the midwife`s journal <
|I am very conscious
of my own life as I reflect on my time with a woman for the birth of her child. The big
themes in the continuum of a woman's experience - learning, loving, nurturing, and
trusting are in the present continuous tense, without a beginning or an ending.
You and I have learned to trust each other a great deal, especially in the past month. And we have learned to trust your child, who was content to stay hidden from our sight and touch day after day. Days became weeks, and still we waited. I looked to you, you looked to me, and we both tried to understand what your body and your little one were telling us. I sought an intimate understanding of you two - the dyad under my care. On the one hand you both consistently told me that you were well. On the other I saw that imaginary clock tick over 41 weeks, 42 weeks , and still you two seemed content to remain as you were.
I know you felt some frustration - the many well-wishers and casual on-lookers ensure that a woman who passes her due date is made fully aware of the inconvenience. Yet your body, and your unborn child made no complaint, and you chose to wait.
There were times when I began to doubt myself. What was I trying to prove? Who was I trying to impress? Why not call an end to the waiting and insist that you go to hospital for the induction? Was I reacting to the comment made recently by a trusted colleague that "Joy, you are still stuck in the medical model"? Surely you would understand that there is a greater degree of risk to the baby who stays in the womb beyond that magical 42 week mark. Surely you would trust me when I told you that I must advise strongly against further delay.
I cannot promise homebirth. I offer a one-to-one partnership in which I accompany you in this small part of your journey. I seek to use all the knowledge and skill at my disposal to empower you for the road ahead, to help you prepare for and engage in all that your journey brings. Your journey brought waiting - waiting for the climax which remained just out of reach.
In our preparation time I had told you that if at any time I detected irregularities that suggested complications for either you or your child I would advise you on appropriate medical care. This is what I say to every woman. Collaboration with other professionals is an essential part of midwifery in times of illness. You showed no warning signs, other than the postmaturity.
Easter came, you passed 41 weeks, and I expected you to call me very soon. I heard the words of the risen Christ, "Peace be with you", and I accepted that peace. We talked about checking baby's condition. I listened with my little doppler, and we heard the reassuring acceleration of the heart rate with a mild contraction. We had no hospital arrangement for prenatal monitoring. The hospital would accept you only as an emergency admission. The need for consultation while still planning homebirth was not catered for.
The next weekend came, you passed 42 weeks, and we checked out another option. Another public hospital, a little further away, has recently re-structured its maternity services. That hospital had a clinic at which you could be seen on Monday. As we expected the monitor tracing showed a healthy baby. The doctor, also as expected, advised induction. While declining the induction you accepted an ultrasound to check your baby's wellbeing.
Having completed this process of review, and confirming wellness, your labour began! That mysterious state which had eluded you was wonderfully present.
I don't need to record the events of that night. Your baby and your body worked in harmony and your man was beside you. There was nothing easy about the labour, and none of us had any sleep that night. In the early stages I sat and stitched the hem of a quilt which was waiting to be finished. Later you wanted me to be close as you worked. Then your daughter was born, in her own time and place, and you held her close to your heart.
In the past week I have witnessed a beautiful transformation as you and your man have become parents. Your main teacher has been your little one. In trusting your body, your heart, your baby, and our partnership for the birthing of your child you have moved on into the nurturing phase of the experience with a high degree of confidence. Seeing this makes me feel satisfied. I cannot see what is down the road for you, but I know you have made a good start.
Today I met another young woman whose first baby is also about a week old. She asked me to advise her on breastfeeding. I visited her in her home, and found a woman whose words and actions were in conflict. While saying "I really want to breastfeed" she could not trust her baby to her breast. The process that she described to me was a jumble of bottles and pumps and expressed breast milk and formula. She had kept a diary of times and quantities; even which breast she had used on the few occasions when she allowed her baby access.
The baby was asleep when I arrived so we sat down to chat. This woman not only perceived her breasts to be ineffective, she believed that her body would not have been able to birth her baby either. She had accepted elective caesarean because her mother had had caesareans. She accepted that she had inherited an abnormal pelvis.
I looked at her in disbelief - a beautiful tall young woman with classic proportions. How could she doubt herself? What lie had been instilled into her mind to make her submit so readily to outside control? I commented on how pale she looked and asked if she had lost excessive amounts of blood. She didn't know, but she did recall large clots being expelled from her womb while she was in Recovery. This was done several times, and she had remained there for four or five hours until her condition was stable.1
I shuddered. A potential disaster. A healthy young woman has come near to death from post-operative haemorrhage, and is now struggling to trust herself and her baby.
The experiences of the two women I have written about today have been very different. I feel compelled as I write to affirm the wellness of the woman giving birth. Somehow she needs to know that her body is good. And if surgery has been her experience, who will see to it that she is quickly able to reassert her authority for her wonderful body? Surely that is also the midwife's role.
© Photo used with permission