Thursday, July 12, 2012

I never wear Birkenstocks..Confessions of an uncrunchy midwife

I have never worn a pair of Birkenstocks. I am not attracted to them and I know that they wouldn't fit my long, narrow feet very well. I think this is surprising to folks who meet me for the first time expecting a super crunchy hippie to be welcoming them to her office (People also expect to see a very old woman because my name is Bettie-I am often a source of confusion). I am not a hippie at all, well maybe I am by the true definition of the word but I don't own anything that is tye-dyed. I don't even think I know how to spell tye-dye (tie?). Anyhow, I am just me.

This, at times, is an advantage to me as a business woman. Many women are considering out of hospital birth who are not crunchy at all. They do not fit the stigma of the homebirthing mother. They meet me and breathe a sigh of relief because they can relate to me. Other times, I admit that I feel like a fraud. What would my clients think if they knew that I keep Capri Suns and GoGurts stocked in my fridge when they are dutifully drinking Kombucha for its probiotic value? I drink Kombucha, by the way but my panty is full of inconsistencies.  I would rather drink a beer than wheatgrass. I like to shave my legs and armpits. I dye my hair and wear make-up and get pedicures. This is all sorta disappointing for the crunchy crowd, but they usually get over it. I can usually speak their language. I get where they are coming from and why. I respect it immensely.

There was a time when I could have been considered a midget crunchy. I used to cloth diaper my babies, grind my own wheat, baked all of our bread, make everything from scratch. I grew a garden and hung my clothes on a clothesline. Then, a series of illness and difficult pregnancies put an abrupt stop to all that and my days of pseudo-crunchiness were over. The kids ate Little Debbie snacks instead of homemade cookies sweetened with sucanat. I try not to think about what the health drawbacks are to that. I simply can not afford to purchase pre-made foods which are healthy and I don't have the time or energy to do all that anymore. I learned that making a wholesome dinner on the evenings I can and providing fresh fruits and veggies are probably good enough. Good enough is good enough sometimes.

Homebirth is not about being crunchy, it is about what makes sense and what works. Homebirth was a natural occurrence for all women until the last 75 years or so when women began to be convinced that being somewhere else was safer. Queens had their babies at home, perhaps they were better attended than their peasant counterparts, but probably not. They were fussed over to the point that they were unable to give birth in a natural way at all. Still, they were home. Regular housewives who never heard of a hippy had homebirths. I still meet old ladies who were born at home, it was just the way. Why do we suddenly believe that the only women who give birth at home are selfish hippies who want a "birth experience" rather than just women who sense that everything would work better if they were left alone to let their body and their baby guide the way? Homebirth works because women are comfortable and are able to allow their hormones to guide the labor process in a way that is usually impossible in a hospital setting. This interference is a risk factor any way you slice it. Of course there are benefits to having an OR nearby, but really for the 90% of women who wont need that OR it is probably not worth that interference. Only 1-2% of all complications would require an OR fast enough to make a homebirth risky. Why are we placing so much fear in women over their choice of location to birth when those risks are so low?

I have never been a hospital hater. I gladly send my clients to be evaluated by physicians. I try to never forget what I don't know. I know that I am well versed in the ways of normal birth; not high-risk birth. I am vigilant about looking for cues that a mother and baby need help beyond my expertise. In fact, sometimes I have sent ladies in who probably could have skipped that extra visit, but I would rather not take a chance. Homebirth Midwifery is not about taking chances in my book. It is about allowing pregnancy and birth to unfold the way it should and knowing that if you are careful not to become complacent you will see the red flags to alert you that medical attention is required. This is why I do all the routine lab work and monitoring prenatally. I would rather ruin a mother's dream of a beautiful homebirth than take the chance that she will regret her decision to have that homebirth against the odds. It isn't worth it. Birth can absolutely be risky at times, but I firmly believe that most women will not need medical intervention. Most women will give birth at home without incident. This is my experience and the experience of my sister midwives.

Let's remove the labels and consider homebirth as something that works and is normal. Let's not fight about it. If people are freaked out about having their baby at home and want an epidural, then let them. It isn't a competition and we are not required to police the choices that other adults make which have nothing to do with us. Instead, just quietly go about the business of having your baby in the way that works and makes sense to you. It will rub off on others without you needing to do a thing. Find yourself a midwife whose philosophy makes sense to you and in whose wisdom you trust...no matter if she is wearing a long tie-dye skirt and Birks or stilettos. Trust your body and your instincts. Let go of the perfect birth and do what works.

I may not be crunchy, but I do marvel at the beauty of birth and the women and babies who I take care of. I am amazed time and time again at how well the process works. I trust in it because I have also seen that when it isn't working we will know if we are humble enough to pay attention. I am blessed to be in this profession. Sorry about the Birkenstocks, I just like flip-flops better.





Back again...

I haven't written a post in awhile. I have been busy rebuilding a new life after leaving my marriage of 20 years. It has been bittersweet. Mostly sweet. It is good to find out that you have enough of a life left to take a huge risk. For awhile, I was treading water and didn't want to do much of anything but watch HGTV. Lately, I have ideas running through my mind again. I feel like I am coming back..changed, but for the better (I hope). Anyway...I missed this.