A Longer Introduction

I didn’t come to midwifery in the usual way or at least what I assume is how most midwives get to the profession. I didn’t have an amazing home birth experience of my own or even witness one that changed my life. I entered the field of medicine due to a great book I read at the age of 8 which convinced me that a career in medicine would be possible for a young girl of the 60’s and a desire to be independent and earning my own way. I graduated from Nursing school in the early 70’s taking from that hippie era a strong belief in alternative medicine and a grounding in respect for the environment or Mother Earth. I started my R.N. career working in the Intensive Care Nursery. It was a new area of medical care, one in which few experts yet existed and I saw a chance to be in on the ground floor of a field that was drawing young physicians at the top of their class. It was all of that and more. I followed the best of the best to the West coast at the University of California, San Francisco and Stanford. In five years in the field I moved to the top or as far as that was possible as a R.N.

While I loved all the front line action, open heart surgeries on babies smaller than your hand, the development of breathing machines to help premature lungs carry oxygen and found I had a natural talent working with machines of every type I found the area of medicine that I’d devoted myself to far from my heart. I’d pictured myself preventing the medical problems I was now busy treating, and while it was noble and cutting edge it was not where I wanted to be. So I left, left it all and took a year off. Single and free I roamed and thought. Went overseas, explored America and let my medical mind wander. I discovered midwifery in my reading and suddenly visualized the answer of working to prevent the very problem children I’d been in the work of treating but at the time with only 12 certified midwife programs in the U.S. and few jobs I knew it was going to take some doing to get where I wanted to be. I also had no labor and delivery experience a requirement before admission to advanced programs. I looked at going the apprentice route but felt it would leave me with less options and I didn’t want any legal limitations standing in my way after investing time.

So back to school and work for three more years and finished with a CNM that seemed to open only a few doors as the late 70’s were still not a time that believed in or saw a place for a modern midwife. I tried private practice, but felt I saw too few patients to learn what I needed to. Went to a large inner city hospital which eventually burned me out but in 2 years taught me more about delivering babies than most midwives could learn in a lifetime. There were nights when I delivered 16 babies in 24 hours, delivered twins, breech babies, learned how to do vacuum deliveries, turn babies both externally and internally to get them to slip through the birth canal, learned how to say push in five different languages and sewed every type of laceration and episotomy. I learned the limits of my own knowledge and read daily to push those limits till I felt comfortable assessing pregnant women and handling all the types of deliveries that came my way. I learned to work fast and efficiently, training myself to feel confident in my decisions and to make corrections if first impressions proved wrong.

The work was exciting but mentally and physically abusing. Once again I was not quite where I wanted to be. I was getting closer but there was no time or energy to influence outcomes. I felt like a fireman with a hose trying to put out fires but with no time to teach people about playing with matches. The mid eighties presented some new possibilities, the natural childbirth movement having taken hold, Lamaze, homebirth, Leboyer. Opening my eyes I found it all around me. So I moved out of hospital. Now with only a nursing assistant I began teaching, following patients and delivering in a non-medical atmosphere. I learned how to work without fetal monitors, pitocin, and drugs. Most was available in case of emergency (all except fetal monitors) and there was always the hospital transfer. I found new ways of assisting mothers, using positioning, practicing patience that I’d never experimented with before. I read everything I could get my hands on about natural childbirth, use of herbs, took advanced courses in resuscitation of infants. I began to see how my work with infants came in handy. How feeling comfortable with newborns gave me an edge in understanding when a delivery was best done in a hospital or when an infant needed to be transferred after birth.

It was a good eight years and gave me the foundation I needed in natural birth methods that have since stood me in good stead. To this day I miss it but there were times I felt alone, very alone in the decisions I made, times when I had to push patients to the point that they found me mean but got the job done. I asked patients to dig deep and some were not up to the task. I was good at what I did but not always loved by my patients and I found this difficult. When I got pregnant myself at the age of 39 I choose an in hospital birth with midwife friends and experienced first hand so many of the aspects of birth that I watched others go through.

After delivery I took a year off to nurture my own child and motherhood and slowly returned to work in a new local. In the 19 years since that move I’ve seen many changes in maternity care and have done my best to serve my patients in all the ways demanded by modern medicine and the changing generation who has a different view of childbirth but all the same love of their children, wanting the best for them but not always very knowledgeable about what that is with all the mixed messages proclaimed by the media.

Now I work in a large hospital with epidurals, a rising induction rate, and a c-section rate while still much below the national average is still much higher than just 5 years ago. Patients are expecting c-sections on demand, painless vaginal childbirth, and fewer and fewer women having the time, energy or belief in childbirth preparation. Breastfeeding while known by most patients to be best for baby is pursued by only about 30% of our population for more than 6 months. Most of my patients return to work by 6-12 weeks post delivery, most infants cared for by relatives or home childcare givers where up to 6 other infants maybe under the care of one babysitter for 8-10 hours per day.
This is not a home birth, touchy feely midwifery. This is midwifery in a modern high tech environment. This is where the majority of American women give birth. The stories in this blog will reflect that modern atmosphere and the families I meet and work with here. I hope you will enjoy them. I am still a midwife and will demonstrate how I keep to my own philosophy intact in what can only be called at most times a modern but hostile atmosphere.