Thursday, December 27, 2007

A Happy Year, Indeed

Happy New Year, Dear Readers
I look forward to the many changes the new year will bring. I continue to work diligently on my book. Not quite ready for a send out yet, for those who have volunteered for my reading group. I'm excited about the possibilities this book brings. I just booked my first speaking gig for 2008 (my agent negotiated a very lucrative deal)! I also sent an article to The Birth Project, a Michigan publication. This year will also mark the second anniversary of this blog. Whodda thunk it? My work in this world is beginning to take shape at last. I'm more excited about birth than ever, and the possibility of delivering my message to those who desperately need to hear it (women and care providers alike) makes me feel vibrant and alive.
To think, an annoying an inconvenient pregnancy at the grand old age of 45 has initiated all this. As an extra bonus, we have a 1 year old toddler who makes a mess of everything in his line of sight, and also just happens to be the light of our lives.
Maybe God knows what she's doing after all.
Peace to you all in the coming year.

Sunday, December 16, 2007

World Traveller

I got in! Next month at the end of January, I will be attending the US Breastfeeding Committee meeting in Washington DC. Now I was not chosen for one of the freebie slots offered to two people from each state (my buddy Charlene got one of those) but I was selected for on "Open Slot" which just means I pay my own way. Unfortunately this means I won't get to go to Mexico for the San Miguel Walk. Both events happen over the same weekend. I'll miss Mexico and San Miguel.

My favorite memory of both times is watching from across the street as hundreds stream into the local parrochia (church) to participate in the special mass and recieve the special blessing before the walk begins. It is pitch black 0utside and the moon is high. Its about 4:30 am and the air is cool. We are all dressed in layers since the temperature will reach about 80 degrees at midday, but at the start of the day a hat and gloves are needed. We mill around our truck as the cook hands out atole (a hot corn meal based drink that is thick and reminds me of hot chocolate) and tamales (usually cheese tamales for breakfast, at first I don't care for the taste of them and stuff two of them into my pockets, several hours later during the walk, I am ravished and they taste like mana from heaven) We will walk about 8 hours today, the first 5-6 before we stop for lunch. The mood is quite festive and as the walk officially begins at sunrise, it appears the whole town has come out to see us off. They line both sides of the streets as the walkers or peligrinos (pilgrams) as we are called head off into the great distance on the road out of town. We are preceded by native dancers and municiple bands. There is a great clamor of humanity as 10,000 souls stream out of San Miguel on the road to San Juan De Los Lagos in the neighboring state of Jalisco (actually there is no road, we mostly travel through mountain ranges and cow pastures- somehow the leaders know the way). Onlookers press oranges and bottle water into our hands, it is said to be a blessing to give something to the pilgrams during their journey. One of those oranges becomes a blessing to me. The thin air and high altitude are hard on a midwestern girl. At one point I am dizzy and tired from dehydration and low blood sugar. I remember the orange in my pocket, peel it and gulp it down. Its sweet juices immediately revive me as I continue walking... The town of San Miguel seems a second home to me. Its streets are sweet and familiar. I have a favorite park, a favorite restaurant, favorite shops, a bank I prefer, and an internet cafe where gringas are warmly welcomed by the owner. When I return I would like to stay a month and attend language school. The locals are used to foreigners and are very patient with those who don't speak the language well. I get stares on the street because I wear my hair very close-cropped and because I am dark-skinned. I'm sure they don't see much of either. I take to wearing a straw hat or serape over my head to keep from drawing so much attention from my nearly bald head. I am head and shoulders above most of the indiginous indians, even the men. I am so tall and so fat- this too makes me stand out. Estrella, my American guide reminds me to smile to soften my face and put them at ease, or else I look severe to them. She is right, when I smile, they always smile back. All this and so much more I will miss of San Miguel when I am not there next month. The street vendors selling my favorite snack, cool peeled cucumber drenched in lime juice and sprinkled with red pepper. Sitting down to miskas (mexican scrambled eggs with vegetables and torilla strips cooked into the eggs) at my favorite haunt. The slower and decidedly different time frame. I usually started my day with fresh fruit at around 7am but didn't have a real breakfast till nearly noon. Amazingly (to me) all the restaurants were still offering breakfast at noon. Lunch time didn't start until around 2pm. Here in KC, you'll get no breakfast after 10:30 unless you find a restaurant that serves breakfast all day. Dinner time was about the time I usually went to bed! I would purchase cheap and abundant avocados and tiny flavorful limes along with handfuls of fresh cilantro and make my own guacamole for snacks or meals at tiny little store front shops that were located about every other block. Or for a few pesos, I could buy a freshly made tortilla stuffed with chicken, napoles (cactus), and beans from a street vendor. Can one be homesick for a place that is not actually their home? My heart, my head, (and now my stomach) tells me that it must be so.

Tuesday, December 04, 2007

The Value of Worth

I had dinner with a midwife last night. We chewed the fat about how things were going and I reflected on the first time we met... I had invited her to my office for a meet and greet. This was around 2002 or 2003. She accepted my invitation and we sat and chatted a couple of hours. (I often meet people this way. If I want to get to know someone, I simply call them up and invite them out to coffee or lunch or something.) During our conversation I asked how her collaborating physician was compensated, and she confided that he got what seemed like more than his fair share of what she made. "What !?!" I yelled without stopping to censure myself, "that's more like pimp and prostitute than doctor and midwife!" I pictured some middle-aged guy in a lab coat but sporting a purple feathered fedora and two-toned wingtips... I chuckle about it now, but that was really a defining moment for me. I wanted to help women have better births and more options, but the work of the midwife seemed so unfairly compensated. I also saw midwives getting little respect from their OB colleagues while doing twice the work for half the pay. I dropped in on a local meeting of CPMs last week and found them discussing compensation for their work. They laughed about how clients would say they could not afford their fees and yet would miss appointments because their pedicures were still wet, or their massage appointment ran late. If we want to be valued for what we do, we must first value ourselves and the work we do. I want to help women, help themselves. I want to help careproviders provide better care AND I want to be well compensated for it. Do those values seem at odds? They are not. They are both essential to a quality life.

Sunday, December 02, 2007

Midwives locally, breasts globally

The United States Breastfeeding Committee is once more planning its annual conference for state breastfeeding coalitions. They sponsor two attendees from every state to come with expenses covered. I did not get one of those slots, so I applied to attend in one of the limited open slots (which means I pay my own way). I'm hoping to get a slot and attend in January since they have some special training they are doing on lactation support in the workplace. A member of my breastfeeding committee, Charlene, was selected to attend last year, and may be selected again this year, so at least Kansas City will have someone there if I don't make it. It would be so cool to meet breastfeeding coalition members from all the US states and territories (and Tribal Nations). I'm keeping my fingers crossed, its a very selective (and costly) event.

I got an email from a reader in my area looking for a certified nurse midwife to do a homebirth.
She had mentioned that she wanted a 'legal' homebirth and therefore only wanted to interview CNMs since CPMs are not legal in Missouri. (Though technically, the illegality is on the part of the CPM for attending her, not on her part for hiring one.) I encouraged her to interview the two CNMs she was aware of but also to consider this option:

"If you are considering a homebirth with a CNM, I think you might find Sage Femme and its midwives a pleasant surprise. It provides a lovely birthing environment and Kirsten Miller was my midwife for my homebirth last year (she no longer does births at home). I think she is wonderful and ditto for Sage Femme. It is a jewel and a well kept secret. If I were you I would appeal to my insurance company- they may very well cover a birth center birth. I went through the appeal process with my insurance company, who at first refused to pay anything. They eventually (it took a year!) covered 100% of the cost of my homebirth- even though their policy was not to pay for them. To speak to your comment, "I was afraid that my options might be limited" - they are. That is why we as birthing women must be willing to negotiate for what we want in birth- and fight if need be. Let there be no doubt- women are losing their options in birth. If we don't work to keep those options open, no one else will. "

Though I really don't want to steer this woman away from homebirth (I hope she'll be happy with one of the two midwives she has to choose from), I was happy to be able to offer another option. Women like this are exactly why I'm writing my book. I can't tell you how many women I meet or hear of who are interested in homebirth but drop the idea because they can't find a midwife to attend them or buckle under the pressure of opposition. My book won't create midwives where there are none, but I'm hoping it will help women find the resources they need to make their births happen in an out of hospital birth environment. (For instance, I'll have a whole chapter dedicated to dealing with insurance companies.) Homebirth and Birth Center birth are the real options to hospital birth. What can we do to make them more accessible to more women?