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Did I get your attention? Good. The talented Betty Jo is has written a post just for OMK. Maybe, if we’re nice, she’ll send us more.
By Betty Jo
I’ve had a chance to birth my two kids at two of the most progressive hospitals in the nation and have some thoughts running around in my head about the pros and cons of such birthing options for the completely normal birth. Since health care seems to be sucking up ever increasing resources and birth is a feminist issue at its core, I thought I’d use this space to pen some of my (flaky, sleep-deprived) thoughts.
To start, I suppose I should define progressive. These are mother-centered hospitals with enormous (12+ women) CNM midwife groups that encourage doulas and natural birthing if you so desire. Hospital #1 is a teaching hospital which also has a long-standing CNM (certified nurse midwife) degree program inside a university that is known for integrated primary care; the CNM practice is integrated into a larger ‘woman’s health center’ type place that is lovely. Hospital #2 is the primary hospital in the region for a large HMO which has one of the longest-standing hospital midwife programs in the country; it contracts out all of its high-risk births to another hospital in the region so the midwives actually rule the roost so to speak at HMO hospital. It is also a WHO ‘baby friendly’ hospital – so no arguing about whether or not a pacifier will be given, etc.
I myself saw only a midwife for prenatal care in both pregnancies. In some ways, seeing a midwife within these large groups is great – when things came up that were possibly out of the norm, a quick email to high-risk OBs quickly resolved the issue. Everything is all coordinated with my primary care doctors; my prescriptions are seamless; even my (and the newborn’s) followup apt-making is seamless.
But there are some drawbacks of these big groups. First, there is no guarantee (and very low odds) that your midwife will be on-call when you deliver. This is how they keep costs down; but it also kind of wrecks (what is in my view) one of the attractions of midwife care – that you have a personal relationship of enormous trust with your provider.
The second is that you must birth in a hospital. If I’m completely honest with myself, that wasn’t a complete drawback for the first birth. Even though I have a mother who (for the 1980s) was pretty progressive in terms of how she interacted with pregnancy, I had my doubts and the hospital seemed ‘safe.’ My husband was even more skeptical of the process. And even though I wanted a anesthesia-free birth, the knowledge I could change my mind at the last second was somehow comforting. So, I had probably the best in-hospital, low-intervention birth you could want. But it was a very lengthy labor and, despite the best care and great facilities, I found all the poking and prodding annoying during and especially after delivery. After a 32+ hour labor (nearly 20 of it at the hospital) and less than a 30-hour post delivery stay, we walked out knowing (at least with a normal, low-risk pregnancy) why people choose to birth at home.
Fast forward 4 years and we were expecting #2. We also had different insurance….the HMO insurance that keeps costs down by making sure everything ‘normal’ is done within their facilities. Well, birth is normal. Normal enough that people like me should be able to have a baby at home. But my house is not their facility. We toyed with getting a homebirth midwife. But at the end of the day, we could not justify the cost differential of home vs hospital birth.
And that is lesson #1. We pay over $600/month in insurance premiums for our family of 3 (now 4) which is matched by my husband’s employer for great insurance. A hospital stay copay is $100/night. My entire birth and our 2 night hospital stay cost a $200 copay. Sure, it was billed out at $7500 – and that is cheap because it was a midwife attended birth within an HMO that pays providers salaries rather than by procedures with no epidural (so no anesthesiologist charge), no interventions, nothing but a bag of pitocin when I started bleeding a bit more than desired and two nights of a hospital bed. But I only had to pay $200.
A homebirth is obviously cheaper than $7500. In this area, they seem to run $4-$5K. But because we have an HMO (which, for the record, I actually love in so many other respects both in terms of care and in terms of overall efficiency of health care provision), none of that would have been picked up by the insurance.
Look, I had a nice birth experience and have a healthy baby. I am incredibly happy with my prenatal and postnatal care. But this is likely our last child, and I’m mourning my lack of homebirth this time (and I’ll tell you why in my next post). And I’m feeling angry that I have to mourn that. What kind of choice is that? $200 vs $4500? The incentives are such that I chose the less efficient option (and the more emotionally draining option) because the out-of-pocket costs. Something is incredibly perverse in this cost structure, don’t you think?
It is raining outside and I am thinking of this poem by Billy Collins, former Poet Laureate of the United States who is well-known for his accessible and deeply grounded poetry.
by Billy Collins
It is on dry sunny days like this one that I find myself
thinking about the enormous body of water
that lies under this house,
cool, unseen reservoir,
silent except for the sounds of dripping
and the incalculable shifting
of all the heavy darkness that it holds.
This is the water that our well was dug to sip
and lift to where we live,
water drawn up and falling on our bare shoulders,
water filling the inlets of our mouths,
water in a pot on the stove.
The house is nothing now but a blueprint of pipes,
a network of faucets, nozzles, and spigots,
and even outdoors where light pierces the air
and clouds fly over the canopies of trees,
my thoughts flow underground
trying to imagine the cavernous scene.
Surely it is no pool with a colored ball
floating on the blue surface.
No grotto where a king would have
his guests rowed around in swan-shaped boats.
Between the dark lakes where the dark rivers flow
there is no ferry waiting on the shore of rock
and no man holding a long oar,
ready to take your last coin.
This is the real earth and the real water it contains.
But some nights, I must tell you,
I go down there after everyone has fallen asleep.
I swim back and forth in the echoing blackness.
I sing a love song as well as I can,
lost for a while in the home of the rain.
“Water Table” by Billy Collins, from The Art of Drowning
A special installment!
Yesterday was my baby boy’s birthday (2!) and today is E.E. Cummings’ birthday… so this poem is dedicated to my not-really-a-baby-anymore boy. This poem usually gets categorized as a romantic poem, but that interpretation has never really resonated with me; Cummings doesn’t usually talk about women in terms of their “intense fragility.” My theory is that this poem is about a baby. So: perfect.
somewhere i have never travelled,gladly beyond
by E. E. Cummings
somewhere i have never travelled,gladly beyond
any experience,your eyes have their silence:
in your most frail gesture are things which enclose me,
or which i cannot touch because they are too near
your slightest look easily will unclose me
though i have closed myself as fingers,
you open always petal by petal myself as Spring opens
(touching skilfully,mysteriously)her first rose
or if your wish be to close me, i and
my life will shut very beautifully ,suddenly,
as when the heart of this flower imagines
the snow carefully everywhere descending;
nothing which we are to perceive in this world equals
the power of your intense fragility:whose texture
compels me with the color of its countries,
rendering death and forever with each breathing
(i do not know what it is about you that closes
and opens;only something in me understands
the voice of your eyes is deeper than all roses)
nobody,not even the rain,has such small hands
Derek Walcott is a poet from St. Lucia who won the Nobel Prize for Literature in 1992. I know it’s not midsummer right now, but this is the poem that I’m in the mood to post today!
Broad sun-stoned beaches.
A green river.
scorched yellow palms
from the summer-sleeping house
drowsing through August.
Days I have held,
days I have lost,
days that outgrow, like daughters,
my harbouring arms.
Warning! Adult content ahead. The sound recording in this post contains some language not suitable for young children.
In one of my classes this morning, a gangly 20-year-old stood on the stage tell us about some charity type work overseas. He spoke at 75 miles per hour and in a thick Australian accent, and I didn’t catch most of what he said. What I was able to comprehend had to do with living with a host family and using a shovel.
I’m just gonna come right out and say that [most/typical American] (<–see the qualifiers? ) 20 year olds are useless, self-important brats that annoy me. Being surrounded by them everyday on a university campus has removed any charitable opinions I may have had. The only thing worse than being around a useless, self-important 20-year-old in their natural habitat (uni), is running in to one in the real world and having to interact with them a professional capacity. Oy!
I think Louis CK does a fine job of explaining what I’m talking about here:
Wangari Maathai was Kenya’s first woman to earn a Doctorate and the first African woman to win a Nobel Peace Prize for her “her contribution to sustainable development, democracy and peace.” In addition to many other significant contributions to the world. She passed away yesterday, 9/28/2011, after losing her battle with cancer. She was 71 years old.
I first learned of Wangari Maathai when I watched the movie, “Dirt”. She won me over with her big beautiful smiling eyes and her telling of the hummingbird story.
As environmentalists, peace activists, lovers of all species, and neighbors, it’s easy to get discouraged and feel like your efforts and opinions don’t mean anything. But they do. You, by how you live and the things you say, inspire other people around you to take up a cause.
I took Ms. Maathai’s hummingbird story to heart. It was following her rehearsal of it that I decided to do and act more in the causes I believe are moral imperatives and claim the title of “Activist”. Until that point I shied away from using the label because I feared it would offend and put people on the defensive or that it would require something of me that I wasn’t willing or couldn’t give. And I feared doing anything that would make me look like a ‘radical’.
What’s wrong with being radical?
Some of the things I do won’t rock the boat and other things I do are guaranteed to offend. Sometimes-most times- anything I do will be of little significance, but like I said in my OMK introduction:
When I’m long gone after living a comfortable life with fast transportation, mostly clean water and air, and more food options than I could use, my grandchildren will still be here. It’s my job as my clan’s matriarch to do what I can to make sure they, too, will have access to a comfortable life with clean water, plentiful food, breathable air and a place to stay warm.
This blog won’t make it happen, but it’s just one of many little things I can do.
So following Ms Maathai’s example I, too, have become a hummingbird.
Hey, check it out. Saudi Women can vote. (be sure to read the fine print.) My initial response to this news was positive, but then my inner uppity feminist yelled at my don’t make waves feminist self and I realized two things: 1. How noble of the Saudi King to grant women the right to vote. <—-read that again
And the other thing I realized is summed up perfectly right here:
“So I can vote, but I can’t get a driver’s licence,” said one Saudi woman from Jeddah, who said she had to remain anonymous. “If I use my name I may be breaching the guardianship law here.”
Laws demand that a male guardian – a father, brother, or son – accompany women on any trip outside the house. When some women in Riyadh attempted to test it earlier in the year by driving cars, the move was seen as a provocation by authorities and several of the drivers were arrested. Separation of the sexes in public is also strictly enforced.
Oh, I know. Many of you will think that those of us in the Western part of Little Blue ought to rejoice because ‘it’s a step in the right direction’. Maybe you’re right. But I just can’t get on board right now.
#&^%*@#!!!!!! IT’S 2011 AND WITH ALL OF OUR ‘ENLIGHTENMENT, INDUSTRIALIZATION, PROGRESS, ETC., WOMEN OF THE WORLD ARE STILL BEING RAPED, BEATEN,and HACKED TO BITS. THEY ARE STILL PROPERTY–a resource or an asset that a man (a human lucky enough to be born with a penis) has the right to buy, sell, and treat in the way that he sees fit. Women are still being held responsible for the crimes and misdeeds of men (something we can discuss in the comments).
Even in the US, women are silenced in the boardrooms, the office bullpen, and even in their own homes when they share that space with men.
So why am I supposed to be thrilled over this little bone thrown in the direction of women’s rights?
Does the treatment of women around the world remind you of how we treat something else of great value?
From the Poetry Foundation: Once shunned for his unpopular political views and harsh critiques of mankind’s egotism, Robinson Jeffers has regained popularity in recent years as environmentalism’s most forceful poet-advocate. His uncompromising work celebrates the enduring beauty of sea, sky and stone and the freedom and ferocity of wild animals in contrast to human pettiness, meddling and greed.
Then what is the answer?- Not to be deluded by dreams.
To know that great civilizations have broken down into violence,
and their tyrants come, many times before.
When open violence appears, to avoid it with honor or choose
the least ugly faction; these evils are essential.
To keep one’s own integrity, be merciful and uncorrupted
and not wish for evil; and not be duped
By dreams of universal justice or happiness. These dreams will
not be fulfilled.
To know this, and know that however ugly the parts appear
the whole remains beautiful. A severed hand
Is an ugly thing and man dissevered from the earth and stars
and his history… for contemplation or in fact…
Often appears atrociously ugly. Integrity is wholeness,
the greatest beauty is
Organic wholeness, the wholeness of life and things, the divine beauty
of the universe. Love that, not man
Apart from that, or else you will share man’s pitiful confusions,
or drown in despair when his days darken.
From THE COLLECTED POETRY OF ROBINSON JEFFERS, edited by Tim Hunt.
There have been times in my life when an important event transpired at the culmination of various factors, a dozen external events, decisions and choices seemingly random, but somehow delivering me to the moment I needed. Mormon rhetoric is ample with polarizing concepts such as fate or personal significance. The language of my patriarchal blessing is a good example: “You chose to be born at this particular time. You knew the challenges you would face, but you still had a great desire to come….Be mindful of bearing your testimony at the proper and time and place for there are those who will need what you have to say, and they will be strengthened.” The beliefs I hold now still kowtow to these overarching ideals: I wanted and chose to be here. My life has purpose.
A series of seemingly random events delivered me to Minneapolis one weekend. I had originally agreed to run nine miles through the woods with Amy, my one (cherished) single girlfriend in Iowa. I had spent the summer in Utah looking for work, searching for the holy grail of a job that would keep me there permanently. As we worked through the details of our divorce, my ex agreed to move if I found work. And one week before I was to return to Iowa, it happened. I was offered a job. The stars had, at last, lined up for me, and all the good karma I had sent out into the world was finally finding its way back to me, as I well knew it would. Then my ex backed out of our deal.
The morning I woke up to return to Iowa, I was physically incapable of getting out of bed. I had been suffering from a herniated disc and though I had been running easily all summer I had relapsed worse than ever. I lay in bed, helpless, and cried, needing over an hour to warm my muscles enough to finally crawl out, shower and dress. It was, I think, the lowest moment of my life.
I returned to Iowa and re-entered physical therapy on Monday, the same week I started teaching composition classes. The first day, I couldn’t get off the table after treatment, and I was ten minutes late to the first lecture of my second class. A month later, I had recovered, but I certainly didn’t trust myself to run. I told Amy I would cheer her on. I thought about cancelling the trip entirely. Money concerns and other appealing offers from friends tempted me, but somehow I ended up in Minneapolis.
The first night in the city, I dreamed I was in Terry Tempest Williams’ house. We were caring for sick animals and children together. I woke, feeling transformed, rejuvenated. Once in a while, I will have an intuitive dream that will set my world right again. I had not had one of these dreams for months, perhaps even a year, having suffered for too long beneath a dark cloud. Yes, I thought now. Care for the animals. Care for the children. I felt wholly connected to my life’s purpose, connected to the glory of nature and my inherent natural state. We drove to the race. The Minnesota woods, exuding early fall, captured my heart.
“There’s going to be fairies,” Amy said, and I believed it.
I had dressed for the run just in case but still felt unsure about committing. I would be running in barefoot shoes, a transition I had made after my back injury, and I didn’t know how I would fare on a nature trail, especially in the woods. I had injured my foot running on uneven surfaces before. It made no sense for me to run this race whatsoever, but I promised Amy I would listen to the wind, and decide.
“What does the wind say?” Amy asked.
I walked out onto the trail and listened. The leaves whispered. The crisp air patted me gently.
The wind said yes. I could do it.
We lined up, the gun fired, and I started running with the crowd, terrified of injury. I did have the luxury of an exit strategy. At two and a half miles, the path diverted and I could finish by running the half distance, about five miles. The path, we discovered, was mostly hills. I pulled way back on the first steep downhill and lost Amy. Rocks, twigs, incline. Every step took faith. For me, this entire year had been about moving past my fear, and I practiced that now in each moment. I feared for my feet, which were striking hard against the rocks. The last injury took a year of recovery.
After a mile, it became clear that I could do this. My breath was steady and my back was holding up fine. I had run only twice in the past month, but my legs felt strong. My feet not only handled the rocks, they seemed to be adapting easily. I connected with the path. I felt every rock, every twig. We merged, the forest and I, creating a moving, breathing intersystem of existence, each acknowledging the other.
I reached the fork in the road at two and a half miles. The path for the half race was downhill, the path for the full race a steep uphill. I paused, and listened to my body. My back felt great. I knew my legs would not wear out. Yes! My feet said. More rocks! More twigs!
I ran up the hill.
To the scientist, God says, come sit at your microscope, and I will show you what I know. But to the writer, God says, come out into my wilderness, and I will show you what I know.
I had always wondered how ancient tribal people ambled about the wilderness barefoot. This was how. By merging, by not being afraid, by allowing what already is and adapting to it. As a writer, as a mother, as a woman with her share of personal stress, as a dreamer, I struggle almost constantly to live in the present moment. This race, this forest, these rocks and trees and twigs pulled me into the now and held me.
And I was happy to be here.