"I want to birth my own baby," she said.

She is a tiny lady with a big, basketball-sized belly. Mary Lou, who works at the bakery, and her husband, Joe, our local mechanic, had found their way to our county's childbirth education class. Mary Lou and Joe had grown up in a small Eastern North Carolina town. They had married right out of high school and now, living in Raleigh, were preparing for the birth of their first baby.

Mary Lou was quiet and soft spoken. She rarely raised a question but often jotted down notes as the class went along. When asked, "Why did you decide to come to this class?" Mary Lou had said, "'cause I want to birth my own baby. I want to push him out into this big, wonderful world!"

Mary Lou had heard stories about birth from other ladies at the bakery. Benita had been told that her "baby seemed too big," so she was induced -- only to deliver a 6 pound, 3 ounce baby boy. Jackie's doctor had thought that her pelvis might be too small, so a c-section was done and she delivered a 7 pound, "late premie."

Mary Lou's doctor had already discussed with her "getting an epidural"; he also mentioned that a c-section before the holidays might be "more convenient" for her. But Mary Lou stayed determined. "I bake great sourdough bread," she exclaimed. "It's supposed to stay in the oven for 60 minutes. If I take it out at 50 minutes, it's soft in the middle!"

Mary Lou asked for a volunteer doula to be present at her birth. The three of them made a formidable team, and Justin was born a healthy 8 pounds, 3 ounces, two days after her "due date."

It's such a big job being a parent. There are challenges such as solving early breastfeeding problems, teaching a two-year-old not to bite his best friend, advocating for a kindergarten child with learning issues, helping a school-aged boy deal with a bully in class or a teen whose friends use drugs. I often wonder what impact we have on the confidence and fortitude of parents from the get-go when such a large percent of women are told they can't even birth their own baby. What does the medical world take from women when we deny them what may be the most empowering experience of their lives?

May Lou had it right: "I want to push my baby out into this big, wonderful world." We are lucky when our job is to help her do just that!
[See www.dona.org/ for information on doulas and www.birthsource.com for further birthing information]

Moms and Dads Can Be Really Different!

Terry is an energetic, seventeen-year-old dad. He is the quarterback and a senior at the local high school and comes to the office today with his girlfriend, Diane, and Eric, their three-week-old son.

Terry holds his son like a football then places him enthusiastically on the exam table for his check-up. Diane laughs as Terry starts to poke at his son. First he pokes at his feet, then his knees, then his stomach, then his nose. Eric starts to breathe a bit faster and his feet start to look jerky. His eyes spring wide open, his eye brows rise, and his shoulders go up toward his ears. "I'm ready for you, Dad!" his body seems to say.

Dad steps back from the exam table as Mom reaches over to undress Eric for his exam. As she moves toward the baby, Eric's eyes start to look drowsy and his body relaxes. His movement slows down and his breathing quiets and becomes regular.

Though certainly there are differences in individual parents and babies, Eric demonstrates what research now shows, that dads and moms approach babies differently. Even fathers with childcare experience often approach a baby with big, enthusiastic movements. Their very presence seems to stimulate the newborn, as if to get baby ready for the big world out there.

The more stereotypical mother's approach is quieter, one that seems to calm the baby rather than stimulate him even more.

Babies benefit from both approaches as they grow and learn, suggests psychologist Kyle Pruett. They may learn to regulate their internal stimulation from one parent, and learn to deal with external excitement from another. See Pruett's Fatherneed: Why Father Care Is as Essential as Mother Care for Your Child. http://www.drkylepruett.com/publications.htm

Most mothers and fathers experience some conflict as they struggle to love their baby in the best way they can. It's the lucky baby whose parents approach this struggle with passion and humor as they each become the parents they were meant to be.

In Celebration of Grandpa's Life 2/27/23-1/18/2008

“Not Aware of the Moment”
-Tagores

I was not aware of the moment when I
first crossed the threshold of this life.

What was that power that made me
open into this vast mystery
Like a bud in the forest at midnight?
And yet when in the morning I looked
upon the light
I felt in a moment that I was no stranger
in this world.

That the inscrutable, without name and form
had taken me in its arms in
the form of my own mother.
Even so, in the end, the same unknown
will appear as ever known to me.
And because I love this life I know
I can never fear death.

The child cries out when from the right
breast the mother takes it away
And the very next moment to find
in the left one its consolation.

"I'll Play With My Baby When He Can Catch a Ball!"

That's what Jerry, the husband of 28 year-old Elizabeth, said one afternoon at their first pre-natal visit. "All the baby does is eat and sleep that first year anyway, " Jerry explains.

Jerry is not alone in this view of a newborn. A study by Zero-to-Three asked new parents "at what age do you think babies can 'take in the world?" 61% of parents thought that a baby needed to be two- to three-months-old to notice the world around them.

The real truth is good news for you, Jerry (and for Elizabeth too!). Most babies can "play ball" (and actively engage in the world around them) as the tiniest of newborns. But parents need to notice a baby's special ways of approaching this ball game.

Now, at the young family's first post-natal check-up, Jerry holds his newborn, Joey, and gazes intently into his eyes. I almost have to pry little Joey from his daddy's arms. In addition to the routine physical exam, I always love to take time to help parents appreciate some of the amazing capabilities of their baby.

As I hold Joey in front of me his eyes fix on mine. I slowly tilt my head to the side; Joey's eyes follow. As I move a bit more to the left, his eyes drop from my gaze. I hesitate a moment, and then he engages with me again. I'm not worried when I see his eyes jerk a bit as they move. (It will be a few weeks before they move continuously like grown-up's eyes.) "Wow!" Jerry says. "He can really pay attention!"

Then I pick up my little red ball. Joey stares at the ball differently than when he looked at my face It is normal for many babies to be more interested in a face, initially, than in an object. But I just jiggle the ball a second and Joey's eyes start to follow it as I slowly move it. When Joey starts to wiggle around, and his breathing increases, I recognize an SOS (Sign of Over-Stimulation). [See blog article: Babies send out an SOS] I hold his little hands gently against his chest, and his eyes immediately look intently at the ball again. Now he follows its movement from one side to the other.

"Yep! Like I thought," Jerry declares to all. "He's a star ball player already! It's my turn to play ball with him now!"

Learning to Talk "Baby Talk!"

Debbie came to see me for a check up with Rebecca, her six-month-old daughter. Though I do not provide prenatal care, I had seen this mother a number of times during her pregnancy. She described herself as "a worrier” and wanted to discuss with me the things she was worried about or the things she might find worrisome in the future. I realized that Debbie was at significant risk for post-partum depression and wanted to keep a close eye on her when the baby was born.

I meet Rebecca when she was only a few days old. She had newborn jaundice and was struggling to wake up to nurse. Debbie was determined to succeed with breastfeeding so was open to any ideas which might help. From my first visit with Rebecca, I focused on helping Debbie tune into what “Rebecca is telling us.” Debbie and I watched together as Rebecca “told us” about her sleep cycles and how she could be aroused from active/light sleep but not quiet/deep sleep. (See http://www.hugyourbaby.com/sleeping.html to tell sleep cycles apart) Debbie learned to read her daughter’s SOSs (Signs of Over-Stimulation) and to tell when Rebecca needed a rest or could handle more interaction and play. (See http://www.hugyourbaby.com/skills.html for tips on SOSs)

Debbie taught me something very important. The more a mom learns to read her baby’s body language, the less she will worry. This mother, who had worried and suffered much during her pregnancy, never did develop post-partum depression. Instead, she learned to read her daughter's "body talk," and she gained confidence as a mom while learning to do so. At our last visit Debbie summed it up this way: “I worried a lot when she was inside of me. It’s easier to have her on the outside telling me just how she is doing.” And, Rebecca seemed to say, “Gee, Mom, I’m doing great!”

Being a Parent is a Tall Order!!

I call them the "TALL Family." That's because when they enter the exam room, Mom, Dad, and both grandparents tower over me. They're all over six feet tall. As they place their very LONG baby onto the exam table, Mom suddenly bursts into tears.

"He hasn't stopped crying since we got home," Mom weeps. "It's been four very long days. We waited so long for this baby, and now we must be doing all the wrong things!"

Sabrina had indeed waited a long time--three miscarriages, two years of infertility work-ups, and then, at last, little (and long!) Jakie.

I start Jakie's physical exam. When I check out his hips he starts to fuss. Eight eager arms reach out immediately to comfort Jakie. But he seems to cry even more. The next time he cries, I suggest that we add a new ingredient to the mix. "Let's watch him just a second when he cries and see what happens."

I turn Jakie over to check his back and he starts to fuss. I then lie him gently on the table and talk softly over his face. "Little Jakie, can you help calm yourself down? Are you listening, little Jakie?" Jakie pumps his arms a second, then hesitates, then looks off to the side and stops crying. He looks relieved, as do his parents and grandparents. Mom then swoops up Jakie in her arms with a big smile and a hug.

Parents who have suffered much loss before the birth of a baby often see their young one as very fragile. For parents such as these it is especially magical to be able to see their newborn participate in calming down. Parents then see his capacities, his abilities, and his strength.

Two weeks later I saw the "Tall Family" again. As Mom was leaving the waiting room, she told me how calm and happy Jakie is. "We're a team now. We help him, and he teaches us every day how to be the parents he needs us to be."

Mom glowed as she marched out. She looked ten feet tall!

Grandpa and My Boys

The road leading from his apartment building is Bittersweet Lane. Those words capture the mood of this holiday season as we move my father-in-law to hospice care at an assisted living apartment. It all feels a bit surreal. Can this journey with him be our last trip together before his transition onward?

Like most people in this situation, I take time to look through photo albums and to dwell on details of memory, attempting to understand the comings and goings of life. I am particularly drawn to a picture of Grandpa cradling my second son (and his namesake, David Robert) minutes after the birth. I am struck with how completely his arms encircle the infant. How wise, secure, dependable, and reassuring those arms look to me now--as they did then, 21 years ago!

Moments of watching this grandparent interact with my children have been unexpectedly rich and satisfying. Grandpa's early games with his grandson: "How big are you?" or "How strong is David?" made us all chuckle, as Grandpa captured the attention of a one-year-old. Tommy Taxi's chugging around the carport with our older son, Jonathan, was delightful as Jonathan shouted, "I'll take a Coke," to Grandpa who played the role of drve-through staff. "I hate Banks," David announced about his best and beloved three-year-old friend in an effort to spend a morning with Grandpa instead of one at pre-school. A five-year-old Jonathan traveled atop a handmade wooden "booster seat" in Grandpa's truck with ample time for conversation about soccer, Dr. Suess, and God. How many dozen times did David and Jonathan run for an Oreo cookie from Grandpa, who regularly "bribed" his grandsons into lunch on the playground at the school where he volunteered as "Mr. Fix-it"?

Caring for babies, as I do, often causes me to marvel at the mystery of beginnings. That sense of beginning seems very connected, now, to this feeling of ending I have, as Grandpa prepares to move on. A Buddhist friend reminds me of the circle of life and the comfort and reassurance of sensing ourselves on and in that cycle. Tonight the "sweet" holds more power than the "bitter," as I look again at the picture of Grandpa and his grandson. The promises and hopes of those young family days are fulfilled in me tonight, and for this, I am grateful.