Breathe Easy, You've Found Me ((HUGS))

People will wonder why this blog is needed, why minority midwifery student? It's very simple actually; I was looking for this blog...but I couldn't find I created it. We all have unique experiences, and every experience, every story, can help someone else. I am a black girl from the hood at an ivy league professional school. That, alone, is reason enough to write. Somebody was looking for this blog. Someone wanted proof that what I'm doing can be done - even when you come from where we come from.

To that person especially, WELCOME.

Monday, February 18, 2008

Processing the Births

I was overwhelmed and dazed after catching the first baby a couple of weeks ago. I felt the magnitude of what was happening, and I couldn’t believe that it was finally my hands that I was looking at, catching a baby. It was amazing to watch someone’s eyes open for the first time, take their first breath. But do you all remember this post?

It didn’t feel like that…I didn’t feel like that, after it was over. Not to say that everyday should evoke some greater sense of purpose and make me feel like I’m changing the world, but I surely expected to feel similar to that day after catching my first baby. I was happy. I was very happy. But it was definitely not the same. The principle, tell the truth, present the options, and listen, were the same, but I didn't feel like "I can do this, all day, every day, I can do this." So far, I can only imagine it for a finite time...a short finite time.

I went to visit the mama a couple hours later…it seemed odd that all in the span of three hours I had met her, caught her baby, and sent her away to postpartum on another floor...I needed to see her again. It is possible to build connection in that time, but I would guess…actually, I am hoping… that it is no where near the connection you’d build if you had continuity of care with a woman. It was wonderful to see her afterwards because she was so excited that she had done it “all by herself” and she couldn’t believe that she “did it without nothing.” Over and over again, she said, “and I did it by myself.” It also helped me to get some glimpse of how she was processing her birth, because there’s a good chance that I won’t see her again in a clinical setting, although I might see her working at some time. How do midwives who do intrapartum call shifts without providing the prenatal care or post partum care deal with this lack of, or very short, connection? With having no clue what she and the baby are going home to…if there’s food in the house…if there’s heat? I guess what I’m saying is birth is not enough for me…it is not the epitome of this education, although at times it seems like it is supposed to be. There’s a lot of birth counting going on in my program…I hate that. Last week our teacher went around the classroom and asked each person to tell her how many babies she had caught, along with other opportunities such as admission procedures, c-section assists, rounds, etc. I asked if we would have to do this in this way every week? I think it’s building some kind of competition that I don’t want to participate in…everyone is obsessed with the numbers. I was glad when she said that that would be the only time we would do it. People are excited, I get it, I’m excited, too! But I hate that “how many births do you have now? How bout now? Now? I don’t know what the hell is up. I’m just not processing the experience in the same way maybe, and that’s fine, I don’t have to. But how am I processing it? I think I’m going to need to be the kind of midwife who knows the mama of the baby I’m catching.

The second baby I caught was, again, wonderful, but even less connection than the first. We shared the same first name. I literally met her once, then caught her baby in a very hastened manner because even though she was a primip, she went from 3cm to fully dilated and pushing very quickly (in fact, had not had a vaginal exam in that time – which is rare in the hospital) and did not feel an ounce of pain (her words) until late in transition when she said she had to poop and started vomiting….which is usually the sign for “baby’s coming” but not always, but in her case she was pretty close to crowning. We didn’t even have the birth cart yet. We managed to get it, get gowned and gloved, she pushed a few times and baby was here. We somersaulted the baby, which was a great learning experience because it’s not very common. Again, an hour later she was gone.

There is a young girl that I have as a prenatal patient who I do whatever I have to see myself. The first visit she barely spoke to me. Two visits later we were cool…my code switching in full effect, and all PC professionalism dropped. Her, flowing with the truth. I am worried about her. For three weeks she’s been contributing to her “cab fund” as we discussed since she has no car, and had no idea how she would get to the hospital if she couldn’t reach her aunt. But what about when she gets to the hospital? Her planned labor support is a little shaky. I’m imagining her there, alone, trying to have a baby. Yes, there are nurses, but nurses are not doulas, and they have more than one patient…but we are lucky with the nurses we have because they are supportive of midwives and decreased interventions (ie: they don’t mind doing intermittent auscultation even though it’s more work for them). But my point is, I can’t tell her that I will be there for her, and that sucks. Chances are I will catch the baby of another woman I've never met, while someone she's never met will do the same for her. It's frustrating.

The other reason I’m writing all this is because, unlike my classmates, I am hardly ever excited about call…I could take it or leave it. Half of my class signed up to take extra call over spring break in a couple weeks…I thought, you must be kidding? They seem so enchanted…so in love with this experience…they can’t get enough. Maybe I’m jealous. My big sib said, “It’s so much different, so much better when you know who you’re getting up in the middle of the night for.” My last shift was from 7pm to 7am. All I wanted to do was go home and go to bed.

I’ve caught two babies. Safely. I understand how huge that is. I am thankful. I am thankful to have been trusted by those two women. I get that. As I think about bringing my own into the world, I imagine that it will take me a very long time to find someone who I can trust to catch my babies, so, even though they had very little choice in the matter, I appreciate being allowed to be present.

I guess it will just take me a while to process...


Dark Daughta said...

I realized that both you and belly tales work in hospitals. I'm not acquainted with midwives in hospitals. Both mine were in private group practice with other midwives. It can be different. But in truth, I've narrowly avoided having to birth with someone I've only said hi to in passing. Still not cool. Smaller pool of possible midwives, but still a stranger might have delivered my babies. And no matter what anyone says, I'm understand what I'm coming with to be specific enough that I wouldn't want to have some stranger catch my baby after having spent months coming out in multiple ways to a primary midwife.

I hear your sadness. You want that connection. You want to be able to follow through. I think that because you're planning on birthing, you're already in the shoes of the mama, knowing that it would be best to not birth factory conveyor belt style.

It's jarring and disconnected. You're right. How will you make your peace with working in a big city hospital birthing environment? Are you planning on staying in a hospital environment or is this just part of your training?

Myra said...

what a blessed place you are at now... It is so new to you - still mysterious and wonderful.. Don't ever let it get old. Oh, I hope I don't..
I'm still here.. Just refreshed the old blog with a new one...

ktg said...

something i had to tell myself over and over in nursing school is "school is not the real thing."

you don't have to always do what they tell you when you're on your own. you don't have to work in a place that works like the hospital you're in now.

the hospital i work at is tiny. we have 4 beds. can you believe that? 4 freakin beds. we have 2 FP MDs and an OB/GYN. it's fabulous as far as hospitals go. when you graduate, you make the calls. it's not always so impersonal.

just keep thinkin - it's almost over, it's almost over...

doctorjen said...

I typed out a comment last night and my freaking computer ate it, and I was too tired to do it again, but here goes one more try! I hope you don't mind a non-midwife telling you anything about attending births, but I wanted to tell you that I hope you are not too disappointed so far with your training birth experiences. I initially went to medical school because I wanted to attend births, and was sort of disappointed during all those call shifts at how the births didn't really overwhelm me. Once I had the opportunity to have continuity clients, though, it was a whole different ballgame.
I have a lot teen clients like the one you are worrying over - but instead of wondering how it all turned out later, I have the opportunity to be right there with them through their journey. I had one client who sounds very similar, who would not make eye contact with me initially, would not answer anything but a direct yes/no question. In fact, I felt so much hostility at our first meeting that I almost felt I should refer her elsewhere, because I thought maybe something particular about me brought all that out. Over a few mos, we were able to develop a great working relationship, and by the end of her prenatal care, she was telling me how she wanted the birth to go - not asking me. It was amazing to see her work through a long and difficult labor with a depth of strength I didn't know she had. It was phenomenal to see her having gone from viewing me merely as another disapproving authority figure, to a point in labor where she was comfortable enough to be able to tell me what to do for her. And after that long, difficult labor, it was truly sweet to kneel on the floor with her and help her catch her 9 lb baby pushed out squatting on the floor. And seing the confidence in herself just bloom because she felt in control and strong and mighty throughout this birth was definitely worth working through all that initial negativity. That confidence has spilled over into her mothering and it's been a joy to watch her with her daughter. Down the road, I hope you will have many such experiences where you are able to build trust and mutual respect over the course of a long relationship!
Today, I did a 1 week postpartum and newborn check for a mama whose second baby I caught 8 days ago. I attended her first birth over 2 years ago as well. Today, we were practically dancing in my office because breastfeeding is going so well for them, and the babe had already gained 12 oz over hospital discharge and was well over birthweight. And this was all the more meaningful because I'd been with her through the awful difficulties she had nursing her firstborn eventually culminating in early weaning and lingering sadness. It's so sweet to celebrate these successes with clients when you've been through difficult times with them.
When I attended births as a trainee, it was always sort of interesting, and cool, but never the same experience it's been in private practice. It's a whole different ballgame to attend a birth when you were there when they found out they were expecting, you were there when they heard the heartbeat for the first time, you were there to discuss all the fears about childbirth, and help make the birth plan.
Anyway, congrats on your first catch - and I hope you'll have many more in a long and happy career!

the robot said...

this is the piece of student-hood that I hate the most - the flicker of time that I get to spend with patients. What's so freaky is that I'm actually able to spend 5x as long with the patient as the nurse does because I don't have anyone else to cover or any charting to do. The system seems to be preparing me for a lack of connection, a 'come in and do your job' mentality.

I started nursing school because I need something different than that. I need to be happy, energized, enthused about rolling into work every day. I need that because I've chosen not to have another adult in the house helping me raise this kid. I need that because I will have to work my ass off to be able to afford a house, and build a retirement fund and an emergency savings account and alla that. I've gotta love it - it's the way I've got everything else set up.