Tuesday, February 16, 2010

Food for Body and Soul

I had a beautiful meal today with a lovely couple I'm working with who were so kind as to invite me to share lunch with them. If you have never tried the smoked goat cheddar that's made in Quebec and has in fact been deemed the #1 cheese in the world of its kind, you have not lived. It was truly special, as well as the company. I often rush around my day doing my prenatal and postpartum appointments and either forget to eat, or simply don't have time. It was wonderful to sit down with some truly great folks, eat a beautiful meal, and talk about breastfeeding. Life is fine in those moments when we are nourished by good food, good company, and good conversation. In those moments there is joy, even when sometimes things outside of that circle of contentment can be heavy. The space of nourishment is such an important place within which to centre ourselves, to gather up energy and re-source ourselves. Then we can go out into the world with some fuel and handle things with more clarity...perhaps see things with a little more warmth.

I spoke with a lady yesterday whose story made me quite sad. She had a very difficult birth, having avoided a C-section by the skin of her teeth. Her waters had broken, so when she went to the hospital as she was told to do, she was not allowed to eat. Because her baby was extremely high and her membranes ruptured, she was considered high risk for a C-section, which means eating is a no no. I guess they were terrified of a prolapsed cord, even though she stayed in bed as she was told. Most likely they gave her Synto to augment the process after hours of long, hunger riddled labour. The long and short of it was, that she got terribly exhausted. She felt so hungry, and was not allowed access to the nourishment her body was crying out for. She was not given information about what was happening and why. Of course, the poor woman completely ran out of steam in trying to cope with her labour sensations without the benefit of fuel, and resorted to taking an epidural she never wanted or thought she'd need.

Finally, when it was time for her to start pushing, she was told it would be hours because of how high the baby still was. The baby was born in 15 minutes. We are not aware of all the details, because she really wasn't informed of everything. You go into the hospital with an expectation you will be made to understood everything that is going on, yet I have so many ladies come to me in their second pregnancies in tears because they are traumatized by their birth experiences, and are not exactly sure why they turned out the way they did.

This story breaks my heart....so many interventions related to a lack of vital nourishment. Were the risks associated with not eating truly smaller than the risk of an occurrence of prolapsed cord, if that was indeed what they were worried about? Yes, prolapsed cord is a huge emergency. I have seen it. But is not C-section for a stalled labour, had that been how it went down for this lady, and how it happens for many others, super risky in and of itself? In the here and now the baby comes out just fine, infection and bleeding can be treated in the mother, and another "disaster" has been diverted by the magic of surgery, bada bing. Sounds appealing. But the long term risks are becoming more evident, such as scar tissue in the uterus from the surgery causing the placenta of the next pregnancy to attach there, which can result in disastrous, life threatening bleeding. The maternal death rate is climbing, due to so many surgical births...and many other things I just don't have the energy to get into, but you get the drift.

Where has the soul gone in this business of baby catching? Midwives and doulas consider nourishment in the form of food, loving words, gentle touch, respect, and the joy of being together in a loving environment essential to the care of the birthing couple. Many medical practitioners feel safer with cold, hard, shiny instruments and machines which monitor, cut, scrape, vaccuum, and suction, and are less invested in a woman's experience of birth. I can't tell you how many times I've heard a woman say to her doctor, "this isn't what I wanted," and the clinical reply, "This is Obstetrics. You don't always get what you want," as if having wanted anything in the first place was silly. Besides, giving birth is NOT obstetrics. The woman giving birth isn't practising obstetrics! It's what the doctor is doing, and what he wants has a lot of sway. I understand their job is to monitor for and treat pathology in most birthing women, not to join hands and sing with their patients (though Michel Odent has done that, and it has worked wonders for his practice). But a doctor's warmth is today considered a blessing and a bonus; a little icing on the cake instead of something that should be expected. The care of birth in North America comes primarily from a mind oriented, intellectual place. Being logical and clinical and applying technology according to arising potentials is what saves us from disaster, not something earthy crunchy like eating, or loving support. Or does it?

A primarily mind oriented approach to maternity care as opposed to an approach which is certainly clinically skilled, but acutely aware of the need for compassion and nurturing seems to create the best outcomes. Midwives care for the vast majority of pregnant and labouring women in the Netherlands, for instance, and they have some of the most commendable birth outcomes in the world. We, sadly, do not. Our neonatal mortality and morbidity rates are pretty awful, considering all the emphasis on technology. Sure, they have great OB care in Holland too, but not for the majority of births. OBs take care of women who are higher risk, instead of almost every garden variety birthing lady as they do here. The OBs also seem pretty content to allow the midwives to deal with normal births, and they seem to have great respect for the birth process, supporting the idea of homebirth, which happens in around 1 in 3 births there. NOT here. There doesn't seem to be a lot of love between doctors and midwives.

Trying to outsmart Birth as if we were playing a game of Chess clearly is not the ideal way to approach maternity care. Let us bring heart back to caring for birth. Bringing in more love, compassion, and trust is not just some hippie la la notion. It is a crucial missing element. This is why doulas tend to have such great statistics with their hospital birthing clients...we bring the love. We will feed you and nurture you. We will encourage you and buffer a harsh environment. As Ina May Gaskin quotes in her book Spiritual Midwifery, "With love, even the rocks will open."