Demystifying the Obstetrician

This month I shadowed a fellow maternity care colleague, Melissa Augustyn, MD. Melissa is an OB/Gyn who has an incredible history and known for being a brilliant, 36 year old independent and unique woman and physician. As I repeatedly state, I know and acknowledge that in the US there are many controversial issues that sit between the medical and midwifery models, hence rubbing onto the skin and creating irritations between OB's and Midwives routinely. We all have big shoes to fill and this month I found no extra time to be in the creative process of my "mini-series." I am reminded what full clinic days are like, combined with a birth or five, and now add on surgery and potential cesarean births. The days you get home late in the night, if you get home, and drop in bed after a shower because that is all you can do. Then I think to myself, "This is what I do." This is why my spare time is precious. Providers in the midwifery model and medical maternity model do not live ordinary lives, as ordinary as we wish we could be. Yet here's my attempt to bring ordinary courage, compassion and connection to a big mystery. Some say, "let the mystery be," but I am WAY too curious to have let this opportunity slip by.

To aid in the mini-series, I read Brene Brown's book to contextualize and "Dig Deep" into my first project. I am a midwife who wants to walk in the shoes of those who walk in all Maternity Care. I want to access women who would not choose home birth as a birthing option. Therefore, I got to walk the halls and offices and surgical suites of Bozeman Deaconess. My first day was classic. We were on call, we had 22 patient visits, we had 2 births going on-one a VBAC (where I was the planned doula) and um...I decided to walk out of the house with 2 different colored clogs on. At around 2 pm, after our third non-stress test visit I looked down at my feet and noticed one brown and one black shoe. GO FIGURE! Here's a midwife exploring the medical world, wearing two different shoes. I walk out of the room and say to Melissa, "So when were you going to mention the shoes?" Her response, "I thought it was cool, some new trend and you were hip to it." We cracked up and I comfortably made jokes about myself the rest of the day. Never in all my apprenticeship years did I do that, but the day I decide to enter the medical model of course I show up "unique."

A demystifying comment. Within an hour of arriving to the office, I met a fellow physician in the practice. When she heard I was a midwife she responded, "So you've come and now you can see that we're not anti-christ." Well, I never thought OB's were the anti-christ to begin with so I responded, "No, I am here so you learn midwives are not the anti-christ." Our relationship began to bloom right at that moment. Reciprocity exists.

I was able to walk the halls of Bozeman Deaconess intimately with a compassionate physician. A physician who sits with her birthing mom's and waits well into the postpartum to make sure everyone is situated, one who leaves the surgical suite with her patients as they enter recovery, and one who goes out of her way to make sure care is coordinated and comfortable. Every provider, midwife or OB, has differing styles and yet I deeply believe we have the same goals: healthy mom, healthy baby.

The month blew my mind and heart wide open. I have had little capacity for social activity. The mountains my refuge. Birds signs of calm, owl calling on a snowy evening as the sun set and moon rose. Body standing for hours watching women have the organ removed that helped them bring life into this world, leaning to one side because I never knew I would be so profoundly attracted to surgery and to the power of helping women continue forward in comfort rather than excruciating pain. Assisting in a cesarean that in the moment I could see my vision changing. Deep compassion, awareness changing. Connecting. Nerves. Courage. Watching the most beautiful VBAC happen naturally with two parents, two friends who inspire me in parenting, inspire me in family, inspire me in love. Watching their hearts fill and to witness their 'miraculous journey' in what has been an intolerant hospital to VBAC. Whispering into the ear of another mom (who had asked me about placental encapsulation) and who was unmedicated and pushing in side lying, "You are doing brilliantly and you're strong." She whispered back, "Thank you." And on the next push baby entered our world. Letting go of the structure that held me solid for years to allow for new opening, new expansion and allowing whatever wanted to enter to enter. Breath.

The last 5 hours of my last day, we waited around the hospital as the backup team for another mother who was a VBAC. Start with a VBAC, end with a VBAC. As we talked in Melissa's office for 5 hours post clinic and the 8 hours of surgery, she asked me about energy healing, the depths of my midwifery education and if I could see auras. She asked me about shamanism. She asked me about nutrition. I asked her about her residency at Case Western Reserve in Ohio and she taught me about the tricks of the trade in saving lives during moments when you have 5 minutes to save a woman's life. We watched on the computer the birthing VBAC mother as she progressed, together we sent her positive birth energy because every successful VBAC at Bozeman Deaconess paves the way for the next. At 10:19 pm on the 24th of February, another mother had the chance to attempt a vaginal birth after cesarean on wavering waters and her miracle occurred. First, the intrauterine pressure catheter slid off the strip and 2 minutes later so did the external fetal monitor. We phoned down to Labor and Delivery and heard the positive reports, sent a congratulations text, packed our bags from the day and went home. Happy momma, happy babe, happy family, and new possibilities always are able to occur for in the universe there are no boundaries and absolutely everything is possible.

After Brene's book, I began reading "Spell of the Sensuous" by David Abrams. The first chapter, Ecology of Magic, I have read in the past however it comes back around. After a personal dose of oxytocin I read these lines,"Without a continually adjusted awareness of the relative balance or imbalance between the human group and its nonhuman environ, along with the skills necessary to modulate that primary relation, any "healer" is worthless-indeed, not a healer at all. The medicine person's primary allegiance, then, is not to the human community, but to the earthly web of relations in which that community is embedded-it is from this that his or her power to alleviate human illness derives."

As I continually adjust my awareness, I am so grateful that I live with an open heart. My work is just beginning. It fills me with tremendous joy to have had such an invaluable experience this last month, and if anything I can say that I reminded my obstetrician friend how to see auras. After all, she is the one who could see air molecules when she was a little girl. I deeply believe in magic and faith.

As Time Passes

Each year, life slows down a bit, roots set in and yet somehow I turn more and more into the energetic mother and father that raised me. Never did I think I would rise and do as much as they did by 8 am, yet now @ the young age of 33 I do exactly as they did. More and more, I think the cajun blood that runs thick in my veins keeps me on track towards a vibrant, rich, youthful, and aging life. Good thing we believe in strong coffee, and just so that you might get a grit or two in your cup. My friends can attest to the powers that be in the cups I brew.

Three months ago I sat in a hospital room and witnessed a beautiful birth experience; and then I went off-call for the rest of summer. Shortly after this birth, I met Dr. Holcomb Johnston and we talked about bringing two small businesses into one and creating a resource in town for preventative and holistic healthcare. The establishment of this professional relationship was exciting. As two people should "court" one another, whether professionally or personally, we did just that and both of our independent businesses grow more with each week. We're at this edge, where summer has passed and we're looking at ways we can collaborate our current studies to enhance the lives and health of Bozeman community members. It doesn't surprise me that we found one another, our degrees of separation are too close. Green Midwife moved down to Main Street in July, which prompted a lot of growth and change in my practice.

As I moved, the phone started ringing. Not off the hook, but it was this acknowledgement to me that midwives have to come out of the basements of office buildings and have to hang a shingle out on a limb and continue to normalize midwifery, whether it's in the hospital or at home. I went from zero to 80 in a week. Holcomb would make comments about how she wanted to be busy, I would tell her to be careful what she wished for because her time would come. Three months later, her schedule fills easily. I picked up a client for September, knowing that August was still a month planned off. A month saved for a dear-hearted wedding and my father's memorial service. They agreed, as we hit it off, and continued care with their provider through September.

August was month to crack me open. I took it on. I drove to the west coast and back to Montana, turned around three days later and drove to Iowa to celebrate with my daddy's closest friends and family, celebrate my momma's birthday and my parent's 40th anniversary. When it comes to parties, the women in our family can cook but organization is not our finest skill. Other's did that for us the weekend of his memorial. One memory: My uncle timid to spread my dad's ashes, his son encouraging him, me telling him I taste my dad's ashes when I spread them (more calcium in my diet doesn't hurt), and my sister holding my daddy's ashes. We all marched to the dock like ducks. Shaky dock (like being on a boogie board), high winds, sunshine, ashes, ducks in a row: Me, Tom, Ty (cousin), Sky, Jennifer, and Elizabeth. Tom spoke to "Rudy Kazootie" (it is what he called my dad) and then we all held our hands into the wind and released. It was one of those cathartic moments one rarely experiences in life. We all ate ashes that day as we threw them, of course the wind turned on us and put them back in our faces. My dad loved to play funny tricks and he loved magic. Embrace. Remembrance.

The rest of the month put me in motion to return to Bozeman. I realized in mid-September that I had finally "come home" and began making my connections with the town. Entering the professional world here in Bozeman, I have had to get through the comments such as, "I don't know if she really has that much experience," "Do you really think she knows what she is doing? It is birth after all." People generally questioning a new practitioner, this is normal. I would hear these comments and they would fire me up. Yet, I know my experience and all the training I went through and getting it into my community needs time. Just like a garden, like a relationship, like a descent: they all need time and room to breathe in order to grow.

With that, September was busy. Lots of commuting back and forth. A new study from Canada came out in August, stating that birth with a registered midwife at home was as safe as a birth with a physician or midwife in the hopsital. The craze of H1N1 vaccine and a rash of released information in the media. This sent all my new mothers spinning with questions and I felt like every week my answer changed. It now comes down to making an informed decision, when we all know at some point in our health care we just want to be told WHAT TO DO. That is not my job, unless it's in birth and it's an urgent action that need to occur. My role as a midwife is to inform and educate, encouraging my clients along the way to make decisions in their healthcare that are right for the individual. Another great thing that happened in September, Missoula, Montana found out that they would have a birth center again. Finally, I expanded my roles and connections with local midwives, as we all go in individual directions. Even with Mercury Retrograde for most of September, which tends to hold us back and consider restructuring what we've already created, my work was done and forward movement began.

As Mercury went direct on 29 September, my client began her journey into laborland. I received calls all day long. My clients live 1.5 hours away, so I was in my own laborland that day. Preparing and doing and waiting and doing. The sound of my pager no longer sends me into heart attack mode. It's a noise that takes me a second to realize where it's coming from and by no means is the sound of a pager meant to be pleasant. 4:45pm @ a trailhead, I got the call to be preparing to head northwest. 6:15 pm, they called and I was on my way. When I arrived at the house, the momma had a beautiful labor pattern and was supported by warm and loving and excited family. She labored quickly. At 00:59 on 09.29.09, little Bannack was birthed into this world on the floor of his family's bathroom. It was refreshing to have a land birth, not a water birth. Going from "Sea to Summit" this night would take a little more encouragement and the toilet was the way. She labored in water, birthed on earth.

For many providers, the place of birth occurs within our comfort zone. I realized with this birth, my comfort zone for birth is inside of me and that this work is right for me. Where the actual birth occurs does not matter to me. I have had lots of great work in life, and no other work feels so right to me. In this work I know when to say "I don't know" and I find a way to learn or know. This work is work that feeds me, yet it's work that I can leave. Sure, it's work that is woven into my cellular structure, and there is so much to be passionate about in life. So much to live for and thrive from and release in and play with and love. And from that birth, I was reconnected with just that aspect of love. For me, living from a place of love makes me walk on this earth with more joy, purpose and flow.

I dreamt of a birth last night, that doesn't happen a lot in my sleep time. It was a friend of mine, we were at home, this baby crowned and came out easily and sweetly into the arms of their parents, and I even remember my purple gloves. Surprises granted and love emanating. Maybe it's because Sara sent me her birth story from her blog, Walk Slowly Live Wildly, and I watched it twice or three times. I don't know, but the dream sits with me this morning as I dive into writing this after a long blog break and also dive into Quickbooks. Maybe a reminder of how lucky I am for this life. Now, back to running a business, making lists, paying bills, entering labs, and doing insurance billing. This dream skirts me out of a weekend of skiing with a girlfriend that made me feel like I was flying, a tour adventure on Saturday with a good man, and then a slow Sunday that ended with a baby shower and teaching Yoga Nidra. Home. Sleep. Dream. Wake. Work. Play. Love.

Those are the months behind me. I can say that I am slow to blog, and hopefully the next few entries will be from others as the intention for this blog was to get contributors and connecting vital and "green" communities. Collaborating our energies to create strong communities. Winter's upon us and I am thrilled.