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.

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?

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!

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.

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.

snow in our backyard!!!

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

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

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.

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...

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.

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.

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.

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....

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

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.

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?

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?

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.

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...