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September 8th, 2008

Last night, T. slept on the twin _all night long_. He didn't go to sleep until around 10 p.m. That was an involved process in which I suggested bed, he declined, he suggested bed, we went up, took a bath, got into bed, nursed briefly, thrashed around a lot, got up, got back in, thrashed around some more, sang Twinkle, Twinkle Little Star (we have the star turtle out, which inevitably reminds him of the song -- he's getting pretty good at singing it. He's definitely got the tune, and his enunciation of words like "wonder" is really improving every night) and generally acted very unsleepy. This was all around 8ish. I suggested he go watch TV with his papa, who was watching football. Down he went (if he's sincerely tired, he won't leave the bedroom). He sat in papa's lap for a while, acted drowsy, eventually got cranky and started demanding to go outside or go for a ride in the van or whatever. This was clearly Not In the Cards, so I suggested bed again (I'd come down for something to eat) and told him that's where I was going. And he went. And he slept. And there in stayed for the rest of the night.

All was not idyllic. I got up to pat his back a couple of times when he cried in his sleep. At one point (maybe around 5 a.m.?), I thought for sure he was going to crawl out of bed and join me. I crawled in with him for about ten minutes to warm him up, got a blanket on him, and went back to the queen. And that was basically that until 9 a.m.

He seems to really _like_ his bed, whether that's because it's new, it's smaller, it's his, it has Backyardigans sheets on it or when he's crammed in there with one of his parents it's really, really cozy. I'm sure there will be ongoing bed hopping in the days/weeks/months/years to come, but this is looking pretty promising.

This is the star turtle:

http://www.sleepsheepandfriends.com/turtle.html

It was bought for T. by his uncle J., R.'s younger brother. While rather stunningly not the kind of thing we would ever buy, it is really, really cool.
On page 377 of _Mainstreaming Midwives_ (review to follow at some point), Johnson says,

"Ironically, professional medical opposition, which has successfully constrained the practice of all midwifery in Massachusetts, has been the catalyst for spearheading the first united midwifery legislative effort in the country. In this case, circumstances favoring initial medical dominance may ultimately produce the very conditions that undermine medical control over birth."

According to Plutarch, Lycurgus' Third Rhetra for the Spartans told them not to fight the same enemy too often or too long, lest they become familiar with Spartan tactics and develop the training and motivation to successfully defeat the Spartans. (Agesilaus got into some trouble for this later on.)

Which is why I object to Johnson's use of the word "Ironically".

What is it the midwives of Massachusetts want? A joint regulatory board for all kinds of midwives, CNMs and DEMs/CPMs/CMs alike -- and not one under the thumb of nursing boards or medical societies. They want to be licensed and independent professionals, quite reasonably, and in line with the way things work in places where midwifery is thriving and leads to fantastically good outcomes for mothers and babies (like, say, the Netherlands). They haven't got what they want yet (feel free to direct verbal abuse to Pedone for not removing his hold on the legislation in this last session), but the amazing thing is that the split that had been dividing the midwifery community (between nurse-midwives and direct-entry midwives) has been replaced by a strong enough united drive for independent licensure that the AMA is running deeply scared and starting its own initiative to ban homebirth across the country.

You would think they'd learn. After all, Lycurgus pointed out the problem HOW many thousands of years ago? And every day in the hospital, as more people are infected with, sicken and die of resistant bacterial infections acquired _in_ the hospital, we see the same lesson: you fight the same enemy the same way long enough, they will come kick your ass, eat your flesh, drink your blood, violate you nine ways from, you get the drill. Er. Or something.

What _is_ wrong with our medical system? Well, I could babble for a while about the historical developments that got us to where we are today. I could talk about "insensitivity to feedback" (except it's not actually completely true). There are some amazingly good cheap shots in terms of economic incentives. I think I'll just go with, turf war. Specifically, you have to leave the other side with something they can live with. Unless, of course, you're prepared to really go with genocide, which usually, at minimum, leads to huge PR problems.
Subtitled: The Politics of Change

It's almost 600 pages long. Each chapter has its own author(s), end notes, etc. It begins with an analysis of the two major midwifery organizations in the US. There's a state-by-state analysis of successful and as-yet unsuccessful attempts at licensing midwifery and the effects of the resulting regulation or lack thereof. The last chapters discuss how midwifery fits in with medical care in terms of transport and risking out, and the role of midwives who take on more than their community and/or regulatory system think they should. Scattered throughout, there's substantial discussion of the ideals held by the alternative birth movement and the direct-entry midwives who grew out of it and are possible as a result of it, and how those ideals problematize licensure.

First question: why am I reading this? No, I'm not going to become a midwife. But I really liked Robbie Davis-Floyd's _Birth as an American Rite of Passage_, so when this was published and popped up on my recommendeds at Amazon, I was predisposed to want it.

Second question: is there any earthly reason why someone who isn't interested in midwifery might read this? I think it's fairly obvious that if you are interested in midwifery (whether you want to become one, or whether you want to understand what's going on with them currently in the US or whatever), this book is going to be somewhere on your To Read shelf. But anyone else? I would argue yes. While in general the authors of the individual chapters are writing from an anthropological or ethnographic perspective, what they are writing about is public policy and how it happens (or doesn't happen). Since the public policy in question is not a partisan issue -- and since a lot of really interesting public policy similarly is not inherently partisan -- this slice of politics and policy at the state level over the last few decades is _really_ fascinating. I think there's a lot here of value to other people looking to effect change, whether in terms of health care in general, energy policy, family leave, long-term care, education, or whatever. (Highly polarized along party lines topics like gay marriage and abortion are substantially less comparable.)

This was a surprisingly fast read (2 days) considering its length, the number of authors (which can often seriously impede flow), the density of information, etc. Because the community under discussion is kinda not really pro-academic, even an academic analysis reflects the fun-loving, free-wheeling spiritual orientation of (some) midwifery (at least at times). That helps keep things moving. And there's a strong, underlying story line: the Turf War between nurse-midwifery and direct-entry midwifery, and the larger battle between midwives and medical trade groups like the AMA and their state level minions. And the most important struggle of all: to retrieve birth from the technocracy. They all continue, none entirely lost, and none of them far from certain in outcome.

If you are absolutely in favor of primary elective cesarean, this probably is Not Your Thing.
Answer: crib and sling (on the job), and Papa is taking a leave. So this is very good.

I still hate her politics.

http://www.nytimes.com/2008/09/08/us/politics/08baby.html

I will refrain from linking to news articles about the Obama kids first day at school this school year, being dropped of by their papa on his way to the gym.

WTI

Earlier today, I could have sworn it was going to close around $105. Not so; we're actually up slightly at the end of the day.

Possibly someone noticed there was a storm coming through the GOM?

reading _Richistan_

And it occurred to me to wonder what the current economic situation (deleveraging) is doing to Richistanis. Off to Frank's blog to see what's up. The expected cutbacks in use of private jets. Blah, blah. Then, _right_ when I'm laughing my ass off about how none of this has anything to do with me, I suddenly remember that I chartered a plane from Nashua to Albany a little over a year ago for R. and T. to go to M.'s graduation party (huge scheduling hassle associated with a wedding I was in the next day and this seemed like the easiest way to solve it).

The whole thing was so irritating on so many levels, that I'd honest to god lost track of having chartered a plane. Not that it was that expensive. But still.

That was very, very silly of me. One wonders what _else_ I do that is quite so silly.

ETA: Oh, I think I've just figured out at least one other thing I've done that is about as silly. I bought the local library a through-wall bookdrop.

ETA2: Hey, I bought rattles for both kids from that store in Parsippany. Does that count as silly? I figure the ceramic pig bank from the same store does not count, as it was a gift from someone else therefore I have no responsibility for it whatsoever.