[Friday Wrap Up]: 28

This week: a lovely photo essay and video telling stories about abortion experiences, a reframing of abortion beyond “women’s rights,” questioning the (dreaded) pelvic exam, a new continuing ed opportunity from Evidence Based Birth, revolutionary NICU care, and more on full spectrum doulas from a new blogger!

Abortion: After the Decision

Love this photo essay:

I was surprised when I started talking openly with my friends and colleagues about abortion how many of them had had one themselves. I hadn’t known that 40 percent of American women will have an abortion during their lifetimes. While it’s a personal and private experience, there are 45 million women in America who share in it, and it shouldn’t be a shameful secret. The silence creates a stigma that prevents a meaningful discussion and understanding in the national debate and dialogue.

Not Everyone Who Has an Abortion is a Woman: How to Frame the Abortion Rights Issue

I missed this when it first came out, but was happy to come across it recently. There’s a lot of good stuff here that directly speaks to the kind of inclusive environment of care I hope to create as a nurse-midwife.

We must acknowledge and come to terms with the implicit cissexism in assuming that only women have abortions. Trans men have abortions. People who do not identify as women have abortions. They deserve to be represented in our advocacy and activist framework. Honestly, I am guilty of perpetuating that harmful myth, both in my rhetoric and framing. I often frame abortion restrictions as misogynistic attacks meant to control women’s reproductive lives, and that is true. But abortion restrictions also affect the lives of people who aren’t women, and they hinder trans men and gender-non-conforming people and others who were Designated Female at Birth (DFAB) from accessing abortion care, as well.

Questioning the Pelvic Exam

I know I’m not alone in wondering what the heck the point of this annual exam is…in fact, I was thrilled last year to read Feminist Midwife’s questions about it, too. This week, the NYT’s Jane Brody writes about a growing number of gynecologists who are starting to question the purpose of this exam.

These experts say that for women who are well, a routine bimanual exam is not supported by medical evidence, increases the costs of medical care and discourages some women, especially adolescents, from seeking needed care.

Moreover, the exam sometimes reveals benign conditions that lead to follow-up procedures, including surgery, that do not improve a woman’s health but instead cause anxiety, lost time from work, potential complications and unnecessary costs.

And even more stunning, yet not surprising:

How important is this exam to a doctor’s income? Slightly more than half of those surveyed ranked “ensuring adequate compensation” as very important or moderately important.

One of the most vexing problems in medicine today is the fact that doctors get paid only for performing procedures, not for the time they spend talking with patients to discuss issues of possible medical importance.

Giving Birth Based on Best Evidence

Rebecca Dekker, PhD, RN, APRN, over at Evidence Based Birth, is starting an online continuing Ed series, beginning with a class on “Big Babies.” Be sure to check the giveaway!!

NICU program that gives parents charge of baby’s care cuts stress

This is an awesome, awesome new movement in NICU care: giving parents more responsibility in the care of their newborns.

“With family integrated care, we have done something quite different,” explains Dr. Shoo Lee, pediatrician-in-chief and director of the Maternal-Infant Care Research Centre.

“What we’ve done is to say that for all babies in the NICU, the parents should be the primary caregivers, not the nurses. And the nurses are really teachers to the parents.”

The program was instituted following a 2011-2012 pilot project in which the parents of 40 newborns were asked to spend a minimum of eight hours a day in the NICU and tasked with the overall management of their child’s care.

That included bathing and changing diapers, monitoring the infant’s vital signs, and recording feedings and weight gain on their medical chart. Nurses were responsible for the medical side of care — looking after feeding tubes, adjusting ventilation apparatus and administering medications.

The babies’ progress was compared with those whose care was primarily provided by nurses, and Lee says “the results were phenomenal.”

Full Spectrum Doulaa new blog!

A friend and fellow doula has started this awesome blog about full spectrum doula work…here’s an excerpt from her first post, The Politics of Pain, Part 1

I am very much in favor of a movement that reclaims abortion as a complex matter of the heart, just like birth. Birth and Abortion are the yin and yang of reproductive power. I know that abortion will never be a happy event in the way that birth usually is… but I know it is a powerful experience and I think even in our most “pro-choice” enclaves, we are still blowing it. We are often working to hard to “rescue” people from their circumstances, thereby failing to embrace the growth and change that come with going through something.

[Friday Wrap Up]: 27

Doula care in low-income communities, an awesome new children’s book on where babies come from, a pair of articles exploring infertility, a rocking birth story, thoughts from a 20-something who’s tired of being asked when she’ll start having kids, and a gorgeous photo essay of Muxas, or ‘third’ gender folks in Oaxaca. Another beautiful week of vacation reading that left me inspired, provoked, intrigued and more.

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The Amazing People Who are Changing How Low-Income Moms Give Birth

A great article exploring the rise of doulas in low-income communities and the ways in which doulas can improve birth outcomes in these communities.

You should really pair this with Miriam Perez’s great blog post earlier this spring about the future of the doula movement. I appreciate the hard questions she asks about the intersections of doula care, sustainability, finances, etc. The real question is…as we move more towards seeing Medicaid reimbursement for doula care, what does that mean for the way in which the doula role might shift?

What is the end goal of the doula movement? What are we working toward? Many doulas would likely say—and I would have been among them just a few years ago—that the end goal is to have a doula at every birth. But I no longer believe that’s the right goal.

I think doula work is valuable and important, and I also don’t believe the essence of doula work—non-judgmental and unconditional support for pregnant and parenting people—needs to be locked away in a system that says only a certain amount of training, certificates, or other paperwork bestows upon someone the right to provide this support. We run the risk of replicating the model we’re trying to revolutionize. And I don’t think that is where real social change happens.

What Makes a Baby

An awesome new book by Corey Silverberg. In his words:

What Makes a Baby is a children’s picture book about where babies come from that is written and illustrated to include all kinds of kids, adults, and families. 

Geared to readers from pre-school to about 8 years old, it teaches curious kids about conception, gestation, and birth in a way that works regardless of whether or not the kid in question was adopted, conceived using reproductive technologies at home or in a clinic, through surrogacy, or the old fashioned way (you know, with two people and some sexual intercourse), and regardless of how many people were involved, their orientation, gender and other identity, or family composition.

Just as important, the story doesn’t gender people or body parts, so most parents and families will find that it leaves room for them to educate their child without having to erase their own experience.

Fertility Diary (a new Motherlode blog feature by Amy Klein)

This I.V.F. stuff is hard. It is my first time in the trenches, but I already feel as if I need some sort of medical degree to do this — or at least a medical technician degree to give myself daily shots. Some women I know hire nurses to come to their homes to do it. Other women have to take two shots a day.

and related to this, an editorial called Selling the Fantasy of Fertility:

As former fertility patients who endured failed treatments, we understand how seductive that idea is. Americans love an uphill battle. “Don’t give up the fight” is our mantra. But the refusal to accept physical limitations, when applied to infertility, can have disturbing consequences.

It’s no wonder that, fueled by magical thinking, the glorification of parenthood and a cultural narrative that relentlessly endorses assisted reproductive technology, those of us going through treatments often turn into “fertility junkies.” Even among the patient-led infertility community, the prevailing belief is that those who walk away from treatments without a baby are simply not strong enough to run the gantlet of artificial conception. Those who quit are, in a word, weak.

I LOVED this birth story, from Mutha MagazineS. LYNN ALDERMAN’S Ugliest, Beautiful Moment (Or, Fuck Ina May): 

But inside my head, I could not believe what was happening. How painful it was. How terrifying. I felt helpless. And degraded and humiliated by there being witnesses. And at the same time, I felt so, so alone.  I remember at one point saying, completely out of my mind, “I don’t understand why no one is doing anything to help me! Please help me!” Della reminded me that what I was feeling was the baby coming. That I was doing just what I was supposed to, having the baby, right then.

26, Unmarried, and Childless

This post comes from a Christian-focused blog. I found the perspective quite intriguing. I grew up in a Catholic family, in which having children was seen as a way of manifesting God’s love and fulfilling our God-given role as men and women. Reading this article brought up a lot of memories of arguments with family members about this argument can lead to hurt feelings for those who experience infertility…or simply don’t want to have children or be parents.

Instead of relishing in the freedom, blessings and limitless possibilities that this stage of life offers me, I am left frozen, feeling like I’m not enough. Like what I’ve done doesn’t really matter or that I’ve accomplished nothing. I’m an outcast. I’m defective. I’m panicked. When you comment on my life stage as if there was something I could do to change it, it makes me feel inadequate. Most days I truly do love where I’m at right now, but when people question my marital status, I think I’m messing up my chances to do anything worthwhile with my life.

Striking Portraits of Muxes, Mexico’s ‘Third’ Gender

Before Spanish colonization blanketed Mexico with Catholicism, there were cross-dressing Aztec priests and hermaphrodite Mayan gods; gender flexibility was inherent in the culture. In much of the country now, machismo prevails and attitudes toward sex remain relatively narrow. But things are different in the southern state of Oaxaca where more pliant thinking remains. In the Zapotec communities around the town of Juchitán, men who consider themselves women—called “muxes”—are not only accepted, but celebrated as symbols of good luck.

[Friday Wrap Up]: 11

I’ve known about Doula David for a while now…so I was super excited to read this interview he did with another doula, Sarah. I admit, when I first became a doula, it never really crossed my mind that men might be interested in doing birth work…but of course, as my friends in the LGBTQ community pointed out, there are lots of ways to create a family, and lots of room for diverse support.

And I absolutely agree.  I’m especially interested in learning more about transgender health care, because I think it’s an area that is still developing, and that many people don’t know much about.  As a future midwife, I would be thrilled to be able to support transgendered folks who are wanting to get pregnant–and equally–I want to be able to guide them to doulas that they feel comfortable with.

So here’s to all kinds of doulas–not just doulas of differing philosophies, but doulas of all ages, races, ethnicities, genders…there’s room for everybody, and in the end, we are all better off when pregnant people feel supported and nurtured.

Juicy excerpt:

Q: As a male Doula, you are working in a field that most think of as a female only profession. You are in a way, changing what we assume a Doula to be. Do you feel as though you will be able to help other men that have the desire to Doula?

A: Honestly, I had no idea that I would be the second known certified male doula. I assumed that it would be rare but not THIS rare. I imagined there would be some fellas out there who supported a partner through multiple births and who was such a great supporter that he became a doula. I know there are other men both trans and cis-gendered who are providing doula support and I imagine that there will be more to come.

I feel that the birth world is diverse in philosophy but lacks racial, ethnic, and cultural in addition to gender diversity. While I did not set out to break any boundaries, I do hope that if my presence has any effect in addition to simply providing doula support that it will help inspire more diversity. I hope that what we assume a doula to be will explode and that we will see doulas of all shapes, sizes, colors, languages, cultures and of course genders.

Read the entire interview here.