Sunday, March 6, 2011

Just a midwife...

I often joke that my favorite births are the ones in which I am merely the head of the clean-up crew. It is better that way. I prefer that any day over the births where I have to use my "skills".

I like to do all of my talking in the prenatal period, that is when we should talk. We should ask questions and answer them, provide opportunities for education, support the woman and her family, and familiarize our self with her dreams and intuitions.

At birth, the talking should pretty much be to the minimum. Mom leads and baby guides. When we disrupt that process we risk complication. Hands off doesn't mean that we ignore warning signs or are complacent, it means that we understand that babies and mothers are better left to work their magic alone without the midwife interfering.

The best midwives are thrilled with how unnecessary they usually are to the actual birth process. The best birth stories are the ones who merely give a shout out to the midwife.

So, while yes I do rely on the clinical to help paint a picture and I search for opportunities to educate myself so that I am prepared for the times when I am needed, I strive to be more or less just a midwife. The gal in the background. A member of the clean-up crew.

Saturday, March 5, 2011

What a homebirth midwife does

Because I am so used to being involved in providing homebirth care, sometimes it is hard for me to think back to the times when I really didn't understand a thing about what homebirth was about. I remember when I was pregnant with my daughter and preparing for my first homebirth that I thought I shouldn't bother my midwife if I was having preterm contractions! I went to the hospital instead and just told her about it at our next prenatal visit. I am sure she was exasperated with me, but I have clients do just the same sort of thing. So in order to clear up any confusion, I thought I would write a little post about it. Remember, I don't require much...this is what I offer.

Here is what I do as a homebirth midwife, your midwife may offer different services...
  • complete prenatal care
  • nutritional counseling
  • a little massage, craniosacral work, and myofascial release
  • well-woman care
  • newborn exam
  • provide emotional/physical/and informational support
  • referrals to local resources
  • proof of pregnancy letters
  • Placenta encapsulation and prints
  • sign and file birth certificates
  • blood tests, paps, GBS, and newborn metabolic (PKU) testing
  • Clean-up after the birth (for the most part) including the starting the laundry
  • In-home postpartum visits
  • good old-fashioned mama love
What I DON'T do:
  • Ultrasound
  • C-section
  • Tell you what position to get in to push
  • Count while your pushing
  • Clean your windows or your car

Friday, March 4, 2011

Reasons why I love my fetoscope...

I have a love affair with my cheapo fetoscope here's why:

  1. It is cheap enough to send home with a mom
  2. The tubing is long enough to reach a mom's ears so she can have a listen
  3. It is just the baby instead of a reproduction
  4. There is no exposure to ultrasound
  5. Everything in the room slows down for just a minute while we focus
  6. It doesn't make a bit of noise
  7. It helps me to confirm a baby's position
  8. I feel more connected to the baby
  9. I like kickin' it old school

Thursday, March 3, 2011

Practicing Midwifery?

What are we practicing anyway?

If it is to paying attention to the unique needs of the woman sitting in front of us, then count me in.
As I see it, the goal of midwifery is to recognize how we can best serve women at any given moment, not just to check the boxes off on a to do list of midwifery care. Those to do's may be important and I may certainly do them...but that is not the end all for me.

Physical assessment can give us a lot of clues, but in my admittedly short time of practicing, I have learned that the really important clues come from the time you spend that sits outside of the clinical aspect of the visit. During that time, over laughs and a cup of tea, you learn what this beautiful woman is dwelling on, worrying over, and letting go of. In between the lines you may have an aha! moment that far surpasses what you will learn from her fundal height.

There are times when busy midwives may not be able to just sit and chat, but I feel that it should be our goal. Even when there is no mystery to unearth, there are golden opportunities to educate and/or help to strengthen her trust in herself. I love those moments when a simple prenatal visit becomes a defining moment. Midwives are so blessed to bear witness to the powerful process of pregnancy and birth. I for one want to make sure that I don't miss an opportunity to learn from my greatest teachers...my clients.