Saturday, November 18, 2006

Midwifery diaries, part 1

In late August, I wrote:

It's been a busy week for all of us for various reasons. I went back to work for the first time since 3B was born, although for only three days. On Thursday, we all took a day trip to Philadelphia to help out a friend of Mama's who is a midwife, which was our first time traveling more than five miles from our house since 3B was born.
. . .and then life intervened and I never finished the post. I was going to write about how strong and wonderful Mama's friend is, but I haven't had the chance until now. I feel that this is an appropriate time to get around to it, however, since (here in the U.S.) we're going into the week of Thanksgiving, when we traditionally look around us to find those favors, large and small, that have come into our life that we're thankful for.

Mama and I, of course, continue to be thankful for everything that 3B has brought us. Sure, appreciate the grinning good morning greetings more than the lake-of-fire diapers, but we are genuinely thankful for all of it. Of course, we wouldn't have made it this far without plenty of help, starting even before he was born. Back then, in what Dad-to-Be calls the "ante-natal" days, which we call the "prenatal" days here in the colonies, also referred to as "back when I had a brain," we wrung every bit of information we could out of our midwives.

And when it came time for birth, we had one dud midwife, but the rest of them were wonderful partners. Although she wasn't with us for 3B's birth, Mama's midwife friend is just such a person, and then some. We're thankful to have her in our lives, and that we get to visit with her the week after Thanksgiving. We'd love it if you all could meet her, but we figured it would be bad manners to invite you to come with us to her house, so I'm going to do the next best thing and invite you into her world--the world of a midwife.

The world of mommyblogs and dadblogs is full of birth stories, including my unfinished tale, but I found it fascinating to read birth stories told from the other end of the bed, from a midwife's perspective. After her first day at work in a hospital, Mama's friend sent out an account of her whole 12 hour shift. Just reading it exhausted me. I immediately asked her if I could share part or all of it here and she thoughtfully replied
My only concern is that most people who aren't familiar with birth tend to pathologize the process and rely on medical interventions very heavily, rather than trusting that it's a normal process that can deviate from normal more rarely than is seen and discussed in this culture. So--my concern is that my email was from a day that was heavy on pathology and light on normal labor and birth.
She offered to share some journal entries from some of her more normal, pre-hospital days, when she was in midwife school. I'm going to start with those, so you can get a sense of what normal days are like for a midwife before moving on to the hospital day, which as she says, was full of "many non-birth related things," but which also showed just how much midwives have to be prepared for--not just, as she says, normal labor and birth.

I'll spread these out over a few days, so it's not so much reading all at once, and I'll pass along any comments to her, since I think she's probably still too busy to read our blog regularly. I hope that you enjoy this visit to the world of a midwife, and that you parents out there remember to give thanks this week to all those who supported you during pregnancy, labor, birth, and beyond.

[Note: All of the names and initials have been changed, and any identifying characteristics have been omitted or modified, to protect everyone's privacy.]

It was one hell of a week--four births in three days and I am tired. They were all fabulous births, however. The first made me laugh--not because of the birth, but because of the postpartum period. The woman (AG) laboring is so fabulous and sweet and I have been really looking forward to supporting her during her birth. She has this incredible family--one of her sisters also had a homebirth with Kathy and Sally, her other sister was going to a birth center, but had a precip birth and AG caught her baby at home for her. AG does childbirth education. She embodies kindness and love, as does her husband. Her whole family was planning on being at her birth and it just sounded like fun (for us, anyway).

She had a long latent phase (about 2 days of irregular contractions) and finally hit a point where she needed us there. When we arrived, she was just getting out of the tub and it was obvious that she was well into active phase and soon to deliver. She was nervous about being checked because she didn't want it to be a discouragement, but after a time, she felt like she wanted to know where she was. It was interesting, because Sally was heading into the other room and I asked her if she wanted to be there while I checked her and she said, no, she knew I could do it. I said, yeah, it's not hard. Then I put my fingers inside her and had no idea what I was feeling. Well, not exactly--but I couldn't immediately find her cervix and, intuitively, I knew that she could not be long, closed, and posterior (LCP) from the way she was laboring. I didn't want to dig around looking for it--because her own childbirth education knowledge would tell her she wasn't dilated. I didn't want to say she was LCP because it sounded so awful and discouraging. But, her cervix wasn't immediately obvious to me--which was distressing.

So, I took my hand out and said I wasn't sure what I was feeling and I wanted Sally to check instead. So, Sally did and she was fully dilated (FD) with a bulging bag of water (BBOW) and a slight lateral lip. What I thought was anterior vaginal wall was the BBOW and I hadn't recognized it. AG broke into tears she was so excited and I sort of burned up with embarrassment. I couldn't believe I didn't recognize that--especially after I had been so confident about it to Sally only minutes earlier. Later--when we talked about it--Sally was really supportive, telling me it was great that I recognized that I didn't know and asked for help. She recounted a story about a student who checked a woman and said she was FD and encouraged her to push. Quite awhile later--after no apparent progress/descent--the student checked again and turned bright red in the face. Apparently her first check had been wrong and her cervix was only 6cm dilated. I suppose this made me feel better--but it is still awful to make mistakes and to be so unsure--especially in such intense moments as labor and during such invasive things as a cervical check. I know I'm allowed mistakes--but it doesn't make them feel any better when they happen. And--ugh--LCP versus FD? Seems pretty obvious, no?

Anyway--that wasn't the part that made me laugh (obviously).

Find out what made her laugh tomorrow . . .

Subscribe with Bloglines
Now with complete posts!

1 comment: