El Paso Adventure in Midwifery

http://birthnexus.blogspot.com/ is my next adventure...please take a peek

Sunday, January 06, 2008

And to the next adventure


I am being prodded onto the next "phase" of my life and so I thought that it might just be appropriate to move on to a new idea that I have been working with...please have a peek. I need some conceptual ideas, springboards of thoughts from you all who read and comment, read and e-mail me off the list, read and do not say anything (come on I know you are out there :)I also need encouragement. Please take a peek http://birthnexus.blogspot.com/
Sunshine

Monday, November 26, 2007

3 months Later


So many people are asking for updates!

Could it possibly have gone by so quickly? Could I now be home, struggling with my NARM application, getting homework done, dotting my i's and crossing my t's, making sure that everything is in place?

Some reality twist I have been through in the last 8 weeks. I haven't bleached anything in awhile. I haven't stood in circle at 8am going over the day before and discussing how many times the doorbell rang last night. I haven't listened to a baby's heartbeat in 8 weeks. I haven't heard the llanto of of newborn except in passing in the grocery store. I have spoken Spanish, but Castillano, to one of my friends. and to the criadas at the park who care for the neighborhood toddlers.

Sigh... I am back to being agringada.

I struggle with not feeling quite in my skin. I miss El Paso, I miss the clinic. I miss the kids school. I miss my sisters, who I could say anything to.

I have sisters here thank goodness, but they do not know what I have been through in the past year.

They are busy with their lives and children as I am. They are busy plugging on with daily tasks and chores. They are busy living the southern California life. Sometimes that means pretending that life is giving you the substance that you crave.
I am sure that feeling is universal, not unique to Southern California. At least I keep telling myself that.

I thought that having time to myself would be satisfying, but sometimes time stretches in front of me like a very lonely road. I miss being absorbed in the craziness. Making your own schedule and sticking to it can be daunting.

On the other hand I had a nightmare that I got in trouble for not giving someone a "consult" to an OB for constipation. If you have worked in the clinic you will find that funny.

I am being a bit melodramatic here, but it is complicated, life is hard in general I think when you are in transition.

I have been in transition for awhile and I am so very tired of that feeling that I have many hurdles still to cross. NARM, California Challenge, Homework, Applying for my License. It will take another 3 months to complete all of that. Meanwhile I am readjusting to being a full time mother and helping my children to integrate the last year, keeping up a household (poorly I might add), working on a lovely sailboat that needs tremendous TLC, and renewing relationships in my life that I had neglected.

Poor me huh? Really don't believe it for a minute. I spent the week on the bay, socializing, playing with my kiddos, eating too much, laughing a lot, sleeping 9 hours a night. The most strenuous thing I did was walk 20 minutes to an artisan bakery in Point Loma and sip coffee while eating walnut whole wheat bread with butter and jam. My life is incredible right now really. I am just a bit wobbly.

Having choices and privileges can be lovely and can create lots of anxiety. I am exceptionally grateful for my life right now. I am exceptionally grateful for my experiences the past year. I needed to stop and take inventory of what I have.

Thanks for listening. Now my dear sister midwives if you read this.......COME VISIT, salty air is good for the soul.

Wednesday, August 29, 2007

Vessel..

As I get closer and closer to the end, the end of the beginning at least, I meditate on what kind of midwife I will be.

And just last night I was asked to have a blessing ready for one of my private clients for her blessingway.

It struck me as a profound honor...and it struck me as quite extraordinary that it was mine to give...Finding myself in a place like that is...

A blessing.

A long time ago (almost 4 years)I attended a seminar with many midwives and doulas. Part of that seminar was to set an intention for the future.

My intention was simple. I wanted to be a vessel for the strength of women. At the time I envisioned it to mean birth...

that I would meet women where they were in their journey to birth, and provide what they needed to find their strength and their way through those moments.

And daily I ponder what that means, daily I renew that commitment to women, but it expands to mean all families that I have the privilege to attend.

It expanded to encompass...

Every time I touch a belly

Every time I listen to fetal heart tones.

Every time I do a Pap (yes it can be quite empowering for women when they are in control of the experience)

Ever time I listen....to a question, to a complaint, to a fear, to a joyful 1st cry of a newborn.

Birth is the lovely reward, birth is quite a gift for the midwife. I have found that being a midwife can be quite ego pleasing in those moments. You can get addicted to the reward, the love that flows from people in those moments, the joy of being in those situations, and the gratitude for your presence.

For some women it is the 1st time in their live that a care provider has showed them a measure of respect.

I say that birth is the icing and the care you give is the sustenance( ok the cake :)

While that is ok to soak in that gratitude. I have seen many midwives live on that sugary reward.

So this post is a bit of a wandering yarn at this point but if you are reading, I think I am coming to my point.

I still hold that intention, to be the vessel. To meet families where they are at, to listen, to let their energy guide the interaction prenatally, in the labor and birth, and postpartum.

I have ideas, I have information and lots of it, I have fears and reservations, I have lots of stories, I have lots of things I put meaning into, I have imperfections (some would say too many).

But...somewhere in all of what I am, there is a place of emptiness. There is a place to allow other peoples wishes, desires, fears, strengths, stories too to guide my hands and heart to be exactly what is needed in the moment. Whatever that is.

After all the information and experiences I have had this year, that is still my intention, putting it out there in this place is a renewal of that.

May I always be grateful to be in the position...

to listen
to touch a belly (always with permission)
to listen to heart tones
to listen to fears
to have a fathers or mothers hands (not mine) to be the 1st to touch a babies head as it crowns
to be there when a complication arises and my hands are needed
to give lab results that are perfect, and imperfect
to help someone grieve

and all those other things that midwives do.

What a place to be in? Very ripe with responsibility but a place where you can allow the strength of the people for whom you provide that care, to guide you to do what is needed in each moment. Sigh.....

Thursday, August 23, 2007

rules of being tagged

RULES - Post rules before giving the facts - Players start with eight random facts/habits about themselves - People who are tagged need to write their own blog about their eight things and post these rules - At the end of the your blog you need to tag six people and list their names - Leave them a comment on their blog, telling them they have been tagged and not to forget to read your blog.

who I tagged?

Durafemina

http://meconiumhappens.blogspot.com/

Mama Midwife Madness

another mama midwife

A womb of her own


My profound friend Ariel

I have been tagged.....

I have been tagged, playing a silly and kinda enjoyable blogspere game...a fellow blogger and midwife has tagged me so here it goes. It goes deeper with every post so read...you might be a bit surprised.

(should I really publish this?)
DISCLAMER

These are thoughts I think often and people ask me why I even write but why not? Our culture is so reserved, we are so guarded, we stay in our little bubbles, we try not to let others see our weaknesses. Truthfully others could take this information and make fun of me but really the only person that could hurt me is me. I suppose I could lose some friends but...well you know the answer to that.

8 SECRETs (or things most people don't know about me....)

1. Right now I have probably about 100 hrs of stacked up homework that could have been somewhat completed if I had just taken out more time when my kids were in school to do so. Now it is a looming monsterous pile of procrastination.

2. What I do to procrastinate...guilty pleasure? Uggg...sometimes I play lame silly computer games. When I start doing that, I know I am in deep, am seriously avoiding something in my life.

3. I am currently using the electronic babysitter (named KPBS kids) to make this list. Some of the purists I know would be shocked at my use of TV and videos right now to just get a few minutes to myself.

4. Sometimes I am shocked by the thoughts that I have about my fellow sisters. I sometimes think very mean things about them....my brain goes on automatic teenage girl at times and is very bitchy. It is usually at the end of the day, when someone is avoiding doing list or avoiding doing a difficult cita. Or I am avoiding doings something that involves bleaching or taking out the trash or filing. Compassion flies out the window and I want to throttle someone. I try to control my bitchy brain so that dumb things don't fly out of my mouth. Sometimes I can, sometimes I indulge the thoughts. Sorry sisters, I try, but my evil self sometimes gets the best of me.

5. I used to think that I was really stupid...I got S on every single category on my report card... I was put into the special catch up reading program in elementary school. I got C's all the way through high school. I still have learning problems, I just recently learned to read a map well. Sometimes I struggle with directions, r and L, anterior and posterior(not good to get confused with that in midwifery school but i am working with that). If you tell me something orally, especially how to do something complicated, like say how to suture, I want to cry. You have to stand behind me and show me step by step, don't tell me out loud, it will confound my brain. If you ask me to draw something, you will laugh, guarantee, you will want to laugh even if you do not do so out loud.

I am really smart on paper, I am really good with languages, I am a fantastic teacher, I am quite artistic (not with drawing). I am wonderful with other things, it just takes me a bit of time to learn certain things... I eventually learn them on my own terms.

6. I grew up very poor, like no running hot water, leaky roof, screens instead of glass windows, DIRT POOR. Mostly caused by parental alcoholism, addiction, etc...Ever read Bastard Out of Carolina? That book pretty much sums up my childhood. It was a brutal. I feel like it was not me who experienced that but it was you know. People who have "overcome" childhoods like that are called surviors.

7. 10 + years of therapy didn't hurt either, well maybe it did hurt a bit. Sometimes therapy is painful, sometimes therapy leads you to believe that you can separate yourself and overcome things like that, to the point that you overcompensate and want to be perfect. Like white picket fence perfect...I strived for much of my life to be white picket fence perfect and still do sometimes. I am materialistic and still trying to make up for being poor by having a nice house and nice car and nice things knowing full well these are superficial longings that cover up a deep insecurity.

8. I love the idea of giving up all my possesions and sailing off into the sunset. That dream is very close to being realized...

SEE HERE (and for my dear friends this is not a secret) WWW.SAILMAKANIKAI.COM

Sunday, July 29, 2007

Morning

Just a quick bit before I am off to shift. It is quiet and I rarely get these quiet, sacred moments to myself.

I working on little sleep, so forgive me if I ramble. The sky is blue, with clouds dispersing bringing humidity...It reminds me so much of my island home.

Can one miss two places at once? Can you feel homesickness for two places at once?

Hawaii calls me back with this EL Paso morning, and San Diego's beauty has me craving a walk at the Cove and breakfast at the Bungalow.

Sigh...I keep telling myself to be present but the workload at MLL is causing me to regress to "calm waters."

New students coming in who read my blog will soon understand that work load.

I have one word for you "Surrender"...Seriously, you will never know another time in your life when you are stretched so your boundaries. I know I write a lot of the beauty of MLL, but you also need to know a bit of the shadow so you can cope.

Here is my mantra right now, telling myself that this is temporary madness helps...In the future, after MLL...

You will rarely fold laundry at 2am in your real life.

You will rarely be filing at midnight again...

You will do very few 36 hour days...

There will be few 4+ cup blood losses...

You will have few times that you are up 24hrs, have class, then go home, get as much sleep as humanly possible in a night, then have shift again...

10, 1 hr appoints in a row will probably be a rare occurance...

Sunday, June 17, 2007

Vulnerability.


I do not know where to begin to unravel the long ball of yarn that is this topic.

I am in my last semester. I am crossing over, have my foot poised to begin a new phase of my life while still living the intense world of MLL.

I have sadness over leaving. I am so incredibly grateful for the families that come into the clinic. They are the most loving and gracious people that I have met in my entire life. I am sure I will meet more in my future practice, but I have been immersed in a culture that still relys on family as a main support, where an appointment that I do with a client might involve 5 people listening to the baby's heartones with a fetascope. Where a birth might involve 4 cell phones ringing at the same time. Where in the middle of the night the doorbell rings 10 times because 10 different people are walking in to check up on a laboring mom. It is not considered interference, it is considered love.

Yes, sometimes it can be a bit overwhelming but it is mostly amazing.

I am so independent, and have been taught very well to rely on myself in times of intesity that the contrast often brings tears to my eyes.

Students being to take on-call clients when the are deemed ready to give continuity of care and you get even closer to the woman and the families. When you chooses your client, you are choosing the family as well.

One of my on-call clients came in the other day in labor. She saw my face and promptly melted, sobbing in my arms, tears streaming down her face. I got scared and thought something was wrong.

It wasn't, she was expressing the pure emotion of transition, she was expressing a complete vulnerability and trust that I rarely feel. It moved me to cry along with her.

She had a trusting relationship with her family, she has assumed all of her life that it extends to the rest of her world and that it included me.

These woman have so much to teach me. The rawness of that moment still brings tears to my eyes.

The places that I am vulnerable are here in these pages and in the arms of my husband and in my role as a mother to my children.

The rest of my life is mostly business. I do not breakdown in my friend's arms, nor in my mother's, aunts, cousins, my doulas, my playgroups, my midwive's. If I have a problem, I may speak about it, rarely with emotion, I scratch the surface in my writing and intellectualize it.

When I was in labor I wanted to be alone, I coped in my brain visualizing my body opening.

Watching a laboring woman cope with her labor by relying on others always blows my mind, watching a laboring woman just unfold in her vulnerabililty moves me because that is so difficult for me to do.

I know that I don't stand alone in this, many of us independent, self sufficient, intelligent, strong, California (and other places) girls do not express vulnerability often. We keep much at a distance, keeping a close circle of friends and a therapist.

There is a whole set of circumstances that brings us to that independence. It would take a book, not a blog to explain them, but you who read here know exactly what I mean.

So here is to trust, to vulnerability, to rawness and to relying on our sisters. I covet my independence and my strength, but....but maybe there is much that is missing from my life as well.

Always having your guard up takes a lot of energy.

Friday, May 11, 2007

Another Exceptionally Ordinary Birth

This was a birth that I assisted at.

A first time momma, very young, comes in with ruptured membranes, light contractions. She had care with an OB throughout her pregnancy, had only been to two appointments with us.

It was a beautiful day so she walked around a bit to get things going, through the hallway, into the back courtyard. She walked in slow circles for an hour or so and then went back to her room.

She listens from her room and hears another woman birthing. I was told that she became a bit afraid, a bit desperate all of a sudden, to have this over with quickly. She labors for another hour in her room. I am not privvy to what is unfolding with her after that point.

I am sitting at the back table, listening to a beautiful song with tears in my eyes, it was my 1st shift back after my fathers death.

Birth team is called (the sign that she is probably pushing and help is needed) Staff and I go into the room to find her standing, very disoriented and very frightened, the baby is crowning, the other student trying to make sure the baby is born safely. We move her to hands and knees onto the bed.

The baby is born wailing, wrapped up and passed between her legs. She just stares at the baby in disbelief . She asked what just happened. "Your baby was born" Her baby is scooped up lovingly after a long minute and welcomed with tears.

A birth like that for a momma can be like plummeting down a roller coaster ride. It takes a while to not feel dizzy and disoriented about the surroundings.

I think that is what pushing is all about, the threshold crossing. When a woman doesn't feel like she pushed, when the baby rockets out, she might feel psychologically spacy, like someone just pushed the fast forward button on her live and skipped a big scene.

My third baby was like that so I know, I had the same reaction that this woman had..."what just happened?"

Another exceptionally ordinary birth...

Exceptionally Ordinary Birth

Every day that I step into the clinic I wonder what birth lies around the corner, what unveiling of the inner most sanctum of a woman's world will I be priviledged to experience.

Most doulas and new students who have experienced hospital births revel in the birth that shows the primal. The woman squattting, the woman shrieking, the woman pushing her baby out on hands and knees. Birth without interference. Birth without the intellectualization.

At MLL I have seen lots of those births when the woman follows the natural flow of her body. Over and over that is what I see. There are a lot of fast births at the clinic. Fast fast fast.

My last shift a woman came in with contractions spaced about every 5 minutes apart that had begun an hour prior, I was the only one to do the labor check. The clinic was a bit busy (understatement) and so I went through the normal set of questions to see what was happening with this womans contraction pattern. This beautiful woman smiled and answered my questions. The only way that I knew she was contracting was that she would take a deep breath at what seemed like the peak of her surges. She was incredibly serene in the midst of what seemed to be intense laboring. About 5 minutes in, after listening to heart tones, I saw a thin sheen of sweat on her forehead and felt her back. She was working hard and the temperature of her skin gave it away.

I checked the front of her chart for any pertinent info (that is where we document if a woman wants a water birth, if she is RH-, etc..) HISTORY OF FAST LABORS written in bold lettering. Ok, well still need to do the intake process.

I felt like I was bothering her a bit with all of the questions required for this process, so I took a minute out to observe really what was going on.

In that minute she stated "ay, I feel something below" her voice became elevated and her smile was gone from her face. She wanted to push.

Ok, time to get to a room.

She walked, rather gingerly, head held high, smile on her face to one of our birth rooms. I called for staff and this woman lay down, was checked for completeness (per protocol) and pushed her baby out into the world. The baby had a nuchal hand, a nuchal cord weighed 8lbs 12 oz and it came gently into my hands despite all of this.

This all occured in the clinic without anyone knowing what was going on besides me, the staff midwife and another student assisting.

And this is not the 1st time this has happened to me, usually I am awoken at 2am, barely have time to put on gloves, and at 2:15 am have slippery beings glide right into my hands.

It is incredbily, quite ordinary.

Sometimes I feel it is a bit dangerous to post stories like this, even though our culture needs to hear more of them. Most of us don't have births like these.

I know, lots of questions, lots of things to ponder. What makes it so easy for this to unfold over and over and over again?

Trust? Faith? A fit body?

And then judgement that we have for ourselves if our birth is not like this, if our birth doesn't unfold so easily, if we are not smiling during contractions.

What key does this woman carry to unlock herself so easily?

Thursday, May 10, 2007

Descent

The intention of this blog was to write about birth and my experiences at MLL and it has gone beyond that to a deeply personal sharing of all that has unfolded.

I haven't posted about my experiences much lately at MLL, mostly because I have been in the metaphorical underworld.

The western world has a strange view of the underworld, a fiery place perhaps... but the underworld in myth is very different than that.

http://members.tripod.com/~ideomagi/library/inanna.html

There is an incredible story of Inannas decent that I tell in my Birthing From Within classes about a woman on a journey who decends to the underworld to give birth. It is a story of the stripping off of all of the images that we posses of who we are, it is a story about a deep journey into your shadow self, it is a story about crossing a threshold into another way of being.

Innanas decent is an ancient story of a journey with many facets and a journey that we take in our own lives as we transition into any new phase of life. It has a universal theme, mostly directed toward the female archetype.

So my journey into the underworld has been a long winding path and a stripping down to the bone of who I am. Some of it had to do with my fathers death but much of it has to do with the intense process that is MLL. For awhile, the process to becoming a midwife became too difficult to speak about. I was a bit stuck in politics, difficult births, difficult interactions, difficult self reflections, a heavy work load etc... to even begin to share lovely birth stories.

In short, I was in the underworld.

The story also speaks about ascent. After Inanna "gives birth", she begins her renewal and her journey back into the world. The original myth does'n't elaborate on that journey too much but that is where I am now.

It is May....In September I finish the clinical experience. And then what?

Parting with the Ashes



Photos is of the flowers spread during my father's memorial service. The background is Lanai. It was a beautiful ceremony done with much ritual and song. I couldn't have asked for a more beautiful goodbye.

Sunday, March 25, 2007

Grief part 3

MY FATHER’S body

Is ashes now…I had to fax a note to Nakamura’s mortuary. It said this “This note authorizes Nakamura’s mortuary to creamate the body of Walter McAnally.”

I spelled cremate wrong.
That is so far the only part that I have in the transition of his body to spirit.

The last time I held his hand was in August. Brad and I flew to him, he said he was sick so we went to see him. He would not tell us what was wrong, mumbled something about Rehad, needing to get off of the sauce. He could not drink and live at the same time.
Apparently the drink was more important than his life.

I am so glad that I followed my gut and said goodbye. When I drove away from his Lahaina house, I knew that it was goodbye. His closest companion didn’t seem to think
So, his boss seemed to think he would choose to live somehow.
Oh crap, this story is probably going to far.

But you can see friends who requested that I update my blog, that grief has anger in it too.

It sucks to be angry at someone who is gone. I know, I know, it is part of grieving but it still sucks.

I know my body relives the first abandonment at 3 years old when my mother left him, and he fled to Maui. I didn’t see him for 15 years…I don’t remember that 3 year old me and the grief that must have generated.

But I feel it, somewhere it is buried in me, it is resurfacing.

And I think that is Universal, when someone dies, all the unfinished business, all of the memories, good and bad come up. The “proper” thing is to let go and remember only the good, to smile and cry and grieve the loss of the person. The truth is though that you are grieving your own personal losses, every one of them comes up again.

The losses are like a can of shaken soda, the cap comes off and the bubbles explode out.
All of the emotions, the good, the bad and the ugly…

Grief part 1


Beginning something, with words, feeling my way through the text.

I have had reluctant fingers, afraid that they won’t represent well, or afraid on an even more difficult sentiment, that I will get started and won’t be able to stop.

The emotions that I have been carrying around are a great sea trench. I have been floating over them, looking down and wondering to what depth the darkness goes.

I was afraid to take the plunge, to swim in them, in they mystery and depth.

But last Thursday, I had no choice.

A week has gone by since I got the news, via phone message, that sent me plummeting, iron weights on my feet, into that watery cavern.

The message from my uncle was that my father lay in the hospital with tubes in him, making his heart beat, breathing for him. He decided that methodone and alcohol would be the way to end his life, he decided that his body had betrayed him and that it was no longer worth living in.

I know he made that decision awhile ago, but last week he carried it out to a fatal end. Intentional? Unintentional? The answer to that will only be known to him. I can’t go there, the world of questions could make me crazy.

His decision did not surprise me, but the phone message shocked me, grief enveloped me, pulled me under. I was driving when I heard the message. It took all of my strength to turn my car around and be back where people would ground me. I couldn’t go home, Arno and the boys were out camping.

So I went back to the clinic where I was held as sobs wracked my body. I was taken home and fed and helped to figure out what to do.

If any of your read this…thank you. I couldn’t have gone at it alone.

I was stuck for a bit, figuring out how to deal with my father’s death alone. They had made the decision to take him off of life support and I wouldn’t be in Maui in time to say goodbye to his physical body.

So I did the only thing I could think of and that was to go to San Diego, to be with my older son, to connect with my father that way.

Arno joined me two days later, he had been out of cell phone range for two days. Not being with my guys was disorienting.

Grief part 2


Grief is a strange thing. There is not a set of instructions on how to grieve.

There are times when I smile and feel awful for doing so, I am not supposed to feel like smiling am I?
There are times when I can’t form a sentence, when I have delved so far into my inner world that asking a simple thing like “What time is it?” seems to drain all of my energy.

I cry at inappropriate times, standing in line to get on the airplane, at the bookstore counter.

Yet, I cannot cry at appropriate times either.

I feel huge anxiety every time I move into new interactions because people want to say the right thing to me. People want to give me comfort, want to embrace me, and when they do, the wound opens up fresh, the emotion threatens to send me sobbing in the arms of near strangers.

I wonder how people would react, casual acquaintances, when offering condolences, if I did just let myself cry in their arms.

The hardest part is staving off that wave of emotions with every new “I am so sorry for your loss.”

I know, I should just let it out right…I was taught to stuff it. It is not so easy to overcome that teaching.

Sometimes I want to carry around a notepad and just write out what I am feeling, for me that is so much easier.

I stumble over my spoken word, it cannot convey what it is that I feel. Spoken words for me just tumble around like rough rocks in my mouth. I cannot speak the depth of love and gratitude that I have, the depth of grief, I cannot speak tears into my eyes.

Monday, January 29, 2007

Uggggg......

In previous posts I had gone off on a vent of my evals...I was venting and was very much in my emotions and not in my thinking brain. Meaning I did not think how my words might affect other people. So I blogged, venting some frustration not realizing that I might hurt someone and I did.

I have had a lot of time to process those evals and the end it was my pride that was hurt, it still is, and so I vented. Not because the evals were inacurate, but because they were. It was difficult to deal with the feedback.

It is a tough line to tow, one which doesn't offend when you are offering up your rawness. I risked a lot and for that I am sorry. My intention was not to hurt but to get my frustrations out. I was too specific.

Those who read this blog should know that it was a momentary feeling that I let sit on the pages of this blog. I considered changing it awhile ago but I didn't.

I apologize, I really do, everyone at MLL is amazing and I have learned both from my positive and diffficult interactions. I have learned some humility but I have so very far to go in so many ways.

Some might say that I should not censur myself and on some things I think I shouldn't but when it is a shared experience, it is a difficult judgement to make ya know?

At any rate it is late and I need some sleep...

I feel like I share so much of the beauty of my experiences here, and that mainly is what is expressed here(I would say 95% is joy). Part of that beauty is the contrast, the difficulty of this hard work and the level of intimacy that you have, the beauty of serving as a midwife, the priviledge of learning.

Tuesday, January 23, 2007

10 minute list


I have 10 minutes, thought it would be fun to make a list of things that I have experienced birth and prenatal wise in my time here that I am grateful for. It has been huge learning:

1. Nuchal hands in abundance
2. Babies in the caul
3. Only one nuchal chord
4. Placenta previa
5. Palpating a breech (a few times)
6. Polyhydramnios
7. Oliohydramnios
8. varicosities in strange places(I won't get too descriptive but you can guess)
9. caput
10. molding
11. 2 minute second stages
12. 3 hour second stages
13. PIH
14. Gestational Diabetes
15. Fainters
16. Hemmorhage
17. Placentas with various insertions:velimentous, battledor
18. Heart shaped placentas
19. accesory lobes
20. PROM-prom sucks
21. SROM that soaks through scrubs if you don't put on the waterproof gown.
22. Painless birth
23. Women who suffer in labor
24. 42 year old primips
25. 16 year old multips

and so much more. This list actually only took me 5 minutes! Cool tomatoe huh?

Wednesday, January 17, 2007

Instant sisters...just add birth and mix



It has been quiet here, in my blog but I would like to pose this question to the lovely human beings who read here. I would love to hear your responses.

I have been thinking quietly about the profound loss of so many things in our femininity, our connections to other women mainly, mirroring our connections to the devine feminine. I think of how as women we have so few things that link us together and how we can be so suspicious of each others motivations. It is difficult to trust one another at times because we have been so wounded by our culture (wether it is family culture or the culture that surrounds it)

I see it everyday, this guarding and unguarding that we do...the subtle dance of friendship, the subtle rules and rule breaking. Alliances forming, cliques forming then breaking apart.

It is interesting and painful to be a part of. We are such strong women at MLL, you can imagine how things could get difficult in such an intimate space with so much brillance and insecurity at the same time.

I have had some recent interactions with a fellow student that have brought me to place where I wondered if I had grown up, or if I was still stuck in the trauma of being an adolescent girl. It brough me to a time in my life where being "in" was so much more important than being myself. It was/is not pleasant reliving that.

I am in the constant process of healing and moving through painful things, like the birth learning process, the social process learning curve is just as steep here.

I haven't had sisters, I grew up with 5 older brothers. I have instant sisters now, for good or bad. Someone help me understand this whole thing. I am at a bit of a loss right now on how to move through it.

I am serious, share with me your understandings on how this all works...I should have the answers but I don't.

It is a silly plea I know....HELP!

Friday, January 12, 2007

Dreaming


I am going to ramble for a bit to see where this takes me, funny how I don't know....

This weekend I had the opportunity to visit Pam England in Albuquerque. Those of you who don't know who she is should know the title of the book that she wrote "Birthing From Within". At any rate she has been a mentor to me and a transformational figure in my life. How she has mentored me goes way beyond birth, she has taught me to find beauty in the mundane, beauty in what others might see as ugly, beauty in the moment.

She has mentored me to heal myself, silence my judge, nuture my child and develop my inner warrior. I have crossed many thresholds in her presence and for that I am grateful...

I got to see the inner sanctum of her world, her little casita in Albuquerque where she runs BFW and spend at least 2 hours with a cup of tea in my hand and warmth in my heart.

I was so grateful for a peek at how ordinary her life seemed. Sometimes I think the perception that we have of a figurehead of an organization can be that they are untouchable, and though she has never appeared untouchable, I have always thought that I could never aspire to be a person so centered as she is.

I noticed many things as I sat and spoke to this woman one on one. This was the one that was most powerful for me:

She is a master weaver of words. She doesn't speak as most people do, she speaks with tenderness, she speaks with images and she speaks with stories. She uses what she calls "delicious" speech. The words that come from her are carefully chosen for their affect...yes they are hypnotic and she is a master at that hypnotic language.

Some describe her as shamanic and I always wondered what that meant as I have never met a shaman. I always have envisioned that as a mysterious leader as someone who is capable of leading people across profound points in their life through ceremony and ritual. And she does that for many. But she does it unmasked...there isn't a mystery to it. She has mentored many about how to do this leading of parents across a threshold into birth.

I had my 1st mentor training almost 3 years ago but I have not delved into BFW as much as I would like, parts of me where afraid to because it is so very unconventional. My conventionalized mind couldn't always accept it.

And I see here at MLL how much it has helped me. I would like to bring a little BFW to the new students coming in. I think it might have a profound affect on how they experience MLL.

So why did I title this post dreaming? Not because I am dreaming of BFW but because of a story that Pam told me about how we dream our reality, how our perceptions influence our joy and how much we open our hearts to people.

How do we dream our lives?

I will give an example....

The photos I post here are of pure things, it is intentional that I do this. I love to capture the pure joy of moments. I think it sets the feeling tone before you read, dear readers.

So what if I posted photos ugly things, a piece big piece of raw meat or a car crash...

How would you then begin to dream my posts? How would you then receive my words with this simple change?

Pam gave and example that I will summarize:

When you are walking out in nature, up in the mountains, or surrounded by tall lush trees in the forest, how to you greet people as you pass each other on the path? Notice what your eyes and mind do when you see people in this setting.

Think of a dangerous city that you know imagine yourself walking there midday, how do you greet people? What do your eyes and mind do there?

Both of these situations are interesting are they not? In one setting you might "dream" people to be gentle and smiling. In the other you "dream" people to be in a hurry or to have poor intentions.

It is a really simple concept, one that most people are aware of. Pam calls it "dreaming" because it is something of the mind
and only of the mind that we create.

Then translate into your birth life if you are a doula or a birthing mother. How do your "dream" a cesarean birth with lots of interventions? Now how do your "dream" a homebirth lit by candlelight and warmed by soft music.

Most of the people who read this would dream the 1st one as awful and the other as lovely and transformational.

But haven't we met many individuals who would dream the opposite dreams that one was scary and the other predictable.

And we judge them as wrong.

Pam would argue that these are just judgements that we have and that homebirth or cesarean could have the same level of transformation...one doesn't have to be good or bad. It is how we help, as care providers, to shape the dream that is so important.

she rocks many worlds.

Tuesday, January 09, 2007

Ancient Ones



How can words describe a world made clean by snow...the tracks of history somehow made pure by the white blanket that covered it?

The only footprints visible were the ones made by our explorations on Saturday afternoon in the mountains of New Mexico above Albuquerque...

How such an amazing place was made empty could be explained by the 29 degree temperature and the new snowfall.

But what fun we had exploring the maze of below ground dwellings, that had existed way before a mission was created over 200 years ago.

"What remains today are austere yet beautiful reminders of the early contact between Pueblo Indians and Spanish Colonials. The ruins of four mission churches, at Quarai, Abó, and Gran Quivira and the partially excavated pueblo of Las Humanas or, as it is known today, Gran Quivira. Established in 1980 through the combination of two New Mexico State Monuments and the former Gran Quivira National Monument, the present Monument comprises a total of 1,100 acres."

This is an excerpt from the state government website, that it defines it as a mission is astounding. The mission church is such a small part of the ruins, the Pueblo people existed in that place long before religion imposed its structures. There are reminents of Kivas and sacred ceremony sites around the large church.

Tuesday, January 02, 2007

snow in our backyard!!!


















and what do california boys do when it is freezing outside?

Wednesday, December 06, 2006

Sacred ground


"My involvement with midwifery has been the very best life I could have. I feel I have been living on sacred ground."

~ Jan Tritten


What looks like shadow exists only because light exists. One cannot be present without the other. These past few days I have been dancing between shadow and light. Bear with me, stay with this metaphor as you read.

What I have to write about is haunting, so if you would like to dance only in the sunshine of midwifery, you might not want to contine reading. I am afraid to write this blog because it is loaded. I feel though that it is important, probably the most important thing that I have written about to this day.

I don't even know where to begin except with the exact moment. On Friday a woman came in for a scheduled appointment. I went to get heart tones...you can guess right? Take a deep breath.

There were none, her baby's little heart had stopped beating. This was her 1st pregnancy, she thought she couldn't get pregnant.

I asked why I had been the one to receive this brutal message. I was terrified, I moved slowly and got the staff midwife. I wanted to run away but I couldn't. How could I? Many thoughts crowded my head, how could I possibly support this family when I was in shock?

Another midwife went to the hospital with them for a sonogram...when I gathered myself together, I took her place. I was there when the father received the news but I was not allowed to be with them.

I went back to the clinic with a heavy heart but at the same time I felt like this was an amazing gift that I had been given.

This is every midwives worst fear no? And I was in a situation where I had to deal with it. The gift is this: I wasn't alone, I was in a learning environment with 20+ women to gather around me and help me cross this threshold. I was dancing in shadow and light and being present in both. It was hard, it is hard. It is not the end of my story.

On Sunday I was on shift and by chance it was my turn to go to the hospital (we do followup on people who are transported out of our care). This time I was allowed in to see this family, as I crossed the threshold to their room, the nurse was checking this mom's dialation. I stood outside and wondered how it was that I was here at this exact moment. The mother was complete and ready to push.

This time I did not want to run away. I commited myself to serving this family and I did. I was there for the birth of this baby. It was phenomenal.
After the baby was born She lifted her little 8 1/2 boy into here arms and spoke words of love to her child asking it why it had choose to leave.."Que te paso mi amor?" She wrapped the baby in a blanket, they took photos, there were profuse tears. She named her child.

The baby's heart had not beaten for at least 3 days, before she had entered the clinic for her appointment.

I am in a very strange space, 4 days later I have cried, I have grieved, I would say though that I am more grateful than anything.
I don't think this is a reaction that everyone has.

It was a gift, it was no accident that it was me that did not find the heart tones and it was no accident that I was there the moment that she was ready to push her baby into the world. Is it?

At times I think that I just haven't quite absorbed the profound sadness of it all. The hardest part was not my involvement, the hardest part is thinking about the grief of this family. I have just had a small brush with it. I was allowed to be on the outside, I am allowed perspective. It wasn't me who lost a long awaited child.

I am sure that many people who read this will have specific questions, and specific judgements. As of now, the cause of the baby's death is unknown.

Does it matter? Does there need to be blame? Isn't life so very mysterious?

Thus the beginning quote:

"My involvement with midwifery has been the very best life I could have. I feel I have been living on sacred ground."

~ Jan Tritten

Thursday, November 30, 2006

Birth Standing


Writting a specific birth story is challenging because of all of the births I have seen in the past three months, they blend together. I was going to write about my last catch but I am not so great at narrative. I thought it better to write some of the more intense moments instead, kinda like looking through a photo album of snapshots of the past 3 months here.

I could even catagorize them according to interesting little details no?

Moms standing and squatting during pushing...

1. A mama came in pushing, we brought helped her to the "peach room", barely had time to put a chux down, before her baby came out hollering. Her huband stood behind her and held her elbows as she squatted with each back to back contraction and pushed. None the less, he had a backache afterward.

2. Sylvia...one of the strongest woman I have ever seen. A 3rd time birthing machine, she followed her instincts so amazingly. She birthed standing until the head began to come, then moved gracefully to the birth stool where to rest of that 9 1/2lb baby came sliding out. We were a little worried as the heart tones slipped below 90bpm as the head was compressed (very normal but it always seems to bring a bit of worry into the room). Baby came out a litte gunky but beautifully pink.

3. The first time I assisted was with a momma standing. The baby's head came sllllllowly out without restitution and then had some sticky shoulders. A slow 2 minutes ticked by before we moved her to the bed into McRoberts, that seemed to work to birth the rest of the body. The baby was great and the parents were estatic. The whole labor and birth we had been speaking in Spanish. As the momma received her little girl, she looked at all of us and said "OH THANK YOU, I am so happy"

A little side note:

I have seen a lot of sticky shoulders, for awhile I was equating it with bed dystocia, or "mammas birthing on their backs" dystocia. I don't know now though...I have seen hands and knees dystocia too. I also used to think that dystocias were caused by directed pushing too, but that theory hasn't panned out either. Most of these babies were under 8 lbs too.

I wonder sometimes if the dystocia is about fear, or disturbing the birth space as well. I imagine that Michel Odent would agree...

At any rate, the sticky shoulders have always easily resolved...so maybe that would not define a true dystocia? I am still working it out in my head and may never draw any scientific conculsions. Birth never seems to follow the paridigm of science, there are too many variables to adequately give theories about labor patterns and complication patterns that apply regularly: ie, dystocias are more likely to occur with babies over soo and such weight. It just doesn't seem to happen that way....

I was talking about birth stories was I not? It is so easy to get off topic...part of my writing is processing all of these experiences and information. To be continued.

Monday, November 27, 2006

Mother Nature

I haven't written in awhile, things continue to flow for us well here with a few stops and starts, minor glitches. It seems like conflict would be more exciting for a blog no? I haven't written much because life here seems to continue to astound me, energize and lift me up. I feel like a broken record. If you don't want to hear me wax philiosphical, read the last paragraph, it contains the birth story.

I really do believe that the power behind your emotions is what drives how your life unfolds. Life unfolds sweetly now, the glitches seem so minor that they are not worth putting much energy into complaining about (housework, homework, car repairs, ocassional grumpy children, ocassional grumpy staff members and students).

So the "feeling sense", the power behind these lovely feelings, continues to be the lense through which I am viewing my time here. Good good things continue to unfold.

I could write an entire blog on the color of the trees here as they prepare for winter. I understand why so many writers wax poetic about fall and how it sets the world ablaze with its stunning shades of yellow and green against an azure and cloudless sky. The upper valley, where our home is located, is like fairy land to me. I have never lived in a place with grand seasonal changes. I could stand still in our back yard for awhile and just watch the yellow leaves of trees drift gently down and make feathery piles on the green grass. Sometimes, after dropping off the kids at school, I drive aroud the neighborhood just to look at Pecan orchards in their seasonal bloom.

Silly, sentimental me. Natures beauty has always been my church. As a child it cradled me, as an adult it feeds my soul.

I almost titled this post "PRAYER" because of the power of it, prayer in nature, prayer in birth...

My last catch brought tears to my eyes because of that power. That was the way this laboring mom coped with the intensity of her labor....she had her rosary beads in her hands, and at the peak of contraction she whispered a prayer to the Virgin Mary and rubbed on the beads. It was stunning to watch her draw on the power of that. Her voice was so soft, her words inaudible and sacred. Her body moved instinctively to that ritual. She moved in a circle around the room, moved her hands to the circle of the beads. Her voice circled through the prayer over and over again.

Ok, I ran out of time...will post the entire story next entry. The point is though that mother nature is amazing, I see it around me and I get to see it in this midwifery journey. Trees, mammas, babies...

Tuesday, November 07, 2006

Cowboys in our garage


There are 2-not one, but 2 Ford f-150 huge, deluxe, cattle guards and gun racks, fully loaded trucks in our front yard. Are they strange neighbors? Are they looking for things to shoot in the wilds of the Rio Grande? Are they farmhands at the neaby ranches? Are they chasing down a lost horse that may be roaming the open fields down the street?

Nope folks none of the above...they are here, in my house, staring over my dear husband's shoulders in our garage learning to make biodesel. Yep-these cowboy hatted booted mustashed tobacco chewing lovely folks are getting chemistry lessons in our garage.

Those Ford-150's? Yep Diesel trucks that run on recycled, converted veggie oil.

You think Californias are forward thinking folks, and Texans are assbackward? Nope-yer wrong.

I have met more mammas here (outside of the birth clinic) who co-sleep, elimination train, extended breastfeed, home birth in the few short months we have been here than most of my parenting years in San Diego.

Mind you, we are 5 miles from the border of New Mexico. That has something to do with it. Our kids are in Montessori school and that has something to do with it to.

I really thought I would be miserable here. I am not. Kids, husband even the dog is happy here. Arno is in heaven, he is teaching bio diesel to some cowboys. Plus he starts a very lucrative job next week...though sigh, his 1st paycheck doesn't come until January 15th.

Are you all trembling in your California Birkenstocks dear friends in San Diego?

I miss the sand, I miss the ocean, I miss my family, I miss my dear grandmother who just got out of the hospital. I miss my California king sized bed. I miss my long time friends. I miss you all!

Ps-My darling 5 year old made the society pages of the Diario. He was at a Holloween birthday party and in troops newspaper man to take photos of kids. I am a pround mama. Sorry the photo is not turned correctly.

Saturday, November 04, 2006

Hands and Knees


Everyday joys of life in the clinic...
1. Watching a mom who waited 4 long years to concieve rub her belly in joy, her eyes welling up with tears. I get choked up myself. She listens for a full minute to her baby's heartrate on the fetoscope, her eyes closed and a smile on her face.

2. "Que nombre le vas a poner?" one of the staff (a native speaker) asks a little girl what name they are going to give her little brother. The little girl's answer? "hermanito" or "little brother", Como? responds the staff asking her to repeat it, the little girl answers "con marcador"
It is a language joke of course ...the word como could be interpreted two ways, you use it when you want someone to repeat something but it also means "how?"-well with a marker of course, that is how we will put his name on him. The expression in Spanish is "what name will you put on the baby" which can be a literal interpretation to a 4 year old.

3. A dad really trying to be macho but sobbing in the corner where the midwives hear him but don't see him. His little boy just entered the world.

4. A mom birthing on hands and knees to a baby that enters the world sunny side up and crying before the shoulders are born (my 3rd catch)

5. The 9 centimeter expression "I can't do this anymmore"

6. The color of the 7 am morning sun on the 1930's building across the street- illuminated amber. For me it signifies another beautiful beginning of the day.

7. A wise 15 year old crying upon the arrival of her baby, kissing her 17 year old husband. No fear, no shame, just pure joy.

8. Babies coming out with nuchal hands, nuchal cords, lower than anticipated heart tones. No forceps, no vacums, no cesareans, they just come out with love and patience and freedom of movement.

Thursday, October 26, 2006

The fullness of the moment


My very sweet man brought home this cake last night. I wanted to open the bottle of champagne but we decided chocolate might be wiser.
Really there is no new thing to celebrate, but as days go by I feel like I am growing, expanding, learning and experiencing joy that I never thought was possible. I am moving beyond judging to being in the moment. It is quite an awakening to be capable of doing this and brings fullness to my life.

Things are tough yes, so very very difficult. I get tired and cranky, it is hard work, things unfold at MLL that I don't always agree with. There is such beauty in the clinic too and the families there. I will share some of these moments in a bit. 1st here is a quote that I sniped (with permission) off of the BFW mentor board from Isabel Hoskins:

"All of life and self being in HARMONY with the Tao and/or God's Plan/Love, whatever term one comes to, is quite different to me than saying it is all good. It is moving beyond good and bad and am embracing the FULLNESS of all that exists, that within violence and oppression and horror their is also light and love and beauty and it is impossible to ever really separate out the distinction, where one ends and the other begins or the cause and effect. In the end we are left with the events and though we may define them on the surface as "bad" did they not bring us where we are today, to the gifts we know and claim? We can never seperate it. It just becomes what IS, which is an embracing of the Harmony that is the Way. To move beyond good birth/bad birth, right birth/wrong birth, good self/bad self/, and see that perhaps such terminology is, though understandable, forever limiting for ourselves and experience. - there is great power here. "

I couldn't have said it better really.

Wednesday, October 11, 2006

Only to be awoken 45 minutes later....

A continuation of the last post...

...only to be awoken 45 minutes later. I was in a dream still I thought as I helped the room set up for a mom who was at 8cm after her labor check. She entered the room saying "Ay quiero empujar" I glanced at her face and wondered what magic had brought her into my life for my 1st catch. This woman was stunning, filled with that incredible light and energy that gets a baby out. She was flushed from her work, skin glistening,the picture of perfection with this dad who was also smitten with her glow. Selma Hayek meets Aztec godess...

This was an instance where I literally just caugh the baby. She laid down and after a few pushes, this child litteraly launched out of her. I had my hands out to receive as the baby was crowning, looked up at her to say "sople, sople" to let the perinuem stretch a little. That second of looking away to her face, the baby came out with this popping sound and launched into my hands. If they hadn't been there, I think that little man would have hit my chest. I fumbled a bit and placed little Jesus Abraham on her belly. The staff midwife looked at me and said "did you hear that?" Yes, was my reply," what was that?" " Shoulders" was her reply. I am still wrapping my head around that one, not sure what that was, I think perhaps just pressure of fluid behind him that helped him on his way. He surfed into the world. Hang ten little guy.

This family was so lovely, 1st words out of dad's mouth were. "Your service is so much better here!" which gave us all a laugh. Their last baby had been born in Juarez and 3 years later mom still had pain from her epis (she had to be sutured again for this birth and had torn on the same line)

Dad was so exited, he wanted to see the placenta, the chord-its vessels, he was a litinay of questions for the rest of the night (even at 3am)

It was nice really, all perfect, the placenta came on its own, 3/4c blood loss. Baby latched right away. Etc, etc, etc....

Whew.

Adelante-2 shifts later

A photo of Ali'i beach(in the town I grew up in) on a calm day
I was a beach baby and learned to negotiate the tides and waves of the ocean well. I learned to swim in Waikiki in those calm waters and as I grew was drawn into the wilder shores of the North Shore (Rocky point, Waimea, Haleiwa Reef/Ali'i Beach). There is a thrill to just being in that water, not surfing it, but riding the waves in the shallows before they break. The secret to those waves is letting your body flow with their energy. You don't struggle to keep your feet on the sandy bottom, don't jump over them, turn your back or panic, you just give your body a little push as they come near and you will be carried over and gently down. It is a nice flow, an ocean cradle rocking you up and over, a weightless experience of surrender.
That is exactly what I have had to do for the last week, surrender to the mystery of birth and all of its wave like action and especially to the MLL birth energy. I was 1st up on Friday and there was a woman in good active labor who was transported for high fetal heart tones...so ended up at the hospital with the family helping to negotiate that experience.

After I came back from there (only 1 person allowed in the room with her at Thomason) Another beautiful mother walked in with premature rupture of membranes. I supported her and her husband through the night, but alas she wasn't going to birth on my shift. I stayed anyway for her birth and got to assist. It was one of the most gorgeous births, no vaginal exams, spontaneous urge to push, standing and rocking through each contraction with tears running down her face. Sigh... such beauty in that intensity.

Next shift I was still 1st up and the only one to not have caught a baby out of the class. A woman had come in at 8 am with light contractions, already exhausted from 2 days of labor and at 4cm. She had lots of family support so I just did 30 minute rounds of heart tones for the day, as the day wore on you could see her exaustion more and more though it seemed to me things were progressing well. She was beginning to get crazy stabbing pains in her back and I could see that baby was posterior (there was a lot of kicking and punching toward the front of her belly). She was checked and at 5 cm after 6 hours of labor. I got busy trying different positions, lunges, side lying, hands and knees, standing, dancing, rocking, robozo. At 8pm she was checked again and her cervix had not changed. Oy poor mama, because of Mll protocols, we had to transport. The family wanted to go by car so she signed a waiver and followed me. I stayed with that family for a few hours and helped them understand the ins and outs of hospital. She birthed that morning by cesarean. The baby was indeed strait OP. I think more than anything she was exahusted.

I was still on shift though after I returned at 11pm, and still up to catch so I went to sleep only to be awoken 45 minutes later....

Thursday, October 05, 2006

Born in the Caul


Before I entered this program I had a pretty clear picture of who I wanted to be as a midwife. It is evolving, this idea, changing so quickly. I have seen some amazing things these past weeks, some things that downright scare me as well. I feel very human and very vulnerable right now and I can't quite pinpoint the anxiety source, it comes from many places of insecurity.

Tomorrow morning I am back on shift, I am first up to catch, it will be my 1st catch and I want it to be gentle. Is that too much to ask? I am trying to focus on what I would like to experience, instead of what I don't want to experience as I know if I focus on what could go wrong. If I focus on what I don't want I am liable to end up with just that.

The very 1st catch in our group of students was a lovely gentle birth of a baby the day before yesterday. It was born in the caul. Could that be a better sign? Being born in the caul is supposed to be good luck. I imagine the baby blinking its eyes, still present in its aquatic world, cushioned from bright lights and loud voices by fluid, gently the midwife made a hole in the bag at the chin and pulled the delicate membrane up and over its head. It takes its first breath gently. I have yet to see a baby born in an intact amniotic sac, I would have liked to have been there.

I would like a little of this, a little good luck, a gentle birth into midwifery. This feels like a big deal you know, but in some ways it isn't, it is just one part of all of this process. One tiny part. Being a midwife is so much more than supporting a perineum. I make a joke frequently that catching a baby isn't difficult. Really-babies come out without midwives all over the world(and without any other health professional). Just make sure the baby doesn't fall to the ground, that is all it should be. I feel like there shouldn't be a need for glory, a woman should never say "I couldn't have done this without you." Yes she could have and she would have.

As I write I am identifying my anxiety. A long time ago I made a pledge that I would be a vessel for the strength of women, nothing else. A vessel is a place to hold something temporarily, it really gets no glory. I am ashamed that I am seeing this 1st catch as a time to prove myself. There are many people watching me as I unfold in this new role. What I really want for this time is to be alone with it. I don't want anyone watching or evaluating. I don't want it to be about me and my abilities. I want it to be about the family, the woman, the baby, the dad if he is there, the grandmother, the aunt, whoever is in the room. I want to trust that all would have unfolded normally had I not been there.

Mll doesn't operate this way, I will have someone whispering over my shoulder about where to put my hands and what to say as the baby comes. It is a paradigm that is not wrong, just different, and so I have to shift a little in my expectations. I feel that my expectations should be that there are no expectations, and so I will go with the flow wether that flow is a transfer to the hospital, a baby born in the caul, a precipitious birth, a long labor. Whatever it is, it just is and there is no changing that, no forming it to my needs. The only thing I can be is present.

How is that for waxing philisophical. I feel better

Wednesday, October 04, 2006

Sleep

I had a full nights sleep last night at the clinic, no doorbells ringing, no phone calls, no women walking in for labor checks, no middle of the night mammas pushing as they ring the doorbell. Wow!

Of course normally I would be estatic, but last night I was 1st up for my 1st catch.

So instead I awoke at 6am, had my ritual cup of coffee (later everyone asked what madness had gripped me to wake up at that ungodly hour) and stared at the piles of bleached laundry, walked outside to see the sun cast its light on the earth colored buildings across the street and just breathed in all the beauty that comes with morning silence.

No toddlers asking for the tv to be turned on, no lunches to make, toys to step on, dishes waiting in the sink. Silence, simple pure silence. And me alone with it for an hour, shaking off the nights sleep. Sigh....Sigh...let me do that again...sigh.

Monday, October 02, 2006

Anyone out there?


I am stumped, having an itch at the tip of my fingertips to write but not so clear about what to say. I have been wondering if people are reading my blogs or if I am being narcissistic for no reason at all. My friends and family read but don't comment online but send me nice little messages.

A dear friend wrote to me saying this:

"I’m checking your blogs from time to time. It sounds like you’re still falling down a rabbit hole into a strange world, in which the extremes of your endurance and emotions are tested on an hourly basis. My heart races when I read them. They are breathless and engaging. And I start missing you for all the wonderful qualities you have and bring to a friendship. But there is a beautiful logic in the fact that you now bring these qualities to the women and babies at MLL. It’s like a piece of a puzzle is falling into its place."

and so I am restored, someone is listening!

BTW that is a hedgehog, just thought it needed acknowledgment too. Isn't it cute?

Tuesday, September 26, 2006

Placenta Previa



Things move so quickly, my understandings of things evolve at a rapid pace. I blink and something has changed profoundly for me in this place. It is quite an odd sensation, like the one you feel when you jump as the elevator touches the ground floor(if you haven't done that, you have not lived). For a moment you feel suspended in the air, you lose you equilibrium but then are grounded again.

Placenta Previa with a breech! A very rare thing... I now know what it looks like, sounds like, feels like. I didn't have to open a book to learn it, but had it walk into the clinic at 8am when this beautiful blue eyed woman came in for a labor check. I got a crash course in it. Heavy stuff you know, I am still processing how my day could begin with such an amazing birth (see last post) and end with such drama. Oh my, what a gift and what a difficult thing to witness. Mom is shaken (mostly with the expense of the hospital bills) and baby is great. I visited her the next day and despite quite a bit of blood loss, she was up and walking around.

What is a bit nutty about the whole situation was that an ultrasound had been done, and the condition went undiagnosed somehow (and how about that breech baby?). Crazy that a technician would miss it. I still have so many questions which may never be answered because there is very little communication with the hospital.

So...Universe? What is next?

Saturday, September 23, 2006

Twins

Wed night before shift, I dreamt that I gave birth to twins. The dream was incredibly real. Shift on Thursday was an echo into reality of my dream or was my dream an echo of things to come?

When I came in, the clinic was hopping. One birth in the night, 1 woman pushing, 2 in labor. There had been 4-5 labor checks through the night...One of those labor checks was Esmeralda (not her real name). E was a mama that I had done a cita on 3 days before that was very difficult. She had many issues out of my scope of new student understanding, but the one that I could fully connect with was that she was 17 and afraid of labor. That day I hoped that somehow I would be able to serve her but who knew?
Before we went to morning class I was told that E had come in, I asked my group for a special request: if the opportunity presented itself, I would like to be at the birth even if it were not my rotation.
I love the universe and how it works out. After class, we came back and 4 of us were assigned various tasks, including shadowing a birth. I walked in to one of the smallest rooms to observe but it was so crowded! I slipped out feeling akward about watching such an intimate event and not being invited or without having the opportunity to ask permission as this mamma was pushing. I instead let the other student take that rotation who had less births than me.
As I walked through the kitchen from that room one of the interns grabbed me and asked: Do you know how to do labor support? Ok how am I supposed to answer that one? OF COURSE! She steered me into the sala (sectioned off part of the clinic because all of the birth rooms were taken) and right into the more intense gaze of E looking desperate for support.
My heart soared! She looked at me with her liquid brown eyes and softly said "no puedo, me duele, no puedo" (I can't, it hurts, I can't).
For the next 15 minutes I held her hand, emptied a vomit filled trash can, and said "si, se puede, lo esta haciendo, y si le duele" (yes you can, you are doing it and yes it hurts-I am not good at lying, I believe that, one of the worst things you can say to a woman is that it doesn't hurt). That little bit of encouragement seemed to work wonders and she settled into her labor with grace that awed me. A staff midwife drifted in and out during this sacred time, I took heart tones and vitals as well as gave labor support. After about 2 hours of this routine, she was moved to a room that became available. She was listless and tired, her family was difficult and this was the way she shut them out. She tuned in during contractions, and drifted off to sleep in between. At one point her mother yanked off her underwear and said "get this over with, have your baby, start pushing" I was stunned and ummm a little angry! But the gruffness of her mother was an indication that she was worried, I was able to help her understand and she eased up. Her energy began to change and her anger gone
.
After that E began to get a little grunty during the peak of contractions so she had a "tacto" and was 4-5 cm. Not time to push....This was a little torturous for us all as her urge to push became stronger in the next 15 minutes. Getting her to stop pushing is not fun and I just let up with my mantra "sople sople, no es tiempo para empujar"(blow, blow, its not time yet to push). There is a lot of anxiousness in the clinic over a swollen cervix. I don't share that fear(yet, who knows if that one will concern me) but I had to relay the message.
E was a determined woman, and she began to push pretty adamantly on her side. The staff midwife came in to make sure her cervix wasn't comepletely swollen (there was talk of transfering her) to find that there was a head there and not a cervix!!!

Now one of my favorite things is when a woman is so tuned into her body that her urges are right on. Only 6 hours had passed from her entrance into the clinic, she came in at 1cm. She was a 17 year old goddess in my opinion. I could hardly contain my enthusiasm as I watcher E push her baby into the world. At one point she reached down and touched the babies head as it was crowning. I was so excited that I docummented 5 minutes of of incorrect times on the labor flow sheet, including the time of birth! It was quickly remedied, I was made fun of and then forgiven.
A little girl 6 lbs 2 oz came gently into the world, into her estatic mothers arms. She had a solid latch within the 1st 30 minutes, very little blood, lots of photos, and mom, family and newborn left an hour early.

Such a gorgeous birth. What a wonderful blessing as it was the 1st time I was given responsibility and not just shadowing someone.

Now you might be wondering about the twin dream I had? Where is the other baby? Time has gotten away from me so I will tell the other story later. Suffice to say that I had an experience quite the opposite of that birth 12 hours later, as my shift ended. I will get to that story soon.

Wednesday, September 20, 2006

Emotions

I haven't written about all of the emotions. They flow from me, stop me up, overwhelm, build one upon the other until I don't know where they came from, which came 1st, which one is resolved, which one is breaking my heart and why. It is impossible to process them all at once, so impossible to be clear about any of them. They are hydras, chop off one head and another one appears. Forgive any errors in this post, it has been a long day (most of this typed on Wed. eve)
A common theme of this 3 week process that is called orientation (I am apt to name it disorientation) has been "midwife, come birth yourself" and that is what we are doing, all 12 of us, laboring through it all, swimming in the thickness of our emotions searching for the light, seeking to be born, sliding out slippery and vulnerable and crying bloody hell.
Crap.
We are such incredible beings, each unique, talented, intelligent, wise, angry, revolutionaries who seek to preserve a way for women in the world. We are guardians, we are fierce...The fierceness can come out at inopportune times, the fierceness sometimes directed at each other. We are not yet at a 2 am shift, tired, hungry, irritable, having our moons at the same time. What will happen then?
If now we are sitting on our a*** in class and getting a bit irritable at each other, what will it be like when we are really fricking exhausted. Perhaps we are fricking exhausted, knowing today was the last day of dis-orientation, we let a bit of our shadow selves out to prowl the weaknesses in others.
God what to do with these emotions that I am swimming in. I feel unbelievably irritated at other's faults, and feel more guilty for being in affect of it. Stupid cycle of feeling something, then turning around and feeling guilty for feeling it. Isn't that the definition of madness?
Then there is the digging up of painful memories, before breast exams we discuss in depth the development of our self image, dredging up some things I think I have healed from. People sob, Kleenex goes around, you are fine, then someone else gives their story, you emote for them, you feel the same thing you just got done feeling for yourself. You can't figure out which yarn is yours, it's a tangled mess of different colored threads. A massive bundle of nerves, sadness, shame, guilt, fear...

Tuesday, September 19, 2006

Full of Tamales


This is a photo from a hike in the Organ mountains last weekend. We hiked a beautiful in bloom desert trail up to "Dripping Springs". It used to be a resort and sanatorium. This window is from one of the buildings of the ghostly hotel that sits in silent ruin.

Has it been a week since my last post? It feels like a year has gone by, a years worth of learning, tears, frustration and joy. What a place I am in right now, and how fortunate I am to be able to experience it all.

Here is a sample of what I did yesterday:
1. Began the day with someone crying in our morning circle check in (not me-I don't cry, ever. Ok maybe once or twice I have. )
2. Hopped in the car and toured Thomason hospital with 11 other students, got lots of dirty looks when staff read our badges.
3. Stopped on the way home from the hospital at a local bakery that specialized in pumpkin empanadas and rockin tamales. I won't tell you how many tamales I ate.
4. Came back to MLL and participated for 100 heart thumping minutes in mock emergency scenarios. We dealt with shoulder dystocia, hemorrhage, baby with a serious birth defects, resuscitation of a baby and one normal birth.
5. Restocked the room where we had the scenarios.
6. I think I ate more tamales after that.
7. Umm...oh yeah, began a short shift from 5-8pm.
8. Did 3 blood draws, got stabbed twice myself. Oh yes and did a hemoglobin check and glucose check. All on my sister students.
We are quite comfortable experimenting on each other-yesterday we did pap smears. I will skip the description of that and leave it to your imagination.
9. Was handed a chart by one of the interns and told to do an observed cita (huh, I am not ready to do that yet) on a 17 year old with a STD. Needless to say I bumbled through it, was pushed out of the way because it was way to complicated and she had too many issues to deal with.
9.5 I did a successful finger stick on her-yippeeeeee. Am I truly excited that I hurt someone and drew blood? Yikes.
10. Came home and read 1/2 a story to my children while they drifted off to sleep. A sweet 10 minutes that I got with them. Sigh. They are better than all the tamales in the world.
11. Passed out myself at 9pm.

Sunday, September 10, 2006

A picture worth a thousand words



A picture is worth a thousand words no ? Yesterday we had a 6 hour class on complications. Ugg, more talk about blood and I might spontaneously hemmorhage.

All jokes aside though, most complications are manageable and I will have a lot of learning on this front, by the time I leave MLL, complications will be pretty darn familiar occurances and I will be quite comfy will some things that might make others pass out.

Yes, there are more complications at MLL period. Hemmorhage being the most common of them. If you do research on the subject Hispanic women are more at risk for PPH. Perhaps they have a larger blood volume? Yes, one is tempted to blame poor nutrition, stress, poverty...but most of the women served at MLL are not living in poverty, if they were they would not be able to afford the out of pocket expense of care.

So why is it then truthfully? Perhaps because of their genetics, they have more blood to shed? What if it is just that, a normal physiological process that we clinically interpret as dangerous? I know, I am in innocence right now, but these are things to think of.

Wednesday, September 06, 2006

My 1st shift began with drama on Tuesday! Birth is an amazing process full of twists and turns, suffice to say that my first shift began with a baby crowning and having some sticky shoulders- easily remedied by a few maneuvers but nontheless dramatic. A big baby boy close to 10 lbs came vigourously protesting (screaming bloody hell as soon as his body felt the temperature difference) his entrance into the world. In the span of 1:30 very slow minutes I learned McRoberts and suprapubic pressure techniques for relieving a dystocia. I was so awed by how calm and efficient everything was, the family hadn't a clue what was going on, they were so wrapped up in greeting their new life.
An hour later I got to "labor sit" with a very dear human being (who's soft spoken presence is a joy to all her know her) and then witness a very normal birth at 8:00 pm of a 1st time mamma whos labor was 6 hrs long from start to fininsh. That baby decided it wanted to be born waving to the world, with its little hand by its head. Normally a nuchal hand creates a somewhat interesting labor pattern but this mamma was keen on getting her baby out without any bumps in the road. She was probably only 130 lbs pregnant too. Women continue to awe me!

Tuesday, September 05, 2006


What can I say about the strange art of venipuncture?
1. It is certainly painful being a demo especially when someone has a needle in you and moves your arm on accident.
2. It is strange bonding.
3. It causes random boughts of tears in the person drawing blood (not necessarily the person receiving).
4. It was less difficult than I thought.
5. It is quite triumphant finding someone's vein.
6. WHEW, most of the learning of that is over.

Sunday, September 03, 2006

Circle at MLL
I cannot even begin to describe what it has been like the past 2 days. Look up "amazing" in the dictionary and get all the synonyms, look up "exhausting" too. 1st day everyone shared their stories, and it wasn't 12 stories, it was 20 something because staff midwifes and other students came to "circle" too. This day was filled with profound rituals and one of them was the telling of our individual stories.
This is a tradition at Maternidad la Luz, the welcoming of all the fresh shining faces by storytelling. Storytelling must take on different forms in different groups but for our group it meant profound sharing, it meant the falling off of the day to day facade that we erect, it meant tears, it meant laughter, and it meant truth. At the end of the day the air was thick with meaning, compassion and great love.
Yesterday we had a day learning about MLL logistics, protocols (some so very different than the way that I have learned, I am sure I will discuss this later on), and then an afternoon discussing Juarez and Mexico, most specifically the concept of a border city and the situation. The afternoon was tough, shocking, humbling. Google Juarez and you will see what I am saying, mostly articles about the violence against women and the murder rate, the maquiladores, the orphans.

It is all part of my reality right now, Mll is a mile from the border. We feel rather protected in our lovely birth space with pink walls and all kinds of birth art on the walls. We feel liberated ya know, man are we ever sheltered from most but not all of this.

I figured out how much about borders I know just living in San Diego and being a bilingual teacher for so many years. But I don't know and don't think I ever will know really. I still live in "gringolandia"....I am grateful for that card I drew in life. I feel a bit guilty saying that but despite all of the crap that I have been through, I am grateful for my life. It is a good life

So my little man is calling me out to play with him, and I must go, lego calls. Please keep me in your thoughts (in a good way)

Friday, September 01, 2006

Practice being open the moment....while washing dishes, while shaking hands, while changing a diaper, while walking through a door, whild taking a shower, while listening to music, while meeting a group of 12 amazing women. Practice being present for one minute, then two, then five. Watch as your breath changes, as the sensations around you change, as your interactions change, as your body begins to breathe in all of the energy of your surroundings. Watch as you open to blue, to red to beige...open to all colors of your surroundings and the people in them
Watch your pride melt away, your image dissolve, and watch what your heart does. It is pretty amazing, being in the moment suspends judgement, evaluation, fear and brings in the energy of the vastness of what is, not what the imagination creates.

If you have taken BFW, then you have a small glimpse of what I am writing about. Non focused awareness, combined with a bit of David Deida's Blue Truth (the book, amazing, has changed my life)...
A paragraph before I am off to my 1st day of MLL to meet those 12 ladies.

Thursday, August 31, 2006



How do I begin? This has been a crazy and beautiful summer. We spent 4 weeks in Europe, came home, then was off to Maui for 8 days to see my ailing father. Arno got established in El Paso while I took a short and stressful jaunt to see my father. He's not doing well and I wanted to see him before he declined any further. That is a long heart wrenching story though in itself, and perhaps I will find the courage later on to tell it. I feel like if I begin, the grief of it all will overwhelm.

As for now my focus has turned to establishing our life in El Paso and my Orientation at Maternidad la Luz (I begin tomorrow). My fears that EL Paso would be a city vacant of nature were completely unfounded. We found a lovely southwest style house in the Upper Valley on the outskirts of the city. There is no beach or ocean but mountains surround and awe us, the rio grand is 2 blocks away, Our backyard is greener, the trees are larger than our semi-dessert San Diego.

It is quite lovely if you wear lots of mosquito repellent and don't go out in the middle of the day. Yes- the mosquitos are outrageous here and the sun unrelenting. It sounds a little mad that we are aproaching vampire status but we are adapting. I think that this time of year is the most difficult weather wise. I could spent quite a bit of time writing out a list to compare SD to EP but I think it might be rather tedious-good or bad, it is what it is and I am enjoying the exploration of that.

The boys are adapting as well, we found a great Montessori nearby and I can already see Kai's pride in his accomplishments growing. Montessori promotes independence and responsibility, I can see it already that he is taking well to it all. He began to push in our chairs for us after dinner last night and just the other day he sat down and created his own art project without help or prompting. That seems small but it is quite a big deal for him. Myles began two days ago and had a little tougher time, we shall see how he adapts.

Tomorrow-yes tomorrow!!! So much work has gone into this moment of tomorrow, it is just that isn't it? A moment followed by another and another. It does feel like that, like a cumulation of many small things. I am waiting for this explosion of accumulated energy but I don't think it will happen. The first meeting of these 12 aspiring midwives will, I think, be phenomenal but it will be just a moment, then it will pass.

Before I left one of the wisest pieces of advice that I received was "Be mindful of the process". I think that will be the secret to passing throught this " laborinth". I will be taking things one at a time, one breath, one surge, one experience at a time. Some of it will bounce off of me, some of it will sink gently in. I am sure there will be moments of trauma, enlightenment, profound friendship, great joy, supreme sadness and all those other things that go along with Birth and Life.

Any threshold crossing contains all of these elements don't they?

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