Monday, March 22, 2010

Happy anniversary to me!

The title says it all. Today we are married six years! In six years we have had 3 kids and lived in 2 different countries - well really two different continents to be exact. So if you are reading this, dear husband (and I know you do ever so often), a very public happy anniversary to you :) I am looking forward to sharing many more years of laughter, joy and blessings together.

Sunday, March 21, 2010

The tale of the stroller

Living in Manhattan with three little children, I rely heavily on my stroller as a mode of transportation. We joke around that they are like our cars- outfitted with shocks, breaks and top of the line amenities. In truth, we have quite a few strollers (I won't say how many) but the one I use the most is the Baby Jogger City Mini Double Stroller with a buggy board attached in the back. If this sounds like greek to you, you must not have any children yet :)
Yesterday, as I was walking home from the park with my kids, I heard a funny sound and saw a wheel on the ground. I thought it looked awfully familiar and as I looked down at my stroller, I realized it was my front wheel and that it had just popped off! I quickly picked it up and ordered my kids to get out of the stroller. I didn't want to learn what happens when you push a stroller with only three working wheels. Thankfully Baby M was home so the older two could walk, although they were not happy about it. Thus began a very long walk home, punctuated by complaints and attempts to climb back into the stroller.
My doorman thought the problem was easily fixed but I did not have time to do it then, as the kids were cranky and hungry. After attempting to take the kids out with a single stroller on Sunday morning, I realized that I needed to get my other stroller fixed ASAP. I asked my doorman if he would do it and he said to bring it down so he could take a look at it. As I got in the elevator, my neighbor asked why I was taking an empty stroller downstairs. I showed him the wheel that had come off. He took a look at it and said, 'Oh, I can do that no problem." And he did. When we got downstairs, he turned the stroller on its side and within 5 minutes, had the wheel back on, good as new. I was thoroughly impressed and relieved-and I did not even have to tip him! So that's the happy ending to my story. My stroller is back in one piece and I am a happy but tired mommy.

Saturday, March 20, 2010

book suggestions

I just received my copy of DONA International's quarterly magazine, and in it there was an interesting article with book recommendations for clients. It was quite an extensive list but it made me think about what books I would (and often do) recommend to clients.
Here are my top three, not ranked in any particular order:
1) The Birth Partner by Penny Simkin. A great overview of the different stages of labor and appropriate comfort measures at each stage. Simkin also explains some common complications that may come up and suggestions of how to handle them. As an aside, Simkin also has a great book called Pregnancy, Childbirth and the Newborn that (as the title suggests) also covers the topic of pregnancy and initial newborn care.
2) Speaking of newborn care, The Nursing Mother's Companion by Kathleen Huggins is a great resource and reference book about breastfeeding. It is very thorough and goes all the way from initial latch, building up a supply and engorgement to issues related to weaning. She answers common questions and concerns that may come up such as when to introduce a bottle and what medications are safe for breastfeeding. While the book does not replace the advice of a lactation consultant, it does address many important issues and it's a great book to have on hand.
3) Lastly, a Jewish spin on childbirth- A Labor of Love by Rachel Broncher. This book, written from the perspective of an orthodox childbirth educator goes through a lot of the general material- pregnancy, childbirth, initial breastfeeding- but also injects a religious voice into the book. She discusses the religious significance of pregnancy and mothering and mentions some of the relevant Jewish laws related to childbirth.
Mrs. Broncher is a yoga instructor (full disclosure-she was my prenatal yoga teacher when I lived in Israel) and so she incorporates a lot of information about the power of breath during labor. She has a fantastic chapter about nutrition and healthy diet, as well as a supplementary audio CD of guided relaxation and deep breathing to help prepare for labor.
Obviously there are many more fabulous books, but here are some initial suggestions.
I think it is so important for women to be educated and to have all the relevant information so they can make good decisions for themselves and their baby. That is why I encourage women to read as much as possible. I would be happy to recommend other books to anyone who is interested. Let me know.

Tuesday, March 16, 2010

I'm still here

I've been quiet this past week. Just trying to catch up on a million things and clean for passover.
There is a lot going on with Y and his schooling. His IEP meeting is next week, so we are trying to formulate some sort of plan. We are applying to some programs and checking out a few more. It's March already and I feel like I am always a step behind, despite my best efforts to stay on top of things. Then I make the mistake of speaking to the "supermom" who has everything figured out. She has lawyers, educational consultants and has seen every program that exists in NYC. She knows how to develop an IEP and what her kid's IQ is. I feel overwhelmed and want to go hide. My husband reminds me that this woman is about 15 years older than me and has a background in law. Maybe that will be me 10 years from now, giving advice to the newbies still trying to figure out the system.
I guess it's a good thing that things have been quiet on the doula front this past month or so. But I have been getting some inquiries for May and beyond, so I am hoping things will pick up again after Passover.

Wednesday, March 10, 2010

Girl's Night Out

Last night my closest friend drove into the city to hang out with me and make sure I am not too lonely. We went out to dinner at a cute cafe and had a great time. Although we talk (and text and email) almost every day, it's usually in 10 minute increments that are often interrupted by children's requests, misbehaviors or tantrums. It was so nice to just spend quality uninterrupted time with a quality person and wax philosophically about the meaning of life :) Well not quite the meaning of life but things like parenting, marriage, and religious values; all the fun stuff we are continuously working on.
Every time we get together sans kids, we talk about doing it again soon. Usually it takes about six months but that's okay. We always get our act together eventually.
We are slowly heading for Friday and while the week has thankfully been smooth and uneventful, I am definitely looking forward to some adult company and the end of this solo parenting stint.

Tuesday, March 9, 2010

ICAN's VBAC blog carnival

ICAN (International Cesarean Awareness Network)is having their first ever blog carnival where they link to birth professional's blog posts on VBAC.
I know not everyone is as fascinated with VBAC as I am, but it's worth a look. There are a lot of different perspectives mentioned. Plus, yours truly is one of the contributors too.
Check it out

Sunday, March 7, 2010

The Specials

Last night when I was checking out some down syndrome blogs, I came across this website for a reality series called The Specials. It's a series about 5 young adults in their early 20s with developmental delays living in their own home in England with a support staff supervising them. Basically an assisted living facility.
It is kind of cool to see them living their day to day life- doing laundry, going to school or going out to a nightclub like everyone else. What I did not like so much was that the emphasis of the series was mostly on boy-girl issues: who likes who, who wants to date who. On the one hand it is nice to validate that people with down syndrome have feelings just like anybody else and can have crushes, feel lonely, etc. On the other hand, is that the only issue these men and women are dealing with? There must be a bit more to their life, don't you think?
I'll let you see for yourself. Here is a clip of one of the episodes. It's only about 10 minutes long. I am wondering if they will continue this series for another season.

The Specials - Episode 1 from KADA Films on Vimeo.

Saturday, March 6, 2010

Solo parenting for a week

As I am writing this post, my husband is on his way to the airport to catch a flight to Israel. He will be back Friday morning, which leaves me alone with my three wonderful and high-energy kids for 5 whole days.
Part of me is just really jealous. Most of my family lives in Israel and we try to visit at least once a year. It seems kind of unfair that he will be having a little reunion dinner with my siblings without me. But I am also really happy for him. He is going for work so he will be really busy, but it will also be a nice break for him and a chance to reconnect with family and friends. And just be in Israel. Anyone who has been there understands what I mean.
As I mentioned, my family is in Israel and Europe so it's just me and the kiddos. And whatever babysitting help I decide to get. The truth is that my husband is a pretty busy guy and I don't really depend on him for much in terms of childcare during the week. Sunday is our family day but other than that I have the wake up-get dressed-school-after school activity-dinner-bath-bedtime routine pretty much down pat. It's more the adult company and conversation that I miss. Talking to 4, 3 and 1 year olds all day can make you feel like you are losing your mind at some point. The apartment is also really quiet at night and there is noone to ask to change a diaper or get a 2am water bottle for a screaming child.
What I usually end up doing when my husband is away is pampering myself a bit more. Ordering take out for dinner if I am not in the mood to cook, getting a babysitter to go out one night, etc. Whatever it takes to make things a bit easier and to stay calm.
And I make him call me at least twice a day for an extended phone conversation/chance to vent about everything going on on this side of the ocean.
Tomorrow is really the hardest day because it's Sunday and I have to figure out a way to entertain everybody for a full day. Fortunately the weather is supposed to be nice so the plan is to go to the park and tire everybody out. Once we get back to our school schedule, we should be fine. I'll post updates as the week progresses. Shavua tov!

Thursday, March 4, 2010

VBAC- a vital option

In anticipation of the National Institue of Health's policy conference on VBAC next week and ICAN's blog carnival on this topic, I wanted to share some thoughts on VBAC.
For the uninitiated, VBAC stands for Vaginal Birth After Caserean. It is a subject that is near and dear to my heart, not just because I am a doula but because I have had two successful VBACs myself.
The question posed is, why is VBAC a vital option. To my mind, the more important question may be- how can VBAC not be an option for so many women? How can we be limiting women in the size of their families, subjecting them to major abdominal surgery and depriving them of the life-changing opportunity to find their own inner strength? All this is done in the name of safety although it is not so clear that a Cesarean is a safer option than a VBAC.
Let's start at the beginning. The main risk to VBACs is that of uterine rupture. Although there are differing numbers, the risk is usually thought to be 1 in 100. That may seem like a high risk for someone to take, but consider these factors and risks associated with cesarean sections- higher rates of infant and maternal mortality, risks of infection, double the bloodloss of a vaginal birth, complications such as adhesions to scar tissue as well as the life threatening complications of placenta previa, accreta or percreta in following pregnancies.
Not to mention that the baby is subjected to drugs during the surgery, there is a delay in mother-infant bonding, and cesareans are associated with greater difficulties establishing breastfeeding. Additionally, the more difficult recovery can affect the mother's ability to care for her newborn.
I was fortunate to have had my first VBAC in Israel, a country where doctors are more open to VBACs in general. The large orthodox Jewish population who aspire to big families has motivated doctors to shy away from automatic repeat cesareans. While he did insist on the protocol of continuous monitoring, I felt confident that my care provider was committed to my VBAC and I indeed had a wonderful experience.
Once I moved to the US, a different picture started to emerge. Because of my husband's pastoral involvements, I was privileged to be part of many life cycle events, particularly celebrations of births. Over and over I would hear the same stories- primary cesareans for failure to progress, botched inductions and twins. Repeat cesareans because the doctor convinced the woman that the risks of VBACs were just too great, whereas the risks of cesarean where virtually non-existent (untruth #1). Additionally, they would often question a woman's ability to birth vaginally, thereby destroying any confidence she may have had in her body (untruth #2).
Women who had already scheduled their sections were told to come to the hospital if by chance they went into labor because their uterus may burst any minute (untruth #3).
If, for whatever reason a woman was allowed a trial of labor, she often did not get very far before a cesarean was recommended. During these surgeries, the doctors would often say how fortunate it was that a c-section was performed because they could see that the uterus would not have withstood the "stress" of labor and delivery. How doctors could make such claims I still do not know (untruth #4).
When I was expecting my third child I was determined to find a care provider who supported my desire for a VBAC. I was not interested in becoming another statistic.
I had a wonderful experience and I felt greatful and empowered. I was also aware that my positive birth experiences are a product of the choices I made- to educate myself, to know my options and advocate for myself.
That is part of what is missing in our maternity care- women don't know what their options are. They do not know what questions to ask and although they consent to procedures performed on them, it is not informed consent because they often do not understand the risks involved and do not know that there are alternatives.
It is unfortunate that there are many places where a woman cannot try for a VBAC because the hospital policy does not allow for it. The fear of litigations and the constraints of malpractice insurance have created some difficult scenarios for careproviders and pregnant women alike.
I am curious to hear what the outcome of the NIH conference will be. VBAC is a vital option because it is a viable option for the vast majority of women, if we would only believe in them and give them the tools to succeed.

Wednesday, March 3, 2010


I was so busy with sick children and Purim that I did not have the time to post about my training in Hypnobirthing that I attended almost two weeks ago.
The instructor, Jenny West, was a homebirth midwife from Alberquerque, New Mexico. The students were all Orthodox women. It was a very interesting meeting of cultures.
Jenny explained that when most people hear the word hypnosis, they conjure up images of people doing embaressing things on TV shows because they were under the "spell" of some hypnotist. In truth, hypnosis is really just a state of deep relaxation. While a person can be deeply relaxed, they are still aware of their surroundings and will only do things they feel comfortable doing.
The premise of hypnobirthing is really for a woman to be able to achieve a state of relaxation that she can maintain throughout her labor even as it intensifies. Once you take away the fear of pain and take the focus away from the contractions, there is virtually no pain, just an awareness of sensations in your body.
Another big tenet of hypnobirthing is that your beliefs will shape your experience. That is why there are certain positive affirmations women are encouraged to read several times a week, in order to truly internalize these messages. For example "Birth is a natural, normal and healthy human experience. Women's bodies are created to conceive, nurture the development of babies and to birth. Their bodies are not flawed and destined to malfunction..."
Hypnobirthing practitioners also encourage women to replace the medicalized language with terms that they perceive to be gentler and less harsh. They replace the word "contraction" with "uterine surge/wave" and instead of "pushing" call it "birth breathing". Initially I was skeptical about this change in terminology. It just seemed like semantics and an attempt to romanticize things. The more I thought about it, though, it did seem to make sense. The way we think and speak about things do shape our experiences, so it is important to really discuss birth in the most positive and affirming way.
I am not about to attempt to summarize 8 hours into one post, you can read more about Hypnobirthing on their website. For me, the course was a really interesting experience. I feel it gave me the tools to work with couples who would like to incorporate Hypnobirthing into their childbirth experience. In addition it had a lot of general valuable information that I can use in my doula practice. It also reinforced the general concept which is a key concept in my beliefs about birth- that child birth is really so connected to your mind/emotions. The way you feel about your labor, your surroundings, etc will most definitely affect your physical experience. The goal is for a woman to feel calm, comfortable and cared for- and whether she does it through a doula, hypnobirthing relaxation, massage or all of the above is irrelevant as long as she is able to get to that positive place.