10 Rules for Avoiding Complications or Transfers During Labor:

It is human nature to immediately search for a solution when presented with a problem. Or, perhaps it is just the nature of birth workers and other people in proximity to a pregnant woman. I wish that I didn't have a list of examples of when women had their perfectly normal birth hijacked by well meaning people. Here is some food for thought. There are always exceptions, but don't assume that you are one of them. Also, keep in mind that you can do literally everything right and still have a complication. So, this list is not meant for you to feel guilty about. You can't change what already happened. It is a list of tips for prevention.

10 Rules for Avoiding Complications or Transfers During Labor:

1. Trust your provider, or find a new one. 

Don't think that you can choose the c-section king of the county and hire a good doula and all will be well.  It only will if you have your baby in the car on the way there. It is not too late to transfer most of the time. This goes for midwives too. Not every midwife is the right fit for every woman. If you don't trust your provider it is a big problem that could have affects on your ability to give birth and their ability to care safely for you. If you are supplementing your care, in routine situations, with another provider beware that this can cause a confusing "too many cooks in the kitchen" scenario. I see this in women who want midwife care but also want to see an OB "just in case". Why? If you aren't feeling safe with this provider and trust that she will consult as needed, just go with the OB.

2. Don't tell your family and friends what your actual due date is.

Avoid the unnecessary stress that having people breathing down your neck either in person, or through technology brings. It does affect you. My solution? Just give them a due month, or add a couple weeks. It is okay. They know not what they do.

3. Do not be tempted to put yourself into labor early. 

Just don't. It either won't work, or it will work enough to put you in a dysfunctional labor pattern that will tempt intervention. Be still and know that you will go into labor.

4. Do not let your (doula/herbalist/neighbor/online group) muck with your body. 

I know that people will not like this one. Too bad. Who are we kidding here? Intervention is intervention. If you don't trust your provider to give you good advice, find a new provider (see number #1). Herbs, oils, etc are INTERVENTION. Period. Intervention is fine when it is necessary, be sure that it is necessary. I have had alternative health providers cause transfers in completely healthy low-risk women by creating a complication. Don't let this be you.

5. Do not invite 50 people to your birth. 

This is not a party. This is physiology. It works best in the absence of pressure, in a dark, quiet, and safe place. There are absolutely exceptions. If you think can poop in front of all the people you can ignore this and invite away.

6. Don't keep things from your midwife or doctor.

If you ignored Rules #3 and #4, or "forgot" to disclose a bleeding disorder,  heart disease, etc, etc just admit it now. It's okay could keep you and your baby safe. While there are certain conditions that are incompatible at home,  know that midwives want you to have the birth that you desire. You would be surprised at how often we are able to find a way to work around risk factors to achieve a goal that accommodates your wishes and keeps you safe.

7. Don't expect your partner to be your coach. 

Be realistic. Most partners are going through their own stuff.  If they aren't up to it, ask someone else. There are partners out there who put doulas to shame but there are also some who need to be in a safe room until the baby is born. Know your person.

8. Don't have a coach. 

You don't need a coach, or even a method. You need to have things in place so that you can get out of your own way and have a baby. This is hard. "Coaching" implies things that do not help women labor. Most women do best with a quiet, supportive presence in a safe place. Explore this and come up with a plan that is best for your individual needs.

9. Be Realistic.

Understand that things happen, judgments are made, complications occur. It does not have to be your fault or the fault of anyone else. It is even okay if red flags where seen, changes were made, and it ended up being okay in the end. We cannot predict outcomes but we should always listen to warning signs. Sometimes everyone does their very best and it doesn't work out.

IF, someone really does you wrong send me their name and I will quietly "take care of it"

(wink, wink).

10. Don't over plan. 

Birth can be breathtaking. There are lots of pictures floating around with water, candles, and bikini tops. However, there are also lots of beautiful births that occur on toilets, floors, in closets, and doorways. There are beautiful births that occur in operating rooms after a stress-filled transfer from a planned homebirth. There are beautiful births that occur after a long, long labor, epidural, and everything medical in the world. I do not negate that some births can be traumatic but I notice that women are less traumatized when everyone was realistic, she had trust in her provider, and she and her partner felt part of the decision-making process (see #1).

Do not plan to give birth in water or any other place.  Don't worry too much about what positions you will be in, or what comfort measures you will use.

Prepare yourself. Be mindful.  Learn to relax your body. Learn to let go. Find a way to immerse yourself in nature. Don't push fears away, explore the things that trouble you during pregnancy. Clear the air. Have a back-up plan. Don't place pressure on yourself to 'make something happen' when you should be going along for the ride.

It will be beautiful and if, for some reason, it is not you will deal with that later. Finding your ability to trust this process that is bigger than you is the stuff that life is made of.

Allow the power of birth with all its mysteries and lessons to unfold.

I believe in you.

Yesterday, Today, and Tomorrow.

I am no Beyonce, but I know lemonade. In fact, I am in the process of whipping up a batch right now. It is still a little sour, but think about sitting down with me anyway. THIS is who I am right now. THIS is my life, and just because it isn't currently the stuff of a fairytale ending, it is no less valid. How often do we share the struggle that we are in rather than the one that we overcame? Indulge me. Let me do it. Forgive the self-centered, sad, and bitter place that I am in. It might be worth it. I am really good at oversharing. Let me do it while I am making lemonade and not drinking out of a paper bag in front of a check cashing store.

Today, I am a woman who has a mind flooded with questions. I am grappling with a sense of bewilderment over my circumstances. Today, I have no idea which one of the many ideas that I have will be the one that works. Today, I am living in an upside down world where the one thing that made sense for years and years is not what I am doing. Today, I am just sick of trying to rebuild..

I had a personal tragedy in January 2014. It is a story that I might not ever publicly tell and certainly not today. At the time, I had a thriving homebirth practice, my profession was not the problem, my personal life was. My profession was my safe place. I could have the whole world falling apart at home and rock a birth. I could feel like a failure as a mother and woman and feel like a good midwife. This tragedy rocked me off of my axis and instinctually, I knew that I had to leave that place to survive and rebuild a safe world for my kids. It wasn't neat and clean, it was messy and filled with regrets. It meant leaving things behind and maybe even creating problems for others. Yet, I had to.

Arizona. A birth center! A steady paycheck! Regular hours! The West beckoned me. It felt familiar; I was from there. I even had family there. From the time that I landed in the bright sunshine at Sky Harbor, to meeting all of the beautiful women who would become my clients and co-workers, it felt right. More than right, it felt like I had done something right to be given this opportunity and I didn't take it for granted for a second. I couldn't. As single mom, a CPM, and a woman walking away from everything that she had known for 17 years; I had to be on my game. There were minor rough patches. Overall, I thrived in a setting where I could put aside my own ego and be part of a team of midwives focused on good care. It was easy, because as a midwife, birth is never about me. It is about the women I serve. I happily worked extra hours and gave up time off. I spent hours on the phone talking over our clients on two hours of sleep. I loved it.

 A year later, I was inexplicably feeling tension, but I was determined to ride it out. I remember saying, "I love and need this job. I am not going anywhere." It wasn't about my work performance, it seemed personal, so I put my head down and showed up. I poured myself into the relationships with the clients and my co-workers, all of whom I adored. I made efforts with the people who didn't like me. It seemed to pass. I received a raise and a glowing yearly review without a single criticism. I thought I was okay. I planned to be there for years and years. Maybe even decades.

Another year passed and again, I found myself in the midst of a situation with tensions that I couldn't rationalize. I was determined to be part of a solution and to handle the issues that had come up respectfully and purposefully. As part of a team, I participated in carefully preparing what we hoped to be a fair and solution based proposal. However, before we could present it the sky fell in.

I was not a strong as I would like to relate to you. I remember quietly pleading, "Please don't do this." I remember being backed into the proverbial corner crying in front of people who did not seem to be sorry to see me go. You know how sometimes you cry when you really want to go all Jerry McGuire on people? Yeah, that was me. I was told that I was replaceable. I saw this perfect thing that we had crumble. Devastation isn't a good enough descriptor of how I felt.

 I had one month to get a job before my checking account was empty. Here is the thing about being a CPM in a state where you have only lived for 2 years while working 60-70 hours a week at a birth center: there is no job for you. I scrambled to start a practice. I had a website up and running in a matter of hours. I had glowing reviews from past clients. What I was missing was an income. I had started a business before. I knew that it would take a good year to be able to pay myself, but I didn't have that luxury.  I didn't have another income. I had a boyfriend and we had just started living together and sharing household expenses, but not a checking account. I worried that said boyfriend was going to run for the hills after the independent and gainfully employed woman he fell in love with turned into a jobless wreck.  I panicked because I was at the tail end of digging myself out of the debt that my divorce, business, and move had left me in; I had no savings. I had to get a job. Here is another thing about being a CPM: your credential doesn't translate in the work force. Outside of homebirth and birth centers, being a CPM is a tough sale. I took a position were I was told that, "maybe you could get a CNA" and was trained by a medical assistant on how to fold robes.

Don't get me wrong, I was grateful for the work and anyone who knows me knows that I will happily and without complaint, catch a baby, chart, suture, and then go clean the mama's toilet and start some laundry. I am not too good for folding robes. However, it was the fact that I had gone from a job where I specialized in complex decision making and now was only allowed to answer phones and perform other menial tasks. I had gone from being trusted with what mattered most to people to being trusted only with things like collecting the mail. Worse, I found out that the person whose position that I was supposed to be taking, was not leaving after all. Worse, that person seemed to be hell bent on making my life miserable.  Worse, I was moved to a corner in a file room isolated from the rest of the office because I had no place. Worse, I found out that I am too old to master in the art of handling mean girls. I was having babies and cleaning toilets when those girls were perfecting their skills. I don't know the secret handshake. I am the guy in the corner (literally) wondering when this will pass.

I tried pathetically to be proactive. I hung inspirational quotes in front of my computer monitor and looked at them to keep going. I took to finding little undone things that I could help people with to make their life easier. I showed up early. I cleaned shelves and organized things. I found solace in the patients, I understood them and they understood me and it was nice. Outside of work, I started classes  to get a nursing degree and give my future self the security that I was currently lacking. I fell into a rhythm and routine. I counted my blessings. I restored relationships with my kids. I let myself feel safe with my partner.

I thought that work would improve and I would have a job for years to come. It did not seem to improve. I started getting sick all the time. I was miserably exhausted and burning myself out trying to "make things better." I started to jump when people spoke to me and winced when I realized that this was going to be complaint number 3, 4, or 5 for that day. I had to take breaks from my desk to cry in the parking lot. Then, I arrived to work one day, still running a fever after being out from the flu for two days and was told that it wasn't "working out." And just like that, I was packing up my things in front of people who didn't seem to be sorry to see me go. Fired, for the first time in my life.

Yesterday, I wondered why a woman who had caught over 350 babies and was good at what she did was trying to drive for Uber. Yesterday, I lamented for the millionth time why I wasn't still working at the job I loved and was good at, the job I moved 2,500 miles to take. Yesterday, I felt guilty that the few close friends that I have are forced to listen to me struggle for six months straight. Yesterday, I got my unemployment debit card in the mail. Yesterday, I showed up for my class and took an exam and studied for finals. Yesterday, I looked at the face of my new granddaughter on my phone and knew that it would be awhile before I could afford to go see her. Yesterday, I had panic attacks and night sweats as I fought away the lies, the uncertainty, and the shame.

I am still a midwife, that will never change. I am grateful for the former clients who have found me and asked me to care for them during their pregnancies. I am grateful that, because of their trust in me,  I am able to hold on to what I know. I am able to focus on them and not me. I am working on things that will allow me to do what I am good at while continuing to work on having that security that I need. However, it is hard to build a business with no funding.  I have to wait for the word of mouth and the little opportunities. It is hard to ask a man, who is making sure that you have a roof over your head, for more. The business ideas are good. College, even the repetitive stuff, is good. Underneath this current pain, I am still me. I am the person who can build a business and can give excellent care. These hurts do not define me, even if they delay me.

Today, I wish I had a neat little explanation for what has transpired in my life, a nice little object lesson for my readers. Today, I am holding on to snatches of hope that come in the form of ideas for the future. Today, I am grateful that I have enough mental clarity to write this, even if it is a bit risky. Today, I am making lemonade. It is still a little sour, but don't let that stop you from coming over and sitting down with me. I am good at making lemonade. I will keep working on this batch until it is ready to pour over ice and sip on while sitting in the shade somewhere.

Tomorrow, I will wake up. Tomorrow, I will hike through the mountains and contemplate and find the good. Tomorrow, I will start again.

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. 

A very personal poem

Mother

A decade ago I sat outside

I looked for beauty

I would find enough to justify little gifts from God

Hummingbirds who took the bait

Blue jays who played in the trees

 The place that I created; a little spot to hide the rest

Big enough that if you set your gaze just right

You could only see beautiful

Sometimes I sat and did nothing but find the beautiful

I would become filled with wonder

 That the woodpecker joined me for coffee

That the eagle circled overhead

I pretended that there wasn’t any darkness inside that door

Sometimes I was inspired enough to write things that nobody would read

To sing even when I was told to be quiet

I laughed and danced and loved

Sometimes, if I were really lucky, they joined me

I hugged and kissed them all

I wondered if they would ever know

How big my heart grew when I looked at them

How lucky I felt to have them

Its how I was able to go on

I was given these little gifts from God

Signs that it was all okay

Now, in the courtyard

There are only things that I have placed there

The little deer that belonged to grandma

The wind chime I bought as a token of freedom

I haven’t charmed the hummingbirds just yet

But, there is peace here

There is never a need to escape from what is inside the door

There is never a need to play the game of finding gifts from God

Now, when I am inspired I sing, write, or dance

I have no critics

They still lack an understanding of the way my heart grows when I look at them

They are not all here for me to hug and kiss

My heart aches for more, but rests in the knowledge that they have better now

There is no veil over the truth

Someday, if I am really lucky, they will all join me

And we will see the beautiful

It's not about us...

Even the most humble of birth servant will have a time when they feel that they "saved" a mom or baby or both in the course of a birth. This feeling may be more truth than fiction. The wise eye of experience or intuition may catch on to the red flags and spur appropriate action that changes the course of the event from tragedy to triumph. This is why we have midwives, right? To safeguard the birth and save lives, right? Wrong.

The truth is that we are simply there. Our passion for our work, our study, our innate and learned abilities are not the key. The key is that the mother-baby unit will nearly always reveal that attention is needed to those who pay attention. We should be marveling more over this wonder than praising those who preside over the birth in the role of professional. In this knowledge, we should be able to step back even more. To allow the birth process to unfold without unnecessary interruption and to feel that we are needed more to protect the physiological process than to manage it.

The bigger job of the midwife is to assist the mother during pregnancy in believing that her body is capable of wonders beyond her imagination. To prevent her from being mired down in details. To support her in tuning into the the spiritual and biological magic that is developing within her. Her body has the tools it needs to make this safe and functional. The real trick is to teach her how to get out of her own way and to embrace the mystery of it after she accepts the science.

The pitfall in birthwork is that our culture is so far from supporting mothers in that journey that we are tempted to create cookie cutter solutions to a problem that stems from our own births. Can we believe in something that we ourselves have never experienced? Can we promise something that can be nearly impossible to comprehend?

We not only can, we must. Our survival depends on it, as dramatic as that sounds. We need humans running around this planet who were marinated in Oxytocin. We need mothering that stems out of ecstatic birth. This is not to say that the births that go awry are tragic because we are blessed to live in an age where we can actually prevent tragedy in birth and we should. It is that we should not go around preventing tragedy when nothing was wrong. We should not save anyone who does not need saving.

I like to imagine myself in the role of midwife as the servant. Maybe I have sharp skills and a vast knowledge of normal birth, but I would rather be outside the room because she will be better off without me, or standing nearby showing her I believe that she is fine, or laying next to her quietly to show her I am not going anywhere, or sitting at her feet amazed at what I get to witness when I do almost nothing.