Wednesday, June 13, 2012

What Las Vegas Can Teach Mothers

June 10th marked the 12-year anniversary of my arrival in Las Vegas.  While I am now quite happy to call myself a resident of this bustling, hot, flashy city, I was not always so.  I am a country girl at heart, and I came from Icy Cold Nowhere, Colorado.  When I left my hometown, they had not yet installed their first stoplight.  So, you can imagine my terror the first time I was forced to drive a busy Las Vegas freeway.  I was sure I would die from the heat. But, over time, I came to love Las Vegas and my family thrives here.  I often look back on those first few years of life in this desert paradise.  They were also my earliest years of parenting babies and toddlers, and it's interesting to reflect on the lessons this city has taught me about pregnancy, birth, and parenting.


A woman who has learned she is going to have her first baby often doubts her ability to handle giving birth. She's heard the stories and she's watched the movies, and if there's one medical term she is familiar with, it's "Epidural."  She probably has friends who've told her that they intended to give birth naturally, but when the contractions became unbearable, they were happy to have the drugs.  Maybe she doesn't think of herself as a very strong person.
I liken labor to a Las Vegas summer. Yes, it is scorching hot.  No one around here is saying it's "on the warm side."  And I'm not going to lie to a first-time mother and tell her that labor is "very uncomfortable." Her contractions will be very, very hard, and they will be closer together and longer than she would like.  But each one will have an end. If her labor began normally (meaning she avoided induction), her brain will be kicking out endorphins stronger than morphine, and as the intensity of her contractions increases, so will her ability to handle them.  My first summer here, I counted the hours till the sun went down each day.  It only took a few weeks for me to realize that the sun was guaranteed to set every single evening, and I could look forward to sitting by the pool and refresh my sweltering, shriveled self in preparation for the next day.  A laboring mother gets times of refreshment and rest, too.  Even when labor is at its strongest, most urgent stage, she will have breaks.  Some mothers joke, eat, or even sleep during these breaks.  Labor is a lot of hot, sweaty work, but you can take the heat. You really can.



Perhaps more than any other US city, Las Vegas is obsessed with billboards.
Most of them can be divided into two categories: Young, Underdressed Women and Ecstatically Happy Gamblers.  Both are misleading. Having known personally many of the women who dance at the "gentlemen's clubs" here, having massaged them and caught their babies, I can assure you that they are quite ordinary-looking women, with all the same aesthetic flaws you and I have.  And having observed the real, zombie-like, lethargic people who gamble at the local casinos, I can assure you that most of them seem to be bored to tears.
Those billboards don't bother me so much anymore, however.  It's easy for me to point to them and tell my children, "That's a lie."  What bother me more are the billboards, and even the less obvious forms of advertising, for the local hospitals' labor and delivery wards--oh, excuse me, "Birth Centers."
It's really just a floor in the hospital, but the advertising gurus have discovered that women like the idea of giving birth in a more "home-like" environment, so they use the term quite loosely.  One local hospital boasts of their "all-private Labor, Delivery, and Recovery rooms."

                                           Here is the truth: there is no such thing as privacy in a hospital birth.
The gown they insist you wear does not button in the back, there is no doorbell on your door, and there is very little discussion before any number of people put their fingers inside you. If privacy is important to you, stay home, lock your door, and turn away uninvited guests.


The above-mentioned ad also uses a  rather unfamiliar term, "couplet care," which refers to the idea that the mother and baby will share the same nurse. This system, evidently, "optimizes family bonding time and enhances continuity of care." It goes on to say that if a prospective customer would like to tour the home-like L&D, she is encouraged to bring her partner, but children are not allowed to join in the fun.
Here is the truth: the hospital staff is not as interested in your family bonding as they are maintaining protocol.  And why should they be? They work with each other every day. They have never met you. During your labor, you will have one set of nurses (usually two or three), and if there is a shift change during your labor, you get a whole new batch.  Most OBs are present only for the bare minimum time requirement--the instant he has sewn the last stitch of your episiotomy, your care is transferred to a team of postpartum nurses.  Your baby will probably be transferred to a team of pediatric nurses. If your hospital was one which was built using the generous donations of an infant formula company, it is likely that your baby will be kept on an entirely separate floor from you.  Your husband will have to choose who needs his attention more. When you and your baby are released, you will probably never see any of those people again. If continuity of care is important to you, hire a midwife.  See her for the entirety of your pregnancy, and at each of your prenatal visits, plan to stay for at least two hours. Bring the kids; they love to help hold the doppler when it's time to listen to the baby's heartbeat.  Enjoy the company of this midwife for your birth, all of your postpartum visits, well-baby visits, future births, and playgroups for many years to come.


A friend of mine came to visit recently from out of town. She called, distressed, as she was trying to find our house."There were these cones and flashing warning signs everywhere!" She wailed into the phone. "I tried to follow the detour signs, but they didn't seem to lead to anywhere.  And I couldn't see any construction happening. My GPS was telling me one thing, but the signs were telling me another..."
Fortunately, my husband and I were very familiar with the area, and we were able to give her clear, simple directions.  We laughed when she arrived and explained that the road construction was fake.  The warning signs had been up forever, and the cones were beginning to melt into the asphalt with age.  But no work had commenced.  We were convinced it was all a ruse to test our intelligence.
The road to having a baby is often fraught with dire warnings, signs flashing at you to proceed with utmost caution.  There are important-looking machines on display to remind you that soon, the road as you know it is going to undergo some drastic changes and you'd better have your seat belt on.
"Don't eat tuna--the mercury will poison your baby." "Don't raise your arms above your head--the umbilical cord will choke the baby." "Don't take a bath--the dirty water will infect your baby." "Don't breastfeed--it will ruin your breasts."  "Get regular ultrasounds every two weeks just to make sure everything is OK." "Find the best doctor and the best hospital and get there as soon as you think you are in labor, or you and your baby could die." "You must stay on your back.  If you try to roll on your side to deliver, it will kill your baby!" I have heard all of these uttered in all seriousness...that last phrase, in particular, was yelled a mother I was assisting in the hospital.  Fortunately, she was too busy pushing her healthy baby out to listen, and delivered on her side, as millions of women have done.
Very often, it is easy to dispel these fears with a little common sense. (If a pregnant woman could choke her baby on its own umbilical cord by lifting her arms over her head, how have women been shaving their armpits for the past century?) It is when the dire warnings are so cleverly presented as medical "fact" that it becomes more difficult to trust that pregnancy and birth are a normal, everyday state of nature. (Did you miss that link? It's a good one.)
If you want the quickest, safest route to your destination in spite of the crazy, fake road construction, call a friend who lives in the area.  And if you want a normal birth, call a person who specializes in normal birth.


Las Vegas can be a challenging place to make friends. Lonesome for family, daunted by the freeways, and unwilling to step foot outside without your own personal fan, it can be tempting to become a recluse. I recall vividly my first official social gathering here. It was about four miles from my house, but it may as well have been four hundred.  I was lost. I was pouring sweat. I almost turned back for home. My baby was crying in the back seat, so of course I arrived with two wet patches of breast milk on my shirt.
I spent the evening in the company of people with whom I had very little in common. There was not a child in sight and I was afraid of getting fingerprints on the glass coffee table.  Truth be told, I didn't have a very good time. But, as I was headed home (in the blessed coolness of a 90 degree evening), I was elated.  I was very proud  of myself for getting there, sticking it out, and getting to know some people.
As it turned out, one of the women who had been there introduced me to another young mother...who, Providentially, happened to live in my apartment complex!  It took a little courage and creativity, but I found excuses to knock on her door.  (The first one was lame.  I asked if she needed any of the boxes I'd unpacked before I threw them away.) We became fast friends, and so did our children.  I hadn't realized how desperately I needed a friend! A few weeks later, I was stunned to hear her say, "I hadn't realized how desperately I needed a friend! What would I do without you?"
A few years later, I found a true friend in my midwife, Corrine.  I thought she went a little overboard trying to connect me with more friends, though.  She was constantly giving me meeting times for  La Leche League. If I mentioned I needed car repair, she was quick to give me the name of her mechanic friend "whose wife is so-and-so and whose baby is so-and-so." She pointed me in the direction of other mothers to answer questions I knew she was capable of answering herself. She invited me to sign up for a Yahoo group of like-minded "radical" moms. I didn't feel I had much to offer anyone, being a young, newly single, broke person whose children often misbehaved. Though I felt woefully unworthy, she sent countless people to me for advice and massage. After a few months, I found, to my complete surprise, that I had a sizable group of people I considered good friends. I needed them. And they needed me. That silly word, "community" took on a whole new meaning for me. I became addicted to introducing people to other people.  (I think this had more to do with my becoming a midwife than my interest in natural birth.) It's catching, too. My friends have caught the bug, and they regularly snag unsuspecting women at parks, grocery stores, and libraries.
"I love your skirt. Did you know my friend makes those?" "We're dairy-free, too. I abhor coconut, too. But I learned how to make coconut milk in my blender, and it's yummy. Want to come over, and I'll show you?" "Your baby's coming in a few days?  What does your family eat? I'm bringing you dinner." "I heard your husband restores cars. Deborah's husband, does too. Have you met them?" At Pinkpeas, my home away from home, I am warmed to the toes to hear these sorts of conversations nearly every time the doors are open.

And that is the most important lesson that Las Vegas has taught me: Mothers need other mothers much more desperately than they need a midwife. Good friends will keep you cool in the heat, help you sort through the false advertising to get to the truths you need to make your life better, send you on detours that actually lead somewhere you want to go, stick with you longer than it takes to build a casino, and, best of all, they will need you.