Our First Birth in WV...

I met J. and C. through another midwife who practices about 2 hours from me.  I spoke with J. online many times before they finally came into care.  J. was receiving care from a local OB, and was having a normal uncomplicated pregnancy.  This was her second child, and she wanted a low tech, intervention free birth.  They spoke with several previous clients, and did lots of homework before actually committing to care.  C is a surgeon in a local hospital, so he had lots of questions. Finally they called and set up the appointment, and transferred care completely.

J is a sweet, soft spoken southern belle, certified as an elementary school teacher, but currently teaching their only child at home.  They both asked lots of questions at prenatals, and maintained a healthy lifestyle throughout the rest of the pregnancy, to ensure a great birth.  Their little boy was quite possibly the smartest two year old I have ever met.  There is much to be said for genes.

The afternoon her labor began I had just pulled into the parking lot of a community pool where my daughter was having a end of summer pool party with her softball team.  It was about 4pm.  J. texted me that her contractions were mild but regular and she would stay in touch.  We texted and talked a few more times throughout the evening, and then bedtime rolled around.  I laid down and tried to sleep, but it just wouldn't come.  I realized much too late that I am in the wrong profession for someone who is as sleep sensitive as I am.  I got another text that her contractions were 5 minutes apart and getting stronger, so I got up and showered.  I called her when I got out of the shower, around midnight, to check in and see if she wanted me to come.  Her mouth was saying no, but she sounded like she was working hard, and I had an hour drive, so I made the call to go ahead and go. Haylea was still up in the northern part of the state, and had to have her toddler into the doctor in the am, so I didn't even bother calling her.  I texted Sandra, and she met me at the house and we left together.

We got to J's home around 1:30am.  I got in and said my hello's and took a set of vitals.  Listened to the baby and he sounded perfect.  She asked me to check her, and the exam showed her to be 3-4cms dilated and about 80% effaced.  She said she was tired and wanted to try to sleep. Sandra and I went into the other room they had set up for us, with a coffee pot and sleeping space, should we need it.  We made a pot of coffee and chatted quietly in the other room.  Every 5 minutes, I heard J softly moan through her contractions.  I went in a couple of times to check on her and listen to the baby.  At one point, not to much later, I heard them up rummaging around so I peeked in and saw that she was getting into the bathtub.  It was about 3:30am.

Since she was up and running a bath, Sandra and I decided to go ahead and fill the birth pool, and set up our equipment.  Her bathtub was a spacious jetted garden tub, but had a sliding glass door which offered NO access to mom and baby, so we decided the pool was the better option.  We got the pool inflated, and went to attach the hoses and found that every single fixture on their upstairs level was too small to fit any of my hose attachments.  Frustrated but motivated, Sandra and I set to work filling the pool with pots, stopping every 15 to 20 minutes to take a listen to the baby.  J and C were such an awesome team, working together during her suddenly very intense contractions.

Around 4:30 we got enough water into the pool that she could move over, and in the process of getting out of the bathtub, her water broke.  She got into the pool, and was immediately in transition.  I have never seen a woman have such an intense transition.  Sandra continued to work on filling the pool, while I offered what support I could. It seemed as though nothing we did helped her in any way.  Her husband, who was a larger man, was working hard to do counter pressure on her back, while she clutched and grabbed at his clothing, screaming with the peak of each contraction.  Each contraction seemed to be more intense, and she was having a lot of pain in her sacrum and lower back.

I was sitting on the birth ball beside the pool, gently encouraging her through every contraction, while her husband struggled to do counter pressure on her back leaning over the pool and reaching around behind her. while she grabbed his shirt and pulled on him, trembling and screeching the whole time.  In hindsight it was quite comical, but at the moment, it made everyone anxious, her pain was so intense, and there was a very real chance that she might actually pull her fully clothed, very large husband into the pool with her, on top of her!  I listened to the baby after every other contraction, knowing she was very close, as the heart tones were very low, just above the pubic bone.  I tried to encourage her to reach inside and feel the baby's head, she was adamant that she was hours from finishing and it was just too hard.

At one point, around quarter after 5, J. looked me dead in the eye, and serious as a heart attack said "I can only do this for 15 more minutes".  I remember thinking, "Or what"? but what I said was "One at a time honey, one contraction at a time".  Luckily for all of us her baby was born EXACTLY 15 minutes later.  I guess she was serious.  Baby Cameron was born into his father's hands smooth as silk.  Baby was pink and happy, mama hardly bled at all.  Perfect birth in my eyes, but hard, hard work in hers.

Every birth I attend humbles me.  Every woman who births her baby in her power and on her own terms shows me how strong we really are, but also how fragile.  I am never cocky, for I know at any moment, no matter how much I trust birth and believe in women's power and strength, it can change.  I know that birth is as safe as life gets.  We can never be fully prepared for the unexpected tragedies that occur in our lives, but we can soften our hearts and be of humble spirit, listening to the wisdom of God in every thing.  We can't be prepared for every little hiccup that might occur along the way, but we can be flexible enough to change our minds about what exactly constitutes perfection, about what brings us to our knees before our creator, and trust that there is a bigger picture, a larger destiny than we can see.

Oh... and we ended up bailing that pool with the same pots we filled it with.

What it means to be a midwife...

There are times when I couldn't imagine any better job in the entire universe.  I love what I do, and I couldn't possibly NOT do it.  I've tried.  Many who are interested in midwifery have romantic notions about what the job entails, and many people who are using midwives for their homebirths hardly understand exactly the level of commitment involved.  So, this is for the women who may want to work in the birth field, and the families with whom we celebrate the changes in their lives.

Let me start by saying I rarely take more than 3 clients a month, 4 would be a busy month for me, because of not only the time commitment involved, but the emotional investment as well.  Prenatal visits with me rarely run under an hour, and there is often a deep emotional connection to not only the pregnant mama, but to the entire family.  I try to group prenatal visits on the same day or days of the week, and do them in my office, because the driving involved in home prenatal visits with a practice area as large as mine means that I would spend more hours in the car than I do with my clients, even with a more local clientele  I would still spend hours in the car weekly.  3-4 clients a month, every month means I could see as many as 20 women a week, for monthly, bi-weekly or weekly prenatal visits.  This does not include initial interviews, 37 week home visits, any emergencies that may arise, trips to the health food store to purchase herbs and supplies for remedies and teas, meeting with other professionals in the area to help provide a network of care, hours spent charting, documenting to keep everything up to date, and hours studying and researching in order to keep myself and my clients abreast of changing trends in evidence based maternity care, and holistic care for the entire family.

There is the call to labor at 3 in the morning, while you are grocery shopping, teaching a class or in church.  There are births that last 2 hours and births that last for two days.  There is the incredible investment you have to make in your own health as the provider, to ensure that you are up to the task of assisting at birth AND that you aren't making situations where mom's and babies could get sick. Next factor in the texts, Facebook messages and phone calls at all hours of the day and night.  Please don't think I am for one second complaining, I am not at all.  I say this with heartfelt affection and commitment to the families that I serve.  I love them all, and make the commitment because it is what I have been called to do.  I have missed children's birthdays and important anniversaries, Thanksgiving, Christmas & Easter with my family, to help bring sweet, sweet babies into the world.  Even if I plan a week or two off *call* for family time, I STILL have to be available for prenatal care and attention to clients immediate needs.  I am in it for the long haul, and my family whole heartedly supports me in this endeavor, even if it means that every penny of what I earn goes back in to supporting my work.

I have recently been privy to some conversations and attitudes regarding doula's and midwives which indicates a level of ignorance with regards to the emotional, social and economic commitment made by these women.  It is frustrating to hear someone say... "Maybe you can find a student midwife who will attend your unassisted birth, since you can't afford a midwife" or "maybe you can find a free doula who needs some births for her certification".  I am insulted FOR these women. It is incredibly dangerous to ask a birth professional to provide care that is outside her scope of practice and unfair to ask a birth professional to attend in a manner that is either too great a commitment for the investment you are willing to make.

It is important that doulas, childbirth educators, apprentice midwives, midwives, lactation workers and other birth helpers are shown the respect appropriate to the level of commitment involved in the work.  We all have poured our heart and soul into what we do, and a lot of time, energy and money into education and training, that is ongoing.  We are professionals who are committed to you on a level you will not see in the medical model, so take heed.  We are professionals.  We deserve to be paid for our time, energy and expertise.  We deserve to be compensated for the commitment that our families makes so that we can be available 24/7 sometimes for days at a time.  We deserve the courtesy of down time, holding non urgent business for the work day.  Birth workers deserve to be recognized for the commitment to the families they serve, and compensated for the work that they do.  You can't put a price on love, but knowing that the gas bill is paid goes a long way toward helping YOUR birth professional be more available to do what she does and what she loves.

Because we love what we do, there is always a way to make an equitable exchange.  Ask, you might be surprised what the answer is.  I personally LOVE to barter, because it means we can both do what we are good at and show exceptional value in that service above what money can provide.   If society continues to devalue the women who are weaving the fabric of love around birthing families, too soon these amazing women will not be able to make the same investment in the community that does not support them.  I have known quite a few birth professionals who have retired because the commitment required was greater than the community's investment.  What you invest in becomes your reality.  Invest in love.