Doubts and questions

I’ve been feeling very frustrated lately about a lot of the choices I’ve made (not all of them school or work related, but certainly a few of them are). I feel like I will never be a midwife. Yes, I know I’m in midwifery school, and that the eventual outcome will be me as a midwife, but everything we’ve done this semester has been so medical: primary care, health assessment of women. I’ve learned more about hyperthyroidism and breast disease and urinary tract infections than about pregnancy and birth. Next semester I’ll be taking antepartum and well-woman gynecology, so at least in antepartum we’ll be dealing with pregnant women, as opposed to non-pregnant, but even so…labor and birth is still a long way off. Sometimes I wonder if I went about this the right way. My heart lies so clearly with homebirth, and being a homebirth midwife someday, but the path I chose is going to teach me a lot about hospital birth, and the two are completely different species. I’ve seen hundreds and hundreds of hospital births in my work as a nurse. After a certain point, they’re all the same. The women get epidurals, they watch TV, they polish their nails, their water is broken, they get pit, they push on their backs, the doctor cuts an episiotomy, the baby is born, usually everything is fine, and sometimes, if you’re lucky, you have time to help the mother nurse before she is whisked away to postpartum. Sometimes I am able to make a huge difference in a woman’s birth, but a lot of the time, she doesn’t want anything different. She wants to be treated with care and respect, certainly (and sometimes it is a real fight for her to get even that from her caretakers), but she wants exactly what she thinks her friends have had—she wants that hospital experience. She wants the ritual of birth in a hospital, the rite of passage we’ve developed: the hospital gown, the epidural, the painful stitches and ice packs afterwards, the grandparents and husband looking so cute as they peer at the baby through the glass of the nursery wall. 90% of women in this country give birth in a hospital, and most of them are perfectly content to have thier babies while numb up to their waists; a healthy baby and minimal pain is all they desire from the experience.

Birth can be so much more than that, though! I’ve seen the rare natural childbirth in the hospital, and I’ve seen several births at a local birthcenter. I’ve seen the woman in transition, unmedicated, her face glistening with sweat, her body glowing, working harder than she’s ever worked before, her eyes with a dreamy, far away look. I’ve seen women overcome the pain and the relentlessness of the contractions. I’ve seen them rise above, and do something they dind’t think they were capable of. I’ve seen births where I am so obviously in the presence of Deity. I’ve watched babies crown, and sometimes it’s like staring at the unmasked face of the Goddess. Having birth while medicated is like having meaningless sex your entire life, with someone you don’t care about and aren’t in love with, and thinking that that’s what sex is, without ever once dipping into the Mystery of it, into the incredible beauty of two souls entwined, without ever once making love. It’s the same kind of energy. Birth is making love in a different way—and who would want to make love while numb up to their waists? True, this may not be the best metaphor in the world, and true, birth is not always (or even often) a pleasurable experience, but it’s still one that I think you should feel.

When I started my work in the hospital, I was excited about being able to reach so many women. I knew that the majority of women give birth in the hospital, and I felt like that’s where my presence would make the most difference, but now I am starting to wonder. By the time a woman gets to the hospital, she’s already taken steps down a road that’s very difficult to get off of once you’ve started down it. If I want to reach out to women and help them have better births, I should probably be reaching out to them before they even get to the hospital. Meeting them at the doorstep and telling them I’ll be their nurse is probably not the best way to affect change. Educating them before they’re pregnant…teaching them about other roads before they’ve made their choice…would probably much more effective. So many women don’t even know that there ARE other options, let alone that they would want them. How do you open women’s eyes?

And of course, there are those women who don’t want their eyes open. Which is fine. That is their choice, and if you are committed to caring and respecting women, that includes respecting their choices. When I have patients like this, it’s so easy to be their nurse, and give them exactly what they’re looking for: make the usual banter, ask them what they’re naming the baby, explain what the epidural will feel like—and that’s all it takes to make them so satisfied with the experience! If my path is truly to become a midwife, and not a childbirth educator, then maybe what I really need is to apprentice myself to a homebirth midwife. Maybe I shouldn’t be pursuing a CNM certification after all, but a CPM instead. If my calling is to assist women through the long, exhausting hours of labor—to wipe their brows and support them while they contract, and tell them over and over that YES, they can do this, and YES, they’re doing great, to be the silent gaurdian at the doorway—then maybe I shouldn’t be working at a hospital.

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