Inspiration and dedication

A little timeline about me and why I am a midwife...might be a little frank and TMI. You were warned:


1991:

I gave birth to my first child at the age of 17 in an old school hospital, even for 1991, complete with a shave prep and enema. I was "treated" to an epidural. My sweet daughter was born healthy, full-term, vigorous. I was "allowed" to kiss her head as she was taken to the nursery for 8 full hours. We struggled with breastfeeding and eventually switched to formula. It wasn't traumatic, but it sucked. I  remember that I had a lovely, devoted nurse who sat silently next to me and who was my favorite person in the world during those hours.

1993:
I gave birth to my son with my friend sitting next to me, I learned about the benefits of a supportive presence at birth. It was better. All the other stuff? Just about as bad, but this time, nobody was allowed to take my baby anywhere and we nursed for 11 months.

1995:
I learned about midwives from a friend. I planned a homebirth. I paid for most it with cash from our tax return and the rest in payments. My daughter was born at home. It was great, but the best part was just being left alone after the birth was completed. I didn't have an orgasmic birth,  just respectful one. I also learned that I was meant to be a midwife because I wanted to be something like the midwife who just swaddled my baby in a receiving blanket and then sealed her in with masking tape. Not now, you know. I had babies to raise and no family around to help. A husband who doesn't want me to work or go to school. It was not a priority for me to do anything other than raise kids. I would just be a LaLeche Leader and help women to breastfeed. Then, I might also go ahead and become a doula since I was pretty good at being there for other people. I would also buy a LOT of books about birth, breastfeeding, including midwifery texts. I would read them all over and over while nursing the babies to come. P.S. I also learned about how NOT to take birth photos. 

1997:
I learned that I could have a baby well pretty much anywhere if I chill and relax my body. He was born in a military hospital because I couldn't scrape the money together for a homebirth this time. It was my most comfortable birth and I more at ease with my body. This is when I learned to ask other people for help when I needed it, but also that I do better when I do some things on my own. 

1999: 

I learned that I could get through a really crappy birth while signing Fleetwood Mac and The Pretender's songs very loudly ( and anyone who knows me and my music tastes knows that I go through phases). I learned that singing while doing pelvic rotations and leaning over the back of a hospital bed was an even better. This was necessary while I dealt with "back labor". I went through several shifts of hospital staff and was most grateful for my last nurse who sat behind me and gave me counter pressure on my lower back while I rotated those hips once more on a birth ball. She also pretended to believe me when I said that I had to poop and that, "no, it's not the baby". I was very grateful for that trip to the bathroom alone to discover a baby head almost on my perineum. It was oddly empowering after a long labor.

2001:

So, you thought that #5 sucked? Well, let me tell you about my hardest one. Or, maybe not. It isn't necessary. Just suffice it to say that I still to this day believe that I should have had a c-section. I believe it was poorly managed at best and traumatic for sure.  I don't remember a single provider or nurse from this birth with any kind of fondness.

2004: 

On the heels of that last birth, I gave up my belief in my body. I wanted pain relief. I didn't want a natural birth. I didn't want to go through any of that ever again. Thankfully, a very smart CNM didn't buy that line from me at all. She encouraged me to at least give it a shot. I did. It was uneventful, but there was a very funny Stadol element to it that still makes me laugh and also makes me sad because I don't remember much else. It could have been a much more empowering experience and that is still a little sad for me. It is also the birth that makes me understand a lot of my clients and how our previous births shape us. It is humbling, but it is also just what it is and I did it. I also learned that it was okay to choose my health over breastfeeding this time (I needed to stay on a medication to treat an active autoimmune disease). I learned to use breastfeeding behaviors and to love without guilt. I learned to delegate to my older kids a little and as a result, was able to really enjoy a baby for the first time since 1991.

2005:
I went through an early miscarriage and quickly got pregnant again. Then, I gave birth to my last child. She was stillborn. I kissed her tiny head and sang to her and handed her over. I was so sick following that I couldn't celebrate her life. I had five surgeries within a year. I learned all about anxiety and panic attacks. I lost my sense of safety. I lost my ability to bounce back from little things. I lost a little bit of myself. I threw out all of my dog-eared midwifery textbooks that I had been reading for 10 years. I didn't want to go to births anymore because I was afraid to bring my baggage into the room. I remember my obstetrician crying at my bedside and my CNM offering support. I remember the awkward hospital residents who stepped in when it all happened too fast. I remember the nurses who did little things they didn't have to do.

2008: 

My friend needed me. She needed a doula. I was afraid, but my fears didn't matter as much as her need and in realizing that, my perspective changed. I got excited. I researched all over again. Why not get certified? I had never done that. Why not just start the process of becoming a midwife? Okay! I can do this. Is this okay? Is it okay for me to take this step? What about my kids? Is this selfish? Yes, according to a lot of people it was very selfish. It was also a choice that would ultimately end my marriage and that was a big deal. In truth, I made a conscious choice to do something that could ultimately end my marriage. Why? Because I chose to survive and in that marriage I would have never survived. 

Holy crap....I never looked back and nothing was stopping me now. I made mistakes. I made sacrifices. I worked hard. I met a ton of people. I remember the preceptors who helped me along the way. I remember the other midwives who took an interest in me. I remember the fellow students who came along with me. I remember the families who let me learn from them. 

2011:

I did it. I'm a midwife. I'm humbled all over again. I did it. I remember all the people I learned from. I realize that it is time to do what I learned first with being a LLL leader...take what resonates and leave the rest. It is time to be the midwife who I am. It is just beginning all over again. The future was full of good stuff and some really horrible stuff. The midwifery part? It is good. It was the best choice I ever made. I believe that we know when we are meant to be something and that a calling should never be ignored no matter what the sacrifice (as lofty as that sounds). Another big lesson that I learned was that my personal experience, even with 9 pregnancies and 13 years of constantly being pregnant or breastfeeding, was not as significant as the experience of the woman sitting before me. I learned to empathize, but not to know. It might seem like a grey area, but it is an important distinction. It is about believing in the woman and her experience. I remember when I learned to trust women. 

to be continued....

Losing our intuition...

I have noticed a trend lately and it isn't a good one. It is one that masquerades as a beneficial and supportive. It appears to be the fruits of better access to information and support. However, it also breeds guilt, confusion, and worst of all: the loss of intuition.

New mothers are sitting ducks for "helpful" advice. Well-meaning friends, family, strangers, and professionals spew advice freely without any concept of how much the mother has already digested that day, let alone that week. These mothers are exhausted, worried, and confused. They digest all this information and even search for more. They post to groups online, they search for research, they read blogs, they very quickly become over saturated.

I am not one to always reminisce about the "good old days", but I have been helping women long enough to remember when having major breastfeeding issues was a rare event. I can't help but wonder if we are just retaining moms who would have given up earlier, or if we are creating problems in situations where women would have just "muddled through" and been fine. I want to be happy that we have so much help accessible for women, but I wonder if professionals are causing life for new mothers to be overcomplicated. I also wonder if professionals are just not taking into account how many other "professionals" may be involved in the care of this woman, not to mention how many friends, strangers, and websites that she may be consulting with to further confuse the issue. Soon, we find that this woman who is more dedicated than average, is no longer accessing commonsense or intuition, she is just following directions to the detriment of herself and her baby.

I don't have an answer. I do have a suggestion. When you are pregnant, and especially when you are postpartum, pick one source of information and remain in touch with your intuition. I often tell women, "pick the source of advice that best resonates with you and that will best fit the needs of you, your baby, and your family. Follow that advice, listen to your own gut, and then, after that, if you need more help, coordinate with both advisers to avoid confusion.

Mothers need to feel like they are the expert on their own baby. Providers should be careful to assist mothers and support them in feeling like they are, in fact, an expert and avoid creating a sense of dependence. Friends and strangers should remember that they do not have the complete picture when they open their mouths to give well meaning advice that may cause more confusion.

The longer I do this work, the less I say. This is not because I care any less. It is because I have realized that what I say means less than helping a mother find her own way.

The Legacy of Birth

It was a normal prenatal visit late in pregnancy. It was that time in pregnancy when we talk about where she 'is' emotionally, in preparation for her upcoming birth. This particular client is pregnant with her second child. We have talked about her history before, but I know that as pregnancy progresses, so does our perception of a number of things. Her last birth did not go as she had hoped. In light of this, I wanted to explore her feelings and emotions with her to see if there were any areas that we can be aware of as we approach the end. We discuss her vision for her upcoming birth and she states that she hopes that she will be able to deliver her baby outside of the hospital, but fears that she will have to transfer. I am incredulous; before me sits a young, healthy woman having a normal pregnancy. She is strong and intelligent. She has taken care of herself all the way through her pregnancy. She has done everything “right”. Yet, she is riddled with anxiety over being prevented from giving birth without the need for intervention. Why? After further discussion, it comes to light that she has a family birth 'legacy', a legacy that has affected her mother and sisters.

A lot of us have birth legacies. We hear that, “None of the Smith women can have vaginal births because we have tiny pelvises”, or that, “Just like my mother, my water never breaks on its own”, and many, many other myriad of legacies that never cease to puzzle and amaze me, as a midwife. Sure, there are times when family history plays a very important role in prenatal care. There might be an indication for further testing for genetic conditions, or rare physical defects, but almost never will we need to give up any hope of a normal birth because our mother, aunt, cousin, sister, and so on did not have one.

What struck me the most about this conversation was that though these legacies are most often presented without any credible scientific evidence, they are powerful enough to strike terror in the heart of a woman who is otherwise rational and intelligent and who did all her research prior to to choosing a midwife for out of hospital birth. Despite the lack of evidence to support them, she embraces the unfounded theory readily. In my opinion, this is because pregnancy and motherhood makes us vulnerable. In every other aspect of our lives we might be in charge and in control, but in this, we are vulnerable. We think we know what to do. We find a provider that we trust to help us in pregnancy. We eat right, we exercise, and we take classes.  However, we don’t know exactly how to negate negative messages, or to find strength in what all seems like theory. We don’t know have to have faith in our bodies because we don’t know what that means and we don’t know what to do with the legacies.

I was told that I wasn’t athletic from a very, very young age. Why?  My mother wasn’t athletic and her mother before her, and her mother before her. At some point, it all stopped being individual and became a legacy. This legacy was so strong that believe it caused me to be clumsy and awkward while attempting sports. I loved being outside, I loved to play. Yet, there I was; one of the kids who was chosen last for the team. It wasn't until later in life when I started challenging the theories, of my own personal legacy, that I decided to give athleticism a try. I found out that, though I would never make it to the Olympics, I was ‘pretty okay’ while performing a lot of activities. In fact, I can’t imagine life without being active anymore. I am sorry that I didn’t take advantage of my youth to enjoy sports. I have learned that in reality, I didn’t lack athletic ability as much as I lacked confidence. It is much the same in birth. I see women who have done everything right; yet, they believe that they failed on some level because they didn’t do it the way they expected to (even though they might have had unrealistic expectations). I see women who never really try to have a normal birth because they expect to fail. I see women who want so badly to have normal, but feel that they are ill equipped because of legacy.

So, what is the answer? How does one sort through powerful negative messages? I asked my client this question and I thought her answer was profound. She said, (and I paraphrase) “We have to first recognize that they are negative messages." This is the absolute truth. Seeing something for what it is truly makes it lose its power over us. When we look at a negative legacy up and down and call it out for being just that: a negative legacy, it no longer has a claim on us. We realize that our story is our story. Birth does not have to be predestined any more than athletic ability. Some of us are rare and wonderful in our ability to overcome. Some of us are gems who will surprise everyone. Some of us no longer believe in the lies that women have been told for centuries about our bodies.  

Let me tell you what I have learned about birth: Waters will break when they are good and ready to (maybe not until after the baby is born). Babies will come when they are good and ready to. Women who are tiny will give birth easily to big babies. You will have all the tools you need to give birth to your baby.

I speak in strongly because this truth is more probable than improbable. This is my challenge to you: start a new legacy. Start a legacy in which your daughters and granddaughters will never question their body’s ability to give birth. Start a legacy in which they will never question their body’s ability to signal the need for intervention. Start a legacy where we, as women, believe that each woman, baby, labor, etc. is individual. These are the birth legacies we need and with them we can gradually replace all the many ways that we have been lied to about the strength and ability of our bodies. This will never mean that every birth will go as we hope, but it will definitely mean that each pregancy brings with it opportunity rather than limitation. I am so hopeful, that I write this before I know the end of my client's story. I believe in her body. I believe that she has the tools that she needs to have the ending that she wants. I also believe that if it does not go as planned that it will not be because of her negative legacy, it will be the example of the perfect way that our bodies signal their need for assistance and that in the very intelligent and wonderful way that she knew to surround herself with people who would listen and believe in those signals and would act accordingly. The truth is that we need to make our legacies be the gift that the true definition of the word requires. Gifts should never be negative. Legacies should be strong and empowering. Choose to give birth in a way that honors your predecessors, but defines your own legacy. You and your baby deserve to have your own story and I can't wait to hear it.