This One's Not About Midwifery

Most of midwifing is about joy, whether subtle or overt – the excitement of a new pregnancy, the welcoming of a new life into the world, the beauty of a woman as she blossoms throughout the stages of life. The days when things aren’t so easy – long, drawn-out labors, difficult clients, or struggles to understand vague symptoms and nagging ailments – pale in comparison to the wonder of a mother gazing into her firstborn’s wide eyes.

This post, though, is about those days, few and (thankfully) far in between… as a nurse, a friend, and a family member, I’ve seen grief. Grief that sneaks up alongside you, taps you on the shoulder, and then takes you out at the knees; finally helping you up and keeping pace with you, step for step, until you feel as though you can no longer take it. I’ve worked with families who’ve had babies born still – babies born fully developed, perfect in every way; other babies have been lost far too early, months before they were expected to arrive, yet already eagerly anticipated and much loved. I’ve known and cried with families as they mourn the loss of babies diagnosed with terminal illnesses, not compatible with life, and supported them as they honored their loved, tiny infants the best way they knew how. As a midwife – remember, I have only been able to claim that title for two weeks – I have yet to embrace women and their families in those desperate, dark hours… but I will be there.

My grandpa died.

When it comes down to it, that’s what this post is really about. Barely two months ago, my grandpa – my Mini’s “Puppa” – was diagnosed with Acute Myelogenous Leukemia – and given a prognosis ranging from moderate to poor (depending on the treatment regime chosen and the response of the disease to it, of course). One dose of chemotherapy didn’t significantly improve Puppa’s counts, but didn’t drag him down at all, either; he still fought like hell. Even a nasty, raging infection to his IV port didn’t take the fight out – it was only when his oncologist really explained why he had recommended hospice care (rather than continued chemo treatments) that he just gave in, and let go… within a week, he was gone.

To me, Puppa was larger than life – he wore Brut cologne, farmed his entire working life, fished and hunted like a “real man” in the Midwest would, and ate headcheese and liverwurst (ewww). My memory is flooded with treasures from my childhood; this is the man who taught me how to bait a fish hook (and get a fish off the hook, once caught), climb up on a tractor to ride beside him, play cribbage, and to open a glass bottle of Sun-Drop with a bottle opener. I could go on and on – like any good granddaughter – but I’ll keep those memories as seeds to plant for the Mini’s, or if nothing else, for a day when I’m a little more awake, and it’s a little earlier. Memories that they may lose (or have never experienced) like how Puppa always had a teeny Tupperware container in his shirt pocket for them, with just two jelly beans or marshmallows in for them, or how on birthdays, he had a special card just for the birthday kid with exactly the number of crumpled dollar bills as years old you were turning, the envelope and card addressed in his loopy writing… his love of Diet Sun-Drop – but *only* in the old glass bottles, not in cans, and not in the ‘new’ glass bottles. And the dimes – always the dimes…

When death comes, it’s amazing how fast/slow things move. I swear it was just yesterday that my grandpa walked into my living room, showed me the lab results from his recent hospital stay, and asked me what I thought of them (as my heart dropped to the floor). And, just a few days before that – it had to have been – we were all out on the pontoon boat, with everyone healthy and happy. But it seems like it’s been months and months of watching him slowly fade away….

I can’t imagine the pain of losing a child, or a spouse, or a parent… yet I can’t fathom thinking that I’ve “only” lost my grandpa. How do you compare this hurt? I feel selfishly grateful that this is really the first time in my memory that I have lost someone close to death; I’m also so grateful that my family is so close to begin with, and that the Mini’s know their greatgrandparents so well. The very last words that my grandpa really said to me, a few days before he passed away – looking me right in the eye, with a squeeze of his hand – were, “Thank you.” When I asked what he was thanking me for, he said, “For it all.”

To everyone who has gone through this grief, whether the loss of a parent, grandparent, spouse, a sweet child, or the whisper of a child yet to be --- let yourself be embraced by the open arms of those who care. Open yourself to the friends who can offer words of comfort, hope, and love; to the family that shares your memories and knows stories outside of your own. Realize the true beauty of the people who will forgive you when you 'disappear' for a few days or weeks, lost in your own world of clouded thoughts and reminiscences. I feel so blessed and have so much appreciation for everyone who made the last few weeks, especially the last few days, easier than they might ever have been otherwise.

Thank you… for it all. XOXO

~*~*~*~*~*~*~

(P.S. This post formed in my head as I finally took a hot, hot shower, letting the past few days and weeks rinse over me; as I got out and wrapped myself in warm pajamas, I was overwhelmed with the scent of Brut…. *tear* Things always end up all right, don't they?)

Will work for Food...

Seriously, I will... I certainly have a bit of a love affair with food. Especially this time of year, with the county fair in town: cream puffs, beer-battered cheese curds, funnel cakes.... Oh, my poor achin' arteries.

And summer. I love summer too. (Can it seriously be Labor Day already?! I want to cry! I do *not* do well with winter... sigh...) Anyway.... this blog has clearly been neglected for the past month or so. Oops.

I've been a little busy, to be fair. Since the last time we met, I scratched off each and every last clinical hour and visit I needed to meet the requirements of my program, as well as having a "declaration of safety" submitted by Dee (signifying that she feels I am a safe, beginning-level practitioner); one of my biggest feats was taking - and passing - the first of the last 3 big tests standing between myself and midwifery. I'm engaged, descended, and flexed - now on to finishing the rest of these cardinal movements, little by little...

(was that too corny?!)

From a personal standpoint, things have also been busy. Family life has been hectic as always, with ups and downs. My bigger-Mini started Kindergarten (!) last week, which seems incredible; I still remember the moment she was laid in my arms and the immense feelings of wonder and

awe I felt to be a mother to such a wondrous little being; my Mini-er is beginning preschool this week (and memories of her labor, and birth, are even more vivid; the moments in the shower, visualizing her path down to birth, and the moment when the Warm One proclaimed her as a "little girl"... so clear!). Harder to work through these past weeks have been the continuing struggles with my brother and his own battles (battles which he alone can fight, but that as a family we have been trying to find ways to support him in...), the diagnosis of Lyme's disease in my father, and acute, aggressive leukemia in my grandfather. It's painful and exhausting to see the toll, both physical and emotional, that's accumulated across the family lines in the past weeks and months; through hopes, prayers, and support (and communication), I'm waiting for a strengthening of the bonds that hold us together.

But, back to the "Work" thought that started this whole rambling... I'm starting to think more seriously about jobs again. (It's getting to be time, I suppose. I have one more "school" test - the competency/completion exam, after which I am officially a graduate nurse-midwife, and the final step is the national certification exam). I've realized, after doing a phone interview or two over the past few months - mind you I haven't interviewed in years! - that I need to brush up on my interviewing skills. I thought maybe I'd toss out a few random, jarbled thoughts on here, if nothing else, to help myself sort out a little more about myself (you know how they - "they" being interviewers, of course - always ask about your strengths/weaknesses, what you would like to improve on, etc...)

About Me...

* I'm not there yet, but I'll be there soon!

* I don't drink coffee... but I anticipate that I will start to do so soon...

* I run habitually late (not much, but just enough to be a few minutes late...)

* But - see above - I'm reliably late those few minutes!

* I learn by doing, not by reading/listening

* I'm quiet - but only for so long. I will open up (you may be sorry....)

* I do have a sarcastic streak... and a good sense of humor!

* I may hold back a bit at first - let my confidence build, and I will shine.

* I trust women, their bodies, their intuition, and their abilities.

* I am a very dedicated, motivated employee.

* I can't even come up with enough to write here! Man, I better hire myself out to a farm or

something instead....

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...

~*~*~*~*~

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.

Birth photography...

... is something that I've always loved the idea of. As an OB nurse and now student nurse-midwife, I always find my mind taking these mental snapshots during labor, birth, and those first few days of each new family. I find myself saddened by the intimate moments lost, the sweet "firsts" that are missed, and the beauty of a partner's touch or a newborn's soft skin slipping by unnoticed. "Where is your camera?!" I scream, noiselessly, to the new parents, or the grandparents, or anyone else nearby. "Don't you realize how precious these moments are? You'll never get them back..."

Part of this melancholy stems back to Mini #2. As I was preparing to host the luncheon for her baptismal party, I was throwing together a photo album/scrapbook of her first days. (Of course, this happened to be only a day or two before the party... but that's another story.) It was only then that I realized - I only had a few pictures that were taken during labor and delivery. But... what about... I don't remember... How come....

Suddenly, it wasn't about the photo album (Heaven knows we had plenty of pictures for that), but the fact that I wanted to remember more. Now, granted, I feel like I remember our labor very, very vividly; my water "sprung a leak at home", I knew it was definitely my water (because, first of all, as an OB nurse, you just know amniotic fluid... and second of all, I had somehow accidentally managed to procure an amnioswab...), went in to the hospital and was deemed to not be ruptured - but still given IV antibiotics "just in case" since I was GBS +... continued to labor, eventually beginning to have "real" contractions and delivering within a matter of about four hours. I remember reading No Country For Old Men early on, I remember the Warm One laying out on the cot next to me and snoring away through much of my labor, I remember my boss coming in about two hours into labor to visit for a few minutes; I remember realizing in amazement that I was using a focal point (a focal point! something I have always discussed in Childbirth Classes, but never actually thought of using myself...) on the chest of drawers, and I remember visualizing my cervix melting away as I waited, and waited, and waited, in the shower. Anyway --- the point of this post wasn't to share my birth story (that's another day) but to mourn the lack of pictures.

But, now the Warm One came in and ruined my train of thought. I'll leave you, instead, with an invitation to visit these friendly blogs that I've come across - gorgeous examples of a touching, sweet birth story, told in pictures:

http://www.jackspratphotography.com/category/birth/

http://capturingdayone.com/gallery?pid=173 (click through the 16 images)

http://creativelookimagery.com/blog/?p=2441&cpage=1#comment-207 (my favorite - make sure you view the full-screen version, with your sound on...)

http://imaginatephotography.com/blog/2010/03/19/baby-ms-birth-illinois-birth-photographer/ (another video)

Enjoy!