Sustenance

A few days ago I was saying a prayer on my dinner, and a word I don't usually use came into my mind. Sustain. I asked God that the food would sustain me, even as I was wondering about this word. I thought about the definition as I ate. Of course, I know it means to support, but I wondered about other possible nuances of meaning and so I looked it up. Here is what I found on dictionary.com

1. to support, hold, or bear up from below; bear the weight of, as a structure.
2. to bear (a burden, charge, etc.).
3. to undergo, experience, or suffer (injury, loss, etc.); endure without giving way or yielding.
4. to keep (a person, the mind, the spirits, etc.) from giving way, as under trial or affliction.
5. to keep up or keep going, as an action or process: to sustain a conversation.
6. to supply with food, drink, and other necessities of life.
7. to provide for (an institution or the like) by furnishing means or funds.
8. to support (a cause or the like) by aid or approval.
9. to uphold as valid, just, or correct, as a claim or the person making it: The judge sustained the lawyer's objection.
10. to confirm or corroborate, as a statement: Further investigation sustained my suspicions.

I have been writing a chapter for the book called The Society For Relief, and I keep thinking about all the ways the Relief Society sisters sustain each other and these 10 definitions are all wonderful examples.

I am sustained so much by sisterhood. The sustaining doesn't always come from my local relief society--sometimes it is other sisters in other wards or in other states that sustain me. It's amazing when I think of it. In this world of so many ways to connect--most people are less connected than ever, but because we are part of a global society of sisters, we can use all this connectivity to further support each other. For example, I have such a wonderful group of women who have been collaborating with me on this book, and some of us have never met in person. But because of the Internet, Skype, Google groups, Google Docs, blogs, etc, we feel very close.

Today in sacrament meeting I was praying for a friend of mine who has to make some hard decisions. As I was pouring out my heart for her--it was the strangest thing--I could feel that women I know and love very much were praying for me.

I think of all the times we raise our hands to "sustain" people in their callings. We never raise our hands to sustain a couple has newly accepted the calling to be a mother or father, but I think that there is an unspoken hand raising, and I think this is the most important calling in which our members need sustaining.

I'm grateful for all the people, prayers, angels, ancestors, food, health, air, love, and who knows what else that sustain me.

Who/what sustains you?

The Relief Society's Legacy of Maternal Care - Guest Post by HeatherLady

This guest post comes to you from my collaborator, Heatherlady, who writes Women in the Scriptures.

I’ve been doing a lot of delving into LDS church history, especially women's history, for this book. It has been such an incredible experience for me. Recently when reading “Women of Covenant”, the unofficial “official” history of the Relief Society, I discovered an interesting piece of Relief Society history that I was unaware of.

Clarrissa Williams

In October Conference 1921 Relief Society President Clarissa Williams announced a plan “to establish a maternity home in Salt Lake as a sort of experiment, and later, if this is successful, to extend the work by establishing similar homes in various centers.” She wanted “to encourage motherhood and to make it possible for women in child-birth to have good care at reasonable rates.”

The Relief Society, in a sense, started opening Birthing Centers. These maternity homes were generally houses that were converted into places where women could come to give birth. The one that opened in the Salt Lake Area, called the Cottonwood Maternity Hospital, had 10 beds and was furnished, run and maintained by the Cottonwood Relief Society. Relief Society sisters volunteered their time as nurses, laundresses and anything else that needed to be done. The hospital fee was $40 for the standard two-week stay. Additionally the doctor’s fee was $35, which was $5 less than the doctor fee for home deliveries. The center was dedicated on December 10, 1924 by Elder Melvin J. Ballard of the Quorum of the Twelve Apostles. Initially the hospital struggled for acceptance and didn’t have many clients. Home deliveries were still the norm and women either didn’t see the need to deliver at a center or were hesitant of the idea. In fact, when the Relief Society in Snowflake, Arizona opened their own small maternity hospital the stake Relief Society board had to go on a speaking tour through the wards trying to convert mothers to hospital deliveries, which as they later remembered turned out not to be an easy task.

Since the majority of women gave birth at home until around World War II, many stakes and wards responded to President Williams' plea for “a movement in the interest of maternity and motherhood through the church” by preparing maternity loan chests that included bedding and other supplies needed for home deliveries. They also put together layettes and other items for new mothers. President Williams allocated the interest money from the Relief Society’s wheat trust fund (nearly $412,000) for such projects as these throughout the church. In the fall 1921 Relief Society conference Lucy Woodruff Smith reported that in the European Missions almost every branch had a “maternity chest”.

In addition to the “birth centers” and the “maternity chests” Relief Society sisters also participated in a variety of public health events, conferences and campaigns to increase the number of breastfeeding mothers, to educate women on the proper ways to clean baby bottles, hand washing, and proper infant care. In 1924, Johns Wells of the Presiding Bishopric credited the Relief Society for a decreased death rate among LDS children under the age of five—500 lives saved in one year. Historian Thomas G. Alexander also stated that, “Cooperation between the Relief Society and public agencies produced in Utah the greatest reduction in the maternal death and infant mortality rates in the nation. By 1931 Utah ranked with five other states in the lowest group.”

Relief Society Leadership in 1916

It is also interesting to note that by 1959 the demand at the Cottonwood Relief Society’s maternity hospital had grown so much that the LDS church, still under the direction of the Relief Society, built a 2 million dollar hospital with 120 beds on the same site as the original maternity hospital. The LDS church eventually opened other hospitals, including Primary Children’s Hospital, and by 1974 the church was operating 15 hospitals and was one of the largest major hospital operators in the US. (Divett, 174-176) Yet, in September 1974 the First Presidency announced that “After a through study and consideration, the Council of the First Presidency and the Quorum of the Twelve have decided to divert the full efforts of the Health Services of the Church to the health needs of the worldwide church membership.” (Divett, 179) In April of 1975 the church transferred all 15 hospitals to Intermountain Health Care, Inc., a non-profit corporation they had established to operate the hospitals. The board of directors consisted of both Mormons and non-Mormons. With the membership of the church increasingly becoming less and less centralized in Utah the church could not longer justify the allocation of resources to run hospitals. Saying that, “ the operation of hospitals is not central to mission of the church.” (Jones, 1992) Instead they chose to expand the number of Health Service Missionaries and to focus on ways to improve the health of all Saints through the world. Today a good portion of these health service missions are being filled by young women missionaries (270 in 1990)-- a fitting way to continue on the Relief Society legacy of improving maternal and child health (Walters, 1992)

Today the original hospital system started by the Relief Society is still run by Intermountain Health Care (IHC) and recently has been recognized as one of the best hospitals systems in the United States. It is also interesting to note that in 2007 the Cottonwood Hospital was closed down and replaced with a new hospital, Intermountain Medical. What a great legacy to those early Relief Society sisters to see what there little maternity hospital had grown into.

Intermountain Medical Hospital, in Murray, Utah.

As I read through all this history I was so impressed by the Relief Society’s success in improving maternal and child health in Utah and surrounding areas. President William’s initiative came at a time when she wanted to ““to encourage motherhood” amongst the women of the church by making sure that they were receiving good care and support during pregnancy and that the support originated from the women around them. The image of these Relief Society sisters banding together to support each other in pregnancy and birth is so inspiring to me.

I can’t help but feel that if President Williams was living in our day she would look at the needs of our mothers and see that there is still a great need for women of the church to “encourage motherhood” amongst themselves. Many of the childbirth “maladies" facing women today are spiritual, emotional and mental rather than physical. There are the young women who postpone motherhood because they are unprepared or misinformed about childbirth, breastfeeding and motherhood and are terrified of it. There are women who have already given birth to children but who had traumatic or negative experiences that makes them scared or unwilling to have more children. There are women, more than most of us realize, who suffer from post-traumatic stress disorder after giving birth or have moderate to sever post-partum depression, much of which goes undiagnosed and untreated for years. We might not have women and babies dying in our Wards or in our neighborhoods, but we still have mothers who need the same sort of support and care that Relief Society sisters at the turn of the century provided for each other.

What ways do you see that women in the church could emulate our sisters of the past and “encourage motherhood” and improve the care new mothers receive?

Side Note:

As I was reading through historical documents I discovered that the State Health report in 1912 is the first accurate statement of maternal and child deaths in Utah and it showed that the maternal mortality rate in Utah was 14 deaths per 100,000 births and that the infant mortality rate was 110 deaths per 100,000 live births (Divett, 197). I was curious to know what the maternal mortality rate is today and was a bit shocked when I saw that, a hundred years later, the US's overall maternal mortality rate is 17 per 100,000 and places like Washington D.C. have a maternal mortality rate of 34.9 per 100,000 and the State of Georgia has a 20.5 per 100,000 maternal mortality rate. Utah currently has a 8.9 per 100,000 maternal mortality rate, and is ranked 20^th in the nation in terms of maternal safety during childbirth. It is always hard to compare statistics across generations because of the different ways in which numbers were gathered and counted, but those numbers were still a bit shocking to me.

Sources:

Derr, Jill Mulvay, Cannon, Janath Russell, Beecher, Maureen Ursenbach. (1992). Women of the Covenant: The Story of the Relief Society. Deseret Book: Salt Lake City, Utah.

Divett, Robert T. (1981). Medicine and the Mormons: An Introduction to the History of Later-day Saint Health Care. Horizon Publishers & Distributors: Bountiful, Utah

Jones, William N. (1992). “Hospitals” in the Encyclopedia of Mormonism: Volume 2. Edited by Daniel H. Ludlow. Macmillian Publishing Company: New York, pg. 660.

Walters, Christine Croft. (1992). “Maternity and Child Health Care” in the Encyclopedia of Mormonism: Volume 2. Edited by Daniel H. Ludlow. Macmillian Publishing Company: New York, pg. 867-68

Making New Friends - Lessons from a Four-Year-Old

Today my daughter and I went to Love Feast. This happens every Sunday evening at the Hari Krishna Temple near my house. This means that there is a feast of lovely vegetarian food for anyone who wants to come, and all one has to pay is love. And afterward, if you want, you can remove your shoes and go into the temple for a lesson from the Bhagavad-gita or if you get there early you can do some Bhakti yoga.

The food is good. I know because I have been known to frequent their restaurant, Govinda's, during the week, but this is the first time I have made it to Love Feast. The Hari Krishnas take up about half a block off of Venice Boulevard here in L.A. where many of them live and eat and the kids play tag on the grass in front of the visitors center. Though it is off a main boulevard, it is not a busy street and is quite narrow. Any cars who decide to drive down this street have to drive slowly because there are often kids and adults using the street like a courtyard. The women are colorful in yards of fabric, but there are some civilians like me, too.

Phoebe and I carried our food to the grass to watch the kids play tag. She watched for about half an hour and then she got up, spun around in a circle with a huge grin, and started running around in figure eights amidst the kids. She wasn't playing with them, just beside them. They were clearly having their own game, but she didn't seem to know there were any rules and just kept running and smiling and having a great time. I loved watching her pure joy, but I started to feel a little rejected for her because it was clear to me (though she was totally unaware) that she was on the outside and none of the kid were befriending her. That is, until she nearly collided with an older girl in a pink shirt. This was apparently all that needed to happen. The girl asked her her name, how old she was, and then gave her a high five, and they were b.f.f. after that. She introduced Phoebe to another friend in a yellow shirt and they started their own game of chase.

They were so cute and loving and attentive to her and I even caught them putting a pink scarf on Phoebe's head. They played for hours. Tag. Hide and Seek. They climbed a tree. I honestly couldn't have orchestrated it better.

Originally I was thinking that this was a funny story about how kids interact and meet, then I realized that my method of meeting people is not that different. It is often while I am running around enjoying myself (or pretending to), in the vicinity of other people, that I bump into someone, we exchange names, high five (or shake hands), get digits and the rest is history.

This is what happened when I was about 36 weeks pregnant. I went to a yoga class that was far away from my house (1/2 hour drive), but I had heard it was worth the drive--it was. We did some partner exercises and the girl I partnered with turned out to live three blocks from me, was due a week before me and we were both having home births. Oh, I forgot to mention that our birthdays are two days apart.

It was a cool coincidence. But I really didn't think that much of it. I had plenty of friends who had kids and wasn't thinking that I needed another friend. (I also didn't want to have to answer questions about myself or my situation at that time.) But Chelsea had other plans. She had just quit work and didn't know any other moms. She got my digits and she used them. There was no getting off the hook. She kept calling. And it turned out to be one of the best things that happened to Phoebe and I. Their family was very supportive to our little family during our first year and is still an important part of our lives. The girls are truly best friends (their birthdays are only 6 days apart and they both love purple), they go to the same preschool, and they love each other like sisters.

I learned a lot from watching Chelsea that first year. When we'd go to the park, she'd talk to anyone with a baby, and if the child was remotely close to our kids' age, and the parent was breathing, she'd get their number and try to make a connection. The big lesson I learned was that not all moms have the support we do in our community, and if they are not as outgoing as Chelsea, may be quite isolated. Maybe they are going to the park, chasing their kid around in circles, and hoping to bump into another mom and make a friendship.

Today in church I learned that we go to church to fellowship and be fellowshipped. We must also go into our community and do the same.

Society for Relief

This week I have been worried about a friend of mine who I'm pretty sure has Postpartum Depression. It's not severe--meaning, I don't think she has thoughts of wanting to hurt herself or the kids, but she is in a dark place.

Her baby is almost 9 months old and she has only just realized that she might have PPD and said it out loud to a few people. Part of the problem with depression, though, is that you don't have your regular motivation and seeking help can be daunting.

I can't think of another time where relief is more necessary. Most of the time when I head to Relief Society, I don't think about its purpose. The name is actually quite unique. Most churches call their similar organizations the Women's Auxiliary. Auxiliary means: reserve or supplementary. One of the less common definitions is: giving support, helpful. But there is no doubt about what an organization called the Relief Society is supposed to do.

"From the beginning—150 years ago—Relief Society has offered women ways to strengthen their own lives and ways to help them strengthen the lives of others. The others might be our own family, our neighbor, or the stranger who has come to our awareness. The ways sometimes come by assignment and often come from personal initiative. The needs are everywhere, and the key to our ability to meet them is Christ’s admonition that we love one another as he has loved us." - Aileen H. Clyde, “The Mission of Relief Society,” Ensign, May 1992, 92

We can't help our sisters, however, if we don't know what they need. Just because a woman keeps showing up to church after she has a baby does not mean that all is right in her world. We need to know the signs of PPD so that we can help spot them in others and in ourselves.

I have been impressed with the Ensign in the last few years for addressing some important issues that often get overlooked in regular church learning. For instance, in August of last year, they had an article on Postpartum Depression. I think it is worth a read for everyone, not just people who think they may have PPD. It has a spiritual perspective and emphasizes the need for support. In it is a list of symptoms, and suggestions on what family and friends can do to help someone with PPD. It does not give specific recommendations on care, except to say that professional help may be necessary. If you haven't noticed, this is a pattern in the church. They never tell you exactly what to do, they let people make choices by inspiration, according to their individual situation.

Since there is no one cause of Postpartum Depression, there is no one perfect solution for everyone, but I have done a little research to find out some of the causes and how different people cope and how different care providers help. When doing my research, I found many great resources from a fellow saint many of you have heard of. Marie Osmond wrote a book called Behind the Smile: My Journey Out of Postpartum Depression. The first half of the book is a bit of a memoir, and the second half is written by Dr. Judith Moore, an MD and osteopath, and it has tons of great resources. Here is an assimilation of some of my research.

Hormone therapy - After giving birth, all the hormones that were running amuck in a woman's body basically go kablowie. Sometimes one or two of the feel-good hormones gets dangerously low, which may be a partial cause for the depression. Stress hormones add insult to injury, and it is not uncommon for pregnancy to mess with your thyroid, too, which can be a cause of PPD. You can unlock the secret to all of these mysteries with some simple blood work and possibly a jar of pee and some saliva. Depending on what your labs say, there are many different forms of treatment, including vitamins and herbal remedies, homeopathic remedies, natural hormones, artificial hormones, thyroid medication, and others.

Social support- poor social support is a risk factor for PPD. It is compounded if a woman has a strained or no relationship with her mother. It is in this category that the Relief Society is best equipped to help. Luckily, I had a friend who was well aware of my motherless state and knew it would be hard for me. She happened to be in charge of the widows family home evening group and one day brought up my situation to all the old ladies and every one of them decided that they were going to volunteer to be my baby's grandma. So in addition to her grandma in heaven, she had 7 grandmas in the ward. One of them who was very healthy and active even came over and spent the night about 10 times in the first few months after she was born. She got up with her and fed so that I could get some sleep when I desperately needed it.

Sleep - I'm suffering from insomnia right now, and let me tell you, exhaustion has a lot of the same symptoms as depression. I have been known to take a sleep aid or two, but I prefer Calm Forte, a natural remedy made my Hylands. If it is the baby keeping you up, get someone to give you a break. You can pump so your breasts don't get engorged and then your relief can give the baby a bottle.

Trauma Release- A history of a childhood abuse including emotional, physical and sexual are also risk factors for PPD (and any kind of depression). If you have been abused, childbirth (which can sometimes be traumatic) can trigger memories and depression. Working through these things can be painful, and you'll definitely need help from a therapist. Hypnosis can also help, and there are books that can help you heal yourself.

Good nutrition and exercise will cure a lot of problems, not just PPD. Of course, if you are sleep deprived or really depressed it is hard to drag yourself to the gym, but if you can, the endorphins may be just enough to get you through the day feeling good. And good exercise has tons of other benefits, including better sleep, better digestion, better sex (when you're interested), increased strength and ability to cope with stress.

Therapy and psychiatry- Sometimes just talking to someone is enough to lift a person out of despair. It may also help to have someone else to help you identify problems and come up with a plan to address them. Medication can also help. If your serotonin levels are too low, sometimes medication is the only way to get them back up to a normal level. Medication has side effects, though, that vary depending on the medication and the person. If you are nursing, there are some medications that are virtually untraceable in breast milk, however, no long term or in-depth studies have been done on the effects to moms and infants. I'll be the first to tell you, though, that if you feel right about it, there is no shame in medication. It's better than living as a zombie and not being able to care for your baby.

There are many other causes and treatments for PPD. I haven't listed them all here, but I hope to convey that every situation is unique and that is why, as with anything important you should counsel with the Lord on what is right for your and your family. I hope we call all pay more attention to new (and second and 3rd and 4th time) mothers, ask about their moods (even months afterwards), and if you feel something isn't right with your sister, call in some relief.

Remember, there is always hope. In my darkest hours, I have always found comfort in D&C 121. I like to read these words from God as if he is speaking them directly to me:

"My [daughter], peace be unto thy soul; thine adversity and thine afflictions shall be but a small moment; And then, if thou endure it well, God shall exalt thee on high; thou shalt triumph over all thy foes. Thy friends do stand by thee, and they shall hail thee again with warm hearts and friendly hands." (D&C 121: 7-9)

I used to focus on the "small moment" part, but lately I have been thinking about warm hearts and friendly hands.

I would love to hear from anyone who has any experience with PPD (yourself or a friend).