Please don’t shoot my baby

I know how dramatic the title sounds. Like, trust me, I know. It’s hardcore melodramatic. Ridiculous. Absurd. Who wants to shoot a baby anyway?

Yet this was an actual thought I had in December of 2012. My son was 4 weeks old, and I was smack in the middle of the holiday psychosis that is Wal-Mart 10 days before Christmas.  Between the sheets of rain that were pounding on the roof, the Direct TV representative in the center aisle aggressively pursuing me to sign a contract, and all of the strangers commenting on my infant, I was feeling a bit frazzled.

It was the first time we had taken him out in public. I wasn’t the crazy “total shut in” new mom, I mean, I had taken him on walks around the neighborhood and over to my brother’s on Thanksgiving.  But that trip to Wally was the first time he had been out-out. We’d decided to go because we needed preemie sized onesies.

My son was born at a robust 8 lbs 1 oz and was the cutest little pink man who ever entered the world. But then I had trouble with my milk coming in, and after his first two weeks of life he had dropped down to a slim 6 lbs, 2 ounces. That, my friends, made him one teeny tiny little dude. And the zero to 3 month outfits that filled his little dresser drawers just hung off of him.

And since Christmas was rapidly approaching I wanted at least a couple of outfits that actually fit him. Doesn’t every  twenty first century middle class suburban mom yearn for that “Baby’s First Christmas” picture to be perfect? So since Wal-mart was right down the street and we didn’t want to venture too far in the rain (Pro tip: Californians cannot drive in rain. Like, at all. They somehow become convinced that liquid falling from the sky means that going more than 40 mph on the freeway will result in the car spontaneously combusting so they avoid it at all costs.) we headed there.

The good news was that there were indeed many cute preemie holiday themed pajamas. The bad news was that the store was jam packed with what approximately half of the population of Fresno.  It was stuffy, hot, loud, and filled with the uniquely frenetic energy that only applies to people desperately trying to finish purchasing their holiday gifts before every store everywhere sold out of everything worthwhile. As someone who had moderately struggled with social anxiety  since childhood,  I felt my heart rate pick up as soon as we stepped past the Salvation Army bell ringer, but I was determined to get my little outfits. So we headed straight to the baby section, gracefully circumventing the aforementioned Direct TV sales girl. I picked out a couple of things and then we headed to the grocery section. Which is when everything started to go horribly wrong.

It all started pretty innocently in the cheese aisle. My son was tucked into his infant car seat, which was sitting directly on top of the front portion of the cart. (Let’s just address now that this is horribly unsafe. Never put a baby in a car seat there.) At this point my baby was all cozy  and asleep in his little seat, and I had a baby blanket draped over the handle to prevent people from touching him with their flu-season-germy-hands.

As I opened the door of the refrigerated cheese section I heard a little kid cough behind me and a woman laugh. I turned back toward my kiddo and saw that somehow said woman had completely removed the blanket and was lovingly stroking my sons head and cheeks with one hand while she held the hand of a coughing runny nosed toddler with her other hand. The horror, fear, and rage that washed over me in that moment were absolute.  Up until this point in my son’s life even my parents had washed their hands and/or used  a shot of Purell before holding him. Now, I am a  very polite and calm person by nature, so I stood there for at least a full three seconds staring at her (while she continued to keep her hand on my kid’s face) before I was able to formulate words. It had honestly never occurred to me that random strangers would feel entitled to touch my newborn without asking. (All moms everywhere please feel free to laugh now.)

I don’t remember what I said to that woman as I yanked my child away, but I am sure it was polite. What I do remember is the terror that rose up inside of me as I walked away. I pulled my son out of his car seat and decided to keep him cradled against my body to keep anything like that from ever happening again. (Keep laughing all moms everywhere!) As I walked away (from my shopping cart that still contained my car seat, preemie outfits, and cheese) all I could think about was that someone I didn’t know had touched my perfect little baby. I thought about the sick little kid that she was with, and saw her runny little nose, and heard her soupy cough over and over again in my mind.  I went to search for my spouse, who (of course) had been snared by the Direct TV sales person.

As I turned out  of the cold grocery aisle and into the dry goods aisle, I almost walked right into a group of three tattooed young guys.  ( I most likely wasn’t paying attention to where I was going on account of clutching my newborn to me and obsessively worrying about whether he’d just been exposed to H1N1.)  The tattooed  guys didn’t notice me though, because they were having a heated verbal argument with three other young guys who coincidentally were also covered in tattoos. It took me less than 2 seconds to absorb the fact that three of the young gentlemen were wearing red baseball caps and had paw prints incorporated into their tattoo work. In my city, those are definitive markers of a pretty popular gang. As in gang bangers. As in, dudes with guns and agendas and a visceral and intense dislike for gentlemen who wear different colors and have different symbols represented in their tattoo repertoire.

I didn’t bother turning around to asses whether the other group of young guys was from a rival gang. I didn’t actually do anything other than freeze. I stood there with my son in a death grip, and stared at the floor. I physically could not move. All of the thoughts in my head stopped, my heart stopped, and I couldn’t breathe. All I could envision was one of the guys pulling out a gun and a massive gang war starting next to the tortillas. I saw me and my son getting caught in the middle of it. I actually pictured my most perfect tiny human being shot and killed, and all I could think over and over and over again was “Please don’t shoot my baby, Please don’t shoot my baby, Please don’t shoot my baby.”  The guys yelled at each other a little bit more, but then moved on. The whole altercation was probably less than two minutes.

And yet, I was  deeply affected. I don’t need to finish describing the rest of the Wal-Mart experience but for those interested: I found my spouse, we didn’t sign up for Direct TV, and I waited outside with the baby now zipped inside my sweatshirt while my better half retrieved the cart and paid for our goods. As soon as we got into the car I started Oprah-ugly-crying and continued to do so for the remainder of the ride home. After I got it out of my system I took a nap at home and when I woke up I wondered why I had such a severe over-reaction but then shrugged it off as new mom nerves.

Fast forward to two weeks later, and the NP in my OB’s office doing my six week postnatal checkup. One of  the questions she asked toward the end of my visit was “And how have your moods been? Any thoughts of harming yourself or baby?”  The Wal-Mart incident flashed across my mind, or more accurately, my intense vision of my child getting murdered in my arms, and I paused. My NP looked up from the clipboard and paused, and then (gently) kind of drew out my name. “Saaaaaa-ra?” And I just shook my head and mumbled “Uhh no, the exact opposite actually. I feel like EVERYONE else is going to hurt him and I can’t keep him safe enough. ” Down went the pen, the clipboard, and  she sat back down again. With all of the warmth in the world she kindly said “Hmm, let’s talk about that.” And so began my journey into learning about Postpartum mood and anxiety disorders.

I didn’t know postpartum depression could manifest as anxiety. Or more accurately that there is an entire spectrum of postpartum mood disorders that ranges from baby blues, to anxiety, to panic, to OCD, and all the way to psychosis. I didn’t know that “birth  trauma” is actually a thing. I definitely had never heard of birth PTSD, and honestly even if I had heard of it I’m not sure I would have believed it was real.  I didn’t know that statistically up to 20% of women experience one of these mood and anxiety disorders.  Take a second and think about that for a second. Twenty percent of women can experience a mood or anxiety disorder after giving birth. For my fellow non-mathematically-inclined folk, that means 1 in 5 women who have given birth. Know 100 women who have had babies? Twenty of them probably experienced something on this spectrum. Real women. That you know.  Which begs the question: why aren’t we talking about this?

If you have studied postpartum mood and anxiety disorders, you probably saw all of the red flags that I mentioned as I was describing my Wal-Mart story. Problems with lactation, baby losing too much weight, fear of travelling far from home, exaggerated fear of germs, and and an admitted predispositon to social anxiety; when taken all together made me a likely candidate for a PP mood disorder.  However screening for these types of disorders is often overlooked or at best conducted in a rush as a compulsory end of the “six week check.” Did you know that in the vast majority of American healthcare networks Postpartum Depression is not even given a billable diagnosis code? So even if a provider DOES care enough about helping women through these issues, there isn’t a code for them that can input to get paid for it? So I ask again: why aren’t we talking about this? Why are we failing women?

At this point in my blog, I could easily go into a tailspin talking about all of the problems in healthcare, and how the stigma around mental illness prevents people from seeking help, and that millions of women will suffer in silence because they don’t have resources to help them, but for your sake I will just stop here.

As far as my story went, I was one of the lucky ones. My NP referred me to a lovely psychologist. I’m lucky because my insurance let me see a psychologist as many times as I wanted for any issue I wanted and I only had to pay  $35 copay. I’m lucky that I even had insurance. I am lucky that my provider was a bright-eyed twenty-something working her way through medical school and was still young and passionate about women’s health instead of jaded by years of the bureaucratic BS that many providers are put through by for-profit insurance companies whose bottom line is making money instead of caring for women. I’m lucky my boss was supportive enough to let me take almost six months off of work and still welcome me back with open arms. I’m lucky that I have a huge family full of supportive and loving people, who are fairly educated, mostly white, definitely affluent compared to the rest of the world, and who would have noticed I needed help whether or not I was aware of it. These are not privileges I earned, or even really deserved, but by sheer luck of the draw was born into.  I got the help I needed, and six months later was a well adjusted happy mom who delighted in every little sound her baby made. So many other women aren’t that lucky.

Now that my son is a precocious and energetic four year old, and now that my life has taken some unexpected turns it is very easy for me to realize how ridiculous my “please don’t shoot my baby” phase of life was. My son was never in any imminent danger, but I can assure you that at that time in my life the feelings were real. Nobody could have convinced me they were irrational thoughts triggered by a chemical imbalance and looking back now I wonder how my life would have turned out if I hadn’t had help to get me though it.  If you know someone who recently had a baby, will you please stop by her house one morning with coffee and bagels, or a pizza for dinner, or anything to just be with her for a little while? Social support can make a huge difference to moms who are feeling alone.  It will also give you a chance to check on her and assess her well being. Friends are often pretty adept at recognizing when “something is off” and you might be the person who sees it in her.  And it just might make a world of difference.



This may be T.M.I. but…

I cannot even tell you how many times I have heard the phrase “This may be T.M.I.  but..”  in my doula career. It is usually followed up by a quickly mumbled question or embarrassed revelation that I can’t quite interpret. So I just smile and say “Don’t worry. Nothing is TMI to a doula.” And you know what? That’s virtually always true. There isn’ anything about the human body embarrasses me. And certainly there is nothing about pregnancy or childbirth that makes me unsettled. Doulas have pretty much heard it all.

Pregnancy is weird. It affects the female body from head to toe. ( Literally. Hair grows like crazy and is super lustrous, and tootsies get super swollen and sometimes ache. So seriously, head to toe!) Everything is in a state of constant flux during the forty-ish weeks it takes the human body to successfully produce a tiny human. Most of the changes are due to the avalanche of hormones the body produces while gestating. Estrogen and progesterone levels are sky-high and will never be at the same level at any other time in a woman’s life. And as much as humans like to pretend that evolution stopped with us, the fact of the matter is that really we are all just animals, and are as much a slave to our hormones as any other mammal is. So trying to sail smoothly along the tidal wave of hormones can throw any woman for a loop!

According to  this article on WebMd, excessive gas, increased vaginal discharge, hemorrhoids, incontinence, and weird body odors are all common pregnancy symptoms. Have I had clients ask me about every single one of these? Yep!  Sure have! Even though they’re busy telling their friends, family, and the cashier at Trader Joes that they love everything about pregnancy, most women usually have at least a few less-than-pleasant side effects occur at some point during their pregnancy. And although their care provider (AKA doctor) is the best resource for discussing this information with, there is something about sisterhood that makes women feel more comfortable sharing this information with other women.  And while a doula has absolutely no medical training and is not equipped to answer any medical based question, we CAN tell you that yes, if you’re twenty weeks into your pregnancy, it’s totally common to have crazy pimples and maybe pee your pants when you hear a really funny joke.

Sex is another thing that people tend to be incredibly embarrassed to ask about. And lets face it, much like pregnancy, sex can be weird Some women are ashamed to admit that they want to have sex “umm, like all the time,” while they’re pregnant. Others wonder if something is wrong with them because their libido seemed to have disappeared with their period. I don’t know what makes sex so taboo to talk about in our culture, especially considering that we’re bombarded with it in at least half of the advertisements we see on the daily.  (Honestly, this article talks about how companies use sex to sell everything from hamburgers to tennis shoes!)  However for some reason we’re conditioned to accept it as a normal advertising tactic, but are afraid to talk about the real thing when it comes to pregnancy.  Doulas have heard SO many sex-related questions that it doesn’t even phase us; so if there’s something you’ve been wondering about, please don’t hesitate to ask. (News flash, if we’re supporting you and your partner while you await the arrival of your bundle of joy, there is a pretty good chance we’re already aware that you two are sexually active!)

In my personal approach to doula-ing honesty, authenticity, and humor are all traits that I try to integrate into my work. If a client has a “TMI” question or comment, I usually try to make a joke to diffuse some of their anxiety and then reassure them that their issue is totally normal. (99% of the time, it usually is!) Then I answer them  to the best of my ability using plain language and actively listen to make sure they feel reassured. By plain language I mean that if a client texts me something  like “Sorry if this is TMI, but my vajayjay is super itchy and it’s freaking me out,” I’d probably text something back like “Lol, totally normal girl! Hormonal changes can make lots of things happen and increase blood supply everywhere, including the labia. Yeast infections are also incredibly common in the second trimester so call your OB in the morning and tell them what’s going on.” Then I’d probably email her a few evidence based articles and remind her to avoid the myriad of home remedies that are online.  And that’s pretty much it! No big deal!

So the moral of this story is…don’t be embarrassed to talk about anything and everything that you go through during pregnancy. Your doula will not freak out, think differently of  you, or call all of their friends and tell them what crazy thing they just heard.  We understand the female body, pregnancy, and childbirth pretty well and usually have had lots of training about all of them. We probably even have access to our trainers, who have even more experience than we do and are happy to support us through anything we haven’t heard about. At the end of the day, most doulas have their clients best interest at heart and are genuinely happy to help them navigate through all of the unique issues that accompany pregnancy.  We became doulas with the earnest desire to support women and their families and know that a LOT of the best things in life are awkward, messy, and “TMI.”