Bridging The Gap: Racial Disparities In Health Care

This past week, I had the honor of co-organizing the workshop series: Bridging The Gap: Diversity and Cultural Competency in Health Care with the NYC Doula Collective and Pacific College of Oriental Medicine. Bridging The Gap was designed to push practitioners and students to strive for competent health care practice by considering the social pressures and expectations intertwined with the realities of different communities.

As part of the workshop, I presented a segment on a topic that hits close to home, Racial Disparities in Health Care. Here is a brief summary of that workshop: 

As the role of racial diversity is amplified in society, it is increasingly important for holistic health care providers to be adept at interacting with patients from all backgrounds. The goal of this session was not to define racial diversity but to create a space to share our experiences. In this workshop, participants are given space to navigate the reflections, emotions, and assumptions that surface around race in the field of medicine. Attendees walked away with methods for actively recognizing and assessing racial biases. 

If you were unable to attend the workshop or would like resources to develop your knowledge around Racial disparities in Health Care, take a look below. It is my hope that this workshop will continue to develop, and health practitioners interest to provide holistic, and socially/racially conscious health care will grow.

If you are interested in learning more about this workshop or bringing it to your school or community, please contact me. 

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The Boston Women's Health Book Collective. (1998). Our bodies, ourselves for the new
   century. New York: Simon & Schuster.

Bridges, K. M. (2011). Reproducing race: An ethnography of pregnancy as a
   site of racialization. Berkeley, CA: University of California Press.

Morgen, S. (2002). Into our own hands: The women's health movement in the United States,
   1969-1990. New Brunswick, NJ: Rutgers University Press.

Nelson, A. (2011). Body and soul: The Black Panther Party and the fight against medical
   discrimination. Minneapolis, MN: University of Minnesota Press.

Ina May: Reducing Fear of Birth in U.S. Culture

Listen to Ina May speak at TEDXSacramento on Reducing Fear of Birth in U.S. Culture.

Ina May Gaskin, MA, CPM, PhD (Hon), is founder and director of the Farm Midwifery Center in Tennessee. The 41-year-old midwifery service is noted for its women-centered care. Early in her career, Gaskin learned an effective method for dealing with a feared obstetrical complication (when baby's shoulders become stuck during birth) from indigenous midwives in Guatemala.

Penny Simkin on Delayed Cord Clamping

Many of the families that I support ask me about the benefits to delayed cord clamping. In this video, Penny Simkin, shares the process of delayed cord clamping and what it can provide for your baby. 

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∆ Affirmations For Birth ∆

For many families expecting a baby, the biggest challenge is often overcoming the fear of childbirth. Sometimes, inspiration and empowering words can help you have the beautiful, calm and intimate birth experience that you want. 

Here are some of my favorite birth quotes and affirmations. Use the ones that feel right for you and your birth.

Image Source: SacredPregnancy.com

BIRTH QUOTES

“Nothing in life is to be feared. It is only to be understood. “ - Marie Curie

“The same movements that get the baby in, get the baby out.” -From Birthing From Within

“The whole point of woman-centered birth is the knowledge that a woman is the birth power source. She may need, and deserve, help, but in essence, she always had, currently has, and will have the power.” -Heather McCue

“When you have come to the edge of all light that you know and are about to drop off into the darkness of the unknown, FAITH is knowing one of two things will happen: There will be something solid to stand on or you will be taught to fly” - Patrick Overton

“Let me let you in on a little secret, your cervix is not a crystal ball. It cannot predict when you will start labor. It cannot predict if you will deliver before, after or even on your due date. The cervix can do many wonderful things, but let’s not give the cervix more credit than it is due. A cervix cannot read the future.” -Maria Pokluda

“Muscles send messages to each other. Clenched fists, a tight mouth, a furrowed brow, all send signals to the birth-passage muscles, the very ones that need to be loosened. Opening up to relax these upper-body parts relaxes the lower ones.” – William and Martha Sears

“The knowledge of how to give birth without outside interventions lies deep within each woman. Successful childbirth depends on the acceptance of the process.” ~Suzanne Arms

“There is power that comes to women when they give birth. They don’t ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it.” – Sheryl Feldman

“When I say painless, please understand, I don’t mean you will not feel anything. What you will feel is a lot of pressure; you will feel the might of creation move through you. Pain, however, is associated with something gone wrong. Childbirth is a lot of hard work, and the sensations that accompany it are very strong, but there is nothing wrong with labor.” – Giuditta Tornetta

“Birth is an opportunity to transcend. To rise above what we are accustomed to, reach deeper inside ourselves than we are familiar with, and to see not only what we are truly made of, but the strength we can access in and through birth.” – Marcie Macari

“So the question remains. Is childbirth painful? Yes. It can be, along with a thousand amazing sensations for which we have yet to find adequate language. Every birth is different, and every woman’s experience and telling of her story will be unique.” –Marcie Macari

“My baby is healthy and innately knows when to begin labor. My body knows how to birth by instinct. My mind has released all fears and trusts birth. I am enjoying this process and growing through it all.” - Mrs. BWF

BIRTH AFFIRMATIONS

• I surrender with confidence.
• I have grown this baby; I will push her out.
• My job is to simply relax and allow the birth to happen.
• My body has a wide open space for my baby to descend.
• My body is indeed beautifully and wonderfully made
• 300,000 women will be giving birth with you today. Relax and breathe and do nothing else.
• I will breathe slowly and deeply to relax my muscles and bring oxygen to our baby.
• My body is opening wide to let my baby out.
• My body is not broken. I can do this.
• Soon I will meet you, baby.
• I am a strong, beautiful woman. I accept myself completely, here and now.
• I am completely relaxed and comfortable.
• I trust that my body knows exactly what it’s doing.
• I visualize my baby moving gently through the birth canal.
• My baby is happy and healthy.
• My courage and patience will send my baby into my arms.
• My baby is born with pure pleasure.
• I have courage, faith and patience.
• I am in complete control of what is going on around me.
• My body will give birth on it’s own time.
• I give birth in safety and solitude.
• I follow my instincts and give birth in the way I desire.
• I am ready and prepared for my birthing experience.
• I visualize myself handling everything beautifully.
• Everything is going right.
• I feel the strong waves of labour and know that everything is normal and progressing.
• I relax my mind and muscles.
• Keep breathing slow and even. Inhale peace, exhale tension.
• Keep my mind on acceptance and surrender.
• My body will give birth in its own time.
• I love my baby and I am doing all that is necessary to bring about a healthy birth.
• I am ready and prepared for childbirth.
• I see myself handling everything beautifully.
• Each contraction produces a healthy, positive pain that I can handle.
• I deserve this wonderful birth! 

What A Family Needs After Birth

I stumbled upon this wonderful piece by Gloria Lemay Birth Blog on the things families should ask for in the postpartum period. Too often, new parents are expected to say that "new parenthood is wonderful."  And it is most of the time, but there are moments when you need a little help. I always encourage families to ask for help when its needed - from cooking and cleaning up the house to simply holding the baby so that you can pee. When someone says, "let me know if I can lend you a hand" they really mean it because a. they want to see this new bundle of joy and b. they care about you.  So, when your next friend or family asks, "How can I help?" tell them:
 

1. Buy us toilet paper, milk and beautiful whole grain bread.

2. Buy us a new garbage can with a swing top lid and 6 pairs of black cotton underpants (women’s size____).

3. Make us a big supper salad with feta cheese, black Kalamata olives, toasted almonds, organic green crispy things and a nice homemade dressing on the side. Drop it off and leave right away. Or, buy us frozen lasagna, garlic bread, a bag of salad, a big jug of juice, and maybe some cookies to have for dessert. Drop it off and leave right away.

4. Come over about 2 in the afternoon, hold the baby while I have a hot shower, put me to bed with the baby and then fold all the piles of laundry that have been dumped on the couch, beds or in the room corners. If there’s no laundry to fold yet, do some.

5. Come over at l0 a.m., make me eggs, toast and a 1/2 grapefruit. Clean my fridge and throw out everything you are in doubt about. Don’t ask me about anything; just use your best judgment.

6. Put a sign on my door saying “Dear Friends and Family, Mom and baby need extra rest right now. Please come back in 7 days but phone first. All donations of casserole dinners would be most welcome. Thank you for caring about this family.”

7. Come over in your work clothes and vacuum and dust my house and then leave quietly. It’s tiring for me to chat and have tea with visitors but it will renew my soul to get some rest knowing I will wake up to clean, organized space.

8. Take my older kids for a really fun-filled afternoon to a park, zoo or Science World and feed them healthy food.

9. Come over and give my husband a two hour break so he can go to a coffee shop, pub, hockey rink or some other r & r that will delight him. Fold more laundry.

10. Make me a giant pot of vegetable soup and clean the kitchen completely afterwards. Take a big garbage bag and empty every trash basket in the house and reline with fresh bags.

These are the kindnesses that new families remember and appreciate forever. It’s easy to spend money on gifts but the things that really make a difference are the services for the body and soul described above. Most of your friends and family members don’t know what they can do that won’t be an intrusion. They also can’t devote 40 hours to supporting you but they would be thrilled to devote 4 hours. If you let 10 people help you out for 4 hours, you will have the 40 hours of rested, adult support you really need with a newborn in the house. There’s magic in the little prayer “I need help.” 

Source: Gloria Lemay Birth Blog

How-To Latch CheckList

Ananda Lowe, co-author of The Doula Guide, created a how-to latch checklist for her clients who are having a difficult time with breastfeeding. I think she includes some great basic reminders (i.e. skin-to-skin, tummy-to-tummy), but if you are still struggling to breastfeed or are in pain, please feel free to each out to me. I can put you in contact with a lactation consultant in your area. 

5 Breastfeeding Tips That Made Life Easier For Me. By Genevieve MamaNatural

1. Skin-to-skin – important!

2. Tummy-to-tummy – important!

3. Baby directly faces nipple – follow the “angle of the dangle.”  (Nipples may point forward, up, down, or to the sides.  Line up baby with your anatomy, which may be different than the placement you’ve seen someone else use.) 

4. “No pillows or Boppys” is best, allowing for fullest range of motion

5. Do not remove baby’s hands from mouth or breast.   (Baby uses hands to locate nipple and to stimulate mouth, and will remove hands on her own)

6. Support baby’s neck

7. Do not touch back of baby’s head

8. Do not position baby as far out as the crook of your elbow; move baby closer to the center of your body

9. Position baby so his jaw is well below the nipple.  Baby will tilt head back, then mouth will align with nipple

10. Place your hand far behind nipple and areola

11. Wait for baby’s mouth to open very wide – important!

12. Hug baby in close to you, so his mouth can take in breast

13. In case of nipple discomfort, use micro-adjustments.  Move baby a centimeter to the left, right, above, and below nipple, until you find the placement that is not painful.

14. If baby’s lips are tucked inward around the nipple, you can use your finger to gently flip the lips outward

15. Do not tolerate pain with latching.  Gently insert finger into baby’s mouth to break suction, and start again.

16. If latching involves struggle, hold baby to breast when she is not frantic, such as upon waking.  Stop “trying” and simply hold baby tummy-to-tummy and skin-to-skin.

17. Wait for baby to discover nipple on her own, usually within 5 to 30 minutes.

Monthly Series: Resources for Pregnancy, Childbirth and Parenthood

In the age of digital media, it seems as though everyone has a website and is blogging. The overload of information can be overwhelming for birth workers or expecting/new parents. For this reason, I have decided to feature my favorite websites and journals related to birth and parenthood each month. 

As a doula, I spend a lot of time researching the latest evidence-based studies on pregnancy, labor and birth and the postpartum period as well as blogs from fellow birth workers, birth activists and moms. For the month of November, I decided to start with my favorite evidence based websites.  

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Evidence-Based Birth
Giving Birth Based on Best Evidence 

The Cochrane Collaboration
Evidence for Health Care

Midwifery Today
The Heart and Science of Birth 

Childbirth Connection
Up-to-date evidence based information and resources on planning for pregnancy, labor and birth and the postpartum period.  

What are some of your favorite evidence-based research sites?