01 February 2011

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.