No matter how many books you read, how ready you think you are, or how long you’ve been pining for a child, there is nothing that can truly prepare you for parenthood. Many people are the “best” parents before they have children, vowing that their children will never do this, eat that, or be allowed such-and-such. The reality is that having and raising happy children means releasing selfishness, rigid schedules, and preconceived notions. It means letting go of some of the hopes and dreams you have for your children and allowing them to aspire to their own. Parenthood is about acceptance of the process, despite your confusion and frustration as to why your child isn’t sleeping for a specific number of hours in a row, wanting to play a particular sport, or has a certain medical condition.
Releasing is not easy. It takes time, practice, and dedication. However, the rewards can be great. You will find that there is sweetness in the toddler snuggling in your bed, the girl who favors stained Beatles t-shirts over her sister’s hand-me-down skirts, the child who decides ballet is not for her (making for an abundance of tutus and dance shoes in the dress-up bin) and the boy who prefers to sleep in a pink owl bed with his little sisters versus being alone. When you’re able to let go of what you thought your children should be, you’re able to love and accept them for who they are.
[Reprinted here with permission from enlightenedmama.com and with gratitude for all Liz Abbene and the enlightened mamas of Minnesota do for all of us!]
Everything You’ve Always Wanted to Know About Agpar Scores But Were Too Afraid to Ask
History
In 1952, an anesthesiologist named Virginia Apgar proposed a formula be devised that could be used by all medical professionals to assess the condition of a newborn infant. Up until that time anyone—doctor, midwife, nurse or anesthesiologist—could (and would) simply look at a baby during the time they remained in the delivery room and the conversation could go something like this:
Doctor: “He’s a bit floppy, let’s suction him again.”
Nurse: “Maybe a bit of oxygen will pink him up a little, do you think blow-by would be enough?”
Midwife: “I’m going to rub him a bit with a towel here on Mom’s tummy and get some better muscle tone.”
Mother: “Isn’t he too blue?”
Yes, he is blue and it is has been five minutes and someone could have/should have tried all of the above, but you get the idea that assessment of a newborn was haphazard at best, and could have been managed better. We have attempted to make alternative arrangements over the years in deciding who the decision-makers in the delivery or birthing room (or home) are going to be, but our wise friend Dr. Virginia Apgar gave us a tool to use that would become a universal way of guiding our protocols, which just means we now know what we should be seeing in a newborn, when we should be seeing it, and what to do about it if we don’t. It was decidedly instrumental in taking an ambiguous concept and turning it into a workable framework in order to obtain an accurate reflection of the observations at present. Actually very simple, it works, and Apgar scoring has changed very little since its inception. I am including a short summary of the Apgar Score to give a little background for how this played into my own research and work in bonding.
What is the Apgar score?
Ninety percent of term infants make a successful and uneventful transition from living within the womb to the outside world. About ten percent will need some medical intervention and less than one percent will require extensive resuscitation. A reproducible and rapidly determined rating system is necessary for evaluation of the newborn infant. The Apgar score is a practical method for assessing a newborn.
How is the Apgar score done?
The Apgar score is a number calculated by scoring the heart rate, respiratory effort, muscle tone, skin color, and reflex irritability. Each of these objective signs can receive zero, one, or two points.
What does a high or low Apgar score mean?
A perfect Apgar score of ten means an infant is in the best possible condition. An infant with an Apgar score of zero to three needs immediate resuscitation. It is important to note that diligent care of the newborn is an immediate response to the current status of the infant. It is inappropriate to wait until Apgar scores are obtained to begin or continue to address the needs of the newborn.
Why was the Apgar score developed?
The score is named for the preeminent American anesthesiologist Dr. Virginia Apgar (1909-1974), who invented the scoring method in 1952. Having assisted at thousands of deliveries, Dr. Apgar wished to focus attention on the baby. Babies were traditionally dispatched directly to the nursery, often without much formal scrutiny after delivery. Apgar wanted the baby to be assessed in an organized and meaningful manner by the delivery room personnel. Dr. Apgar was the first woman to be appointed a full professor at Columbia University’s College of Physicians and Surgeons.
Resources
Videos
Birth Story: Ina May Gaskin & the Farm Midwives, 2012, directed by Sara Lamm and Mary Wigmore. (DVD)
“Breast Crawl by UNICEF” http://www.breastcrawl.org/video.shtml A must see!
Breastfeeding: the Why-to, How-to, Can-do Videos—Vida Health communications. www.vida-health.com
The Business of Being Born with Abby Epstein and Ricki Lake. (DVD) (See also More Business of Being Born, the continuation of the series.)
“Christian Dads Experience What It Feels Like to Give Birth”—One for your partner! (YouTube)
Doula—about Loretha Weisinger’s work with teens. (Netflix)
Doula: A Documentary—produced in 2012 by Childbirth Collective in Minneapolis and Emily Rumsey. http://www.emilyrumsey.com
“The Dramatic Struggle for Life”—very amazing footage from Bali. (YouTube)
Everybody Loves . . . Babies by Thomas Balmes. (DVD)
“Extraordinary Breastfeeding” A five-part online video series, these videos give real food for thought! (YouTube)
Guerrilla Midwife—Follow CNN Hero of the Year Ibu Robin Lim into the trenches of her work from Bali, where hemorrhage after childbirth is a leading cause of death, into the Tsunami disaster zone in Aceh, where her battle is fought with only one weapon, love. (Online video)
“Thalasso Bain Bebe par Sonia Rochel”—Baby bath by Brazilian midwife Sonia Rochel (YouTube)
Twin Vertex Birth—the birth of the author’s twins at The Farm in 1982, with Ina May Gaskin. (DVD)
Internet Resources
AskDrSears.com—valuable advice on breastfeeding and parenting (my personal favorite)
Breastfeeding Resource Pages—La Leche League International.
www.llli.org/nb.html
Caroline Flint, U.K. Midwife website: http://carolineflintmidwife.tumblr.com/
DONA International website: information on doula training, certification and Doula magazine. http://www.dona.org
Ina May Gaskin’s homepage: http://inamay.com/
The Newman Breastfeeding Clinic, the Centre for Breastfeeding
Education, and the Centre for Breastfeeding Studies:
http://www.nbci.ca You can call them for help anytime, too: 416-498-0002. A connection to an amazing group in Canada with seemingly endless information—all excellent.
Ongoing blog: callthedoula.blogspot.com
Books
Attatchment Parenting: Instinctive care for your baby and young child, by Katie Allison Granju
Babies, Breastfeeding and Bonding, by Ina May Gaskin
Baby-Led Breasetfeeding, by Gill Rapley and Tracey Murkett
Birth Matters: A Midwife’s Manifesta, by Ina May Gaskin
The Birth Partner—Revised 4th Ed.: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions, by Penny Simkin
The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth, b
y Penny Simpkin
Birth—Through Children’s Eyes, by Penny Simkin
Breastfeeding and Natural Child Spacing: How Ecological Breastfeeding Spaces Babies, by Sheila Kippley
The Breastfeeding Answer Book, by the La Leche League International
Breastfeeding Matters: What We Need to Know About Infant Feeding, Maureen Kathryn Minchin
Comfort Measures for Childbirth, by Penny Simkin
The Continuum Concept: In search of happiness lost, by Jean Liedloff
Do Birth: A gentle guide to labour and childbirth, by Carolyn Flint
Hold Your Premie, by Jill and Dr. Nils Bergman
Ina May’s Guide to Breastfeeding,by Ina May Gaskin
Ina May’s Guide to Childbirth, by Ina May Gaskin
The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia, by Penny Simkin
Medications and Mothers’ Milk, 14th ed., by Thomas W. Hale
Mothering the New Mother, by Sally Placksin
The NAPSAC Directory of Alternative Birth Services and Consumer Guide, by Penny Simkin
Natural Health after Birth, by Aviva Jill Romm
The Nursing Mother’s Herbal, by Sheila Humphrey
Parenting Without Borders: Surprising Lessons Parents Around the World Can Teach Us, by Christine Gross-Loh
The Politics of Breastfeeding, by Gabrielle Palmer
Pregnancy, Childbirth and the Newborn, by Penny Simkin
Saving Babies? The Consequences of Newborn Genetic Screening, by Stefan Timmermans and Mara Buchbinder
The Simple Guide to Having a Baby, by Penny Simkin
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, by Anne Fadiman
Spiritual Midwifery, by Ina May Gaskin
The Tender Gift: Breastfeeding, by Dana Raphael
Testing Baby: The Transformation of Newborn Screening, Parenting, and Policymaking, by Rachel Grob
The Ultimate Breastfeeding Book of Answers: The Most Comprehensive, by Jack Newman and Teresa Pitman
When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women, by Penny Simkin
The Womanly Art of Breastfeeding, by La Leche League International
Waiting With Gabriel: A Story of Cherishing a Baby’s Brief Life, by Amy Kuebelbeck
Products
Beba Bean Pee-pee Teepee
“Birthing is the most profound initiation to spirituality a woman can have.”
~Robin Lim
Acknowledgements
I must first honor here the very courageous Ethiopian and Somali women and men I have had the privilege of getting to know and love: Jamad Sheik Nur, Fatima, Jama, Farhia, Said, Fosiyo, Fowsiya, Meskia, Hikmet, Mahdi, Tigist, Mantegbosh, Mohammad, Abdighani, Yohannes, Keleme, Chala, Shamsudin, Hibo, Radiya, and so many, many others.
Next, for her courage, fearless outspoken wisdom, and insight, along with thousands of other midwives, doulas, and parents, I wish to thank Ina May Gaskin for her life’s work, which has immeasurably blessed us all.
Special thanks goes also to those who believed in me when I didn’t: eminent scholar and author, my father, Dr. Maurice L. Schwartz (1925-2014), who had ten books under his belt in his lifetime; David, my husband of thirty-eight years, who has encouraged me through every last step of the impossible paths I have chosen throughout our lives together—I will have you canonized yet! Our children: Abraham, Isaac, Ruth, Rachel, and Hannah who, each in her or his own exquisitely unique way, helped me grow and discover first who I am now and then what eventually became this book; and my sister Phebe Schwartz who is wandering around somewhere in Cambodia as I write this. Stay well and safe, my love!
My cousin Roslyn Sternberg-Willett—author, world traveler, feminist, and a rare woman of distinction and accomplishment, was the driving force behind getting me to ever bring my stories to a publisher in the first place.
For his tremendous support and invaluable advice throughout this entire project I wish to thank Mr. Nasibu Sareva, CFO and Executive Director of the African Development Center (ADC).
Ms. Ma Xiong holds a very special place in my heart, as does her family. Look for her forthcoming memoirs that I have been honored to work on with her.
Roberta Poirier, CNM, is my heroine and has been my mentor throughout my adult life, once I finally figured out what I wanted to be when I grew up. She has also been my midwife and friend. Hugs and many, many thanks, my dear!
And without my very own personal wizard-magician-computer-guru, Don Geronimo, I would not have gotten to first base, much less been able to let the rest of the world know about this book via our blog. (Did you know some people can talk to laptops? And they listen, too?) Thank you, dear Don. I owe you big time. Just say the word!
For all the mothers—Native, African, Indian, Asian, European, Arab, and American—who have permitted me to attend their births during the past thirty years, it is an honor that I don’t take lightly. Each mama, each and every baby, and each partner make their birth unique. The time of that particular birth, that nanosecond within all the cosmos, makes that birth the most important single event in the universe that is happening at that moment, and you shared it with me. I am deeply grateful.
A huge thank you, too, goes to all of the midwives, doulas, nurses, and doctors who have shared their wisdom with me and supported me in my work, especially Debby Prudhomme, CD(DONA), Mary Williams, RN, CD(DONA), Catherine (Molly) Szondy, RN, CNM, and Valerie El Halta, CPM.
And for the real blood, sweat, tears, and prayers that birthed this book I have my very own doula, Tabatha Obert, to thank. (Starbucks helped!)
I also want to thank everyone at North Star Press: Corinne, Curtis, Anne, and everyone else who played a part, no matter how small, in the labor and birth of Ma Doula. I had no idea when I began this adventure how close we would become to one another. I could definitely not have done it without each one of you!
Last, but certainly not least, I must thank my agent/friend/editor Patricia Morris for her faith in my work and her unwavering support when I was ready to ditch the whole project. You are my fairy godmother! Who else makes dreams come true?
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