Long time gone...

Hey, nice to see ya! Where've you been?!  Oh, wait, I guess maybe it's where I been, eh?

So, needless to say, this post is loooooong overdue.  I think this blog's last posting was somewhere around, oh, six months ago?  Huh.  I guess it's been a busy half-year.  Since our last rendevous, old friend, I've packed up and picked up everything to move half a days drive away, officially gaining entry into the world of a practicing (and paid!!!) nurse-midwife, and gloriously helped a powerful mama pull her newest into her arms, standing alongside her bed... (my first out-of-bed birth - woohoo!). I've said goodbye to so many friends --- and in a heartbreaking moment that doesn't end, to my baby brother, standing alongside each of my family members as we realize the swiftness with which goodbye can be missed; I've lain awake at night and struggled with my own internal guilt, fears, remorse, anxieties - both professional and personal.  I worry about meeting the expectations of my clinic administrators, meeting the needs of my clients, about being thorough yet not over-ordering or falling behind; I fret about when the golden hospital privileges will finally be mine, how stressed my partners are in the meantime while they await that day and how tiring it must be to have to back me up until then.

And, of course - I yawn, I drag, I sleep only halfway 98% of the time, hoping/not hoping my pager will go off... if it does, if that next mama's water finally breaks, it will be one more babe closer to independent privileges and a bit of relief for everyone all around (but if it doesn't, of course, it means a bit more sleep for everyone on the home front.) Officially, I'm on call something like four nights a week - but unofficially I've been sleeping with my pager under my pillow just about 24/7 since starting in April - or at least since getting permission to get near hospital patients a month or two ago. It doesn't beep at me often ... yet I still dream that it does, or that it did and I slept through it, or that the batteries died and someone's been frantically trying to find me, yadda yadda....

Oh, but the catches - the sweet, slippery, lovely babes!  (Really, isn't that what it's all about??) When it's down to that moment, the rest of the stress, the worrying, the anxiety melts away.  Until, that is, the hemorrhaging afterwards... or the placenta sticks... or mama passes out later on.... you know, those sorts of things....  But the catch itself, usually, is a rush!
 
I pledge, from this point forward, to stay more loyal to this blog.And I hope you'll stay here, too.  Like any good things, any journey worth taking, it may be a long road, but hopefully worth the travel....

My "birthingway" necklace ... or "mamalove" necklace... or "I Catch" necklace" ... or ??? 
(I'm open to suggestions!) ... for every babe, a bead <3 

 

Opening

That last post? It was the darkening before the dawn... the cold, bitter rains of March right before springs first tentative blooms poke through the thawing ground... the tensing of every last muscle, stressed, fearful, fatigued -- and then a loved one's arms are there to encircle and release it all to the universe itself.

Do I need to step back a mile or three? Maybe that would help...

From a career/baby-catching standpoint - you could say that the last post was somewhat colored by the sludginess I've felt in my job search. (Which, in itself --- seems somewhat silly... I didn't expect to come out of school with a job in hand, as nice as it would have been. But still - now that it's been five months, I'm getting a little antsy...) Every day that I go without that delightful weight sliding into my hands, without gifting mothers with the words "here's your beautiful child" ... it weighs on me. Sure - I can still go to work as an L&D nurse; I can still whisper forbidden encouragement into the ears of hardworking mama's ("go ahead... eat some crackers... nibble on that granola bar..." ), but it's not the same. The mothers, the fathers - they know I am the nurse; they have only just met me, and even if we have "clicked" and even if they can sense that I am there for them and their babe --- I am still, just, the nurse.

I've sent resumes, CV's, emails of inquiry. I've had an ongoing email chain, complete with an powerpoint proposal, to the physician group that I've worked with for the past five and a half years - a handful of great family doctors who practice this close to the midwifery model of care. Throughout my clinical rotation with Dee, there was the shadow of a promise of her practice adding a second CNM. Nothing. Zipzilchzerozuess. "My" doctors decided that while they felt there would be interest in a CNM in our area, they feared "there would not be enough demand for a full-time position". A few attempts to get in touch with Dee (after a promising email before the holidays that her administrator was going to start the process to try to get the wheels going...) weren't returned. A promising position - complete with loan forgiveness via the HRSA program - seemed very likely and suddenly... *poof*! Que sera, sera.

But. On top of this, I live in the Midwest. In winter. A gray, long, cold Midwestern winter. The task of looking for a job - refreshing the same search engines, day after day (many times multiple times daily) - combined with more and more student loan payments being auto-debited as the days stayed devoid of sunshine ... you get the picture. Little by little, negativity begins to replace the fresh enthusiasm of graduation; did I really just sacrifice three arduous years and an incredible sum of blood/sweat/tears/trees/memories/etc (not to mention indebtness to the good old Department of Education/Loan Repayment Program), only to continue to work very part-time as a labor and delivery nurse?! Am I undesirable as a CNM?? Is there something that screams "don't hire this girl, for pete's sake!!" on my resume? Do I need to eat more chocolate - will that help??

So - anyway. It was a long couple of weeks, and maybe that post reflected some of that. In the end, I resigned myself -- or liberated myself -- to the old "letting go, and letting God" (or the Creating, or the Universe, or destiny, or karma, or what have you... I'm not entirely sure, myself) take over.

And - it worked.

Not long afterwards, I heard back from the site that seemed like it could be the "perfect" fit (we'll call that site "North" for the sake of, well, easy-ness). It turned out the midwife's mother had been ill and unfortunately passed away; that had prolonged the interview process, but ultimately within the next week or so I spoke with the midwife and HR folks, and set up a time to go up and meet them all in person and tour the site. I also sent a CV to a second site - this one a private midwife practice out west (we'll call this one "West" for those of you following along), and had some nice back-and-forth communications with them via email. After my first Skype interview (interesting enough), I was invited to fly out there and meet them in person as well. Both visits/meetings went great, and now I sit with one likely offer (from "North", pending the approval of one final committee) and a call back next week from "West", where there were still 2-3 other applicants to be interviewed.

My dilemma may or may not be solved by next week's call by "West" ... but that's another post!

The Abyss

I waver between two different realities. One, I stand on the edge of a total, all-encompassing darkness. My bare skin is chilled - goosebumped - but invigorated. Behind me is all I know, everything familiar, the things that have always been. In front of me is... what? Nothing? The steep, sudden chasm at my toes should frighten me, yet I feel nothing but an overwhelming sense of calm now; that fear - fear that should envelope my entire self - has vanished along with the light from this space. I know that to step off could end everything - but it could also be the beginning of everything. With the slightest step into the unknown I will open my wings and fly to the place of my dreams, or simply land where I'm meant to be: a pillow of soft clouds, the waiting arms of a One who created me, or the place of my family's future. A soft wind's push, a strong legged-leap, a quick stumble... any of these things would move me on, and yet - I pause at the edge of the question marks beyond.

Then there's the second place; the place where the Fear lurks. Down a constricted, narrow earthen tube - barely wide enough to descend, long enough to make the late afternoon light little more than a tarnished penny above - lies the insignificant yet crucial room. Constructed of thick steel, lined in double layers of thick and splintering wood, barely larger than a bathroom stall (and certainly less than five feet tall)... it smothers, it suffocates, it shrieks. Time stands still at the same moments that it races by; in the silence of the box, the deafening darkness threatens me with insanity. I stand at this fissure, knowing the only way to complete this journey - to pass this test - is to descend the long ladder downward, to endure my time inside with my Fear, and fight my way back up and through the long, tight passage back... and I struggle, I fight. I know I can do it, and I know I should do it - go down, do my time, and emerge victoriously, proud of my dirt and raw, rubbed skin; I know the struggle is the true origin of my Fear.

~*~*~*~*~*~

And yet - I still stand here, at the edges. Aquiver.

The Most Wonderful Time of the Year... ~ Or ~ When Things Look Bleak (But Aren't Really That Bad, Right?)

A happy and blessed Christmahanukwanzakah and New Year to all! Pardon my hacking as I make it through the six weeks of dust being knocked off the blog as I start typing through this post *blush* ... (I guess it's been a while. Oops.)

Where've I been? Bouncing between the new-found freedom that comes with ((drumroll please)) no more schooling, the excitement of two Mini's and impending snowflakes and thoughts of Christmas time, and the gnawing concern that my baby-catching days are becoming further distant with each day that passes with no job opportunity at hand.

(Now, this post isn't meant to be a mopey, woe-is-me sort of thing... what fun is that?? As you may have gathered from previous ramblings, it may just lazily wander around this topic and - hopefully - come to some sort of resolution by the end. Over the past week or two, these thoughts have built into a strong mental blizzard, worrying at me like a six-year-old wiggling a loose tooth. It's amazing, though, how cathartic putting such thoughts out into the universe can be... I'm looking forward to that sense of peace that I know I'll find after hitting "publish" and sharing this with the world, even if no one actually reads this blog any more.)

Anyway - back on track. No time for anxiety or worrying too much about the job situation in the first weeks of December; our family celebrates Christmas, so between the holiday preparations themselves (taking the Mini's out to my dad's to find the 'perfect' tree, then trimming the tree and decorating the house, etc) as well as holiday concerts for both girls, cookie baking, the traditional trips to see the big red man, and all the other festivities, I was content to wait. (As of the first of December, I had contact with both Dee and the physicians I work with considering adding a CNM; I also had an interview lined up for a part-time CNM position at a family planning clinic...) It was only after all of the "fun" ended - including the last-minute shopping runs, an unexpected slippery couple of inches of snow (pretty to give us at least a bit of a white Christmas, festivily enough --- but oh-how-slick!), and a surprise attack of fevers, aches, and slug-mimicking for the Mini-est - that everything caught me. And by everything, I mean everything. I realized that just about ALL of my student loans were suddenly coming into repayment (which, considering I have not only my graduate school loans to repay, but also those for my ADN-to-BSN bridge program, and my ADN program, and the assortment of loans I had as I was waiting to get into a program... it sucks. Did I ever tell you the story of how it took me six years to get my 2-year associate degree, by the way? Good times, good times....). My student loans, and the Christmas bills (which, of course we tried to go low, we ALWAYS do... but isn't this how it is every year?! Suddenly *someone's* favorite team is selling 'stock' - which by the way is non-transferable and pays no dividends, but does look good on the wall... and who else owns a piece of America's team, right? - and this other thing is on the best, most SPECTACULAR, *AwEsOmEsT* SALE EVER!!! so it needs to be bought now... but if s/he gets that, then of course this one needs this, and yadda yadda.... Oh hey, isn't this Brazil?! How'd we get so far off track here, and can I even use these sweet new snowshoes south of the equator? Where's that map?!) are coming in, and no one was as excited with the gifts that I worked so hard to get *just right* for them, and I was exhausted, and my schedule at work wasn't right and I ended up bawling like a baby because I was exhausted when I saw it to begin with (and I HATE crying, especially when I'm upset/angry/trying to discuss something...) and why was I on a night shift to begin with on Christmas Eve night - my holiday is Christmas Eve, evening, arrrgh?!? and it was just the longest week ever.... and so on, and so on.

And it just kept going. And the family planning job, that I thought I had interviewed fabulously for, apparently was a big bomb. Was it exactly the perfect job I wanted, and was I a wonderful candidate who interviewed like a rockstar? Uh, not so much probably - but on the other hand, I thought I was pretty good and would (all in all) fit in well and enjoy the job. The biggest downside, of course, was the no-baby-catching. My biggest downside - I thought - was that in my typical fashion (ha, ha, pun ahead!) I neglected to actually try on an outfit for the interview until 11:30 p.m. the night before, and the outfit I planned to wear - a sweet little black and teensy, thin blue pin-striped suit... - had somehow gotten a couple of sizes too big (!%@^*), leaving me flustered in the wee a.m. hours trying to decide if I would try to pull it off with some sort of cinching (sans belt loops, of course) or go a little more casual. Anyway, it's starting to look like we're in the tropics again here, so I'm going to leave the interview territory and my fashion deficiencies (for proof of my fashion sense, see right), and go back to my other worries now.

I was assured that I would hear back in about a week about the position, and truly did expect to; the clinic had been short-staffed for awhile, they needed help, all the signals I picked up were a 'go'. I waited... and waited... and waited... (and sent a 'thank you' email...) and waited some more... and nothing. No "thanks, but no thanks" call, no polite "we've gone another way" rejection letter, nada.

I've also just been hanging with both of the nearby clinics; I emailed Dee a few days ago, gently hinting that I'd love any updates if she had any from her clinic administrator (who had started the process of checking into adding another CNM around the end of November, and had thought she would know more one way or the other in three weeks...). Checking my email neurotically - the one where messages from either Dee or my current physician group would contact me - doesn't seem to be doing much more than giving me little blisters, so I'm at a loss. It seems to be a fine line between being pushy, persistent, and the perfect amount of persuasive... it's just so difficult to read where things are at.

At this point, honestly, I'd just love to not be in this no-man's land. If all three (really, just the clinic groups - I've more or less written off the family planning clinic, although I may call the director just to touch base) facilities would just give me an answer, one way or the other --- I'd be happy, even if it's not the answer I really want to hear.

Even working as an RN in L&D is getting to be a struggle now. It's difficult to not step on toes, and to remember my scope of practice... and I miss being the midwife, making the calls, being able to do (and not do - or to be able to say, "we're not going to do this - we don't have to do this, everything is fine.") ... or if a baby is coming too quickly for the physician to make it, having to try to stay back and have another nurse 'catch', or have a mama try to not push --- one of the worst feelings in the world, and not good for mama or baby --- to provide the assurance needed to everyone that I wasn't trying to "take matters into my own hands" on some level. Awkward, awkward....

Soooooo, about the IHS.... 23 pages of application for *possible* loan reimbursement, if funds are ever available? Oh heck, why not. What else do I have to do???

Thank God for Midwives

(And mama's, and babies, and supportive dads/aunties/grandmas/friends, and doulas...)

But, at least for me and at least for this week --- thank God for Midwives! If you've followed along at all, you might remember how intense (is that a good word??) things became at my last clinical site. I won't go into all of the details again - because frankly, it makes me feel pretty lousy and I also start to feel a little badly for the women who really want a midwife and don't realize (until it might be too late) when they've actually found a medwife - but it was rough.

Rough on me a student, as a person, and even as an OB nurse. That site caused me to question a lot of things both about myself and the way I have been prepared to practice as a CNM; the Midwife was motivated, she was popular, and she was good. But - she was also (either by choice or by necessity) very much a medwife. As a learning experience, it was good; the four months I spent with her allowed me to begin the hands-on learning I needed to grow as a new midwife, and the last few weeks (along with many, many weeks thereafter) gave me pause to reflect on ways that I myself need to grow my personality to better perform in that role, as well as on the pieces of the Midwife's practice that I did and did not want to take with me into my own practice.

It wasn't until today, though, that I realized how deeply I felt wronged in my previous site. My faculty advisor has been working hard to help me find a new clinical site; this process, which originally seemed as though it would be fairly quick (I had another preceptor in mind, who was happy to work with me) ended taking 2 and a half months. Obstacles with policy, administration changes, and just enough little roadblocks to keep things from progressing have kept my hands from officially (as a student nurse-midwife, that is) welcoming a baby into the world since March 1st. (And it has been kiiillllllllling me!) As things continued to stall, my advisor suggested I come to a site that has welcomed several of my classmates in the past; while at first I was hesitant (as this site is a 3.5 hr drive from home) eventually it got to the point where any site was perfect, and I jumped at the chance. The midwifery group agreed to work with me, the paperwork was approved, and plans were made for my arrival early this week.

And, it has been amazing. Amazing for the births I have attended - 9 so far since Tuesday (and I missed several others one day when I finally had to admit that my body and mind needed rest), including two glorious waterbirths, two VBAC's, and a handful of other triumphant displays of mama-power. Amazing in the fact that the midwives and nurses have welcomed me with open arms, eager to help me blossom as I work my way towards becoming a beginning-level midwife. I've had "scary" moments - a decel that wouldn't come up (while my precepting CNM and the OB on-call were in the midst of a c-section and completely unavailable), a shoulder dystocia that didn't resolve easily with McRobert's maneuver and suprapubic pressure - but made it through them. I've been allowed to be more independent in four days, with four different midwives, than I was in four long months with the Midwife: when our dystocia baby's shoulders didn't ease out shortly after his head, the CNM I was working with that day didn't push me aside to take over... instead, she stayed back (as hard as it must have been) and allowed me to identify the situation as a shoulder dystocia and to work to resolve it. When my efforts weren't quite doing it, and I looked to her for help - she was there. The trust that I've found from these midwives - each of whom I have met for the first time the morning that the call shift begins - literally brought me to tears as I finally took some time today to reflect on this first week. It takes a momentous amount of trust to stand back and allow a student to be in control of a situation - especially one that is as intense as a shoulder dystocia or prolonged decel. I can't even begin to fathom how difficult it is to stay back and just "be", while a student works to resolve something that can so quickly develop into disaster. And yet - the true mark of a good teacher is to understand that without allowing a student to take the next step towards independence, the student will ultimately never succeed, and both teacher and pupil end as failures. In labor and delivery, with the life and well-being of a longed-for baby on the line (as well as the mother's safety), the amount of trust and courage in takes to do this is multiplied ten-fold... with the rewards equally as impressive.

I'm not there yet - a part of me froze up in those tense situations, and it took longer than it should have for the little voice in me to say, "this is what you do... remember?". But the gift of being allowed to wake that little voice up, to do my best, and to know that I had a supportive preceptor right behind me --- rather than pushing me to the side immediately --- was worth more than anything else. Then, the bonus of constructive feedback and open communication - rather than quiet, tired frustration - after each incident: What should I have done? What might have been a better way to do that? And - what did I do right?

As I wrote what was supposed to be a quick update to my advisor, letting her know how incredible of a learning experience this has been so far, I found myself reflecting back to the days with the Midwife and comparing the feelings I had at the end of that rotation (inadequacy, doubt, fear, shame) and the ones that have emerged in just a few days here (confidence, readiness, calmness). Sitting on the back porch of the midwife who so graciously invited me into her home, smelling the lilacs with songbirds for a soundtrack, tears rolled down my cheeks as I typed on and on. Where my hands were rarely able to catch without the Midwife's covering them before, they now have eased 9 new lives into the world with very little guidance; when I reluctantly began to perform certain skills in the way that I had been taught from the Midwife (but had never been comfortable with), I was reassured that there was another way, and that the way I learned was not necessarily the best practice; what had been frustrating in the past (lack of expectations, absence of any real rapport) was nowhere to be found among these midwives.

So, thank God for midwives... the midwives I've worked with this week, who took my hesitant, injured confidence and allowed it to begin to heal; the midwife who opened her home to me, with its peaceful quietness (no television, no cell phone reception) and country beauty; the midwife (my advisor) who spent so much time working with me to find this happy place again. And even the Midwife, who started me on this journey and puts this all into perspective.

Be --- Aggressive... Be, Aggressive...

(First and foremost, "aggressive" is probably the last word anyone would think to use to describe me. And personally, when I think of midwifery, it's one of the words that seems the least appealing... who wants an aggressive midwife?!)

But. I'm 1/3rd of the way through my clinical hours, and halfway through the births required for my program (woot, woot!). I'm thrilled about that, but still don't feel like I'm "there" if that makes sense. I still feel like a beginner. A pussyfoot. A lightweight. Dumber than a box of rocks. A little slow. Wet behind the ears. Scared. Mumbly, fumbly, and bumbly.

I can't be sure, but I think I lack confidence. A lot of it.

See, I've always just figured I was quiet, reserved; calm, cool, and relaxed. (And, to be fair - I think this is mostly still true; ".....they call me mellllllow-yelllllow....") On the other hand, my preceptor (we'll call her simply "the Midwife") is full of energy, and has been doing this a loooong time. She's got tons of experience under her belt - as an OB nurse (forever), then as a nurse practitioner, and as a CNM for the past decade. She's understanding - but she's driven. She can easily see 16-20 patients a day, plus manage a labor and have a surgery in the morning before her office hours. Knowledge and good judgment spilleth over her cup, if you get my drift; the woman is wonderful at what she does, and her clients love her. She is a wonderful teacher, but I think it's been tricky for us to work out the dynamics of our partnership; the first couple of months have been awkward and have left me feeling somewhat anxious... I'm two-left-feet-and-balding Barney, who was paired with the gorgeous and talented Ginger-Rogers-esque at the local singles dance class. I so want to learn everything from the Midwife (and to possibly build a lasting relationship, or at least a quality reference), but feel as though I just keep fumbling around at her feet.

I need to remind myself to speak up, breathe deeply, and trust in myself. No more light taps on doors - the Midwife tells me, "knock like you mean it!". No more mumbly little explanations - I need to enunciate, and project, when I speak.

(I don't think these are necessarily "aggressive" things, but rather "assertive". Unfortunately, there is no catchy "Be. Assertive. Be-e-e assertive..." cheerleading cheer, so --- aggressive is what will have to work in my little head, from my little midwife-on-my-shoulder cheerleader)

My RCC - regional clinical coordinator - is coming to visit my site in a few weeks. I just learned this today, from the Midwife. I am petrified, for the above reasons. (See also "Scared to Death"). What are the odds that there will be an impassable avalanche that day, or every single patient will cancel? Dang. A girl can hope (and will keep hoping).

This post, I'm afraid, isn't very exciting or enlightening. I'm sorry for anyone who just started reading --- what a way to join! I promise, there may be better things buried beneath... or to come.

Things To Remember: (Not-quite-pearls)

~ the bag of waters really won't break when it's just touched with an amnihook (usually)...

those buggars are tough!

~ the Midwife LOVES her some goo (so I am starting to love me some too)

~ bulb syringes get very slippery when you have gloves covered in goo

~ bulb syringes bounce (and are no longer clean)

~ Pull those legs back and try to give that cervix a little gentle help...

~ Sit on the bed for delivery - not on my foot...

~ Lower the seat of my stool before starting a spec exam

~ Keep the feet off the footrest (I guess it's *not* for me!)

~ A vagina/perineum is a lot trickier to sew up than, say, a block of foam or a cow-tongue

~ I'm learning

I'm scared to death.

Period. End of story.

I thought maybe if I said it (typed it?), it would make me feel better, or at least feel something different - but I am still scared sh*tless, to be perfectly frank. Within six short months (god willing), I'm going to complete my clinicals, work on passing comps, and take my boards. And then, I'll officially be able to call myself a midwife in front of clients - something I've been feeling for months now (or even longer).

And that, dear anyone-who-may-or-may-not-be... almost paralyzes me some days. I am a terrible, awful student. I procrastinate, I get distracted, I prioritize poorly. I don't know when exactly this happened - I used to rock in high school - but at some point over the past few years (maybe once my brain cells started being killed off by motherhood?), my attention span has decreased. Somehow my remaining brain cells get overloaded, and everything I have studied flies out the window - things that I know, that I can explain frontwards, backwards, and upside down. But when it comes to spitting them out for an exam, or off the top of my head for a professor, spur-of-the-moment? Hello, pee-in-my-pants-because-I-got-nothin'! Not. Good.

Don't get me wrong - I'm working on this. (I like to think that I'm smart enough to realize that I can't be successful and still have this HUGE crater in my path). I've talked to other students, I've had study groups. I've gone to counseling. I've got awesome support from the Warm One. Some of my family recognizes how hard this is (full time grad school + working 20ish hours a week + family), others don't... but that's all right. And, I've got the Bears. (More about the Bears later on)

So, most days, I can work through the fear, and I'm good. But. There are other days.

Like, the days when I realize that, holy shit, I need to basically learn (or at least very, very deeply review every SINGLE thing I have learned since starting grad school - not to mention a very good portion of what I learned in my associate's nursing program) in the next few months. Some days - when the Bears are closing in, and I've forgotten to avoid the crater in my path - I let myself get anxious and (again) horrified, realizing that I never really learned even the basics of anatomy and physiology. Autonomic nervous system? What's that do again? Tell me more about the parasympathetic stuff, again... Oh, f*@#!

And then there's meds - I learned them enough, for long enough, to get through at the time. (Or at least - again - that's what it feels like). What's a beta blocker for, again? Double f*@#.

The basis for EVERYTHING I have learned, and need to know, is built on an awful shaky foundation (at least in my own mind). I have been flying by the seat of my pants for the past five years, milking the "fake it till you make it" mantra for all it's worth... but something tells me that as a provider, that won't cut it.

Or, the days where I remember deliveries I've seen as a nurse: moms who come in, with no risk factors whatever. Spontaneous labor, or just something "not feeling right". Baby hasn't been moving as much as usual, a little bit of unusual discharge or bleeding, sharp pains... whatever it may be, or nothing at all. Perfectly normal pregnancies - and then, when the fetal heart tones are doppled or monitored --- a "bad baby" is seen immediately, a crash c-section is called, and a little boy or girl, pulled out a thick, dark meconium is worked on in a curtained nursery for a long, long time by nurses, doctors, respiratory therapists, and finally the NICU team that has flown in. Or, maybe it's a baby that looked fine throughout labor - a nice, normal, happy vaginal birth - and then with no warning, baby just doesn't transition after birth, needs help breathing, and help is an on-call doctor or an ambulance ride away (which, of course, seems like days and days with a baby that isn't breathing).

Or, the days when a baby is suddenly no longer there. Or is found to have an abnormality non-compatible with life. Or anything that will be very, very difficult to share with the parents. I am terrified that I won't have the words or the grace to share these moments with the families that need me to, the most...

Please, please, if anyone is out there and has been in this place (specifically or not), please tell me it passes...!

~*~*~*~*~*~

On "The Bears"

This is a technique that was shared with me during a counseling session when I was struggling especially hard with stress and anxiety (thanks, Dave - I hope you don't mind!). I am most certainly paraphrasing the technique, since I don't really remember how it was explained to me... so please 'bear' with me (groan!).

Setting: Wooded area surrounding a small clearing (perhaps a campsite?) with a campfire, simple block bench, etc

The Players: A handful of the Bears (these symbolize Stress/Anxiety/Fear - any negative or bothersome issues - I always picture them as cartoon characters similar to, maybe, "The Far Side" or something?) and You

(We enter the scene with You sitting on the crude bench near the campfire, maybe toasting marshmallows or a hot dog. Something's troubling you - fear? stress? anxiety? - and you realize that the shadows creeping up behind you are actually several large - albeit cartoonish - bears)

Don't Fight the bears - this will only encourage them to come back (and release adrenaline - the 'fight or flight' hormone - in you... leading to more bears --- and more stress/fear/anxiety) and... Don't feed the bears! (I.e. don't let yourself dwell on the anxiety/fear/stress/whatever's bugging you - that will also keep them coming - it also releases adrenaline) Just look 'em in the eye, say, "Hey bears, I see you there, you're right, I am stressed/freaked out/pissed/etc, and it's okay. I'm not going to feed you, and I'm not going to fight you. I'm just going to be."

It may sound silly -- but to me, it was very, very helpful. (And, in fact, as I typed this I realized how very little I've 'practiced' it lately - which can't be helping the topic of this posting.) On a side note, the ringer of my cell for a while was Mini #1 saying "Don' feed tha' bear!" - from the Adventures of Winnie the Pooh - for a year or so, which made this technique feel even more 'right' for me... every time I was getting myself worked up, her sweet little voice reminded me not to.