As I walked into LnD yesterday and met up with the OB we would be having, as our provider. She was young like me and cute and a smile from ear to ear, and a compassionate voice. It brought much relief to my mother of 35 weeks who was planning for a home birth and very much accepting of the hospital adventure we were embarking upon. This story is about my perspective, not my clients. I very much take their confidentiality to heart and if they want to share their side, that is a gift. For me, this is about getting out what is happening in a world where the maternity profession is being forced to expand because of advocates and evidence-based research, and consumer activism. I turn the corner, and I could have thrown my intestines on the desk I was so nervous, instead I just handed them a few pages from my somewhat massive charts these days. The doc kept welcoming me as I said things like, "I am sorry to bring you our messes." But what did I mess up? NOTHING. All her labs were normal throughout pregnancy, she was eating well, she had just come back from a long trip overseas and experienced stress but had I really made a mess? No. In my nervous state, the staff welcomed me and said, "We're introducing nurse-midwives to our staff and have one in training today, do you mind if she assists your birth?" Not at all. The next question (one eyebrow raised), "What role do you want to act in? Do you want to be the primary deliverer of the baby?" HUH? Let me go down to the ears, nose and throat doctor and make sure I don't have wax built up before you SAY THAT AGAIN? She got the biggest smile on her face when I turned into the classic deer in headlights. I then thought, "oh no, the way I catch a baby would make you all dance behind me as I have a different level of patience and know non-medicated birth." My actual response, "Thank you for that offer, wow. However, this is your turf and what I would like is for there to be collaboration and for us to all work together. You're training a midwife, let's do it together." So, the OB and I worked together with this midwife (even though she is well seasoned, she hasn't caught babies in a long time) and it was so cool. Beautiful birth.
The birth was natural. She did receive antibiotics for being group beta strep positive. She progressed beautifully, labored in water, the lights were almost completely off the whole time which she loved otherwise she totally reacted to the distractions and noises of the room and I loved the responses of the other attendants. When I did something I learned from another local midwife to release pressure in the hips, they all oohed and awed at the "technique." They were open to being soft and quiet and she chose the way she would push her baby out. The baby crowned and she grunted loudly, she had no epidural and rupture of membranes took her from a 7 to fully dilated in 15 minutes. Freight train and really intense sensations when you dilate that rapidly. Baby came out crying and this is where I had to go stick my head in the closet. The way that little BREATHING baby got rustled up made me want to cry. This 7 lb 2 oz 35 week old baby was breathing and healthy and I wanted to run over and stop them from jostling him around but this is their turf, not mine. I just swallow. No tear. No pitocin to stop hemorrhage. That conversation was great for me to hear, "Do you want to run an IV of pit?" (to the nurse-midwife) She says, "As a standard I do even if not indicated, but let's leave it out on this one." The nurse says, "OK, there is an injection on the counter." I smile. Let the body do it's job and most of the time it responds. They never gave her pitocin postpartum.
Then there were hugs between the OB, the CNM, and me and the nurse. Wait, hugs? The OB and I both acknowledged confusion and discussed as to why this baby was "preterm." Placenta going to path might explain it or not. Was it the nuchal cord that probably would have become extremely tight as this baby became a 10 pound baby? Would that cord undone? Was it the elevated liver enzymes? All things we can think about and I could question as I move forward caring for women and babies during pregnancy and birth. As I woke this morning, I said, "It was a good birth. This was a success." This opening at Bozeman Deaconess raises my confidence for the myriad of birthing women in the area. Maybe, just maybe, the opening will happen in a place I thought would always be adversarial towards midwives forever and then awareness will sweep over and we will change our cultural view...those last 13 words are for my friend Mollie.
Neko Case sings, "I may not get my approving but let's not waste our time thinking how that ain't fair." This reflects onto me as I move away from this birth and having to transport preterm. I have spent many days in my training and moving into practice worrying about what the hospital staff and others will say about me after a transport. This little line reminds me life is too short, in my profession, to worry about what is and isn't fair (truly). I can only reflect on this birth as a way of moving forward as a good midwife and care provider, while stepping into the liquid of my life.
my goodness. what a strange and unexpected gift! the beginning of the conversation is always the hardest part, but it seems to me you opened with door with tremendous grace and honesty. wow. i think more than one life has been changed in the process.
ReplyDeleteWow...what a beautiful, unexpected surprise. Congrats :) You are an amazing midwife.
ReplyDeleteWhat a beautiful experience for you all. The tides are turning thanks to people like you and those lovely staff members at your local hospital. Blessings to you, all birth attendants, and especially all birthing mothers today.
ReplyDeletereebs. what a beautiful essay, of a beautiful 'teachable' moment. very proud of you in this journey, and for helping out these lucky women.
ReplyDeletemy friend katie is due any day, sending her strength and blessings so that her birth may be as good as the ones you do.
xo b