all posts, community, mortality

let’s talk about death

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Photo by Mike on Pexels.com

I seem to be drawn to fields of study that general society deems taboo. From talking about vaginas and all things women’s health, to my desire to talk about death, I really seem to have no boundaries. And so, with that, let’s talk about death.

I recently came across the profession of death doulas, and if I have a calling, I think it’s to become a death doula one day. More on that in a bit.

A doula I believe traditionally is defined as a woman who serves, and is used to denote women who work with other women, specifically in a birth and postpartum context. Both birth and postpartum doulas work as support people for pregnant women/moms, helping them to navigate various systems and life changes. Historically, communities were stronger and so the need for doulas was not so defined (women generally were supported by other women of varying ages, from friends to skilled midwives, and this support could start during the pregnancy and continue through childrearing years). But as we’ve become more individualized and modernized, this communal support has seen rapid decline, and so the doula profession developed to help remedy the lapse of the support.

So then, death doulas? Well, another consequence of the rapid modernization and aggressive individualism has been a shift away from dealing with death. We don’t tend to our deceased personally, we often have family members in homes that we don’t visit, we see more and more people dying in hospitals alone, or dying after enduring unending painful medical attempts to save/prolong their lives. More and more people are starting to feel that the way we treat the dying, and the lack of support around the times of dying are wrong, and it was from this belief that the profession of a death doula was formed.

The first formalized death doula I believe was Henry Fersko-Weiss. Inspired by the birth doula model, and disappointed by his own experience with his father’s and many of his patients’ deaths, Ferkso-Weiss wanted to create a profession that would allow for people to die better.

I know this is a weird and uncomfortable thing to get around. How on earth does one die better? Dying is miserable! It’s the end of life, etc. It’s hard to wrap one’s head around it, but that doesn’t make it any less important. A consequence of our culture’s death aversion has been increased fear. I distinctly remember my own personal existential crisis around age 7 or so when I confessed to my best friend that I was terrified about dying and becoming nothing. She replied back that this is why many people turn to religion, because it gives us something to believe in (very wise words for a 7-year old). This led me to years of trying to decide whether I believed in something or not (jury’s still out) and if not, how did I make sure I had a meaningful life until my time was over. The culmination of years following show a web of confused choices as I tried (and continue to try) to figure out what is important to me. As a result, I personally come across as erratic and fickle because I seem to change my mind instantaneously when in actuality I am constantly weighing my choices via long term projections, and thus constantly tweaking my day to day behaviors.

Now many people think that thinking and talking about death will get you depressed and worried. I believe the results of the death doula profession are seeing the opposite. Many people find that understanding that we are mortal and working towards accepting that allow them to appreciate life more. And people draw to being death doulas seem to be extreme lovers of life. My personal role model is Alua Arthur. She has an amazing video called I Plan People’s Death For A Living, which so distinctly highlights why she does what she does, and how it’s not as morbid as you think.

To fill the time between now and when I start actively studying to become a death doula (so after the baby (babies?) is (are?) in high school most likely), I have begun the process of reading all there is to read on dying, death, and how we as humans think about it, and how we process and deal with our/our loved ones’ mortality. It’s a fascinating field. And yes, it definitely can provoke the waterworks, but that’s just part of being human.

It’s also interesting because having the skin condition/autoimmune issues I do has made me much more aware of my mortality. If everyone is going on about how your 20s are your magic years, your skin is still great and you are super healthy, yatta yatta, than I already identify as someone who is past her prime. And I don’t feel negatively about this, but I do believe it influences the way I see the world and makes me think about the future in a more concrete fashion than many of my peers. Like when I said I wanted kids before 30, I realized I was 26, that it takes 10 months (ish) to create a baby, and so if I want to be done having kids by 30, it was time to start (and luckily my partner felt the same way).

I’ll end there for now, but this will probably be a running series of posts because it helps me get things out of my head if I write them down.

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all posts, parentings/things about baby and kids, women's health

on new adventures (sleep training and postpartum doula training)

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Photo by Oliver Sjöström on Pexels.com

I’m combining all my other blogs’ content to this site. Please bear with me as I post older content.  🙂

Hello again. It’s been a while since I’ve posted any content, in fact I think I haven’t posted since I was in my second trimester!

Well, I have since given birth to my beautiful little one, Fiona, and am now working through a new stage of life with her: sleep training.

It may seem a bit late as she is almost 7 months now but in reality sleep training can be initiated at any age. In my case, in her earlier months I was so worried about her weight gain (as she is small and has been consistently in the 5% quartile) and her potential food sensitivities that I was eating (she’s exclusively breastfed and she occasionally had blood in her stool), that I focused on nothing else.

As a result, Fi now appears to be in a bad holding pattern where she fluctuates between waking up twice a night to waking up every hour or so from 12pm-5am and fighting going back down to sleep unless I feed her. Her daytime naps are a total crapshoot (sometimes she sleeps like a goddess, other times she will fight it for hours but is too tired to do anything else).

So, I am working on reading through the research about various techniques to go about breaking the latter habit, looking at everything from the Ferber Method to the Sears Method. I’ll be headed to the library later today to get the official books on various methods, but in the meantime, from scouring the internet at 2am, here are a few of the suggestions (from secondary sources):

The gradual retreat/disappearing chair method

  1. place chair by crib
  2. put baby down when drowsy then sit on chair
  3. when baby cries, go to her and pat/stroke her but avoid eye contact
  4. when baby stops crying, move chair slightly further away and sit
  5. if baby cries again repeat pat/stroke and no eye contact
  6. when baby stops crying move chair further back again
  7. repeat until baby is asleep. might take 10 minutes for them to fall into deep sleep

The kissing game method

  1. put baby down when drowsy and promise to return in a minute to give a kiss
  2. return almost immediate to give another kiss
  3. take a few steps towards door then return and give another kiss
  4. promise to return in a minute to give another kiss
  5. put something away/do somethin in room, then give another kiss. 6. promise to return in a minute for another kiss
  6. pop outside room for a few seconds then return for a kiss
  7. as long as child is lying down she gets more kisses (no chat, cuddles, stories, drinks)
  8. repeat until child is asleep

The Ferber Method

  1. put baby in crib awake, turn off lights, say goodnight and leave room
  2. if baby cries, come back after predetermined time (a minute or two). Pat baby in reassuring way but don’t pick up. Leave room promptly
  3. this time stay out of the room slightly longer before returning to reassure baby
  4. continue with longer and longer periods of time
  5. if baby wakes in the middle of the night, start back over with lowest wait time at beginning of night
  6. on second night, wait a little longer than previous night (so first night try for example 3 min, 5 min, 10 min. second night try 5 min, 10 min, 12 min)

The night weaning method

  1. start gradually by nursing baby shorter periods of time or giving smaller amounts of milk in bottle, prolong time between feedings by patting baby to sleep
  2. make sure baby get plenty to eat during day (decrease distractions)
  3. offer extra feeding in evening
  4. avoid weaning during transitions (vacations, traveling, teething)
  5. have non-boob feeder comfort during night
  6. eliminate feedings one at a time. tell her she can nurse in teh morning. pat her belly/back

The pick up, put down method

  1. if baby cries when first put down, put hand on her chest with “shhh” or key phrase
  2. if that doesn’t work, pick up and repeat phase
  3. when she stops crying but is still awake, but her back down even if she starts to cry on way down
  4. if still crying, pick her up again. do until you can see signs that baby is settling (cries getting weaker)
  5. when behavior settling, don’t pick up anymore. place hand on chest and say phrase
  6. leave room
  7. if baby starts to cry, repeat process again as many times as needed until she’s asleep

The nighttime crier method

  1. put baby down when drowsy
  2. Visit baby briefly ever 5-15 min if she’s crying
  3. make visits boring, brief, but supportive
  4. do not remove child from crib (no rocking if you do). Most babies cry 30-90 min then fall asleep
  5. middle of night crying: temporary hold baby until asleep (helpful for transitions) if she cries for more than 10 min. little talking, no lights. dad is often more effective 6. give baby security object 7. phase out nighttime holding

The overall commonalities between all these methods is that you first have to have a good bedtime routine established, and that you should feel free to adjust the timings as you feel best fits your baby.

So far we’ve attempted sleep training once with Fiona (last night in fact), and it took hours to get her down. Jake had to do it because she got ragingly upset if I tried to and me attending to her didn’t result in her getting fed. I am handling the nap version of this today (so far unsuccessfully) and then we’ll see how tonight fares.

Speaking of how things fare, that brings me to my other adventure. I have finally gone and signed up for a postpartum doula course and will be working my way through that in the coming months. I might just skip ahead to do the reading that pertains to sleep habits and use the material to help inform my ongoing real life experience. I’ll be taking the little one to the library next to where we live to stock up on the necessary books and then I’ll come home and work through them with her.

More to come about my course and in depth sleep training experimenting with Fiona soon!

all posts, women's health

on racial differences in maternal care

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Photo by Nicholas Githiri on Pexels.com

I’m combining all my other blogs’ content to this site. Please bear with me as I post older content. 🙂

Way back a few months, Fi and I visited my parents, and as a result she got her fill of dog exposure. Studies are still looking into the impact of early dog exposure (e.g. the first year of a baby’s life) on the child’s risk of asthma, allergies, and eczema later in life, and preliminary data seems to suggest that dogs have a positive effect in decreasing the risk of all three.

One study even found a higher correlation of eczema reduction for black children as opposed to white children from dog exposure, which could be useful as black people statistically have a higher risk for eczema (especially women).

These kinds of studies highlight the need for analysis of subgroups (e.g. race, gender, type of birth) to really understand who is being affected specifically. However, subgrouping is only useful so long as the studies are done through non-biased non-reductionist lenses. If accomplished, such specificity would allow for more applicable research to come out that could help promote better health, wellness, and medical decisions.

Which reminds me, I also listened to a webinar from the Black Mamas Matter Alliance. It covered a lot of material, but there was one particular point that stuck out to me (besides the need for a lot of policy reform across the country). It was the need for doulas, particularly those who live in the communities they serve (called community-based doulas).

Doulas act as support people for mothers, providing nonjudgmental (and non-medical) advice to moms from pregnancy to postpartum, making sure moms understand their rights and options. A doula from one’s own community would invaluable as they would understand the dynamics behind the community, as well as having firsthand experience with how the medical/clinical facilities are.

The webinar also talked about the need for insurance coverage for doulas (especially under Medicare), so that more mothers can afford them. I couldn’t agree more, especially as doulas correlate with better outcomes and statistics for the mothers overall.

The webinar is up on the BMMA site if you want to listen to it.

And lastly, I also read a book by a black midwife called Listen to Me Good, which was a book about a less well known figure in women’s history named Margaret Charles Smith. She was a midwife in Alabama who worked from the 40s to the 80s.

She never thought she’d become a lay midwife, as the hours were terrible and the pay even worse, especially for a black woman in the south. She learned traditions of birth and postpartum care through her grandmother and other “wise women”, and then later got standardized training through the nearest hospital, which allowed her to assist more women in a systemically recognized and medically approved fashion. She still continued to serve women as best she could without putting her neck on the line (she also helped deliver white women’s babies, which was a contentious point at the time).

The book also reflects on the various struggles black women faced in trying to work as midwives in Alabama, first due to explicit racism, but in later years, also due to systemic racism and prejudice through the worlds of healthcare and medicine, as doctors sought to get rid of lay midwifery (and devalued nurse-midwifery too in some areas). Many women, like Miss Smith, continued to try to care for women regardless, as they were the only option for hundreds of miles, and because white doctors were generally not interested in making the trip to aid poor black women give birth.

It really puts into perspective that even today, black women in America are still three to four times more likely to die during childbirth (or the first week immediately after) than white women. Food for thought.

One thing that could help bridge this increasing gap is better sensitivity training and education for medical practitioners. I was curious about different traditional practices and beliefs around postpartum care which led me to some interesting studies. One such study covered a few Central American countries and their beliefs around both the perinatal and postpartum periods.

I do think it’s important to know of the different roots behind postpartum treatments to help understand why a family may act/react the way they do to particular medical practices in western birth facilities (like hospitals). This is the way, in my opinion, to create a culture of care that uses a mom’s background/culture along with the medical evidence based practice to put the best interests of moms first, rather than of healthcare premiums.