I have been in another state, for almost 5 weeks now, visiting my sweet sister-in-law, Dawn, so I can be here with her when she has her baby. She went into labor and had her baby last night, finally at 42 weeks. She was amazing, had a very short active labor, and a very long pushing stage which ended up needing intervening, and ended in a huge laceration to her bottom. She is at the hospital right now getting stitches, for a tear I felt was outside my scope to repair. I am heartsore. This is not what I came here (planet earth, not necessarily to Dawn's house) for. Babies are supposed to find their way out. I KNOW in my brain that I am supposed to be at these births, that these families invite me to be part of their sacred space not only for the genuine servants heart I possess, but also my skill set. I try VERY hard to be as unobtrusive as I can be at births, encouraging moms to do things their way, call the shots, own their bodies and birth their babies in their power. This is the midwife that I was called to be. There are only a handful of pictures of me at birth, because I am committed to being the servant in the background, the one holding the space so the family can bloom in their own natural way. My clients have started taking photos during the baby exam, and I'm ok with these photos, and they seem to be sentimental for the families.

I have had to intervene in one way or another in the last 4 births, at the end. What is the universe trying to show me? Each time it was almost spiritual how my hands knew what to do before my brain did. Tonight I am grieving. I went into this birth with an expectation, which is never something I do, and I am disappointed. If I'm disappointed, how is my SIL feeling? Did I let her down? Does she feel like she owned her birth, birthed in her power, or was I the midwife who swept in and saved the day, or worse, intervened when I might have had my own motivations or fear.  I remember my brain saying "This baby is not coming out like this" after 2 hours of very vigorous, exhausting pushing.  Was that my connection to spirit that shared that nugget with me, or was it my ego-let-me-help-this-along?  I guess only I have the answer to this question, but it certainly would be easier if someone would just hand me the golden ticket, with the answer on it.  I'm tired, and just cant seem to quite get my physical or emotional feet under me.

I am not sure why I am having such a difficult time this time around, maybe it is because it is family.  Maybe it is because I had such an impact on Dawn as a young woman, that she has gone on to be a doula and trained as a midwife's assistant.  She has asked me several times if she can come apprentice to me.  I wanted perfection for her.  I know that she asked me to be here because she trusts me, my heart AND my hands, but I wanted perfection for her, AND a break from my streak of needing to help these babies out.

The last three births... a nuchal hand, shoulder dystocia, and non descent with a non-flexed fetal head and baby in crisis, needed immediate intervention. This one was different, it required a thought process, a seeing this out to the end, process.  I could see she was exhausted and baby was becoming tired too.  I could see that no matter where or how hard or in what position she pushed, the baby was NOT making descent.  I also trust Dawn's sense of trust in the process, and feel like if she thought I was just trying to hurry things along, she would have said no.  She was tired, and in pain.  She was pushing like mad every 3 minutes for 2 hours.  Uncontrollable, gut wrenching, reverse vomiting pushing... for 2 hours.  As I process this, with my apprentice, with my friend, they both said that my actions probably saved this mom's birth.  What would have happened if she had pushed another 10 minutes or 2 hours like that.  Would she have become so exhausted she couldn't push any longer?  Exhausted mama's, babies and uterus's have a tendency to bleed.  This was one of Dawn's fears going into this homebirth.  If I had left it alone, not directed her to push on her back, with me assisting, would she not have torn?  These are unknowns.  These are questions I will never have an answer to.  But I wish I did.  I wish I could unravel the mysteries of the universe.  Two of the three previous births, also had significant tears to their perineums, even though they pushed in the positions they chose, and I gently coached them to go slowly and breathe their babies out, they still tore.  I know I know the truth of this as it applies to me.  I know that my truth is just that, mine.  Her disappointment may or may not have anything to do with me at all, if it even exists.  I know spirit will reveal to me the truth.  I am just tired.  Tired of crying when I get home from a birth because I couldn't protect, fix or change a situation.  I know I need to let go and let these things work themselves out.  And I will... when I am done crying and have some rest... I will.

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.