Going back a few steps... to a birth story

One blog I love to follow is "My OB Said What?!" (If you haven't checked it out, and are a fan of birthing/pregnancy/empowerment & advocacy, etc --- I strongly encourage you too! :)

Anyway, the site allows readers to share off-the-wall, rude, demeaning, jaw-dropping, and sometimes just plain ridiculous comments that their OB's/midwives/nurses have made while caring for them. It can sting to read some of the stories shared - but is also eyeopening. As a provider, caring for women and families... it is hard to realize how much impact a few words can have on a woman looking towards you for reassurance, guidance, and information. (I hope that I never end up on MOSW --- unless of course it's on "Thoughtful Thursday" --- but as sometimes we all have those moments when we find our foot in our mouths... *gulp*)

Back to the point, here. Recently, one of the posts revolved around a woman who asked her nurse-midwife why she decided to become a midwife. Rather than sharing her love of women's health, the normalcy of pregnancy, or helping bring new life into the world, the midwife explained something about not wanting to take the time to pursue a degree in medical school.

Doh.

Of course, the comments to this post were varied, some defending the midwife and the current, exhausting med school process, while others were shocked and appalled that this midwife was clearly a doctor in midwife's clothing (if you will). A few were just grateful that she was "honest" about her path to midwifery, which would lead them to quickly switch providers.

But to me, mostly, it led me to ponder... why did I become a midwife? What led me here?

I think, to answer these questions, I have to start with my own birthing experiences... (I'll start with my youngest, as I wrote it shortly after her birth; as I re-read it, some things jump out at me and I think, "my, how things have changed!") More on that, as well as my older Mini's story, soon...

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Birth of the Mini-est

It was early June, and I was miserably pregnant - but still far from my due date! Since my first daughter came right at 37 weeks, I had this faint hope (although I knew so much better) that #2 would also come early. So, once that 37 week mark came and went, I started going insane and feeling ridiculously overdue. Like every pregnant woman, I started examining my toilet paper, panties, poo, and anything and everything watching for the "signs" that labor was imminent. Of course, I had them all... and they didn't mean a damned thing.

I really wasn't THAT miserable, except my pelvis felt as though it was going to crack in half (and made a noise that reminded me of being a kid, and pulling the legs of my Barbie's apart - and then having them 'pop' out of the little plastic sockets, with that white plastic stuff... remember that? Eww) and I couldn't sleep for crap. I was achey, and kind of sick of having to hold my uterus up off my bladder to pee, and puffy - but could have been a lot worse. Still, though, I decided it was time to start working on Operation Baby OUT.

I walked, walked, walked, made my poor dh do things he probably did not care to do with a cranky, swollen whale (sorry about that, dear...), ate jalepeno poppers by the handful, climbed my wobbly self up onto a bike... anything and everything! Finally dh reminded me that the night before #1 was born, we had pulled weeds in the little flower garden out in front of our house. I rolled my eyes several times but decided what the hell... so A and I went out there and yanked half-heartedly at some weeds. Definitely made a dent, but the flowerbed still looked horrible. Had some dinner (don't remember what...!), went to bed (and again made my poor dh make a, um, prostaglandin deposit...?!), and thought about my big to-do list that I had made to keep myself busy and not looking for those aforementioned 'signs'. (The list included a pedicure the next day, calling to take 'call time' the next day at work, picking up some quilts at the dry cleaners, etc, etc)

Around 3 o'clock I woke up... with wet panties. Ewww! But, just like the first time around, I knew that it was amniotic fluid and not just a leaky bladder. To be sure, though, I snuck to the bathroom and fished out the nitrazine swab I had "accidently" liberated from work, and swabbed my gooky underwear - and saw a bright blue response immediately. Of course my heart was racing, and I got all shaky and excited (I had been dreaming of this and playing it in my mind for months, mind you!), but decided to shower before doing anything else... a girl's gotta be properly shaved for these kind of things, you know! So, I took a shower, then got online to kill a little bit of time and logged onto contractionmaster.com to see where my contractions (or lack of) were at. I also turned on the TV, and apparently at 3:30 a.m. there isn't a whole lot on - the old "Roseann" rerun where she's pushing free samples at the grocery store was all I got. Finally, around 4 I woke up dh, got his butt in the shower, and then after informing Jana of the change and rewriting my to-do list (so much for my pedi) we gathered the bags and walked over to the hospital. (I had called to let them know we were coming while dh was showering)

Go there, registered, got up to room 233 - and had the nitrazine now come out negative. Still not having much for contractions, and wondering if we'd even be staying. I was 2 cm at this point and pretty posterior (from my own guesses, I had been thinking I was around 2 for a while already) . But, nurse Angie decided to just put the IV in "just in case" (I was GBS positive this time), and wait and see - this was around 5 a.m. Assumed that Dr. Q would be coming in around 7 during rounds, so dh napped on the couch and I read my book ("No Country For Old Men") to pass the time... eventually reading only between contractions. By 7, I was definitely feeling them, but doing all right - I think it was around then that I put down the book, though; with the bustle of the day shift coming on around 7:30, dh woke up and turned on the TV, and kept asking me what I wanted to watch (not getting that I couldn't care less at this point!). My nurse manager - i.e. boss - came in around this point as well, and I remember talking through a contraction or two while she was in there, and afterwards thinking, "Huh, so far so good - I can still talk through them!". After that, though, they kept getting stronger, and I had to focus pretty intently on my focal point (the upper left drawer pull on the entertainment bureau) and breathe through them; I was also battling an achey back which I blamed on the bed... I started piling pillows on the bedside table and trying to hunch over it during contractions. Once or twice dh and I 'slow danced' through them. Around 8, since there was still no sign of the doc, I decided to hop in the shower both for the relief from the back pain and contractions, and also just for something to do to stay awake. Things got pretty intense in there, and I remember a few times thinking that if I pushed a little it might help... (it didn't). Still no doctor, so I stayed in there and alternated the hot water from my belly, to my back (or as best I could), to right at my perineum. I worked at visualizing that little head stretching my cervix and moving down... until finally at about 8:45 Dr. Q poked her head in to see how I was doing, and told me I didn't have to get out to see her if I was doing ok. By this point, I was thinking that I might be ready for something for pain, if things were moving - maybe nubain?? And I just wanted to know if things were progressing; if I was still only 3-4 cm's dilated I think I would have died, or begged for a c/s. I still felt like I was doing great... just tired!

So, I popped into bed, and she offers to break my water if I want; she also says that she has the nurses mixing up my second dose of ampicillin so we could get it in "just in case". I tell her it just depended on where we were dilation-wise if I wanted my water broke, and that I was maybe getting to the point for pain meds... so she grabs the amnihook and does the check. And pronounces me 9 cm! Since I had this great fear that I was only still 3 cm, I was pretty pumped... especially since I still had this mindset that things still had to get A LOT worse before getting to pushing. She decided against breaking my water, and the flurry of activities started (warmer and table coming in, that last dose of antibiotics being run in over 10 mins, etc) ... once the antibiotics were done, around 9:10 a.m., she broke the rest of my water (strange feeling!) and we started pushing. Pushing was awful! Last time I loved it... this time it killed me. Part of it was due to baby --- which also explains some of the back pain, which apparently was back labor! --- being posterior and rotating during pushing. At one point Dr. Q offered me some lidocaine gel to help with the burning, and I replied "it's not going to help at this point!" and everyone laughed at me... and then with the next contraction and push, I was ready to beg for it (except the head was coming out, and I couldn't get the words out... a little late, I guess!). Again, the best feeling in the world was when the shoulders slipped out and my second daughter was born at 9:15 a.m.

Due to a short cord, it was clamped right away (although I don't think I had even told the doc that I wanted to hold off on clamping/cutting until after it stopped pulsating) and cut by dh, and then she was placed on my tummy. I fumbled with the snaps on the gown, trying to get her to breast, until nurse Terrie said "it's easier this way" and just pulled the gown up from the bottom. Smart girl! She latched on easily and went to town... but I was still in awe of how HUGE she was!

Long story short, it was a very fast, relatively 'easy' natural labor - no pain meds, no unnecessary interventions. We did almost immediate skin-to-skin following birth, and my perineum remained intact with just a tiny skidmark. Recovery was fine, although the cramping was much, much stronger than with my first daughter - it was really worse than the labor was. My back was sore for a few weeks afterwards, but all in all - not too bad!

Olena Marie was born on 6/11/08 at 9:15 a.m., weighing in at 8# 7 oz, 19", and a whopping 35.5 cm head of dark hair.

Teeter Totter

Up... and down... and up... and down.

Seems to be the story of my life, lately! I have a strong belief that things always work out the way that they are supposed to, and that it doesn't pay to struggle against what's happening to you... why waste that energy. To quote a song from my high school days (does this date me?!), "Fuck it or fight it, it's all the same..." Or maybe another generation: "Go with the flow, man..." (followed by a haze of some decidedly dubious smoke). Whatever works.

Just after my last post, I made a call back to the clinic where an old co-worker (and nurse-midwife alumni of my school) is employed as a CNM/women's health nurse practitioner. I had already called once and left a message for her on the nurse-triage line - always an iffy way to leave a message - but hadn't gotten a response. When I was able to get through to her this time, she seemed excited to talk with me and we planned to work out all the nuts and bolts of working out a student/preceptor partnership together. Though she isn't doing births (yet) in her role, she is doing OB visits and postpartum rounds, and hopes to be doing births in the future... and (bonus!) may be needing a partner before long. "And of course I thought of you right away!" she said.

(Up starts the swing of the see-saw....)

The next day, I get an email from the new midwife... finally! She apologizes for the length of time between our messages, and explains about the changes that have been happening at their facility. I don't care --- it sounds like the ball is finally rolling. Suddenly, I have not one, but two preceptors on the horizon. I may graduate soon after all! Huge sigh of relief, new fantasies of "life after school", and more worries of comps, boards, and practice... but mostly, glee.

(And so, the top of the teeter-totter...)

This week, emails from the various credentialling offices at the clinic and hospital where my clinical experiences will be held. Forms, forms, forms; lots of blank spaces, spots to fill in, and dates to ponder. Worries about what happens if I don't complete my hours by the end of this term, and spill into next term - what about financial aid?

And then - an email from the facility where my new midwife catches her babies. The medical executive committee there has determined that "provider students present in the hospital are limited to observing patient care activities". Emphasis theirs.

(Huge, tailbone-shattering return to the rock-hard ground. Teeter-totter down.)

How will I complete the births that I need by "observing" patient care activities? That is the complete opposite of what a midwife does; she touches, she sways with, she assesses, she massages, she gently coaxes.... and she catches. Yes, some observing may be observed... but it is so very, very not the essence of the work she does with women.

I'm so hoping that this is just the mumbo-jumbo wording of this policy, that exceptions can be and will be made, and that the big fat policy that caused me to fall so quickly back down will work with me instead, seesawing me back upwards.