madwifewrites

The College Responds

2008-07-11T19:47:00.000-07:00

Well, I asked where the response was from our college: It was there, out there, but hidden away on back pages, not making it to the internet lists of headlines, certainly not on the fromt pages of our papers. I know not many people read here, but maybe, somehow, this will help to spread the word.

The following media releases are a good start:
Midwifery care is safe
Dominion Post Rebuttal
Sally speaks

But are they enough? No, because they are not seen, except by us, and our supporters: How do we get the media to accept that we are safe, and reasonable, and responsible professional practitioners? We are not crazy hipy's attending births in secret and fear: Midwives globally are not the witches and baby killers we are made out to be. Not here, not in America, not in the UK (I would link to Agatha, but she has been chased out of blogging, by breaking the "rules" which say you can't mention a problem in public without getting shut down! NOTE: Agathat did not break any rules, but readers will know that her blog has gone. This is because she was accused of breaching the same rules referred to in the linked article. I read her blog avidly, and did not see her bringing the profession into disrepute, or being unprofessional, nor breaching patient rights: she just argued for change. Apparently, censorship is OK if you are the NMC, regardless of your members opinions!) any of the places we are still fighting to be treated as normal professional human beings!

Karen says in her article in yesterdays dominion post: We are saying enough is enough.

We support and believe in women's right to seek an investigation into events, and answers to their questions, but that DOES NOT make all midwives answerable for the actions of one. We do not accept that this should be done through the media in a blatant show of sensationalism not applied to any other medical dispute. We say NO to the idea that a midwife be tried in the media, instead of through the appropriate and LEGAL process developed by government for ALL health care practitioners to be mediated. We will NOT be accused of being unsafe and dangerous by people with no knowledge or basic understanding of who we are, what our job is and what our training entails.

Midwives of the world, we face the same fights: It comes in different forms, but the fight is the same. And we fight it because we dare to be women, working mainly for and with other women. Let's do this together! what works for one, can be held up to all as an example... and at the end of the day, midwifery improves outcomes and saves lives. Lets shout that to the rooftops, as loud as we can.

Tagged

2008-07-03T20:09:00.000-07:00

My big sister, Denise tagged me with the following assignment:
1. Write the title to your own memoir using SIX words.
2. Post it on your blog.
3. Link to the person that tagged you.
4. Tag 5 more blogs.

She had a very cool and pretty image to go with her title, but I am not that clever (well, I am clever, but not having an artistic bone in my body, cause she got them all, I have to make do with merely writing!)

so, what would I call my memoir?

"why I never travelled the world"

If you are around and have the time, I tag

Kristina at Red spiral
Agatha
My very special friend the Jewish midwife
Pamela
Barb

and now the chance to stand up.....

2008-07-03T19:39:00.000-07:00

Already, we are in the news again: with the call that we must Let the Babies Live and the suggestion that us midwives should be better trained and supervised as Baby's death was avoidable. Now. I do not know the details of this case.... It doesn't look great, does it, from reading those two articles? But, mystery recently qualified independent midwife, whether you were right or wrong, my thoughts are with you. If you need words of support and care, find them here. As you walk into the fire (along with your "midwife supervisor" whatever that may be), know that I am walking along beside you, in spirit if not in body.

So, the next question.... why aren't midwives fighting back in the papers? Why aren't we pointing out that we are over worked, under paid, and often under supported? When the senior and junior doctors strike, who supports the labouring women? US. When the cleaners are on strike, who picks up the slack on maternity? US. Are we thanked for this? No. Are we paid for this? No. Are we given annual pay reviews, and offered what we are worth? No. Do we do what we do because we love it? Yes. Otherwise, Goddess knows, we wouldn't do it for the money or the glory!

As Karen Guilliland said in this months Midwifery news, midwifery issues are global, and women who are cared for by midwives have better outcomes: So why WHENEVER anything goes wrong, is it always us "dangerous" midwives being hauled over the coals? Why when doctors stuff up (and we all know they do) do they come out of it unscathed, unphotographed, and certainly unjudged? Why do we say "well, they are only human, they can't be perfect, they do their best" when doctors err, but mount a full scale witch hunt against ALL midwives if a midwife makes an error?

Why are we held to a higher standard? why must we be perfect, to prove our right to do what we have ALWAYS done, care for women? Sometimes, awful things happen. sometimes, babies die. sometimes, mothers die. sometimes, people get sick, or hurt and sometimes we can't fix that. But most of the time, we get it right. Most of the time, we improve the outcomes. Most of the time, we FIX problems. When does that get to be front page news? When do we MAKE that front page news?

I am sorry to my sisters.

2008-06-25T00:32:00.000-07:00

We don't support each other enough. When the going gets tough, we judge and whisper. We owe each other more than that. We owe each other more than "there but for the grace of God (or Goddess) go I" as we bow our heads to avoid judgement by association. So, the next tme a midwife is being balled out, in person or in the media, I will stand up with her. Bala Naidu made some mistakes. She wasn't perfect. But the witch hunt that took place, and her abandonment by her sister's during a three year ordeal due to mistakes that ANY ONE OF US could have made.... (And when the proceeding rather than just the judgements are released, we will be able to see that this is true) she did not deserve that. I have never met Bala, but I apologise to her, in this forum, for not standing beside her in her hour of need.

But, Bala's is an extreme case. I also would like to apologise to my sister's who I have seen or heard being run down or attacked by colleagues in the staff room or public. To the ones who are called lazy and uncommitted, when I KNOW they are neither of those things, but just trying to avoid Bala's fate. To the one's who are called "dodgy" cause they believe women have a right to choose where she births. I daresay that the same is said about me when i am not there to defend myself.

The shortage of midwives in NZ should bring us together....instead it seems to drive us apart and make us attack each other with undue cause. I am sorry to my sisters for being part of that. It stops today.

Whoops, where did the time go?

2008-06-25T00:26:00.000-07:00

How did it come to be the end of JUNE? I am mind blown that it has been so long since I was last here! So, personal updates, which may explain my absence to any who care... I moved house, to a bigger, prettier, more expensive house ten minutes from where I was before. I had a student from Scotland come stay and follow me around for three weeks (Hi Karen!!!!). I caught six babies, supported three women through Caesareans and missed one birth (the first one I have missed!). My little man turned seven, and I did a whole lot of crazy prep work for my partner joining me in January (Blonde Ambition will be on board soon). Sorry for abandoning you all, work recommences as of now.

On a quiet day...

2008-04-17T16:54:00.000-07:00

I sit and see the wind blowing through the trees, visible in the leaves moving, the boughs bending. I hear the rustle of the leaves, and the whoosh of the air moving. But wind is invisible. Not there to be seen. It can be felt, it can be heard. So it is with so much in our lives. The eividence of a phenomenon exists in the doing, in the feeling, in the hearing. But not actually, tangibly present.

That's all.

My first birth....

2008-04-15T17:50:00.000-07:00

Well, inspired again by NG's call for us to share our stories, I thought, what a way to procrastinate doing any of my required reading and other hard work. So here is the story of how I came to be Alyssa's mum. It was a bit of a typical first timers tale, but here goes anyway. At the ripe old age of seventeenn years and 25 days, I began "labour" with my daughter. Well, I say labour. I thought it was labour. But, like so many other first timers, I had NO IDEA what I was expecting. I started having (what I now know were very mild) contractions, every ten minutes at about 11 pm. All night, I stayed up, timing and counting and waiting for more to happen. Nothing much changed, except I got really tired. I went to the hospital at 11am, and was sent home, not dilated. I went back at 3 pm and was sent home, again, only 1 cm dilated. Noone explained to me what was happening. Noone told me about latent labour, or how to cope with it. Just, "go home and come back when it get's worse". So, back I popped at six pm. And now I was the magic three cm's. So I was given the gas, and an ARM. Time to "get on with it".

Wow, oh boy, is there a good eason for not going to the hospital early? the impact of an ARM is understated hugely. They told me it would get things moving (no mention of risks like cord prolapse or infection, mind you). They didn't tell me that my pain, if not my labour, was about to enter warp drive! For half an hour after the ARM, nothing much happened. I got in the bath, but I didn't like it, and halfway down the hall to return to my room, the contractions hit. And how. Every two minutes, I contracrted for a full minute. Now, prior to that I had been having these pissanty little 20 second tightenings... I actually thought I was quite a tough girl, and that labour was nowhere near as bad as everyone said... screaming in pain I was given the gas and put on the monitor. Now just take a second and look at this picture:

Ok, so WHY did I need monitoring? I was 17, in perfect health, and labouring spontaneously (albeit with an ARM). But, instead of support I got my machines, and my gas, and I got left, on my back, on the bed. (by the way, it was 1993, and GHD's did not exist, and my hair ALWAYS looked like that. *shudder*) Back then, that was what labor care consisted of. My GP came and went, through the night. At around midnight, they decided my progress was slow, and I needed an epidural, so that I could get some sleep. I said no, thanks. they said, you have to have one. I said,it hurts. They then called the anaesthetist, who was busy at an appendectomy (I remember that being the joke), and I waited. Now, my memory of this is that I had no choice. I know now that I had a choice, but then, I thought, literally, that I had to have the epidural.

So, eventually epidural sited, I went to sleep... and woke up, alone, in pain, and with my birth partners shooed from the room. I could not reach my call bell, and was completely terrified in the half dark, where I lay for twenty minutes till my partner came in to get something from his bag. I ordered him and the other two back in the room, and someone (I don't know who) came and topped up my epidural..... THEN examined me and told me it was time to push. It was three am.

I had a full and complete numb all the way up to the top of my belly. I couldn't feel someone touching my leg or foot. But, it was time to push. So I did. or, rather, I tried. I pushed whenever the midwife nodded at me that it was time. I pushed like I was "going for the biggest pooh of my life" flat on my back with my feet held up in the air. I pushed and pushed..... and nothing happened. Absolutely nothing. They decided that I wasn't very good at this and after nearly two hours of this, they suggested a c- section, and left to organise it. while they were gone, my big sister and friend who were there, helped my completely unresponsive body up into a squat, supported by them. And in that position, I pushed. And something happened: my baby starting to surge down the birth canal.

The midwife called the GP who returned to catch my baby girl as she flew into the world. No tears, not grazing, nothing, just a ring of fire burning that hurt like hell, but was oh so sweet cause it meant I didn't have to have surgery, which terrified me. Again, my birth was so typical of first timers: I knew nothing. I was told what to do and when to do it. But unlike others, I was lucky enough to survive it with not only a healthy baby, but an intact perineum and abdomen to boot! Alyssa weighed 7lb 5oz. And this is the first photo of her.... If you look really closely between all those hands, you can see her little leg!

Seventeen months later, I was back for Erika, and a very different birth. but what stayed with me, forever, was just how lonely I felt, and how little I understood what happened to me. Not long ago, I snuck a peak at my labour notes in my hospital records: They do not tell my story. I do not even know how to tell my story, cause so much of it, I didn't get told about. I don't know if I had a syntocinon (pitocin) drip. It was awful. but, from that xperience, a midwife was born.... and so was my beautiful, wonderful, intelligent daughter, now nearly fifteen: Alyssa.

Horizontal violence in midwifery....

2008-04-14T02:07:00.000-07:00

Well, here goes, a serious post. My experience referred to here has finally settled enough in my brain for me to dissect and analyse all the places it led me to over the ensuing weeks. Horizontal violence in midwifery is something that we who work in this crazy profession have all heard of, and I anticipate, have all seen. It is encompassed by judgement of each other, suspicion of practices we are not used to and anyone who sits out of the box even a little bit has probably experienced. But, it isn't even just those who sit outside of one box that feel it.... It is all of us, cause we can't quite sit in every box.

So, if you are a direct entry midwife you can't sit in the nurse first box. If you do homebirths only, you can't sit in the hospital supporting midwife box. If you don't do home births, you can't sit in the home birth midwife box. If you look after VBAC's, some midwives will view you with disdain: If you don't others will call you uncommitted. If you work with obstetric staff, you may be viewed as a traitor, and if you don't, a dangerous cowboy. We are, quite literally, damned if we do, and damned if we don't do ANYTHING.

So, midwives, what are you? The catch cry of the late eighties and early nineties in New Zealand midwifery was "A midwife is a midwife is a midwife" and at the end of the 2006 NZCOM conference we called out the same cry. Whether you work in a hospital or out, in homes or in specialist areas, we are all the same, we cry. So, why, when I go to a birth in hospital, and roll my birth ball down the hall to my Mama, do I get rolling eyes, and sighs, and feel judged? Why when I tell my old colleagues on the PN ward that my lady has flattish nipples, but a strong commitment to breast feeding, do I feel myself thinking "not that you will actually help". And why when another midwife ends up in the newspapers, do we all jump on the "well I would have..." bandwagon?

In her post on WHO's a midwife NG asks what makes a midwife... and in asking those questions, she sparks me to thinking... Am I a midwife? I don't do what Barb does... I work in a completely different system, and some of her comments are as alien to me as computer language! And Agatha routinely forces me to remember that we have a different reality to each other, even though we are doing the same job. And yes, on the good old SMS we have banged heads over issues that we see differently. I hope that Agatha knows that I hold her in high esteem, despite our occassional differences of opinion. In fact, it is SMS that most makes me aware of the very real and continuous issue of horizontal violence in this industry: It comes up all the time, with students abused and confidence destroyed over and over again by overbearing, mean midwife mentors.

Why do we eat our young? This question was asked in an article I read a few years ago, and midwives were exhorted to stop doing it, to support the up and coming new midwives... and yet, as a "new" midwife, I still feel like I am at least being tenderised on a semi regular basis. But it is not just me: staff midwives bag indy's, Indy's bag staffies and at the end of the day, WOMEN SUFFER. It tires me, it hurts me and it makes me want to cry.

So, if anyone has any idea of WHY we do this, let me know.... I want to avoid it!

Over it.

2008-03-25T02:09:00.000-07:00

Why should I listen to you?
What exactly do you have to offer me,
that I can't get from myself?
honestly, what?

I am done, and sick
and tired and just plain
OVER IT'
Stop talking at me, and try hearing me!

You are my friend
be my friend
stop telling me
start hugging me

Please.

Home birth and other things

2008-03-25T01:32:00.000-07:00

Well, I have now caught two babies in their homes, and I am more committed than ever to the beauty and wonder that is homebirth. It rocks. Life has not been the most wonderful thing ever in my home of late. BA has been having some personal stuff, and I want to take a moment to tell her I love her, just cause this is my blog, and I can. The Mad Rocker, also known as my OH, was made redundant unexpectedly last month, along with beginning my post grad study. Slowly. And on the work front, I have had a difficult run of breastfeeding problems and the like to distract me from the wonderful world of the internet.

I am very happy to announce that I am officially on holiday (well, sort of, I have no babies due now till May, so have very little work to do!) and will be heading off to the bottom of the North Island for a rest and recuperation period. REALLY looking forward to that.

So, for a momentary commentary on how I realised that I really am a midwife now. I was called to a birth, just as I was eating my lunch. I finished my sandwich and dashed to second time Mum's house upon hearing that she was "doing stuff" from her very excited sister. That would not normally be enough to drag me from my food, as any who know me are surely aware of. But, I had a feeling. So I went, and quickly. this was a planned hospital birth, and when I arrived at Mum's home, I quickly realised we were nearing "now or never" transfer time. So I asked if I could do an examination to determine that my gut was telling me the truth. Upon VE, Mum was six cm's dilated, with a nice low head and a very buttery cervix. This from about an hours worth of good contractions. I told Mum it was go now, or have a baby at home. She decided to have a baby at home.

As it played out, that was a very good call. I had a second midwife on the way, but the baby couldn't even wait for that, and withing half an hour of my announcement to mum, she was pushing. Spontaneous rupture of membranes occurred, revealing thick meconium liqour. Bugger. vertex was already visible, so no time to change plans now. I quickly manoeuvred my Oxygen and suction bulb just a bit closer, and poised to catch a beautiful squirming boy child. Who proceeded to Not Breathe. Noone else there, purpling baby boy, meconium everywhere...... Double Bugger.

Thankfully a bit of suction and some free flow oxygen were enough to get him to gasp, and further stimulation got a cry. But seriously, I knew what had to be done, and did it, but GODDESS I did not like it! I am glad we were at home. I am glad I had all my supplies easily reachable. But I do not want to do that again! The second midwife arrived moments after the placenta delivered by maternal effort.

But, I am a Midwife now, because Mum and dad had no inkling of my heart palpitations. They knew baby needed some help to get going, as I explained it all to them as I went. But they felt calm and trusted me to do what needed doing, and I did not panic or run away: so I am a midwife. I was with woman, and did my job, despite my desire to be anywhere else in the world but there!

As to my earlier comments on horizontal violence in midwifery. I am building a little list, which I anticipate being done with in the next few days. It links in to recent posts by Barb about midwifery education. so watch this space, more to follow soon!

And another thought...

2008-02-04T15:21:00.000-08:00

So, the other day I had a really hard birth, with a long latent phase, augmentation, slow progress, and finally a "crash" section for fetal distress. I am not going to discuss that birth here, as I am not ready yet. Suffice to say, I sought help at appropriate times, but the help I got made my life much more difficult. But it raised something else which I do want to process.

Horizontal violence is often discussed in midwifery, but I realised during that birth that it is alive and well. The backbiting and sniping that can be associated with attacking others practice is painful and not at all helpful to anyone. So, although i don't have time to go there now, I will be following up this issue soon.

On another note, remember my domestic violence posts? Imagine my surprise when I picked up the local paper only to see that the "man" in that case is there on the front page, in court on charges after assaulting (allegedly) two couples on the beach front in the last two weeks... one of the victims required brain surgery for her head injuries. But, of course, he wasn't a violent man.

Books.......

2008-01-31T19:47:00.000-08:00

I got sent this, and thought, well, okay then. So, if you are reading this too, have a go at your own blog!

Instructions:

Look at the list of books below. Bold the ones you’ve read. Itilacize the ones you want to read. Leave blank the ones you aren’t interested in.

Movies don’t count!!!!! (K. - Damn.)

The DaVinci Code (Dan Brown)
Angels and Demons (Dan Brown)
Pride and Prejudice (Jane Austen)
To Kill a Mockingbird (Harper Lee)
Gone With the Wind (Margaret Mitchell)
The Lord of the Rings: Return of the King (Tolkien)
The Lord of the Rings: Fellowship of the Ring (Tolkien)
The Lord of the Rings: Two Towers (Tolkien)
Anne of Green Gables (L.M. Montgomery)
Outlander (Diana Gabaldon)
A Fine Balance (Rohinton Mistry)
Harry Potter and the Goblet of Fire (Rowling)
Harry Potter and the Order of the Phoenix (Rowling)
A Prayer for Owen Meany (John Irving)
Memoirs of a Geisha (Arthur Golden)
Harry Potter and the Philosopher’s Stone (Rowling) Fall on Your Knees (Ann-Marie MacDonald)
The Stand (Stephen King)
Harry Potter and the Prisoner of Azkaban (Rowling)
Jane Eyre (Charlotte Bronte)
The Hobbit (Tolkien)
The Catcher in the Rye (J.D. Salinger)
Little Women (Louisa May Alcott)
The Lovely Bones (Alice Sebold)
Life of Pi (Yann Martel)
The Hitchhikers Guide to the Galaxy (Douglas Adams)
Wuthering Heights (Emily Bronte)
The Lion, the Witch and the Wardrobe (C.S. Lewis)
East of Eden (John Steinbeck)
Tuesdays with Morrie (Mitch Albom)
Dune (Frank Herbert)
The Notebook (Nicholas Sparks)
Atlas Shrugged (Ayn Rand)
1984 (George Orwell)
The Mists of Avalon (Marion Zimmer Bradley)
The Pillars of the Earth (Ken Follett)
The Power of One (Bryce Courtenay)
I Know This Much is True (Wally Lamb)
The Red Tent (Anita Diamant)
The Alchemist (Paulo Coelho)
The Clan of the Cave Bear (Jean M. Auel)
The Kite Runner (Kaled Hosseini)
Confessions of a Shopaholic (Sophie Kinsella)
The Five People You Meet in Heaven (Mitch Albom)
The Bible -- Yes i used to do regular bible studies... what ever happened to me!
Anna Karenina (Tolstoy)
The Count of Monte Cristo (Alexandre Dumas)
Angela’s Ashes (Frank McCourt)
The Grapes of Wrath (John Steinbeck)
She’s Come Undone (Wally Lamb)
The Poisonwood Bible (Barbara Kingsolver)
A Tale of Two Cities (Dickens)
Ender’s Game (Orson Scott Card)
Great Expectations (Dickens)
The Great Gatsby (Fitzgerald)
The Stone Angel (Margaret Laurence)
Harry Potter and the Chamber of Secrets (Rowling)
The Thorn Birds (Colleen McCullough)
The Handmaid’s Tale (Margaret Atwood)
The Time Traveller’s Wife (Audrey Niffenegger)
Crime and Punishment (Fyodor Dostoyevsky)
The Fountainhead (Ayn Rand)
War and Peace (Tolstoy)
Interview with the Vampire (Anne Rice)
Fifth Business (Robertson Davis)
One Hundred Years of Solitude (Gabriel Garcia Marquez)
The Sisterhood of the Traveling Pants (Ann Brashares)
Catch-22 (Joseph Heller)
Les Miserables (Hugo)
The Little Prince (Antoine de Saint-Exupery)
Bridget Jones’ Diary (Fielding)
Love in the Time of Cholera (Marquez)
Shogun (James Clavell)
The English Patient (Michael Ondaatje)
The Secret Garden (Frances Hodgson Burnett)
The Summer Tree (Guy Gravriel Kay)
A Tree Grows in Brooklyn (Betty Smith)
The World According to Garp (John Irving)
The Diviners (Margaret Laurence)
Charlotte’s Web (E.B. White)
Not Wanted on the Voyage (Timothy Finley)
Of Mice and Men (Steinbeck)
Rebecca (Daphne DuMaurier)
Wizard’s First Rule (Terry Goodkind)
Emma (Jane Austen)
Watership Down (Richard Adams)
Brave New World (Aldous Huxley)
The Stone Diaries (Carol Shields)
Blindness (Jose Saramago)
Kane and Able (Jeffrey Archer)
In the Skin of a Lion (Ondaatje)
Lord of the Flies (Golding)
The Good Earth (Pearl S. Buck)
The Secret Life of Bees (Sue Monk Kidd)
The Bourne Identity (Robert Ludlum)
The Outsiders (S.E. Hinton)
White Oleander (Janet Fitch)
A Woman of Substance (Barbara Taylor Bradford)
The Celestine Prophecy (James Redfield)
Ulysses (James Joyce)

seeking self

2008-01-30T01:15:00.001-08:00

Are you in there?
I used to be so in touch with you
Used to hear your voice everywhere I went
Used to believe everything you said to me

Where did you go?
I know I am busier these days,
And not listening as hard….
But I find myself sitting in the silence, wishing I could hear you

Is it that you think I don’t need you?
Cause, I really do.
I am not the way people think I am
Not so sure of myself as I seem

How can I reconnect with you?
I really want to catch up.
I want to hear what you think of me now…
Want to see where you think I am headed

Can you tell that I am scared of you?
You are my truest reflection
Of what I truly am, and what you say
Could shatter my world if it is not what I expect

You force me to take notice,
Show me what is really there.
I know you are really just a part of me
But, goddess, I need your truth.

Post graduate study?

2008-01-30T00:28:00.000-08:00

So, I am heading back to uni. I have enrolled to do my honours and will be studying parttime for the next two years to achieve this. I must be mental! But I love the learning almost as much as I love the work. So back to it I go. But the process of applying, and deciding on course structure has raised some stuff for me. I was not a good student in high school. I dropped out, pregnant, at sixteen. I then worked in a series of completely shite jobs, getting nowhere fast.

I never imagined a time when I would be a university student, let alone a graduate with a degree. Post graduate study wasn't even on my radar! And, now that I am doing it, I have this wierd am I getting above myself and pushing to high feeling in the pit of my stomach. Who the hell am I to think that research I might do could be of interest let alone benefit to others? I was the woman I now want to study!

I am constantly surprised by the realisation that I am an educated and intellient person. This is quickly followed by the question "how the hell did they not realise how shit I am?" I really honestly expected to fail out of my degree at every stage. And now, going into post grad studies, I feel the same way, like I am asking to fail spectacularly at something that really matters to me. Friends tell me constantly that I am "uber smart" and other such bollocks, and to me, it is like when ssomeone tells me I have lost weight or look good... the auto denial is right there.

Goddess, this is rambling... my point. In my heart and in my honest moments, I know I am good at this job. I know the stuff I need to know to practice safely and smartly. I am not scared to integrate others knowledge and other ways of knowing into my practice. I am fully and wholly committed to what I do, and if I didn't believe I could do it, I wouldn't do it. But, still I have these masses of self doubt and feelings of being a fraud... Is that just what women do to ourselves? Is that why we birth in the hospital but want a natural birth? Cause we know we can do it, but doubt it anyway?

I am confused. I am scared. And yet, I am excited.

Births, being an LMC and American doctors.

2008-01-10T22:45:00.000-08:00

So far this week, I have attended two births, one a VBAC with slow progress but a good outcome in the end, and the other a lovely physiological birth with a primip who was perhaps the most relaxed woman I have ever come across in labour. She laboured while sitting with legs crossed gently on a chair, eventually getting on to her side when she wanted to push. She did the whole thing in just over four hours, with only 20 minutes of pushing. Truly a lovely birth. the VBAC delivery was a bit more difficult. A long latent phase, followed by very slow progress, eventual syntocinon augmentation, and then a long second stage. I had to hand over care to the hospital eventually, due to sheer exhaustion and was appropriately villivfied as being a lazy uncommitted independent midwife. They argued that the woman was needing "primary midwifery care" I argued that syntocinon augmentation with a VBAC is very much secondary care!

But, what am I talking about, ask my non kiwi readers. Well, here is a quick run down of how being an LMC midwife works in kiwi land.

Section 88 is the legislation that governs maternity care in NZ. Under this legislation, Midwives gain the ability to practice at home or in hospitals, by gaining "access agreements" which allow them to use a facility, and receive support from that facility. We provide antenatal care under our own supervision throughout the pregnancy. when labour begins we must attend a woman within twenty minutes of her arrival in a hospital/ birth unit, or by negotiation with the woman in a home birth. We are not bound to follow the protocols or policies of a particular hospital, although there is an expectation that you will be able to well defend any variation. We are able to prescribe medications applicable to common pregnancy problems, and IV fluids, etc. We are responsible to provide all primary midwifery care, either by ourselves or by arranging another midwife to cover from the arrival of the woman at the hospital, until at least two hours post partum.

The referral guidelines list the criteria for consulting/referring or handing over to obstetric care. therefore, if something is a "level two referral" such as syntocinon augmentation, then we are required to inform the woman that we recommend that she allow doctors to coordinate her care. We can stay and provide the midwifery care for these women, or we can "hand over" to secondary care. In most instances, we stay with our women, for as long as we can. But when you have been awake for 27 hours, you are perhaps not the safest practitioner, especially in a complicated labour.

We are then required to provide at least five to seven home visits during the four to six weeks following birth. Most of us do more than this. for this, the government pays us as per the schedule in the above link. As you can see, it is not a huge reward for 24/7 on call! However, I don't think anyone becomes a midwife for the money. That is a really basic rundown!

So, having explained that... my issue the other day was that i had been caring for a woman who was secondary care from the outset by dint of being a VBAC attempt, who then had slow progress, ARM, Meconium, syntocinon, etc etc. At the 27 hour point, i knew I could not safely continue. And I was basically attacked, for being lazy and uncommitted. What do you want? Blood? Right, that is that rant over. Onto the next....

My dearest friend in the world, who I will call Blond Ambition, is a beautiful and vivacious 22 year old midwife, working for a different busy hospital. Once a week we move heaven and earth (and shift rotations and labouring women) to get together and spend time catching up on our lives. This week, we went for a lovely walk on the beach, where there was sunshine, small children, and lots of dogs. There was also ice cream (goody gum drops and marshmallow coconut ice for BA, and rum raisin, cappuccino and butternut pecan for me!) and lots of chatting.

During the chat, BA told me about an American doctor, doing an obstetric rotation at her unit. She had a conversation with him, where they discussed the difference between NZ and American obstetric care. She asked him what was the most different, and he replied "you". It really was a challenge to him to work in an environment where most of the labour care happens independently of the doctors, with midwives doing the ordering, and doctors doing the "fixing". It highlighted for me just how different our systems are. Here, a midwife is the primary carer for the vast majority of women. Therefore, obstetricians really do provide "secondary care", just as they should. But maybe, that is why they are so anti midwives... because would you want to give up all your normal births, and only have the complicated and problematic cases?

BA asked the doctor what he thought of homebirth and he responded "I wouldn't touch it with a bargepole". when asked why, he said "well, for a start I would lose my licence to practice". Surely that is not true? If a doctor backs a home birth, he is delicenced? Or is he just concerned that if something went wrong he could lose it? Or so convinced that homebirth is inherently unsafe that he KNOWs he would have something bad happen, leading to the loss of his licence?

Blonde Ambition ended their chat their on the grounds that he was not open to the chat, and she had way more important things to do... but it saddens me that doctors can't see the difference between a normal woman birthing at home, and say a really dangerous situation like a placenta praevia delivering at home. Hmmmm.

Maybe, this then draws back to our language difference. Maybe this basic difference between doctors and midwives is more than a misunderstanding... As pointed out by both Peggy Vincent and Penny Armstrong in their memoirs, doctors view birth as normal only in retrospect, and midwives see it as normal unless it deviates away. If you do not believe that birth is inherently natural and safe, then how could you, ethically, deny women the right to avail themselves of medical care. Think about how you would feel if a woman with twins, placenta praevia and preterm labour with both twins breech requested you to attend her at a home birth... Now what if doctors feel that ALL deliveries are that dangerous?

I don't know how we save the women from this attitude, but I begin to understand why none of our evidence is enough to change the minds of doctors so heavily indoctrinated into a model of birth as pathology.

Wow. BA will read that and laugh her head off, cause it is not where I planned to go AT ALL.

Never mind.

Runs of three

2008-01-05T21:10:00.000-08:00

Is it just me or does anyone else have runs of three? Since I entered independent practice, every birth I have attended has been one of three! I swear, it's true, not a single stand alone birth! Last month, I had two runs of three, a week apart. The month before two runs of three, two weeks apart. This month i had a run of three last week, and now already, I have a woman in labour and another in early labour... which could of course all stop, but.... if they keep getting closer like this, will I end up with runs of six? I couldn't cope with that!

One of the deliveries last week was a wonderful primip, so strong and grceful and bave, that I wanted to cry for her! She laboured beautifully to full dilatation with no pain relief except the pool, and began pushing soon after. Eventually, after two hours we got out of the pool. Baby was fine. Slow but steady progress forr the next half hour, but mum's contractions started to go off. The head was "right there" but the contractions just weren't bringing it any closer. Nipple stimulation failed to increase them, and the position was all wrong. Finally, I asked her permission to do an episiotomy. I hate doing them, and never do them, but I did this one, and it was immediately followed by the birth of a good sized pink screaming baby. But my call was a good one. That uterus had had enough, and despite active management of third stage, next thing I knew there was blood, and lots of it, everywhere. Basically, she lost about 1100 mls. So, after her beautiful strength in labour, and completely unmedicated birth, she ended up with suppositories for her stitches, and an IV for her bleeding.... Why does it happen that way?

Domestic violence....

2008-01-05T20:45:00.000-08:00

This post was a while ago, but I now have a follow up on the story, that raises more questions than it answers.
I was at the hospital the other day, and ran into the social worker involved in that case. She asked me if I had heard from CYPFS. "Errrm, no?" I replied, slightly confuzzled.

She then told me that my client has been admitted to hospital twice after beatings, and the child is now at the centre of a massive custody battle. The partner is wanted by the police for assault and battery and CYPF's are asking why "something wasn't DONE". WTF? we BEGGED them to do something! Everyone who was involved in the case had nightmares about the potential headlines, and now, although it is not the baby being beaten (to our knowledge) they are coming true, and WE are in the wrong!???

Sorry, got a bit carried away there. I guess my point is, that this woman had the right and the responsibility to avail herself of help all those months ago. While I agree it is sad that she may now lose her child, this was her decision. Her plan to "change him" didn't pan out, and now, the shit has (predictably) hit the fan. but, my question to you, my intelligent and opionated readers, is what could I have done to hellp her make a different, better decision? Anything? Suggestions, please!

Self fullfilling prophecies.

2008-01-01T21:58:00.000-08:00

In my everyday life, I believe in self fulfilling prophecies. If you think it, you may make it so. I often use this method to try and get my vacuuming done... but although that doesn't often work, I still believe that what we think might happen often comes to be so. And the more energy we give to that thought, the more likely it is to occur. For example, I believed I would be happier when I started my independent practice. I thought I would have more time for my family, and be more energetic. I believed it had to be better than working in the hospital. And it has so very definitely come to pass.

But, like every good thing, it has it's reverse aspect. negative beliefs seem to be given more mind space, and so often, we believe in a negative. So we believe that we CANNOT. Cannot achieve, cannot succeed, cannot birth. And that is what sparks this post. A woman, who honestly has said to me at every one of her (22!!) Antenatal visits, "I will need a cesarean" in some variation, finally began labour at 41+3. She then contracted for twelve hours at three minutes apart, lasting a minute to ninety seconds, and managed to get to ........ 2 cm dilated. The head was high, the contractions were "unbearable" and slowly, but surely, things went Tit's up. FH was high, and a CTG was commenced. Baseline: 160 bpm. Long story short, after about 16 hours of labour, a cesarean section was performed, with a FH baseline of 200 bpm. At 2 cm's. A normal size baby in OA position was born, with heavy mec staining and apgars of 6&9.

Why did this happen? Did she believe this would happen because intuitively she knew there was going to be a problem? Or did her belief create the reality? Could I have saved her alot of heartache by pushing for an elective CS at term for maternal request? Would she have even been happy if she wasn't "saved" by the doctors who operated to deliver her of her burden? I struggle with this aspect: How do you help the woman who wants to be saved, not empowered? Is it right to try and empower someone who sees herself as inadequate, and doesn't mind?

Agatha raises interesting points about language here and a similar vein of discussion occurs on One Hot Mama's site. Both of these post's struck a chord with me, originally sparked by Barbara. I don't know quite how my ramblings are going to end up linked to their thoughts on language and empowerment, but it is brewing. Just so you all know.

what a year....

2007-12-29T17:51:00.000-08:00

Well, it is one day off of the last day of the year. This one has literally whipped past me in a whirl! But what a great year it has been. No really bad things have happened to me or any of mine, and lots of good things have, with engagements, weddings, career changes and all sorts of positive things happening. Professionally, my world has changed more than I would ever have anticipated, and right now, I love my life. I have a great rewarding job, wonderfully supportive colleagues who appreciate me, respect and autonomy up the wazoo. At home, my kids are all happy and healthy, despite the normal road bumps of adolescence, OH and I could not be happier, and are sound for the first time in a long time. I have amazing friends who I love to be around and enough time and money to do stuff with them.

This sounds all very gloaty, but actually, it comes from a place of real gratitude. Two years ago, I was broke, depressed, terrified of failing, on the verge of losing my relationship and my kids and in a bad place in many other ways. This is a message to give hope to those people who are now looking down the barrel of the new year wondering how the hell they are going to survive it. Not only have I survived, I have thrived and my world is a wonderful place to be! Thanks and blessings to the Goddess for holding me to the path that I needed to trudge along to come to this place of happiness. Joy to the people who trudged it with me. Peace and Hope to the people facing such a journey themselves.

My daemon

2007-12-24T01:36:00.000-08:00

I just discovered the golden Compass website, and thought I'd stick this in for a giggle. Does it match me?

About my family.

2007-12-22T22:32:00.000-08:00

I have a big family. My kids have an even bigger family. This makes this time of year somewhat of a challenge. So I thought, I'll spend a few moments, and reflect on my fandamily and just why it is that I do like em, and enjoy being around them!

To start at the bottom, and work my way up, my youngest brother J, is 21. He is a real baby of the family. He was born when I was ten, and so I have always been a bit separate from him: By the time he was six I had moved out of home, and when he was seven, I was a Mum. So, in some ways, I never really was a kid with him. But I remember the day he was born: My first experience of labour, my first awareness of how babies got into the world. He was eight weeks early, and affected by RH isoimmunisation, so not exactly normal, but he was a fighter. I know his life is hard for him at the moment, and I hope that he knows he can come to me if I need him.

Then there is M. My little sister, now 24, a newly married woman, and a Mum of three, with her fourth beauty on the way. She is also a loving step mum of one more. I have to say, if there was a sibling who is closest to all the other sibling's, it is M. She keeps up with everybody, better than anybody. She is smart, fun and talented, with a gorgeous voice and rhythm which rocks. She is skinny and pretty and a spectacular aunty. She is brave (anyone who goes on a several week long tour of the country in a camper van with two kids under two is definitely brave) and a caring wonderful person, who I am proud to know, let alone have had a hand in developing.

Next up the list is JP. 27 years old, Dad to one beautiful little girl and about to be married, at which point he will also become step dad to a lovely lad who we have had in our family since he was about three. JP is the quiet one. He doesn't say alot, but when he does, he means it. He is around in a quiet kind of way, but has a bit of a temper. I remember him best as a sixteen year old, who would babysit for his nieces, and who stayed home to care for our dad when he was terminally ill. JP is unique, and a right typical kiwi bloke, rough on the outside and sincere and sweet on the inside.

I am the next one in the family, and right before me is my big sister, D. 35 years old, and linked to in a previous post, D was my nemesis as a child. She was the talented one, the smart one, and most definitely the pretty one. She was the one I should have been more like: But funny, isn't it, how when you grow up, you find out things aren't always what they seem to be, and she felt much the same about me? D and I have established an ever expanding common ground since the birth of her daughter,who is the same age as my DS. She was one of my strong supporters when I decided to return to study, and has been a huge help in the technical and artistic side of setting up my practice. She is also the most talented artist in the family!

In pole position, first born in our tribe, is yet another J, JD. My parents weren't very imaginative with boy names! J is now 38, and he and I have always had a difficult relationship. J made some choices in life that I would not have. we have spent years incommunicado. But in the last two years, he has worked hard to begin turning his life around. He is clean now, and even beginning to gain some weight. And I am proud of him.

As referred to earlier, my dad passed away nearly ten years ago. He is missed. Nothing will ever replace him, but he taught us all well. Family are the people you choose to have around you, and they are the most important thing. So to top off our family, we have my Mum, G, and her partner, believe it or not, J. They have been together for nine years, and he is my kids Grandad, even though Dad is too. And Mum? Our relationship is not perfect. She can be a bit neurotic, sometimes hard to deal with, but at the end of the day, she raised six kids to be pretty awesome people, if my round up holds any sway. And she loves us. And we love her.

So that is why, on Christmas day, I will have a day of catching up with my family, and will enjoy doing so.

All up, six kids, four partners, ten nieces and nephews, Matriarch, step dad, and more than a few extra in laws, if the past is anything to go by. And that is just in the afternoon.

only you

2007-12-22T16:54:00.000-08:00

Moving slowly through sunstreaked days
nothing there to hold my gaze
you're the one who moves my mind
always there to hide behind
what will I do without you there
being the one with whom I share
all the things I see each day
what will I do if you go away?

November the month from hell....

2007-12-20T14:59:00.000-08:00

My absence from the blog of late has not been due to my abandonment of blogging, but rather to the existence of the month from hell. With one of my midwfiery partners away for the month, tending to family in lands far away, my other partner and I delivered a total of 21 babies between us in the month of November! My eight consisted of one CS, one water birth, and two ventouse deliveries, the rest all beautiful NVD's, with one of those a VBAC.

My partner sadly, had a series of long haul labours, and several CS, which left her pretty shattered! This meant that we had a heavy load of postnatal work to do as well, and all things considered, we had a hell of a month.

On a personal level, that month also coincided with the organisation of my beautiful younger sisters wedding, which took place on a blissfully sunny day at the beach on the 1st of december. So I also organised a hens night, decorated my first wedding cake (it was ok, nothing exciting) and got to catch up with the wonderful girls who are and have been importnat to my sister, including her bridesmaid Nicky, flown from the distant shores of Australia to spend four whirlwind days with us!

Years ago, when they were teens, Nicky and my sister used to babysit frequently for my girls. Imagine Nicky's surprise on arriving at my sisters to discover the five year old she used to care for standing there, taller than her!

I also did several study days, had my wallet and all my ID stolen from the hospital and lived with next to no income without having any major disasters. It was also the month that lead into the end of my first year of practice: trial by fire anyone?

So, now, I wake up and find myself already at the end of December, a qualified practitioner for over a year, discharging the first of my clients back into the bad bad world. The christmass shopping is done, the presents are laid out with care under the tree. Even the christmas grocery shop has been completed, online, last night for delivery on Xmas eve.

I am preparing (slowly) for my midwifery standards review in january, and slowly starting to get my head around the fact that I am now a self employed responsible member of society. freaky.

The lady in my post on miscarriage has just discovered that she is pregnant again. she is both happy and scared, tenuously clinging to the fear that this may still not be the right time, but relieved to have conceived easily... It is all very difficult for her emotionally, but physically her body is right on track.

My children all got lovely reports,and are all doing well: though one day into the summer holidays, they are already driving me mental with arguing!

So, now that you are all caught up on the humdrum (all may be an overstatement, I don't think anyone much reads this drivel!) I will finish working on a couple of pieces that have been simmering throughout all this professional and personal chaos! a happy and enjoyable christmas is wished to all, and to my fellow pagans, blessed be.

Woman

2007-10-21T20:07:00.000-07:00

hello.

I was just sitting here, waiting for you.
But you never came.
So I stayed, waiting, quietly.
Years passed, and still you didn't arrive.
So I watched the world tick by, and I worried for you sometimes.
I wondered, why isn't she looking for me?
I am not that hard to find.
Doesn't she know I am missing from her life?
Is it possible she doesn't understand the importance, of me?

But, you are here now.
you look at me with such wonder, such delight and just a little fear.
I am nothing to be afraid of, honestly.
I have waited for you for what seems like forever.
I am your friend, or at least, I will be, one day.
For now, though, maybe, just for a minute,
Could you hold me?
I am a little hungry, after all this waiting.
Could you offer me sustenance?
I will give back to you a thousand fold the things you offer me, I promise.

I am your daughter, sent by your mothers, to share your wisdom,
and teach you some of mine. In the way of women.
I shall take my fill from you, while I fulfill the empty parts in you.

That is what it is all about, this being a woman.

thoughts.....

2007-10-21T19:35:00.000-07:00

I have had a nasty cold all week, and not done much of anything other than think because of it. Thoughts about miscarriage, engendered by this woman's story which resulted in a horrible hospital experience including a D&C and a severe reaction to anaesthetic, and the case of the unexplained cervical clamp. Her treatment in the hospital, while not unusual, was so distressing for me, as I heard it in more detail that usual, due to our friendship. I wanted to go in there and demand to know why they left her in a corridor while she bled, with her three year old on her lap. I know why: I worked there long enough: they had no beds, they are oversubscribed, cases are dealt with by level of urgency. But where is the humanity in this system of "care"?

Thoughts about boundaries, as an online friend experienced first hand the repercussions of sharing birth on the Internet. The Internet has become our friend, our close companion in so many ways. midwives on the Internet inform me, question me, cause me to question myself, and are so much a part of my reflection/ Which I believe to be an integral part of midwifery... the story, the tale, the learning, the searching, that comes only from sharing our knowledge, our fears, our concerns and our triumphs. the fact that this sharing can now take place on an international level, on a world wide forum, accessible to all, in some way's is such a blessing. But in others, oh how open it leaves us to criticism, to heartache, to possible litigation.

This friend, a midwife, shared a story, with the full permission of the woman involved and her partner. It was a story which drew much attention within it's forum, and engendered much useful informative discussion. But someone, uncaring of it's benefits, saw fit to print out this story and show it to colleagues, who disagreed with the midwife's comments about a staff member involved peripherally in care. This someone knowingly took this learning story, and shared it with the staff at the very hospital where the midwife works. This someone joined in witch hunt against the midwife who wrote the story, although all of us who commented had been equally shocked by the staff members actions.

As a result, the Midwife who told the story is shunned. Although anonymity of the woman and the second practitioner remain inviolate, the midwife is named and shamed in the tried and true way we see so often. Midwifery, eating it's young, again.

So where are the boundaries of anonymity? Changing names, dates and salient details? Changing the location of occurrences? And what happens if you change the story so much, it becomes someone else's story, recognisable to them, even though you do not even know them? How do we use the Internet safely as a learning tool, a reflecting tool and still protect those involved? does a dangerous practitioner deserve protection? Does an uncaring practitioner deserve the respect they do not offer the women in their care? ah, so many thoughts.

Thoughts on being a Mum to a teenager (or two, as I now am). How do I strike the correct balance, between loving supportive mother, and provider of structure, discipline and guidance? Should I really let her go out dressed like that? Am I proud of her for dumping a boy for being a pot head, or horrified that she knows a pothead?

Thoughts on being a wife, when I am not married. I fulfill the role of wife, by most definitions, but have no ring, no piece of paper. Most days, i would rather die than have the ring, or the paper. But other days, I worry.... what if something happens to him, and no one listens to me? I am the one he has told his wishes, his expectations of his death. What rights does the woman who loves the man, but has no proof of it, have? Is that what it feels like to be gay and is that why they want legal marriage rights? I have always supported that fight, but now, I think, I begin to understand why they want it! (They what a word, the wrong word, but there is no other word, and so I use the word, despite it's inherent wrongness).

Thoughts on wanting to learn a new skill, not related to my work. I want to learn to play the guitar, I want to join the rest of my family in being able to create music. But I am scared that I won't be any good. Sad.

Thoughts on all sorts of crazy things, roiling continuously in my brain, and not making any sense, in there, or on here!

Called out...

2007-10-10T14:12:00.000-07:00

here, darkdaughta has called me out... without even knowing who I am, or that I exist, she has confronted me, and my thoughts are reeling. Really hoping that I will have the guts to be what I am, as opposed to what I like people to think that I am.

My big sister

2007-10-07T03:30:00.000-07:00

My sister was the one who introduced me to blogging and she has done some awesome work for me just lately helping to create my business logo and website... so just a litle credit for talent where it is due... She really is quite clever!

On miscarriage

2007-10-07T00:48:00.000-07:00

I aways struggle with miscarriage. I have a client who is 12 weeks and having a bleed at present. She may or may not stay pregnant, and there is little I can do for her aside from asking the Goddess to walk beside her. Since I qualified, my experience of miscarriage has been minimal, and I am never quite sure how to position mysef: Matter of fact caregiver? Caring confidante? Understanding ear?

For some women, miscarriage is sad, but not overwhelming. For others, it is the beginning of a lifetimes grief and mourning for a lost soul. For some it is a blip on the radar, a signal to "try again" and for others a devestating blow. And predicting what it will be to which woman is a joke!

I have a practice of sending a rememberance card to women who experience a loss while I am caring for them. I am never a hundred percent sure whether it is the right thing to do or not, though. My own miscarriages were not traumatic for me: I was lucky enough to require no medical treatment, and passed my lost babies with minimal pain or fuss. To be honest, as none of my pregnancy's were ever planned, I always just thought of it as the Goddess sorting things, and was never particularly upset. But I have friends and family members who have been devestated by early pregnancy loss, of both planned and unplanned babies.

So, what is the appropriate tone to strike? A woman who feels as I did, is confused at best by a message of sorrow. I remember thinking, "Wow, I am a horrible person for not being upset by this!" when a friend wrapped me in an embrace saying "I know how hard this is". For me, it wasn't hard. But I know one of my close friends felt the exact opposite, saying "noone seemed to care" when describing her devestation at losing her much loved, unplanned baby at 9 weeks.

So what do others in this wierd world of midwifery do? what about Mum's who have lost their babies? How should I approach this?

It feels so cold and clinical to say things like "we have to wait and see" and "Not finding a heartbeat at this stage is commmon, so it doesn't meant there isn't one."
Anyone with ideas on this, please, share them with me!

Happy birthday Erika....

2007-10-04T16:40:00.000-07:00

It is my beautiful daughter's thirteenth birthday today, and this always leads me to reflect on her birth: so I thought, why not share it here?

Thirteen years ago, I was a newly married 18 year old mother of a toddler, pregnant with my second child. My first child's birth was highly interventionist (due in part to my own lack of knowledge) and this time I wanted things to be different. So, I had booked with an independent midwife to dliver at the same hospital as last time. I had written a birth plan, which basically said "leave me alone, my midwife knows what I want". I had talked with my midwfe in great depth about my desire to stay home as long as possible (more thoughts on this later!) and avoid an epidural at all costs.

My due date was the 4th of October, and that evening we had friends over for dinner. About halfway through dinner, I realised that the low throbbing pain in my lower back was not the flare up of an on again off again kidney infection that I had attributed it to, but was in fact, early labour. I decided that the best plan was to completely ignore it, as this had gone on for 48 hours with my first baby, and I didn't want to repeat the mistakes of the past. So I got on with my evening of socialising, and at around 11pm, when eveeryone left, I told my husband that I thought I might be having the baby in the next day or two. "But I have an assignment due" wailed my trainee teacher hubby. Now, I could start a rant here, about how he knew that the assignment was due around my due date for weeks, and had had plenty of time to do it, and his procrastination was really not my problem.... but I won't. I will just say that we spent the next two hours with him telling me what to type and me frantically typing to get his assignment finished.

1am rolled around, and assignment neatly typed, we headed to bed, to get some sleep. By now, the rushes were coming every five minutes or so, but were still pretty mild, and I felt it would still be a day or two. This gives an indication of how long my first labour had been, really doesn't it! We went to bed, and within ten minutes hubby's deep snores filled the air. I however, could not get comfortable for love nor money, and at 2am gave up and ran a bath, thinking that might relax me enough to get to sleep. I jumped out of the bath fifteen minutes later, convinced it had made me much more uncomfortable: In retrospect, I had probably got in just as I started active labour, and the difference was in the strength and length of the surges.

I couldn't sleep, but reasoned that it was still a long way off, and thought I should let hubby sleep. However, I did have a flatmate, asleep downstairs, and so I thought I would waken her so I had someone to talk to. Poor girl, she had never been around woman in labour, and she was terrified I would push it out on her bedroom floor (ironically, a few years later, this same woman delivered her second child on her living room floor with a midwife who had arrived as the head crowned to assess her "early labour" so I guess she got over it!). The next hour or so consisted of me getting more and more vocal, while my flatmate begged me more and more often to call my midwife, and I said "No, I need her fresh later, when I am in proper labour" over and over. Finally, at about 300am, I gave in and rang my midwife, apologised for waking her and told her things were just starting to happen.

I magine my surprise when she said, "erm, I think we should meet at the hospital".
"No, it is really early" said I. "I don't want to get there till I am at least five cms"
"well, listening to you, I think you already are. You do realise these surges are two minutes apart and ninety seconds long, don't you?"
Well, I hadn't even looked at a clock, so no, i didn't know that. Also, I really expected this to get much worse, and therefore, I was pretty sure I was not even three cm's yet. So I continued to argue with her. And she said, "How long is it going to take you to get organised and to the hospital?" and I said "an hour, at least". "See you there in an hour" she replied.

So I slowly started organising my baby sitter (which turned into quite a drama: the girl supposed to do it could not be contacted- pre cell phones, here, and so I had to get my cousin to come, but my cousin had a broken leg, so she had to get her husband up to bring her, and then his car wouldn't start so a third friend was drafted to drive them over. Later, it turned out that the original sitter was IN MY COUSINS HOUSE! shagging her ex, which she did't want anyone to know, so couldn't admit she was there!) and putting bags by the door. Finally at 415am, I woke my husband and off we set.

At the hospital, I was met by my midwife, Chris, two girlfriends who were to be support people, and three other friends who wanted to stay in the waiting room. All the babysitting dramas for my older child meant that everyone knew I was in labour, and I did feel a bit overwhelmed by how much my friends wanted to be there for me.

At 5am, I was examined. I was fully expecting to be told I was less than 3cm's and be packed off back home. But no, I was in for a surprise: I was seven cm's!

Off the bed, and into the shower for a couple of hours I went. That was great, actually, really relaxing. At 0645, I moved back into the bedroom, and we had a wierd discussion about what was playing on the radio for awhile. Then one of my good friends from the waiting room came down and called through the door to see what was happening. Biggest mistake of his life. I told him I was decent and to come on in. He did. I grabbed his hand as transition hit, and the poor bugger ended up as my fourth labour support person! I begged my midwife to check to see if i could push yet: NOpe, still 7cm's. so I asked her to break my waters... well, no, I screamed at her to break them, now.

So she did. And I continued to speed through transition, clinging for dear life to the hands of my hubby on one side, and my dear friend on the other. Hubby suggested I let my friend leave at one point, and I told him to "F#@* himself". Another quick check from the midwife and I was pushing, turning on to my knees leaning against the back of the bed. And at 720am, Erika Jaine was born, over an intact perineum, weighing 7lb3oz, 56cms long. Just like that, I had done it, with no pain relief other than some gas in transition, and my beautiful girl was here. Well, I say beautiful. As one of my birth partners nicely pointed out "You gave birth to ET!" with long spider fingers and big black eyes, and a quite IUGR appearance, she wasn't that pretty at first! But, she is beautiful now, and all grown up. And after she was born, the midwife said to me, "next time, you should have a home birth". And seven years later, I did. And ten years later I started my midwifery training. So the birth of my daughter, was also the birth of my calling to this wierd and crazy world I now inhabit... Something else to thank the Goddess for!

The discourse of becoming parents...

2007-10-03T23:46:00.000-07:00

What he said....

Breathe.

Breathe, that's it.

Ssshhhh, It's okay,

just breathe.

I am here.

It's close now,

Breathe.

Hold me,

That's right,
I know, it is hard, but

Breathe.

Squeeze my hand,

let it flow through you,

and into me....

breathe, breathe, ssssshhhhh.

I know, it is a beautiful day.

Yes the world is silent, and calm

breathe,

breathe,

breathe,

Ahhh, that's it, I can see him,

Look, grandma, see him there?

Tell mum what you can see....

oh yes, my love, that is wonderful,

I can see him, he's coming, our son!

breathe, my love, just breathe.

Oh, here he is, oh my god!

You are amazing!

I love you, so much!

What she said....

You did this!

Oh God, I can't do this anymore, make it go away....

Stop, just stop, please....

Why are you making me do this?

This was you idea, you do it!
I am, I'm trying, please, help me.

I can see the sunrise, it is so lovely today...

Oh shut up, would you, I am working here!

Is he there?

Can you see him?

Oh Goddess, this hurrrrts

Ahh, ahhh, oh god, help me,

Oh, here he is, my baby, oh my baby,

Oh, I love you too, so much....

Boundaries, we all have em...

2007-10-03T23:35:00.000-07:00

Women will just keep on challenging you, won't they? I have a client, a lovely lady, who I really like.... but she can't seem to hear me when I tell her, over and over, the boundaries of my practice. One of my "rules" is non urgent contact should be via text, and in business hours. I have three children, and a partner, and a life outside of midwifery. So whilst obviously, I am on call 24/7 for urgent matters, like bleeding, or labour or unexplained pain etc etc, I ask all my ladies to save non urgent matters for business hours (10-4, Monday to Friday). I ask them to respect my other clients by sending a text, which I can then respond to after appointments, instead of having to answer a call (which should be urgent, because non urgent matters are dealt with by text!) in the middle of a consultation with someone else.

So this one client, who as I say is really lovely, has called me three evenings in two weeks: to ask for a letter, to ask when our next appointment is and to ask about a minor complaint of pregnancy. Since booking, I have had phone calls on at least three weekends, and twice during family functions: None of these were urgent. Now, I say again, I like the lady, but come on! Would you ring your doctor, dentist or lawyer on the weekend? I am now starting to get really frustrated by it... Every time she calls, she apologises for calling at the wrong time... so she knows it is the wrong time! Any suggestions for how I can make this clearer? Cause I am beginning to tear out my hair!

Making a difference... can it be done?

2007-10-03T01:44:00.001-07:00

I have been so busy the last little while, that I have barely gotten the chance to think about things let alone write! But now tat the dust is settling, I have a reflection to share. Domestic violence. What is it? Does it have to involve physical fighting? How do you help someone who refuses to acknowledge a problem?

I had a client recently who presented with huge and overwhelming evidence of domestic violence in her life. Over a seven week period, no HCP who came in contact with her (and there were alot, two hospitals, three wards!) doubted that her partner was abusive, and many asked me what I was "doing about it". I had discussed the evidence with my client over and over. She denied abuse. She denied personal danger, and declined information on violent relationships. I referred her to social work, expressing to the SW the concerns that existed: My client denied violence. An episode occurred in the hospital, with security and police called. A referral was made to CYPFs. They did an assessment of the environment, and cleared her for discharge. There was not enough evidence of abuse, despite all the concerns raised.

And so, I wonder. We live in this country at present in a climate of intoerance for abuse. Ad's on TV tell us clearly and repeatedly, "It's not ok." The murder of the Kahui twins, of Nia Glassie, and of so many other babies, are held up as warnings. We must intervene, HCP's are told. We must ask every woman if she is abused. But if the woman says she isn't, then nothing, nothing can be done. I don't know for certain if this woman was abused. I don't know for certain that she or her baby were or are at risk. I know we had a trusting, caring relationship. I know she knew it was safe to tell me things... because there were other issues which she did disclose and seek my assistance with. But what is it that we should do, what is that we should say, that will make it possible to change the abuse cycle?

Answers on a postcard.

Pele - A short story

2007-06-30T18:22:00.000-07:00

The eruption took everyone by surprise, not least the man who had fallen into the volcano. He had been taking a walk, you see, and had not planned the sudden end to his day, and shockingly, his life. There was no time for him to reflect on his choices, as his ankle turned when he saw the beautiful woman, and he began the fall, and before he landed, the hot lava had engulfed him from below, and there wasn’t much chance of thought after that. As the molten fire poured up out of the mouth of the volcano, and spewed it’s burning vomit across the surrounding earth, people were too busy screaming and running to wonder why it had happened.

Which of course, Pele reflected, was the whole problem in a nutshell. None of these people paid any attention to the gods anymore. Oh well of course, they paid lip service to the one’s they had created, but there was no respect for the sheer power of the natural Gods. And, she supposed, whilst her outburst had been rather childish, set off by the man’s careless kick of a stone she had worked for hundreds of years to move to it’s proper balanced place, the did need to learn a lesson. Now of course, all the work she had done here for several millennia had just been undone in a fit of pique, and there would be questions to answer. And she wasn’t at all sure she had any. There was no further time to scheme however. She noticed that the traditional offerings were not forthcoming, there was no chant for her to be calmed by. These humans were truly insufferable.

“Is anyone else coming to gloat at my indiscretions?” Pele asked Baba–Yaga with a quick glance at her from the corner of her eye. All seeing that was a joke too. This witch woman never stayed still, constantly pacing, seeking to grind down the very earth she was forced to walk.

Before Baba could answer her, Durga appeared, leaping off the back of her tiger and falling to one knee.

“ Of course, Durga, goddess of boundaries. Did I cross the line?” Pele asked, trying for sarcasm, but pulling off nervous laughter. Durga merely scowled at her, and stepped forward to greet Baba-Yaga. Most honoured witch woman, I greet you, She said in her formal manner. Pele had always suspected that being the goddess of the volcanoes and flame was a much better deal that what poor Durga had been stuck with. She could never ever cross the line, that one. Pele stifled a chuckle so as not to offend her esteemed guest.

When Kali arrived next, Pele began to relax. It looked like there would be no punishment, only commiseration from her fellow Goddesses. Kali danced into the room, and greeted the three of them in her usual, or rather, unusual manner. Then they all sat down again. Kali spoke.

“These mortals, I know are sending you all mad. In particular you Durga, with their constant change of the rules wherever it suits them. I suggest we all take a break. We still do all the work, and they give all the praise to these ‘Other’ Gods they have created. So what will they do if we all take a week off? No fire, Pele. No defining rules, Durga. No death and no birth and no fear. And no instinct, without you, Baba-Yaga. What do you say, ladies? Shall we show them what we really do?

And that was how it came about that the days after the volcano were very odd indeed. The locals did not need to put out the fires in the aftermath, as they went out on their own. Unfortunately, so did the cooking fires, and raw fish was not appreciated by all. When the lawyers tried to argue the negligence case against the hotel for the widow of the man whose careless foot had started the whole thing, they found they had no case. It was not against the rules not to tell someone that a volcano that hadn’t erupted for two hundred ears still could erupt, and no amount of their usual tactics could bend that rule. Women who had been expecting babies that week had none. Worldwide, there was consternation as it was realised that the birth and death rates had simultaneously stopped in their tracks. The doctors were confused, but not scared by this, as they felt that there must be a logical explanation. But those instinctive risk takers on the stockmarket floor all suffered great losses in that same week. For some reason, they were not being guided in whatever way was usual for them. The goddesses, in their womanly mortal guises enjoyed a fabulous week on the ski fields of New Zealand, and when they returned to their work, the felt a sense of real accomplishment as they set about righting things. The had vowed they would take a break like this each year.

In Life and Death

2007-06-30T18:18:00.000-07:00

Some things are so unthinkable

We don’t let ourselves think them

Some things are so well understood

We don’t see the need to say them

When two of those things collide

The pain can be overwhelming

And the backlash of our certainties

Can make us feel ashamed

But if you knew it in your heart

And showed it in your eyes

Then it was a well known fact

To the one who can no longer hear it

And if now you are forced to accept

Something before you couldn’t think of

The strength within you will come

From the one who you so loved

Days will pass and sometimes,

You will go half a day before

Something happens to remind you

And then you grieve anew

Some days the phone will be ringing

Before you remember there is not

Anyone to answer anymore

But your love will start to heal you

And when it does,

That is when you know

They always knew

What you didn’t need to say

And they will always

Be with you in your heart

And your memory

And your soul.

In memory of Jim Graham

Goddess of nothing

2007-06-18T04:17:00.000-07:00

Exposed in darkness
her head hangs low
she hides her secrets
in moonlit glow
Moving in silence
through the deafening roar
that is her world
she cannot ignore
Goddess of nothing
saviour of all
she keeps her truth hidden
behind the wall
built of tragedy
secured by pain
obscured by roses
beauty in vain
Ties to her past
keep her in thrall
In light she is hidden
In darkness she falls

Superwoman? Well, nah, but I am trying.....

2007-06-13T04:02:00.000-07:00

Well, my practice is up and running! I have clients, and equipment, and a bank loan and thanks to my beautiful older sister (www.lostvoice.blogspot.com), I have a logo, a business name and faith in my ability. I also have still got my passion, and that is amazing given how busy this month has been. I am still working a crazy amount of shifts, whilst visiting women, and squeezing in my mentorship program to boot! I have had birthday parties for my lovely kids, family drama's (but that is hardly surprising in a family the size of mine, really. Once you take my mothers six kids, add three step-siblings, all the partners, and then add your own children, your siblings children, their partners children..... well, you get the idea!) and even a tummy bug!

My ex has announced he is moving to Dunedin (Why? Why? Because he likes to make my life difficult I suppose). My Mum is selling our family home (not that any of us mind, but it is sad, and a hell of a lot of tidying needs doing after a family the size of ours have lived in a home that long), and my eldest daughter has competed in Stage challenge, which anyone who has been involved knows is an amazing experience, but very hard work for the poor kids. And, I restarted my gym membership, in a bid to shake the final five kilos that won't seem to go away.
And now? I am ready to start writing again, I think. With a wee poem, just to dip my toe gently into the water without too much risk of drowning.

Superwoman

She wouldn't be able to leap buildings,
In a single bound.
Noone would ever confuse her with a plane,
She'd be much too thin
Lois Lane probably wouldn't register very high
on her list of priorities
Superwomans life wouldn't be nearly as much fun
As Clark Kent's is.
Superwoman wouldn't wear her undies on the outside:
really, wouldn't that defeat the purpose?
No, superwoman would be too busy,
cooking dinner with one hand, sending an email with the other
and organising her work schedule around school excursions
She would have a sleeping infant at her breast,
while she organised four loads of washing on the line
If she could fly, it wouldn't be to catch falling heroines:
She would have a girl in a ballet suit in one arm
and a boy clutching goggles in the other
Superwoman would use her xray vision to see what her teenage daughter
was really wearing under her raincoat
And her ability to run faster than a speeding train
would just about allow her to keep up with a toddler in the playground
What super power does a woman need, that she doesn't already use?

Superwoman? Well, nah. But I could be.....

Introspection?

2007-04-29T21:21:00.000-07:00

I have spent the day running: trying to organise all the things that I must organise in order to
open my independent practice by it's due date (I think it may need a post dates induction, if I don't get more organised), trying to get some housework done, trying to arrange meetings with the bank manager and the inland revenue department (okay, I wasn't trying very hard on that level). While doing all that running, I have continually tripped over my past. I thought most people knew what I did now, but today, all day, I have run into people I knew in my previous life, who are shocked to find their once level headed banker colleague is now, of all things, a midwife!

And all that tripping over the past made me think just how much my life has changed in the last five years, and just how right that change has felt. How even though I am about to enter yet another stage of change and transition, I don't regret a bit of it. So, seeing as this is my first post, I might as well start where it started, in the past. Six years ago, I was a banker. I worked mainly in complaints resolution, trying to appease people from whom my company had (often unfairly) taken money. Funnily enough, I was very good at my job. I was convincing and calming, and knew how to sell. But oh, how the soullessness of it drained me.

Then I fell pregnant, and had a beautiful baby boy, and my entire life changed. Seeing as I wasn't working anyway (I wasn't earning enough money to justify letting my son be raised by a daycare) I investigated returning to study, which I did when he was two. And when he started school last year, I entered my final semester of a degree in midwifery. In my journey to qualification, my life, my friends and my loves have changed. Nothing really stays the same when you make such a drastic career change, and I am no exception. So here I stand, a different woman, but containing the old me, and starting a new life.

The point of this blog for me is to rediscover some of my old loves, incorporated into my new life. I have always written, but in the last three years, my poetry and stories have been replaced by reflections and essays. I want the old stuff back, but I think it might be mpossible to leave out the new stuff: So any who read this blog, will follow a journey of both self discovery and rediscovery. Comment on my writing, comment on my words: If they move you, or touch or even just annoy you, I want to hear it!