Saturday, January 29, 2011

sweet squishies

Whew, two sweet squishy babes early this morning. One girl and one boy...and a nice way to get out of the land of negative....

But my mind does still wander, this time to the babes. How do we welcome our new generation to this earth? I can't hope but believe that when newborns are welcomed in love, respect, beauty and strength, it leaves an impression. That they are starting off on the "right" foot. Clearly, empowered birth will not change all of the world's woes....but it could go along way toward starting. Ensuring empowered birth is much more than fostering the few months of pregnancy, the hours involved in the birth and the postpartum time. Empowered birth requires that young boys and girls are nurtured and grown in environments that honor and respect thier bodies and that has they grow to young men and women they respect each other. That girls are raised hearing strong, positive stories about the power and wisdom of thier bodies. An environment that honors birth, is one that honors women and children...and when we honor women and children we honor all life. And that! is a start toward ending the woes of the world!

Ok, so there is one of my 'waxing philosphic' moments. I guess that is what sweet squishy babies do to me.....

Friday, January 28, 2011

a little rant

We have been sooooo quiet! I know, I know...don't rock the boat or jinx anything, but it is getting ridiculous. My fingers are getting a serious itch. I have drained and filled, due to lack of use, too many birth pools. All of this 'free time' has lead my mind to wander.....

Recently, I had an orientation (kinda like an open house for the center) with a lot of great attendees. It was a good crowd, with lots of good questions and interaction. At the end of these sessions, I always stick around for people to speak with me privately if need be. A very nice couple approached me and as she started to tell me her story/ask her question, she started to cry. She is early in her prgnancy and has had some spotting. The "care" she has been receiving from her care provider (an OB doc who she has been seeing her whole adult life) sounds less than stellar. Don't get me wrong, it sounds like all the clinical bases have been covered...but the emotional ones have been abandoned. My initial instinct was to reach out and touch her, give a hug, a tissue and some comfort....which I did, even though I didn't really know her. Then we all talked through her experience, I answered questions as best I could, and held her hand. We spent all of 5 minutes together and at the end she said that I "had given her more care and compassion" than her doctor ever had! Me, who is basically a complete stranger!

This is so disheartening. How can we empower women to demand and get the care they deserve? This story is so common in our culture....we need to encourage and foster change. Don't get me wrong, I am not bashing doctors...there are fantastic, kind doctors out there; just like there are not so great midwives out there. It's just that, all too often, as "patients" women will accept horrible care as "normal". Aarrgghh!

Whew, I have to pull out of the negative, or I could go on and on down that road! Clearly, I need to catch some sweet, squishy babies and get back in the positive zone. Hopefully tonight!!

Sunday, January 23, 2011

breathe, two, three, breathe, two, three...

One and two and three... release
One and two and three... release
One and two and three... release
One and two and three...release
Inflation breaths....come on inflation....come on inflation....I can hear the words as spoken by my NRP teacher....all is so quiet...except the and two and three...release

The labor had been so sweet, such a natural, instinctual process in a Mama who was strong and a partner who was so supportive...

Come on baby...come on baby...join us here...we are here for you...come on baby...
Breathe, two, three...Breathe, two three...Breathe two, three....
Heart rate is up now....join us little one...all is well and you are loved...

The room is so quiet, everything is in slow motion and at light speed, all at once. Just before birth, the waters had ruptured and there was meconium. The nurse and I got everything ready. The little one had been great in labor, so we weren't too worried, but being prepared is always good. As he slid out of his Mama and into my hands, I knew he needed help...dried, stimulated and no response....heart rate 80-90....

A breath!!! That was a breath from the little one, tentative but a breath!!! The arms and legs begin to flex, color starts to flood in...another breath, much stronger this time and then...the best sound in the world, a CRY!!!...Everyone in the room takes a collective breath and baby is handed up to the loving arms of Mom and Dad, the recovery goes easy as pie afterward. All of this happened in about 1-2 minutes....but seemed to last at least 1 year.

This is why we have trained and trained and trained and sat through hours of classes...this situation, to make the difference at these times. In the moment, my hands took over and I just did the drill, there was clarity in the steps and my focus was amazingly sharp. Afterward, is of course a different story, when out of the room I was shaking and tearing up from adrenaline overload. I give thanks and gratitude to all of my teachers along the way....thanks that through their guidance I was able to be there when this baby and family needed to be the midwife.

Thursday, January 20, 2011

conference day

I was able to spend yesterday at conference, which was fabulous, for several reasons. First, I love learning and studying...I know, I know...but, if I am being honest, I am a complete nerd. Going to conferences is one way that I can get my batteries re-charged and it is always great to share stories and experiences with others. Second, there were several of my past fellow nursing co-workers in attendance and it was great to see them!

I went to the conference because I have been working on our policy/procedure for hypertension and that was one of the main foci. Before I finalized my information, I wanted to make sure that it was all up to date and correct. At the risk of sounding snotty....all my stuff was/is right that was a nice ego boost.

The presenter was great, a nurse with oodles of experience and knowledge. In the middle of the event, surrounded by nurses and other midwives, NNP's and NICU nurses. I had a big realization....I love nurses, I am proud to be a nurse and of the work I did as one....but I don't ever want to work as one again. And, I hope that I am always blessed to work out of the hospital as well.

Sunday, January 16, 2011

how long is too long?

We had all been working very hard for a very long time....

Susan was having her first baby. She had a long first stage, but not really much longer than a lot of Mama's who are having their first. She had a good support system, had been able to keep up with food and fluids, and was hanging in there. The she was ready to push. And she pushed and she pushed and she pushed. Susan fought for every little centimeter of descent. But, there was descent...just at a slow, slow pace. Two times during her second stage, we stopped pushing to discuss if we should transfer to the hospital. Susan really wanted to stay, her vital signs were good, her baby sounded great and her husband was comfortable with Susan's desire. I have never seen a Mama push so hard for so long....

I have often had the feeling of treading a fine line. The line between hard work and pushing a woman to give and do just a little bit more when she can. Many women in labor, at a certain point, feel that they cannot continue the work. However, most of the time, this feeling means that they are just about done and will soon have their babes to cuddle. I am continually in awe of the power reserve that women are able to plug into at these moments. The fine line comes into play when a woman may be truly reaching her physical and emotional limit and can venture into the land of suffering. Hard work vs suffering....the distinction can many times be difficult to distinguish.

Susan's birth was one of these difficult times. She was actively involved in her care and the decision to continue with the work, but it was so very hard. Eventually, Susan gave birth to her baby and both were healthy. Susan felt empowered and was happy to have been able to birth her baby the way she did. However, when I saw Susan during her postpartum care, and I saw the multiple petechial bruises on her face and shoulders....a result of her extreme pushing effort over a sustained time, I definitely questioned my decisions. Had I pushed her too far? Had she truly suffered? It was Susan who then reassured me that she was still secure in her birth and confident in her own power as a mother who fought for her baby.

This balancing act is one that midwives must continually maintain. It is one that I am continually monitoring and debating when I am with a woman. Most of the time the line is pretty is those times when the line is blurry that we must be ever vigilant.

Sunday, January 9, 2011

thinking back

Today has been a day full of snow and reflection. Snow often brings me to points of reflection. My thoughts have been wondering to memories of my own births and very different from each other...for many reasons. I have had three pregnancies and two births. My first pregnancy was almost 13 years ago, boy that is scary to say...I have a 13 year old!! How does that happen?

When I was pregnant with my son, I knew nothing of what I was heading into. The pregnancy was a surprise but welcomed. However, I seemed to know two things, strongly and instinctually. I knew that I had to have a midwife and that I had to breastfeed my baby. In hindsight this is amazing to me...where did this knowledge come from? I had never consciously heard of midwives and I had never been around mothers who breastfed. Somehow, I just knew of these things in my bones...maybe some crazy genetic memory. I was blessed to find a great group of CNM's. I had a difficult pregnancy that involved a serious car accident, bed rest and PUPP's(a difficult skin rash). The labor and birth continued with the pattern and were also difficult. My son was direct OP (posterior or sunny side up) and acynclitic. It took four hours and every ounce of determination and strength in my body to work him out. Afterwards, we had a tough time with breastfeeding, including a tongue-tied baby and a full blown case of mastitis. Looking back now, it is almost comical, at the time it was almost tragic.

My next pregnancy was tragic. (I have written about it before in the post titled 'Just a Flutter'.) It was a desired and planned pregnancy...that was not meant to be. Near the end of my first trimester, the pregnancy presented itself to be ectopic. The baby was lost and I was very nearly lost as well. It was devastating and is something that I still work through.

My last pregnancy was also planned and desired. It also had its share of tough issues, including pretty serious morning sickness, that had me loosing weight. The birth however, was glorious. My daughter was born at home, in a pool in our bedroom. I was surrounded by friends and family and had a great midwife. It was empowering and humbling.

Although my two births were so very different, they did share some aspects. They were both drug free and I had supportive people around me. Additionally, I had a similar experience during both. In the depths of labor, that point where you feel that you cannot possibly do or give more, I had the sensation of being in a great line of women. I could see them flowing through time, all behind me, and feel them supporting me and offering strength. This experience during my first birth was also the moment that I knew, deep inside my being, that I would become a midwife myself. So, here I am, on a snowy winter day contemplating these memories. I sit here as a midwife...the journey has been a long and twisty one...but so worth the effort. I also know that it is a journey that will never end, it will always grow and expand, like the never ending line of women flowing through time....

Tuesday, January 4, 2011

the eyes

Laura is a very sweet first time Mama. I had been able to see her several times during her prenatal care and really liked her and her husband, Tim. She had been on our "labor radar" for several days as she had been experiencing pretty difficult prodromal contractions. She had been up through the night for the last three nights and was very exhausted. The physical toll was also starting to weigh on her emotionally and she was definitely loosing her steam. We had tried all of our usual tricks to help ladies get some rest through these situations...and just couldn't get her any relief.

Finally, as a last resort, I called in a prescription of Ambien for her. She was able to take that and eventually get some sort of sleep during the day. Later that evening she called me and really wanted to come in and be evaluated. I was concerned about Laura and her ability to cope with hard labor after the long, long latent labor trip she had been on. When we met, she looked tired, with purple shadows under her eyes. I hoped to check her cervix and have really good news to share. Unfortunately, it wasn't as good as I had hoped...but not horrible either. We decided to spend some time and re-check her in a couple hours. Then, literally 15 minutes later her water broke. It was like a switch went off in her tired body and she was flooded with energy. Her contractions steadily picked up and she started to smile and shine. I think the knowing that it was now really happening, that the "teasing" was over had given her a strong, hardy second wind. Never underestimate the power reserves of a Mama.

Eventually, Laura was in the birth pool and cranking away in solid active labor. She was on her knees, with her arms and head resting in her husband's lap. It was very peaceful with the flicker of candles and some gentle music playing. Suddenly, with a strong contraction, she opened her eyes and locked them with mine. The look was one of strength and vulnerability, beauty and necessity. She needed me to join her on the ride, together we climbed the hill, made it across the peak and came down the other side. In between contractions, she would close her eyes and just breath. The next wave would start, we would again lock eyes and traverse the mountain together. Without words, I knew that she needed me to be there, that when she opened her eyes, I had to be there waiting to walk with her. We did this all through transition, on and on, I was truly with her, intimately on the journey. I knew, as she did, when it was time to push. Five hours after her water had broken, Laura brought her gorgeous, 6# 9oz., daughter to the world.

I will never forget this labor. I feel that I was completely "with woman" as we worked so closely together and I was honored to support this family.