important information about the moment of birth

....and immediately after:

I've written about this before, and will just link to the entry here. What we know about the hormonal balance and physiology of labor and immediate postpartum is great. What we do to help facilitate that balance and release of normal process is not great.

Even though it's been said a million times before, even though we hear about it at conferences, even though we read about it, midwives still have a hard time letting go of those old pieces of training that keeps us from trusting it.

I still have a hard time. Most of the time, it's simply my client's expectations of me as a midwife and what they expect me to do. As much as I discuss it prenatally, there are still clients who want or expect something different (perineal compresses, wrapping the baby right after birth, etc) than what I believe should be happening. This is their birth, not mine, so I do try to offer them what they desire.

And I think midwives have a hard time NOT doing when our worth is so tied up in all the little clinical things we DO. From routine bloodwork to urine dips to vaginal exams it seems we are going in the opposite direction. Shouldn't our value be simply what we're NOT doing - and how that sets us apart from the medical model?

I had a client who went over her due date and she was asked by a well-meaning acquaintance, "How far over are they going to let you go??" To which she laughed and replied, "Oh THEY? I fired THEY a long time ago. THEY are not in charge of my birth!"

Having this discussion with some clients, it appears that many of them understand the process and conflict that sitting back and doing little creates. However, when we talk about it in terms of other professions, a swimming pool lifeguard, for instance, it's a bit easier to get.

A lifeguard at a pool observes, watches the entire picture. She is there in case there is a need for her skills/assistance. Even when she sees a person struggling a bit, she doesn't jump right in to save them. She carefully watches them and if they do not take care of it themselves, she is there to help.

I am a person that is there for the skills, resources and knowledge that I have. Yet it doesn't mean that I have to use these skills every chance I get. On the contrary, I rarely do. My job prenatally is to inform, educate and support. The clients choose their course of care (testing, etc). At births, my ears and eyes are wide open, but I am holding the space often in a different room from the laboring woman. We check on baby and make sure mom/partner has food/drink, but unless we're asked, we assume that their birth dance should be private.

In the end, it really should be about women not feeling like they owe a debt of gratitude to the midwife, but that they used her as an ally to make decisions in their own birth. When it's all said and done, the parents labored and birthed together - and even if the birth outcome is a cesarean, they made choices regarding their care that left them feeling in charge of their experience.

(photo above taken from a friend's website - I provided support prenatally and postpartum for the unassisted homebirth of their daughter)