Tuesday, September 27, 2011

Jewish. Yogi. Doula.

Allow me to introduce myself...
Cross posted at: Kveller

I grew up in a fairly complicated and very secular latchkey home with Hanukkah bushes, Chinese take-out, and a sick mama.

My mom passed away a couple of months before the Twin Towers fell, when I was 23. Around this time I started practicing vinyasa yoga in Cobble Hill, Brooklyn. I got dumped just days before both of my roommates moved out to live with their boyfriends. Yoga helped me feel calmer and healthier, and allowed me to sit with my various sadnesses. It was different from anything I grew up with.

As I continued my search for meaning, I figured I should check my own Jewish background. Though familiar, I didn’t know an Aleinu from an Aleph. I also thought something about Israelis reminded me of what I found edgy and compelling in 90s era hip hop, so I decided to learn a little Hebrew and went on Birthright (a free trip to Israel for 18 to 26-year-olds). I said the Mourner’s Kaddish for my mom the year after she passed, and it served as a mantra that brought change in my life.

I was working in music marketing when I met my husband Jonah on Jdate. When he showed up I thought, “this guy is wearing a kippah, he’s way too religious for me, he’s moving to DC in a few months, and he really doesn’t seem like one-night-stand material.”

And then I got past all that and was present. We both loved hip hop, and comedy, and spirituality (admittedly in a sort of distance-learning way).

People ask if I got more religious because of my husband. I think we wouldn’t have connected if I wasn’t already interested.

At first we traded. I would become Shabbat-observant if he would become vegetarian. Then circumstances led us to new paths. I enrolled in yoga teacher training at and about a year later Jonah started rabbi school. I learned the rhythms of the call to birth when my mentor Sasha, also a doula, needed me to sub for her prenatal and parent baby yoga classes. I had felt a distinct lack of a calling in my life but around the topic of birth, something clicked.

Jonah and I have grown together so much that it’s hard to extract whose influence affected what part of our lives. Jonah’s tzitzit and now payis–are they evidence of his devoutness, or my love of cultivated eccentricities? My sustained interest in healing–a yogic path, my ambition, or Jonah’s grounding presence in my life?

Yoga has taught me that sensation is fleeting, and that sticking with a challenge is a faster path beyond it than avoidance. Judaism grounds me in ritual and mindfulness (blessings over food, Shabbat, family) in a fairly automatic way. Being present and un-alarmed at births helps laboring couples as much as anything else.

I was attending births and teaching new mamas before becoming a mama myself. Now we look after a 2-year-old baby girl Bina, my mother’s namesake, who both revolutionized and validated the ways I understand birth and life. I try to nourish wellness more than avoid illness, and know that being edgy isn’t about being tough–it’s about being true to yourself.

I am a ritual-maker, fiercely-devoted ima (mother), witness, friend, and iconoclast. Birth is my calling, yoga is my soul, and Judaism is my family.


I have decided to begin a mysore yoga practice. The first morning I showed up at Harlem's new Land Yoga I told Lara that I am committed... but... I have to see how it works with my family after the first session. Lara politely told me that if I intend to take class, I need to be committed to 3x a week for minimum of a month.
I have been deliberating whether to babycare swap or pre-school or pre-un-school this fall. I got cold feet when the JCC required us to commit to a class series in advance without a trial session.
Tis the season to take on new endeavors. Sometimes there is a problem with our culture's insistence that down time is a waste of time. We schedule ourselves and our children into a busy tizzy.
But there is beauty in making a commitment of our time, money, and efforts. I often notice myself weighing all the pros and cons of a particular situation only to find later that as much as I deliberated, the one variable I hadn't considered becomes most prominent. Or if I deliberate too long, the opportunity passed, or I lost steam.
When we look for a backdoor, we often find one. But maybe we don't need a way OUT as much as we need a way IN. When we spend our time avoiding getting stuck, we're not spending time in the current opportunity that presented itself.
I was really pleased that Lara pressed me.
I encourage you to commit yourself to something today. Nurture that part of yourself that still has instincts and intuition and trust that you were meant to encounter the ramifications if there are some. It's not being reckless - even if you make a "mistake," it was a mistake that was made in the name of allowing yourself to practice using your intuition, so that there are less mistakes in the future.
I guess I'm saying... seize the day family.
Posted without 108 revisions,
Julia :)

Tuesday, August 30, 2011

from the campy desk of the yogi doula

After we returned from our year in Israel we spent a month at a camp in Canada, where Jonah taught judaism and I taught yoga. Camp had cool nights, hot afternoons, beautiful lake, a huge open sky, and a few open-minded, thoughtful individuals I will not forget. I learned how children of different ages play and learn and appreciate.
But the cooking spray had butane and propane in it. I missed our organic vegetable delivery in Jerusalem. The highly programmed days and manner of discipline were not my style. Through my own scheduling hiccup, I was busy during free swim. Bina spent mornings at daycare, and even though I worked there, for the first time I did not control her environment. She learned to say MINE like a champ, played dress-up princess barbie, and wanted cookies and chips and dear g!d egg rolls and fruit loops. And it was EVERYWHERE. Our first weeks I was not a happy camper.
"Dear Mom,
The food is bad. I don't relate to these people. I'm homesick."
I was out of my comfort zone.
Then, after falling in love with the special needs campers that I was not even sure I wanted to teach in the beginning, I began to notice how excellent the camp is at nourishing this program. I realized that this institution does have ideals (duh?), even if many of them are different from mine.

I’ve been learning I can't nay-say everything (even when research and intuition are in my favor). Because, among other reasons, I'll probably start teaching my daughter to complain a lot.
And really, why complain? I woke up every morning for a lakeside yoga sadhana. I made a difference at the daycare as morning snack collector (bye, bye candy before noon). My schedule changed and I was in the lake every afternoon until dinner (that was huge). I loved how my 15-year-old girls were so dedicated. I loved how the 15-year-old-boys feigned ambivalence but focused and giggled and asked questions at the end of a session. And I loved watching Bina navigate her environment. I might have preferred different food choices, but I couldn't have asked for any better interpersonal choices. She started saying, "I don't say it's mine. I say, CAN I HAVE IT?" (kvell).
Fast forward to now, where we returned to NY and are finally settled. There are still things that I don't especially want her to have like cheerios and plastic toy strollers. I can explain and model, or take a strong stand when the situation truly calls for it. But as she ages and I have less control, I can learn to accept these gifts: the gift of learning to step back, the gift of time spent watching an intuitive being, and the gift of learning and not always teaching. I want to trust Bina's choices both because she's great, and so she practices making thoughtful choices on her own.
"Dear Mom,
I miss you. I think of all your challenges and idiosyncrasies, and of the way you have managed to continue giving me gifts over all these years."
I have to admit that I actually liked camp by the end. I'm loosing some of my ideals, sometimes. But going with the flow is another ideal that I neglect way too often.

Dedicated to my mother Barbara Gail Uslaner Mannes Walters, who marched to the beat of her own drummer, saw the good in everyone, made thoughtful choices (some more and some less), liked both the mainstream and the unusual, and passed away 10 years ago this summer.

Tuesday, May 31, 2011

We're Growing Up Together

My husband's rabbinical training required that we spend a year in Jerusalem. Now at the tail end of this time, I've been feeling a lot more "in progress" than complete. A dear new Israeli friend and I have just gotten into the swing of things on our babycare swap. A local midwife I just worked with said she had wanted to send clients my way all this coming year. I'm just starting to memorize phone numbers, get some major growth in the garden, get my yoga schedule down pat, string together (three-word) sentences in Hebrew, and figure out a good system for refilling our brita. I'm so ready for NY, but I'm not quite done here.

I'm also grappling for meaning because it's so hard to make sense of the political climate in Israel. There are so many hurt feelings and different perspectives that I don't always know the right questions to ask, let alone how to put forth my own assertions. And there's often a big white elephant in the room (or playground, where I'm told it's best not to talk politics in casual conversation).
Still, what I know about birth brought a few insights for me: The more comfortable you can get with a little discomfort, the less big discomfort comes your way. Be willing to sweat. Meet someone new even if you think you already know them, or have no idea how to greet them. We never know what can shift and make a seemingly insurmountable barrier disappear.

I was privileged to attend and teach babywearing at a gathering of Israeli and Palestinian woman joined together under the moniker Midwives of Peace. We talked about birth politics and procedures, traded trade stories, and told a few (dirty) jokes to break the tension. I learned the Israeli homebirth midwife makes 4 times what the Palestinian one does. I got to attend hospital and home births, and was surprised and relieved to find the hospital experience a bit more humane than what I often experience in NY. I attended a seder in Tel Aviv for the hundreds of refugees who walk here from Africa each year in search of asylum. I got to visit the Hebron Hills, East Jerusalem, and Bethlehem, hear perspectives from Israeli soldiers (including cousins and friends) meet a few Palestinian families (among them dear friends), and see Jewish Israel through new and challenging lenses.

Three years ago when visiting a bedouin family in the Negev desert with my husband's family organization Kivunim, all the women were hidden - this year, just having a daughter was enough to grant me effortless entrance to this (and other) women's areas. Thankfully Kivunim is teaching students to speak both Hebrew and Arabic, because rifts between people are great enough without the language barrier.

Amazing things happen when you put people in a room together. This is a feat unto itself; but if you can witness it, you can have a tactile experience of the other. Sometimes we learn the other is just like us. Other times it's not all pretty, we even deepen our stereotypes. But putting even an ugly face on a nemesis is much better than a bullseye.

Nothing is lost - people I just meet now can be friends in the future; I might not have pragmatic answers for the peace process but I can trust that our abilities improve just by baring witness.
One thing has come full circle - the searing hot sun has returned to bleach the streets of Jerusalem white again.
Maybe I can expect answers the very day we fly home, which is immediately following Shavuot, a time for revelations.
But I still feel like I'm piecing together a puzzle.

Over many years I've been becoming a yogi, a doula, a Hebrew-speaker, and a witness to the middle east peace process.
This year, I've become a mother.
Maybe an iconoclastic mother who likes to practice handstands, but still a snack-prepping, nose-wiping, heart-in-my-mouth-when-my-baby-is-hurt mother. I knew it most when I searched the fridge during Passover for the leftovers I figured the rest of the family wanted least.
On paper it's strange that the thing which feels most definite is the thing that is still so new, and the thing I will continue to grow into over my entire lifetime.
Yet it helps answer the question of why I've been feeling so much more "in progress" about this year, when after most big adventures in my life I have felt a lot more complete - the biggest part of my adventure this year, looking after my little toddler, is no where near complete.
"We're just growing up together," said a student of mine, when I asked her how she and her three-month old had been doing.
I don't think I've ever heard it put so eloquently.

Monday, March 14, 2011

A Doula's Manifesto

An Interview In Honor of Women's History Month
Cross posted at: Health and Happiness Club

Julia Mannes is a is a professional birth consultant and doula certified by DONA International. She provides down-to-earth support throughout prenatal planning, labor, delivery, and the postpartum period. Julia is also a vinyasa yoga instructor specializing in prenatal and parent-baby yoga. She is skilled in acupressure, massage, photography, babycare, and bringing ritual to lifecycle events. Julia teaches workshops in babywearing, alternative newborn care, and yoga for labor and delivery. A native New Yorker who has traveled and lived in Israel, Morocco, Australia, and Europe, she received her Bachelor of Arts in Psychology at Vassar College and worked in the music business for many years. But it was close to home in Brooklyn where she answered the calling to serve pregnant women and new families in NYC. Julia served as Marketing Director for Coalition for Improving Maternity Services (CIMS') The Birth Survey, and Ambassador with Choices In Childbirth, helping with distribution for the New York Guide to a Healthy Birth. She is currently volunteering her services in Jerusalem, Israel and returns to NYC in June of this year. Learn more at www.juliamannes.com and www.juliamannes.blogspot.com.

1) What is a doula?
The word "doula" comes from the ancient Greek meaning "a woman who serves." Doulas provide physical, emotional, and educational support to families before, during, and following their birth. The doula’s role is to stay with a woman throughout her entire labor, delivery and immediate postpartum period – this continuous support is the hallmark of a doula’s care. A doula is distinct from a doctor or midwife - a doula does not attend to the medical aspects of your birth.

2) What drew you to this career choice and how did you get started?
During my primary yoga training in NYC, I was drawn to prenatal yoga. I started teaching prenatal and parent baby yoga classes for my mentor who was also a doula. I learned the rhythms of the call to birth from the times she needed me to sub, and when I completed my doula training I was completely compelled. I had felt a distinct lack of a "calling" in my life but around the topic of birth, something clicked. When I learned a bit about the politics of birth in the United States, I became an activist dedicated to supporting pregnant women and new families learn their birth options.

3) Why is a doula so important for a woman who is considering starting a family to connect with?
In days of old, a doula wouldn't be so important. But today women often haven't seen a birth, or breastfeeding, or even held an infant until their own. Families are spread further apart or just wouldn't dream of attending another family member in labor. But women have given birth with the support of other women throughout human history. It is helpful to have someone minimize bright lights and distractions, massage a sore spot, and keep you focused on productive activities - kind of like a sister or good friend with a few tricks up her sleeve. It is helpful to have someone knowledgeable about birth and skilled at active listening nurture your trust in the process. A partner alone with a woman may (lovingly) ask, "are you ok?," while a doula can emphatically say to the laboring woman "This is within the range of normal. You ARE (or will be) ok." Women are built to birth, but they are laboring under conditions markedly different than the women who came before them. Doulas help women learn how to navigate those conditions, change them when appropriate, and simply bear witness.

Studies have shown that when doulas attend birth, women rate their experience more positively, labors are shorter with fewer complications, and babies are healthier and breastfeed more easily.

4) What do you think are the main issues concerning women's health in the obstetrics field today?
Around the world, the great injustice in birth is the lack of access to basic medical techniques that would improve birth outcomes for both mothers and babies. Unfortunately the great injustice in the United States is the over-access to medical interventions that haven't improved birth outcomes. In 2010 the US ranked 41st in the world for mothers' deaths in childbirth, last among all other industrialized nations. The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn death rate is higher than any of those countries. The countries that have the lowest newborn and maternal mortality and morbidity rates are the countries where the majority of births are overseen by highly trained and skilled modern midwives.
As a society we are much more aware of our choices regarding an unwanted pregnancy than our options for how to birth. A lot of the feminist talk about birth mid-century was focused on a woman's right to pain medication. This is still a hot topic, but many feminists today focus on a woman's right to control the interventions she receives, to stay off her back and remain physically mobile in labor, and on returning to the women-centered midwifery model of care. Some people think avoiding an epidural is about being tough - but a choice to forgo pharmaceuticals unless urgent is most often about protecting your body and minimizing pain in the long run. It is also helpful for naturalists and allopaths alike to think less about avoiding the epidural and more about "how can we make this experience pleasant and functional enough that the epidural is not the main topic?"

5) Why do you think the U.S. has among the highest rate of c-sections in the western world?
If you ask me, it is because the majority of births are overseen by surgeons. An OB/GYN is a trained surgeon who we are lucky to have when truly needed. Since they attend the majority of US births, you will see more surgical births. Midwives are expert in physiological birth, and in cultures where they attend the majority of births, there are more vaginal births. You can read this for a more thorough explanation of this complex issue.
People often say they want an OB "just in case" something goes wrong and I agree! But to oversee the entire pregnancy and birth is not "just in case" behavior. Preventing that "just in case" becomes the focus of institutionalized practice more than the physiological and emotional ways to support a laboring woman. For example, all women naturally vary in their labor time - just like leaves fall from a tree at their own pace in autumn. Averages should give us a rough understanding of labor more than a mandate for each woman. Yet standard practice is to administer a synthetic form of oxytocin if labor is not progressing at 1cm per hour, which causes much stronger contractions and requires women to be immobilized and hooked up to a variety of intravenous drips and machines (and does not always speed labor as intended). Some babies do not tolerate these more intense contractions well, and a cesarean is suggested.
It would be like hiring a pediatrician to babysit your children. Not only might it be overkill, but it is a different skill set. The pediatrician may know about every childhood illness, but you'd want to be sure they know the basics of fixing a meal and connecting with your child.
The World Health Organization recommends the cesarean rate be about 10%. From a public health perspective, some say numbers much lower can result in avoidable natural trauma, and much higher numbers result in avoidable medicalized traumas. The rate in the United States is 32% and has steadily increased for 12 years straight - that is 1 in 3 births. Yet famous midwife Ina May Gaskin who started the birth community at The Farm in Tennessee has a 1.5% cesarean rate and better overall birth outcomes with fewer interventions than the national average.
People often ask me "what would a midwife do if the baby's cord is wrapped around its neck?" and I think to myself "at least give me a harder question!" A person trained in physiological birth should be even more skilled than a surgeon with a manual manipulation such as this - she would unwrap it with her hands. Her expertise is not limited to manual adjustments - a modern midwife has a lot more medical training than most people realize - but part of what makes birth with a midwife safe is that she will transfer care to an obstetrician when medically necessary. I've heard some convincing arguments that lack of faith in midwives is a form of chauvinism, in the sense that we're really saying we only trust the male-oriented medical system.
I have a dream of teaching "Birth and Babies 101" to teenagers because we need to know about birth way before we intend to conceive - it is empowering to better understand how our bodies work, distinguish the "choice" and "chance" aspects of birth, and increase comfort with this topic. TV shows like ER can make you feel like birth is an emergency where things go south at a moment's notice - in fact at most births there is a lot of waiting around, and most problems, when they do occur, have early signals. Movies with birth scenes lead you to believe that you're not in labor until your water breaks and when it does you need to be rushed to a hospital, get in a wheelchair, and be on your back until the baby comes out. In fact labor can start many different ways, often quiet and calm. Unless something is amiss when your water breaks, you are better off staying at home to labor for as long as possible. Put your bags in the wheelchair and push it yourself, if you are going to a hospital at all.

6) What role do you play on the day of delivery?
Doulas can support women at a birth center, hospital, or at home, and have proven helpful whether or not the client chooses or needs an epidural in the end.
The techniques I use include counterpressure, acupressure, massage, aromatherapy, hydrotherapy, use of hot and cold, suggestions for positioning to help speed labor and make you more comfortable, guided relaxation, and breathing exercises. You don't need all these techniques and there's no one best way to breath or move.
I am alerted as soon as my client starts laboring, and I typically offer suggestions and await another call until I am needed more. I often help couples figure out how to get some sleep to conserve their energy at this stage. Once I arrive it is my job to nurture a "rhythm, relaxation, ritual" triangle - helping women remember to move rhythmically, manage just one contraction (or surge, or rush) at a time, stay focused on the techniques that are working for as long as possible, yet help take decisive action to change what is not working, and facilitate communication between partners. We avoid getting caught in a "fear, tension, pain" triangle - fear causing tension, tension making the body more rigid, ridigity reducing comfort, and less comfort triangling back to increasing fear.
I take extra care to be courteous and unobtrusive with maternity-care providers (even if I believe the provider is not offering the best evidence-based care), because I have helped clients learn about their options prenatally and I have subtle ways to remind clients how to advocate for themselves during the birth.
It can be hard to understand the magnitude of why a doula is so helpful before you've been in labor, but when the minutes of labor feel like hours and the time you spend laboring stretches from hours into days, the need for a guide or coach becomes more clear, as much for partners as for the woman - in fact it may be unfair to ask a partner to not only learn all about birth but to also master support techniques and perform them for hours on end when they too are in the midst of the emotionally and physically consuming process of being reborn as parents.
My role actually increases the privacy and intimacy at births. Even though I am an extra body in the room, I minimize distracting intrusions and help clients advocate for their own preferences.

7) What role do you play after delivery?
I help establish initial breastfeeding, and there are many other things I do. After the baby is born I stay by the mother's side even though there is a lot of attention turned to the baby - she still needs to deliver the placenta and may need stitches, she may need support cleaning up, getting out of a tub, changing position, getting some food into her system, or processing her emotions. She may be hot or cold, high, low, or shaky. I do my best to make her comfortable. I also can help minimize separation from the baby, make the room cozier, or navigate the family in the waiting room. I speak to my clients on the phone at least once or twice in the day and days following the birth to make sure all is going well. I can offer support before an issue becomes acute. I visit clients at home a week or 2 after the birth to answer questions, help process the birth, and receive feedback about my role. This can all be very helpful since typical birth protocol involves discharge from the hospital with no follow-up until 6 weeks.
All the above pertains to my labor clients. I am also a postpartum doula, and for these clients I help with household tasks like shopping, laundry, and dishes, light meal preparation, registry/thank yous, and practical baby- and parent-care including breastfeeding, diapering, babywearing, yoga, and postpartum healing. I also remind people that if birth doesn't go as expected all is not lost and we can recover from setbacks.

8) Because of your career choice, you have a very intimate relationship with a woman looking to start a family. How does that make you feel?
It is fulfilling. Different women have taught me different things. I had one woman tell me that she's not into all this "hand holdy" stuff, and low and behold, she's the only client who ever asked me to hold her hand while laboring! You can't know which aspects of yourself will be most present during your birth, and I am always struck by the beauty of what manifests in the moment. I feel honored to attend each birth, and birth is never humdrum.

9) Anything else you want to add?
I suggest you interview a few different types of care provider – hospital or birth-center based midwives, family practice doctors, home birth midwives (read some reasearch about the safety of homebirth here, and obstetricians. Even if you love your current provider personality-wise, make sure you also jive philosophy-wise. Even if they are close to your home, think of other places you are willing to travel, such as your job. Interview others even if you are a little further down the line in your pregnancy (it is rarely too late to change care provider - and if you're concerned about offending them, try canceling your next appointment and see if you even get a follow-up phone call). See who answers your questions about safety and comfort best. People spend more time researching a car they’re going to buy, picking a wedding venue, even picking baby clothes, than they do researching the right care provider for their birth. And time and again, women rate their births as the most memorable events of their lives – so how do you want to remember your experience?

A final word - I loved my birth! It is helpful to know people have had positive birth experiences. Try to inform your psyche with positive stories. My daughter was born at home 17 months ago.

Search This Blog