The difference was apparent immediately.

Yesterday, she’d bounded to the car, filled with glee, unable to contain her excitement about the day. “I loved school, Mom!” she’d proclaimed before she was even half-way in the car. Today was a different story entirely. Hardly half-way in the car, and she tearfully said she’d really missed me at the end of the day. Voice cracking, she could hardly keep it together. And then, through choking sobs, the explanation for all the tears: a yellow card.

A yellow card. In the world of kindergarten’s rules and consequences, the palette of green, yellow, red, and then finally an ominous blue, marks a child’s behavior for the day and the week. Displayed on the wall for all to see, my daughter’s yellow card might as well have been a scarlet letter. The offense: talking out of turn, after repeated warnings. The yellow card her ticket to tears and hurt.

Certainly, she made a mistake. She broke the rules, and she must pay the consequences. Today, no green stamp. And this week, there will be no trip to the treasure box. These are real consequences to her. I believe she’s learned her lesson.

But there are other lessons to be learned which will be much harder to grasp. I’m certain of — and saddened by — this reality she unwittingly faces. Her deep, deep hurt broke my heart today. The tears, the self-disappointment, the anxiety — all of it, all too familiar. She was her own worst critic. And I recognized it immediately. My empathy for her was borne from my own tears. As much as, no, more than I wanted to make sure she understood what she’d done, I wanted to let her know, kindly and gently, that we all make mistakes. All of us. And we must be kind to ourselves when we do. Honest and fair, but kind, too. Because, too often, no one else will. Faced with the puddle pouring into the car this afternoon, I knew that was the lesson that was of import at the time.

Talking out of turn? I’m pretty sure she’s got that one licked at this point. Showing one’s self compassion and kindness? Somehow, I doubt that starting over tomorrow with a green card will be the end of that lesson. If only it were that easy.

Eh. I’m trying to strike a balance. I’m also failing in that regard. But, for what it’s worth, here’s another birth bitch:

I rarely, if ever, participate in banter on my blog — even back in the day when I was posting nearly every day. But Lucky Candice left a comment on my last post that struck a chord, so much so that I felt I couldn’t just respond to her comment in-line. Thus, this post. Her comment was offered respectfully, and I took it as such. Likewise, my response, in the form of this post, is also offered respectfully. Her comment:

I love your blog - so I hope you don’t mind a bit of devil’s advocate here. Many hospitals offer walking epidurals. You can have walking monitors on or take them off. You just tell the nurses you don’t need or want them. If you write in your birth plan that you want the birth to be more natural, most nurses are really really cool about it. Supportive even. Granted, at the hospital you have to stand up for yourself! You have to be in charge and be firm about your wants. I’ve had all three of my kids in the hospital. My doctors (both of them that I’ve had) have been adamant about the fact that they never do episiotomies. You CAN eat, you just tell the nurses you’re going to and they don’t fight it. I guess what I’m saying is this: if you’re going to have your baby at the hospital and want a natural experience - bring a doula or be in complete charge and make it go the way you want it to. Even with pitocin you can walk around, have a room with a birthing tub, request a birthing ball make sure you get the squatting bar. Hospitals have this stuff. People just don’t use it and don’t “shop around” when it comes to the hospital they’re going to use.

Anyway, that’s my two cents.

I’ve heard her sentiments offered often — heck, even I have echoed them at some point in my life. It all sounds nice and good: advocate for yourself, and you’ll get what you want. Except, it doesn’t work all the time, or even most of the time.

Sadly, it has been my work as a doula that has brought me to this conclusion.

Take for example the case of eating and drinking during labor. Honestly, most of the time I don’t see this restriction placed on moms. But sometimes — most recently included — it happens. And mom says, “I know this is bullshit. I should be able to eat.” And I say, “You know, what happens behind closed doors isn’t anyone else’s business.” Yet, still, mom doesn’t eat. She’s been told — multiple times and quite clearly by the nurses and the doctor: nothing by mouth. The unspoken implication being that she’s putting herself — and her baby — at risk. Does this make her a “weak” individual, unable to advocate for herself? Should the blame be placed upon mom? I don’t think so. The blame — and the shame — is on the care provider: for not practicing evidence-based medicine, for unduly using his influence to force someone into submission, and for putting his own self-interests above that of his client’s. The restriction should have never been imposed in the first place.

Now, about those episiotomies. In the area I practice, I too, can say that most doctors don’t perform them any more. “Oh, please don’t be the one to make me do an episiotomy,” they’ll joke, “I haven’t had to do one in two years and I don’t want to sully my record.” Despite the underlying theme of self-interest echoed by these statements, this is a good thing. It gives me hope, in fact, because even as little as five years ago episiotomies were standard practice. If this protocol can change so quickly, maybe, I hope, others can change as well.

But that doesn’t mean that they don’t happen. “You’re going to tear. I can’t tell you how badly, but you will tear. Or I can cut you cleanly and we can have this baby on the next push.” These are the words mom’s hearing. Over and over again, actually. She’s also hearing from me, quietly, “With each push you’re stretching beautifully. A little at a time, just like nature intended it.” But the words from her care provider hold more weight. They do. Is mom to blame? Or is it the care provider? Shame on the care provider, I say: for lacking patience, for not practicing evidenced-based care, and, most of all, for not listening to mom — who’d clearly told him her preference to tear — and, instead, badgering her repeatedly until she finally submits…to his way.

Monitors — just try taking them off, and watch the fireworks fly.  Walking Epidurals — only one of the five hospitals in my area (yes, five) even provide such an option, and you tell me how you’ll be walking the halls with a fine catheter in your back attached to a pump attached to a wall.  A really, really nice nurse — one you’ve gotten by the luck of the draw — just might detach it to let you go to the bathroom, but, otherwise…these walking epidurals are a sad misnomer.  Birth Balls — you’ll get the only one available if someone else isn’t using it.  Squatting Bars — push all you want while squatting, but when doctor shows up to catch, plan on being manipulated into a lying position on your back.   Wireless monitors?  Again, if you happen to be at the one hospital out of five that even offers such an option, you might get lucky — if the two sets available for sixteen birthing rooms are not already in use.  (And, incidentally, the hospital with the wireless monitors is not the hospital that offers “walking” epidurals).  And care providers — for every one in a given practice that you show me who will respect your choices, I’ll show you another one in that same practice who operates on an entirely different playing field.  Which one shows up on the day you go into labor is anyone’s guess, and that’s an uncomfortable gamble, at best.

So, yes, you can make choices.  You can do the research and choose the hospital that has the most permissive monitoring policy, or the hospital with the “walking” epidural, or the hospital with the wireless monitors, or the care provider who you most “love.” You can make all of these choices, carefully and purposefully.  But, in this environment, you can’t guarantee they’ll be respected.  And, that, in the end, is the problem.  You shouldn’t have to fight to be respected during labor.  You just shouldn’t.

The question came up quite naturally.  There was a logical segue to the query, certainly, and the tone behind it was nothing short of friendly.  We were two dear friends sharing an afternoon of poolside conversation, flowing freely  from children’s eating habits to tattoos and topless sunbathing, with a good dose of protective mother-child exchanges peppered in between.  Nonetheless, the question landed like a bomb in my lap.

“My son was born with thick meconium.  They whisked him away with all sorts of neonatologists scurrying about.  How could that situation have been safe during a home birth?”

Again, my friend wasn’t being particularly doubtful or skeptical.  She wasn’t feigning interest while remaining steadfast in her belief that home birth was nothing short of insanity.  I believe she was truly curious.  Still, I needed to take a deep breath before answering.  This wasn’t some highly doubtful, holier-than-thou anonymous exchange on an Internet chat board.  Those exchanges far too often lead to nothing but further entrenchment of divided camps.  This was my friend.  And perhaps this exchange could lead to something different.

So, I took a deep breath and offered my answer.

“Well, in two ways, probably.  In the case of thick meconium being present in the waters, there would have been a conversation well before the actual birth about the prudence of continuing the birth at home.  Perhaps a transfer to the hospital would have occurred in your case, but certainly not under immediate emergency circumstances.  There would have been time to act prudently.”

Ok, that was the easy part.  Now, the more difficult part.

“Secondly, there are some things that occur in hospitals that make things appear to be incredibly dire and emergent, when, in actuality, they aren’t.  In the case of the presence of meconium in the waters, the science and research doesn’t actually support some of the actions they take in the hospital.”

There, I’d said it.  As gently and tactfully as possible, I’d basically told her I felt her beliefs were wrong.  What would come next?

“Oh,” she replied with a bit of a pause.  “All that hustle and bustle was a bit of a self-important show, then, huh?”

I smiled and just let the conversation end.  She could make what she wanted of it.

Talking about birth is a bit like walking through a land mine field.  Talking about home birth?  Nothing short of stepping on a land mine.  Too often, the conversation goes nowhere, with one party convinced the other is sacrificing the fundamental safety of her child all for an “experience,” and the other party believing the first to be uninformed about and deaf and blind to the harsh realities of the hospital birthing culture.  All of it, judgmental.  Yeah, that’s productive.

So, while I believe passionately about informed birthing practices,  whole-heartedly endorse home birth, and am vocal about both here in this blog, when it comes to face-to-face conversations, I tread particularly lightly.  I’m doing neither myself nor my “cause” any favors by alienating people.  I meet them where they are, and I talk.

Whispers.  Hints.  Respectful dialogue.  And room for thought.  Somewhere in there is a place where women can birth at home and not be seen as being selfish.  Somewhere in there is a place where women can birth in the hospital — and yes, still have an epidural available to them — with deserved respect and evidence-based care.  Somewhere among those conversations, those poolside encounters, somewhere in there, I believe, is change.

Years ago, while visiting Yellowstone National Park, Tim and I were struck by how much timber simply lay all over the forest floors. Timber not only from the fires of 1988, but from trees toppled by years and years of storms. The forest floors looked like piles of pick-up-sticks, logs toppled and entwined and tangled together, decomposition nearly frozen forever by the deep cold winters and the dry, dry air. For fifty years or more, that timber will struggle to become dirt once again.

In contrast, it takes hardly five years for the ravages of a good storm to simply disappear from sight here in the humid, wet, hot temperatures of home. Great trees toppled by angry hurricanes, felled by fierce Nor’easters — they melt into the forest floors, crumbling into rich, fertile soil in mere moments, it seems.

I really hadn’t thought about it in the better part of five years.

Sure, I’d thought about the day — that awful, awful day, when everything went so wrong.

I’d thought about how I’d been greeted in the elevator, calmly carrying my pillow and bags, by a doctor presumptively declaring, “C-section this morning?” “Oh, no!” I’d said, correcting him firmly, “Induction.” In hindsight, I can imagine the smile of smug pity he must have suppressed.

I’d thought about the arched eyebrow from the nurse as she listed to my plans to “avoid an epidural as much as possible.”

I’d thought about the confused, doubtful, and surprised expression on my doctor’s face as she discovered I’d in fact dilated completely, chagrined by her failed predictions.

And I’d thought about — oh, how I’d thought about! — the hateful, irritated tone in her voice as she declared she didn’t “have time” for my nonsense — for my screaming and pleading and crying because I could still feel, and that knife was so, so close.

I’d thought about all of that.

But one little detail had slipped past me. One little detail, lost, but for a chance.

Room 237.

I was following Mom and Dad into the Labor and Delivery ward. I had their bags; I was helping them get settled in. All of a sudden, Mom and Dad parted, leaving me a clear view of where we were headed. The door partially open, the great bed looming there, backlit by the window beyond. It all came back. It all came back.

Room 237.

A deep breath, and I stepped inside. This was not that day. This was a different day. A different Mom. A different Dad. A different me.

It’s hard to say how I felt about being back there, back in that room.  Yes, every once in a while, I’d remember my own moments in that room so long ago.  But, almost instantly — as quickly as it had all come back — it all went away. I forgot about that room’s history. I was there for Mom and Dad, not me.

So much had taken place in that room in the years since, and so much would continue to take place in the years to come.  It seemed as though my story was insignificant, lost the next day, really, as yet another mother walked anxiously into that room.  It was no longer that room.  It was only a room.

I thought of the trees.   I was sadened to think that nothing of my story remained.  There was no great tree, toppled in the wood, a frozen monument to my own story.  Mine had disappeared into the forest floor, along with thousands of others.

Then, that sadness passed.  Those great trees, frozen in time?  They’re mere ghosts, refusing to go gracefully from one life into the next.  My story wasn’t insignificant.  My tree, sunken into the forest floor, is now rich, fertile ground — the very ground upon which I stand today.

Microeconomics: the study of economics as it plays out in individual decisions.

Macroeconomics: the study of economics as it plays out in whole systems.

Granted, these two definitions are over-simplified, but, they’re sound enough to help illustrate my point.

I got in my car this morning and drove the better part of twenty miles to go to a well-woman visit. On my way, I undoubtedly passed countless numbers of physicians’ offices, many offering the same services I was driving so far to receive. The difference? My appointment was with a midwife — at the only freestanding birth center in North Carolina. I spent the better part of an hour — not waiting in the waiting room, but with a midwife discussing my health and well-being. Well-woman care. It was my small, individual, and conscious choice to support the kind of care that I believe in. And it was worth the drive.

When I am with a woman in labor, so often — too often, in fact — I witness the spread of misinformation, half-truths and outright lies. I watch, angrily, as practices based on tradition or fear of litigation, not sound science, are perpetuated. And I cry silently. Nothing is changing.

But it is. That woman I’m with? That single, individual woman? is hopefully experiencing something better — even if it is just a bit — than she would have experienced alone. A difference, indeed.

I am not going to change the whole system of maternity care with my work as a doula. I can’t do so any more than I can ensure the financial well-being of the birth center with my one well-woman visit each year. But my choices and actions, deliberately and consciously made and performed, do make a difference. Drops in a bucket? Perhaps. But drops make ripples. And ripples make waves.

I’ve always found bumper stickers in the fashion of this post title to be particularly annoying. What, are you trying to be cute? deep? enigmatic? Whatever the purpose, I have heretofore prejudicially and fully rejected any person sporting such proclamations on their vehicle (or anywhere else, for that matter).

Except, now I feel I might have to claim the proclamation for myself.

First, there was the surgery.

And then, there was the fire.

Soon thereafter, the second surgery.

And, finally, a third surgery, this time, presumably to repair the cosmetic damage from the very first surgery, but, at this stage of the game, I’m entirely uncertain as to whether it has achieved its purpose, or, instead, simply caused me yet another round of pain and swelling.

So, given all of this karmic backlash in my life of late, you can see that I can understandably be questioning my beliefs and wondering whether there is good in this world.

But the final blow came last night. A group of girls, gathered for friendship, wine, a few laughs, and an absurdly simple game. The winner — in the category of most losses for the evening? You got it. Yours truly.

My hitherto unwavering belief in some kind of benevolent higher power–now includes the conviction that said higher power has one hell of a sick sense of humor.

I wrote these words on New Year’s Day, 2006:

I meet this New Year with detached boredom. I feel no excitment at the prospect of turning a new page. It’s cold, dark, and wintry. Certainly not the time of rebirth. These resolutions, they simply slip past me. I’m unwilling to set yet another goal, only to see it not attained. An absurd form of self-loathing. Games, they are. I’m tired of playing games, only to lose each time.

I titled the piece, “Nothing Changes on New Year’s Day,” finding the title dark, bitter, and pessimistic enough to reflect my mood. Nothing Changes. I felt trapped in my shortcomings, shackled by my failures, and utterly incapable of overcoming them. Worse, I found the prospect of attempting to change to be a cruel mockery; certainly, I was destined to fail.

I couldn’t bring myself to publish those words. Too dark. Too depressing. Not for public consumption. But, I held on to them. I didn’t erase them, delete them, or send them off into unindexed, lost, bitspace. There must have been a reason.

It is now a little more than a year later, and I now understand why I saved those words.

A lot of things have happened in the time since I wrote those words. I smile more and I laugh more — at myself more than anyone. And I no longer feel so trapped. My shortcomings and my failures? Many of them are still there. But they no longer anger me or sadden me. They just “are.” I have changed, for the better. And I will continue to change as time goes on. Sure, there will be mistakes, there will be failures, and I’ll stumble and trip along the way. The point is, I have a way, and I always will.

Nothing changes on New Year’s Day. I now read that title and am filled with a sense of optimism, a sense of joy. It’s all a matter of expectations. True, nothing does change on New Year’s Day. Likewise, nothing changes on Tuesday, or Friday, or any other given day. Our opportunities for change aren’t bound by a single day, destined to crumble and disappear should we fail in a twenty-four hour span. We can change, slowly and methodically, on the collective time of each sunrise.  Nothing changes on New Year’s Day;  to me, that is the very definition of optimism and faith.

Twice a year, I sort, wash, fold and put away clothes for days at a time. Clothes for the upcoming season are brought out. Clothes from the season coming to a conclusion are sorted — put up in storage, sent to charity, or tossed away — depending on how they measure up against standards of size, style and wear. For days on end, there seems to be nothing but clothing in my life.

When all this toil is over? It’s inevitable that none of us has anything to wear. In the early days of fall, it’s too cool for summer clothing, but not cool enough for winter’s wear. In the spring, last season’s clothing is tiresome and old, but the exciting new togs for the upcoming season don’t fit quite yet. We are, quite simply, in between days — one step beyond the past season and one step short of the next one.

These short, semi-annual days of discomfort are but reminders of other in between days in my life. That period of adolescence, where I stood scowling disapprovingly at my childish youth, yet recalled with warmth its innocence and joy, where I stood both excitedly and fearfully in awe of adulthood, is perhaps the ultimate of in between days. We all have as proof that photo of ourselves as the gangly middle-schooler — the one that can only be delicately described as coming from our awkward stage. But there are others, too: those uncertain days after college, that engagement period, those nine months of pregnancy, and countless more I’ve yet to encounter.

It can be an uncomfortable place, those in between days, where each day we struggle to figure out which direction is best. Inevitably, what worked last season and what will work the next just won’t suffice for today. So, as we mistakenly seek the comfort of the past and anticipate the excitement of the future, we miss the special charm of those days in between. There’s beauty, you see, in the irascible nature of a passionate adolescent, the potential-laden uncertainty of just starting out, and the sweet mystery of pregnancy. From that awkward photo of our adolescence, the one that causes us to cringe — just a bit — each time we see it, shines a bright smile. Focus on the frustrations, and you miss the pleasures.

So, each spring and fall as I cycle my family’s wardrobe, I try not to focus on what’s not there. And on these fall days that just won’t be served by the clothes in our wardrobes, I try not to rankle at my inability to capture them, contain them, with either short-sleeves or long-sleeves. Instead, I toss on layers of both in a quirky display of fashion and marvel at the wonder that is uniquely in between days.

I suspect it won’t last. I suspect there will be days, weeks — perhaps even years — that I will recall this entry and wonder how it was ever possible. But, for now, I can say it, and I will: Zoe and Evan adore each other.

Sure, there are squabbles. There are times when one wants to be alone, times when they don’t cooperate, and times when the howls of disapproval are more than I can bear. But, those times are few.

More often than not, Zoe and Evan play excitedly, genuinely enjoying each other’s time. They play games only they understand. Giggles are theirs alone, secreted away from Mom and Dad in a united affront to parental involvement. She brings him a lovey when he needs it. He offers her a calming back scratch when she’s tired. She helps him find the words he so desperatly seeks to find sometimes. And he helps her find the courage to take on new challenges by simply making sure she’s not alone.

Most of the time, Zoe falls prey to the big sibling’s tendency to bos–er, lead — the play with intricate rules and fantastic scenarios, while Evan willingly follows. It may appear she’s taking advantage of him, instructing him and bossing him in a less-than civil manner at times. But, without him, there is no one to laugh at her jokes, to chase her around the yard, or to be Superman to her Wonder Woman. Of that, I believe, she’s keenly aware. In short, theirs is a relationship worked out to a perfection they both understand — and love.

I, too, was reminded of their special relationship, and their awareness of it, the other day. In one of their rarer moments of discord, Zoe brusquely turned away from Evan, hoarding her toy underneath her arm and shouted, bitterly, “I don’t want to play with you!”

I sincerely believe that Evan would have taken such news from any other person with aplomb. His cheerful, confident demeanor doesn’t usually have room for the hurt feelings of child-like tribulations. In any other circumstance, he would have simply left the scene, feelings entirely intact, and moved on to greener pastures of play. But, when these scornful words came from Zoe, someone far more than just a playmate, it was too much for even his resilient soul to bear.

I watched as Evan absorbed his sister’s painful barb. At first, there was silence. And then, from a quivering lip came a soulful response: “You’re mean.” The heartbreak in his voice was palpable. The quivering lip soon gave way to an eruption of tears. It was all I could do to keep from crying myself.

I’d never before heard the word mean uttered from the mouth of either of my children. It was painful enough to find out that the concept was known to my children at such a young age. Far more painful, though, was that one of my children had found meanness in the other. Evan’s sister had broken his heart, even if it was for only a moment, precisely because he loves her. My heart was broken, too, precisely because I love what they have together. A bitter, painful lesson, handed to us by somone we love.

Even though it’s every mother’s instinct to protect her children from pain, both physical and emotional, it’s also every mother’s fate to fail to bring that hope to fruition. It’s an unattainable goal, made impossible by the very love that drives our instinct. The same is true for any relationship bound by love — filial, familial, or otherwise.

I think Evan learned that very lesson the other day. And when Zoe gave him a hug and said genuinely and regretfully that she was sorry, I think he learned another lesson as well: when we’re handed a painful lesson by someone we love, there’s always the other hand to hold when it’s hurting so bad.

For years, it was the only calendar I knew. It didn’t begin in January and end in December. Instead, the calendar I knew began in September, at the start of school, and ended in August, at the close of summer holiday. New Year’s day was not a new beginning, it was merely a mid-year holiday. The real beginnings were those first days of school, those post-Labor day rituals of new clothes, new notebooks and new friends. And the ends were sun-drenched and water-logged days of frantic activity, desperate attempts to soak up the remaining freedom of summer.It’s been years since I’ve felt connected to that calendar. The reluctant capitulation at each summer’s end paled in comparison to the utter defeat felt upon that final graduation. In one brief day, my entire calendar was rearranged, my circadian rhythms re-set. No more summers in the sun. Suited and stuffy, their new destiny.And so I toiled, for the better part of fifteen years. My internal sense of time reflecting the more practical and adult-like ticks and tocks of a January-to-December-and-then-all-over-again world. The memories of those summers, faded. The recollections of those first days of school seemingly alien and distant. My new life was a new calendar, each January, filled with appointments and errands and bills and other sordid details of adulthood. New beginnings only meant a frustrating disinclination to remember the new year when writing checks. And ends weren’t a right of passage, a step toward something bigger. They were merely…another step.

This September has taken me by surprise. For the first time, in so very, very long, I’m seeing an end and a beginning in this ninth month of the year. The pool has closed. My garden has petered out, and the CSA has had to surrender as well. Shoes are on my shopping list, and tomorrow, I will pack lunches into sacks and watch my children begin a year anew. The smell of erasers doesn’t seem so far away, and I feel a few of my old rhythms beating back to life. I’ve no doubt that those drums will beat louder and louder in the years to come, as my children find themselves defined by a calendar uniquely innocent and child-like.

I don’t believe in living life vicariously through my children. I don’t believe in putting my children in a particular place so that I may return to those same places from my past. But, if living their own lives happens to impart a change upon my own — particularly this change — I’ll gladly accept it. Happy New Year.