I have been thinking a lot about Cheryl's Blog on Monday, February 23, 2004 about adolescence and the ongoing discussion on a list we are list sisters on. Maturity is a very difficult thing to assess and stereotyping teens is doing them a grave disservice. Where one person may be very mature at 16, another won't be until 30!! There is a lot that goes into the dynamics of maturity, personality, responsibility given from parents, sibling placement and so forth so saying that a person needs "higher education" in order to be mature enough is foolhardy at best.

I married at 18 (just turned) to a 19 yo. We met six months prior and as we grew to know each other, we knew each other was mature enough and ready for marriage. That was outside of our almost instant rapport... we "clicked" and grew to love each other quickly. I was still in high school when we met, yet I am the eldest of three girls and grew up on a farm, which meant I did all that was required of any son on top of learning from my mother the duties of housekeeping, sewing and childcare. My husband however was the youngest of six and though that may lead to immaturity (baby syndrome), his strong choleric personality provided him with the determination and maturity of a man beyond his years. He already had his first year apprenticeship finished toward his autobody mechanic license and owned two vehicles. I am not saying we were "mature" in all senses as we continue to do so throughout life and through life experiences. However, we were both mature enough to handle the responsibilities of marriage, jobs and adult relationships.

If we learn to live within our means, even if that is less than what we hope our children to have, we learn frugality, strong budgeting skills and do without the extras our neighbour has which we covet. In choosing to raise our family on a single income, we have done without and have grown stronger as a family as a result. We don't need the extra TV (or TV at all), the convenient appliances, or the exciting "educational toys" that beep and blink which are touted today. We need each other and time with each other... all of these take away from that. I am not saying education is not important, it certainly is, but if it is in the way of other goals, then it too can be a detriment just as not enough income is.

I was reading the Summer 2003 issue of ICAN's Clarion today and in reading the cover article, I pondered the word Institution. The definition is, in part, [n] an establishment consisting of a building or complex of buildings where an organization for the promotion of some cause is situated and [n] a custom that for a long time has been an important feature of some group or society; "the institution of marriage"; "the institution of slavery"; "he had become an institution in the theater". Thus we would look at the word institution as being either a building or an important custom of sort for a specific group. In looking at the latter, the "institution" of midwifery would then be what females have found to be important during the birth process and obstetrics would be what males feel are important regarding the birth process. In looking at midwifery and obstetrics, I personally could not think of a polarized opposite if I tried!

Midwivery honours women, sees birth as a normal process women experience during their life and, traditionally, rarely interfere with the process. Rather they support the mother emotionally and physically as she goes through this life-changing experience. It is a rare indeed for anything to go wrong when the mother is healthy and not fearful of the process. Why should a woman not choose to birth at home, just as she eats at home, exercises at home (or at least not in an institution where she is monitored in case of a heart attack), and showers and voids in the privacy of her bathroom. If all of these are normal body processes, why should she go to a strange institution, be cared for primarily by strangers in uniform and beeping machines which reduce her mobility and assume specific positions to birth in with out consideration for her comfort or instinctive knowledge to assume a different position?

Obstetrics on the other hand views birth as a train-wreck waiting to happen. Fear is central to obstetrics and prophilactic interventions are extremely routine... it is very rare that at least one intervention is not used at some point during a woman's labour. Even the movement from home to hospital is an obstetric occurance because of the fears surrounding birth. Certainly there are situations where obstetrics is life-saving, but in a proven 95% of births, mothers can birth normally without a single intervention. But the current 100% intervention rate and 20-26% cesarean rate clearly demonstrates the obstetrical model of fear. So why would a woman knowingly put herself at greater risk by placing her life into the hands of this model of care? The only reason I can conclude with is lack of knowledge and assuming that because obstetrics is practiced in an institution, it by that very fact must somehow be safer. Will our society, so focused on institutions, ever see the truth of what we have done to women by institutionalizing birth? Will we blame ourselves for the skyrocketing maternal and fetal mortality and morbidity rates, knowing that they were caused by our blind trust in institutions?

I am one of the survivors, though I am thoroughly scarred by my institution experiences. Four babies I have carried in my womb, all but one cut from me in an ambiguous guise of vague reasons... failure to progress, cephalo pelvic disproportion... and all because of fear. Some on the part of the physician, some on my part, none of them necessary. Without fear and with trust I would have not become one of the institution's morbidity statistics. It was only when I learned of midwifery, and was able to once again trust my body to birth my babies normally (no easy feat, I can emphatically tell you) was I able to birth my daughter as my body was designed.

Our basement bath is nearing completion and I find myself pulled in so many directions. Do I paint it and get it ready for the flooring guys and plumber so that can be finished or do I finish the taxes that await on my to do pile? What about the book that sits unfinished, nearing it's May 30 deadline... or the teaching modules I am writing for a Edmonton based Guiding Parents that are now past due? Then there are the three huge and very exciting projects for ICAN I would love to be working on right now... but when?

And let us not forget "the" project that has taken up a bunch of my February, the Lloydminster Doula Association which will launch this week! This has been a true labour of love for me as I support the doulas in my area who truly want to provide professional services despite the roadblocks that we have to face. Sadly, it's not consumer apathy or negative hospital staff but rather a fellow doula who has intimidated all the doulas here so completely by her overbearing personality and alley cat territorialism. But enough space wasted on the negative, the nurses and everyone we have contacted are absolutely excited about our organization and the professionalism it will bring to this profession. We have filed as a non-profit corporation with Saskatchewan Justice and our website is up and getting rave reviews!

As I get to know the local doulas here, I am excited about their future as an extimated 700 births will take place this year. We have the support of many and have to prove ourselves to a few, but the future is bright indeed! I am excited too for the contribution of doula support to both birthing parents and L&D nurses who work so hard every day. By providing continuous support through labour and through the first hours after the birth, doulas provide an important aspect of care that frees nurses to fulfill their role as medical professionals. Nurses and doctors are then better focus on the medical care they provide. The more I work in the healthcare field, the more appreciation I have for the hard work nurses do every day.

Who invented taxes?! I so hate tax season only because of the accounting involved. It truly only takes a few hours as I have done business taxes for so many years, but I still dread it none-the-less. Thank goodness for Quickbooks!! A true life-saver for me as I have never liked accounting despite taking it for all three years in high school.

I am slowly catching up to the mountain of work awaiting me, the pile to be mailed grows ever larger as my projects complete one by one...

With Breanna sleeping contently in my arms I am finally finished my formal grievance against an archnemesis of mine. It is as if a weight has been lifted off my shoulders. I am sending it in tomorrow and can now focus on the other ten thousand projects I have waiting. It feels good to get all my concerns formally on paper and know that something will be done, even if it is a minor triumph. Regardless of the outcome, it was certainly a step in a positive direction which I feel very good about.

It has been one of those weeks all mothers can relate to. My precious 10 month old was quite sick all week and I am up to my shoulders in work, some now seriously overdue. I literally carried her non-stop all week, even while she was sleeping, because she would not sleep otherwise. Lying her down to nap or sleep at night was not an option as she would immediately wake and cry. So she slept in my arms instead, the least I could do for her! A high fever (never serious), lethargy, stuffed up, coughing... my poor little girl. Yesterday she was herself again and it was so wonderful to see her smile and laugh, and enjoy her Daddy time again. Now, please tell me how I can fit my whole weeks schedule into one day and get everything done? Ah the joys of motherhood.

I spent the weekend honing my marketing skills. I have a lot of knowledge regarding marketing from Mother Care and many other projects, yet I am always seeking new knowledge as no one is ever truly an expert are they? They may know something inside and out, but there is always more to learn. Learning is so exciting, especially when it is done with others! I have to find the time to get all of my thoughts down on paper and with Breanna not feeling well it is very tough.

I am writing this right now with her sleeping in my lap and my keyboard perched precariously at the edge of my desk! All night last night I slept curled up around her as she would not settle if I wasn't. I truly love to do that and cherished every moment last night even though I didn't get a lot of sleep. It's amazing how a mothers touch soothes all.

My heart is troubled as I sort through the myriad of doula organizations which have sprung up throughout the land. The hard part is explaining to inquiring minds why some are legitimately able to grant professional certification status and others are not. Three that can not I hold dear to my heart as they are incredibly excellent organizations and have done so much for doulas... yet have chosen not to become an accredited organization or in one case, a true non-profit which they claim to be. Yet for this reason I have chosen to align myself with an accredited one, the Global Birth Institute.

At three am this morning after getting up to cover Brendan and putting Breanna back to sleep I lay awake thinking about the wording in our upcoming press release. My mind wandered to Breanna's birth as she moved to touch me, needing to know I was there and fell back to sleep.

It is almost ten months since that miraculous night she was born and I am still amazed at how un-painful recovery was despite the tearing and skid marks she caused during her quick passage out and into Cathy's hands. I had assumed some involution pain and was anticipating similar or worse pain than I had experienced after the boys' births. Yet I had no involution discomfort at all, even when breastfeeding!

Then it hit me like a weight, I had not been given oxytocin after she was born! It is standard procedure to give oxytocin after baby is born via IM injection or into an IV (if Mom is unfortunate enough to have one) based on questionable studies showing reduced postpartum hemorrhage with this procedure. However at homebirths it is rarely done, given only when indicated. My midwife did ask if I would want a herbal equivalent given my history (there is an increased risk of placental complications if a mother has had a prior cesarean). Since my placenta had detached within three minutes of Breanna's birth, I declined, wanting to avoid any increased chance of increased involution pain. So once again my belief that routine interventions are rarely necessary and their side effects should be strongly considered when deciding on whether to use them or not.

My dear friend Crystal Sada said it best, "It's not that I dislike doctors or hospitals or even interventions. I dislike routine."

My first official blog... wow, new territory for me! I have kept a diary of sorts on my computer for eons... mostly as a tool in working through stressors and coming to terms with happenings in my life, but this is my first time going "public."

I am working on three very important birth related things in my life right now. ICAN (International Cesarean Awareness Network) has been a part of my heart since entering my life after the birth of my second son when I was looking for answers to my cesarean births. I have been supporting them as Education Director and have great projects I am working on in that capacity. GBI (the Global Birth Institute) is where I spend so much time learning and working... in both attaining my GRPD certification and as their Program Director. Finally, the third one I am not quite ready to expose yet because we want to launch with a bang! We are almost ready, I am so excited. I can't wait to share this new project with the world... it is a long time coming but very much needed.