Controversial

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. ;)

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!

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.

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?