How Did I Get Here?

This past week has been a trying one, as I got word that the position I was slated for didn’t exist anymore. Not because someone else had been chosen, but because the staffing needs of this particular clinic do not require another clinician at this time. It’s not you. It’s me.

This left me feeling an odd mix of desperation, hopelessness, and complete love and support from my wonderful community. Times like these can leave a new grad midwife wondering, “How did I get here? How did I get all the way through school, work so hard, do so well in all my clinicals, be universally loved by my clinical preceptors and faculty, and still end up jobless four months out of school?”

The answer to that question is a complex combination of bad timing, bad luck, the fact that I went to a program that is direct-entry style, as well as a general lack of willingness of practices to hire a new grad into a full-scope position.

The question I want to tackle today has nothing to do with my job search, and how I ended up “here,” an unemployed new grad, but how I ended up here to begin with. What made me become a midwife?

The question of “why” has popped up in every interview I have conducted in the past few months, and at this point I have an easy, rehearsed, precise answer. But at times like these, the lonely times, the dark times, I find it necessary to revisit they why of it all; and discuss the joy that brought me to this place to begin with.

I was about eight years old when I was either given a copy of the young adult novel,”The Midwife’s Apprentice.” I read and re-read my copy until its dog-eared pages threatened to fall out. I thought about how wonderful it would be to be a midwife, in definition, a woman (and now, increasingly, people of all genders) who is with women. But as a girl growing up in America, my only other exposure to birth came in the form of reality television shows like “A Baby Story,” and there were no midwives there. No kind, gentle, quiet midwives who soothe the pain, give confidence to women, and help new life into the world. All I saw were authoritarian physicians, screaming women, and the drama and fear associated with birth.

What I should have been doing is looking more closely at the nurses.

I put midwifery to the back of my mind and rambled through dozens of career options, including a short stint where I wanted to be an FBI agent (thank you Mulder and Scully), then an actress, a forensic scientist, a writer,  a physician (for about 30 minutes until I realized that this prospect would have involved me actually going to med school) and a teacher.

My second semester of college was arguably the most horrific time of my life. My father has just died of pancreatic cancer, my family was reeling with the loss, and I returned to classes just a week and change after his memorial service. But in some ways it was the most exciting time. Possibility abounded, and there is nothing like a loss that comes too soon to instill a drive in you to find your path and live fully and deeply for the unknown amount of time we all have.

I enrolled in a course on the history of midwifery that semester, and lo and behold, midwives still existed! They attended birth in most modern countries as advanced practice nurses, as lay midwives both in the U.S. and abroad, and were all deeply committed to improving maternal and child health.

I insisted that I could never have the bravery, scientific know-how, and ability to be a midwife myself, but I could work on the policy side to improve women’s and families’ access to midwifery. So I sought out a degree in anthropology and women’s studies, which, I hoped, would prepare me to launch into a graduate program in public health, with, of course, a focus on maternal and child health.

Fast forward to my junior year of college, and I was boarding a 22-hour flight from JFK to Cape Town, South Africa. The Mother City. My official internship was with GenderDynamiX, a wonderful organization that does advocacy and education for trans folks, and is the only organization of its kind on the whole of the continent of Africa. I loved my time there, and helped put together the first trans-focused float in the Cape Town Pride Parade. But sitting at a desk was killing my soul and my passion, no matter how amazing the work of the organization,

On the way to the local Pick’n’Pay (the South African version of Safeway), I saw a sign. Midwives Clinic. I scribbled down the number and called, hoping to see if I could volunteer with them on my off-days. This particular clinic only did well-baby exams and vaccinations, but they referred me to another practice that did prenatal care and births.

I nervously called, asked for Ciska, the lead midwife, and we talked for half an hour about c-section rates, my interest in midwifery, and her kind, bubbly voice invited me to visit them at clinic.

I rode the train out to Plumstead, one of the small towns on the outskirts of Cape Town and found the little house with green shutters. I walked up to the gate just as Ciska was pulling her birth bag out of the trunk of her car. She was excited, bursting with joy, and now I recognize the familiar feeling, high on a birth from the early morning. She hustled me inside, plopped me down in the tiny alcove the midwives used as a tea room, and had a cup of  piping hot rooibos in my hand before I could say a word.

My mind was reeling with excitement and nerves and Ciska recounted the details of the birth she had just been attending, and the emergence of sweet baby Amelie into the world. She gave me a quick tour of the clinic before her first patients arrived, and my eyes lingered on the painting of the baobab tree, and I felt a certain peace, knowing that my beloved baobabs would be here with me today.

Patients began arriving, and I watched prenatal visits unfold, and felt care, confidence, and real human connection fill the room. My hands yearned to learn, to touch, and to transform my timid and unsure voice into the one I heard Ciska use. Calming. Real. Truthful. Bright.

I came to clinic every Tuesday of my four months in Cape Town, alternating weeks between bright, bubbly Ciska and calm, quiet Susan. I learned to take blood pressure, dip urine, measure fundal heights, do Leopold’s maneuvers.

Then the call came. I had been waiting for it for weeks. It was finally my turn to be on call. A woman I knew from prenatal visits was in labor, and I threw my phone, keys and notebook hastily in my bag, rushed out the door with a piece of nutella toast in my mouth and ran for the nearest minibus taxi stop.

I walked into the hospital. I was instructed to tell the nursing staff I was the midwife’s apprentice. My lips buzzed with the words, and I entered the room. Rhoda was laboring hard, already in active labor, and her husband shot looks of concern across the room at me. I showed him the spot to press on her back, but was silent as a mouse. I watched as Rhoda rocked and swayed, cooled her forehead with cloths, and I listened to Ciska’s words. Her usually quick-witted words slowed, she was the quiet, thoughtful midwife helping Rhoda through her contractions.

I was stunned by the difference in the unfolding of events that those I watched on TV as a child, as it was clear Rhoda was in charge. She birthed on the floor, husband supporting her in a squat, and Ciska was a witness and an aide. She was the antithesis of the authoritarian doctors I grew up watching, and I could feel the power Rhoda held in this moment.

I crouched down as she pushed, cheering her on quietly, and completely forgot my job of watching for birth time. Tears welled in my eyes, and the beauty, power, calmness, and strength of the moment seemed to remove me from time and space.

When asked for the birth time, I looked at Ciska, tears still falling, and said, “Oh….I just… couldn’t look. I forgot.”

She laughed. “18:36 sound ok to you?”

The new parents also chucked, agreed to the rough approximation. My fingers fumbled as I wrapped the new, fragile girl in a blanket and helped get her to breast immediately. We left after mom, baby, and dad were all resting, and I sat stunned in Ciska’s car.

“Well,” she asked after some time of silence. “What did you think?”

Tears immediately filled my eyes again. “I think I need to start looking at midwifery schools” was all that I could get out.

Ciska drove me home, she talked me through everything she did during the birth, I asked questions, and felt the high of birth rush over me in waves. This is it, I thought. How could anyone want to do anything else?

I walked into the kitchen of the house I was living in, and my roommates peppered me with questions. Was it cool? Was it gross? What did I do? Still riding the tide of happiness, I recounted the story.

“Go write it down. Now.” The voice was that of my friend Brittany. She recognized the enormity of this moment in my life, and instructed me to journal it while it was still fresh in my mind. I am forever grateful of her urging me to do this, as I often look back on that journal entry, details still as fresh as the day I wrote them down.

Right now, it helps to relive the why of how I got here, instead of looking at the “how” of my days currently. Will my first job be one where I work with midwives like Ciska and women like Rhoda? Maybe. Maybe not. My midwifery career is a blank slate in front of me for now, and no matter where it starts right out of the gate, I’ll always think of that moment I recognized my sweet baobab trees and knew I was home.

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One Response to How Did I Get Here?

  1. Beautiful post, Michelle! Thank you for taking us back to the beginning.

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