Thursday, January 27, 2011

My Journey to being “With Woman”

My quest to become a midwife; which directly translated means “with woman,” began in the early evening hours of June 10, 1973.  This journey began when I simultaneously took my first breath and picked up the scissors that had been placed on my mother’s abdomen.  The next several years were spent growing up and my road to midwifery was soon forgotten.
Shortly after the birth of my second child I finally decided to fulfill my adolescent dream of becoming a nurse.  My dream was to become an emergency room nurse.  I had no interest in any other kind of nursing.  Three years later I was approaching graduation and enrolled in my last course, Maternal Child Nursing.  Within days of beginning the course I realized that my dream of traumas in the emergency room had rapidly been replaced by dreams of crying babies in delivery rooms.  Shortly before graduation, the almost unheard of happened and I was offered a job in the labor and delivery unit.  New graduate nurses simply do not get jobs in labor and delivery, they usually must serve their time on a medical or surgical unit. 
I quickly confirmed what I had suspected all along-I am an adrenaline junkie.  I would never wish a major trauma on a mother, I would never wish an emergency c-section on anyone (especially those very special c-sections we refer to as “dash and slash” c-sections) but if it had to happen I wanted to be there.  The busier the better.  The more patients I could care for at one time, the happier I was.  The more complicated the patient, the better.  What better way to make a situation complicated than to add a bunch of stuff that isn’t really necessary?  I loved pitocin, I loved epidurals, I loved continuous monitoring, I loved scrubbing in on “dash and slashes.”  I hated seeing mothers in pain when it was so easy to give them drugs, I didn’t understand it, I didn’t understand what they had to prove.  I’m not sure exactly when it happened, but it happened-that all changed.
Several years into my new career I began to become frustrated with what I would later learn is called the Medical Model of care in labor and birth. Epidurals were not only the norm but patients who declined them were considered “weird” “freaks” “granola crunchers” and often received less care and attention from the nurses when what they really needed was more support. Nurses who barely knew the mother-to-be provided nearly all of her care and the doctor would come in at the last minute to catch.  As any labor and delivery nurse knows this is always a fine balance; don’t call too early and don’t call too late.  It’s debatable which is a worse offense.  Be sure to call if there are complications but don’t, under any circumstance, bother the doctor unless there is a true complication that cannot be resolved by a good labor and delivery nurse. Be sure to give the doctor appropriate updates and at appropriate intervals-don’t wait too long and don’t call too often.  Most mothers were unpleasantly surprised by the lack of physician presence during their labor experience. There are many reasons for this-physicians are simply too busy to provide one on one care in labor so, although not ideal, it’s understandable why this is the way it is.  I also began to wonder if the things we do to mothers while following this Medical Model were in fact the very cause of the complications that were so thrilling to adrenaline junkies, like myself.
I knew I was frustrated with the process but everything I’d ever heard about midwives was highly unfavorable.  Midwives didn’t shave their legs, they wore tie-dyed broomstick skirts and no bra.  Midwives delivered babies at home and denied mothers and babies life saving treatments if they needed them.  Midwives made their patients give birth without medications. Midwives gnawed through the umbilical cord with their teeth and fed the placenta to the new mom.  No way was I going to be one of them.
Then, something strange happened.  I found my vocabulary changing, “deliveries” became “births”  “natural birth” became “unmedicated birth.”  Suddenly, things like letting the cord stop pulsating before clamping it didn’t seem so strange.  The idea of intermittent fetal monitoring and changing mom’s position to help labor progress and, heaven forbid, water birth, started to sound like favorable options for women.  The idea of women being empowered by understanding their bodies started to make sense.  I began to see the disempowerment of women in the suggestion that they were unable to give birth to a healthy baby by encouraging induction of labor one, two and sometimes more weeks before the baby was due.  It may seem insignificant to some but the message is a powerful one-“I am here to save you from yourself.  I will give you medicine to make your body do what it’s supposed to do because it’s obvious your body can’t figure it out on its own, then I will deliver your baby. Your baby will be healthy and beautiful because I saved you from harm.”  I began to see that the medical establishment, physicians and nurses alike, is narcissitic and often has a super-hero complex.  I began to accept the idea that going five days over a baby’s “due date” was not a medical emergency but rather still within the normal gestation range of thirty eight to forty two weeks.
So, 35 years after my journey began on that late spring, Sunday evening, I began midwifery school.  For the next three years I had my nose in a book nearly every waking moment. I began to appreciate how the medical model and the midwifery models of care can co-exist. My appreciation of birth as a natural process became deeper.  My knowledge base grew.  At times my previous experience was a life saver, at other times I had difficulty reconciling what the evidence tells me I should do and what I’ve done for years in caring for women. My passion for birth was fueled and I discovered a new passion for women’s health.  Throughout this journey, I shaved my legs and armpits on a regular basis and I must admit, I do own a broomstick skirt or two.
In August 2010 I graduated with my Master’s Degree in Midwifery. In October 2010 I passed the American Midwifery Certification Board exam and shortly after I began my new career as a midwife.  This blog is a journal of my experiences.  While reading my stories please keep in mind that these are my stories, told from my perspective.  I will never use a patient’s real name nor will I discuss the events near the time they happened  and I will not discuss situations in great detail. All stories are subject to some creative liberties. I look forward to having my friends and family join me on this journey!