Saturday, May 14, 2011

My Town

My town is (relatively) rural, "under-served", and ... beautiful. There are days that I find myself awestruck at the innocence of the people here, the young families working so hard to bring about the change that we need, the grandparents so active in the younger generations, and the community programs that are so involved in so many areas of our growth. Two Native American reservations adjoin the region, sharing a wealth of rich tradition and cultural diversity.

Even after nearly thirty years of living within thirty miles of the same spot, I still have moments of wonder at the physical world around me as well. My home is a mixture of fertile, strong farmland - capable of bearing grains most months of the year - and rolling hills and thick, tall stands of trees. Rusty tractors and beat-up cars dot the highways and country roads; anything shiny and speedy is less likely to be seen. Deer are everywhere (driving home from my mother's today, I had to hit the brakes twice to avoid last fall's scrawny doe-fawns), with wild turkeys just as present and pesky. A bear loping across a country road is a much more sacred experience; bald eagles are a daily, humbling, occurrence.

(Now, of course - don't get me wrong. There are so many areas that could be improved on; there's the same old political drama as any other area - the community is older than the average town, with a very conservative tilt - as well as tension from a so-called "religious cult" that has had ongoing legal claims against the city government over the past five years or so. Racism/ethnicism between "whites" and Native Americans (as well as members of the religious group mentioned above) does exist in the area despite commitment by many organizations to work towards common goals of unity. Business is always business: our small, not-for-profit, community-run hospital recently "merged" with a larger health care system, and competition continues with other clinic systems in town and with the "bigger, better, newer" facilities located slightly further away. My town may not be perfect - but it may be perfect for me, anyway.)

And yet, with all our imperfections, all our arguments and all our petty squabbles - we really do have it good. On our small, four LDRP obsetretics unit - in which each room has banged up doors, peeling wallpaper, and so many aesthetic no-no's that it's becoming painful to give tours during my childbirth classes - we've celebrated the birth of not one, but two sets of vaginally birth twins in the past few months. In the years that I've been a part of 'my' team, we have had several more sets, both to primiparous and multiparous mamas. (I have not be lucky enough to be present at any of these births yet --- can you tell I'm a bit peeved?! --- but am still so excited/proud/any-number-of-adjectives-fits-here that the diagnosis of "twin pregnancy" hasn't automatically equaled "cesarean section" for our mama's; generally, as long as Twin A is vertex and the pregnancy is otherwise healthy without factors contraindicating vaginal birth, trial of labor has been offered/attempted, and as far as I know - all have been successful with wonderful outcomes.)

As a nurse, I've had the joy of holding patients' hands, helping them breathe through contractions and ease their way to the births of their sweetest creations; I've been blessed enough to have to catch babies (when the doctor didn't quite make it to the room, or even to the hospital in time), and instead of being reprimanded or frowned upon, I've been thank
ed and even praised because of how well things were handled. One mama had a vacuum assisted delivery with her first babe, and a massive laceration with repair; she was terrified of pushing and delivery. With the doctor down the hall, ready for the call, she tried her first push - and with just a little encouragement, gentle support, and the right words... she delivered her beautiful daughter by herself, into my hands, before the doctor could make it down the hall to us. No lacerations, no need for any assistance - only her own strength.

Much of this truly comes down to my own inner calmness. As a new nurse - starting directly into OB/L&D nursing, I was terrified of having a mama "precip" on me. And, of course, two of my first handful of mamas did just that. (At that time, I was new enough that I still had a precepting nurse with me, and I basically froze, leaving her to jump in and catch.) From that point, I had such o
f phobia of having that happen again that I became hyper-vigilant of when a mom might suddenly progress to delivery rapidly - and so I began calling the doctors to come in very, very early in second stage. (Now, if they were midwives they would probably already be there... but that's another story...) La la la da.... fast forward a couple years, I became more relaxed and understanding, intuitive, and comfortable with idea of catching if need be - and, I was entering midwifery school, so the idea of catching was a little more addictive at this point! - I had no precips, because I had finally gotten it down pat of when to call the MD's in so they would get there *just* in time. (Drats!) But, finally, I realized, if and when a baby delivers - I'm all right with that. I no longer frantically instruct a mother to "Stop pushing!" or "Pant! Breathe through this one!" ... if she is going to push because the baby is right there, I am not going to stop her. I don't plan to catch any babies in babyland - but, if they come to my mamas and there's no one else around to catch 'em ... mama and I are going to do it!

I live in a town without high rise buildings, with no Starbucks or malls to call my own; "my" unit has only four labor beds, with peeling wallpaper and drab furnishings, and no OB/GYN's to be found. My countryside is, well, just that - fields, tractors, and farms. To be blunt, summertime smells like cow-shit... but also the sweet smell of lilacs, alfalfa, and fresh-cut grass.

And - I like it this way.

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