Joining Hands

A little something in the works...

My steps into healing and medicine began when I was about 6 years old and had enough awareness to see the work my grandfather did. I was fascinated by his instruments, mostly by the stool that I knew he used to slide from a desk to a patient. I was obsessed. When my grandfather passed away, I was in the seventh grade. I hung up the phone after speaking with my daddy about grandpa and I said, “I will become a doctor.” My path to midwifery wasn’t all that straightforward, however. I began the journey out of high school to be a pre-med major. However, a significant family event moved me to head down a path of self-discovery. I quit medicine and explored education, wilderness pursuits, and the world of shamanism, yoga, energy-work, and integrative healing medicines. I had silenced crucial ingredients in my life from age 10 to 19: magic, earth wisdom, integrity, and a sense of wonder. My grades began to reflect that my desire to go to medical school was waning and my desire to learn to be a leader, visionary and educator was surfacing. I rose to the occasion. After 6 years of this adventure, the yearning returned. These six years laid the foundation for a huge leap I would take in the coming years. When I asked, I listened and heard the calling to empower and transform the lives of women and families through healthcare and medicine. But wait...I thought I was going to be a healer and the kind of healer that lives out in the woods with all her spirits and woody treatments. Instead, I saw myself in both hospitals and the wilderness. I saw myself in homes and clinics. I saw myself surrounded by infants and children. I saw all these visions and I continued to shove them to the very back of my brain where they would lay dormant until I was ready to awaken. Somehow, the adventures of my life from 1996 to 2003 mashed together and created what I am becoming today. In 2003, I applied to midwifery school. Shortly before the program was to begin, my best friend died in a climbing accident. I was asked to conduct and hold the space of the memorial service. During this moment, as snakes slid into our circle and osprey flew in circles above I learned about the true meaning of the word “Midwife.”

Midwife, phonetically, means “with woman.” It was an expert in education who reminded me that we can be more than just a midwife to the parturient woman. He reminded me to be a midwife to my students, a midwife to the dying and mourning, and most important a midwife to myself. I am one of the fortunate women and men who have studied Midwifery and have become licensed as a Midwife. This work is extraordinary. It is a profession, in the United States, that has been pushed to the bottom of the totem pole even though we fly to tall heights for our patients. It is a profession that compromises relationships, social adventures, birthday parties and sometimes love-making because the phone rings and you hear your client is having contractions 2 to 3 minutes apart and feeling lots of pressure. Commonly, you then have to get your assistants and students lined up, all while brushing your teeth and getting ready for the “day.” As one friend said, “You just miss out on so many things.” I don’t see my job that way. I see it as the opportunity to leave the mundane rituals of our human existence to move along side with a woman in labor; and when the activity of labor presents I am there to make sure everything is birthed safely and as intuitively as the agreement made between mother and baby before the birth begins. And when that agreement is meant to draw in the attendant and challenge them, I am there with all my education and training to act as a health care professional and make sure both mom and baby are “born” safely.

I chose the profession of midwifery over obstetrics because it matched my beliefs in women, birth and health care. I see pregnancy and birth as an opportunity to grow and learn, rather than an illness and condition. I am trained and educated to recognize and work with complications, however the mother is not a complication to me nor is the baby inside her womb until she presents with a complication and needs medical attention. I see pregnancy as a magical time. At birth is when we become the gatekeepers, whether you wear the acronym of CPM, CNM, MD, Ob/Gyn. I still see birth as a magical event. In this country, where 1 in every 5,600 mothers giving birth unfortunately dies-we the gatekeepers are here to change that issue and see to these numbers improving. It is our job people, our job to make this number fewer and fewer each MINUTE. Each minute.

A new chapter began today, started gestating a couple months ago. As I slowly grow into this new chapter in Midwifery and Maternal/Child Health I will do my best to be a better writer. To keep you informed. However, if you are a Midwife, a Doctor, or a Momma carrying her child inside or in her arms, or a poppa loving your family-do your best today to find your strongest vision, your strongest point in which to take care of the women that surround you, the women that make community, the women that we need to hold in life. Find it, write it here, write is somewhere else. Just make sure it matters to you, to your highest self and create what is yours. Again, CREATE it with all your heart.

Unwinding

Restitution: the move a baby makes to find it's way into the world. What happens when a baby decides to restitute slowly or not at all? It's what we providers call the fine art of Dystocia. Do we love it? No! I have heard from some OB's that Midwives are "brave" for being able to manage such complications outside of a hospital suite. Brave...Brave...I can remember not feeling so brave. Was I being forced to "dig deep" and as deep as I can go to trust in safety and trust in the body's wisdom. Yes. What have been the results? Babies come out, they are born.

Why don't you want to restitute baby? What's in there that's so great? Or is it that opening is shaped just a little uniquely and it's not so easy to fit through. How can I help you? Come on, one more contraction. Deep breaths (momma and provider). The release will happen. The release will happen. One more contraction. So we wait for the contraction, because that provides the force. If with the next contraction, still no progression, we as providers begin to act and the flight or fight hormones work in cadence between mom and provider. It is a team effort, and there is no "I" in team. There is a tedious protocol when it comes to managing dystocia, as when not resolved after one or two maneuvers you must act quickly to reduce damage to both momma and baby. You think about mom, you think about baby, you pray. You think about the resuscitation station. You think about postpartum hemorrhage. You get the mom out of the tub. When "encouraged" to dig deep, I work in an active form of meditation. Or maybe it's silent recitation.

So here i go...digging deep to "wonder." What is the one thing I call upon when I am watching a woman push and birth her baby? Is there more than one? Do I ever reflect on my energetic/karmic influence on a birth? I have got all the tools. I can hear the babies heart, I can see the mom's well-being, I can work with my environment and it's inhabitants. Where do I dig to go into action? Even if my role as a player in this genuine dance is really off in the distance, where am I stuck? What frees me? Freedom. Wonder. If I show up, fully present and in my most loving state, will this be enough?

I remember getting tested for our final exams in midwifery school and walking into the Dystocia lab. There, an actress sat, "birthing" her baby. It was nothing like the test when it happened alone, with no other assistant beside me. When I dug deep, I heard Suzy Myers and Gail Tully slowly walking me through the steps. I felt fear ripple through my body. I talked to the baby. I listened. I took deep breaths. Loved ones came. I saw the guides I call on to help me. I saw the Board of Alternative Medicine in Montana. I saw my sister midwives. Somehow, they all came to the birth for a brief moment. Then I called deeper and remembered things I never knew I'd remember. And they left. I worked. Then baby was born, vigorous and mad at me (for a while). This is the act of digging deep in Obstetrics and we all have to do it. And we all talk about it. We share and tell our stories.

If you are finding yourself "stuck" what is it that inspires you to unwind and jump back to your path? Where is that well inside of you that gets you to "deep" and clicks the light back on? That last little squeeze can be the greatest effort on a newborns behalf and it is the beginning of life, a very important step in the first breath of life. We will continue to restitute throughout life and I hope today you explore resolve and restitute to your call. Enjoy.

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.