Tuesday, August 26, 2014

#LifeOfAMidwife:Struggles

This life is not for the faint of heart that is for sure! Here are some examples of issues often not talked about....

My low beam headlights are out, they have been out. I have been driving at night with the high beams. When will I be able to make it to a garage to have them fixed? Good question!

My oil needs to be changed, see above....

My daughter had her first day of third grade last week, I was not able to drop her off or pick her up. Daddy and Grandma were there, but I was not.

I think I have friends...somewhere out there in the regular world. It has just been a while since we have seen each other.

At my birth center, we have to fight everyday to stay open. Insurance companies don't want to pay us, hospitals are threatened by us and can make life very difficult. The relevant government agencies don't support us and seem to actually hurt us.

My bank account is sad. I make significantly less money than my peers who work at hospitals and don't even get me started on student loan debt.

I wish that I could serve more women and that getting paid didn't matter, but it does. I have a family to support as well.

And yet, to me I have the best "job" possible. I don't want to whine too much, after all, I made a very conscious decision to follow this path and answer this calling. I believe that there are much more important things in life than wealth, however, that does not mean that the struggle doesn't get exhausting sometimes. Why should supporting women and their families be so hard?.....

Tuesday, June 17, 2014

#LifeOfAMidwife: Fluidity

The phone rang, I am hopeful that it is a woman in labor. It has been a couple weeks since I was able to catch a baby, and I feel the urge tickling in my fingers.

I can tell instantly from her voice that this is not the reason for her call. She is early in her pregnancy and experiencing spotting, she is nervous and concerned. We talk. I offer her reassurance and comfort; based on her symptoms this could be nothing or it could be everything. After our discussion, we hang up the phone with plans for her to call me with any needs or changes in her symptoms.

Mere moments later, the phone rings again. This time it is a Mama in labor. Her man is the caller and I can hear her in the background working with her labor. We talk. It is still a little early in the process, so I offer reassurance and comfort. We review labor patterns, I encourage good hydration, eating a light meal and movement. We hang up the phone with plans for them to touch bases with me soon.

Another call, the first Mama. Her bleeding has increased, she is crying, she has questions. We talk. I offer her comfort and a shoulder to cry on; I tell her that now her symptoms are likely a miscarriage happening. Based on those symptoms and the timing of her pregnancy, I recommend that she go the hospital for an evaluation, she agrees.

A short while later and the phone is ringing again. The laboring Mama is ready to come in. When they arrive, she is beautiful, alight in that sweaty glow of labor.  She and her man are working together in such a sweet way.  She progresses well and has a sublime waterbirth to welcome her babe Earthside. It is a birth that feeds the soul of the world. They are then snuggled up in bed, safe and warm.

A final call, the other sweet Mama is now home from the hospital. She has indeed lost her baby, she is heartbroken. We talk, mostly I listen. There are no magic words for these experiences, the only healing is through time. Having someone to listen and simply be present is the support we can give. We then schedule an appointment for her to come in, so we can give her more love and help her through this process.

This is the life of a midwife.....


Tuesday, June 3, 2014

#LifeOfAMidwife

I have to admit that I am pretty much out of the "hashtag" loop, but I couldn't resist....
I have been having a lot of random thoughts lately, so I decided to just list them all together as things that you experience, say and feel as a midwife. Perhaps it will become a little series. Hope you enjoy installment #1 :)

  • Midwives talk about sex a lot; sex to conceive, sex to not conceive, sex during pregnancy, sex after pregnancy, sex during menopause...I think you get the idea here. I recently had one of these sex conversations with a pregnant couple. They were concerned that recently after sex, she had a "long but mild" contraction. We then had a discussion all about oxytocin and orgasm and I said that besides just having sex, they must have had really good sex! Oh boy, the bright red blush x 2 that happened in that room; priceless.

  • When you are at home and doing laundry, you have to wonder "Is this blood or meconium or amniotic fluid or adult stool or...." You get the point.

  • Speaking of body fluids, there is nothing quit like being showered, sprayed, anointed, and getting soaked through your clothes with amniotic fluid during the birth process. I have had amniotic fluid in places I don't care to mention!

  • Experiencing the honor of having the soon to be Mama, who is working so hard, place her head on your shoulder, or place her head forehead to forehead with yours,  to have her lean on your shoulders, to have her clasp your hand in hers, or to be there for her when she opens her eyes looking for comfort and strength. Time can stop in these moments and leave you breathless.

Wednesday, May 14, 2014

We Had Prepared

We had prepared everything for her transfer. Her sweet baby was apparently very contented to remain nestled up in her warm womb. All measurable signs and tests were done and everything pointed to a happy, healthy babe. Mama and her family were hanging in there, anxious to meet this little one, but willing to be patient....

Every birth center has regulations to deal with and work within, we are no exception. I agree with many of our regulations; no Mama's with hypertensive disorders, no twins, no Mama's with major preexisting medical conditions like epilepsy or severe heart diseases to name a few. And then there are regulations that I do not agree with; no Mama having their sixth or more baby and no VBAC's. These examples are by no means a complete list of our regulations, just the first that pop into my head. Our regs were originally written in the early 1980's and can be very restrictive. We struggle with some of them to even remain open to serve our families. Part of the reason why there are so few birth centers in my state (mine, one on the other side of the state and one in the process of opening) is the restrictiveness of these regulations....and we seem powerless to change them.  There is no desire on the part of the state to re-open them. It would literally take an act of (state) congress to make this happen and unfortunately the care of Mama's and Babies falls to the bottom of the priority list when budgets are tight. This is so wrong and is such a travesty, but it is the reality that we currently have to function in. So, we struggle on, we make personal sacrifices and we fight the fights so we can be here to care for our families. And sometimes we have to make decisions based on these regulations that we may not agree with. However, my goal is to remain open and to serve as many families as possible so I must "follow the rules" and walk the line.

We had prepared everything for her transfer, the very next day she was scheduled for an induction as she would be two weeks past her "due" date. The reports had been given, the records has been shared and all was set. Then in the last possible hours, blessedly, her babe decided to make the move.  The birth was beautiful; a wonderful messy mix of strength, perseverance, radiance and sweaty work. Then I got to make one of my favorite phone calls; to the provider who was going to do her induction, and cancel it!

Thursday, March 20, 2014

Midwifery Today

Wow! I am very excited to share that two articles of mine were accepted for publication in the magazine Midwifery Today. For me, this is a huge honor. As fledgling nurse and then midwife, this publication was a powerful source of inspiration for me.  There are no electronic links to the articles in this magazine, but you can learn about this organization at their website http://www.midwiferytoday.com/

If you are interested, you can order single copies of the magazine, my articles appear in the current issue #109, Spring 2014. Of course, you can also subscribe to receive the magazine regularly. (And as a disclaimer, I received no payment for my articles nor any percentage of sales.)

Sunday, February 16, 2014

Midwife Love

Midwife Love may sound silly or cliché, but it is the best description of how I feel right now. I am in love with my midwife-sisters! We are such a diverse and beautiful group of people. Through midwifery, I have had the opportunity to meet women that I otherwise never would have. And many of these women are now dear friends. This weekend, I am a town across the state and had the opportunity to visit one such friend who has recently opened a free standing birth center. She did a portion of her clinicals with us and I am so proud to have played a part in her growth as a midwife. The women and babies here are blessed to have her and her center. I can't wait to hear about their growth and success.

In particular, I am eternally grateful for my midwife-sisters at the birth center. They are a source of strength, humor, support and knowledge. Don't get me wrong, we can also disagree and challenge each other....but what is love without a little challenge.  Being able to disagree and then come to a mutual understanding is a hallmark of love; we don't change each other but make each other stronger. We don't mimic each other or think that we all have to make the same choices. There is great power in our differences.

Recently, I had an experience that really hit this home for me.  It was early morning, I was at the center to be in the clinic.  I was in the kitchen making my (very necessary and much loved) cup of coffee.  The on call midwife was there for a Mama in labor and the midwife who had been on call the day before was at the hospital as she had had to transfer another Mama. The previous midwife had had "one of those shifts"; long and tough, she had been up for 24 hours before the transfer. She returned from the hospital (after the birth and a healthy MotherBaby outcome) and was exhausted.  The first thing that happened when she walked in was a lovely and much needed group hug. The three of us just put our arms around each other and took some breaths, it was simple and took only a few moments but was powerful. These seemingly small moments are among the ones that keep us going in the hard moments. And for these moments, I am eternally grateful.

Wednesday, January 29, 2014

Their Names are Always With Me

Their names are always with me; the names of women that I have had to transfer to the hospital while in labor. I have wiped their brows, caressed their cheeks, massaged their backs, shoulders, arms and feet.  I have done countless flights of stair walking with them, lunge walked the hallways with them, supported them through multiple difficult position changes to encourage babies to rotate. I have fed them and made sure they were drinking.  I have shared this most intimate of experiences and forged a bond with them. I have had to look them in the eye and tell them that, in my opinion, the best place for them in that moment was the hospital. To tell them that all their plans and dreams for this birth will need to be drastically altered. I have shared tears with them over this decision, both in the moment and later in postpartum check ups.

This is what we do as midwives; we walk beside our families, holding space, guarding their health and sometimes making difficult and unpopular decisions. It is an extremely heavy responsibility that often feels lighter than it is. However, in these moments, every ounce is felt to the core. Like many midwives, I keep a Birth Log/Journal of all the births I attend and babies I catch.  I also keep a separate journal for these Mama's, their stories and their outcomes. In this way, I can remind myself of their faces and their strength.  I carry them with me always.