Thursday, January 24, 2008

The Miracle of the Midwife

The first time I picked a midwife, to attend the homebirth of my second child, I just wanted someone who would be nice to me and allow me the freedom to labor and give birth as I wanted to, without drugs or interventions. Of course, I wanted her to be skilled and experienced. Julia more than fit the bill, and she saw me through the later half of my second pregnancy. She arrived at my home less than an hour before my son was born; and her presence was absolutely necessary, as he needed her help to get out of my body.

This time, I sought two things in a midwife who would attend the homebirth of my third child: a strong personality, and a comfort level with shoulder dystocia. My opening words to Martha when I first spoke to her were "Before I decide I love you, can you please answer one question for me? How do you feel about shoulder dystocia?" Her answer was very simple. "Well, it's only a problem if you can't get the baby out." Silence followed for a few seconds, then she continued, "...and I know how to get the baby out, so I don't think shoulder dystocia is a problem." I knew I had found my midwife.

Martha saw me through my entire third pregnancy with a placidity I had never seen before in a woman. At every visit, I was energized by her strength, confidence, and unbarred trust in pregnancy and birth. I listened to stories of the births she would attend for mothers no other midwife would touch -- home VBACs, older mothers, mothers with histories of pregnancy-related medical conditions. Martha's confidence comes from her extensive experience and knowledge of the pregnancy and birth process, but also from her faith in each mother she supports. She knows that we all want the very best start for our babies, and she trusts that our bodies and our intuition will lead us to successful outcomes.
She had far more trust in me and my body than I did.

After my experience of giving birth to Simon, I held a lot of fear about whether I could give birth to another baby. I spent my pregnancy focusing on growing a smaller baby, trying to eat intelligently, exercise when I could, and sleep. Taking care of myself was a top priority and as a result, my third pregnancy was also my easiest. While I carried fear, I also knew that being at home, with Martha, was the very best chance I had for the most positive outcome. The concept of a hospital birth felt foreign and disconcerting.

I called Martha much eariler than I knew I had to, only because I knew that her proximity alone would free my inhibitions enough for labor to do its work. I had been in a holding pattern of labor for several days, but I knew Wednesday would be my baby's birthday. On Tuesday evening, I let Martha know that labor had settled in, and, in her calm, unemotional way, advised me to sleep and call her when I couldn't sleep through the labor anymore.

Martha arrived after 11:00 on Wednesday moring, with her sister, who was visiting from out of town. The most animation I ever saw in Martha was when she spoke of her sister, Etta, during my last prenatal visit, so I invited Martha to bring Etta along if I went into labor while she was in town. I was only 3 cm dilated and contractions were very bearable, so Martha and Etta left to get some lunch while I busied myself arranging food for everyone to eat later.

At around 3 p.m., my mood visibly shifted and Martha strongly suggested that I get into the birthing tub. I was reluctant; I wanted her to check my progress. She assured me that, if it was too early, my body would tell us and I'd get out of the tub again. Getting into the tub was the right thing to do.

Just before 5 p.m., I was feeling tired and characteristically impatient. I wanted to know if my baby was a boy or a girl. I wanted the contractions to stop hurting. I wanted to know if this baby was going to get stuck on the way out. Martha demonstrated no signs of urgency and didn't seem to care whether the labor went on forever. Her trust never failed and her patience was infinite, but she caved to my desire for information and checked my cervix. 7 cm. I was making progress.

Martha didn't touch me again until my baby was born. She didn't break my water in spite of my having been in labor all day. She didn't tell me I needed to make some more progress soon or I would face an intervention. She sat, chatted, and smiled a lot. She checked my baby's heartbeat one time after my water broke; Martha knew that the umbilical cord was low because she heard a "whoosh, whoosh" pulse in one place on my belly, and a "thump, thump" pulse a bit higher...but she was not concerned.

In my previous two births, I received the assistance of the birth attendant near the end of my dilation. In my memories of both labors, that cervical induction, as it's called (manually moving a lip of cervix past the baby's head to faciliate descent), was the only experience of real pain I had. I was waiting for Martha to do this again, but she didn't...she knew my body would do what it needed to do, in its own time.

In our discussions about shoulder dystocia, Martha had let me know that she would ask me to push my baby out from a hands and knees position if she determined it was stuck. My labor was keeping me in a reclined-sitting position, and I felt that this was the position in which I needed to push the baby out. I felt the head descend and pushed like hell. I was determined and terrified and relieved all at once, and Martha was silent and calm. I knew my baby's head had been born, and I was waiting for Martha to direct me to turn over to help loosen stuck shoulders. When she said nothing, I second-guessed her. I had screamed my baby's head out, I think in expression of the fear I had about whether I had grown another barrel-chested baby, but Martha and Bryan were both extremely calm as they looked at the baby's head. What I couldn't see was that my baby emerged facing my right thigh, then turned face down after a few seconds. Her head stayed pink and did not retract as Simon's had as it turned dusky purple. They knew my baby was on her way out safely.

I pushed again and my baby was born. Martha only unwrapped the cord from around her body and pushed her through the water toward me. I gave birth to my baby almost completely unassisted!

The miracle of the midwife is that, by doing nothing, she had done something so incredible: she restored my trust in my body's ability to grow a baby and give birth to it. Her presence gave me the confidence to let my body labor; her proficiency gave me the space to labor safely and effectively, and her trust gave me the gift of birthing my baby without even the slight interventions I had been conditioned to believe I needed.

Once again, my experience of giving birth changed my life.

1 comment:

  1. Diana, thank you so much for sharing your lovely birth story. Congratulations on the birth of Gabriella.

    Sara in Nebraska