Birth Song

I love finding a song that is the theme for a pregnancy and birth. I am weird, I know. You all can call me out on that. It's just something that I enjoy doing.

I remember hearing a song while pregnant with Frank that I loved and that always made me think of how peaceful and beautiful it was to be pregnant with him and that his birth would be the same way. It is a folksy, melodic song called Heavenly Day by Patty Griffin.

Oh heavenly day, all the clouds blew away
Got no trouble today with anyone
The smile on your face I live only to see
It's enough for me, baby, it's enough for me
Oh, heavenly day, heavenly day, heavenly day

Tomorrow may rain with sorrow
Here's a little time we can borrow
Forget all our troubles in these moments so few
All we've got right now, the only thing that
All we really have to do
Is have ourselves a heavenly day
Lay here and watch the trees sway
Oh, can't see no other way, no way, no way
Heavenly day, heavenly day, heavenly day

No one at my shoulder bringing me fears
Got no clouds up above me bringing me tears
Got nothing to tell you, I've got nothing much to say
Only I'm glad to be here with you
On this heavenly, heavenly, heavenly, heavenly
Heavenly day, all the trouble's gone away
Oh, for a while anyway, for a while anyway
Heavenly day, heavenly day, heavenly day

I imagined his birth day to be how the song described - both literally and figuratively. I remember that morning when I was in labor looking out the window. It was a glorious June day. I could see our trees swaying in the breeze with blue skies in the background. I said, "What a great day to have a baby." Indeed - the song was a theme for Frank's birth.

Even before pregnant with Darth I was thinking about the next song. It's not that I was forcing myself to find a new song. It was that I found myself thinking about it. Gosh, I was excited to be pregnant again.

One song, although not at all about birth, always makes me think about birth. I realized, though, that the song is more about my doula work than about my own birth. The song is full of things that I say to moms, about letting go of a difficult moment and about enjoying the birth experience. (I've always tried to create a perspective that birth isn't something you have to get through or endure but rather that it is a journey in and of itself. When mothers look back on their child's life, the little wonders woven through the story of the day they are born are an important part of the memory. Those memories should be cherished as you experience them.) This song is Little Wonders by Rob Thomas.

let it go,
let it roll right off your shoulder
don't you know
the hardest part is over
let it in,
let your clarity define you
in the end
we will only just remember how it feels

our lives are made
in these small hours
these little wonders,
these twists & turns of fate
time falls away,
but these small hours,
these small hours still remain

let it slide,
let your troubles fall behind you
let it shine
until you feel it all around you
and i don't mind
if it's me you need to turn to
we?ll get by,
it's the heart that really matters in the end

our lives are made
in these small hours
these little wonders,
these twists & turns of fate
time falls away,
but these small hours,
these small hours still remain

all of my regret
will wash away some how
but i can not forget
the way i feel right now

in these small hours
these little wonders
these twists & turns of fate
these twists & turns of fate
time falls away but these small hours
these small hours, still remain,
still remain
these little wonders
these twists & turns of fate
time falls away
but these small hours
these little wonders still remain

I have found the right song for this pregnancy. This pregnancy is, and I expect the birth will be, rockin'. I love I've Got a Feeling by the Beatles. If you don't know this song, you should give it a listen. Then, listen to it from the perspective of a woman who is pregnant and then giving birth. Kinda fun, huh? Try not to shake your hips. I'm hoping I'll dance my way through pregnancy and birth. Paul's "oh yeah!" makes me smile. You think you've got a feeling, Paul? Ever given birth?! Now I've got a feeling, OH YEAH! And you betcha it's keepin' me on my toes...

(I'm not so sure about the wet dream part, though.)

I am having fun with this pregnancy. And if this song can serve as a theme, I'll have a fun, rockin' birth. Thank you, Paul.

I've got a feeling, a feeling deep inside, oh yeah
Oh, yeah, that's right
I've got a feeling, a feeling I can't hide, oh no no
oh no, oh no
Yeah, yeah
I've got a feeling, yeah

Oh please believe me, I'd hate to miss the train
Oh yeah yeah oh yeah
And if you leave me, I won't be late again
oh no, oh no, oh no
yeah, yeah
I've got a feeling, yeah
I've got a feeling

All these years I've been wandering around
wondering how come nobody told me
All that I was looking for was somebody
who looked like you

I've got a feeling that keeps me on my toes
oh yeah, oh yeah
I've got a feeling that everybody knows
oh yeah, oh yeah, oh yeah
yeah, yeah
I've hot a feeling, yeah
Yeah

Everybody had a hard year
Everybody had a good time
Everybody had a wet dream
Everybody saw the sun shine
Oh yeah, oh yeah, oh yeah
Everybody had a good year
Everybody let their hair down
Everybody pulled their socks up
Everybody put their foot down
oh yeah

Everybody had a good year
Everybody had a hard time
Everybody had a wet dream
Everybody saw the sun shine
Everybody had a good year
Everybody let their hair down
Everybody pulled their socks up
Everybody put their foot down
oh yeah

I've got a feeling
I've got a feeling
I've got a feeling, yeah

Carnival

Bel's school carnival was recently. She and I had a blast. The highlight was the face painter. She was a mom of one of Bel's friends, and look at the amazing job she did. Bel asked for a butterfly. We expected a small butterfly on her cheek but instead got this:


Turns out the mom worked at an amusement park as a face painter for summer when she was young. What a score for the carnival volunteer committee, huh?

Frank couldn't make it to the carnival, but Bel brought him a balloon and shared a mask that she won. No matter how we tried to photograph Frank in his mask, he always seemed to look demonic in the photo. Isn't this picture scary? Stephen King could do well to use this image as a creepy monster creature in one of his stories.

Inspiration

I find it important to attend births while I'm pregnant. Many doulas take time off during their pregnancies. I often attend more births while pregnant - even in the last trimester. Nurses, midwives, and doctors look at me strangely as I squeeze the hips of a laboring mom for hours with my belly getting in the way as I go. I walk the halls with the laboring mom and her partner, and other families look at us oddly. Are they BOTH in labor? Weird - I wonder why they are walking the halls together? On many occasions, as I arrived at the hospital to attend a birth, the nurses would try to admit me until I explained why I was there.

I rely on the women I support to find my own birthing strength. Every time I watch a women labor and give birth, I am reminded that I can do it, too. I know, I know - I'm a doula and am supposed to just have supreme birth confidence. I have confidence and trust in other women birthing but often question my own ability to do it myself.

As I labored with Frank, I knew that I drew on all the births I had attended. The long, difficult labors show me how much stamina women have. I am reminded that women are strong, and I can do it, too. The short, intense births remind me that I will not die, and if I think I will, I'm almost done. The cesarean births remind me that even if things don't go as planned, birth is still birth - a glorious event to be celebrated and enjoyed. Above all, I'm reminded that it's okay if birth is difficult and joyful at the same time. It's supposed to be - it's Nature's way of preparing us to be parents.

So, all you doula mamas out there whose births I have attended, thank you for helping me find my strength and confidence. Thank you for being my doula.

Back in the Saddle

I'm back in the doula saddle. As many of you know, I took some time off. The primary reason was work scheduling with my "normal job," but I also just needed a break from being on call and the frequent absences from my family for births and prenatal visits.

I wasn't sure if or when I'd start up again. I knew, though, that I'd want to work with families whose prior births I had attended, so I stayed open for them. I happily signed on as the doula for repeat families. I attended my first birth in nine months last week, and I have two more coming up before Darth is born. I've been attending prenatal visits. You know what I've found? I've found my energy, my passion, my spirit again. I had forgotten how much I love this work. It feels so good to be back.

After Darth is born, I'm going to return to a semi-regular doula schedule. I won't do as much as I was doing before, but I'm going to have a regular birth schedule.

Then I need to think through my career. Am I getting the same kind of energy from my "regular" job? Is the steady salary, benefits, and security of a corporate job worth it? Would I be willing to let all that go for lower pay, no benefits, and unpredictable income?

So, are you thinking that I want to become a full-time doula? Nope. I'm thinking I may want to be a midwife. I've been toying with this idea for a long time, but it always gets put into the back of my mind when I consider the logistics of schooling and training and juggling life with young kids. My renewed energy around birth has me thinking this through again.

Then again, I could continue with the best of both worlds by keeping my "normal" job and being a doula on the side.

Any advice?

We Can Do Better

My last post was about how the U.S. spends thousands of dollars more per person in for health care than our developed and developing nation counterparts, yet we have among the lowest overall life expectancy. I ranted a bit about how our fee-for-service health care payment method is a major factor in our high-spending-yet-poor-outcome health care system.

This is apparent in our maternity care system, as well. In a recent publication for the U.S. Department of Health and Human Services' Centers for Disease Control, we see that the infant mortality rate in the U.S. is 30th among developed and developing nations, coming in ahead of only Slovakia.

According to the report, a significant factor in our infant mortality rates is our high rate of preterm births in the U.S. The report goes on to say that our infant mortality rates for preterm births is among the lowest in the world. In other words, while we have among the highest preterm birth rates, once those babies are born, we are good at helping them survive. These seem to be mixed results - we are good at caring for our littlest babies. At the same time, the report goes on to say that if we had the distribution of births by gestational age of Sweden (i.e. fewer preterm births), we could save 8,000 infant lives each year.

The most disturbing part of the report is our that our infant mortality rates for full term births was the highest among all the countries studied. In other words, we are the worst at ensuring our full-term babies survive.



The summary of the report states that if we reduced our preterm rates to Sweden's level, we would reduce our overall infant mortality rate by 33%. That seems obvious. Full term babies are more likely to do well. But what about our pathetic full-term infant mortality rate? I am not alone in my belief that these poor outcomes are related to our maternity care practices. It goes back to the paying-for-services-versus-outcomes thing. Providers are paid for billable services, things like surgery, medications, inductions, etc... It's also tied to defensive medicine - providing medical care based on a fear of litigation versus what is sound, evidenced-based care.

We know that somewhere between 85-95% of women will give birth most safely if the birth is uninterrupted by devices or drugs. In our country, however, about half (depending on whom you ask) births are induced, many are augmented with Pitocin, nearly all involve some sort of intervention and/or drugs, and over a third are surgical births (two-to-three times what is deemed necessary by the World Health Organization).

It's not women's fault. Our bodies know what to do. We are no different than our European counterparts. Something else is broken.

We can do better.

Full CDC report Behind International Rankings of Infant Mortality: How the United States Compares with Europe (Marian F. MacDorman, Ph.D. & T.J. Mathews, M.S.) available here.

Band-Aid on a Bursting Pipe

I saw this graphic in my National Geographic this month, and it succinctly diagrams my frustration with the U.S. health care system and our band-aid-of-health-care-reform our representatives are putting through Congress right now.

Yes, we are reforming commercial insurance polices. It's an itsy-bitsy fix. People with preexisting conditions will be guaranteed health coverage, and insurance companies are saying that by requiring everyone to buy insurance, there will be enough low-risk insureds in the pool of people paying premiums to actually pay for coverage for those high-risk people. But it's a band-aid on a pipe that is bursting. Until we actually fix the pipe, we'll do no more than barely hold back the flood water that is the cost of our unsustainable and money-wasting system.

Does the realization of what this graphic demonstrates disappoint you like it does me?! This is the U.S. We can do better.

A quote that accompanied this graphic hits the nail on the head. Until we stop paying on a fee-for-service basis, we will waste money on more and more health care services that do not improve people's health. We need a system that pays health care providers for providing quality care, even if that means providing no services at all. I know many doctors agree with this approach - it's just that they can't afford to not provide services under our current system - they get paid only if they provide a billable service.

Don't even get me started on how this fits into maternity care, which amounts to about one out of every five hospital discharges. It's money thrown into a black hole with outcomes that are disappointing. (More on that in a few days.)

Here is that great quote. I hope our congressmen and congresswomen are reading National Geographic.

The United States spends more on medical care per person than any country, yet life expectancy is shorter than in most other developed nations and many developing ones. Lack of health insurance is a factor in life span and contributes to an estimated 45,000 deaths a year. Why the high cost? The U.S. has a fee-for-service system -- paying medical providers piecemeal for appointments, surgery, and the like. That can lead to unneeded treatment that doesn't reliably improve a patient's health. Says Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who studies health insurance worldwide, "More care does not necessarily mean better care."
- Michelle Andrews