Midwifery is political

Becoming a midwife was not for me a process with any political intent. Giving birth naturally and becoming a mother were transformational. I wanted to facilitate that process for others and to be transformed again in the process. And so it is. But it turns out that midwifery is political. It can't help it.
Venezuela has passed a law against "Obstetric Violence" which it defines as:
"....the appropriation of the body and reproductive processes of women by health personnel, which is expressed as dehumanized treatment, an abuse of medication, and to convert the natural processes into pathological ones, bringing with it loss of autonomy and the ability to decide freely about their bodies and sexuality, negatively impacting the quality of life of women..."
I have no idea if law suits have been brought by women as a result of this law. I hear there "are no midwives in Venezuela" (excuse me, there are midwives everywhere).
Could we ever dream of passing such a law? Are we so disempowered that such a law concerning the basic rights of women would be laughed out of Congress before it was written? I challenge American women to write such a law. Who is up for it?

A few days away

Thinking about my pregnant mammas. I am about to go away for a few days. I am going on a trip with my youngest son, Daniel. It will be fun and I am looking forward to it. I am also anticipating the release of pressure that comes from not being on call for a bit. But I am sad that the babies who are due will not wait for me. I really do love my clients, all of them. But it's an odd sort of love. We have a close and special but professional relationship, then the story of this particular pregnancy and birth and postpartum is over. We are done.
The mammas chose me to be there for them during their pregnancies and births. I am honored that they chose me and happy. But I know and they know, that the power and the magic is independent of me. A confident woman, supported by any midwife, will give birth.
I know that for me, my Daniel must come first and for them, their births will happen the way they happen, Dinah or no Dinah.
Goodbye for a bit, moms and babies, back soon.

Pressing buttons.

If there's one thing that presses my buttons, it's women who blame themselves for everything.
It is the other side of the nourishing, mothering thing. A mother gives of herself as she is pregnant gives birth and as she mothers, and then when anything goes wrong, she blames herself. More specifically, when birth doesn't go the way a woman had hoped, she often blames herself. "If only I had held out and not had the epidural, I might have not ended up with the C-section" (She forgets that it's a set-up, not her "fault" at all)
I listened yesterday to a woman who told a birth story in which she was being attended by a midwife and giving birth naturally "I wish I had coped better" she said, blaming herself. But, upon eliciting the whole story, I hear that the midwife was in the other room during her labor, having given her a dose of nubain to "help her rest". She would doze and then wake up every few minutes unprepared for the massive power of labor with nobody who understood how to help her at her side. Her huband was unprepared and her mother prayed anxiously. The midwife appeared when it was time to push. I cringe to hear that story. How can she blame herself. I want to shout "BLAME THE MIDWIFE". But, out of loyalty to my sister midwives, and because, I suppose outward turning anger would probably be as unproductive as self-blame, I just focus on stressing that "NO, this is NOT your fault. You were in just as much a "situation" as the woman with the epidural in the hospital"
For most women, giving birth naturally requires support, nothing fancy, not necessarily TENS machines, or medication, doula or midwife gimmicks, just loving, confident support.
Pretty simple really.

Saving humanity with birth!

Women are lucky. We can embody nature, change, new life. We are impregnated, we grow and we are one and two at the same time. Then we labor and give birth, embodying the process of nature in a way that men cannot do. Male and female, we all are born, grow, live and die. But lucky women can sense nature and life in a more profound way. We embody it. In the processes of pregnancy, labor, birth and breastfeeding we are the cycle of nature.
Through our experience, our embodiment, our understanding of natural pregnancy, labor, birth, breastfeeding, mothering, we can touch this hard, metal, concrete, mechanistic world and influence a return to common sense.
Trusting your body and giving birth naturally empowers you to trust yourself as a parent, to parent intuitively as you gave birth intuitively. Giving birth naturally empowers women to parent with love as we gave birth with love. And the children we parent with love and trust in nature, will love and trust in nature themselves. They are those who will live life honestly and with respect for themselves and those around them.
This is not a self-indulgent thing that we do when we give birth naturally. This is a step in the saving of humanity.

A long labor

A long labor can be very laid back but have a certain tension at the same time. A long labor the other day. A lot of hanging out: midwives snacking, mother snacking a little, father dozing, mother moaning, mother resting, midwives gossiping, father massaging, doula pumping milk(!), midwives wondering, mother swaying. Midwives wondering. There is a certain intensity to the wondering and the helping and the evaluating that we do. There is even a certain tension to the studied calmness. And then, of course things develop and the mother is pushing and then the baby is visible and the release of tension and excitement is huge. And then the baby slips out into his father's arms with his crazy long head and his big cry and it's all messy and the relief and the release are immense. That's the way it is sometimes.

midwifery's ripples

Sometimes I think, a little disheartened, "How can a few natural births in a corner of Texas change this overwhelming world order?" I hope that the ripples outward from every woman who feels strengthened in her natural instincts, in her common sense and in her self confidence, by becoming a mother and by giving birth naturally will touch the world. Scientific rationalism, corporate power and a technological (sorry) male view, are so strong..... But the ripple of biological mothering instincts are persistent. I am optimistic. I know that there is really no choice for a human future on earth besides the force of nature from which we spring. It's only common sense!

How are you feeling? And I repeat back to you

A prenatal visit begins with "How are you feeling?" No, that's not true, a prenatal visit begins with sitting comfortably face to face.
Then, "How are you feeling?" I ask. A pregnant woman answers "Good.... tired." Then, with a sigh, "The baby moves like crazy and then I can't sleep and then I have to get up to pee". I respond by repeating back "You're uncomfortable and not sleeping well....". "Yes, I'm tired of this pregnancy. It's getting old". "Oh dear, you are feeling impatient" I am just repeating back and not putting words in her mouth, but we have moved from the simple, often insoluble physical challenges of pregnancy, to the attitude, state of mind sorts of things about which we really have more control.
Later she says "And now my mom has decided that she's coming for the birth." "How do you feel about that?" "Well of course I love my mom and she really wants to be here but I thought it was just going to be me and Chris". "Your mom wants to be here but you visualize the birth differently," I repeat. "Yes, but it's really important to her to be here, I think. She's really excited about it" She is focusing on her mother's feelings not her own, so I will bring her back to her own. "Yes, but what do YOU think about her plan to be here?"
Repeating what my client says to me is a simple tool that creates connection. And the connection that I mean is not between me and my client, it is between the client and her own feelings. When she feels something and says it, she feels it more and then when I says it back to her, she feels it even more. And the more she feels it, the more she gets it, the more she learns and finds solutions.
My clients know the magic tool that I have on my window sill. It's a spiral-bound flip-book called "The Pocket Midwife" It is a book of perfect affirmations for pregnant women. At the end of the visit they flip it open at random and magically the message is perfect for that moment. A woman who is past her due date and fed up will get "I am patient and composed" A woman who is anxious about the birth process will flip to "My body knows exactly what to do" A woman who is feeling overwhelmed may turn to "I ask for and receive what I need" The woman reads the message out loud. There is power in speaking things out loud. There is power in repetition. The pregnant woman leaves the prenatal visit strengthened and empowered, a feeling that will be expanded upon as she experiences labor, birth, breastfeeding and mothering.

Hope on a beautiful spring day

Went to the The Heard Museum in McKinney. It was the end of the day and the light was sharp and clear. I walked a few minutes on the trail and was quickly alone. I walked along the boardwalk that takes you out into the wetlands. Bare trees were emerging from the water into the bright sky and huge birds sweeping across the swamp. The natural world must be preserved and can be restored. The people who, in hope and commitment, have worked to restore this place, are like the women who believe in the way that our bodies work, and are committed enough to give birth naturally. They are the hope of humanity on this beautiful planet.

The thorny topic of Birth and the God thing

I'm going to dive into this potentially very thorny topic. Birth and the God thing.
Pregnant women have an aura about them. Their sensitivity is all over their beautiful bodies. Their specialness could be called sacred. The moment of birth is unique in its power. It demands honor and respect, and also awe. You might call it a moment of holiness. For many, feeling this truth leads directly to their faith, a specific faith, and for many it does not. The power, the holiness the awe, the sacredness of it all are real whether you are believer (Christian, Jewish, Muslim, Hindu, Wiccan, Zoroastan) or an atheist.
So, when a client asks me about my faith, my beliefs, I answer. But I do not like the question. This is not only because this question for me is very personal, at least as personal as my political opinions, but more because the client usually wants to gauge my sensitivity to the spiritual aspects of birth, and I do not think that religious belief and being in tune with the spiritual are necessarily connected. Does not an atheist woman sense equally the power of the moment of the birth of her child as the woman of strongly held religious belief? Of course.
I respect the power of giving birth and I respect the women giving birth enough to know this.

Getting through a transport

If this is a truthful blog about Dinah's Days and Nights, gotta talk about transports. Transports are shit. Transports are really hard. Transports have to happen.
Last week, a first time mother, (and yes, it is usually a first time mother or a VBAC) labored the way first time mothers labor..... A couple of nights of irritating contractions keeping her from resting well, phone conversations and suggestions about ways to get through it and then a meeting at midnight at the birth center. On the phone things sounded good..... she was not exhausted, contractions were consistent, low down in her belly and she sounded like she was coping well. She arrived with her husband, excited and rolling withthe labor..... looking good. I examined her. Cervix completely effaced, 0 station and 3 cms dilated. A nice little bulgey bag of water and baby in a perfect left occiput anterior position....... couldn't be better. 3 cms at midnight, mmmmm. I really wanted her to rest because clearly there would be a lot of work ahead. She lived 40 minutes away. I didn't really want her to drive there and back again in labor, but I've made the mistake too many times before of keeping a 3cm laboring mom at the birth center. Frequent result: exhaustion despite best efforts. C and her hub were happy to head home with a bottle of skullcap and some rest ideas. I went home to rest myself (in theory). Of course with a mom in early labor and menopause plaguing with its nighttime habits, I didn't sleep.
At 4 o'clock, the expected call came. I could hear C in the background loudly moaning and I hopped into the car. She sounded hot and heavy. I ran into the birth center thinking "I knew this was going well" and filled the tub. She was going to arrive almost in transition and would need the water right away....... But you know the end of this story so you know that is not what happened. In she came huffing and hollering........... "Aaaaaah I can't I can't this huuuuuurts" More mmmmmmm. Not good. Birthing a baby requires the "Bring it on" attitude not the "I can't it hurts" attitude.
I checked her: Completely effaced, 0 station and....... still 3 cms with NO bulgey bag of water...... So if you've been to a few births you know what had happened.... yes, water broke on the way home and baby turned posterior....... Oh lordie. This kind of deal requires huge stamina: Mother stamina, spouse stamina, midwife stamina.,.... and it requires motivation: mother motivation, spouse motivation, midwife motivation. So we worked VERY HARD. We worked on motivation. We worked on stamina and we worked on rolling that baby to the front. All of us worked very hard. Knee chest push that baby up and encourage her to turn. Lunge with the left leg. Lunge with the right leg. Dance with the hips rolling. Walk up and down the stairs. Pulsatilla. Aconite. Gelsemium. All these had their parts to play. From 6am to noon C progressed from 4cms to 5 cms and this was not looking good.
When it was time to go, C cried, her huband cried and off we went. At the hospital, wires, tubes and more tears. I stayed at her side in the hospital till at 4pm she got an epidural and it was time to rest. Home discouraged, disappointed, exhausted. That's transports.
After a transport it is easy to self blame, to feel that you are the only midwife who gets transports; that another midwife could have done differently, better; to feel guilty.I know that it is right to think through what happens after every birth whatever the outcome, but especially the transports: How did that happen? What can I learn from this? But at the end of the day, a midwife can't go on if she blames herself. In fact there is something egotistical about self-blame, like the midwife is the center of everything that happens. I must remember that I have a part in the birth story but I am not the cause of most things that happen at a birth.
Being a midwife involves learning to live with transports.
By the way, by 3am, C was still at 8 cms and ended up with a C-section. She, her husband, and her baby, are doing OK.