Monday, December 20, 2010

The Red Hat of Midwifery

I remember when I want to the CAPPA conference in my town many years ago and saw Linda Smith, RN talk about breastfeeding. She had her conference talk and when she couldn't resist chiming in with her own personal opinion, she'd slap a red baseball cap on her head so you knew the difference. It was charming and clarifying and it's a concept I've used many times since then.

One area that I try hard to never wear a 'red hat of opinion' on is my doula work. It's hard sometimes; I see what the client wants, and I see what she's asking for, and being objective, I see the difference in those two things. I ask lots of questions and when clients ask me, "What would you do?" with that serious look on their faces, I know that they weigh my opinion heavily, and that my response will not just be casually catalogued with the opinion of the woman who does her nails. Like it or not, I'm seen as a woman wise to the ways of birth, wise to the ways of navigating providers, and myriad other facets of what we do when having our babies. I'm going to be heard as an authority. I have to take that really seriously because it IS serious.

When she asks me this question, "What would YOU do in my situation?" I remind her that what I would do is based on my own values, my own experience. It is not necessarily what anyone else would do. Also, what I do may not be appropriate for her situation. Last, I do not have to live with her choice- she does.

Sometimes she'll continue to press me, "I know, I know, but if I was your sister, what would you say?"

I care about my clients and being human, I of course also have this urge to share my opinion that is hard to deny- but it's SO important that I do exactly that.  If she presses I tell her pretty directly - "I'm not going to tell you what I'd do. I'm here to help you figure out what YOU need to do. What do you need to know right now in order to make this decision?" I have found that shifting it back toward her turns the conversation away from me, and toward something she can actually use.

Now I'm working closely with a lovely midwife - working hard to be a great assistant and soak up everything I can learn in the meantime. I'm navigating a new world and one where (the midwife's) opinion is expected and offered to clients, alongside support, encouragement, and trust in herself. I'm finding that I have to literally take the Red Hat of Midwifery off of my head when dealing with my doula clients. Because the worlds are so very different, it is a conscious choice I have to make to go back to questioning, rather than answering (not that I'm giving any information to midwifery clients, I'm not, but I don't have to be restrained in my own mind the way I do with my doula clients.) Basically, if I'm not in the right head space, the lines get blurred VERY quickly.

I was talking to my friend about this and I wondered if this was why some doulas struggle between their desire to be midwives and their power as doulas. It takes a lot of restraint, as I'm learning things, not to want to share what I'm learning! I would be *harming* my relationships with my clients if I wasn't clear.

I can see where, when doulas are offered the chance to feel a cervix, check heart tones, etc. that it is so difficult to say no. I've been offered, even implored, to check and I've had to say no. It was VERY difficult because I desperately want to learn these things! However, I knew that no matter what I said, they'd weigh my interpretation very heavily and it was so important that I not disrupt her own knowing with what would have largely been a really inept guess. Imagine if I'd thought she was barely dilated and it turned out she wasn't, and we left too late? Or the opposite- I thought she was further along than she was, we left and found out that she wasn't nearly dilated and we'd gone in too soon, thus exposing her to increased interventions or having to choose to leave? No thanks!

As I move into 2011 I'm finding both feet firmly in the midwifery world- I'm not asking for doula client this year like I did last year - I am accepting what comes, but I am most excited about sitting at the feet of the midwives who invite me along, and holding space for these mothers as they teach me too, in their own knowing, their unfussy-ness, their tentative steps into the unknown with bare feet and round bellies.

I will say that having been so conscious about my professional boundaries, and so serious about not crossing them, has liberated me to become a doula strong in communication, intuition, and heart - things that I know will serve me brilliantly as I inch my way toward midwifery.

Saturday, September 25, 2010

No longer an urge

Today is the day that my daughter was born by urgent cesarean at 35 weeks for fetal distress, three years ago. She was a teeny, tiny 4lb 7oz bundle brought to me and stuffed into my neck where I couldn't see, but only kiss her sticky cheek.

Every year around this time I think back to her birth and I find that the further I move away from all of my birth stories, the less I feel the need to relive them. There is an important healing that happens every time we tell the stories of something that changed us; we reap information and healing and integration every time the story is told.

I started to share my birth story, and I realized that I didn't really need to anymore. I don't need to write it out, I don't need to relive every terrifying moment. It was scary, and it was one of the hardest, most courageous things I've ever done. I did it, and it's done.

When I look back at the births of my sons, at the time I was very upset and even traumatized. I look back and think that I had pretty good birth experiences, all in all. A lot of my suffering was my own creation- hanging on to an outcome to the bitter end as my plans were decimated by pre-eclampsia and a baby who needed to, but was just not ready to come out. Not having the knowledge about what I was agreeing to when I asked to be induced - these were what I used to call mistakes, and now I just consider it a part of their stories. No more urge to look back and judge myself. I realize fully in my soul that I have only EVER done what I knew best in the moment to do, and that bitchy nurses and impatient doctors and doulas with bad breath were all just players in my story. They weren't what defined it unless I empower them so.

Who was *I* in those moments? How did *I* show up - for myself - for my birth - for my babies?

I don't mourn for a birth I never had. I do wish I could have gone into spontaneous labor at least once, but then I remember that my regrets are rather privileged in a world where women give birth to long dead babies with no one at their side, on hefty bags in bays of other women also laboring, in facilities lacking even basic supplies. I didn't get to go into spontaneous labor but knowing that I had a really great chance of surviving my births, that my children had a great chance at survival, that I had every tool at our disposal should it be needed, that my pre-eclampsia was caught early and not when I went into seizures giving birth - it humbles me.

I am not minimizing my births by comparing them to someone else's awful story; these are my stories and I claim them fully. I claim the Divine Mystery that tells me that no matter how well you plan, something that will surprise you is up ahead, I claim full responsibility for the choices I made, and I claim the lessons I've learned because of my births.

This is Eidie's gift to me today! Happy birthing day to us both. May her uterus never be cut and she birth in the arms of those who love her, should she decide that making babies is something she wants to do. ;)

Thursday, September 16, 2010

Well rounded midwife

I was chatting with a couple of my midwife friends this morning at a birth we were at. I really enjoy and value these discussions- I am learning that I yield something completely different from talking in person with these topics than when I'm online. (Not the least of which is that I am usually easily understood and rarely ever have to explain myself or be defensive of my position, but I digress..)

Going back to a discussion I had with one of these lovely midwives about my choice for schools and how I originally thought that I'd want a school that was in alignment with my values about birth. As soon as the words left my mouth I knew they weren't what I really wanted. Why do I need to go to a school that just affirms what I already know? What I really want is to be challenged by my education. I don't want to be bored or agree with most everything. I want to have my boundaries pushed. I want to work with wide spectrums of people in different communities, countries - I plan to work hard not to develop my position but develop my sense of self in the world, my sense of community. At this moment, knowing what I know today, that feels like a healthy approach to midwifery.

A friend and I had a discussion about whether we'd take VBACs once we were practicing. Her position at the time was that you couldn't call yourself a midwife, and be pro-birth, if you didn't take VBACs and asked me if I would take them. Considering my last birth was a cesarean my own response surprised even me. I said I didn't know. I don't know who I will become through my journey. I've met more than one midwife who is in support of say, HBAC for example (homebirth after cesarean) but who has only ever experienced uterine ruptures and serious outcomes when they've attended them. They had the wisdom to know they did not need to bring their fear and concern to these births and have elected not to attend VBACs at home. It isn't anti-birth or anti- woman, it's pro-sustainability of practice, pro-sanity, and even pro-birth/woman/etc. for the midwife to know what her own boundaries are. Sounds healthy, if you ask me.

Thursday, August 12, 2010

Thoughts after SQUAT Camp.

I went to a few sessions at SQUAT camp. Haven't heard of SQUAT? You should read it, and then you should email the people who write it and find out more about them. You should think hard on the topics they're raising because I know I am.

It's time to question- I have been feeling dissatisfied having the same old arguments about the same old stuff. Not to say these things aren't valid, but I just feel that for me, it's time for something bigger, and deeper.

I realized lately that many conflicts are more around semantics rather than separate issues and isn't it lovely that we have the luxury of time to argue the better way to give loving care to women? I think it is- but I also wonder how the hell we get to the next level. Where are the visionaries? I suppose we all are visionary in our own way, and some visions must be huge, and they are lifted and carried by the smaller visions- and all are equally important. I am hungry for big visions and big shifts and big work, and big love.

Today I went to a session where we talked about abortion, doulas, and midwifery. We heard from someone who has worked in an abortion clinic for a long time with a big heart and a lot of passion - the holes are many in providing women good care. It's so parallel to birth- a huge medical event, consent forms, bright lights and protocols. Gone are the days when women went to their midwife with questions about how to terminate their pregnancy - we now go straight to our friends, and then straight to the clinic.

We've lost the knowledge to manage our own fertility- talking about cervical mucus is not something you do in polite company, generally. Often times even when women were frustrated with their birth control options they weren't interested in learning fertility awareness - I suspect there is something too 'real' to having to touch your vagina every morning, examine the mucus that lives there, chart it all. We've grown so distant from our own bodies that even this basic fundamental knowledge that every person should grow up knowing is saved for 'crazy and weird' women.

I've been thinking about offering abortion doula services to women and it's something I feel strongly about. However, I admit I'm afraid to advertise this service in connection with my birth doula services. I'm afraid to be targeted, I'm afraid to lose clients. I know I will find some solution that works - but for now I need to sit in this discomfort. It's been easy to be a doula and be relatively non-political, other than the occassional stirring of the bees nest. Who doesn't need a good sting now and then to remember they're alive, right? This is much bigger- people are murdered for working in abortion clinics. I feel no reservation about working through the clinic but taking it into my own hands and advertising that I offer these services- attaching a price to it? It does scare me a bit.

It was interesting to sit with women who are holding a vision of midwifery that I thought I shared until I realized I didn't. I'm unsure where to go with it. We talked about midwives teaching women how to do their own PAP smears, how to manually extract menstruation, and how acupuncturists might have something to say about non-surgical abortion techniques. We talked about how women have to go onto the internet and piece-meal an herbal regimen together in order to achieve an abortion in the privacy of their own homes, taking risks unto themselves and not thoroughly understanding what they're doing.

How can we retain this knowledge- I think it's at a point now where it must be recreated. Our history has been burned out of us and we're working hard to retain what we can salvage from those who came before us. Political issues like scope of practice and licensure and lawsuits and legality of midwifery, oversight, and so many other things muddy our vision and I know in my case, I did not SEE what I was forgetting about being a midwife. The continuum is not just from family to life, but from life to death as well. We are the witnesses and we hold vigil, and we are the ones that are invited to be present at life's pivotal moments. We hold the stories of families from beginning to end, and to back to beginning.

I still don't know who I want to be as a midwife but I know that I do not want to stand on the shoulders of the midwives who burned before me, who were jailed before me, who lost their families, their children and their lives before me, so that I could attend families in a way that is convenient and easy for me, and compromising for them.

What does it all mean? I don't know yet.

Monday, June 14, 2010

Letter to New Doulas (Part 1)

Congratulations, you've joined an amazing Sisterhood (and in cases of the elusive and rare male doula, Sibling-hood!) There are a few things I want to tell you to help you along in your journey. Some of these things are questions I've heard frequently from new doulas and others are just bits of wisdom I want to pass along that I've learned along the way.

First, let's chat about the issue of charging money. I remember when I was a new doula, the idea of asking someone for what I thought was a significant (although reasonable) amount of money for my services gave me the trots. My very first client was a friend who insisted on paying me $300 which I really appreciated but did not feel I deserved. I tried hard to say no because I felt guilty taking her money when she was letting me be at her birth..... wait a second... did you catch that? I felt guilty for asking for money for my services because this client was doing me a favor by allowing me at her birth. Was she the one providing the service, or was I?

If we don't charge for our services, whether you get paid in cookies, yard work, web design, or greenbacks, we can set up a really funky dynamic between client and doula. I'm not saying it happens every time, what I'm speaking specifically about is new doulas who do not yet (sometimes) know their value - who are afraid to ask for what they have a right to receive - who do not trust that what they offer is worth something significant. We carry this energy into the birth space with us and sometimes the dynamic that happens is that the doula is not a trusted guide, she is a guest in the space. She brings a subservient energy to the space that is not the same as being in service to the client, it is more of a 'thankyousomuch for letting me be here I'll try not to disturb you too much' energy. Asking for money takes the 'favor' out of it, it allows for emotional distance without the distraction of the money issue hanging around in the back of our minds. We're more adventurous in our solutions and we speak up more when the energy is balanced, and who benefits? You and the family, both!

Women in birth need to feel their support system is intact, strong, and without conflict. If we are conflicted (and maybe not consciously, maybe it's purely emotional) about our role in that space, the mother will be too. She will not call on our counsel, or trust what we have to say if we do not demonstrate confidence.

(I learned a long time ago that if you say something with confidence, as if you know what you're talking about, people think you do. It's definitely a double edged sword so I charge you to only ever use this power very rarely and only for good! You know, like when someone asks you a question you can't easily answer and you're in front of a huge group of people... yeah. Don't lie, wing it, but with confidence!)

In my own experience, I've had clients hire me who needed free services. They called me when I asked them to check in after their provider appointments, kept me in the loop, sought me out when they had questions or concerns, honored our barter arrangement if there was one, wrote referrals after the birth and were generally super grateful and wonderful to work with. It felt balanced to me.

I've worked with other clients who were in situations where they were accustomed to receiving free services from others and just didn't generally value what I was giving away for free. I was one in a long line of people giving something for free. There was no accountability, the communication was sticky, my time and offering generally were just not honored. I felt more like I was giving away some kind of charity which did not feel good to me at all, and which I had to work through during our entire time working together. Fortunately this has only happened a couple of times before I figured out what was going on and pledged to myself to approach this differently.

What I learned was that I didn't want to take clients based on if and what they could pay me, I wanted to take clients based on whether or not we had a strong desire to work together, and the chemistry and excitement about each other to have a good relationship. I figure money will work itself out- when one client can't pay me, I know the next one will help pay for them both.

We honor the parents by asking them for money. What we are saying to them is that we know that they (like everyone) has something to offer - we all have gifts. We honor ourselves, too. Take into consideration that you spend this, and maybe more, to just say YES to a client:

* Gas for the consult, gas in your car at all times if she hires you
* Money on hand for child care, babysitter, day care
* Money for food for yourself during the birth, change for machines at the hospital, etc.
* Parking fees, ferry charges, toll booths
* Mileage on your car is reimbursed by the IRS now at I think .51 per mile, so imagine that is an expense of wear and tear on your car until tax time arrives and you can get 'reimbursed'
* Let's not forget your doula training expenses!
* Time off from work for you or your partner to attend the birth, allow for recovery time
* Printing of business cards
* Website hosting, design, maintenance
* Birth bag items, educational items

The list can go on from there, in even finer detail. Now look at this list and think about numbers, and we're not even talking about the reasonable hourly wage you could make putting some of this stuff together. That's a FAT sum of money. Obviously you're not paying for all of this with every client but each client helps to chip away at this larger sum. We didn't go into this work to also go into debt!

The last thing I'll say on this is that there is something Divine about being honored with reciprocal energy after you pour yourself fully out on another human being. Receiving that payment feels good- it honors you AND it honors your entire family for the gift they're giving by sacrificing time with you so that this client can have you there. Being a doula is family work- we work for families, and it takes contribution from our families in order to allow us to do it. Money coming in helps to balance the energy that you're pouring out.

So please, charge something! Being certified has absolutely nothing to do with it. No matter what your trainer said, or what you think she said, no doula organization requires you to work for free until you are certified (and if I am wrong about that please enlighten me and I will amend.) If you want to charge lower rates when you start out, great! Charge $50 if that feels good to you- push yourself on this one. You will not be in your comfort zone for a while and that's okay. The idea is to get yourself trained to ask for money and to feel good when you receive it, and especially for us women, sometimes that's something that takes time. While you're pushing yourself, be creative and offer to barter, offer clients to pay you in other currencies. I can't stress the importance of a good referral, or a letter of reference. Invaluable!

Part 2 to follow, thanks for stopping in. :)

Thursday, June 10, 2010

Singing to the choir

I was in a meeting recently with some people I'm working with to start a food coop here where I live. I raised the point that we've made a grand effort to raise awareness among those folks who would be most interested in having a food co-op, but that it's time now to start pushing those boundaries and speaking to people who might not necessarily be interested in our message off the bat. Let's make it interesting, let's make it rewarding for them to get involved. It feels like a next-stage for us and I am excited to see what ideas we'll come up with around this.

I remember when I first became a doula, I had this fantasy (that quickly burned off once I started working in the 'real world' of birth) of getting a group of doctors, midwives, doulas, and nurses together to start really talking about giving the best care for women, rather than this territorial thing that happens. I think over time I learned that those in charge gain nothing by entertaining those who work against them being in charge- in other words, what would drive an obstetrician to take seriously the thoughts of professionals from other perspectives? If you don't have to change, you don't. No one is forcing anyone to look at what they're doing another way, and considering they have the market on 90% of the births, it's safe to say they're in a position of power.

I was recently reading the Midwifery Today which talked about birth as a human right, and then was looking at the photos of Ricki Lake visiting the CIMS Forum. Almost every face was female. I thought about the advocacy that I have been a part of, witnessed, supported over the years - and while I could list many women, there are only a few men whose names rise to the top.

This seems so obvious now, I almost didn't write about it, but isn't this another issue of singing to the choir? Granted, by no means have we reached critical mass! The choir isn't necessarily singing the same tune, but once we reach that place, it seems that the next phase of things is to convince not necessarily the obstetricians, but MEN in general, that birth is important, that women are important. It seems to me this issue isn't about birth at all, it's about the value this country places on women in general.

I'm tempted to call it a feminist issue but it truly is about human rights- by diminishing one gender, we diminish both. It is an issue for men as well as women - both men and women, both tiny infant boys and girls, are suffering in our current system. We are wedging babies out before they're ready, cutting open their mothers, exposing them to infection, complications and death. We are traumatizing families as whole units- not just mothers. If a mother is wounded, her marriage is wounded, her mothering is wounded.

It seems to be about women but what we're missing is that it's about men, too. We need to be singing to THAT choir.

Our culture teaches men that they are powerless in the birth space. Their women tell them where to stand and where to look and what they can and can't say, they charge their men with protecting them in the birth space with no tools to do so effectively. As a culture, we emphasize the ineptitude of men on television, broadcast for all to see, the panicking father who races through red lights and basically freaks out and is useless in the birth space. We see fathers who are disconnected from their babies, we hear constantly about men who are 'deadbeat' (disconnected?) dads and our expectations of our menfolk sink lower and lower.

Why should men care about birth as a cultural shift? We have not shown them that we believe in their importance, their value and necessity. One family at a time we make this shift where a father goes from doubting and insecure to powerful and present and protective - and then we do not use that energy to our advantage.

Can we make this culture of birth shift without fathers on our side, loud and vocal, organized even? When we get our men on board on equal footing with us, learning with us and passionate alongside us, I bet something big starts to shift. I don't think we can fight this fight without them.

The writings that aren't

It's funny how I come up with ideas of things to write about or am just hit with things I want to say, but as soon as I sit down to write I end up talking myself out of it. What's up with that?

Monday, May 24, 2010


I talked with my husband tonight about my volunteering at Planned Parenthood to be a support person to women having abortions. He was fully supportive and it was green lights down the line. I got excited and went on their site and entered my information into their resume tool, and while in the middle of that had to stop and run down to the store. It hit me that this whole plan might have after effects I'm not even seeing yet. I had a moment's pause when I thought about talking with a potential preceptor and in an effort to share about my experience, discovering that she was fiercely pro-life and could not abide considering me as an apprentice because of my time working in an abortion clinic. I thought about how I wouldn't probably post about my experiences (of course fully honoring HIPAA) because I have friends who are pro-life and I just wouldn't want the weird discomfort of that. I see how this can have some interesting consequences that are likely to be quite uncomfortable, at least momentarily. I don't know if that's what will happen but I can't deny that I at least gave a thought to the possibility of it.

I don't know what it will be like to do this work but I feel strongly that I must do it- and I think that if the timing is right (which it feels like it is, thus far) that it will happen and I will figure out these things as I go.

Blank canvas

Whispering to me in a language I can't yet understand, taunting me.

Oh blank page.

You can go to hell. ;)

Wednesday, May 19, 2010

I'm out.

Well, I'm not attending the MSL. It's been building and building and I'm glad to be released from it, but really sad that I will miss the experience of learning with women I know and care a lot about. That was one of the biggest things I was looking forward to, but I know there will be other opportunities to be with them.

I am grateful that I was able to sign up for the MSL because it was the excitement about attending which led to my epiphany about being a midwife in the first place. That was a really precious moment in my life and I feel warm every time I think about that 24 hours when it was revealed to me what I will do. It all unfolded in Divine perfection. :) It's okay with me that I am not going now, that is also in perfection.

I'm on to thinking about how I will gain these skills on my own and I have some options which I'm looking into. When you don't have what you need, create it if you can! I am excited about the possibilities and looking forward to the next steps toward midwifery.

So now what? Now I am talking to a midwife friend who has offered to teach me what I would have learned at the MSL and I am talking to her about doing a 'mini' session with a couple of friends who also want to learn. Nothing huge, just a few women getting together to learn together. I can't be derailed because of the shift in course on this MSL training and I won't be, I just have to create something that will meet my needs.

I also plan to contact the local Planned Parenthood and talk to them about volunteering there on Thursdays for the women who are terminating their pregnancies to offer a supportive presence. I know this is done at other clinics but not here (that I'm aware of). I realize that I haven't been exposed to this scenario much (beyond one abortion I attended a few years ago). I know that attending with women I don't know, and what I imagine to be a pretty wide cross-section of society. The majority of my practice is of paying clients- they know their options, generally, they have a good idea of what they want. I am not contacted by women in lower income brackets very often, for example and I don't think I've ever had a client of color, or a woman for whom English was a second language, etc. I've liaised with the public health nurses to offer free services to their clients since I started working as a doula in 2002, but we (the local doulas) don't get called very often. I don't know logistically how I can make this work but I'll talk to the hubs about it and see what ideas we can come up with. I can't see asking a friend (who might be pro-life, it's not like I interview my friends about things like that) to watch my kids so I can go sit with women who are having abortions, that seems weird.

I was thinking about it and I'm not attached to attending homebirths as a midwife. I don't have visions of what it will be like as women birth their babies at home. When I think about being a midwife what I think about is bearing witness to women stepping into their fullness, where ever that is. I love homebirth, but I don't have negative feelings about hospital births. When I think about being a midwife I think about meeting with a family, not just a woman, and standing vigil while they go through their own internal and external shifts into parenthood. Being there if needed and hoping not to be. Home vs. hospital is just not a part of my vision, but what I do see is being With Family, not just With Women.

I thought about why not going into nurse midwifery because I could do both, and I just don't think I'd be able to be present for families in the way I want and feel compelled to be if I was a nurse midwife. Maybe I lack information and I probably do- I never really looked into nurse midwifery because I just have a major aversion to being a nurse, being put in a position where I had to do things I had fundamental opposition to doing. Gah. I don't know. I'd love to hear from nurses/nurse midwives on this.

Time to get back to Daphne Singingtree! It was well worth the money I paid for it (and then some), it was definitely what I was looking for in a midwifery workbook for someone like me who is just getting started. I also downloaded some anatomy apps for my iPhone which I think is pretty funny. I don't know that I'll learn much but hey, every little bit helps. I know that I need to make a serious book list! I wish there were more apps besides Contraction Master for birth folk!

Tuesday, May 18, 2010

Birth, Baby or Woman? (Or more than one?)

I had an epiphany today which actually helped me gain some insight into why I seem to struggle in getting my point across to some folks of late. When reading threads on Facebook what I see is a constant struggle for the preservation of the birth experience. Not necessarily that it has to go down a certain way, but in some ways, *exactly that*.

When I did my doula training (DONA) one of the exercises we did was to identify our 'priority'. We answered several questions to identify whether we were primarily invested in the baby, in the woman, or in the birth itself. For example, there is a couple right now planning to have their birth televised live on the internet. There is a really fantastic discussion (which is actually what led me to my epiphany) about what this couple is giving up and/or gaining by having their birth filmed live. Is the birth experience the most important thing? Is it the baby's experience of the birth? Or the mother's experience? (The reason we don't include Fathers in this discussion eludes me but that's a post for another time.)

Reading some of the comments I admit to feeling a little frustrated that the couple's right to choose what they wanted to do with ther own birth experience seemed to be secondary to whatever the priorities were of the people commenting- but then BING! the light went on! I come in with the perspective that the woman comes first, her rights, her wishes, come first, because as I identified almost 8 years ago when I did my training, I am pro-woman. I realized that some of these folks might have had a different result on that test, maybe they are pro-baby, or pro-birth, or maybe their pro-woman just shows up a different way than mine. Duh!

I actually wish I'd had that realization a few months ago! Oh well, it is what it is- I'm grateful to have it now, I definitely feel like I need to bring this concept more into my awareness as I continue to explore, discuss and debate with folks online about some of these seemingly simple, but more often, complex issues.

My feeling is ultimately that the couple have the right to choose for themselves what they want to experience. Would I watch the birth? No. I don't want to be a voyeur, plus, while all births are individually magical and unique, I am honestly just not terribly interested.

Sunday, May 16, 2010

It's not a job, it's a calling

I hope the Trust Birth folk don't feel like I'm picking on them. It's not my intention, really, it's not. I just never felt like I could pursue these topics on Facebook without resistance and well, that just doesn't sit well with me. :)

Okay, so I've seen this said a few times and whooooooa Nellie do I have some major disagreements with it. I don't think it's a TB philosophy (altho I don't know if it is or not, but I'm guessing not) that midwifery is a calling and NOT a job.

Wow, this lands for me in a really um... holier-than-thou kind of way. Now I'm not attacking, just saying how I experience this statement. Bear with me!

Why is making money doing something we are called to do a bad thing? What if a midwife is called to be a midwife and is so successful that heck, she makes a LOT of money doing it?

I want to understand this statement better and that won't happen without some dialogue so I hope someone will jump in and give me some background about what is behind this statement and what it really means, because I'm positive that I don't fully understand it.

Doula Vs. Midwife (my hypocrisy)

I find it really funny (and I'm claiming it here, publicly) that I have two ways of thinking about birth workers. They're very oppositional too, which I haven't delved into but I'm sure it will come up over the next few years!

I am not certified as a doula and have no intention to do so. I don't like the idea of paying out money every year so someone else can tell me what to do. I really think the certification process for doulas is generally misleading to clients and not valuable for the doula herself. Why do we need to be certified to sit with a woman in birth and tell her she's strong and amazing?

Now, as a midwife, I fully intend to license. I honestly can not imagine going to medical school and then not making that last leap that allows me to practice as a physician. I do understand why midwives don't license (see my discussion above lol), but I just personally can't imagine not doing it.

Having plucked at this just a tiny bit, I think one point for me is that doulas aren't responsible in any way, shape or form for the health and welfare of a mother and baby. I think that's the huge difference for me.

So does this mean I'm 'pro-licensing'? NO! I'm not anti-licensing, either. Am I anti-certification? Hmm... yeah I guess I am, in a way, but only for myself. I'm pro-choice too, but pro-life when it comes to my own body.

I think we spend a lot of time in the birth community assessing what other professionals are doing and whether it's 'right or wrong' and less, FAR less time finding the table where we do agree. We do not give each other the grace and trust and support to find our own way to becoming the best we can be. I'm not even a midwife and I already feel defensive (because of conversations I've had) about how I will practice -- and *I* don't even know what that looks like yet!

If women and babies are getting safe, exemplary care, then what do the details matter? Women hire professionals that reflect for them the vision of the birth they want and the things they most value. If we all did things the same, there would be no options for women.

What is 'interference'?

I'm having a nice discussion with some Trust Birth folk on my blog which is much easier here in my own territory, where I'm not misunderstood and have a chance to clarify. Facebook is too frustrating which is why I gave up trying there. Too much 'cheerleading'.

I AM questioning interference, but at this point I'm trying to understand how Trust Birth defines it, and it is also causing me to explore it for myself. I was reading about the Matrona and they share a lot of the interference messages which I thought was interesting. I'm looking at this concept from two perspectives:

1. Who defines interference? Can you know you're interfering until after the fact? What does intention matter, really?

2. What do I personally feel is 'interference' - I'd say unnecessary distraction of the parents (because I do not believe it is just about the mother), whether medical or social or whatever. If there isn't a good medical reason to be fussing with the parents, then don't. If there isn't a benefit to the parents for the social interference (guests, phones ringing, excessive conversation, etc.), then don't. Seems pretty simple to me.

What I get stuck on in this conversation (and I am thoroughly enjoying it!) is that I experience a black and white view of what 'should' and 'should not'. I see comments around what the TB person views as interference but that maybe the client wouldn't at all. Maybe the withdrawal of the support person (if it is unexpected) is an interference, too. I know that generally, women hire people with an idea in mind of what they're going to get. Sometimes they are surprised. If you are high risk and can only deliver with an obstetrician in a hospital setting and require intervention to make that happen- is that interference?

I am struggling to understand where the line is drawn. I love the idea of assessing newborn health without fussing with the mama and baby, which the Matrona promotes. I won't even pretend to say it doesn't scare ME, the idea of something going south and having to take records to a hospital where there is no charting of anything at all.

I don't think it's as simple as surrendering to a philosophy, not in this culture. We're very into records and defensibility. I think that each provider has to design this way of functioning for themselves. I have seen beautiful midwife Pamela Hines-Powell delve into her beliefs time and again and come out changed, with a new shift, with a new way of practicing. I've seen her pull back more and more and have been excited about what seems like a shifting faith and belief and trust, something we desperately lack in our culture. I have learned a lot from the journey's she's shared about simple things like hats, and major things like the birth bubble.

I want to end by saying that I feel very strongly that one message I take away from the TB discussions I've seen (and I've seen MANY) is that there seems to be only one *right* way to be present at a birth. This goes against my fundamental beliefs and it's probably one of the reasons why I just don't connect, despite the many areas we are in agreement. I am concerned about the idea of ANY organization telling ANY group of people that there is one way to be 'correct'. I have met many women and attended many births and each client wanted something a little different. She needed something specific to her to feel safe and feel connected. Let's not forget the fathers who are equally important and have their own set of needs- there's just no way we can ask midwives to subscribe to one set of beliefs and then serve such a wide population.

Let me explain:

One client might want a more hands on midwife because while she is excited about birthing at home, she needs the reassurance of the heart tones checking/vitals, verbal encouragement, etc. Another client might not want any of this. Both clients might not know this until they're in labor and this is often the case.

I suppose this means that the provider needs to discern for themselves in every moment what is 'interfering' and what is not. What worries me is that people might come out of their training thinking that they "will" or "won't" do things (which is fine and great), but until the mother in labor meets this boundary, there's no way to know whether it's interference or not. Maybe that sounds abstract, I don't know. I'm very obviously still plucking at this and working through it.

What is the 'right' way to midwife?

I don't have any idea. I don't know who I will be as a midwife, I don't know what I will value. I don't know what my learning experiences will teach me. I'm questioning NOW, I'm opening my heart NOW to things I do feel pretty resistant to, but I'm doing it anyway. How will I know what fits if I am not willing to really try it on?

Saturday, May 15, 2010

What do we know about the OP baby?

Penny Simkin gave us a great talk yesterday at the MAWS conference about what the research says about OP (posterior) babies. I was chasing my toddler around so didn't get to write any of the statistics but a few things she said stuck out:

* There's no reliable way to know the position of a baby except for ultrasound (at this time). She didn't love saying this to a group of midwives and I doubt anyone was happy to hear that. ;)

* Palpation, back pain, digital examination, etc. - none of it was really reliable in determining the babe's position

* Lots of women have malpositioned babies and no back pain! It's just not a good indicator of whether a baby is malpositioned.

A question I have is whether in these studies it was one type of provider being studied or a cross of several. If we're asking doctors (who aren't necessarily invested in finding out fetal positioned by palpation/digital exam) to stand up against midwives who are, and who are therefore going to (likely) be more successful at it, is it skewing results? Could it be that midwives are better in some ways at determining fetal position than say, labor and delivery nurses?

I've been to many births where I suspected malposition (I have 'OP-dar) and during a vaginal exam would ask the nurse or doc if they could tell, and most often the answer is now. They say that there's a caput in the way, too much swelling. That's the only tool they have and they don't know what to do with information when the baby's head is swelling in the way. Somewhere along the way I learned (and I may be wrong but so far it's been right on) that if there's swelling in the way to feel the sutures, baby's head is in a wonky position, it's not OA. Now I'm not putting my hands in women, I can only go off of what is happening with the labor, what is happening in the woman's body and how she wants to move/doesn't want to move, where she's feeling sensation, and what the provider can say about the position- but so far I've been pretty consistently on about baby's position.

When I'm working with a client and I hear these things, it tells me there's something up with a baby:

* Water broke first
* Water broke and no contractions follow for many hours or even days
* Contractions are coming regularly but are short in duration
* Contractions are coming consistently (not going away) but are irregular in time between or in duration
* Mom has back pain, hip pain
* Belly button area is flat when she lays down or standing straight up
* Mom has a feeling about the baby in a funny position

I don't have to touch a client to see these things (and I don't, because I have no clue how to palpate). I don't have to inquire or interrupt her for the most part, it just is a matter of watching for it.

One thing Penny said was that just because a baby starts out the labor OP doesn't mean it will be born OP, and same goes for OA. Babies move in labor! We don't have to stress mothers out in their last weeks about fetal positioning and avoiding sleeping in certain positions, etc. I think this is a great starting point for dialogue about this. I definitely talk about fetal positioning because I want my clients to understand why it's important, but I don't tell my clients that they 'can' do something. I say they can 'encourage', but that the baby is a part of the deal too and they won't put themselves into danger or a stinky situation. Trust your body, trust your baby - it will be what it's supposed to be and we'll work with it. I have not seen it lead to a stress in my clients about their positions or the baby's positions.

Sometimes I wish I kept detailed information on every birth so I could go back and see how often babies are starting labor OP or asynclitic and then come out just fine, or otherwise - I just don't have that data in my own practice.

Trust Birth and Doulas

I was at the MAWS conference yesterday listening to Penny Simkin speak about what the research is saying about malpositioned babies (which was fascinating, I'll post about that, too). She made a comment about supporting her clients in labor and how sometimes she has to ask the mothers to do something they don't want to do for just a few contractions. I thought about times where I've been with clients and whether I've asked women to do things they didn't really want to do and while nothing specific comes to mind, I'm sure that it's happened.

I thought about things I've learned about interference, at least the Trust Birth philosophy (as I understand it, which I admit, I don't understand it well). I questioned whether doulas are 'interference' or help, and I wondered what the Trust Birth folk think. I'm sure the conversation has been had somewhere? I'm hoping someone will see this and post.

Thursday, May 13, 2010


Sometimes I think I can't really say what I think, feel, discern without pissing someone off. Historically it just seems like this is true. It usually doesn't' matter what I'm saying, how clearly or how objectively I write, someones gonna get pissed. A friend of mine said to me yesterday, "Kristina, how can you avoid being political? *YOU* are political, your very presence is political. Get over it." Oh, well... I hadn't considered that.

I keep feeling that I should just close my mouth and open my eyes and heart. Don't 'get in the way' with what I think. Let my inner silence be my outer silence, and let the thoughts and knowledge and doubts and wishes of others wash over me.

I definitely think that is a wise thing to do, generally. Talk less, listen a whole lot more.

In other cases, I feel like I'm dishonoring myself by not speaking what is true for me. I used to write on my blog prolifically until Dr. HasBeen picked me up and I went through the ringer. Then I went through a couple of things locally, too. Not ever because I was rude, mean, disparaging, slanderous, but because I said *too much*. Interesting. How does one know when one is saying too much until one does it??

My writing has suffered. It used to be a catharsis for me, a place that I could learn and reflect. I would start writing and by the time I was done with a post I had deep clarity, better questions, and usually some direction. Now when I try to write I feel that I must be so careful so as not to rock the boat. I must not write about my experiences with organizations or individuals, no matter how fairly, or to share the amazing gifts I get out of these exchanges, because when ya poke the bees nest you had better be prepared to be stung. I don't like being stung, but let me tell ya, silencing myself hurts a hell of a lot more.

Telling the truth, even if it is only your own truth comes at a cost. Sometimes it shakes the trees of other folks and generally speaking we don't like our trees shaken! I just feel that I was given this voice, this passion, this ability to communicate effectively, to listen and hear all sides - this is all within me for a purpose. I feel that by not sharing what I truly think and feel in the ways that resonate for me and feel good and healthy, that I am almost.. dishonoring these blessings.

I think change is in the wind. I am just tired of worrying all the time about who I'm going to piss off. I'm not co-dependent, I don't know why I'm acting like I am. It doesn't mean I'm on any hunt to target anyone, I'm not. I'm just refusing to filter every single thing I want to write about. Writing used to be a marriage for me, and lately it feels like a hooker I visit now and again, and feel bad about afterward. No more.

Tuesday, May 11, 2010

Career doula

I need a career doula. I need a little hand-holding right now, a little reassurance. Not the pats on the back that Facebook provides (which I do appreciate), but someone who can look me in the eye and ask me the hard questions and push me. That's what I need.

My husband is really good at that but I think what I want is someone objective of the situation. Someone who isn't attached.

I'm trying to figure out what I need to do and it's interesting that I'm actually farther away from midwifery school than I thought/knew I was. I figured it was taking a few classes and GO! Alas, because their program changed (woo hooooo!!!!), the pre-reqs are more involved. I basically should just finish my AAS.

I'm feeling somewhat overwhelmed by that prospect, but excited too. I can take courses here and there as I can afford it, thus getting time behind me where my kids can get a little older (namely my sweet tot) before I head to midwifery school. It all works out, but.. it kinda takes my breath away a little bit.

I'm in the midst of setting up a potluck get-together with the local doulas/birth folk to celebrate International Doula Month. I'm stoked to see everyone who can hopefully make it! It's been quite a long time since we've had a networking opportunity on the peninsula. I hope lots of people show up.

Okay, so back to the school thing. I need to make lists or something, I feel like I need a map of what's up ahead. 1. talk to admissions at midwifery school. 1. talk to advisor at the local community college to see what I have and what I need. 3. Figure out a plan to get some classes happening soon. 4. Dream up some fancy way of making the money to pay for said classes.

Easy enough, right? Ugh. Right.

Monday, May 10, 2010


One of my very favorite subjects - dads! A request for information on how to prepare dads/what to cover with them came up on a list I'm on so I wrote a bunch of stuff and then realized I might want to say something here, too. Disclaim: I don't want this to appear that I spend all my time talking to dads and am not invested with the mother, I'm simply emphasizing the conversations I have with dads for the sake of bringing this to light a bit.

Early on I realized that dads are important (duh, right?). They're not cheerleaders, they're integral to the birth process, and the birth process is integral to them going on to be fathers. I was hearing a lot of unintentional condescension around dads and being the mother of sons I feel rather sensitive around the messages we give boys and men. Words like 'clueless' get tossed around a lot.

I started talking to my own husband about what men want from the birth experience and he gave me a really great insight that has held true through every client over these last many years. Dads aren't invested in the process, usually. They want to know their wife is going to come home alive and safe. Second to that is that the baby will come home alive and safe. It's a hard thing to admit but it's usually true- dads don't want to be left alone to raise a child by themselves, they'd rather have another child with their wife if it comes to that. I totally hear that, I totally understand it.

What I see a lot is couples trying to meet in the middle but dad often doesn't get a chance to say what he thinks and feels without the mom kind of overriding it. I'm not saying this happens all the time, but generally, it's very common. Dads are attached to *survival*, not experience. If birthing the baby while hanging from a tree limb upside down while bees attack is going to be the very best assurance that his wife and babe will come out alive, he's a fan of tree-limb-bee-birth.

Moms want to know that as she goes into the mystery of her birth that he will protect her space, stand up for what she wants. Dads aren't as attached to the experience as they are knowing she'll be safe. This means that when a provider says, "We recommend we make this change in course for your safety," they're speaking to this man's deepest fears. This is going to trump his partner's wish for an experience, and understandably so!

When I meet with clients and ask moms about their desires for their birth, a lot of the time they have a pretty clear idea of what they do and don't want. Most are flexible to what surprises might arise and how willing they are to go with the flow, but generally they know they want no pain meds, or a waterbirth, or an epidural at 7cm, etc.

When I ask dads what they want, I have yet to meet a dad with a detailed vision beyond making sure his loved ones are safe. They often just don't know what exists beyond that. I think that this is hard for moms because we do know what we want and we want our husbands to know, too. We want them to be equally invested (in what we want). We want to know that if someone walks in threatening to break our water that he can speak up for us if we can't.

That's a tall order. It's certainly not impossible, but asking a father to be knowledgeable enough about birth to question the provider in a situation where he is oftentimes entrained to what the provider is saying is a tough spot to put a dad in. I've seen several scenarios:

* Mom wants dad to stand up for her. Dad tries, but it creates a conflict energy and mom shuts him down in front of the staff.
* Mom wants to avoid a certain intervention that is now being offered/suggested by a provider who seems to have a good argument. Dad feels stuck between the provider who is telling him that this needs to happen, and his wife's wishes. He ends up bending to what the provider is saying and helping to talk his wife into it.
* Mom and dad are prepared and ask for a few minutes alone to formulate their questions before deciding.

When I sit with clients at consultations I look at the father and say, "She really wants you to understand that this is a life changing experience for her. She will never be the same after this. You are about to see your wife turn into a bona fide warrior and you will never look at her the same way again. This is huge for her."

Then I say to moms, "He isn't as attached to the experience (and I invite dad to correct me if I have it wrong) as he is attached to bringing you home alive. He will happily chuck the whole scene if it means he gets to bring you home. This is a scary event for him, the closest he's ever probably walked with Death and it's not him, it's his 'heart', his wife, who has to do it." I see the light bulb go on over dads every single time I say this. They've been hesitant to say it for fear of upsetting her, or they haven't been heard, or it's been challenged by the mom's desire for a good experience, so a lot of time dads just keep their feelings to themselves around this. When I come in, objective, a 'professional' (whatever that means!), claiming what I know without judgment and asking the mom to meet him there, it has 100% of the time stimulated some powerful conversation between the couple.

As a doula what I then try to do is talk about how to fill the gaps between what they need. What does the mother need? What does the father need? Now that he's been witnessed in his journey, we talk about what they individually want out of the birth in an open way.

I tell my couples that if we treat men like fathers and not like birth coaches or assistants (or worse), that they will rise and feel like fathers. In a culture where a dad who sticks around for his family is viewed as a 'surprise' or a 'good man', the expectations around men being fathers is very low. I personally believe that if we set people up for success they will rise. If we enter into birth treating men like they must be told where to stand, where to look, what to say, how to say it, they will have pretty low confidence in parenting that babe after it arrives. It can set up a funky dynamic where the mother becomes the 'expert' and the father becomes (again) the assistant. Rather than parenting his child, he's supporting the mother in parenting the child for the both of them.

I argue that men should be heard equally with the mothers. Their own journey should be witnessed. I talked to dads about guarding the space, keeping it safe, and how to do that in a way that makes sense. It's not about standing outside of the birth hut to keep the tigers away. Now the tigers are a little different and the trick is getting dads to see them. For example, making sure the lights are low and voices are kept low so mom can focus. Make sure no one is talking to her during a contraction (unless there is some major necessity). Helping to keep distractions like the phone and visitors to a minimum. Telling her how strong, powerful, beautiful and amazing she is. Being the 'muscle' to hold her up, lift her, support her hips, etc. as she needs.

It's about teaching men a new language for being the protectors of the birth space so they can show up for the mother in the way they do best, and not just shuffling them to the head of the bed so they won't be 'traumatized' by what they see.

If men believed they were, and and were supported in being integral to the birth experience, how might this change how they show up as fathers?

Friday, April 30, 2010

Emptying the cup

Experiences over the last several weeks have brought me to a moment of clarity and I wanted to write it out to be able to revisit it as I go forward.

Facebook has been informative and a total bane to me as I consented to the Universe's plan for me to become a midwife. I have been reading with interest the posts of midwives I know and learning a lot about where they stand and what that means. I hold myself against their points of view to try to figure out where I sit. I ask questions, I say what I think, I get in trouble... what else is new, right?

My husband recently said (and has said a few times throughout our relationship) that I'm easily influenced- I tend to go along with the group. This is absolutely true about me in some ways. I decide where I stand, and then when I figure out who stands on that same side, I tend to take on the characteristics of that group. I see that I am not the only one who falls into this! It's interesting to visit parenting websites where there is a major theme (not naming the one I'm thinking of but you probably know it) - there develops a culture where the radical tend to set the tone and the moderate eventually either become more radical, or depart for smoother sailing.

I'm a sucker for radical, I won't even try to pretend I'm not. I don't care if it's radical left or radical right- it fascinates me. There's something in me that likes living on the edge of controversy. The funny thing is that the main way I survive there is by being a good diplomat and communicator.

Seeing the radical sides (because there is more than one) of midwifery on Facebook, having visitors to my blog who decided to not only misinterpret things I've stated (and very clearly, I might add) but also share their interpretations in an attempt to put my integrity into question (fail, btw.), in addition to the dark-of-the-night existential question of "Who am I and who will I be as a midwife?" have all led me to realize that the best thing I can do is to NOT put my flag in the sand and say that I know who I will be. The best thing I can do right now is to listen and watch.

Listen and watch, open my heart, have boundaries, but to listen, and to watch. I'm seeing so much more now that I've decided to do this. I'm not working to understand, rather to just let the information and feelings settle on me like fine snow.

Can I learn from people who have positions that are polar opposite than mine? Yes. I want to learn from them, I'm HUNGRY to learn from them. Dr. Amy? Bring it on. Have I learned positive things from her (despite her hateful spew?) Yes. Go ahead and shoot me, but this is the truth for me. I can't set aside what resonate to me as 'truths' and even ole Dr. Whatsherface has a precious few valid points buried under neath all the vitriol.

I was talking with a good friend today who is a midwife about midwifery school and what I think I do and don't want to get out of it. It hit me (and I said it outloud to her) that while my first inclination is to look for a school that aligns with my beliefs about who I want to be as a midwife, that maybe the very best gift I could give myself is to not try to decide that, and just be open to what I learn along the way. Maybe the best give I give myself as I proceed is just an open heart.

A friend asked me if I would take VBAC's once I'm a midwife. I answered that I don't know. We argued that midwives who won't take VBAC's don't care about birth, or women, and how the issue was far from that black and white. I don't want to claim a position on it because if I decide that I will and then don't, then I am going back on my word. It's easier for me, better even, to say that I don't know. For one, I had a really fantastic conversation with my friend around this and what it means to say YES when you don't fully know what you're agreeing to, which we might not have had had I just said yes/no. The truth for me today is that I don't know who I will be as a midwife. I don't want to narrow what I might learn by dismissing arguments that don't align with my philosophy. I want a relatively empty cup so that I can sift through it on my own.

I want to walk into every birth I assist with an open heart and know that even if the preceptor I am working with is difficult, that we clash, that she does things I wouldn't do, or whatever, that she is a blessed teacher and that I am a teacher for her as well. I don't want to go in thinking that just because I've been attending births as a support person that I know ANYTHING about taking the responsibility for the very lives of my clients. I don't know what that is like at all. Being a doula is nothing more than an introduction.

So while I've reduced the 'noise' that has pulled my focus away from the birth issues themselves, I am still eager to hear from the teachers out there who will challenge me. I don't want to agree or disagree, but rather to just try things on and see how they fit. I will keep doing that as I go along and define myself as a midwife. I will probably do that forever, I wager.

Saturday, April 10, 2010

Who am I?

The midwife identity... I'm reading with such a different level of interest now the conversations (mostly on Facebook) about things like licensing, hands-on/hands-off, midwife-fear, unassisted birth. I am learning to talk less and listen more. It isn't easy.

I think this is symbolic of something important in birth- that I can be a midwife who doesn't have to show my client that I know everything, but that I can foster trust with my confident silence. I don't have to have affirmation from other midwives/birthworkers and I probably should surrender to the idea that when I am my fullness, my own authenticity, there are plenty of people who don't like me, and don't like what I have to say. I may have to meet that in a whole new way.

I almost don't want the distraction of worrying about where I'll go to school, whether I'll license, if I'll take VBAC or twins or whatever. That all seems so peripheral to just getting *going*. It seems secondary, at least right now. I sense that there will be vast, vast explorations of my values as a midwife, as a woman - I won't (and don't) have the answers anytime soon.

I keep thinking I have something figured out and then I hear something new and I shift. I guess that will always be true, but it feels like a very dynamic and shifting time right now.

Sunday, March 28, 2010

Only 86 noisy women

I've heard it said a couple of times in the last couple of weeks that there are 86 (licensed) midwives in our state, which is well, a drop in the bucket when it comes to the horde working to keep midwives quiet and limited.

I thought about all the births that these 86 women have attended, and how many collective babies that is that have been born. How many of those babies have grown up and are over 18? How many of these families have friends who have been exposed in a positive way to the idea of midwifery? How many of these birthing women have female friends who care about their own rights?

It seems to me that with a core of 86, that's an enormous network. I imagine all of these people standing together with T-shirts that say, I support midwifery and I VOTE!

I wonder what that number would swell to- and I wonder what the power of that could accomplish.

Saturday, March 27, 2010

It's happening

I say yes, I am a midwife. The shift happens and every decision I make is routed toward and around that knowledge - it isn't a matter of 'I hope to', or 'if it works out' or 'if I can afford it.' It's just going to happen, like I will get older, I will pay taxes, I will be a midwife. There it is. Plain and simple.

When I say this out loud, the question gets bounced back to me, "Where will you go to school?" I have no idea. I'm not even thinking about it. It doesn't even matter right now. I have a young child who needs me home right now and we can't afford to think about school anyway. For once I don't feel like I need to map out my future.

I trust completely that this is going to happen in its own time. I see the minute shifts that happen in the way I talk about birth, in the way that I feel when talking about midwifery politics - I chuckled at myself today while having a great discussion with some ladies about the politics of keeping your head down and not rocking the boat. I thought it was funny that just weeks ago this conversation would have confirmed why I would never be a midwife (you know, someone who catches babies), and today I listen and open my heart so that I can meet this when it will surely arrive when I become a midwife (you know, serving women).

I don't fantasize about homebirths. I fantasize about being with women and their partners as they make the myriad shifts into parenthood, into the new phase of their relationships. I think about promoting whole-ness, well-ness, into the lives of other people. Birth is a natural extension of that, not the center of it.

This doesn't live in my head, it's in my heart and bones, and wow, what an immense difference that is.

Monday, March 22, 2010

Trusting mothers

Not for the first time I have a client who is exploring the possibility of a cesarean. Her inner wisdom, her heart, her intuition lead her to explore the possibility of a type of birth she's never dreamed she'd have. When I get her emails I am so conflicted emotionally, but my compass is clear and always rests on trusting the mother.

When I was pregnant with E, I wanted my shot at a homebirth. It was my third and probably last birth, my first two births were induced with epidurals and by this time I'd been a doula for several years and had shed a lot of the fear around birthing at home. Unfortunaltely I was high risk for several reasons, so it was not a guarantee that it was a possibility. I talked with my OB/GYN. I spoke with the perinatologist. I met with the midwife I knew I'd choose if I could go down this road. Everyone single person said, "I don't know yet, let's wait until you're further r

Not hearing "No." meant I could engage the idea in my heart without the distraction of being defensive or needing to protect what I wanted. It meant that my heart could quiet and I could let the answer rise within myself. It was a couple of weeks later that I couldn't deny the quiet but steady voice inside of me that said, "This baby must be born in the hospital." I couldn't say it out loud, it was too painful. I had to give up my hopes and wishes and last dream for a homebirth if I admitted it. I continued to talk about my homebirth but at some point it became so intense that I looked to my husband and said, "This baby needs to be born in the hospital." I burst into tears and he held my hand and we just sat with it. It didn't need explaining, we both just knew, I think.

When I have a client tell me that despite what she thought she would want, she has to change course, I have this moment of, "Oh no, she's succumbing to pressure, she's reading the wrong things, she hasn't seen this study, she's..." It's fast but powerful, the urge to 'correct' her and guide her to the outcome that is least interventive.

Quickly I see how important it is that she is met where she is at - it means trusting her inner voice the same way I had to trust my own. If I had had a doula or a provider try to talk me out of what I knew I had to do to safely birth my baby, it would have broken my trust in her. I would have felt she wasn't listening to ME, she was listening to herself. I would then be defensive about what I'd chosen and less likely to open up about it.

When I am working with a client one of the many questions I ask is, "What does your heart tell you- aside from the noise of everyone else telling you what they think, aside from any fears you're having, what does your heart tell you?" I see women get quiet and go within and come back with very clear information, even if that information is "I don't know yet, I need more information." Another great question that has been really helpful is, "What do you need to know in order to make this decision?"

Sometimes as a professional it's easy to get stuck in what I think is the best outcome. I've learned to be pretty good about letting go of what I want for every client beyond to be met with compassion, treated with respect, and provided information to make decisions, with the support to execute them. However she gives birth, it's her journey.

We learn something profound about ourselves when we give birth - what right does anyone have to step in and tell a woman to go against her inner wisdom when her heart tells her that intervention or surgery is in order? What right do we have to tell her that her birth-journey is not right because it doesn't hold to what we want for her, (even with our best intentions?)

Now when I feel an attachment to an outcome I know that even though I leave my birth-baggage at the door, something snuck in with me and needs to be set aside so that I can truly be with THIS woman at HER birth.

Thursday, March 11, 2010

Not a midwife, my butt.

Okay, I'm going to be really honest here. I'm not stroking my ego in any way or patting myself on the back- this is just the reality of what has gone on, what I've thought, what was said to me, etc.

I have heard it many times, "You're a midwife, Kristina!" I can't deny my ego did take a little stroking to have people 'see' something in me - something that implied that I had something special, something 'next level'. I seriously considered midwifery many times over the years and I have repeatedly come to the conclusion that I'm not a midwife after all. I don't have the ability to keep my fat mouth shut (as I've been told), I am not politically skilled enough. I maybe don't have the guts, either. It's too expensive, I've got little kids at home- blah blah blah.

You know, when you're scared of something, it's easy to drum up excuses, er, *reasons* why you shouldn't do it. The funny thing is when everyone else knows something you don't, no matter how rational you sound.

I decided at some point that I am really committed to being an excellent doula - I want to teach great classes and be an amazing doula and I really don't want to rock that boat. I don't want to want more, I'm really settled. No really.

My main reason for not wanting to be a midwife? Politics and the inherent cannibalization that I see. Eat or be eaten. Keep your head down, do the good work, don't rock the boat too much. The midwives I admire most talk loudly and get hit hard. I knew I'd fall into that camp and seeing how sucky it feels to just be a doula and have midwives pissed off at you, I didn't have any desire to try to play some political roulette just to be able to work the way I wanted. And no one likes to feel disliked. I know that feeling pretty well, and it sucks.

I signed up for a midwifery skills lab. Why? I don't know, honestly. What will I do with these skills? Nothing- I NEVER EVER mix clinical work with doula work, EVER, I feel very strongly about it and I'm very careful. I'm not assisting any midwives. I'm going to learn to do things I might never ever use, but for some reason I laid down 360-nonrefundable-dollars of my hard earned cash and figured I'd work it out afterwards. What does it matter if I use it - I want to know things and I'm going to learn things, mission accomplished.

Setting out to get ready for this lab I decided to re-read Spiritual Midwifery. Well, aside from the whackadoo advice pervasive through it, it was actually pretty inspiring. I was reading it and it hit me, as Ina May spoke about how a midwife needs to have a healthy life in order to show up for her clients, how a midwife meets a family, not just a birthing woman, and how midwives give counsel on more than just how the baby comes out, but on different aspects of life in general, it hit me. It's not about birth. It's not about any ONE thing at all. Catching babies is just one facet of midwifery. I said out loud, "I am a midwife", and I about passed out when it felt totally right. It didn't feel arrogant, or presumptive. It felt like saying, "My name is Kristina".

I thought about the years spent counseling women about their breastfeeding struggles, learning to listen objectively, learning to speak compassionately, talking to women about their cycles, grieving with them as they mourned their miscarried babies, giving direct feedback during times when they were suffering from their own lack of clarity - basically being on the planet, being me. Doing for every woman what I want done for me, and what I invite into my life in my marriage and in my friends. I thought I wasn't a midwife because of the politics, the expense, the risks.

That night I was basically was asked who I thought I was, that I wouldn't have to work and sweat and take chances for my calling? Who did I think I was, that it should be perfect and easy? Wow, that was huge. If it's worth doing, the risks are worth taking, the sweat is worth it, the sacrifices are worth it. It was like it was time to grow up and shed those excuses. I woke up with resolve in my heart - resolve to honor this calling and to stop making excuses. It doesn't mean I'm signing up for midwifery school, but I would stop dismissing the power of the words and let the opportunities come.

I'm not staking out any ground here, I'm just saying that I finally GET what people were saying when they chuckled at my adamant refusals that I am a midwife. I have never caught a baby, and I know that I am a midwife. I have no plans to go to midwifery school, and I know I'm a midwife. It's bigger than your education or how many babies you've caught. In fact I'd daresay that if you're hung up on numbers you're not paying attention to what's important.

Skills lab, here I come. What comes after that? I believe it will unfold on its own and I'll meet what's coming.

Sunday, February 28, 2010

I'm not going to be a midwife

I've made this decision multiple times. I stand by it. I'm not interested in being a midwife. The politics around it alone are enough to kill the desire in me - and yet today I signed up for a midwifery skills lab. What do I think I'm going to do with this skill set? What am I doing, essentially blowing $360?

But I look over what I"ll be learning and I drool. I mean, I have to wipe my mouth because it looks so incredibly delicious. I *want* to know how to do these things. I want to know how to take vitals, palpate for fetal position, check cervical dilation - and it's so funny because I have (and would never) use these skills with a doula client, but I HUNGER to know it.

It's not ego. I don't want to be a "Midwife" with a capital M. I guess I don't know what I *do* want to be, but I have a lot of clarity on what I don't want to be.

I guess I'll keep plucking away and see what happens.