I got called to a birth just as I was going to bed last Wednesday night. Invariably, the second I take out my contacts and call it a night, my phone goes off. It’s gotten to the point where If I want to catch a baby, I guess I should just start taking my contacts out.
Some births are different than others. Some births, I have seen the woman, and possibly even her partner, mom, sister, or other important person in her life for weeks or months before I attend their births. Sometimes, I walk in the room and say, “Hi, I’m the student midwife working tonight. Nice to meet you” and we start from there. Sometimes, I need to explain what a midwife is, and why their doctor isn’t there.
Both scenarios offer challenges, but this particular birth was different for another reason: this was one of the few patients that we see during delivery that was seeing one of our consulting physicians for her prenatal care, and he had even delivered her first baby. The woman had her partner, her mother-in-law, her mother, and two of her sisters with her that night, and as soon as I got the words, “Hi, I’m the student midwife….” out of my mouth both mothers and one of the sisters immediately piped up, “I had a midwife for my babies!” they all chimed, “We love midwives! This is so cool!” I perked up, happy to hear that these folks even knew what midwives were, or what we do.
We let the laboring woman visit with her family for a bit, and came and went, checking to see if her epidural was working better (it wasn’t) and called the sleepy anesthesiologist back to her room not once, not twice, but three times until she was comfortable. Note to self: Uncaffeinated anesthesiologists are not particularly happy to be greeted by a chipper midwifery student at 2 a.m.
We turned down the lights and told everyone to get some rest, it was just about 2:30, and as excited as they were to see all their family, everyone looked exhausted.
“But….when are you going to check her cervix again?” One of the mothers asked as I was leaving the room.
“Well…her water’s broken, so probably not until she’s feeling a lot more pressure, like she has to push.”
“And how long will that be?” asked her mom
“We don’t really guess, but as long as it takes. As long as baby’s looking good, and mom’s ok, we don’t like to mess.” Everyone seemed astonished. I could hear the fluttering of disbelief as I left the room. “You mean they don’t HAVE to check?” “They’ll just WAIT till she feels pressure?” “Is she going to be in the hospital the WHOLE TIME?”
Unsurprisingly, after getting some rest, I was back in the room half an hour later with a crowning baby. The mothers couldn’t believe that we didn’t make their daughter/daughter-in-law use the stirrups, and instead had her hold her legs with help in a way that felt comfortable to her and let her push effectively.
“Wow,” they said, that must be so much more comfortable
“Well yeah, it’s not about my comfort” I retorted. Everyone, again, was amazed.
A beautiful baby girl slipped into new Mom and Dad’s arms, and the midwife I was working with dashed out of the room to catch the baby being born next door. I stayed and folded my hands and waited for the placenta.
There was even more amazement at this. “You mean you’re not just going to yank it out?” Asked the woman. “I think it was out in, like, 5 minutes with my other birth.”
“Nope, I said, the body is smart, it’ll come out when it’s ready. So let’s just wait and you can get to know your new baby!”
I give all these small anecdotes and relay the amazement felt by this family because this kind of care, where one believes that the body is smart and capable, is not one women in America commonly receive. I believe that it is my job as a midwife to encourage family bonding, rest, and excitement, not continually check cervices for the hell of it, or make sure everything is happening on a timeline.
So, I ask, what’s in a midwife? What makes us different?
I think there are many things that make a midwife, but an approach that is hands-on in areas that are needed, like labor support, massages, and making sure you are present, both physically and mentally for a laboring patient, but that is also hands-off in areas that are just as important. Get the hands out of the vagina! Keep them off the pitocin! Let the placenta come on its own time! This hands-on/hands-off approach has many ingredients, but the main ingredient, that all the other bits are mixed into is most definitely a patient heart and a willingness to wait for a woman’s body to act on its own time.