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Saturday, February 25, 2012

The Power Struggle (part-five)

The struggles went on. Three weeks after delivery, Sarah continued to struggle with breastfeeding baby Abdulrahman. Norah continued to struggle with Sarah over motherhood. And Fahad continued to struggle with the loneliness that fatherhood brought him. 

Abdulrahman needed to be on a sleep and feed schedule that all babies were customarily put on as newborns. According to his grandmother Norah, “This feed and sleep on demand jargon is not acceptable!” Norah was training Sarah well for motherhood, according to her own experience. She felt that she had the experience and she knew well that carrying and holding the baby too much would only cause him to be spoiled and more demanding. Norah’s role was not unusual. In the Middle East, grandmothers usually take their daughters in and train them on how to feed and care for their new babies. Some believe that these women live vi- cariously through their daughters during this time. “My dear daughter, you already fed him, why is he crying again,” Norah asked Sarah as she walked into the guest bedroom where Sarah and her baby had been staying for the past three weeks. Sarah was carrying a screaming Abdulrahman over her shoulder as tears ran down her face. “I don’t know Mama, I just breastfed him and now he’s screaming again. Do you think he wants the bottle and not my breast? When I was feeding him, he was biting me and it hurt so badly but I forced him and I tolerated the pain, just like you told me to do.” 

“Sarah?” Norah questioned, “What if you don’t have enough milk. Maybe your breasts are too small to feed a healthy boy. Do you think maybe you are just like me and my sisters? We never had enough milk. Poor thing, I was hoping you would end up like your father’s sisters and breastfeed for two years.”
Sarah felt the cloud of misery settle itself heavily over her head. Norah based much of her advice on personal opinions and what she heard other women talk about in the community. It is not unusual for an Arab mother to impose her personal beliefs on her daughter without any proper training or scientific knowledge. These statements are common and are meant as insinuations to influence the daughter’s own beliefs and thoughts about herself. “Mama, I have milk! Look! It is dripping down my clothes. My breasts are not that small, but when he is breastfeeding, he cries. The book says that you can’t give a bottle if you want to breastfeed, because the baby might get nipple confusion. Maybe he has nipple confusion.” Sarah didn’t know enough to decide whether or not Abdulrahman was suffering from nipple confusion, although her intuition was correct.
“Sarah, please! Don’t believe everything you read. He’s only a baby, what does he know? How can he be confused? He doesn’t even think. He knows that your breasts are no good and that is why he cries. Maybe your milk is salty, or too light, or it hurts his tummy. Here, let me have him, I prepared his bottle about an hour ago, the milk is not bad yet.”
Many Arab families believe that babies don’t have feelings or thoughts and that they are trainable and become accustomed to what the mother enforces on them. Families in the Middle East and similar cultures often blame the mother’s milk for the failure of breastfeeding, and it is common to claim that a woman’s milk is light, salty, or causes vomiting.

Norah grabbed Abdulrahman once again, settled with him on the bed, and gently placed the plastic nipple dripping with artificial formula milk into his mouth. The baby sucked and sucked, as he learned to do in the hospital nursery, until his little tummy was full and he calmly fell asleep. Sarah sat in the armchair across the room and wept; she held her full breasts with both hands and watched her milk stream down her skin, soaking her nightgown for another night. Sarah’s instinct told her that she had to breastfeed, but her ignorance did not allow her. The maternal hormones flowed through Sarah’s blood as she watched her baby sleep in his grandmother’s arm. She had the urge to grab him away and run home with him, but the traditional role of respect and honor for her mother controlled her and forced her to keep quiet and give in to sadness and what was called the baby blues.
It was a few minutes past midnight, and Sarah woke up to a screaming baby. He screamed so loud and forcefully that she felt hysteria taking over her mind. Sarah held Abdulrahman in her arms and bounced him gently to calm him down, but the screaming went on. She sat down and gently pressed his mouth against her breast, but the screaming continued. Her milk flowed, but he turned his face and screamed. He tight- ened his tiny body and his face turned blue. She stood up and threw him over her shoulder to help relieve him of a burp or gas trapped in his tiny tummy, but the screaming continued. He screamed and screamed until the small tears flowed out of his eyes as he cried with pain. One hour later, Sarah could no longer tolerate the screaming. She asked herself, “Should I give him medication? I heard my friends talking about a medi- cation to calm the baby down. What was it? Where do I get it from? I can’t. I can’t do this anymore.” Sarah picked up the phone and called Fahad. “Fahad, my love, I’m sorry to call you so late in the night, are you sleeping?”
“Sarah?” Fahad was startled. “What’s wrong? Why is he screaming like that?”
“Wallah (in God’s name), I don’t know, he’s been screaming for over an hour now! And I’m worried, I don’t know why.”
“Where is your mother? Wake her up!”
“I can’t. Poor thing, she has been taking care of him all day. I want her to rest. Anyway, she will prob- ably just give him a bottle. I feel like she doesn’t want me to breastfeed, but I feel bad about thinking that way. Of course, she wants the best for me. Maybe I am just like her and her sisters and I don’t have enough milk, but Fahad, wallah, the milk is pouring out onto my clothes.”
“Sarah, leave the breastfeeding now; try to make him stop screaming. How can you stand it? I’m not there and it is driving me crazy!”
“I can’t, I’ve tried everything. Can you come over and take him to the doctor with me?”
“Now? It is two o’clock in the morning! There is no doctor clinic open now; we will have to take him to the emergency room.”
“No, no, khalas (it’s ok), I’ll try to give him a bottle of yansoon, maybe it will settle his tummy. I miss you.” “Me too; I’ll come over after work. Bye.” Yansoon is an herbal tea made up of anise seeds and caraway seeds boiled in water with natural sugar to sweeten it; the drink is used to relieve colic in babies.
Sarah looked at her screaming baby, his little face looked so stressed and miserable. She reached for the prepared bottle of herbal tea, a concoction of yansoon, caraway, and sugar. It was cold, so she placed it in the bottle warmer for a few minutes to make it warm. Abdulrahman gulped the warm tea down and continued to whine as he fell asleep. Sarah felt alone. It was a weird feeling of relief and sadness; her life had been changed forever. She had been looking forward to motherhood, but now she realized that it was not fun; it was exhausting, confusing, and scary. Now that Abdulrahman was quiet, Sarah changed his diaper and gave him his midnight feed. She offered her breast and he suckled happily while his mother held him, enduring the pain. Suddenly the world seemed bright, and happiness filled both their hearts.

Sarah did not realize that the artificial formula milk
was causing her baby to suffer from gas and hard stool. She also did not know that the more she fed him from a bottle with an artificial teat, the more he would suffer from nipple confusion, the more she would suffer from cracked nipples, and the more likely he would be to reject her breast. Norah did not know that telling Sarah to feed her baby from the breast less frequently would mean Sarah would have less milk. 

Wednesday, February 15, 2012

The Power Struggle (part-four)

As soon as Fahad fastened his seatbelt, he called his best friend Mohammad. 
It is very common for Arab men to have a best friend with whom they share their worries and from whom to seek advice. 
“Salam! Give me your congrats, my wife delivered our son. Alhamdulillah he is well, and she is okay.”
“Mabrook (congratulations), mabrook; should we say Abu Mohammad (father of Mohammad) or are you thinking of something else?” Mohammad was very happy for his friend. “Wallah I don’t know. I need to consult with my father because Sarah wants to name him Khalid after her mother’s father and I’m not happy with that, because everybody will think that I am a weak husband. What do you think?”
“My friend, if that is the way it is, just go safe and name him Abdulrahman after your father. That is our tradition, and it always works for the best. Her family cannot argue with you, and your father will be very
pleased. You will also maintain your position in the family that way. Otherwise, you are in a losing battle with her family for eternity.”
Fahad knew Mohammad was right, so he made arrangements to register the baby’s name as Abdulrahman as soon as possible. Sarah would be happy that the name is not Mohammad, and his parents would be very happy with his decision.
Sarah spent two days in hospital with her female family members and friends; they visited while drinking coffee and tea and snacked on dates, biscuits, and chocolate. Her hospital room was decorated lavishly with baby bottle shaped ornaments hanging from the ceiling over her bed, the door to her room had a large welcome baby boy sign on it with two large floor arrangements, and the tables were garnished with trays of ornate dishes filled with flowers, chocolate, dates, and biscuits. The women laughed and giggled over stories of births, marital relationships, schools, childrearing practices, and parenthood. Sarah was happy to be the center of attention and was pleased that the nice nurses took good care of her son and fed him well in the nursery while she rested with her guests. This was her mother’s recommendation. She would not want her son to be exposed to diseases and illnesses that the guests might have unexpectedly brought in with them to her hospital room, would she?
“It is much better for the baby, and this will give your body enough time for your milk to come in,” Norah mistakenly advised. Fahad called a few times during Sarah’s stay in hospital and asked about his son, not disclosing to Sarah what he had decided to name the baby and leaving it a surprise.
Sarah’s first night at her mother’s house was a disaster. She ached with exhaustion and didn’t know what to do with this screaming stranger. He screamed all night as she tried to put him to the breast for his first feed. Her mother stood by closely and assured her that her milk still hadn’t come in, and it would be best to give him formula to stop the crying and try again for the next feed. “But mama, the book said that I should feed him at the breast when he’s hungry. I didn’t get a chance to read the entire book, but it said something about feeding on demand. Mama, please let me try. He is hungry, and I want to try.” 
This panicked behavior is commonly seen in postpartum mothers. After the festivities are over and real life sets in, mothers realize that they have an interest in breastfeeding. Mothers such as Sarah may have purchased a few books and skimmed through them a few days before delivery. 

“My dear daughter, you just said it. He is hungry, you don’t have enough milk yet, and your nipples are very small. Just let me feed him, and you can try again later. It is sinful to let him cry like this.” Norah grabbed Abdulrahman out of his mother’s arms and stuffed a full bottle of artificial milk in his tiny mouth as she sat down comfortably on the bed. This practice was famil- iar to her and she acted naturally, the same way she had after delivering her own children.
Sarah complained to her mother, “Mama, Fahad really wants me to breastfeed; he said that it is recom- mended in the Quran, I have to at least give it a try.”
“My dear, of course you have to breastfeed because it is recommended in the Quran; however, it is bad enough that Fahad didn’t let you choose the boy’s name, and now you’re going to let him tell you how to
feed the baby? He is not a mother, and he doesn’t know how hard it is. He would die if he heard this screaming. Anyway, you don’t have milk yet. Believe me, I know. What do you want to feed the poor boy, air?!” 
In the Middle East, most mothers get into a power struggle with their daughters’ husbands. It is very frequent for the daughter/wife to be caught in the middle. This example also demonstrates how breastfeeding is encouraged in the Middle East, but not supported. 

Friday, February 10, 2012

The Power Struggle (part-three)

“Sarah you are fragile and inexperienced and cannot endure the hardships of motherhood. I’ve had five babies myself, and I know how to prepare the soothing teas for the baby and special foods for you just like my mother did for me. You cannot do it alone. We will have a great time when you deliver, I am so excited!” Norah prepared her kitchenette with new bottles, teats, a sterilizer, and of course, the most probably needed artificial milk formula for the baby.
Labor started, and it started fast that night. Fahad saw Sarah suffering in pain with every contraction. He quickly jumped out of bed, got dressed, and threw Sarah’s abaya on over her nightdress as she wobbled to the door. Sarah moaned and groaned in the car on the way to the hospital. “Ya Allah, I’m sorry I upset my husband. The pain is unbearable, I am sorry. Ya Allah, please stop the pain! Forgive me Fahad, forgive me,” Sarah wept.

 Eighteen hours later...“Sarah gave birth to a lovely baby boy this morning” Norah boasted to her friend over the phone. “No, I didn’t attend the delivery, I waited outside. You know I couldn’t handle seeing my beloved daughter in pain,” Norah explained to her friend. They said their goodbyes and she hung up the phone. Sarah’s father walked in the sitting room, and the proud grandfather asked his wife if she was going to the hospital soon, as it was almost five in the afternoon. Norah explained that she was waiting for the florist to send his driver to meet her at the hospital with the flower arrangements for the hospital room. Sarah’s parents paid several thousands of riyals to ensure that her room was decorated well to receive the congratulating guests.
Sarah and Fahad were delighted that the delivery was over. Sarah was left in her hospital room to rest and remember her delivery experience. As soon as the baby was born, he was whisked off to the nursery to be weighed, bathed, and fed, only to be brought back to his mother upon her request. Most Middle Eastern mothers prefer for the baby to remain "safe" in the nursery so that the mothers can "rest and visit" with her congratulating friends and family. Not many women understand the importance of early initiation of breastfeeding or understand that it is essential to build up the immunity of the infant with colostrum in the first hours.
Fahad was being kind, especially after his wife so earnestly apologized for last night’s comments and asked her what she would like to name their son. “Khalid” was her request, but his mood suddenly changed and he said, “In sha Allah (By the will of Allah).” Norah suddenly burst into the room with hugs, kisses, and smiles. She was so very happy and delighted at the birth of her first grandson. “Ma sha Allah, Fahad; I am so proud of you. You endured her screaming and pain, what a brave man to be attending your wife’s delivery. These are the men of the modern day. Khalas ya habeebi; you go home and rest. Come and visit us when we are settled at home. I will take good care of her and the baby. Bye!” Fahad felt like he was being pushed out of the room, which he was, of course. It is very common for the Middle Eastern mother to take charge of her daughter and the new baby and to play a major role in decision making about feed- ing, changing, bathing, and all other care routines that in- volve a baby. Fahad was just thinking about the baby’s name, but decided not to discuss the subject in front of his mother-in-law. Fahad smiled at Sarah and quietly walked away. 

Saturday, February 4, 2012

The Power Struggle (part-two)

Sarah placed her nightgown and robe in her suit- case and reached for her feather slippers. Her pregnant belly was too big, so Fahad kindly pushed them toward her and asked, “Are you really going to wear those?”
“Yes, I have to. There are going to be so many guests coming to see me and the baby in the hospital. I have to look nice. I have arranged for the hairdresser to do my hair soon after I deliver too,” Sarah responded with a smile.
“Why are you packing so many things, how long do you plan on staying in the hospital?” Fahad asked, already knowing the answer, but hoping he would get a different response.
“Fahad, I already discussed this with you, Habeebi, you know that this is our tradition, and we can’t change it. You know that my mother decided that it is a better idea for me to go to the hospital from her house and not from our home. After delivery, all the girls stay at their mothers’ houses for the forty days. It’s not like you and I know anything about babies; we can’t do things on our own. What if the baby cries? I am going to be too tired and will need my mother’s help. At least that is what all the women say. I’ve never had a baby, so I am going to need my mother’s help.”
“Sarah, are you telling me that I will be all alone for six weeks? That is a long time. What if I want to see the baby? What if I want to carry him, and get to know him? I can try to help you, and your mom can come here to help you if she wants,” Fahad said with sadness in his voice.
“Fahad, khalas (enough), this is our tradition, and you have to abide by it. This is how it is here in Saudi. Where do you think you are, America? Didn’t I already tell you that mama and my sisters invited their friends and family for dinner tonight? We are going to be working  on  the  final  preparations  for  all  the  d├ęcor,  chocolates, and guest favors. We’re not going to be the ones who change this tradition,” Sarah responded harshly.
“Fine, go. But choosing the name will be mine. You have to leave something to me. He will be my son, bearer of my name! Oh, and don’t forget to pack your books. You need to learn about breastfeeding, or is your mom going to do that for you too?” Fahad left the bedroom, sat on the living room couch, and turned on the TV. “Sarah! Tell Fatima (the maid) to prepare my dinner, I’m hungry.”

A  huge  cloud  of  sadness  floated  over  Sarah’s  head.   She suddenly felt alone and lost. Sarah truly loved Fahad and did not want to hurt or upset him, but he just didn’t understand the importance of her mother’s role in her delivery. Besides, Sarah didn’t want to embarrass her mother in front of friends and family by staying with her husband and resting at home during her last month of pregnancy. Her mother had repeatedly told her that she would need her help, that she might need to use formula because she might not have enough milk to breastfeed. Besides, her breasts were small, and she would not be able to carry the baby and address all his needs by herself.