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Jennifer Margulis

Mothering Outside the Lines

Don’t Take a Childbirth Class Unless You Know Who’s Really Paying the Instructor

December 29th, 2010

In the last post here at Mothering Outside the Lines we were talking about how to have an empowered labor and delivery.

You might have noticed that I did not suggest taking a childbirth class to prepare.

In her book, Misconceptions, Naomi Wolf writes about how many childbirth instructors are actually employed by hospitals. If they aren’t being paid directly (as many of them are), they are getting their clients through hospital referrals.

Instead of giving true information and really empowering first-time moms, these instructors are often regurgitating hospital policy, showing videos of women being docile and obedient in labor instead of teaching real pain management techniques.

Hint: breathing and panting and staring soulfully into your partner’s eyes all fly out the window when contractions slam your body. Primal noises, animal sounds, shrieks, cussing (”You f——g a—–e WHY DID YOU DO THIS TO ME?”), and deep moans like the ones you made while you were enjoying yourself getting the baby in there in the first place all tend to work much better.

But, as Wolf points out in her book, these fierce and empowering screams to get you through contractions are not “socially acceptable” or “publicly acceptable.”

When you’re in hospital you’re in a quasi public place. The nurses on staff, the other laboring moms and their partners and families, the doctors, the janitors, and everyone else at the hospital (like expectant couples touring the ward) will hear you if you’re managing your pain loudly.

Loud pain management = good for mom to release tension and enjoy labor.

Loud pain management = social embarrassment for all the non-laboring people who would be much happier if you would just. shut. up.

More to the point, a hospital makes much less money if you manage your own pain.

I will write that sentence again in case you were sipping your coffee and skimming: A hospital makes much less money if you manage your own pain.

Almost everyone in the hospital has a vested interest in shooting you and your emerging baby up with pain medication in the form of narcotics or an epidural. What’s wrong with that? Once you’re doped up, you’re tied down, tethered by an IV or an epidural. Which means you can’t walk around anymore, or squat, or get on all fours, or hug your helpers, or hang from their arms. But movement during labor not only helps you open up and birth your baby, it helps you manage what can otherwise feel unbearable.

Once you’re quiet and docile, chatting with your partner instead of working with your body, your baby, and your hormones, the deck is stacked against you. You’re so wired to the bed that you might as well be tethered there, as women of my mother’s generation were. Gravity is no longer on your side. A baby needs to slip under your pelvic bone but the space is now constricted because you’re lying on your back or are semi-recumbent in bed.

Some well-meaning friends gifted us a childbirth class when we were pregnant for the first time eleven years ago.

I remember the instructor’s voice often caught when she talked about her oldest child’s birth.

Since her labor wasn’t “progressing fast enough,” the hospital midwives made her stimulate her own nipples.

Rub-rub-rub. Stop. Rub-rub-rub. Stop.

But the instructor never honestly explained how she felt about that birth. Instead, she presented all the “options” that the hospital presents to laboring women. Hanging off the doctor for dear life during transition is not one of those options.

Now that I’m reading Wolf’s book as part of my larger research on how corporations and private interests are skewing the way we treat babies in utero and through the first year of life, I’m beginning to understand better why our childbirth instructor wasn’t being honest. In the hospitals in Atlanta, which is where we lived at the time, there is very little room for women to have the births they want. Instead of psychological support, I was treated with impatience and scorn during labor (Nurse who checked my dilation after more than 12 hours of excruciating active labor: “Nothing. Not even a dimple.”)

Suzanne Arms, writing in her now classic 1975 book Immaculate Deception (a book which launched a home birth movement in the United States), talks about how childbirth instructors are often part of the problem, part of a complicity of silence that keeps women transitioning into motherhood literally flat on their backs.

Unfortunately, I fear that Arms’ insight is still true today.

There are exceptions, of course. But most childbirth instructors have to be aware that they are navigating a political and financial minefield and they have to be very careful about what they say and how they say it. (This is true for midwives as well. Especially hospital midwives. Sadly, many of the midwives quoted in Naomi Wolf’s book would only talk to her off the record because they didn’t want their names to be used for fear of losing their jobs or angering their colleagues by telling the truth of how laboring women are being treated in hospitals today.)

In the community in southern Oregon where I live people pride themselves on being progressive and forward thinking. When a public panel was being put together to inform pregnant women about birthing options, one of the panel organizers wanted to invite me to speak about my unassisted childbirth. The panel included women telling the stories of Cesarean hospital births, medicated hospital births, natural hospital births, and home births with certified midwives present. I was one of three women who had unassisted births in our city in less than a year. But the committee balked. “We would not want to be seen as presenting that as an option,” a committee member said to my friend when her proposal to invite me was rejected.

One of the reasons I recommended some of the more radical books in my post on how to have an empowered birth is because if you read those books a simple home birth with trained midwives starts to seem like a straight and narrow option. It’s certainly much less radical than an unassisted home birth VBAC after three hospital C-sections (which is one of the amazing stories told in Simply Give Birth.)

You don’t need an childbirth “expert” or a panel to tell you how to have your first baby. You may get more honest answers and be better off in the long run if you do your own research.

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[ 10 comments ]

How to Have an Empowered Birth; or the Second Longest Post in the History of this Blog

December 28th, 2010

In December I visited a labor and delivery ward at a prominent hospital in Boston. There were four women in active labor while I was there. They were all young and healthy with no risk factors of any kind.

Three were having their first baby.

One was having her second.

One was a vaginal forceps delivery after the woman was given an epidural and pitocin (a synthetic hormone that mimics oxytocin and is used to intensify contractions) and had spent most of the labor and two hours pushing flat on her back, one was a vaginal delivery with a second degree tear by a woman who was also given an epidural and pitocin and who also delivered flat on her back, and two were Cesarean sections.

The doctor I was shadowing wasn’t sure why the two women—both of whom had wanted natural births—were sectioned. But she did know that neither of the C-sections were emergencies. “I think it was for failure to progress.”

I can’t stop thinking about one of those women. She was laboring happily, walking the halls with a smile on her face, her partner shuffling along behind her, stopping to buttress herself against the wall when a contraction washed over her. She looked so healthy and alive. She was so present in herself. She looked to my inexperienced eye like the last person on earth who would need to have a C-section.

With the epidemic of Cesarean operations in America today, how do you avoid an unnecessary C-section? How do you have the kind of birth you want? How can you own your own labor and delivery and trust your body and your baby so that you feel euphoric when you remember your birth experience instead of depressed and disappointed?

1. Read the right books

If you don’t want to know anything about labor and delivery until it’s your turn, it will be very hard for you to be empowered when the time comes. It’s a good idea to read up on the process.

But what you read makes a huge difference.

I recommend you, your partner, and anyone who you want to be with you while you’re in labor, read the following books, in this order:

1403533Simply Give Birth by Heather Cushman Dowdee. This is a little known collection of very empowering birth stories where the focus is on the woman and her baby and not on the birth attendant or the intervention. Many of these are stories of women who chose to have unassisted births though Cushman Dowdee did not set out to collect unassisted birth stories per se. Though some of the writing is uneven and some of the narrators might be a bit too woo-woo for you, every story is empowering.

Unassisted Childbirth by Laura Shanley. Even if you just read around in this book, you will learn so much from it. Shanley tells her own incredible birth stories (she had all of her babies unassisted. The first with four of her partner’s male friends watching!), shares birth stories by other women, and also tells about her philosophy that birth is a natural process and that laboring women should trust themselves. She talks, too, about the importance of mind over matter and of teaching yourself to think positively about the birth process instead of dwelling on fear or pain.

Childbirth Without Fear: The Principles and Practice of Natural Childbirth by Grantly Dick-Read. Though this book was written in the 1930s, it is tremendously empowering and affirming (and the book that inspired Shanley and her partner to think outside the birthing box.)

Ina May Gaskin’s Guide to Childbirth by Ina May Gaskin. This book is for both midwives and pregnant women. It includes many of the birth stories in Gaskin’s Spiritual Midwifery, as well as all of the technical details about childbirth. Though I don’t agree some of Gaskin’s approach (she and her midwives tend to interfere more than I would have been comfortable with when I was in labor), the book is a tremendously helpful, detailed, and well-written resource.

2. Mediate every day, say positive affirmations, and tell yourself that you will have a peaceful, fun, sexy labor

Next I’ll be telling you to hug trees. Thinking (if you prefer that word to the more woo-woo one) about the kind of birth you want, imagining yourself in labor, and psychologically preparing yourself to be the calm center in the eye of the storm can help tremendously. You can simply practice breathing. Breathe slowly and count each breath up to ten and then start over again. As you breathe and count imagine your body opening up, imagine the baby coming down the birth canal, imagine that you and your baby are a team working together in a dance that will change both of your lives.

3. Eat well and exercise, you’re preparing for a marathon

You wouldn’t try to complete a marathon without training first.

Being pregnant is a fantastic excuse to spend a lot of time exercising without feeling guilty that you should be _________ (fill in the blank: working more, spending time with your spouse, cleaning the house.)

Do the exercise that works for you: biking, hiking, pre-natal yoga, swimming, running, walking, dancing. You know this already but exercise really helps prepare your body for labor.

Yes, of course, you should eat well and exercise to prepare for an empowered labor. But even if you're in excellent shape, does that insure that you will not have unnecessary intervention during labor? Unfortunately, no. The best way to insure no unnecessary intervention is to have a home birth

Yes, of course, you should eat well and exercise to prepare for an empowered labor. But even if you're in excellent shape, does that insure that you will not have unnecessary intervention during labor? Unfortunately, no. The best way to insure no unnecessary intervention is to have a home birth

4. Think carefully about WHO you want at the birth

This is not a very popular opinion but honestly if your partner or your mom faint at the sight of blood and are totally panicking about you having a baby, maybe you don’t want either of them there.

Sometimes men can interfere with the labor process, especially when they bring their own fear and baggage into your space.

If you think your mother is going to miraculously morph into the attentive person you always wanted her to be while you were growing up, don’t be surprised when she’s reading a manuscript in the labor room and ignoring you completely, that’s what she’s done your whole life and it’s not going to change now just because you want it to.

Women in labor are very vulnerable to suggestion and they need to have supportive, kind, loving people to help them through every step of the birth. The father of your child can be an amazing source of strength and comfort. But in some cases he can be a hindrance. He isn’t doing you any favors if his energy is negative. Choose loving, supportive, kind, patient, experienced people to be with you. It’s also a good idea to have a friend who isn’t afraid of being your advocate if you butt heads with hospital staff.

If you don’t have close friends or relatives who have been through labor and who you want with you, hire a doula.

5. Stay out of the hospital for as long as you can (or have your baby at home)

The best way to have a safe and empowering birth is to have your baby at home. If you don’t believe me, ask Aneka, who had a safe and wonderful home birth after three hospital C-sections.

If you still don’t believe me, watch “The Business of Being Born,” the movie by Rickie Lake that made the ACOG so upset that they issued a hostile, anti-home birth statement in response.

If you’re lucky to have a birthing center nearby, have your baby there.

If a hospital is your choice:

• Forget about timing contractions and going to the hospital when they are less than five minutes apart. Don’t go to the hospital until you feel like you can’t stay on top of the contractions for one more second.

Forget about going to the hospital if your water breaks. Stay home and watch a movie. Stay home and watch two movies. Conveniently forget when your water broke and don’t tell the hospital staff how long its been. They’ll want to put you on an unnecessary timeline and also might start you on unnecessary medications and unnecessary intervention.

First time labors can last a long time, much longer than the doctor has patience for. As a first-time mother what you feel is overwhelming may actually just be early labor. The longer you labor at home the better the outcome for you and your baby.

For most women having a baby is pretty intense.

Maybe you’ll be crying out during the contractions but laughing at yourself during the lulls.

Maybe you’ll enjoy being the center of attention or be mortified by the fact that you’re defecating in front of several people (to say nothing of losing all sorts of other bodily fluids in a public forum—it happens to all of us.)

Maybe you’ll keep your romantic sentiments and tell your partner you love him or her or maybe you’ll scream, “THIS IS YOUR FAULT, YOU DID THIS TO ME AND I’LL NEVER FORGIVE YOU!”

In a rush of body fluids, a baby girl was born. The doctor put her right up on her mother’s chest. “She’s so small,” the new mom said quietly, patting the floppy baby who was lying on her tummy, her voice full of awe and exhaustion. “I’ve never seen a newborn before.”

The whole world changes the moment your baby is born. When you first look into the baby’s eyes you meet someone you’ve never seen before but have somehow known your whole life. You have a lifetime to get to know each other better. What better way to get started than owning your labor and delivery and having the birth experience you want?

The longest post (in case you’re wondering): A Daughter with Special Needs

Related posts:
Our DIY Birth
The Epidemic of Unnecessary C-sections
One Mom’s Home Birth After 3 Cesareans!

If you have children, what kind of birth experience did you have? If you are expecting, what kind of birth experience do you hope to have? Experienced moms and dads, what advice do you have for pregnant parents preparing for labor and delivery?

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[ 32 comments ]

When My Husband Saw Santa

December 24th, 2010

Athena and Hesperus by the tree and homemade ornaments during the year we lived in Niger

Athena and Hesperus by the tree with its homemade ornaments during the year we lived in West Africa

Everyone in my family believes in Santa Claus.

When James was about seven he saw Santa.

He lived with his mom in an apartment in Buffalo. They had a tree in the corner of the living room.

He went to bed very excited and happy on Christmas Eve holding a little elf ornament that he slept with every Christmas Eve on one shoulder, his blue blanket on the other.

Jimmy woke in the middle of the night. Everything was dark except the lights from the tree. He heard some kind of noise and crept out of bed to investigate.

He walked slowly down the hall.

Santa was there! His back to Jimmy, he was wearing his big red and white suit, taking presents out of a big beige sack, and putting them under the tree.

Seven-year-old Etani stops snipping little pieces of paper onto the ground, purple scissors in the air, and listens with wide eyes.

“I had the feeling you weren’t supposed to be up on Christmas Eve and seeing Santa. I thought maybe I was seeing things. Maybe it was just my mom and I mistook her for Santa. So I peeked around the corner again and saw Santa again putting the presents under the tree. I whipped my head back so he wouldn’t see me. I thought about the song that he knows when you’re sleeping and when you’re awake and worried that if Santa saw me he might take the presents away. I could hear the ornaments on the tree jingling as Santa brushed against them. I tiptoed back to bed as slowly and silently as I could. In the morning all the presents were there.”

Last year money was so tight I was really worried Santa wouldn’t come. I kept telling the kids that Santa might be in a recession, that he might have had to let some of his elves go, and that they shouldn’t be disappointed if there weren’t many presents.

When morning came there were so many presents under the tree that the kids could barely contain their excitement.

“He came Mommy!” Athena, who was eight then, cried. “You were afraid he wouldn’t come but he did! He really did!”

Money’s tight again this year but I’m not so worried. One way or another I think Santa will come through. He hasn’t failed us yet.

Note to readers: Mothering Outside the Lines will be on vacation until Tuesday, December 28th. Then we’ll be continuing our discussion of labor and birth and talking about how to have an empowered birth, whether this blog should start doing blog giveaways, and what kind of posts you readers would like to see in the new year. Come back to give your input and participate in Mothering Outside the Lines’s first ever (and only?!) giveaway. Happy holidays to all!

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[ 5 comments ]

The Epidemic of Unnecessary C-Sections

December 22nd, 2010

In my last post here at Mothering Outside the Lines I wrote about an amazing mom who decided to have a home birth to avoid a fourth C-section.

I emailed Aneka’s story to my friend Denise who still has angry, unresolved feelings about a second C-section. Denise was fully dilated and pushing when the doctor told her there was “no way” the baby would be able to slip under her pubic bone.

Any birthing woman is incredibly vulnerable. Her senses are heightened. She looks to those around her for support and love and encouragement.

What if that doctor had told Denise she was doing a good job? What if that doctor had offered her something to eat or suggested she sleep between contractions? (In her book, Ina May Gaskin’s Guide to Childbirth, Gaskin observes that women sometimes need to rest, even sleep, after transition to renew their energy to push the baby out. She also notes that food eaten at the right moment during labor can be the fuel a woman needs to rally.) What if that doctor suggested laboring on all fours? What if that doctor had just said and done nothing but stayed with Denise in an attitude of encouragement?

When your body’s working as hard as it knows how to birth a baby it can be devastating if a doctor or a nurse or a midwife tells you you aren’t doing a good enough job. Or even suggests as much with an impatient or unkind attitude.

When I was more than 15 hours into labor with my first child I was only at four centimeters dilated. Instead of encouraging me the doctor on call–the only man in the practice and the only doctor I had never met previously–told me I was being selfish and making my family suffer unnecessarily (my mom and my husband were there) and that I should think of other people and get an epideral and pitocin.

For Denise just trying for a VBAC had already been a fight. But how could that doctor have known that Denise’s baby couldn’t be born vaginally? Was the doctor subconsciously (or consciously) punishing her for having the hubris to try to do it her way? Or was the doctor just impatient for the baby to be born?

We have a C-section rate in this country that is so high that Amnesty International has issued a call to President Obama to address what they call the systemic failures in the maternal health care system in America.

Augustine Colebrook, a midwife and mother of three who has just founded a birthing center in Medford, Oregon, recently taught a childbirth class for six couples.

Three couples were planning home births.

Three were planning hospital births.

The three moms who chose to birth at home had healthy babies and no complications.

The three who chose to birth in the hospital? They all ended up having C-sections.

As Tiffany, a labor and delivery nurse, pointed out in a comment on my last post, Cesarean birth can be a life-saving intervention. It is a wonderful operation, a medical miracle that can save the life of an infant and a mom when used in a real emergency.

An impatient doctor is not an emergency.

A hospital that profits from billable hours for the operating room is not an emergency.

A previous C-section is not an emergency.

A breech baby is not an emergency. (Babies turn during labor. Vaginal breech birth done correctly, which usually means with as little intervention as possible, has been shown to be safer than major abdominal surgery for most women.)

Twins are not an emergency.

Most people don’t realize that the skyrocketing C-section rate in America has devastating ramifications.

The United States lags behind 40 countries in maternal death rates.

It’s safer to have a baby in Bosnia and Herzegovina, a country recovering from civil war, than it is to have a baby in America.

Katelyn couldn’t lift her baby for weeks after having an unplanned C-section. Her son was born 11 years ago. The operation gave her terrible gastrointestinal problems that continue to this day.

Nora’s scheduled C-section ended in weeks of anxiety. One of her baby’s lungs collapsed and he had to be helicoptered to a hospital with a NICU. “I think the doctors got the dates wrong,” she mused afterwards. A doctor herself, she hadn’t realized that the risk of not letting her body go into spontaneous labor includes premature birth.

This major abdominal surgery has many other risks: hemorrhage, infection, organ damage, scar tissue adhesions (including placental accreta, placenta increta, and placenta percreta), delayed interaction between the baby and the mom which can lead to bonding problems and breastfeeding difficulties, a longer and more painful recovery time, post surgery stress disorders, higher chance of rehospitalization, higher chance of complications in subsequent pregnancies, higher risk of respiratory problems for your baby, and more.

Let’s follow Aneka’s lead and stop the C-section epidemic in America. Isn’t it time for American women to be empowered to give birth on their own terms without unnecessary, even life-threatening, intervention?

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[ 17 comments ]

A Mom Says “No Way” to C-Section Number Four

December 20th, 2010

The safest way for a baby to be born is vaginally but the C-section rate in this country is skyrocketing. American women are starting to protest. If doctors don't let them do VBACs in the hospital, they're choosing to have their babies at home instead.

The safest way for a baby to be born is vaginally but the C-section rate in this country is skyrocketing. American women are starting to protest. If doctors don't let them do VBACs in the hospital, they're choosing to have their babies at home instead.

Last week we were talking about nursing past three and I’ve been reading through all of the comments now that Baby Leone and I are back from a hectic week in Boston. Thank you to those who weighed in on extended nursing. I’ve been fascinated to read the discussion that series started and I’m inspired by the stories everyone shared.

On the subject of inspirational stories, maybe you’ve already heard this amazing CNN story of a mom of four who didn’t show up for a scheduled C-section.

The doctors told Aneka that since she had three previous C-sections she would have to have a fourth.

When she informed the doctor she wasn’t coming in, the doctor told her she could die and her baby could die. Then the doctor hung up the phone.

Ten years ago a doctor cut into her belly because her labor wasn’t progressing fast enough.

Fast enough according to whom?

“Failure to progress” is a common reason for C-sections.

“Failure to progress” is a meaningless combination of three words that seldom makes sense in the context of human beings giving birth.

Birth is not a linear process.

Birth is not a fast process.

Often a labor slows down or even stops in the hospital because of doctor or nurse intervention.

That’s what happened during my first birth.

When we went to the hospital after my water broke the doctor on call ordered a speculum exam over the phone to confirm that my water was broken. When we refused (a simple litmus test would have sufficed), the doctor told me that I could have a ruptured bladder and that my baby would die if I did not follow her orders.

I had been contracting regularly.

After the doctor and my usually mildly mannered husband got into a screaming match on the phone, my contractions stopped altogether.

This is a body’s very smart survival mechanism.

When a laboring animal in nature feels threatened, the birth process often slows down or stops until the threat has passed.

How would a birthing bear respond if someone stuck their fingers up her yoni? (Doctors and nurses routinely “check” laboring women by putting their hands up the vagina. I don’t know about you but I find it rather inhibiting when someone I’m not married to tries to put his hands up my vagina.)

How would a through-hiker on the Appalachian Trail make it past the first three miles with nothing to eat? (In most hospitals laboring women are denied food in case they need surgery later.)

I have a friend who was in labor for forty hours. She had an unassisted home birth. If she had been in the hospital, she would have been cut open. If she had had a midwife attending her, she may have ended up in the hospital. She gave birth to a healthy 10 pound 12 ounce baby boy without any interference or problems at all.

I know of another woman who was in labor for four days. Her husband told me he was glad they were delivering at home so no one rushed them.

Labor takes a long time.

It can take such a long time I’m going to write that sentence again.

Labor takes a long time.

But hospital doctors are often in a hurry. They don’t want to sit on their hands and wait for a woman’s body to open up in the time she and her baby need.

Doctors are not trained to sit on their hands and wait.

Doctors didn’t go to medical school to sit on their hands and wait.

Doctors didn’t incur all that debt to sit on their hands and wait.

Doctors aren’t making $250,000/year to sit on their hands and wait.

Doctors are trained to intervene.

As more hospitals refuse to let women have VBACs (Vaginal Birth After Cesarean), more women who want vaginal births are choosing to have their babies at home with midwives.

That’s what Aneka did.

On December 5, after twenty hours of labor, she pushed out a perfect 9 pound 6 ounce baby boy.

Welcome to the world Baby Annan Ni’em!

Do you think Aneka is a hero who defied the medical establishment and gave birth her own way or an irresponsible risk-taker who put herself and her baby in danger by giving birth on at home?

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[ 22 comments ]

He’s Not Still Nursing, Is He? The Joys of Breastfeeding Past Three

December 17th, 2010
Tough guy Etani who nursed well past three

Tough guy Etani living in West Africa, who nursed well past three

This week we’ve been talking about extended breastfeeding at Mothering Outside the Lines. (At least I hope we have. I scheduled these posts in advance and I’m actually across the country conducting interviews for the book I’m writing. I made the bold move of leaving my computer behind. So here’s to hoping the technology has been working.) On Monday we talked about nursing past one and on Wednesday I interviewed Vanessa Lowe about her radio documentary. For the third and final installment of this series, I’m posting a story I wrote, a version of which was first published in the Ashland Daily Tidings, about nursing my then three-year-old.

He’s Not Still Nursing, Is He?!

When we sat down to dinner, my girlfriend Humaiya marveled at my son Etani, who was putting rice on his fork with his hands and then wobbling it up to his mouth.

“Look at him eat!” she cried. “He’s not still nursing, is he?!”

“I’m planning to rent a house near where he goes to college,” I joked to another friend who asked me in an exasperated voice when I was going to wean my son. “That way he can keep nursing.”

Etani turned three in October. He nurses before his mid-day nap and at bedtime. I sometimes nurse him at other times too, when he feels sad or is really overtired or overwhelmed. He settles right down, his whole body relaxes, and he sighs with deep contentment.

He doesn’t have the vocabulary to tell me in words but if he did I think he’d say that nursing makes him feel safe and protected and loved.

“That is so gross,” an editor said when I mentioned a family I was writing an article about had a nursing toddler. “If they’re old enough to ask for it, they’re too old to nurse!”

That sentiment is so often repeated that it has almost become a cliché. But why are we disgusted by the idea of a toddler nursing? When I went to visit my friend Sue’s family in Mississippi when we were in college her great aunt started talking about the black people in her town. “I let one touch me once,” Sue’s great aunt said with the same mixture of revulsion, fascination, and horror in her voice that my editor used to talk about nursing. Sue’s great aunt was disgusted by the idea of a black person touching her because it went against the social norms of her generation. Though it may not be an entirely fair comparison, I think my editor (a childless woman in her 40s) was disgusted by the idea of a two or three year old nursing because it goes against the social norms of her generation, not because there is anything empirically wrong with it.

In fact, myriad scientific studies suggest that the longer human babies nurse the healthier they become. We all know about the medical benefits of nursing, which include reduced allergies, higher IQ, protection against diseases (including ear infections, respiratory and gastrointestinal problems), better speech development, possible delayed menstruation in the mother, continued weight loss in the mother, and protection against ovarian and other forms of cancer. Today the majority of American mothers decide to try breastfeeding. In 2000, about 68% of mothers initiated breastfeeding. But most of these same women return from the hospital laden with formula samples and coupons, and, despite the fact that the American Academy of Pediatrics recommends that women continue breastfeeding for at least 12 months, the vast majority of American women stop nursing before their infant is six months old.

When my mom decided to breastfeed, the nurse in the hospital disapproved, suggesting she give her newborn formula and bottles of water. “Calves drink cow milk, lambs drink sheep milk,” my mother (a biologist) told the nurse, “my infant is going to drink human milk.” It seems hard to believe that my mother would have had to defend her choice to the medical establishment since the pendulum has swung so far the other way that today women often feel social pressure to breastfeed.

But although nursing small babies has become accepted, even expected, women who nurse their babies past infancy often feel they will be stigmatized and they tend to keep it secret.

Two of my adult friends remember being nursed. Helen, who weaned when she was four, remembers the deep sense of security, warmth, and closeness to her mother that nursing gave her. Richard, who grew up in Rwanda, a country with a high child mortality rate, nursed until he was five and was one of the healthiest children in his village. Today they are both well-adjusted, happy, healthy adults with children of their own and sweet memories of childhood.

When dinner is over and our guests leave, my son climbs onto my lap and leans back into me, tilting his head upward so our eyes meet. His are hazel with specks of green.

“Mommy, can I have some nummies?” he asks, patting my cheek with his tiny hand.

“Pajamas first,” I tell him.

He giggles happily, wiggles off my lap, and runs to get ready for bed.

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[ 49 comments ]

More on Extended Nursing: An Interview with Vanessa Lowe

December 15th, 2010
Vanessa Lowe with her son

Vanessa Lowe with her son

Our guest today on Mothering Outside the Lines is breastfeeding advocate Vanessa Lowe, who has made a documentary about extended nursing. Vanessa Lowe’s background includes a doctorate in Clinical Psychology, as well as four years as host of a radio show on KWMR (a community radio station in Point Reyes Station, CA). She’s a musician and songwriter, and has released four records, with a fifth coming out in 2011. She lives in the San Francisco Bay Area with her husband and five-year-old son. You can learn more about her radio documentary here.

Or listen to the documentary, Breastfeeding Beyond Infancy, now:

JM: Tell us about your documentary.

VL: “Breastfeeding Beyond Infancy” is an independently produced hour-long radio documentary. It features the voices of 14 women who have breastfed their children between one and four years. Some of the major topics covered include dealing with judgment and criticism, public nursing, the benefits and challenges of breastfeeding, weaning, nursing while working, and getting support. Also featured is commentary from Dr. Nigel Rollins, of the World Health Organization, Dr. Jay Gordon, a Fellow of the American Association of Pediatrics, and Dr. Katherine Dettwyler, Associate Professor, Department of Anthropology, University of Delaware.

The piece is primarily about the stories of these 14 amazing mothers who are so considered and articulate about the parenting choices they have made. The moms I interviewed were incredibly candid and honest about the whole process of breastfeeding their kids, including the joys and difficulties they had along the way. There are some truly funny stories, too!

These are the kinds of stories that we just don’t hear about except for in a group of breastfeeding mothers. My goals were twofold: to put these voices out there to support and educate mothers; and to allow these voices to be heard by people who are not aware that breastfeeding beyond infancy is not that uncommon, is actually a positive thing, and is practiced by a wide range of perfectly normal and healthy mothers!

JM: How did you get interested in the topic of extended nursing?

VL: When my son was about two years old, I started noticing that I was sometimes not that comfortable breastfeeding him in public. I was surprised by this because I was well aware of the medical recommendations to breastfeed for at least 1-2 years, and I was also educated about my legal rights to breastfeed in public. I never encountered any negative reactions to nursing in public—I live in the San Francisco Bay Area, which is sort of a bastion of liberal ideology.

But I had heard stories in the media about mothers being kicked off of airplanes or out of stores, and I had received mildly concerned comments from a few family members.

So even though breastfeeding my two-year-old son was going well, I had absorbed some of the negative views on the practice simply by living in a culture that was not widely supportive of the practice. I found myself anticipating negative reactions.

And then there was this huge contrast between all the scientific findings and medical recommendations about breastfeeding, and the negative cultural attitudes about the practice. The discrepancy seemed to me to be largely about many people’s misperceptions and lack of information, along with some insidious cultural biases.

I started thinking about how to initiate an intelligent, informed cultural conversation about all this. I decided that an important step would simply be making the largely unheard voices of breastfeeding mothers heard.

JM: Is it really normal to breastfeed beyond six months? Beyond a year?

VL: Absolutely. As Dr. Katherine Dettwyler notes in the documentary, human children are expecting to be breastfed far beyond even one year. Her argument is based on several different areas of research including studies of non-western civilizations, as well as that of non-human primates.

The World Health Organization recommends that children be breastfed for at least two years.

JM: I’ve heard women say that your milk changes and is no longer nutritious the longer you nurse. Is that true?

VL: Breast milk continues to supply important antibodies to the child beyond infancy. Of course, as children begin to eat solid foods they are increasingly getting nutrition from other sources, and are not as dependent on breast milk. But the mother’s immune system continues to pass on immune protection to the nursing child.

There are other benefits to the child beyond nutrition. Many of the mothers in “Breastfeeding Beyond Infancy” talk about the emotional benefits of continuing to nurse their kids.

JM: I’ve had many family members tell me “Enough already! It’s time to stop nursing!!” when they saw me nursing a toddler. Do you have advice for how to handle negative comments like those?

VL: There are many ways to deal with negative comments. I think it depends on what your goal is. You can choose to educate people and let them know about the scientific information and medical guidelines—many people are actually unaware of these things, and are simply reacting to cultural biases that they have absorbed or inherited. They may have the misconception that there’s something inappropriately sexual about breastfeeding beyond infancy, or may be mistakenly worried that your child will be hindered in developing independence.

La Leche League has a great fact sheet full of helpful suggestions for how to deal with criticism.

Some mothers use gentle humor. When someone asks, “How long are planning to nurse that kid”? you can just say, “Oh, at least another ten minutes.”

It can be hurtful to receive negative comments about nursing a toddler or older child. Negative comments may even cause a mom to doubt her own parenting choices. Seeking out other breastfeeding mothers, in person or on-line (La Leche League can provide info on groups) can be really helpful. Reminding yourself about why you’ve chosen to continue breastfeeding, talking to others, and sharing your experiences are ways to nurture and fortify yourself, and maintain the emotional energy needed to do the best job of mothering that you can.

JM: How else can women who nurse toddlers get support?

VL: There are actually many places to get support for nursing toddlers. There may be a La Leche League group in your town or somewhere nearby. Even if you don’t know anyone else who’s breastfeeding, if you have access to the internet there are a lot of resources. Facebook has several groups where women share their experiences and offer support. Mothering Magazine, both on-line and the print magazine, is a wonderful resource.

There are great books: Ann Sinnott’s Breastfeeding Older Children, Norma Jane Bumgarner’s Mothering Your Nursing Toddler, and Kathleen Huggins’s The Nursing Mother’s Guide to Weaning.

[ 22 comments ]

Nursing Past One

December 13th, 2010

When I was pregnant for the first time, I read everything I could about pregnancy, childbirth, and parenting. But I consciously shied away from reading anything about breastfeeding.

I wanted to breastfeed. But I didn’t want to know about it in an intellectual way. I just wanted to do it when the time came. Perhaps I was afraid if I knew too much in advance, it would make me anxious, maybe even too anxious to nurse.

Nursing at first wasn’t easy. In the hospital my nipples developed painful blisters that filled with pus and then with blood. I fretted that the baby would be made ill by the blood she swallowed (”Extra protein, nothing to worry about,” I was told), and I winced in pain when she latched on. My breasts became hard as tennis balls when the milk came in a few days after we returned home.

I went back to work when Hesperus was just six weeks old. A few days before my classes started (I was teaching at Emory University), I tried to fit the pieces of the breast pump together and started sobbing. I felt scared about leaving the baby, I felt stupid that I couldn’t figure out how the breast pump worked, and I felt worried about trying to be a professional when I was so sleep-deprived and my clothes were so spit-up stained. I was such an inexperienced and insecure mom that for awhile it took three of us—my husband, my best friend, and me—to change the baby.

How would James cope with being alone with her?

How would I cope with being so far away?

Somehow we managed to get through those difficult first weeks. James assembled the breast pump and a friend came over to show us how to use it. James fed Hesperus bottles of pumped breast milk when I was teaching, and the skinny frog-legged creature turned into a roly-poly baby, so fat she had five chins.

Though I got the only speeding ticket of my adult life rushing home to nurse between classes, the time that James was home alone with the baby really helped him feel bonded to her. Staying home with his daughter and getting to feed her bottled breast milk gave James the chance to be the primary parent (at least temporarily), able to satisfy all of the baby’s needs. Eleven years later James and Hesperus still have a special closeness.

I hoped to nurse the baby for a year. I ended up nursing her for over four.

This week at Mothering Outside the Lines is dedicated to the topic of extended nursing. Come back Wednesday to read an interview with Vanessa Lowe, a breastfeeding advocate and the producer of a radio documentary about extended nursing.

Listen to the documentary, Breastfeeding Beyond Infancy, now:

Related posts:
Breastfeeding mom ushered off plane by armed police
What can we do to help American women nurse?
A miracle cure for thrush infections (and it’s totally natural too)

When you have a question related to things like pregnancy, childbirth, and breastfeeding, do you find that it helps to read books or surf the Internet or talk to friends? Or do you just keep your head in the sand (like I did) until the time comes that you have to do it?

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[ 8 comments ]

Five Children Die Each Day in Car Crashes

December 10th, 2010

0127636-R1-052-24A_2I heard about this on NPR yesterday morning, and I’ve been obsessively thinking about it ever since.

About five children die everyday in car accidents.

The NPR story emphasizes that some of these deaths could be averted if American children stayed rear facing for longer.

Even if you have a toddler, it’s safer for her to face backwards.

Apparently in Sweden children as old as four face backwards in their car seats.

But even if your child is safely buckled, you can’t avoid the fact that driving is dangerous.

My friend Vicky’s son Nate died in a car crash. My friend R.’s son died when he was hit by a car. My friend Melissa’s husband died in a car crash and left her to raise three young sons by herself. When my husband was little, he was in a head-on collision. He and his mom survived but he watched the other driver die before his eyes.

What if we all tried to keep our kids out of the car as much as we could?

What if we all tried not to drive?

What if we traded our cars for bicycles?

What if we walked? Umbrella in hand if it’s raining?

I don’t want anyone ever to die in a car accident. Especially not children. I know it’s crazy and you’ll call me unrealistic and there are a million reasons why we all have to drive but let’s just leave our cars parked from now on. Open the driver’s door, think of my friend Vicky’s son who will never go to college, never get married, and never laugh with his mom again, close the car door, and walk to where you need to go.

I want you to be safe. I want your children to be safe. I want mine to be safe too.

My friend Roanna once asked me in a truly perplexed tone, “Why don’t you ever use your car?” We do use our car. James just took it to drive out of town. But we’ve been trying to use it less and less.

It helps that there are six of us but our car only seats five.

The real reason I’m trying to keep my family out of the car? I’m terrified one of us will become a statistic.

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[ 18 comments ]

The Baby is Thirteen Months Old

December 8th, 2010
There was a little girl, who had a little curl...

There was a little girl, who had a little curl...

James was carrying the baby yesterday and her legs looked so long.

She sits on my lap at the table, or in her high chair, and shovels brown rice and grated carrot and bits of potato pancake (stopping to poke a finger in the sour cream and smear it on her tray) into her mouth.

“Nursing’s just for snacks,” Athena says. “Now she eats real food.”

What happened to our tiny newborn? She’s morphed into a walking almost-talking toddler.

I don't know what you think is important in life but for me, at 13 months old, it's all about communication

I don't know what you think is important in life but for me, at 13 months old, it's all about communication

We have a small green statue of the Buddha on our dashboard. James, who likes to pimp out the car in Buddhaware, rubs its pudgy belly for good luck.

This weekend Leone sat on my lap during the state gymnastics meet watching her 11-year-old sister compete. Right before it was Hesperus turn on each event, I rubbed Leone’s belly for good luck.

But. Sitting. Is. So. Distasteful. When there are so many messes to be made, dangers to encounter, and pennies, Legos, and bits of carpet fuzz to put in one’s mouth, why would anyone want to stay still?!

Leone starting walking earlier than her siblings, right before her first birthday. She clomps unevenly around the house, one shoulder up by her ear for balance, arms out. She walks so awkwardly that each foot falls with a thump.

She’s taken 93 steps in a row. Athena counted.

Thirteen favorite activities of a thirteen-month-old:

1. Push the button on the dryer. It goes on!

2. Push the button on the dryer. It goes off!

3. Push the button on the dryer. It goes on!

4. Push the button on the dryer. It goes off!

5. Bother big brother. (”Baby, ouch. Don’t sit on my head!”)

6. Bother big brother’s toys. (”Noooo, Baby! GET AWAY FROM THERE!!)

7. Hold phone up to ear and say, “Hi!” Hold truck up to ear and say, “Hi!” Hold match stick up to ear and say, “Hi!”

8. Try to pull those pesky clear things out of the wall sockets. “Uh, uh, uh.” Almost got it.

9. Find one of those clear things on the ground. Clomp hurriedly to wall socket. Try to put it in the wall socket because that’s where it goes. Why doesn’t it fit?

10. Say “Hi!” to friendly strangers. Hide head if stranger says “Hi!” back.

11. Push the button on the dryer. It goes on!

12. Push the button on the dryer. It goes off!

13. Push the button on the dry–

Wait, wait, don’t pick me up! Waaahh. Can’t you see I’m busy here? Uh. Uh. Uh. I just need to reach that button one more time…

Athena and Etani have nothing to do with this post but I love this photograph

Athena and Etani have nothing to do with this post but I love this photograph

Do you have a toddler? What are some of your baby’s favorite ways of walking into trouble? (and if you’re wondering if you’re crazy because your toddler’s driving you crazy, you can read real-life stories by other parents who have survived the toddler terrain in the book I edited, “Toddler: Real-Life Stories of Those Fickle, Irrational, Urgent, Tiny People We Love” (Seal Press.)

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[ 19 comments ]






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