Monday, February 29, 2016

Birth Isn't for Everyone

Birth workers love birth, and we are passionate about advocating for people who give birth.

When you're advocating for people to be respected and given choices backed up by evidence when giving birth, you're not thinking much about all the people out there who don't want to give birth.

I've seen plenty of blogposts about being sensitive to people who may want to have children, but are struggling with illness, infertility, or financial issues that make pregnancy impossible, or not a good choice.

I see lovely, thoughtful articles about doulas who haven't had children, pointing out that the doula without children is not lacking in warmth, empathy, and presence, and in fact has a few advantages: if you don't have your own birth story, you can't project your birth story onto someone else's. You enter that space baggage-free. On a purely practical level, you also don't have to worry about finding last-minute childcare.

But what I'm not seeing is...an acknowledgement of all the people, both birth workers and not, who don't have children by choice. Who...(better whisper it)...don't want children

It's kind of a scary thing to admit. It's one thing to hire a doula who hasn't had children YET...but a doula who doesn't want children? Isn't that weird?? Why is she even a doula???

Well, lots of nannies, day care workers, preschool teachers, therapists, etc. etc. etc. who have a passion for working with children are really happy about going home at the end of the day and having a break from that intense energy, and they want to keep it that way.

And lets be real, if we're talking birth doulas, we don't spend a ton of time with babies. Our client is the birthing person, and once the baby has arrived, our time with them is nearing its end. That's just the nature of our role in birth work. I think its safe to say that all doulas are moved by the miracle of bringing a new baby into the world, the honor of being a part of welcoming the youngest human on the planet into life on earth. I certainly am...but that's a very different thing from wanting to raise a baby of your own.

Many doulas came into doula work because of their own birth experience, but personal experience is not the only reason to care deeply about an issue. For me, doula work is an integral part of my feminism: birthing people are disrespected and not provided with the resources and care they need because of systemic misogyny. Because not only women give birth, that systemic misogyny affects more people than just women, but the roots are still a distinctly feminist issue.

The way that people who aren't women who give birth are routinely erased from the conversation is an LGBTQ issue, and one I also care deeply about. And the fact that women who don't choose to give birth are also routinely erased from the conversation is another issue I care deeply about. I don't think the two are really comparable, though. After all, if the conversation is about people who give birth, then people who don't want to give birth aren't going to be a large part of that conversation.

The solution is simple: if you're talking about people who give birth, refer to them that way. Referring to them with the simultaneously too generic (lots of women never give birth), and too specific (lots of people who aren't women do give birth) term 'women' is just universally unhelpful. You can read my last blogpost to clear all that up, though.

Any birthing person is free to choose their birth team according to their own needs, and proclivities. There are certainly people out there who wouldn't hire a doula without children, and there are bound to be others who would hire a doula who didn't have children, but not one who doesn't want children...but if you feel like you fall into that category, it's worth considering if you've been influenced by a society that tells cis-women that their worth stems solely from their role as mothers. Things are more complicated for trans-women since their identity as women in is so often questioned, but that only makes matters more difficult for them.

There's nothing wrong with a woman not wanting children. There's nothing wrong with any person not wanting children. And, supporting people in this decision, instead of trying to talk them out of it, or treating them like there's something wrong with them could potentially lower the rate of child abuse and neglect. Pressuring people into parenthood serves nobody. The more we can all love and support each other, even, or especially when, we make very different choices, the closer we'll move to a just, and peaceful world. And using our words to reflect that understanding matters.

Live, and Birth Omily,
~Emily

Saturday, February 20, 2016

Doulas and Dontlas: Promoting Justice for All Birthing People

I had an incredible experience doing my intensive birth doula training workshop last week. Being close friends with a doula, and having an ex-lamaze instructor for a mom (and two little sisters born when I was 11 and 13), I thought I knew a lot about birth, and the needs of birthing people, but we receive so many messages that are based on one specific type of birth that it's almost impossible not to internalize it to some degree.

That type of birth is a highly medicalized one where interventions are used on a 'routine', or 'just in case' basis more so than on an 'as needed' basis.

One important role of a doula is to encourage their clients to research the process of giving birth, and the interventions that might be used, and why,  so that they can make informed decisions.

Another important role is to do everything within the doula's scope of care to make sure those preferences are upheld, unless a deviation becomes medically necessary. Which might seem sort of obvious: like, who needs a doula to make sure a doctor doesn't do something that isn't medically necessary? Except as I already explained, your typical birth in America is full of interventions that are being used on a routine or 'just in case' basis.

Some examples of these include: iv fluids, restriction of movement in labor, augmentation of labor with artificial oxytocin, restriction of movement to supine position during second stage (after the cervix is dilated, when the birthing person is actually pushing out the baby), even episiotomy (enlarging a birthing person's vaginal opening by cutting toward their anus). Sometimes these things are medically indicated, but in the majority of births they are not, but some or all of them are still used routinely by various labor and deliver practices.

Some are falling out of fashion faster than others: I remember reading my mom's Erma Bombeck books when I was a kid, and being confused by her references to sitting on a donut pillow after giving birth. That pillow can provide relief for any person after birth, as their tissues are likely to be tender, or they may still be dealing with hemorrhoids, but the pillow was a potent symbol of the immediate post-partum period for people of a certain age because for a while, episiotomies were a routine procedure to 'prevent tearing' of the perineum. By cutting it. It is exactly as crazy as it sounds. Studies showed that episiotomies did not prevent severe tears, and the practice is quickly falling out of favor, but it's still done if second stage is taking 'too long'.

Other practices, like routine iv fluids, or at least a saline lock to keep a vein open, are still widely practiced, even though studies don't show them to lead to better outcomes for birthing people or babies, and constant iv fluids can actually slow labor by diluting hormone levels in the laboring person's bloodstream.

The connection between the way people are (mis)treated throughout labor and birth, and centuries of misogyny, and misplaced priorities (money over human life) are all too clear to me. Birth is ground zero in the fight for a more just and peaceful world, and I'm honored and proud to be on the front lines, bringing love, advocacy, and support to people during this vulnerable time.

This is all very familiar information to my doula/birth worker/birth advocate audience, but I'm about to switch gears to something you may not have thought about much before, so stick with me.

Depending on how sensitive you are to the vagaries of language, you may or may not have noticed that though I've spent the last eight paragraphs talking about childbirth, I haven't used the words 'mother' or 'woman', or the pronouns, 'she', or 'her' once (except in that first paragraph). That was done intentionally. Very intentionally. I'm still fighting old habits, and that means a lot of typing, backspacing, and retyping, and rereading to catch missed uses of those words.

Both as someone who sees birth work as a way to bring justice into the world, and as someone who tries to be a decent human being, it's important to me to remember, and remind others, that not all women give birth (hey guys, child-free-by-choice Doula here! That will need to be its own blog post, though), and not all those who give birth are women. Trans men, gender queer, gender fluid, a-gender folks, and anyone else with the biologically relevant body parts can all choose to bear children, and because the same system that oppresses women also oppresses these populations, I'm proud to support them as well by avoiding referring to all people who give birth as 'women', or 'mothers', and by using the pronoun 'they' to refer to birthing people (both singular, and plural), as opposed to 'she' and 'her'.

It's impossible to learn about the history (herstory) of giving birth without having opinions about present day interventions in the process, and without having a lot of anger about the oppression of birthing people throughout the process. Many advocates, in their admirable efforts to speak up and move into an era where women, and birthing people are not oppressed, unintentionally oppress trans people (trans encompasses all people who don't identify with the gender they were assigned at birth, so it applies equally to trans men, trans women, a-gender, gender fluid, and gender queer people) by conflating 'women' with 'birthing' people. This implies that only women are oppressed through our modern institution of childbirth, effectively erasing trans people completely from the picture.

That is a really hurtful and unhelpful thing to do when you're fighting for justice. It's not that we can't talk about how cis-women are hurt by modern institutions of childbirth. It's that we need to specify if we're talking about cis-women vs. the entire population of people who give birth. And that we need to recognize how trans people are being hurt in the same way birthing cis-women are, but they are suffering from additional layers of oppression on top of it every time a nurse comes into the room and misgenders them based on the fact that they are giving birth. Cis-women have a level of privilege in that they are not subject to that extra level of erasure and dehumanization.  It's equally hurtful when a birth worker/birth advocate/doula misgenders them in a post or article meant to support and advocate for birthing people.

Historically of course, trans people weren't acknowledged, so you may think that if you're talking in the past tense, referring to all birthing people as women is fair game, but erasing trans history is no better than erasing trans people in the present. Though there weren't structures in place to allow trans people to be empowered to embrace their identities and come out in most cases, they still existed.

Just to be clear, individual people have preferred pronouns and words they want to be referred to by. There's nothing transphobic about referring to yourself as a woman, a 'she' or 'her', or as a mother, or using those terms to refer to a person or group of people who clearly identify with those terms. It's always wise to ask someone what they're preferred pronouns and words are, even if it seems obvious. It will feel awkward at first, but it's an important step toward a kinder, more just world.

If you have questions about this issue, I welcome them, but I ask that you reach out to me privately, instead of in the comments, because I don't want those questions to make trans people reading this post as a sign of growing support uncomfortable. You can go to the contact form on my website, www.emilyhursh.com to ask those questions, and as long as your question is thoughtful and genuine, you'll receive a thoughtful and genuine response.

As you can see, I take my role as an advocate for birthing people very seriously, but the role of advocate for oppressed populations in childbirth, and the role of a doula, a one-on-one support role, are quite different. My opinions have no place in the time spent with my clients. Just as I support a person who wants a planned induction of labor or cesarian with the same loving care as I do a person hoping for an intervention-free home birth, I know that labor is not the time to discuss, suggest, or correct pronoun or word usage.

Thank you loving and awesome doulas, birth workers, and birth advocates for all that you do! Please take a long, hard look at your habitual language around birthing people, so that you can be even more powerful promoters of love, acceptance, and justice.

Live, and Birth, Omily,
~Emily

P.S. In the next five to ten years trans women who were assigned male at birth may have the opportunity to bear children as well as the experimental procedure of womb transplants becomes more widely available. Five pregnancies and four live births have already resulted from this exciting technology. You can read more about it here.

Monday, February 1, 2016

Eating Omily: the FAQ

"How often do you go to the farmers market?"

"Isn't that expensive?"

"I could never cook that much."

"I'm just not that dedicated."

These are some of the more common questions and responses I get when people get a gander at my insulated tote bag, heavy with wonderful foods from the Union Square Farmers' Market. They're good questions, and they deserve answers! And the myths that lead to those questions and comments should be addressed as well.

First off, let me reiterate that I am a huge believer in baby steps. If you try to adopt my lifestyle overnight, you will likely feel overwhelmed and give up. I didn't adopt my lifestyle overnight; it evolved over time. I was able to slowly discover a system that works for me. The same can happen for you, too, if you give yourself time to do it.

Secondly, the Union Square Farmers' Market has changed A LOT in the ten years I've been shopping there. My habits have shifted to allow me to purchase more of my foods at the farmers market, but the farmers market has also grown, making many more things available to me that didn't used to be there. If you're dealing with a smaller market, no amount of dedication will enable you to do most or all of your shopping there if no one's selling staples that you need. It never hurts to mention what you're looking for to different farmers. If they discover there's a market for it, they may start producing it.

So, lets start with, "How often do you go to the farmers' market?"

I go three times a week: Monday, Wednesday, and Friday. All three of those days (and most of the other ones, too), I'm within two blocks of Union Square already, so walking through the market and picking up what I need is just a matter of remembering to bring my insulated tote with plastic bags with me, and taking out cash. I leave an extra fifteen to thirty minutes to do my shopping, depending on if I just have to pick up one or two things, or if I'm restocking a lot of basics. I almost always end up picking up one or two things I didn't plan on: a cheese that I sampled and couldn't resist, a piece of maple sugar candy to nibble, a catnip plant for my cat...I'm spoiled: the Union Square Greenmarket is a spectacular market!

Since my trip to the market is never an isolated errand, I have to think about how much I'm buying, and how heavy it will be to carry. If it's time to buy a half gallon of milk, I'm not going to want to pick up a few pounds of apples, and potatoes, and a quart of frozen soup at the same time. I have to plan a head a little bit, and consider what I need, and how soon I need it. I also have to ask for ice, if I know it'll be a long time before I get home, and I have something sensitive like milk, or fresh fish to buy.

Since I shop so frequently, I just keep a loose running tally in my head for most things: how are we doing on onions? Garlic? Sweet potatoes? Potatoes? Seasonal fruits? Green veggies? Bread? Popcorn? Milk? Butter? Yogurt? Cheese? Maple syrup? Honey? Flour? Corn meal? Dried beans? Eggs? Breakfast meats? Other meats? Bone broth?

Does it seem crazy to you that I have all that information in my head at any one time? Every time I'm in the kitchen I do a quick scan. The basket that holds apples also holds garlic and onions. If I get something out of the fridge, I glance at the milk, and yogurt. It's just a habit now. I've been known to let a bag of potatoes rot in the back of the pantry every now and then, but in general, its second nature to be on top of it.

Something that helps me manage my shopping is to meal plan. When I'm really on top of meal planning, my life is a million times easier. On Sunday nights, I go through my kitchen and see what foods I have, and look through my cookbooks for inspiration. Usually I plan a slow cooker meal, a really fast meal for my late night of the week, and then whatever I'm feeling inspired to make for the other three nights (on weekends, we're out often enough that its easier to just throw something together if we end up home). Once I know what I want to prepare that week, I know exactly what I'll need to and when I'll need it by. I make my list, and pick it up as needed when I'm at the market, along with any pantry staples I discovered I was low on during my meal-planning session.

Lets skip the second question for a second, because I think we're bumping right up against the next comment down: "I could never cook that much."

I get it! Cooking takes time, energy, and planning, all things that we're in short supply on when we stumble through the door after a long work day...but if you take the time to do the planning over the weekend, half the battle is over. You can plan how ambitious you want to be based on how your day usually goes, and if your week gets unpredictable, and you need to swap two meal nights, its usually not a problem.

What if you don't know how to cook?? You can learn. Don't get too ambitious right off the bat! Learn to scramble eggs. Learn to sauté onions and garlic. Saute garlic and onions, and then add eggs and scramble. Try the same thing, but wilt in spinach. Buy pasta at the farmers market. Buy sauce at the farmers market. Make yourself a delicious pasta dinner. Try making your sauce taste more aromatic and fresh by sautéing garlic, onions, and herbs, then adding the sauce just to heat through.

Watch cooking shows (look for shows on netflix and youtube). You might try some of the new services that ship you fresh ingredients and recipes that you cook yourself. They could help you learn basic techniques hands-on in a more fool-proof way. Invite your friends over for dinner, with the caveat that you help them cook, and they teach you what they're doing.

Take baby steps! Try to cook once a week until you're comfortable with several different kinds of recipes, then step it up to more and more often.

At first, you'll treat recipes like gospel, and panic when you can't find a certain ingredient, but keep trying, and start experimenting. You'll soon learn the basic techniques behind recipes that will enable you to see substitutions that are easier for you to come by at a glance. Eventually, you'll use recipes for inspiration and guidance, but you'll rarely follow one start to finish.

You also don't have to cook every night. Frozen quarts of soup, the afore-mentioned pasta, pre-mixed bags of salad, and ready-to-eat meats like duck confit, and smoked trout are all available to bail you out.

Once you're comfortable cooking, there are also dishes that are so easy and quick to make, you won't mind except on the roughest days: scallops sear over high heat in just a couple minutes per-side, and pair beautifully with whatever veggie's easiest: sautéed greens, roasted root vegetables, a simple salad. I put fish fillets in a paper bag with corn meal, and shake to coat, then cook till brown and crisp in ghee, with a sprinkle of salt and old bay seasoning blend.

And don't forget about your slow cooker! Chop and drop things into the slow cooker in the morning, add water, turn it on, and when you get home dead on your feet, not only do you not have to cook, but an incredibly warming, comforting, nutritious dinner is waiting for you! It's pretty much the best thing ever.

Don't underestimate the power of left-overs. If you're cooking more often than not, a surprise crazy day that leaves no time or energy for cooking can be covered by enjoying whatever tasty dishes you made earlier that week! I eat most of my leftovers for breakfast, but they make great packed lunches, or easy dinners, too.

"Isn't that expensive??"

It can be. If you lean hard on those ready-to-eat meats, and pre-made meal options, you'll have pretty expensive meals. If you cook whenever its feasible, and take advantage of dried beans, eggs, and tough cuts of meat (much cheaper main courses), it's more manageable.

If you already choose sustainably raised options at the grocery store, your bills won't go up much. If not, take the time to learn about what you're paying for with that extra money, and you may find you're willing to give up a couple cocktails and lattes to make it work.

If you're relying on seamless (or however you order takeout in your neck of the woods), even with the higher rates you'll pay over the grocery store, you'll save money by buying foods and cooking them!

"I'm just not that dedicated."

Start picking up what sounds delicious to you and that fits in your budget when its convenient, and you might surprise yourself. Seared duck breast and broccoli rabe? Skip the expensive restaurant and make it at home in about half an hour, dirtying only two pans, a stirring utensil, and whatever you eat off of. Take whatever baby steps work for you. Don't push yourself to overwhelm, but also don't tell yourself that you could never do that. Leave yourself room to grow and change.
Chili with all local ingredients (with the possible exception of the beer)! Saltisfying, and healthy with of veggies and beans, and pasture-raised beef!
Fresh rainbow trout pan-fried in corn meal with sautéed Brussels' sprouts! 
Now that you know how I make it work for me, I hope you're feeling inspired to try to make it work for you! Any burning questions I missed? You can ask them in the comments...