Birth and Mothering in America: Mothers Deserve More

Working as a public health nurse with low-income, high-risk families has opened my eyes to the world in so many ways. The person that I am today and the person that I was seven years ago(before embarking on this area of nursing) are so very different and for that I am so thankful.

In all(or nearly all) nursing jobs, nurses are privileged to work with people of all colors, cultures, languages and personalities. The uniqueness of my current job is that I work with my families in their own homes and, thus, am immersed in their cultures while we work. The majority of my clients are refugees or immigrants and it is not unusual for me in one work day to visit a myriad of homes-- all of which may speak a different language and have a completely different culture(many thanks to the amazing interpreters who help me in my work). I believe that I have grown more as a person in these past years than at any other time in my life.

As I learn from these new Americans about the cultures that they have come from, I've been shocked many times over to find the disservice of our U. S. culture, medicine and politics on mothers and families.

One of my first expecting clients was a woman from a small African village(I know that Africa is a continent and am being intentionally vague in order to protect my client's identity) and she, a brand new refugee in America, was ready to have her baby any day. I remember during our education about what to expect from a birth in an American hospital, looking at her and realizing that she looked terrified. When I asked her what she was feeling, she said that she was scared and asked me where all of the other mothers would be? She said that in her former home, all of the mothers in the village would come and support her during both the labor and the weeks after. Every need would be met and she was treated like a queen during labor. After the baby was born, the baby would be cared for while the mother rested. The entire village would celebrate the birth and the mother. New motherhood had previously been such a joyous time and now she feared that it would simply be lonely and exhausting. 

Here, she said, she'd never felt more alone. Pregnancy seemed to be treated like a contagious illness and the birth like a surgery to correct it. Everything seemed so clinical and cold. She wished that she were back in the refugee camp, she said.  I remember freezing in place at those words from a woman that was so proud to be a new American and had otherwise completely embraced our culture and traditions.

Another client of mine, who had birthed another child in another small village and now had a newborn in America was suffering from Postpartum Depression. She was struggling each day to simply keep her head above water. I asked her if she had experience Postpartum Depression with her last pregnancy. She looked at me,eyes heavy with sorrow, and replied, "There was no such thing as postpartum depression in my country." I assured her that there must have been, that mental illness permeates everywhere, but she was adamant. She said to me, "I was supported by my entire village every moment of my pregnancy and the baby's first months. I was never alone. Here I am always alone. No one asks to help me. My neighbors don't even reply to my hellos in the hallway and seem to not even have noticed that I now have a new child. This is the loneliest place that I have ever known. It surprises me that all women here don't suffer from depression."

Yet another beautiful client took me aback at her response when I asked her how her first American birth experience was.  She responded that the birth that she had in the refugee camp was a far better experience. She hoped to never experience an American hospital again in her life. Her response held the theme that many clients before her had shared-- the birthing experience here was cold, clinical and lonely. 

I can't help but wonder-- as a mother, a nurse and a human being-- if we are doing a grave disservice to our mothers here. For all of our focus on a medical-based, clinical birth, studies show that the U.S. has the worst rate of maternal deaths in the developed world and that 60% of the maternal deaths each year are preventable(Source here). The U. S. is one of only two countries that don't mandate any paid maternity leave(source here).

We are giving mothers a cold, clinical birth that may not even save them from death in preventable situations, providing little to no support after the birth and forcing many mothers back to work before healing their bodies or bonding well with their children.  Our communities don't rally around new mothers to offer assistance. Other mothers often offer only criticism of the new mother, even strangers in the grocery store feeling compelled to offer unneeded advice without compassion or real assistance. New motherhood is terribly lonely and exhausting here. I cannot help but know, with a sickening pit in my stomach, that we could do so much better here in America.

This Mother's Day I wish for a better future for the mothers in America and around the world. We celebrate our moms one day per year, but the truth is that babies are being born into the world by mothers each day and they deserve so much better than the current American experience of new motherhood.

Cartography for Moms: Making a Map to Leave Behind

In the still, small moments of the dark of the night, I often catch myself wondering and worrying what would happen to my children if I were to die?

I'm not a stay-at-home mother but you might guess that I were by the amount of work that I do around my home. I am married but am the sole person responsible for cooking, cleaning, laundry, shopping, bill-paying and nearly every other chore around our home. I also meet 90% of the needs of our three children. I carry the weight of this family on my back every single day, like many mothers do. I'm not saying that my husbands contributions are not worthy-- he is the primary breadwinner and a good father. However, the scales for the entirety of our marriage have been tipped, no matter how I fight it, so that I do the vast majority of the household work and childcare, even when we've both worked all day.  While this is something that causes me stress on a daily basis, this article isn't about the unfairness of the situation. No, the stress of the work is minor compared to the constant worry that I carry about what would happen to my family in the instance that I would die.

Now, I'm not planning to leave this Earth anytime soon. There is nothing more that I want in the world than to care for my children until they are grown and to see what they become as adults. I am a nurse by trade, however, and I am painfully aware everyday that we are never promised tomorrow. This fact, the fact of my very impermanence, leads me to wake suddenly in the night, heart pounding in worry about how this house will run if I were leave my Earthly body.

There is nothing in my life that I love more than being a mother. It is the greatest honor of my life. It is also, particularly as a working mother in a high-stress career, the hardest thing that I have ever done in my life. My mind is a running to-do list that is never complete. I juggle so many damn balls every day that I have forgotten what it is like to have a peaceful mind. The chores, the worry, the duties-- they are never-ending. I feel, many days, that no matter how hard I try, I am failing. This is not an easy life but I never stop learning and have become somewhat of a juggle master- able to juggle it all and only rarely letting a ball drop. I often wonder if I were to pass on, if my husband could step in and juggle the same life so that my children would continue to thrive. I worry about it every, single day.

I'll often sit in bed and wonder if my husband can remember how to balance a checkbook and form a budget. He probably doesn't even know our bank password. Shall I leave it to him in a hidden document in the computer just in case? Should I write a cheat sheet for how I create our monthly budgets? I have a running mental list of where I can find our common household items and food for the best price so that I can feed our family and provide toiletries on a tight budget. Shall I make a list- won't the prices continually change? Would a list matter? Can I teach him about coupons and planning meals around grocery sales?

I'll be sitting in traffic and wonder what my children would eat every night if I were to pass on. Would my husband remember that he has to check each and every label for our youngest daughter's allergen? Could he learn to cook more than chicken nuggets and frozen pizza? What about cleaning up after dinner? I don't think he's loaded or unloaded the dishwasher more than a handful of times in our 16 years of marriage. Will he just leave the dirty dishes out on the table like he does now? Who will clean them? Will my children eat junk food and live in filth?

In the witching hour of early evening, when I am simultaneously and frantically cooking dinner, helping the kids with homework, making sure dance/tumbling/scout costumes are cleaned for their activities and cleaning the house...I wonder if he would be able to transition from an existence in which he gets to walk in from work and go straight to the couch into an existence of having nearly every minute of every day be in service to other humans.

When I am comforting my children after they had a hard day, I wonder about writing a document about all of the tiny nuances that I know about each of them so that my knowledge of them would never leave with me. Each of my three children could have their own, massive book. I know them better than anyone else in the world. Of course, as soon as I finished the books, they would need to be rewritten. My amazing children are growing and changing each day. I make sure to sit and listen to them each and every day because, somehow, each new day they are different than the last. I am willing to forgo time with my friends, a perfectly clean house and 10,000 other things to be sure that I get this time with my kids each day. I carry these moments with me in my heart. I cannot imagine how I transfer this knowledge of the metamorphosis of my children onto paper.

There are so many daily duties, large and small, that encompass my day as a working mother. How do I transmit this information to someone else so that they can care for my children in the best way if I was to leave?

And, so I wonder- is there such a thing as cartography for Moms?  Is there a way for me to make a map to show others the way of my family's life?  How can I leave a map behind in the case that I am no longer able to lead the way for my family?

Some items on the map seem much easier to navigate. I can much more easily leave a detailed budget than I teach the subtle nuances in our teenage son's voice that let me know that he had a bad day and might need to talk. I can leave recipes for healthy dinners and lists of what each child likes to eat but how do I explain how to navigate our middle daughter's mood swings when puberty rears its ugly head? I can teach him how to manage a calendar that is carefully color-coded so that he never misses an important activity for one of the kids but how do I explain the way our youngest daughter's eyes change ever so slightly before she has a flare up of her medical condition?

I do not know how to create this magical map, one which keeps my family afloat and moving forward even if their mother, the captain of the boat for the entirety of my children's lives, had moved on.

I think that maybe the maps that we, as mothers, so carefully craft to keep our children's life journeys running smoothly always have roads that lead our children back their mothers so that we can love and care for them at every step in the journey. I fear that if the mother is removed, that this magical map would not work at all. All of this worry has led me no closer to the cartography of the mythical mother map, and maybe the reason is that if you remove the mother, the map becomes useless.

I simply must trust that, should I leave this world, even as hard as I try to tether myself to it, everything will be okay. The map would not stay the same, their lives would not remain the same but my family would carry on their journey without me. Instead of spending my hours worrying about what my children would do without me, I must focus my time on making the most of the hours that we have today. Tomorrow isn't promised but this moment is and I must use it in a better way. I cannot leave my husband or my children a map that will magically light their paths but I can leave them a legacy of love.