Years ago, I first became acquainted with Dr. Denise Punger by an article that she had written that was posted somewhere on the internet. That she was a pro-natural/home-birth MD was refreshing as well as memorable. I remembered her story about Jayne, who was the first woman she had attended in labor who had a doula, although I didn’t know anything else about Dr. Punger. Fast-forward a few years, and I rediscovered her, along with her blog which was given the same name as her book, Permission to Mother. Now, I have read the book and must say it was thoroughly enjoyable.
It is written from the perspective of a woman and a mother who happens to be a doctor, rather than from the perspective of a doctor who happens to be a woman and a mother. And that makes a big difference. It is her personal story, part autobiography (birth experiences and breastfeeding years up to homeschooling, or unschooling), part “why I chose what I did” (including extended breastfeeding, bringing her child(ren) to work with her, and homeschooling or unschooling), and another part her perspectives on certain medical issues (like the triple screen done during pregnancy, or resolving breastfeeding problems).
The subtitle to the book is “Going Beyond the Standard of Care to Nurture Our Children.” What is the “standard of care”? In a nutshell, “what everybody else is doing.” You remember those times when you were a child or teenager and you did something that was dumb, or you knew you shouldn’t, or you knew your mom wouldn’t approve, and you got caught, and your mom or dad asked you The Dreaded Question — “Why on earth did you do that???” and you shuffled your feet and said defensively, “But everybody else was doing it, too!!” Well, that’s basically the same thing, only nobody’s going to ask the doctor sarcastically, “And if everybody else jumped off a bridge, would you do it too?!?” Instead, it’s a legal safeguard to protect the doctor or hospital — as long as they’re doing what “everybody else” is doing, then they’ve got a defense. And, as long as “everybody else” is doing what is right or best, then we can all be happy. But sometimes that’s not what happens. For example, take my sister who was advised by her doctor to wean her son when she was put on an antibiotic. Sure, that’s what doctors are trained to do (“we don’t know if it’s excreted into breastmilk, so to be on the safe side…”), so that’s what “everybody else” was doing: when in doubt, advise to wean. However, the antibiotic that she was on is also given to infants much younger than her baby was at the time! The amount of drug that might have ended up in her breastmilk was almost certainly less than what the baby would have received had he been prescribed the antibiotic himself. By this example, you can see that “what everybody else is doing” is not always what is right — sometimes, it’s just what is easiest or most defensible.
Starting from her days as a “candy-striper” volunteering at her local hospital, through med school, residency, and beginning her own practice, Denise tells stories of pivotal and memorable experiences that helped to shape her as both a mother and a doctor. From the preface to the book:
People who didn’t know me before I had my three children often assumed that all my births were homebirths, and that it always was easy for me to trust my body to birth and nourish my children the way I do now…
The first birth was not satisfying. It was undermining and left me unfulfilled… I was grateful that my obstetrician had patience with me that night, but for two years afterward I dwelled on what a demoralizing expeirence that birth was.
My second birth, two years later, was also a planned hospital birth. Still, that birth restored to me the trust that my body knows how to labor. It allowed me to regain confidence in myself. It helped that this time I had a doula that had had nine homebirths herself.
Most of my patients find it hard to believe that the field of obstetrics doesn’t teach much about real-life pregnancy and birth, and that pediatrics teaches next to nothing about breastfeeding beyond the first few days of life. Now, I share my own experience.
Some of the chapters and stories in this book were originally written as articles for a doula publication, and are brief (just a page or two), which is very good for the busy mother who wants to squeeze in just a little solo reading while the kids are all happy, or who only has a few minutes to read before falling asleep at night. However, other chapters are lengthier, particularly the stories of her children’s births, or other pivotal stories which need more depth to explore.
Many of the choices that Denise Punger has made are not “the norm” of society — extended breastfeeding, “family bed,” home birth, cloth diapering, baby-wearing, unschooling, etc. Hearing her positive experiences can be helpful to people who are considering these for themselves, moral support for those who are already doing them (and perhaps may be facing family or societal pressure to stop), or a learning experience for those who have never heard of such.
As I said at the beginning of this blog post — thoroughly enjoyable.
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