the midwife`s journal <
25. sunshine and shadow
I have forgotten your actual words. I was very tired as I prepared to leave you resting in bed, nursing your daughter. You said something like "Im surprised that you will admit that you have doubts". Yes, I have doubts.
A little later, driving through the empty suburban streets, I found myself reflecting on my doubts. With my heart full of thankfulness, sharing in your sense of triumph over your personal obstacles, I could allow myself to enter that darker corner.
You asked me to be with you, to help you reclaim your own birthing process. The caesarean had left a scar not only on your womb, but on your mind. You needed me when, under pressure from your medical carers, you wanted help to get labour started. Then, as wave upon wave of birthing energy gripped your body, as you cried out "no, no", you heard my voice and your cry became "yes, yes".
As each medical carer who came near you reminded you of your scar, that this was a trial of scar, and offered to take away your control, you resolutely kept going. Even in the noise you made you seemed to be claiming the space as your own. That was no calm, ordered, sterile hospital it was your birthing place.
Unremitting back pain, tiredness, your need for your mans strong touch even when he was becoming weary all were balanced by your determination and strength. I can say that now. I had my doubts at the time. I hear the words "I dont think I can take much more of this" from many women, and I heard them from you.
I have no birthing magic. I carry no potions that will make it happen. My confidence is in you, the woman. I know that most women, given appropriate support, are able to birth their babies under their own powers. Not the 40% of the Victorian Birthing Services Review more like 90%. Our bodies are not perfect, and even the woman who has no sign of any risk factors may need to call on outside help. So I, the midwife, must never close my mind to doubt, or in doing so I could endanger someone elses life. That small doubt is balanced by a bright hope which I have stored up from my experience, and the combined wisdom of many others. As a mother I know that you receive hope, encouragement, empowerment from within. You progress and your body tells you that you are on the right track. And your hope is counter-balanced by the doubts in your mind, the product of your own experience and perceptions. I do not try to hide or remove your doubts rather I try to enhance your hope, and protect you from taking on extra, unfounded and unnecessary fear.
I reflect back on the events leading up to your babys birth. At any point doubt could have overwhelmed hope. But it didnt.
Your waters had broken, and you needed to labour. Memories of last time ruptured membranes at 34 weeks, no labour, emergency surgery, separation all this and more threatened your flickering candle of hope. You told me how dreadful it had been for you to go home without your baby.
The medical model seemed to offer two options: a caesar now, or induction. You told me how powerless you felt in the face of authority. I understand. Society has conditioned us into easy submission.
The midwifery model as I practice it depends on your readiness to engage your body in its work. My system of nipple stimulation will not work if the oxytocin released when you lightly touch your nipples is blocked by adrenalin, the fear hormone. An attempt at self-stimulation of labour would be at best useless, if not offensive and counter-productive, if you did not feel comfortable in the process. This is not something that can be done to a woman.
Other midwives may have alternative therapies homoeopathics, herbs, energy work, manipulations, oils to try. I am a very plain midwife. My faith is in you, and your bodys wonderful ability to do what it wants to do.
Labour progressed quickly. I think you were surprised by its intensity. We went to hospital together, and we worked through the contractions, one by one. As you had planned you rejected the hospital protocol of continuous fetal monitoring. Every time we listened to your baby through the first stage she reassured us that she was strong and well.
I dont know why the second stage did not progress normally. The asymmetry of her head, tilted to the left, with the circular swelling from the vacuum cap over her right parietal bone indicated to me that her passage through your birth canal had been difficult. We were thankful for a medically assisted birth, and I know that your sense of achievement has not been dulled in any way by that timely intervention. Collaboration with medical experts is an essential component of midwifery. You gave birth to a healthy, alert little girl, and neither you nor she had received any chemical mind-altering substances that would have interfered with your experience or robbed you of your memories.
While I was with you I could not be with another woman, whose homebirth planning meeting was booked for that evening. I was to be second midwife. My colleague went to the home without me. There she encountered a dark shadow that baby had become still. There were no movements, no reassuring sounds from the warm and safe womb.
The day after you gave birth that mother birthed her darling, helped by his father and his two brothers. The birth was quick, and my friend arrived a little later to give care and support.
Bright sunshine casts deep shadows.
As I treasure my memories of being with woman for your daughters birth I also share the sorrow and loss of another woman and family.