Pregnancy Milestones

I am officially twenty-three weeks as of yesterday. This means that three weeks ago I crossed the halfway mark and could officially begin to count down.

While my husband has tried to be as supportive as he can be, I have essentially been alone for over two-thirds of my pregnancy due to the fact that his work flies him out of town for two weeks at a time and sends him home for one quick week before he’s off again. However, now that it’s the Christmas season they’ve given him three weeks off. The bonus of this is that it seems as if this is where the milestones have really began to pick up. For instance, my ultrasound was booked for the day after his return.

My husband had been home for the dating ultrasound. The timing proved to be crucial as both of us were able to see that our baby really did exist - as the only evidence was my 24/7 nausea and constant vomiting. This was a profound moment for him and I. It was a time where both of us could tangibly grasp the reality that our life was changing. It was a moment that deepened our connection. Therefore, both of us were equally excited for this upcoming ultrasound where we’d be able to witness the rapid growth that had occurred in the last twelve weeks: a fat little body with short limbs that measured just over an inch and barely resembled a human being to now being over a foot long with clearly defined features such as its eyes, nose and mouth. Imagine our disappointment when after waiting with such anticipation the technician told my husband he was to remain in the waiting room until she called for him. Once again I was alone.

I lay out on the narrow examining table while the technician squeezed jelly onto my abdomen and focused all her attention on the screen. I looked over expecting to watch and somehow bond with my baby like I had the first time. The only view I had was the screen’s black backside. I closed my eyes and hoped that all was well.

Finally after a half hour I was told I could clean up, go to the bathroom and retrieve my husband for our viewing of the baby. The viewing took about one rapid minute in which we were quickly told this is the head, the arm, the heartbeat, and the bum. I barely had time to focus on the different pictures - let alone make out what I was seeing. The only image that concretely stands out was a single image of my baby’s skeletal arm. Then the appointment was over and we left bewildered with my husband wondering why he even bothered to come along.

Although the experience is slightly bitter it did teach me to stand up for what I want. If there happens to be a next time I will be insisting that my husband accompany me into the room – I’ve had enough of being alone. In addition, moving forward with this pregnancy the experience has taught me that when something is important to me I need to speak up and use my voice. In all honesty, I’m glad I experienced this early on so that when it comes to more pressing matters, such as when I go into labour, I’ll have the determination it takes to be heard.

On a positive note, a few days later our baby’s movement became strong enough to be felt by others. While I have been feeling my baby doing fish like flip-flops (or quick bloop-bloops as I like to describe the sensation) ever since I was sixteen weeks, my hand still had yet to feel it while resting on my protruding belly. The first time my hand felt the baby was during David Bazan’s concert – the highlight of my night. It seemed perfect: a night out on the town with my husband, listening to good music, the vibe and energy was positive, and then with a soft boof I felt it. In the middle of all the people surrounded by music, my baby and I shared a private moment.

The following evening my husband also felt our baby for the first time. We were curled up on the couch watching a movie, my hand rested on the underside of my belly when I started feeling the baby’s movements. I reached over and took my husband’s hand and replaced mine with his. I wondered if the baby could feel the difference in weight, pressure and even warmth and if it would cause it to become still from shyness or stage fright. For a moment the activity ceased, but within minutes it started up. The look of awe as it spread over my husband’s face as he felt our baby’s motion for that first time is one that I hope remains ingrained in my memory. It was just one tiny moment; yet, it was one that further connected us.

I have come to relish the small moments, but the big ones are an excuse to celebrate. For us one such moment was a perfect opportunity to throw a sex party.

“It’s not what you think,” my husband would reassure after leaving an awkward moment of silence. “It’s a gender reveal. We’re having cake that once you cut into it, it’s either pink for a girl or blue for a boy.”

Our party was just a family affair, but it was an exciting moment to share. As my husband’s family lives out East he had a live feed through his phone so they could participate as well. I was a little concerned that I would open up the cake box and that the colour of the cake would be exposed through certain spots, so I gave it to my brother-in-law and asked him to check it out and creatively fix it if needed. As it turned out there were a few spots, particularly on top, so thankfully my brother-in-law covered it with a floral arrangement made from mandarin orange slices.

I really didn’t care, nor did I have a strong idea one-way or the other, if it was a girl or a boy. If it was a girl I knew that we’d be set as my sister’s seven-week-old baby was a little girl and a bunch of friends had just had girls as well. Plus I thought it would be nice if my baby was a girl so that she’d have a cousin the same gender and close to the same age. Yet, I knew it would be fun to have a boy as well. Plus, three of my husband’s good friends had boys and I knew it would be nice for my husband as well. However, while I didn’t have a feeling, I did have a theory.

To be honest I never used prescribed birth control. Personally, I wasn’t interested in introducing my body to extra hormones – particularly since I already knew that medically I had a hormone imbalance. So, I chose to use the scientific natural birth control called the Fertility Awareness Method (FAM). I had been introduced to this method through a book called Taking Charge of Your Fertility by Toni Weschler that a group of midwives recommended and lent to clients who were looking for a natural method of birth control either for religious or personal reasons. The book is highly informative and gave me a lot of insights to the workings of my body that neither doctors nor naturopaths could really help me with. For two and half years this had been my form of birth control. One aspect of being this in tune with my body was that I was able to tell within a twenty-four hour period when I was ovulating.

Toni Weschler also gives certain methods to try out if attempting to get pregnant with a specific gender. Although my husband and I were no longer avoiding pregnancy – we definitely weren’t trying either. In addition, with his work schedule being the way that it was, I was never fertile while he was home; so, pregnancy (let alone gender) really wasn’t an issue. However, in order to get pregnant, all it took was for his work schedule to be delayed by an extra three to four days. Like I said, we weren’t actively trying to get pregnant but neither were we avoiding it. Four days after he left for work I ovulated. As the theory goes y-sperm are quick swimmers and even though x-sperm are slower, they are hardier and live longer. So, according to this if you want a boy it’s best to have sex as close to ovulation as possible and if you want to try for a girl (while it may be harder to time and therefore take a little longer to accomplish) it’s best to have sex approximately five to three days before ovulation. So, while I had neither a preference nor any true feelings, my suspicion was that we were having a girl.

The moment I cut into the cake and pulled out the knife the gap glowed pink. 

The cake glows pink: it's a girl!

Once I made the second cut and pulled out the slice for all to see, the room exploded in excitement and congratulations: we are having a girl. My sister was ecstatic,

“I was hoping you were having a girl! I have a box full of stuff for you right now.” Then turning to her daughter cradled in the jungle baby swing she expressed, “Emma, you’re going to have a girl cousin to play with.”

For some reason we had a boy name picked out, but still had not agreed on a girl’s name. Finally Luke got right on it and started looking up girl’s names. We still have not chosen one, but it’s nice to know what we can focus on. To be honest, if I had had the perfect pregnancy I would’ve waited until our baby made her entrance into the world to have her gender revealed. However, for eighteen plus weeks I was so nauseas and puked more than a couple times a day that rather than being excited I was slightly resentful, bitter, and actually quite depressed about this drastic change plaguing my body. Consequently, filled with all these negative emotions, I felt no bonding with my baby. I hoped that discovering the gender would be something to look forward to, something concrete to cling to, and a way to specifically connect. I’m pleased to say that although we don’t have a specific name chosen, it is really nice to call her my baby girl.

My belly at 23 weeks

To look at you're baby's fetal development check out the following site:
http://www.babycenter.com/fetal-development-images-23-weeks

The Rhetoric of Canadian Midwifery Presentation

While there is much to personally relay about the progression of my pregnancy: experiences, emotions, new sensations and realizations, and I will be sharing all of this in due time, at this point I want to share another accomplishment and subject that remains a passion of mine. In addition, this is an opportunity for all those who have heard about my participation at the Congress 2012 Seminar to see for themselves what it is that I had been working on for the past year and a half leading up to my presentation.

Thank you,

Erin Schartner

The Rhetoric and Ideology of Canadian Midwifery

Presentation

By Erin M. Schartner

Slide One:

 In my research paper The Rhetoric and Ideology of Canadian Midwifery I ask the question, “How has the rhetorical discourse surrounding the genres of midwifery helped to shape the current status of midwifery, and what does the current discourse of midwifery reveal about what can be expected of both its status in the near and distant future?” With this question in mind I apply rhetorical theory to the discourse pertaining to midwifery both historically and presently in order to see how the current discourse is providing information on what to expect the future of midwifery to look like. I am convinced that it is worth discussing the rhetoric that is included in the discourse of Canadian midwifery as a means of presenting its ideologies to society. In addition I realize that it is imperative to take a look at the rhetorical discourse surrounding different genres in order to reveal the ideology of the historical periods themselves and how these ideologies influenced the perception of midwifery during these times.

Slide Two:

For instance, on this slide we have two pictures that were found in the genre form of newspapers. These pictures were printed in the mid 1900’s and have a clear rhetorical agenda. The first picture depicts an old woman, who is a foreigner without education. The second picture depicts a woman who is quite large and rough looking. The background is dark and there are shady figures in the background suggesting that a midwife is also a shady figure and someone to be feared.

Slide Three:

However, compare this to a video clip broadcasted last year in 2011.

RHETORICAL HISTORY

2011: A PART OF OUR HERITAGE MOMENT

http://www.youtube.com/watch?v=YL6o_JommjE&list=PLF620EFE83B8A3CA7&index=41

This is a dramatization of the heroic midwife who, against the odds, is dedicated to attending women in birth. Even at quick glance this image clearly supports and encourages midwifery. 

Slide Four:

A comparison between the written rhetoric is also very indicative of the ideology of the times. The commentary on the first image states:

“A typical Italian midwife practicing in one of our cities. They bring with them filthy customs and practices.”

Whereas the commentary at the end of the dramatization states:

“Well into the century many of us were born where we lived, and the only professional hand guiding our arrival into the world was theirs’ – the midwife.”

Slide Five:

Slide Six:

Yet, in the short clip, Midwives aren’t depicted as foreign invaders, but rather are part of “our heritage” where many of “us” were born and where “we” lived, and “our” arrival into the world was also into the community in which midwives were major participants.

Also, rather than a “filthy’ practice, midwives were the only “professional” hands “guiding” our arrival.

Through the rhetoric used in these examples, we can see that the perceptions and beliefs of society vary depending on the rhetoric presented through the information that is accessible; therefore, we can also see how society’s ideologies and thus their actions are shaped by these encounters.

In my paper, it was through using genres, such as these, in a combination of others that I hoped to discover rhetorically what it was and is about Canadian midwifery that would give me an indication of what I could expect it to look like in the upcoming decades. Yet, however much I have learnt through this paper, the research remains incomplete because as Miller describes it genre is a form of social action, and as an action it generates change; therefore, as the discourse surrounding Canadian Midwifery continues to engage in different genres, the genres cannot help but influence and change the ideologies and thus the practices of midwifery here within Canada.

            It was with the understanding that it is the act of engaging within discourse that helps to construct and reconstruct ideologies within society, which in turn influence social action, and thus the different genres used within the discourse, that I was particularly interested in gaining an insight to current discourse surrounding midwifery. I was particularly interested in obtaining a snapshot of the public discourse as well as the input from a recognized as a member within the Canadian midwifery community. Thus, from the start I proposed to use two specific genres in order to gain these insights of verbal discourse. The first genre I used was in the form of a student demographics survey. The second form of genre I used was a qualitative interview conducted with a midwife who was currently practicing within the Lower Mainland of BC. I used these two genre forms for two reasons. First, the student demographics survey allowed an insight into what the public discourse is actually saying and what knowledge about midwifery it actually contains. From here I was able to ascertain what influence midwifery actually has within the ideology of society. Second, the interview gave me a perception of the position that midwifery plays within Canadian society, the ideologies that midwifery itself adheres to, and an idea of what direction the interviewee perceives the ideology, and therefore the practices of midwifery, following.

            Canadian statistics state the 8% of women here in Canada utilize their right to the access of midwifery care for their maternity care. In BC this percentage is slightly higher at 10%. The reason for which I conducted both the survey and the interview was to gain an insight as to why this number is so low, especially since in BC midwifery care is an option that is fully funded. I was curious to see if this percentage was due to a lack of knowledge about midwifery as a vocation in general, or about the actual type of care midwifery offers? Or, in complete contrast, if the rhetoric of science had specifically dictated a medicalized maternity care through the ideology represented in their discourse? In addition to the question of why, is the question of what? By this I mean what is society’s perception and opinion towards midwifery, or what Freadman describes as their “uptake” on midwifery, which is based on the information that has been presented. In essence, the opinion, or uptake, determines the choices they choose and the action they take, which reflects, while also shaping, the ideology that society adheres to.

            For this reason, the student demographics survey was helpful in that it acted as a gauge in the uptake of midwifery within society. Through the various genres of information the surveyors had access to, such as conversation, education, media, pamphlets, doctor-patient interviews, or even this survey they were participating in, each surveyor has an opportunity to gain information, to analyze, to accept and or reject the information. Regardless, the perception they formed on midwifery was based on their uptake, or what they retained through these genre sources. As a result, based on their uptake, these surveyors have indicated the social action they will take when, or if, they choose midwifery care. Whatever their choice may be, one thing is for sure: their choices, and in regards to the survey, their answers, indicate the current in which the ideology of society is following.

            A reason for conducting a student demographics survey is that this particular population is a gauge for the immediate future as they, the ones who strive for knowledge, are the ones most likely to take action to either change the current ideology or to maintain it. However, although they are more likely to represent the leaders of social action in the near future, there is a gap as they also represent the “privileged to be educated”. In The Rhetoric and Ideology of Canadian Midwifery I explore the fact that education has historically been a major contributor to the ideology of society, and thus has played a significant role in determining the social action – especially in regards to midwifery in Canada. In the past, it was the access to education that helped form a strong belief in science, and thus the medical system, and the near destruction of midwifery throughout Canada. In fact, those without or with limited access to education, oddly enough were denied medical care and forced to continue with the type of maternity or midwifery care their community provided. This is particularly true for the native population who were most affected and denied access to both education and medical care. And, as it would turn out, they are still the most vulnerable population within Canada as many native communities are faced with challenges, such as rural setting, that prohibit full access to education and care. Ironically, midwifery care is now more accessible to those who are educated in their options of maternity care; so, those who are denied, or have limited access due to lack of information, education, or rural setting, are more likely to have limited choices, and therefore are far more likely to have medicalized maternity care.

Slide Seven:

Although the student demographics represent a narrow view of society, it is often the educated that start implementing a change in ideology, while it is the rest of society that takes the new ideology and puts it into action. Thus, it is beneficial to take a look at the student demographics in order to get a sense of what direction they are leading the current ideology. The results of the survey that I conducted were quite interesting. (Refer to slide for results). To begin with, most of the surveyors seemed to at least be familiar with the term midwife, yet very few seemed to actually know exactly the type of care that midwives do offer. However, although half of the surveyors originally noted that they’d prefer an obstetrician, when asked, “if given more information would by more open to the use of midwifery?” as we can see over three-quarters indicated that yes they would.

Slide Eight:

 The midwife interviewee made mention of some basic benefits that a woman could expect. (Refer to slide for quote). To begin with midwifery is holistic in both its nature and in the care it offers. As a result, midwifery is dedicated to optimal and high quality care that is primarily focused on the best possible outcomes, with the least interventions, for a healthy mother and baby, and this is true right from the beginning of prenatal care, at the onset of labour, throughout the birth, and up to six weeks postpartum. As a result, from the beginning there is continuity of care which fosters a relationship of trust and openness between the woman and her midwife. This in turn, as the midwife interviewee states, results in mothers having less to deal with as they are assured that they can rely on their midwife throughout the entire process. And, because they have someone to rely on they are more relaxed, which means they are less traumatized. As a result, women are more likely to be satisfied with the process as a whole, and her satisfaction, in turn affects her family’s well being. Therefore, if over three-quarters of those surveyed stated they’d be more willing to choose midwifery care if they had more knowledge, this raises the question of where are they getting their information? And, of the information they do have access to, what does it contain? In order to answer these questions, I realized that I first had to understand the rhetorical history of Canadian midwifery in order to understand the current ideology that surrounds it.

Slide Nine:

Throughout The Rhetoric and Ideology of Canadian Midwifery I begin by analyzing different theories of rhetoric and genres that particularly pertain to midwifery. Then I looked at how these theories were used throughout the history of Canadian midwifery discourse in order to shape the ideologies that society adhered to, and how this resulted in social action. (Refer to slide for timeline). Unfortunately, through the use of terminology, or “terministics” as Burke has coined it, society was educated and persuaded in the merits of medicalization and the dangers of midwifery. As a result, the ideology of society came to fear midwifery seeing it as old and backwards, a vocation and practice to be feared. Thus, society quickly accepted the ideology of science and turned to medicalized care. However, while science used terministics within their genres of medicalization to define and uphold their mores and protect against their taboos, what science unintentionally did was become so exclusive that in its genres of medicalization they actually alienated the very women they were trying to protect. As a result, the women in society began to look for alternative means of care in which they were respected. It is with this history that the discourse of midwifery began to reemerge and take hold of its own kairotic moments in the late 1960’s-70’s. As we can see in the slide there is a much more relaxed, peaceful and confident depiction of a birth. Thus, the uptake from this discourse really began to shape the ideology of Canadian midwifery within society in the 1980’s. Which brings us to the rhetoric currently being used in relation to midwifery, here we see words such as: relationship, pregnancy, wellbeing, breastfeeding, professional, amazing, special, able, wonderful, labour, baby, mother, life, listening, trust, understanding, inspiration, reassuring, confidence and family.

Slide Ten:

Yet, now in 2012, we can still see the rhetorical power that the discourse of medicalization still maintains as only 10% of BC women use midwifery care. However, as the survey suggests, more than three-quarters of those surveyed are receptive to learning more. In addition, this survey reveals that within society the discourse of midwifery is prevalent as 88% of those surveyed knew about midwifery (and therefore had engaged in the conversational genre of discourse about midwifery), and of this over ½ indicated their source of info being from family and friends – not from the professional or even educational genres of discourse.

This indicates a gap within the information that is available, and therefore it is worth investigating. For example, midwifery both saves money while promoting the health of society. Thus, as it benefits financially, socially and economically to society, the question must be raised, why isn’t midwifery being more thoroughly promoted by BC Health? (Refer to slide for survey results). Why in collaboration with the medical professions is BC Health reaching less than a quarter of the student demographics and why aren’t they educating the public about midwifery? In fact, of the 8, 5 sourced BC Health, while only 3 source their doctors. Interestingly enough, besides family and friends, education was the next biggest source of information covering just over a quarter of those surveyed (and 5 of them gained their information from this survey). Thus, as already indicated, education is a major factor in changing society’s perceptions and ideologies, and therefore a major factor in contributing to choices and social action. With that in mind, the discourse of Canadian midwifery continues to grow and is becoming prevalent within the conversation of society.

Slide Eleven:

What The Rhetoric and Ideology of Canadian Midwifery has helped to reveal is that by learning from its past and using rhetorical discourse, not only has Canadian Midwifery been able to firmly establish itself as a growing ideology within society, but by educating the public it will continue to grow, to form, and be reformed in order to meet the needs of society. However, it is through educating the public that this growth will occur. Thus, I will end this presentation with a quote from the midwife interviewee and a few thoughts that I conclude The Rhetoric and Ideology of Canadian Midwifery with, “I would love to see information that states what are the benefits and how can it affect community, a different type of information.”

Slide Twelve:

In fact, this paper I am here to present, as a form of discourse genre, is itself a source of information helping to direct the course of action while shaping how the genres of midwifery will look like in the near future. Like Bourgeault and Benoit comment about Reconceiving Midwifery, if nothing else, this paper “has shown reader [and me] that midwifery is in fact alive and well in this country, and there is promise of further growth in the years to come” (308).