I’d like to approach the delicate subject of transports to the hospital from home; mainly for my own reflection and processing. I say “delicate” because for many (midwives and mamas alike), a transport conveys the “failure” of someone or something. In the past, I’ve been the midwife that, I’ll admit, has heard other midwives’ transport stories and thought indignantly, “You transported for THAT?” I’ve also been the mama who had to transport her own non-breathing baby boy at birth. These different perspectives are all a part of the midwife I am, and the one I will become. And just so you know, the subject of “transports” is really the vehicle for discussing a deeper topic….
I’ve had 2 transports in my year and a half of practice. Of course, by even telling you that I am trying to prove something, or maybe it’s to disprove something. That my transports (or lack of) somehow indicates my worth as a midwife. As if I am in control of the outcome, as if these births I attend are all about ME and how skilled, intuitive (substitute your favorite midwife attribute here) I am. These 2 transports, the most recent in particular, have shown me how ridiculous this mindset is. And how if I (or any midwife) operates under that notion, birth becomes ego-centric and also totally disempowering to the woman.
All I can really say detail-wise is that these transports were non-emergent–as in there was no emergency present and everyone was aware of that fact. I can’t explain it but I also can’t judge it. The lightbulb that went off this time around (and I do believe it’s because I missed it the first time around!) is that not every woman I serve will have a homebirth. Shocking! Not every woman I serve will “get” the birth she wants. Even more shocking!
And even MORE shocking than that is, it is not my responsibility to make sure that she does. Because by doing that, I make my own story more important than hers. I make the “homebirth” the goal, I make the “perfect birth” the goal because that is what I want, that is what I think she needs….and if that doesn’t happen, then somehow I have failed. Maybe she has failed. Thinking that “perfect” means something other than anything being WHAT IS.
There’s a midwife who in her worldly and spiritual perfect-ness is desired to be emulated by midwives and other women in general; she may or may not exist, I really don’t know. This midwife is infinitely intuitive, able to be the utmost counselor, able to deal with every woman’s emotional/spiritual/psychological issues in a timely manner so that nothing is preventing the woman from experiencing the most blissful, unhindered birth. I too, long to be this extraordinary midwife sometimes until I realize that I don’t think that’s the point. As midwives, we take responsibility for taking care of mama and baby in as many ways and variations as we can. But birth is NOT about us- we are the guides, the caretakers. We are not perfect either. We are the protectors of the space, and I see that as a huge responsibility.
The true empowerment can only be “gotten” by the woman herself; and in what form that is, we cannot know or judge.
I want to offer a different perspective, both from my eyes as a midwife and a mother. There is a bigger picture at work here. There is a Higher consciousness that serves us all, and to act like we KNOW how things need to turn out is just plain arrogant and egotistical. Who’s to say that a woman needs or should have a certain kind of birth? How is that respecting the path that she walks? It is not my job or my goal to affect change on anybody’s path. We each have our own to walk, and out own lessons and trials and triumphs.
To want to direct someone’s path to look like our “perfect” is no better than to disempower women in other ways. If I am but a guide, but a trusted advisor as a woman enters labor and birth, then it is not my job to feel responsible for where she is or to judge where she needs to go. The ONLY reason we have come together is because we have gifts to offer each other–even if mine is simply being the person that doesn’t judge her for changing her mind, or for wanting pain relief. The second I make her birth a story about my validation, I take her away from graciously accepting the lessons she needs, not necessarily wants. I am just another person that is distracting her from her true self–and a disconnect to that part of her being will affect her birthing, and her mothering and beyond.
As midwives, we love these women and these babies. We do everything we can for them, to protect them and assist them in realizing their own power. Part of that process, part of realizing our OWN power is to separate all of that from the outcome…as undesirable as transporting, or even something like death, might be. We are not that. Our egos cannot be inseparable from the path she must walk, whatever that is.
To me, that is the true meaning of “midwife”. To walk with women with no expectation of feeling our self-worth or lack thereof. To know that we are not a part of anyone’s “perfect”.
Excellent and insightful observation, Maryn. And I totally agree with your analysis of the role of the midwife – the Guide and Protector – perhaps with a bit more experience along the Birth Journey path than the mother has. We are not in charge here. As a Christian midwife, I firmly believe that God is in charge of this entire process, and respect is completely in order.
I have transported for reasons that were medical, social, and in one instance – simply a response to my midwife antenna tingling although there was no data to support the need for transport. That fetus crashed about twenty minutes after the mom was admitted to the hospital, from a placental abruption. Something/someone told me to get to the hospital ASAP since it was about 30 minutes away. Had I ignored that inner voice, we would not have celebrated a birth that day.
If the birth process is not proceeding as “we” expect it to (everyone defines that box for themselves – midwife and mother alike), then to move to a location with more available bells and whistles is the prudent thing to do. It is certainly not what Home Birth midwives are about or what they desire, but in the interest of completing the birth in a prudent and “safe” manner, a transport should never be viewed as a failure, but a transition to a more favorable environment for accomplishing the purpose – protecting the fetus/newborn.
Vicki Taylor, L.M., C.P.M., Mama’s Cradle, Pensacola, FL
Thank you, Maryn. It’s good for me to keep this in mind as I slowly make my way toward being a midwife. I have heard it said by many other midwives, but it seems this lesson is one we all must learn on our own. I hope I can learn from you and not have to hurt to get this important observation through my head!
I really agree with you Maryn. I like to look at my job as a life guard at a beach. I am there with specific skills to observe, teach, and assist when the “swimmers” need me. It is truely an honor to be at each unique birth, and I am humbled when they our grateful of my presence and assistance.
The third to last paragraph brought tears to my eyes. I really wish my midwife had realized that while attending my birth instead of trying to fit me into a mold that she liked to work with. I truly believe if she had just been patient and kind instead of attempting to hurry my labor and belittling me I would not have ended up in a hospital. I did get a completely natural, medication free birth, but still left with a huge feeling of inadequacy and failure. I tried to take the lesson from it though, and I always tell my mama’s they do not need to impress me or anyone else, they just need to do what feels right. Wonderful article!
What a humbling article. Thank you for the gift of clarity that you have given me tonight.
Such a wonderful article. I only wish more midwives would think this way about their role in a woman’s birth. My midwife was insistent upon comparing my birthing experience to her own… so much so that it would have been detrimental to myself and my son had I not insisted upon transporting to the hospital when I did. I hope every midwife reads this.
This is an amazing article. My paradigm has shifted to a serene place. Thank you for sharing.
You can be as philosophical about her transfer as you like, but it’s her privacy you are sharing and experience I hope for the clients she has given you permission to discuss her transfer publicly.. And so you know, it might be true whatever you are saying, but to say this now after that transfer, mean possibly you did not screen, or prepare your client well.
As professional we know sometimes not everyone is meant to “homebirth” but this is something for you as the midwife to try to discover before you take her as a client.
Your lack of experience is showing in this post.
Have you read Ronnie Falcao First baby policy?
http://www.gentlebirth.org/ronnie/firstbaby.html
It’s worth you reading and learning from
The “philosophy” comes AFTER the technical, intellectual reasons for anything that we deal with as midwives. If you are a midwife, you will be well acquainted with this. It bears saying, apparently, that the midwife must exhaust her “skill set”–that which includes emotional and psychological review of the mama. It’s always possible that I could/should/would have done “better”. But, after that has been evaluated and thought through and discussed with the client, the next phase of rationale kicks in. As someone that cannot separate the Spiritual aspect of birth, my “philosophical” post is my real, heartfelt way of taking all of birth (and not just a transport) to the next level.
It is only PART of my job to prepare a client.
Her birth is ultimately her responsibility. That may not be your belief, even as a mother. But a woman must accept responsibility for her body, her baby and her birth.
And as far as screening, we can only be so judgmental with this delicate process, wherein half the time midwives rely on their own fear (or lack of) to pre-determine a woman’s “success rate”. In the absence of a serious medical condition or huge red flag, this “screening” is not for me.
Wanting to call “fault” to the midwife in the event of a transport is also a dangerous business. It is only when we can all remove our own personal stories from topics like these that we will get anywhere with TRULY watching a woman empower herself with the birth process.
What I like about the word midwife is that it means “with woman”. We are with her in her journey, feeling with her and therefore knowing (most times) how to help her, protecting her space, giving her space and time to discover her way to birth and work with the Universal power flowing through her. No one has control, it is beyond us. We bring everything that we know, who we are, what we have experienced to be of service to Life. and we are always learning.
There is way too much blame and lack of clarity as to who is responsible for what.
Thanks for voicing these thoughts and insights.
Thank you for your support, Helena, and others…not of me but of the idea that birth is SO much more than physical circumstance and so much about spirituality and really, being ultimately responsible for ourselves. The midwife “does” all she can, and then after that is just walking with the woman, as you said, Helena. And “yes” to always learning and evolving.