Sunday, January 18, 2015

Virtue as the Mean

     About a week ago I found this article in the Washington Post. It is the experience of one woman, a self-described "physician, teacher, and health policy researcher" while having her baby in a hospital. She details the immense pressure she felt to have a high intervention birth and almost a cesarean section despite her wishes to have a low intervention birth. The big take away from the article, at least from my perspective, was the danger lay women face in the delivery room given the adversity this woman of medicine had to confront in her own labor. At one point she mentions consulting with several other M.D.s of various backgrounds in order to advocate for herself and her child. While I thought the article was an insightful and pointed statement about maternity wards, the larger cultural commentary came from the vary first comment that showed below the article itself. I normally avoid the comment section like the plague but happened to catch this one as it was the only comment at the time. I didn't feel like wading back through that trash to get a direct quote, so I will paraphrase. The commentator basically said "Shame on you" to the mother. She was doctor. Apparently she should have known better and advocated for herself more. If she felt pressured it was her own fault for letting herself get into that situation.
    This is not the first time I've heard this argument. It actually comes up quite a bit. Women share their stories of abuse and mistreatment during their births, and they are blamed. It is there fault for not being more prepared, more educated, more anticipatory of the events. It's their fault for relying on doctors. It's their fault for not taking responsibility in their own care. It's their fault, period. I find these arguments confusing for several reasons. One is because there seems to be very few other specialized fields where consumers are expected to have expertise. Most people who go to a mechanic can't build their own engine. Most people who go to a gourmet restaurant can't cook French cuisine. This is also a huge issue of privilege- assuming that someone who is already paying a professional to perform a service also has the time and resources to teach themselves the ins and outs of the field and be independently educated on the topic. Is assuming that someone trained in healthcare and beholden to the hippocratic oath will provide adequate care really that far of a leap?
     But another thing about this idea of "it's your fault for not educating and self-advocating" is that it's bullshit. Because women who do all those things above- who prepare and seek out education and information and participate in their care- aren't treated any better a lot of  the time. They are labeled as pushy. As non-compliant. Demanding. Relying on Dr. Google. Buying into psuedo-science. Believing everything they read on the internet. They are accused of being selfish and even worse, of not valuing their child's life and health. These women have been dropped as patients by their doctors and had CPS and police called on them. They have been dragged into the OR against their will. Laboring women have been put in handcuffs.
    Apparently, there is a delicate balance to be found for a laboring women. She should be educated, but not questioning. Responsible but yielding. She should stick up for herself, but not to the point of stepping on the toes of the almighty gods in white coats. It's not surprising then, that so many women fall short of the virtuous mean. For me personally, I will always recommend erring on the side of education and empowerment. However, I think there is an alternative.

   What if, just for shits and giggles, we entertain the idea that maybe, just maybe, the birthing women     aren't the problem?

   What if maternity care in the U.S. is intrinsically flawed?

   What if the entire healthcare system is set up to thrive on profit driven by disease and trauma?

   What if the field of obstetrics was never intended to cater to the masses?

   What if our view of womanhood and motherhood is deeply ingrained in the patriarchy?

   What if profit drives care more than science and research?

   What if convenience is more sought after than health?

   What if we knew that the U.S. funnels more money into maternity care than any other developed         nation but has the absolute worst results?

    Maybe that is where all of  these people should be pointing the blame. But instead we invent these "mommy wars" and blame some women for being too informed and blame others for being too compliant and once again place that ever-tantalizing image of the perfect (birthing) woman on a pedestal for everyone to collectively emulate. All the while, ignoring the real problem of a deeply entrenched system that as it exists now is set up to undermine evidenced-based care. Education and advocacy gives women a fighting chance. It is the kevlar that they wear when they walk into the war-zone of the current maternity care system. But it is not a guarantee that they will come out unscathed, anymore than blindly following someone across the battle field with your eyes shut and fingers crossed. What we need is a collective cease-fire. A real, open and honest peace talk about how we got to the place where battle was a useful metaphor for childbirth. But as long as women are spending all their time and energy attempting to find the balance between advocating for themselves and being polite, no one is addressing the core issues. No one is trying to fix the problem if we are all too busy arguing about how to adapt to it.


Wednesday, January 7, 2015

The Most Challenging Practice

    January each year is a bit of anniversary for me. January is the month I began my journey with my yoga practice. It was supposed to just be a simple "Yay! My last semester of undergrad; I'm going to reward myself with a fun class." And yet here I am five years later, still sweating it out on my mat. That college class ended in May, but I found classes in the community. And then I started attending workshops. And then I completed teacher training and became a registered yoga teacher. I taught my own classes for a year before Perrin came along. In fact, I taught right up until 2 weeks before Perrin was born.

   I have had some hard yoga classes. I have had teachers completely kick my ass. I have left limping and sore and feeling like I was hit by a truck because I rode my edge to my utmost ability and used muscles I didn't know I had. I regularly practiced Ashtanga, which if you are unfamiliar with is a pretty badass (yet completely accessible, not trying to scare anyone) practice. I attended some intense workshops and training. But it wasn't until recently, on the eve of my five year yoga-versary, that I began the hardest practice I have ever attempted.

   Before Perrin (a time frame measure I regularly use nowadays), when I practiced yoga, I practiced yoga. I attended led classes with incredible teachers. When I did my ashtanga practice, I did the full 90 minute primary series. I had a room in our house devoted as my own private shala. I did yoga right. And it felt good. Because that is part of my baggage that I am just now noticing. I have to do things right. Do them completely. Do them at least 100%. Because to not do it perfectly is to not do it at all. Or so my "rules" led me to believe. So you know what happened? I stopped practicing all together. And when I tried, it was only if I could make it to a led class.

   The thing about making it to a led class is  that generally yoga studios have classes at regular times. There is a start time, and a stop time. And it's at a place. That you have to get to by the start time. And when you have a Perrin, it's incredibly difficult. So my practice became more and more sporadic. And I started to put it off and avoid my sad neglected yoga mat because I knew the mat would feel SO GOOD and then I would feel SO BAD because I wasn't giving it (and myself) the time and attention it (and I) deserved.

   But like I mentioned in my last post, I'm starting to really take a look at my "rules" and challenge some of them. And I know, in my head, that some practice really is better than no practice. Even if it's only 15 minutes. Even if it's in our cluttered office surrounded by bunch of junk. On a mat covered in cracker crumbs. While Perrin's voice carries over Jai Uttal's and my cat somehow repeatedly MacGyver's the door open. And so I've committed to getting back into it. To practicing 6 days a week, no matter what each day's practice looks like. And it is the hardest thing I have ever done. It's hard not to judge myself. To say I slacked off or didn't do enough. To lament where I could be if I did more. To resent the fact that I just can't do more right now. It's hard to not do it "right". To not be "perfect". It is so, so fucking hard to accept my present and be at peace in it. So this takes the cake. Not the days of back to back teacher training; not the intense workshops; not demoing bakasana into tripod headstand while 36 weeks pregnant. Doing yoga- practicing real, truthful, compassionate yoga- is the most challenging practice I have ever attempted.

Tuesday, January 6, 2015

Head Shrinking

    You may have seen in our last Perrin update that Joey and I have begun some new and fairly intense therapy work. I wanted to share a little bit about that as it has been immensely eye opening and beneficial. It all started when Joey decided that maybe we should get divorced. Remember that post about how we talk pretty openly about that kind of thing? Something just wasn't feeling right for either of us, but we didn't know what it was. So we decided to do some couples and individual counseling and then reassess our family situation. Spoiler alert- we figured out that "we" weren't the problem. At least, the together "we". Our relationship in and of itself isn't really the issue. What is the issue is each of our relationships with ourselves. Let me explain-

     We found a fantastic therapist who we see individually and then together as a couple. What she is having us work on is digging down into who we are and why we are that way and what needs to change for us to live healthy functioning lives. We have done some therapy/counseling work in the past, but it mostly centered on tools to deal with our individual quirks and issues. The therapy we are doing now is getting down to the core of who we are. What are thoughts are and where those thoughts come from and how they affect our lives and interactions. This has been the most mind blowing part for me. You don't realize how much of you take for granted when it comes to who you are. You just assume "that's the way things are" or "that's just who I am", when in reality a lot of that is baggage that you have accumulated and learned through out your life. These lessons and experiences overtime shape our thoughts about things, and those thought trigger emotions, and then those emotions affect our behavior and actions. So what we think is a simple X occurs and I do Y, is actually much more layered and nuanced. Something may occur, and that "data" gets filtered through our complex systems of thoughts and emotions and when it is played out in our behavior may not look at all related to the original stimulus. Because a lot of the times it's not. 

    Here is an example- I had been wanting to get the garage door fixed for a while. It's been broken for about a year and it's a pain in the ass to drag our bikes and things through the house instead of just opening the garage door. At some point I asked Joey about getting it fixed and he kind of just didn't really say much. He didn't say yes. Well this came up in our couples therapy as Joey suggested spending money on something and I was upset because I would rather have spent the money getting the garage door fixed. Our counselor asked Joey why we couldn't fix the garage and his response was "I don't know; I guess I just never thought about it." So she asked me, had I told him that I wanted it fixed? I told her about the time I asked and that I never really got a response. So her question to me was, why didn't I ask or bring it up again? Maybe Joey just didn't realize it mattered since I only mentioned it the one time. This was a huge learning moment for me. My reaction- "But I asked and didn't get my answer, so it's over. That was the end of the conversation about the garage." See, I didn't realize until that conversation that I have some sort of "rule" in my head that you can only ask for things once. The answer you get is the answer you get and that is that. To ask again is rude and disrespectful and nagging and annoying.  So I was feeling bummed about the garage because Joey didn't understand that it was important to me (which "made" me feel unimportant) and I felt like I was powerless to do anything about it because I used up my one asking time and that was that. So I felt sad and frustrated and angry all because of this completely imaginary and arbitrary rule that I picked up from somewhere. But in reality (objective reality, not the reality in my head), Joey was perfectly fine getting the garage fixed once he understood that I cared a lot about it. We even decided to go ahead with the skylight I had been talking about, too. 

    The lessons get even more nuanced and layered than the above example, but you can see how these "rules" and thought and emotions we have cloud our relationships with others and ourselves. Another big part of it is esteem. Learning to have true self-esteem. That you are worthwhile and valuable simply because you exist. That was mind blowing for me as well. So I am working really hard on learning how to voice my thoughts and advocate for myself, and to stop censoring myself for the perceived comfort for others. That is the other big lesson for me so far- I am not responsible for other people's feelings. And other people are not responsible for mine. I don't have to "let" others "make" me feel bad. That is their own issues about their own thoughts and emotions and realities and doesn't have anything to do with me. And I don't have to worry about "making" other people feel bad. I am learning to have a healthy emotional boundary where my reality is protected from other people and is also free to be expressed. 

    Anyway, maybe all of this seems really obvious to you. But even really simple things- like asking for something more than once- never ever occurred to me. Because my reality was built where those things weren't options. So now I am learning to be more aware of my thoughts and emotions so that I can examine the validity of them and decide whether or not I should hold onto to those ideas or whether they are just baggage that I need to discard. If you are interested more in the things we are learning about, feel free to chat with me about it. We have been reading through a books and listening to workshops by Pia Mellody, who does a lot of work on codependence, which is essentially the issues that I talked about above as well as many other common problems. Basically it's learning to how to take of yourself as a functioning adult- recognizing your wants and needs and getting them met with the help of others. It's very interesting stuff and I'm amazed by how much I notice these mechanisms at work around me now. It's also been incredibly valuable for parenting purposes. It really helps you be aware of what "rules" you are instilling in your children.