently sold the video of her cesarean section to Entertainment Tonight (sorry, not linking to that one). Like the Bodies Exhibition, it speaks its own truth (yes, that is a "section" cut out of a real woman, knifed in half and bleeding, crying through drugs for her baby). It is indeed educational. But the fact that we can view it so casually (even unwittingly -- be careful clicking on links that read "Anna ET Video, TMI") raises questions of exploitation, profit, and dignity.
When it comes to prostitution and pornography, our culture draws the line -- too much potential for abuse, too much exploitation, and at some point, just "too much" -- consent or not. Yet when it comes to death, we tend to deny its intimacy. I remember being so disturbed by the decaying flesh of the Pirates of the Carribean Zombie-Ghosts. Why is it cinematically appropriate to represent the inner structure of a human arm as it loses its rotting skin, but a healthy woman breast feeding a child is quickly criticized as "too much?" Death, violence, injury, surgery -- these involve our vulnerability, privacy and humanity, as surely as sex does. But we're supposed to act tough -- to turn away -- to shake it off -- to see it as tecnical, academic, and scientific. What have we lost?
The exhibition website describes it as an educational exhibit that tells the story of ourselves "with reverence and understanding." I would hope so. These are the real remains of real human lives: The muscles, bones and skin that grew with these people from childhood. Legs and backs that worked for a living. Lungs that breathed and brains that dreamed. Arms that held lovers and cared for babies. These bodies aren't just artificacts of life -- they were life itself.
In every culture, human remains are treated with some kind of ritual and reverence. Even when they are destroyed through cremation or funeral pyres, it is not because they are so much waste -- it is because they have so much relevance. For the people who became the "Bodies" exhibition (all former Citizens of China), their funerals consist of a transportation across the United States for public education and viewing. The exhibition is their final rest.
I love science -- in fact, I love anatomy -- and find myself staring in wonder at the complex interplay of tendons and muscles on display I see on the side of the Metro Route 15X bus. Perhaps the exhibit itself (like others, such as the display of ancient Egyptian mummies in Chicago's Field Museum) lists the dead by name and respectfully asks for prayers in their memory. But the advertising (which is everywhere) doesn't. I see a skull without a face; I see a heart without a name. I know science and education are public and social goods. But is this?
I'm happy to find, on doing some quick research, that it's not just me: The Seattle P-I has written a cogent editorial about consent; unlike human cadavers used in medical study (which I have seen, in educational settings), there is no evidence that the people exhibited intended to donate their remains to public display. The Exhibition has affirmed that it has a "contract with a Chinese university" which, while it apparently guarantees the bodies are not from political or religious prisoners, doesn't say much else about the source or intention of the remains. The Stranger's article, "Unrest in Pieces," includes an article written by an employee there who describes the moral and political ambiguities of law and death in China.
So at least it's a "controversy," in the headline-grabbing sense. Yet I'm still kind of surprised that this is this where our standards are: It's socially acceptable to display tastefully flayed dead bodies on billboards, as long as they weren't executed for political reasons by a totalitarian government. Apparently, under our American values system, the victims would be much more sympathetic if they were killed for exercising their civil rights. Perhaps it would be okay if they were criminals, executed for morally reprehensible crimes like rape or muder. Or best of all if they'd simply died "naturally" from malnutrition, disease, poverty or unsafe work conditions.
I wonder whether the cause of death even matters. Or is it that, in contemplating the specifics of individual human deaths, we must see these as individual human lives. And maybe the issue of "consent" distracts us from the real moral question of whether there are some things just too intimate to buy and sell, no matter who consents. Anna Nicole Smith, for instance, has apparently sold the video of her cesarean section to Entertainment Tonight (sorry, not linking to that one). Like the Bodies Exhibition, it speaks its own truth (yes, that is a "section" cut out of a real woman, knifed in half and bleeding, crying through drugs for her baby). It is indeed educational. But the fact that we can view it so casually (even unwittingly -- be careful clicking on links that read "Anna ET Video, TMI") raises questions of exploitation, profit, and dignity.
When it comes to prostitution and pornography, our culture draws the line -- too much potential for abuse, too much exploitation, and at some point, just "too much" -- consent or not. Yet when it comes to death, we tend to deny its intimacy. I remember being so disturbed by the decaying flesh of the Pirates of the Carribean Zombie-Ghosts. Why is it cinematically appropriate to represent the inner structure of a human arm as it loses its rotting skin, but a healthy woman breast feeding a child is quickly criticized as "too much?" Death, violence, injury, surgery -- these involve our vulnerability, privacy and humanity, as surely as sex does. But we're supposed to act tough -- to turn away -- to shake it off -- to see it as tecnical, academic, and scientific. What have we lost?
Wednesday, November 01, 2006
Tricks, Treats and Tantrums
I was going to start by saying, "Our child has never had a temper tantrum." But that would be obnoxious, if not dishonest. This morning, for instance, went something like this:
And so he proceeded with "an irrational fit of crying, screaming, defiance, and a resistance to every attempt at pacification in which even physical control is lost," which is Wikipedia's definition of a "tantrum." I'm pretty sure he wanted to bring his Halloween Candy in the car with him, and is angry that I stashed it on top of the refrigerator (he may even suspect, correctly, that I'm eating most of it myself). But since I recently came across the suggestion to avoid using the word "tantrum" at all, I can say he didn't have one. And though this may sound pedantic, or semantic, or even absurd, I’m amazed to find myself really feeling better about the whole morning.Me: It's time to go! Here is your coat!
Child: No coat. NO no no no no nooooo cooooooooaaaat!
Me: Here is your coat [forces coat on child]. Now it's time to go. Let's get in the car. Here we go! [uses fun voice]!Child: No car nocar nocarnocarnocarnooooooo!!!!!!!! [lays down, hits head on the floor, screams]
Me: Time to get in the car. [carries to car, buckles carseat]
Child: No carseat no buckle no no nooooooo [Kicks. Screams. Defies consolation. Cries for ten solid minutes].
No, I haven’t lost my mind from getting hit over the head with sections of toy railroad track. I’m serious: Letting go of the "tantrum" label has separated my child’s irrational, screaming behavior from my own desperate need to snap him out of it. I've read about all different ways to prevent, control and react to the dreaded Big T, and so far this one little trick has helped me the most.
Labels matter: They're little bits of linguistic shorthand that reduce entire categories of behavior, expectations and perspective to a few short syllables. Since the moment I became pregnant, I've had labels to define all my parenting fears and achievements: When is my "due date?" Will my son hit the "terrible twos?" Is he "potty trained?" When we use labels enough, we take them for granted -- and forget, for instance, that a pregnancy "due date" represents an entire body of research, tradition and cultural expectations about what should happen, when it should happen and how we'll react if it doesn't.
But children operate without language – a gestating baby can’t count to 280, and an overwhelmed toddler doesn’t self-identify as an autonomous person who’s exhibiting a specific behavior pattern called a "tantrum." When my child loses it, he is so saturated with fear and anger that he’s hardly capable of protecting his own body from harm. He might be raging for a variety of reasons – exhaustion, confusion or experimentation, to name a few. It’s only when I choose to label these behaviors that they coalesce into a recurring "event" called a tantrum.
As soon as I let go of the label, I'm free to focus on the bigger picture -- in a way, the conscientious use of language is part of a powerful paradigm shift away from adversarial parenting and toward a mindset of helping my child. So when he goes into an irrational rage, my priorities are something like this: 1. Keep him safe. 2. Keep myself calm. 3. Keep our lives on track. 4. Help him calm down. And, in the long run, I will 5. Teach him the skill of behaving appropriately under stress. For instance, if I’m carrying him through a doorway, I’ll 1. Protect his head (or try to, oops, bonk.) If I’m about to lose it, I’ll 2. Leave him alone and go take a few deep breaths, for my own peace of mind. After that, 3. What we do depends on what needs to be done: If it’s time to go, we’re going out the door, even if he’s got big feelings about it. If it’s time to relax and get in the bath, I’ll devote more time to calming him down. 4. Depending on the child and the situation, this could include rocking, nursing, a bear hug, or leaving them to unwind alone.
Of course, I’ve tried tons of things that don’t work, too. Sometimes it’s easy enough to leave the TV on for five more minutes instead of dealing with the screaming because he can’t watch the end of Little Einsteins. I’ve been known to regret this, but I don’t worry too much about spoiling my child by occasionally accommodating him – I think it’s fair to say, "I didn’t realize this was so important to you," give him a spoon instead of a fork, and quietly move on. On the other hand, I won’t agree to "no diaper" just because he wants to keep playing with his pee-pee (okay I confess I stole that one, but I love it because it is SO TRUE). Some things aren’t optional around here, no matter how upsetting this might be for someone who loves being naked but is too young to clean up his own undiaperedly mess.
And this is where Number 5. comes in -- that we're in the process of teaching him how to behave appropriately even when we're overwhelmed by big feelings. I’m not interested in instigating good behavior by making my child feel bad when he fails. And I'm not all that concerned about "rewarding" his meltdown with some calm attention and help where it's needed. And looking at the big picture, there are lots of things I can control (our routine, meals, rest and exercise) to avoid us getting so burnt out that we become utterly unable to cope.
On the other hand, I don’t go out of my way to be sure he never has bad feelings at all. In fact, when we step back and realize that big, loud feelings aren’t a failure – that they are, in the end, "just feelings" – it’s much easier not to take it personally when a child is overwhelmed with emotion. In fact, simply labeling the emotion (instead of the tantrum), in a calm voice, can be powerful: "You are angry. You want to stay home. So angry." Sometimes, as silly as it sounds out loud, wrapping my calm words around his raging feelings helps me believe that it really might not be that bad.
And I know that as he gets older, my child might start to "tantrum" more strategically. Kids do tend to experiment with the power of their big feelings over the adults around them. It's my hope that, by modulating our own reactions to his outbursts -- and by accepting our own frustration, without using anger to threaten or manipulate our child -- we can set a tone in this family that honestly helps each other through the hard times without being scared of our emotions.
I'm sure it will be an adventure. I have bad days, where I forget all this and we both end up crying on the floor anyway. But on a good day, it’s almost as if I can look down on the whole scene: A screaming and confused little boy soaking wet on the bathroom floor, and an exhausted but calm Mama who's finding her authority and managing to be in control. Who knows she’s strong enough to dry off a thrashing toddler, clean the tub, and find pajamas -- while making a mental note to herself that next year, Halloween candy won't go in the bath in the first place.
I owe my perspective on tantrums, as I do many things, to the work of Crystal Lutton.
Tuesday, October 31, 2006
With Love and Without Fear
I haven't forgotten that I have a blog. I met a new coworker yesterday, and when she introduced herself with ". . . and I'm a knitter," I heard myself say ". . . and I'm a writer!" So time to get to it. I've been away on vacation, taking my toddler to visit family in Alaska. This is a trip that, a year ago, I would have dismissed as impossible. My husband and I couldn't both manage the time away from work, and a thousand miles of air travel with an almost-2-year old seemed beyond my solo parenting capacity. But as my son has grown from a baby to a toddler, I've grown too. And part of my growth includes a determination to avoid the phrase "I can't" whenever possible. (Not that I'll do anything -- I still reserve my right to the phrase "I won't.") So with his second birthday (and the mandatory full-price airfare that goes with it) looming large, I decided we would go.
But realizing that "I can" fly my son to Alaska didn't solve my anxiety of "HOW on Earth can I?" How could I manage taking his little shoes off when we go through FAA security? How will I know whether to pack new books and toys, or comforting old ones? What if he refuses to eat? Or sleep? How can I be sure he doesn't get lost, or hurt? What if he screams, and screams, and doesn't stop? These kind of fears startled me awake, in the nights leading up to our trip, with my anxiety screaming in my head: "How will I do it?" And at some point, I unbelievably got an answer -- from my intuition, from the depths of my soul, from the universe or God Itself I don't know. And the answer is, "With love, and without fear."
Which wasn't exactly what I was looking for. I had hoped the universe would give me more specific directions. Maybe along the lines of "you will take the second elevator down to the L-2 gate, and then feed him goldfish crackers until he falls asleep." But instead, I got a rough outline that reminded me how I will cope: I will mother my son with love. I will not let fear overwhelm me. When things get difficult, I will rely on my love to calm me and guide my decisions.
So off I went. My newfound conviction found me hauling 30 bundled pounds of little boy up the steep stairs to a little 12-seat prop plane, too small inside for anyone to stand upright but him. And so (after our long trip from Seattle and a longer turmoil of baggage, security and lost stroller issues), we finally took off from Anchorage, across the Kenai wilderness, over the glaciers to chilly-yet-cozy little Homer, Alaska. And the whole trip turned out fine -- to keep my son calm, I found myself affecting a calm attitude even when I didn't feel it. And my "message," or whatever it was, was right. I did it all With Love and Without Fear. It wasn't easy, but we managed. Even bedtimes away from home (which I was dreading without husbandly assistance) went smoothly, with the substantial assistance of my loving and fearless sister who enjoyed the moments of snuggling her sleepy nephew while I enjoyed emptying and loading her dishwasher. With Love, and Without Fear.
And now I'm noticing all the ways this applies to parenting. How will I cope if my son screams and hits when I'm running late to work and straining to buckle him in the carseat? With love, and without fear. How could I ever manage another pregnancy and childbirth? With love, and without fear. How will we get him to sleep tonight? And the next night, and the next? Same answer.
I have a lot more mom-thoughts I'm trying to get down this week: one mess of ideas about "tantrums" and one about "praise." But today I'll stick with the theme: That with my son facing down the Tender, Terrific Twos, I've found tremendous strength in believing that "with love, all things are possible." And that this is ultimately enough -- no matter how much I might personally prefer "all things are easy." In my more difficult moments, I'll try to remember pressing my cheek against my son's silky blond head as we watched out the window of our little plane -- over the trees, I told him, over the mountains and above the clouds -- each of us amazed, for our own reasons, that we really can fly.
Books:
Your Two Year Old
Easy to Love, Difficult to Discipline
Unconditional Parenting
Websites:
Dr. Sears on Why Toddlers are Difficult
Crystal Lutton on Tantrums
Get off Your Butt Parenting
But realizing that "I can" fly my son to Alaska didn't solve my anxiety of "HOW on Earth can I?" How could I manage taking his little shoes off when we go through FAA security? How will I know whether to pack new books and toys, or comforting old ones? What if he refuses to eat? Or sleep? How can I be sure he doesn't get lost, or hurt? What if he screams, and screams, and doesn't stop? These kind of fears startled me awake, in the nights leading up to our trip, with my anxiety screaming in my head: "How will I do it?" And at some point, I unbelievably got an answer -- from my intuition, from the depths of my soul, from the universe or God Itself I don't know. And the answer is, "With love, and without fear."
Which wasn't exactly what I was looking for. I had hoped the universe would give me more specific directions. Maybe along the lines of "you will take the second elevator down to the L-2 gate, and then feed him goldfish crackers until he falls asleep." But instead, I got a rough outline that reminded me how I will cope: I will mother my son with love. I will not let fear overwhelm me. When things get difficult, I will rely on my love to calm me and guide my decisions.
So off I went. My newfound conviction found me hauling 30 bundled pounds of little boy up the steep stairs to a little 12-seat prop plane, too small inside for anyone to stand upright but him. And so (after our long trip from Seattle and a longer turmoil of baggage, security and lost stroller issues), we finally took off from Anchorage, across the Kenai wilderness, over the glaciers to chilly-yet-cozy little Homer, Alaska. And the whole trip turned out fine -- to keep my son calm, I found myself affecting a calm attitude even when I didn't feel it. And my "message," or whatever it was, was right. I did it all With Love and Without Fear. It wasn't easy, but we managed. Even bedtimes away from home (which I was dreading without husbandly assistance) went smoothly, with the substantial assistance of my loving and fearless sister who enjoyed the moments of snuggling her sleepy nephew while I enjoyed emptying and loading her dishwasher. With Love, and Without Fear.
And now I'm noticing all the ways this applies to parenting. How will I cope if my son screams and hits when I'm running late to work and straining to buckle him in the carseat? With love, and without fear. How could I ever manage another pregnancy and childbirth? With love, and without fear. How will we get him to sleep tonight? And the next night, and the next? Same answer.
I have a lot more mom-thoughts I'm trying to get down this week: one mess of ideas about "tantrums" and one about "praise." But today I'll stick with the theme: That with my son facing down the Tender, Terrific Twos, I've found tremendous strength in believing that "with love, all things are possible." And that this is ultimately enough -- no matter how much I might personally prefer "all things are easy." In my more difficult moments, I'll try to remember pressing my cheek against my son's silky blond head as we watched out the window of our little plane -- over the trees, I told him, over the mountains and above the clouds -- each of us amazed, for our own reasons, that we really can fly.
Books:
Your Two Year Old
Easy to Love, Difficult to Discipline
Unconditional Parenting
Websites:
Dr. Sears on Why Toddlers are Difficult
Crystal Lutton on Tantrums
Get off Your Butt Parenting
Wednesday, October 11, 2006
Evidence instead of Evidence
The Washington Port is reporting concerns about the use of magnesium sulfate in preventing early labor. This fascinates me for a few reasons. I was briefly monitored for possible "early labor" at 34 weeks gestation (my baby would have been born 7 weeks early). I thankfully avoided magnesium, (but got a shot of terbutaline, which is a story for a different day). At it happened, I didn't go into labor early -- in fact not until 10 past my "due date" (41 weeks 3 days, which I'm now learning is exactly average). But I ended up finding magnesium sulfate anyway, when I was diagnosed with mild pre-eclampsia.
The Post article doesn't challenge magnesium’s use to prevent seizures. But no matter why it's used, the drug's side effects still "range from highly unpleasant to lethal." I guess this doesn’t surprise me, even though no one told me this before they started pumping the Epsom Salts into my veins. I’m sure I had signed some intake paperwork that waived my right to be informed of drug dangers when something critical like a seizure (maybe, possibly, until we get your bloodwork back) might be on the line.
I can vouch that an IV of magnesium, even without a severe complication like "life-threatening pulmonary edema, in which the lungs fill with fluid," is no walk in the park. Reading the article brought it all back to me: nausea, blurred vision, headache, profound lethargy, [and] burning sensation[s]. They don't mention the mad craving for ice cream (especially acute after going without food and water for 20 hours), which can be tolerated only by playing slightly delirious games where you demand that everyone in the room help you name all 31 Flavors of Baskin Robbins Ice cream (I still can’t believe we couldn’t do it – but then we were all pretty tired).
The Post article is noteworthy for another reason: it quotes obstetricians blatantly admitting what I'm always suspcicious about -- that they are more concerned with malpractice liability than patient safety. As Dr. Michael Gallagher, a specialist in maternal-fetal medicine, or high-risk pregnancy, puts it:
It makes me wonder what Dr. Gallagher would do if all the other obstetricians jumped off the Brooklyn Bridge. Would he follow them? (Maybe if they threatened to raise his insurance premiums?) Or is this beside the point – since it’s the mothers and children, in this metaphor, being asked to line up and jump.
On the other hand, maybe all the doctors are desperate for some sensible freedom from the viscious cycle of standards and liability. It reminds me of Cass Sunstein's hockey helmet theory -- hockey players always knew they'd be safer with helmets, and wouldn't have minded wearing them. But no one wanted to be the first person to be different, so they didn't wear helmets until it became mandatory. According to Sunstein, there's no bright line between what's "rationa" (ie, evidence based medicine) and the "social norms" (how you'll be judged -- literally -- compared to all the other obstectricians). In fact, peer pressure can influence our beliefs until the "norms" become intertwined with our deepest levels of thought. It's easy to imagine this happening in medical education, where new doctors learn not just from research but from the practice, anecdotes and experience of other doctors -- even when this becomes distorted (perhaps through single a dramatic example, like a fetal death) from what what evidence-based medicine would tell us.
Things become even more distorted when we bring "patients’ wishes" into the discussion. Patients know nothing about magnesium – or any medical intervention – until their doctors tell them. And patients facing preterm labor surely pressure their providers to do whatever they can to help. But perhaps this is just another symptom of our inflated faith in what medical technology should do for us. Who’s to blame for that?
As far as the Post article goes, I did find myself touched to read that another OB/Gyn, Gary Cunningham of University of Texas Southwestern Medical Center, had the empathy to once take magnesium sulfate himself to see what it was like. "It was scary," he said. "You feel like you're burning up."
Yep, scary. A burning arm where the IV enters. Double vision, flu-like symptoms, sweating, chills and vomiting. Enough to scare a healthy, symptomless man in controlled research conditions – even scarier for a woman in labor who is fearing a premature birth. And scariest of all -- it probably doesn't help her.
Lonely places.
The Post article doesn't challenge magnesium’s use to prevent seizures. But no matter why it's used, the drug's side effects still "range from highly unpleasant to lethal." I guess this doesn’t surprise me, even though no one told me this before they started pumping the Epsom Salts into my veins. I’m sure I had signed some intake paperwork that waived my right to be informed of drug dangers when something critical like a seizure (maybe, possibly, until we get your bloodwork back) might be on the line.
I can vouch that an IV of magnesium, even without a severe complication like "life-threatening pulmonary edema, in which the lungs fill with fluid," is no walk in the park. Reading the article brought it all back to me: nausea, blurred vision, headache, profound lethargy, [and] burning sensation[s]. They don't mention the mad craving for ice cream (especially acute after going without food and water for 20 hours), which can be tolerated only by playing slightly delirious games where you demand that everyone in the room help you name all 31 Flavors of Baskin Robbins Ice cream (I still can’t believe we couldn’t do it – but then we were all pretty tired).
The Post article is noteworthy for another reason: it quotes obstetricians blatantly admitting what I'm always suspcicious about -- that they are more concerned with malpractice liability than patient safety. As Dr. Michael Gallagher, a specialist in maternal-fetal medicine, or high-risk pregnancy, puts it:
. . . jettisoning a long-standing practice [magnesium for preterm labor] in obstetrics involves factors other than evidence, some doctors say. They note that the standard of care -- a benchmark of evidence in malpractice cases -- as well as patients' wishes and the desire to prevent a bad outcome such as premature birth -- all contribute to continued use of the drug . . . "Suppose we don't use it [to stop pre-term labor] and a patient delivers [early and the baby dies]," Gallagher said, noting that might violate the prevailing standard among OB-GYNs. "You find yourself in lonely places."Oh, those lonely places. So even when the hard, scientific evidence casts doubt on a drug’s safety and effectiveness, the "standard of care" still won't change because each doctor is afraid to stand out from the crowd. They're more concerned with the potential "evidence" that might be brought against them in a malpractice lawsuit -- the testimony of trial experts who tell a jury what "all the other doctors do." They are safe from liability as long as they act consistently with each other -- as long as they all do the same thing -- regardless of whether it protects patients.
It makes me wonder what Dr. Gallagher would do if all the other obstetricians jumped off the Brooklyn Bridge. Would he follow them? (Maybe if they threatened to raise his insurance premiums?) Or is this beside the point – since it’s the mothers and children, in this metaphor, being asked to line up and jump.
On the other hand, maybe all the doctors are desperate for some sensible freedom from the viscious cycle of standards and liability. It reminds me of Cass Sunstein's hockey helmet theory -- hockey players always knew they'd be safer with helmets, and wouldn't have minded wearing them. But no one wanted to be the first person to be different, so they didn't wear helmets until it became mandatory. According to Sunstein, there's no bright line between what's "rationa" (ie, evidence based medicine) and the "social norms" (how you'll be judged -- literally -- compared to all the other obstectricians). In fact, peer pressure can influence our beliefs until the "norms" become intertwined with our deepest levels of thought. It's easy to imagine this happening in medical education, where new doctors learn not just from research but from the practice, anecdotes and experience of other doctors -- even when this becomes distorted (perhaps through single a dramatic example, like a fetal death) from what what evidence-based medicine would tell us.
Things become even more distorted when we bring "patients’ wishes" into the discussion. Patients know nothing about magnesium – or any medical intervention – until their doctors tell them. And patients facing preterm labor surely pressure their providers to do whatever they can to help. But perhaps this is just another symptom of our inflated faith in what medical technology should do for us. Who’s to blame for that?
As far as the Post article goes, I did find myself touched to read that another OB/Gyn, Gary Cunningham of University of Texas Southwestern Medical Center, had the empathy to once take magnesium sulfate himself to see what it was like. "It was scary," he said. "You feel like you're burning up."
Yep, scary. A burning arm where the IV enters. Double vision, flu-like symptoms, sweating, chills and vomiting. Enough to scare a healthy, symptomless man in controlled research conditions – even scarier for a woman in labor who is fearing a premature birth. And scariest of all -- it probably doesn't help her.
Lonely places.
Tuesday, October 10, 2006
Simplify a Change of Season
For some reason I was charmed to read yesterday that more parents are becoming open to large families. I grew up in a family of 6, but have never had any particular conviction about the "right" family size. In fact, I'm pretty noncommital about the whole thing -- especially when it comes to deciding when to have more children of my own. For some reason, I find it reassuring to read of contemporary, urban professionals expecting another child (their sixth) with a warm "why not?"
A family larger than four (mom, dad, two kids) is virtually unheard of in my circles. All the lawyers I know have a pair of children, almost as if they order a stair-stepped "Zach and Molly" set from the American Girl catalog. Families with three or more kids seem to have suffered some unexpected accident (an older lawyer, whose second pregnancy led to twin daughters, told me that women lawyers tend to have more twins "because we're OLD.") Obviously, busy city people like us have limited time, money and real estate -- as well as goals for career, travel and personal achievement to pursue when our children are grown. But the logistical considerations aren't enough to describe the small-family epidemic among professionals. It makes me wonder what we've convinced ourselves of, and what we might be missing.
Why not have children? It’s such a refreshing question. My parents had four children because they didn't want five. Yet I've always had to ask myself all the hard questions: Why have children? How many? When? I understand all too well the burdens of adding more people to the family. And it's our responsibility to decide to have children (right?) Yet no matter how I put my mind to it, my intellectual and intuitive capacities have failed to guide me.
How do I know I'm ready to have a child? I think that women of my generation, along with our powerful right to control our own reproductive destinies, feel an acute responsibility to determine, rationally, when to have each child. If our careers or finances are not in order, we are to use artificial contraception until we are ready. This is true even of women who are fully capable supporting whatever children they have. When women expose their fertility to chance, they're perceived as sloppy, even negligent -- Britney Spears being a recent example of this.
The concept of "birth control" promises more than it can deliver. Having babies is both mundane and mystical. It's not a simple matter of ordering up Zach or Molly for a scheduled delivery date. These little people, running around your house yelling about bananas and tipping over the dog's water, are an obvious yet enigmatic result of our biological and social sex lives. Conception is a curious alchemy of physiology and intimacy. It can happen in an accidental instant, or it can evade months of concerted effort. Yet I'm asked, and ask myself -- How did we decide to have this baby? When will we have more?
In other times and places in global history, parents have had far less luxury and leisure time to dedicate to their families. But here, in our relatively wealthy culture, it's socially acceptable to have children only at an appropriate time: Planned Parenthood, for example, supports individuals "to have children when and if they are ready." The idea of "reproductive self-determination" (intended to describe our fundamental privacy rights) can pressure us to "determine" each and every choice we make. Each day, each month. And who decides when we’re "ready" to have a child? I just reviewed Planned Parenthood’s "readiness" checklist and learned that I've got a ways to go before I'm ready (I still need to "come to terms with my own childhood experience," and "cope with tighter budgets"). And my son turns two next month.
This dilemma isn't just for pregnant teens who suffer problems of domestic violence and drug abuse. There's no "them" and "us." More mothers than I can count – women I admire and consider mentors if not role models – originally became parents in difficult or accidental circumstances. And many of us -– financially stable, established, deliberate parents –- jump confidently into the cold water of motherhood only to flounder, overwhelmed, in its cold, black depths. We're a continuum of women, from young to old, conflicted by our desires, our means, and cultural messages about what is expected of us. How much of successful parenting is maturity and preparation, and how much is inherent to our character? How much is luck?
Of course, this implicates religion, too. Yesterday Pope Benedict XVI exhorted Catholic families to be missionaries of love and life (which I like). Protestant fundamentalists, while less doctrinal about contraception, often describe themselves as "quiverfull" (from Psalm 127) in giving their family planning over to God. It's easy for the secular mainstream to dismiss these kind of "open to life" attitudes as irresponsible or even oppressive. But it's not that family is a religious issue – it's that family is important. In any paradigm, our fertility is a critical – even sacred – part of who we are as people, both individually and in relationships. If faith deals with anything relevant to our human experience, it must speak to families and the mystery of new life. And maybe the underlying value of fertility, if not the exact paradigm, is an important one for our culture to keep hold of.
When faced with the question of having children, I haven't found any analytical framework much more useful than religious doctrine. No matter how I calculate the months, the hours, the dollars and the square footage that would be required by another child, I'm left feeling less capable than when I began. With all due respect to Planned Parenthood, maybe there is no "ready" to have a child (although there is surely a category of "not ready," perhaps that's less obvious than we think).
So I wonder if a pregnancy is something I can "decide" on at all. I don't believe in fate or think my family size is preordainted. But I still don't understand how much control I have over it all. And even if I have another "well-timed" pregnancy, the entire process is a cascade of growth and change over which I have little direct control. When our modern reliance on technical management of gestation and birth has resulted in so much risk and pain, it makes me wonder. What would happen if we just let go? What if our "reproductive self-determination" is a determination to set down the calculators and calendars, and live our lives as they come to us?
Why not?
A family larger than four (mom, dad, two kids) is virtually unheard of in my circles. All the lawyers I know have a pair of children, almost as if they order a stair-stepped "Zach and Molly" set from the American Girl catalog. Families with three or more kids seem to have suffered some unexpected accident (an older lawyer, whose second pregnancy led to twin daughters, told me that women lawyers tend to have more twins "because we're OLD.") Obviously, busy city people like us have limited time, money and real estate -- as well as goals for career, travel and personal achievement to pursue when our children are grown. But the logistical considerations aren't enough to describe the small-family epidemic among professionals. It makes me wonder what we've convinced ourselves of, and what we might be missing.
Why not have children? It’s such a refreshing question. My parents had four children because they didn't want five. Yet I've always had to ask myself all the hard questions: Why have children? How many? When? I understand all too well the burdens of adding more people to the family. And it's our responsibility to decide to have children (right?) Yet no matter how I put my mind to it, my intellectual and intuitive capacities have failed to guide me.
How do I know I'm ready to have a child? I think that women of my generation, along with our powerful right to control our own reproductive destinies, feel an acute responsibility to determine, rationally, when to have each child. If our careers or finances are not in order, we are to use artificial contraception until we are ready. This is true even of women who are fully capable supporting whatever children they have. When women expose their fertility to chance, they're perceived as sloppy, even negligent -- Britney Spears being a recent example of this.
The concept of "birth control" promises more than it can deliver. Having babies is both mundane and mystical. It's not a simple matter of ordering up Zach or Molly for a scheduled delivery date. These little people, running around your house yelling about bananas and tipping over the dog's water, are an obvious yet enigmatic result of our biological and social sex lives. Conception is a curious alchemy of physiology and intimacy. It can happen in an accidental instant, or it can evade months of concerted effort. Yet I'm asked, and ask myself -- How did we decide to have this baby? When will we have more?
In other times and places in global history, parents have had far less luxury and leisure time to dedicate to their families. But here, in our relatively wealthy culture, it's socially acceptable to have children only at an appropriate time: Planned Parenthood, for example, supports individuals "to have children when and if they are ready." The idea of "reproductive self-determination" (intended to describe our fundamental privacy rights) can pressure us to "determine" each and every choice we make. Each day, each month. And who decides when we’re "ready" to have a child? I just reviewed Planned Parenthood’s "readiness" checklist and learned that I've got a ways to go before I'm ready (I still need to "come to terms with my own childhood experience," and "cope with tighter budgets"). And my son turns two next month.
This dilemma isn't just for pregnant teens who suffer problems of domestic violence and drug abuse. There's no "them" and "us." More mothers than I can count – women I admire and consider mentors if not role models – originally became parents in difficult or accidental circumstances. And many of us -– financially stable, established, deliberate parents –- jump confidently into the cold water of motherhood only to flounder, overwhelmed, in its cold, black depths. We're a continuum of women, from young to old, conflicted by our desires, our means, and cultural messages about what is expected of us. How much of successful parenting is maturity and preparation, and how much is inherent to our character? How much is luck?
Of course, this implicates religion, too. Yesterday Pope Benedict XVI exhorted Catholic families to be missionaries of love and life (which I like). Protestant fundamentalists, while less doctrinal about contraception, often describe themselves as "quiverfull" (from Psalm 127) in giving their family planning over to God. It's easy for the secular mainstream to dismiss these kind of "open to life" attitudes as irresponsible or even oppressive. But it's not that family is a religious issue – it's that family is important. In any paradigm, our fertility is a critical – even sacred – part of who we are as people, both individually and in relationships. If faith deals with anything relevant to our human experience, it must speak to families and the mystery of new life. And maybe the underlying value of fertility, if not the exact paradigm, is an important one for our culture to keep hold of.
When faced with the question of having children, I haven't found any analytical framework much more useful than religious doctrine. No matter how I calculate the months, the hours, the dollars and the square footage that would be required by another child, I'm left feeling less capable than when I began. With all due respect to Planned Parenthood, maybe there is no "ready" to have a child (although there is surely a category of "not ready," perhaps that's less obvious than we think).
So I wonder if a pregnancy is something I can "decide" on at all. I don't believe in fate or think my family size is preordainted. But I still don't understand how much control I have over it all. And even if I have another "well-timed" pregnancy, the entire process is a cascade of growth and change over which I have little direct control. When our modern reliance on technical management of gestation and birth has resulted in so much risk and pain, it makes me wonder. What would happen if we just let go? What if our "reproductive self-determination" is a determination to set down the calculators and calendars, and live our lives as they come to us?
Why not?
How can you have too many children? That's like having too many flowers -- Mother Theresa
Wednesday, October 04, 2006
Yes, more of this
I wrote a letter to the Editor of the New Yorker today:
For Publication
Editor:
Atul Gawande's article about birth and modern medicine raises the bar for birth journalism -- his historical treatment and surgical descriptions are eye-opening -- but I find myself deeply disappointed by the ending of Elizabeth Rourke’s story. Dr. Rourke’s misery and debilitation following her cesarean section were not “stupid feelings.” As one of the many women who suffer from what Gawande calls medicine’s "tyranny" against birthing mothers, I observe that mixed feelings after a cesarean, while varied and intimate, are far from stupid. The pain of women like me– from IV bruises and infections, from confusion and anxiety – is real, even if it is usually invisible to institutional healthcare.
It’s not just medicine that lets us down. It’s our culture and community – often other mothers like Rourke – sending the constant message that all that matters about birth is a healthy baby. As if, were our child only “gorgeous” enough, our gratitude only deep enough, then we could ignore these “stupid feelings” of pain and regret. Like all mothers, I value my healthy son more than my very life. But I’m not alone in grieving a birth I never knew I wanted (I being one who yelled for my epidural before I had my shoes off) until it was lost.
When the most recent evidence (perhaps published after fact-checking for this issue) suggests that cesareans nearly triple the risk of maternal and neonatal death, the damage we face is not just sentimental. The prevalence of cesarean delivery is threatening every doctor’s ability to treat patients and every woman’s right to choose the safest birth for herself and her family. Only with accurate information, and honest emotional support, will this begin to change.
Robin Grace
Member, International Cesarean Awareness Network (ICAN)
For Publication
Editor:
Atul Gawande's article about birth and modern medicine raises the bar for birth journalism -- his historical treatment and surgical descriptions are eye-opening -- but I find myself deeply disappointed by the ending of Elizabeth Rourke’s story. Dr. Rourke’s misery and debilitation following her cesarean section were not “stupid feelings.” As one of the many women who suffer from what Gawande calls medicine’s "tyranny" against birthing mothers, I observe that mixed feelings after a cesarean, while varied and intimate, are far from stupid. The pain of women like me– from IV bruises and infections, from confusion and anxiety – is real, even if it is usually invisible to institutional healthcare.
It’s not just medicine that lets us down. It’s our culture and community – often other mothers like Rourke – sending the constant message that all that matters about birth is a healthy baby. As if, were our child only “gorgeous” enough, our gratitude only deep enough, then we could ignore these “stupid feelings” of pain and regret. Like all mothers, I value my healthy son more than my very life. But I’m not alone in grieving a birth I never knew I wanted (I being one who yelled for my epidural before I had my shoes off) until it was lost.
When the most recent evidence (perhaps published after fact-checking for this issue) suggests that cesareans nearly triple the risk of maternal and neonatal death, the damage we face is not just sentimental. The prevalence of cesarean delivery is threatening every doctor’s ability to treat patients and every woman’s right to choose the safest birth for herself and her family. Only with accurate information, and honest emotional support, will this begin to change.
Robin Grace
Member, International Cesarean Awareness Network (ICAN)
Wednesday, September 27, 2006
The Wretched Refuse of Your Teeming Church/State Paradigm
Lou Dobbs writes today on Keeping Religion Out of Politics. He's apparently getting some hinky feeling about houses of worship violating Federal tax laws (which prohibit endorsing or opposing candidates). This I get; I don't want my church to be a cog in a political machine. That's an important moral issue, and not just because it affects Mr. Dobbs' precious tax dollars (in the macroeconomic sense that he's ultimately affected by my church's tax-exempt status).
But Dobbs gives only one example -- the Mormons "helping a pro-amnesty incumbent with a get out the vote campaign," where a church is accused of supporting a particular candidate. His argument is much broader: No religious organization, apparently, should participate in any activity within what he has deemed as a "political" sphere. He mentions that the IRS has dozens of investigations underway, and snarks that, "apparently nobody in the federal government is too concerned that the Catholic Church has repeatedly lobbied on behalf of millions of illegal aliens and their supporters for wholesale amnesty and open borders." And he says it's "time for all of us to examine closely, both in our communities and in our Congress, just what separation of church and state really means to us and to the nation."
Okay, I've examined it. How about this, Lou? Keep your politics off my immigration issues. Maybe the reason "nobody in the federal government is too concerned" here is because you're wrong.
This is my religion: "for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me…. Truly I tell you, just as you did it to one of the least of my people, you did it to me." Jesus Christ. Immigration isn't just a footnote to Christianity; it is one of its core themes and defining values. What kind of government would deny me my right to study this in a Bible group, announce it to my fellow parishioners, and minister to immigrant peoples? On what theory does my personal religious practice become a government "establishment" of religion to the extent that my own right to free exercise -- in fact to free speech, to free assembly, to free press -- can be abridged?
I'd say "we were here first" -- that immigration has been a religious issue far longer than it's been a political one -- but that buys into Dobbs' polarization of "Church" and "State" as two institutional spheres that should never influence each other. But "religion" isn't simply an institution. Religion is a paradigm; a set of values; a defining premise that guides the lives of individual men and women of faith. Whether these people meet in a church or synagogue, worship their God by name, or pray together or separately -- their faith is an innermost, private process of the human heart. Likewise, "politics" isn't a disembodied activity that occurs only in campaigning, in voting, in the activities of our legislature and judiciary. "Politics" are the very processes by which we argue, buy, discuss, read and spend according to what is most important to us. Political process and religion perspective are each part of all of us. How can one be ever kept wholly distinct from the other?
Yes, I hold the establishment clause as dearly as I hold my right to free exercise. But telling my parish to stay silent in the face of massive social oppression, as if we must shut up and stick to singing Kumbaya on Sundays, is unconscionable. If immigration is political, it's because of the way our government uses its economic and military power to control its borders and deny its privileges of citizenship to outsiders. This threatens the life and safety of the thousands of men, women and children who their lives for a chance to come join (and be exploited by) our society. This is a tragedy and an epidemic. And if my heart and soul tell me not to look away -- to help, to reform, to fight the tragedy -- does it matter that this particular heart is informed by a particular faith? It cannot.
But Dobbs gives only one example -- the Mormons "helping a pro-amnesty incumbent with a get out the vote campaign," where a church is accused of supporting a particular candidate. His argument is much broader: No religious organization, apparently, should participate in any activity within what he has deemed as a "political" sphere. He mentions that the IRS has dozens of investigations underway, and snarks that, "apparently nobody in the federal government is too concerned that the Catholic Church has repeatedly lobbied on behalf of millions of illegal aliens and their supporters for wholesale amnesty and open borders." And he says it's "time for all of us to examine closely, both in our communities and in our Congress, just what separation of church and state really means to us and to the nation."
Okay, I've examined it. How about this, Lou? Keep your politics off my immigration issues. Maybe the reason "nobody in the federal government is too concerned" here is because you're wrong.
This is my religion: "for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me…. Truly I tell you, just as you did it to one of the least of my people, you did it to me." Jesus Christ. Immigration isn't just a footnote to Christianity; it is one of its core themes and defining values. What kind of government would deny me my right to study this in a Bible group, announce it to my fellow parishioners, and minister to immigrant peoples? On what theory does my personal religious practice become a government "establishment" of religion to the extent that my own right to free exercise -- in fact to free speech, to free assembly, to free press -- can be abridged?
I'd say "we were here first" -- that immigration has been a religious issue far longer than it's been a political one -- but that buys into Dobbs' polarization of "Church" and "State" as two institutional spheres that should never influence each other. But "religion" isn't simply an institution. Religion is a paradigm; a set of values; a defining premise that guides the lives of individual men and women of faith. Whether these people meet in a church or synagogue, worship their God by name, or pray together or separately -- their faith is an innermost, private process of the human heart. Likewise, "politics" isn't a disembodied activity that occurs only in campaigning, in voting, in the activities of our legislature and judiciary. "Politics" are the very processes by which we argue, buy, discuss, read and spend according to what is most important to us. Political process and religion perspective are each part of all of us. How can one be ever kept wholly distinct from the other?
Yes, I hold the establishment clause as dearly as I hold my right to free exercise. But telling my parish to stay silent in the face of massive social oppression, as if we must shut up and stick to singing Kumbaya on Sundays, is unconscionable. If immigration is political, it's because of the way our government uses its economic and military power to control its borders and deny its privileges of citizenship to outsiders. This threatens the life and safety of the thousands of men, women and children who their lives for a chance to come join (and be exploited by) our society. This is a tragedy and an epidemic. And if my heart and soul tell me not to look away -- to help, to reform, to fight the tragedy -- does it matter that this particular heart is informed by a particular faith? It cannot.
Give me your tired, your poor
Your huddled masses yearning to breathe free
The wretched refuse of your teeming shore
Send these, the homeless tempest-tossed to me
I lift my lamp beside the golden door.
Inscription on the Statue of Liberty
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