Saturday, January 29, 2011

Hands off!

I’ve been thinking a lot about birth and midwifery ideals lately. (Some of it was sparked after the hands on breech birth I had this last week but it’s been a long time coming actually.) Too often, I resort to med-wifing to hurry my labors along. Too often, I strip membranes and augment labors with oxytocin. The women here seem fine with it all because it get results. I’ve been fine with it too because I’m often tired and (Yikes! Can I admit it?) impatient. However, each time I mettle, a little piece of my midwifery innocence dies.

I want gentle, unhurried births. I want tender moments and relaxed atmospheres. I want to offer these women a joyful experience... as much as is realistically possible; I want be hands-off.

So, out of protest (of what? of my wrong thinking and silliness!) I’ve decided to practice ‘intentional inaction’ with all my future births. The joy of this resolve has been overwhelming.

Let me explain.

The other day, when Anyang waddled in with contractions every 3 minutes, I knew she was close. I forbid myself from doing an ‘admission’ vaginal exam. Instead, I reassured her that she and her baby were doing famously and that the birth would be soon. Would she be interested in walking around a bit?

She was and immediately marched off. I joined her in her journey not wanting her to be alone. I was there just as an observer. She chose to circle the clinic grounds, stopping every few meters to kneel for a contraction. I kept pace with her, though at times it was difficult; she walked so fast!

On the last leg of her trek, while kneeling in the dirt she began to grunt and push. I asked her if it was time and she nodded. Together we hurried back to the birth-room. She crawled on the bed, even though I assured her she could deliver in any position she wanted. After pushing once of twice on her back, she decided that wasn’t what she wanted after all.

Moving to the kneeling position on the floor, her friend behind her and me in front, she pushed determinedly. Her baby was happy and so was I. Practicing my ‘Hands-off’ approach, I didn’t even tell her when or how to push and strictly forbid anyone else the room to do so as well.

Minutes later a tight ball of beautifulness was birthed! Everything about it was simple and intimate. There was no yelling, no chaos, no hurrying here and there. It was just like I hoped for her. Afterward, she smiled so sweetly while holding her baby to her breast. I loved it. 

Her birth was the most fun I’ve had midwifing in ages!

Don’t get me wrong, there is a place for vaginal exams and labor induction. There is a place for fundal pressure and vacuum extraction. There is also a place for cesareans. My point is that just because they have their place in some births, they don’t need to be a standard in every birth.

Does that make me a radical? To some perhaps, but I doubt it means that to everyone. I feel a bit more mature as a midwife today-- sort of like, I got my training wheels off. I feel free-- Free to trust women’s bodies in this miracle called birth.

I’m sure I haven’t mastered this lesson yet but I hope to one day make it my own. Pray for me to be wise enough to know when NOT to act and mature enough to BEND when necessary. May my determination be for each woman’s best-- not what her family wants or how it might effect me.  Thanks!