Wednesday, July 28, 2010

The Secret Life of Midwives - Dads

It would be crazy to say that dads have the most difficult job during the birth of their babies. No one would buy it anyway. Well, possibly other dads. But, let us not disregard nor overlook the unsung partner in the childbirth experience.

I only attended two births, but there was plenty of time to observe. It kept my mind busy, plus I enjoy watching the dynamics of people. The man of the house has to be strong enough to be gentle. He has to read his wife, turn on his finest sensors, develop an extra layer of skin, and sharpen his mental capacity for staying focused.

In retrospect, I feel badly that we didn't emphasize and encourage the dads' intake of protein and liquids. It's very possible this was part of their birthing class preparation, and I simple wasn't present to hear the information. It is vital that dad is just as energized and hydrated as mom is during the exhausting journey of bringing their new baby into the world. He is the one who is going to have to remain strong and focused, during the times when his wife is waning in her strength and confidence. It is his role to know which hat to wear at the appropriate moment, sometimes wearing two at a time, and knowing when to toss the one that is annoying his wife, though he has no idea why it's annoying her!

I witnessed some of the needed hats, and I noted some hats that could come in handy.

1. Coach - Leave the whistle in the locker room, but bring your ability to encourage, support, and build your wife's confidence in her game. Remember, SHE is the one on the field!

2. Cheerleader - No need for a skirt and pom poms, but you will definitely need to cheer in spirit, not in volume.

3. Masseuse - Your bride will require unending amounts of massage, and it is your job to know what part of her needs the attention, how much strength to use, and for how long.

4. Stabilizer - If the emotional storm starts rocking the core of your wife, you are going to be called into action to calm her. This hat may also require a creative mind and equal parts of gentleness and firmness. Good luck.

5. Psychic - At any time, without warning, the current hat you're wearing will change its affect on your wife, and it will annoy her. Toss the hat as quickly as you can, and keep trying on other hats, until one meets her approval. Psychic abilities to foretell the coming annoyance will be hugely valuable to both of you.


As this beautiful event begins to unfold, take a moment to breathe, and mentally shower yourself in the love that the two of you share. Imagine God's hands, lovingly holding your sweet baby in deliverance to you and your wife. You are embarking on the journey that leaves you with the most precious souvenir of your life together. Family.

Friday, July 16, 2010

The Secret Life of Midwives - Birth #2

I suppose since birth is such a spiritual and direct link to God, the ability to be intuitive and read the wants, desires, and needs of couples becomes clear. During the week, Cathy left for another birth. I'd met the couple at her home on Saturday, and I was touched by the bond and love between this couple. I had a feeling that their birth needed privacy. Cathy agreed, so, I stayed behind.

I really don't remember what we did on Friday, but later in the afternoon, Cathy and I each retreated to our own space to catch a nap. I was in a deep sleep, but for how long, I never checked. I was awakened by a text message (technology at its finest) from Cathy -- "Get your birthing suit ready." I looked at the message and thought, "Am I up for a repeat?", but, I then I realized Cathy wasn't inviting me, she was informing me. We needed to get ready. A minute or two later, I received another text that said, "We'll leave in 40 minutes."

I got up and went to her birth room of supplies. The towels were clean and folded, and I knew which bag was used for towels, so I packed the towels she would need. I don't really remember much more.. what did I wear? How did I get myself ready? I remember that we got the car packed and ready, that's about it. No more detailed memory than that.

Again, birth time. We arrived maybe around 8 pm. We were greeted by a nice, calm dad holding a, not feeling so well, 18 month old. A glowing mother, affectionately rubbing her tummy, was sitting on the lower stairs. I noticed, in the family room, were their other two boys, happily watching a movie. Three boys, and sometime before morning, their baby sister would be joining the family. How exciting! The comparison was made to Christmas morning, going to bed knowing Santa would visit during the night. Tonight, Santa Cathy would deliver their baby sister.

Cathy went upstairs with mom to check her, ask questions, and get a feel for what was presently happening. I started unpacking the car. If I may add a personal whine... the altitude of the Salt Lake City area is MUCH higher than what I'm used to in the Central Valley of California. And EVERYONE has stairs and levels to their homes!! Carrying things in and out from the car, up a driveway, up to the front door, and then upstairs in the house made me feel like an old worn out lady. The only positive part of it was, no one was around to talk to me, to find out how out of breath I was at such seemingly easy tasks! I felt privately out of shape and embarrassed.

The birthing pool was set up in the couple's bedroom, but had not been filled yet with water. Mom sent dad to the store to get snacks. Grandma was on her way to care for the boys. While surveying the birthing supplies, Cathy realized we'd forgotten the chair. She was disappointed, and took some time deciding if it was important enough to drive home to get. Since it appeared that her services were not going to be needed within the hour, Cathy decided we'd return home for the birthing chair. She estimated being away 40-50 minutes. She let dad know we were going to get it and on the way we'd stop at the store for some coconut milk for mom, her favorite rehydrating beverage. Dad seemed totally at ease and anticipated no problem with Cathy leaving. Cathy instructed him to call her immediately if anything changed, and she'd zip right back to their home.

Cathy called Briana to let her know who was in labor and update her on current details. Briana was at a concert with her sister, but said she'd come over as soon as it was over, which seemed within an appropriate time frame for the birth event.

We continued on our trip to retrieve the forgotten chair, and while at home realized we probably should get a protein snack to energize us for the pending activities. I had a nectarine with cottage cheese. I don't recall what Cathy had, but I know it was protein packed. We hop back into the car and drive back to the home of a waiting mother.

When we return, grandma has arrived to take over care of the boys, so dad is available for his role : a source of love, support, encouragement, and focus. (I will write more about the dads later). It is clear that mom is progressing in her labor.

Again, I witness a couple who have not stumbled upon their homebirth decision accidentally, or on a whim. A homebirth requires both husband and wife to be onboard completely. It requires a total committment and responsibility to the experience, from beginning to end. It requires confidence in the decision. This couple have had three children in a hospital setting. Cathy informs me, in the car, that the mom may need more verbal support during her birth, because she is working out of the realm of her previous birthing experiences. She might question more. She may need more reassurance as her birthing progresses with different decisions and techniques from her midwife at home.

We all go upstairs to the couple's bedroom. The pool is filling with hot water, so by the time mom needs to get into it, the water is comfortable. Contractions are felt strongly in her back hips, and she needs her husband to provide counter pressure, by using his arms to squeeze against her hips during contractions. I privately time her contractions, as an activity to keep myself focused on the events. It really is amazing to me that contractions get into a rhythm, and can be predictably expected. At this time, they were occurring every 5 minutes.

Mom begins to appear sort of restless. She's looking around, appraising her own situation, and then voices to Cathy that she really doesn't think she wants to use the birthing pool. She is almost apologetic in her tone, and asks if that's okay. It wasn't surprising to me that Cathy let her know that it is all her decision, and it is perfectly okay for her to do this anyway she wants. I look at Cathy's face, and I suspect she believes the mom will change her mind, but she is not going to express that at this time. I wonder if my presence is a distraction for mom. I don't feel she wants her body so publicly expose, so I go downstairs and write in the journal I brought with me.

After a while, Cathy comes downstairs and joins me. Mom was doing fine, and possibly needed some time to get herself sorted. Cathy gives the couple some alone time. In a bit, Cathy is called back upstairs to the bedroom. I follow to see if there is anything I can do to be of service, within reason of course. I know that each time Cathy checks the baby's heart rate, I need to record time and rate. I record other events, figuring if it's not necessary information, Cathy can simply omit it when writing her final records.

Mom is definitely being called to duty. She's doing everything right, yet definitely feeling some strong contractions. Her husband is giving her all the support he can, continuing with the counterpressure on her hips. Birthing time continues, and I really don't recall the elapsed time. Briana and her sister, Candace, arrive. Once again, Briana doesn't waste anytime, she gets right into the bedroom and finds a midwife perch.

At some point, mom was getting tired and frustrated with the pain and her laboring positions. She asked Cathy if the pain would be any better or relieved in the pool. Cathy smiled and said, that it would help. I noticed, almost instantly, that once mom moved into the pool and got situated, she seemed to relax a lot more during the contractions. She was asking questions, just as Cathy predicted. She made a comment that her hospital midwife did something that helped progress the birth. Cathy listened, but really didn't respond or comment.

While she was laboring in the pool, I took notice of Briana and Cathy. Later, I would imitate what I coined, "the midwife stare." They sat very quietly and watched the mom labor. Just watched. Sometimes Briana's eyebrow would give away her thoughts, and it would arch. I wondered what analysis she was privately forming. To me, it just looked like they were staring at her, allowing her to work through her own process. Cathy explained that, in the midwife world, this is referred to as "holding the space."

Cathy continues to check the mom and baby. All is fine, progress is being made, but it seems the sac is bulging, but not breaking. Cathy reports to mom that she now understands what the previous hospital midwife may have done to progress the delivery. Together, Cathy, Briana, mom, and dad decide that Cathy should puncture the bag, since it seems to be in the path. They decide to do this over the toilet. After the bag has been able to release, mom returns, not to the pool, but to her bed. The final phase of birth begins to unfold.

Their baby's head starts to show, and I witness an event that will forever touch my heart. Dad lovingly and gently "talks" this baby and mother through the delivery. He is telling his wife everything he sees of their baby girl.... "Oh, I see our little girl's head!" "She has hair!" "Oh, our baby girl is coming" And he continued to verbally support his wife in this most precious, gentle fashion. This baby girl inched her way out, peacefully, gently, and beautifully. And, in joy, she rested on the chest of her mother, with both parents enveloping her in their love.

This new baby girl cried dutifully, then rested so comfortably and contently with her mother, it was apparent that this is a child of peace and calm. Her brothers had gone to bed hours earlier, with eager anticipation of meeting their baby sister in the morning. They were not going to be disappointed.

Wednesday, July 14, 2010

The Secret Life of Midwives

While visiting my soul sister, Cathy, I was invited into her sacred world of midwifery. I arrived at her home on a Saturday night, right in the middle of a party, celebrating the conclusion of a birthing class she'd taught. There were six couples, two of the couples were there to share their birth stories, and the other four happily/anxiously awaiting the birth of their baby. Cathy introduced me to the group and explained that I may be attending with her at any one of their births. I was amazed that no one seemed to balk at the idea, or at least, no one did in my presence.

I cannot say I was positively up for the idea of witnessing one of Cathy's births. I didn't know how I would react. I didn't know if I would get squeamish. I didn't know if I'd be more of a bother than a help. I even worried about getting bored! But, I'm learning this about my lifetime friend.... she is exceptionally skilled at easing me out of my comfort zone, and I trust her. She makes me want to be a better person. She has faith in my abilities, when I am busy questioning myself. I had to turn myself over to her confidence and follow her lead.

Of this I am sure - Cathy is skilled, gifted, and born to this Earth to support and love couples as they welcome their babies to their family.

It was the evening of July 4, and Cathy got into her own preparatory mode. She started getting towels packed, looked over her birthing basket to restock necessary items, checked that her oxygen tank was working properly, and basically, getting herself ready for whomever called her first. Everything was in order, ready to go.

Birth #1
July 5, it's time. We got the car packed and I accompanied Cathy to the home of our first birth of the week. We gathered her bags, baskets, and duffles, and proceeded to the home. As we were walking through the complex, Cathy said, "Isn't it cool that there is all this living going on around here, but in one apartment, there is a baby getting ready to be born?" Yes, it was very cool.

This is one of those experiences that as soon as it's over, you can't remember how you'd pictured it to be. We entered an apartment that was quiet, soothing, and prepared. Candles were lit, a well chosen playlist was creating a deliberate mood, and a beautiful laboring mom welcomed us into her home. Husband greeted us politely, but it was obvious he was there for one person, and she owned his attention. What soon struck me, as wonderful, was the fact that this couple had created their birth scene. It was staged in the way that the two of them had chosen as the best way to bring their new baby into their loving world. I would learn later in the week, that these birth scenes are personal,individual,and equally beautiful.

As Cathy gave her attention to the mom, as a support, not a director, I found myself feeling completely soothed, relaxed, and taken in by the calming energy in the home. Cathy gave me the recording job, documenting events, heart rates, stations, etc. Parents asked if I'd take pictures. Both of these assignments were within my capabilities, and made me feel within my personal parameters of being useful.

The laboring mom kept herself moving, feeling her body's work, breathing herself along the natural path her body was creating for this event. What really impressed me about this mother was that she seemed to own her labor. She was working with it, keeping herself on top of the discomfort (PC term for pain) in a way to work through it, not tightening against it. I could see her concentration and determination to not let it get the best of her. I thought she looked radiantly beautiful. I wish I could see the pictures of her, because I was sure I was capturing her deepest beauty as she performed her great task.

Then, it was apparent that she had transitioned into a deeper level of labor. Her participation in conversation ceased, as she entered a much more demanding phase. She started to vocalize more, as had been discussed and practiced in the birthing classes. Moaning is not a purely accurate description. It is an expulsion of energy. Release. Flow. Using her voice to work with the pain, not against it. I found it to be an empowering, earthy sound.

Cathy is positioned close by, quietly reading the mother's movements and sounds. She seems to know the exact time to suggest an adjustment in position. She offers help. I watch Cathy watch the mom. Cathy uses well experienced measures of intuition and medical knowledge. A perfect balance.

There is no denying that the time was starting to approach. Mom's intensity creates a heightened energy in the room. It pumps into everyone, a blanket of adrenaline, so that all present are prepared for action. The energy is still pure and good, not a manic energy at all. I'd describe it more as a living energy. I'm pretty sure Cathy has grown addicted to this energy. It is full of life.

Mom is in the birthing pool, and we see her baby begin to emerge. Cathy is guiding her with gentle words, as well as guiding her baby from her body. I really don't know what the time frame was during this part of the birth. I'm not sure I was breathing. The baby is a good size, and his shoulders are not coming through easily. Cathy doesn't exhibit any signs of anxiety or fear. In a very controlled tone, she instructs the dad and me to help her lift mom out of the birthing pool and place her gently on the towels already spread on the floor. Cathy needs a better position to help get this baby's shoulders turned.

Cathy and mom are working together, and there is a general sense of urgency, but Cathy is not showing any signs of distress, she is completely focused. She enlists us to help this mom turn to her hands and knees, hoping that position will help turn the baby and allow Cathy to get a better grip (I'm thinking). AH!! The baby is out, and in one motion, Cathy hands him through mom's legs to her, so she instantly has her new baby boy in her arms. A family grew before my eyes.

My novice, supremely naive self thought that we'd clean up, pack up, and get home in time for a tasty lunch. It was just a little after 2:00 pm, so I allowed myself to start thinking about eating. I'd forgotten that, at one time, Cathy had explained to me that her role elevates at the moment of birth. This is when a midwife's skill, knowledge, and expertise are most needed. And, this mom needed Cathy.

Mom, dad, and baby got themselves to the bed, leaving behind a graphic reminder that this birth wasn't completely smooth sailing. Cathy joined them, waiting for the placenta to pass, tending to mom, and checking the happy condition of new baby. Since I had nothing with which to compare, I thought this was all within the norm for a birth. Later, I would learn that this was one of Cathy's more difficult births. I would have never known had she not shared that. Nothing about Cathy's demeanor indicated anything other than normal. Nor, did this incredible mother show any panic, fear, or frustration. I witnessed the peak of female strength.

I also experienced a new concept of time. Birthing time. Time is not measured by a traditional clock. It is internally measured. It is transitionally measured. Time during a birth moves separately from the outside world. As I mentally retrace this birth story, from my vantage point, I find myself recalling time in different increments. Cathy's midwife partner, Briana arrived. What time? Sometime after the placenta! 15 minutes after placenta?

Briana's arrival brought new eyes, fresh perspective. She was not drained by the focus necessary for the labor and birth. As Cathy addressed some of the mom's issues, Briana was now available as a collaborative partner and a team member. She entered, scanned, assessed, and jumped into helping Cathy. She appeared to do this quite effortlessly, making it look everyday and breezy. Personally, I was relieved to see her! I didn't know what Cathy might ask me to do next.

A baby was born at 2:07 pm. This is the only exact time documented. We were packed up and driving away sometime around 6 pm.

On July 5, my world expanded.