Fear

As most of you know by now, I will soon be taking the leap from family planning, gynecologic and abortion care into the realm of my first full-scope job. I have been reflecting a lot lately on the fear that I felt when I was a brand new provider and contrasting that with the very different fear that I feel now.

While the fear I felt by first being left alone in clinic was real and tangible (and rightly so) my new fear is one that has been lurking deep inside me since midwifery school.

I am scared I am going to hurt someone.

There. I said it out loud. I feel as though this is a feeling that most providers have (or should have), because fear, in some ways, keeps us safe as providers. It keeps us from harming others because it means we look things up over and over again, it means our red flags raise more liberally, it means we  are always looking for for the zebras among our horses. 

I haven’t caught a baby, or cared for a pregnant woman in prenatal care in over a year. I have not carefully and delicately sutured a perineum since August of 2013. I have not jostled a slippery little baby awkwardly a brand new parent’s arms for far too long. Everyone keeps reassuring me that “they’re still coming out the same way.” Or that “It’s like riding a bike.”

I deeply want to believe everyone who tells me these things. I deeply want to believe that I am the same, if not even more confident, midwife that I was at the end of my training, bringing with me more skills, greater ease in handling difficult situations, and a keener clinical sense.

But that doesn’t stop me from laying awake at night, envisioning terrifying shoulder dystocias. Running through drills for postpartum hemorrhage. Practicing silently how I would explain to a woman that I am pushing up her baby’s head to keep it from compressing the cord in the event of a cord prolapse. Seriously considering tattooing the neonatal resuscitation protocol on my forearm.

All of the above emergencies are exceptionally rare in the world of midwifery, but they happen. And I must maintain constant vigilance for their occurrence, thinking about risk factors, and continuing to rely on my midwife spidey-senses.

In an effort to pump myself up for this new type of fear, as well as exhaustion, beauty and love, I went back into my archives to find some of my favorite birth stories from my training:

I walked back into the room, the lights were low, and the woman was curled up on her side, laboring hard. Her husband had a mostly-full cup of coffee and a half a sandwich in front of him, but was dedicated to pushing on his wife’s back for as long as he could to relieve the incredible pressure she was feeling from a baby turned in the occipit posterior position, or what we call “sunny side up,” where the fetuses back is lined up with the woman’s back. I nudged him over to take my turn rubbing that magical spot until he could slurp down that cold coffee and a few bites of sandwich.

“Will you check? Please?” Came a whimper from the hard-laboring mamma. “I just have to know. I have to.”

I nodded, slipped on a glove and quickly checked. I’m still working on keeping my face neutral, but I think my shocked expression made everyone in the room perk up immediately.

“You’re 7 to 8 centimeters dilated, your cervix is all thinned out, and the baby still needs to come down a little bit, but I can feel her trying to turn!” I exclaimed, all of the excitement returning to my heart. We were going to have a baby soon!

Within an hour her cervix was completely dilated, the baby had turned into a better position for birth, and she was ready to push. Sometimes I am amazed and awestruck by the power of birthing women, and this woman was definitely one of them. It took her a few contractions to figure out where to push, but with our gentle coaching, she figured out her breathing, rhythm, and was the incarnation of power in that half hour of pushing.

Soon, a pink, screaming infant was handed directly into Mom and Dad’s arms, and the elation I feel at every birth rushed over me. It is am emotional thing, birth, full of excitement, trepidation, disappointment, uncertainty, but in the end, always the joy of honoring the hard work of labor, and helping to add a family’s newest member.

Even a year and a half later, I remember this labor well. I remember the anticipation, I remember the joy, and I remember this birth because I saw the true power of women’s bodies in that moment, and that’s what lights me up inside, and I can’t wait to get back to it.

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