Back to the middle - Part 1

I was 20 years old when I had my first child. I'd come from a seriously dysfunctional family of origin and I realized as soon as the nurse at the Health Department said, "Your test was positive," that I knew nothing good about being a mother. I knew in that same moment that I would do absolutely everything in my power to find out what that was, and throw myself into it fully. From day one, I was obsessed with finding out what I'd never been told - how to nurture a human being to become the best they could be.

I read every book the library had on pregnancy and birth. I read Dr. Spock and he warned me to chart my baby's pees and poops and feeds for the first few weeks. I remember thinking, "Is is really this complicated to be a good mom? Oh well, whatever it takes!" I felt disconnected and troubled by all of these books warning me of things I worried endlessly I'd forget, and obviously, instantly fail at mothering my own baby. Then I read Dr. Sears - he is the Ina May Gaskin of parenting - he said, "Trust your instincts. If your body says to hold your baby, then hold her. Keep your baby close, we are mammals and meant to be close to our mothers. Independence will come, just trust your heart, trust your baby, trust yourself."

Consider my hair blown back, and my heart blown open! I was so relieved to hear a message from a pediatrician no less, that I didn't have to have Excel spreadsheets of my baby's ins and outs in order to qualify for the Good Mother Club. I felt like I'd just found some secret- we could trust our babies? We could trust ourselves? I started questioning, and doubting what I'd been hearing my whole life, and what some of these books were saying now. Why was I being sold this story that I had to perform in a certain way to be a good mom- why couldn't I just BE a mom?

Not realizing I had legal options that would have allowed me to choose a different provider, I gave birth under the care of my family practice doctor in our HMO. At the time he was the Chief of Staff and my biggest memory of him was coming in, touching my belly and listening to heart tones, and then standing with his hand on the door asking, "Do you have any questions?" How could I have had questions, I was still trying to sit up and he was halfway out the door! At one point he scheduled the MSAFP test which looked for spina bifida, trisomy 18 and markers for Down's Syndrome. My consent on this test was, "We always run this test at 21 weeks (or whenever it was), it's just a blood test, do you want it?" Of course I wanted it. I was a Good Mother.

What I wasn't told was that this test has a perilously high false-positive rate. I didn't discover this until a nurse left a voice mail message at my house telling me that my baby screened positive for Down's Syndrome, and that I'd need a Level 2 ultrasound. I was shocked - terrified- I was visiting my mother at the time and I asked Randy to drive the hour and a half to come get me, I needed to be with him, and I needed to be home. I had to prepare myself for a life with a Down's baby, I had to process what this would mean for us- I'd just been told my baby had Down's Syndrome and that I'd need some higher level ultrasound - probably involving giant needles and drugs - and I was scared SHITLESS.

I called the nurse back and she was blase'. I asked what a Level 2 ultrasound was and she said, "It just looks in more detail at your baby." I wanted to know the procedure. How big was this needle they were going to poke into me? How long would I be out from what was sure to be a lot of drugs in order to get this giant camera loaded needle shoved into my belly? She didn't understand why I didn't understand what a Level 2 ultrasound was. She explained that it was just another ultrasound, like I'd had before- but the image would be more clear. Well, couldn't someone have said that from the beginning?

We went to the genetic counselor and fortunately all was well with our sweet little boy. But something had been broken in me- my trust. I went online and read all about this test and when I discovered the high rate of false positives, and read other women's stories that were exactly like mine, I was absolutely livid. I felt tricked, lied to, misled. Why didn't my doctor tell me what this test involved, and the risk of taking it? Why didn't he warn me about the false positives so that I'd be prepared in case that happened to me? I started to realize that I didn't have to just accept what I was being told and that maybe part of being a Good Mother was also being informed. I kept reading my books and going on websites for pregnant women with voracity. I wanted to know all of those secrets- I didn't want to be fooled again!

Finally I was 41 weeks and still not going into labor. I didn't know about doulas, this was a pretty new concept at the time - and I hadn't taken any childbirth classes so I sat at home while my boyfriend worked graveyards, unable to drive (because I didn't know how) waiting, and waiting for my baby to come. We had a trip to Iowa for my husband's family reunion coming up and it was getting awful close to the time I might give birth, so I asked to be induced. My doctor of course was accommodating, so we set off for our induction.

My blood pressure had been creeping up but hadn't hit any serious numbers - still in the 135-80 range. Somehow at the hospital I developed pre-eclampsia and a nurse came in and said, "You have pre-eclampsia, we have to give you magnesium sulfate so you don't have seizures." She plugged it into my IV and walked out. I was suddenly out of it, and on fire at the same time. I couldn't get comfortable and now I felt like a caged animal at the same time. My mom and aunt arrived and I asked them to leave because I just couldn't handle the distraction of being stuck in the bed, lit on fire with Pitocin contractions at the same time. I don't remember almost any of my labor.

My baby boy was born and after a brief stint of panic and disassociation on my part, we were working on breastfeeding and sent home, a family. I went home with my baby who had been inside me when I got morphine, magnesium sulfate, and an epidural. The kid was tired and nothing I did would wake him up. His latch was so much work when he would wake up that at one point at 4am (I'm now convinced that all breastfeeding emergencies happen at 4am) I put him down on the bed, crying, while Randy made a bottle and cried my soul out that my baby  hated me and that I was a failure as a mother from the start. I did not know that the drugs from my labor would affect my baby and his ability to breastfeed - I wasn't told even after he was born. I didn't know that breastfeeding would be SO hard. I had thought that with all my reading and time on bulletin boards that I'd know exactly what to do, and when I didn't, it was really earth shattering for me. The bottle crushed me, it crushed my heart- it was the first symbol that I was not going to get this mothering thing 'right'.

I got myself together and I looked at my son and I told him, "We are GOING to figure this out." I was determined. We would feed this baby however he needed to be fed but the first sensation he'd have every time he squawked was my nipple at his lips. Finally, he chose me. My heart was bursting as nursing got easier and easier, and I thought - I can't be the only person who is struggling with breastfeeding!

With the best of intentions and with my confidence up, I went online and started talking with women about breastfeeding - working through troubles, and learning a lot myself.

Birth as Prayer

In the dark the phone rings. It startles me awake and I struggle to sound like I've already been awake for a while. (Why?) My heart races as I grab my bags and race out the door.

Blessed are the police officers who will turn a blind eye to my dark gray vehicle, slinking through the night. 
Blessed are the traffic lights that will turn green just for me.

I drive quickly and my belly fills with the juicy anxiety of not knowing what will happen next. What will I find when I arrive? I pray that I will be a tree, that I will be grounded deeply to the earth and that my vision will be limitless for all possibilities. That my arms will be strong to hold this family, that my heart can carry whatever will come. I drill through neonatal resuscitation, that I will remember what to do if this baby needs my hands to help it.

Blessed are the trees, who remind me.
Blessed are the skilled teachers who prepared me for this birth.


I arrive and slow my breathing. I stand outside the temple of birth, where secret, mysterious and sacred goings-on are hidden inside like a jewel in the night. Everyone around us is unaware to what is unfolding in the steamy, pungent night. I greet the midwife, I greet the family. I set down my things and I wait to see where my energy will slip into the labyrinth.

Blessed are those in vigil, even those who are unknowing.
Blessed are the hands and heart of the midwife, the guide and guardian.
Blessed is the Baby, pushing, rolling, and knowing nothing other than total trust to navigate earthside.
Blessed is the Partner, guardian and defender.
Blessed is the Mother, Holy Vessel for life, unfurling from her.


I greet Death. Welcome, Death, please stand with us as we see this family through their death and rebirth. We, the midwife and I, sit quietly by as this couple dies in front of our eyes. We wait for their first breath of rebirth, which comes with the first breath of their baby. The Underworld is a stop in the journey of birth, one where we pray that the family will not visit long. The death of a couple, reborn into a family. The death of a maiden, reborn as a mother. The death of things that will now fall away, unneeded, deprioritized, and the birth of new priorities, new ways of communicating, new levels of love, and trust. Thank you, Death, for your guardianship, and for stepping away as we claim this family for Life.

Blessed is Death, the sister of Birth, who stands in vigil with us.


In the steamy dark, a cry cuts through us all. An exhalation passes through me while the parents lay tentative hands on their baby, hot and slick on the mother's belly. The pulse of the cord beats between mother and baby, the clock ticks while we assess that the transition has completed and that Sister Death will not be needed today. We sit back and watch the baby's eyes and mouth and hands open to explore the soft, yielding flesh of the mother, and the mouths, eyes and hearts of the parents open to greet their baby.

Blessed is the Opening.

Catching up

I don't have any illusions that I'm going to write on any sort of regular basis, but it feels good to check in now and then.

I have shifted from sort of dreaming about midwifery to actually moving toward it. It's funny how profound and how simple this journey is- I've seen so many other doulas take it and it always felt so magical, and mundane at the same time. I've known a lot of doulas who have dreamed of becoming midwives, and I have only recently fancied myself one of those with any real seriousness. I feel like I'm joining another set of ranks in between the worlds of the lesser liabilities and responsibilities, to the greater ones.

Something that I am really grateful for as I march forward is number one, the length of time I spent doing doula work before I started to pursue midwifery. I've been able to in a huge, hands on way, really explore who I believe myself to be in the birth space, letting go of attachment to outcomes, separating myself emotionally from my clients and cleaving to them in appropriate ways, having boundaries (I am still working on this, but probably always will be, right?), and so much more. It is not just a passion for women, birth and babies that brings me to midwifery, I feel like I had to really develop a strong, mature sense of self before I could start down this road.

Submitting to a woman in labor is one thing- letting go of ego, of attachments to what I want her to do, or what I want her to experience - submitting to a provider whose decisions I must not only quietly accept but then also execute, is a different level. Thankfully I'm not terribly challenged in this department - I have the good luck to be working with midwives I know well and whose protocols I feel comfortable with- but I know this will not be true always. I remember being a fired up doula who was totally ready to stand in front of a provider and say STOP! I find it funny now, it's like looking back at my own doula-childhood.

Recently I was at a birth where the mom had some complications and we had to move swiftly to support her. It wasn't anything critical but you never know until you look backward- we were a fluid team that moved easily together and I felt absolutely relaxed. I reflected later that it was because I trusted this midwife to know what to do, and that we would have what we needed to care for her until EMS arrived if we needed them (we didn't). I also realized that I trust myself too - even in those moments of HOLY SHIT WTF IS PITOCIN!? where my mind goes absolutely blank for a fraction of a second, I know what is needed, I know what to do, I have the experience at births to know what is coming down in the next two or three (or more) steps. I don't expect that I will always feel so relaxed, but right now, with the births I've attended as an assistant, I absolutely hunger for more. I also realize that part of feeling so relaxed is that I am not the provider making the calls on what must happen next, I am simply doing as I am told, for now.

It is challenging to try to sort out where, as a birth assistant, no longer 'just' a doula, now on the leading edge of midwifery with more responsibility, more at stake - to get support and process these things. I'm wishing for a community of birth assistants like I have as a doula with my colleagues, and I also am grateful it doesn't exist at the same time. It feels good to cleave to my midwife and to my one or two friends who are on the same path I am- to not have to process everything out loud/in public.

Just rambling- I feel like I forget how to write sometimes and while this may be disjointed it feels good to just write a little.

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.

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. ;)

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.

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.