Its been a very long time since I have written anything. I had a bad experience with a mum who had contacted me from afar and asked me to deliver her in a neighbouring country. Needless to say it did not work out and a hard lesson was learned in the process. I will leave that to one side for now as I did reflect a lot on that particular experience but I am still not at the point where I can share that reflection. It very unfinished because I was not given the chance to have closure. Of course that’s life and I have done the best I can to create value from the experience but I feel writing about will only leave me sounding very negative, which I am, and I honestly don’t want to be.
In this blog I want to share something I feel is very interesting. I have seen this over and over in my practise here in Spain and I really want to throw it out here. I hope I get some midwife feedback on this one.
As students and midwives we are told and begin to expect that birth is a long process and this is all the more true for first time mums. We expect these mums to fall into guideline birthing times of between 12-24 hours of labour. My own team often tell first time mums that its very normal for them to have 24 hours of pre labour and then 24 hours of actual labour, what ever that is. But this has not been my experience in my practise. In the 3 years I have worked here I have had as many long labours, eg over 10 hours, as finger I have on one hand. Granted we deliver about 30 women a year but still something does not add up.
My last few births with first time births have all been under 8 hours from beginning to end. Most of them have been 5 hours of less!! All of the mums are different ages, different cultures and races but the one thing they have had in common is the fact that I have been their midwife. Okay, I know how that sounds so let me explain that statement.
As I have grown into my practise I have realised the special gift I have within myself that only I have to share with my clients. This gift is the gift of my heart. To each of my ladies I open my heart, ears and arms. I listen to what they need on an emotional level to be able to really relax and enjoy their pregnancy experience and birth and I do my best to support them in having this. At times it is giving weekly massage, doing weekly guided breathing and relaxation support visits or just letting them talk through every fear worry and doubt of which after I supply good evidence for them to read to dispel or explain the basis of their concern. In short I really become their ‘professional friend’. I make myself as available as I humanly can and give them the support they need up till their birth and after until 6 weeks.
But this relationship I develop with them, I believe, actually enables them to labour well and with very little impediment. They trust me and really learn to trust their own bodies there by labouring well and efficiently.
Okay, so that is also a big statement I know so I will give two examples to sum it all up. I am not sure if I blogged about this woman before, but she came to me at 32 weeks pregnant. She was angry with the medical system and very frightened and unsupported. The time we spent talking in my office convinced me that this women really just needed a hand to hold. She had all she needed within her to birth well and she just needed someone to walk beside her reminding her step by step if necessary that she was everything she needed to be to open and allow her baby to enter this world with love and dignity.
I gave her all the support I could and after a few sessions of massage, relaxation and bi weekly chatting through all she need to chat through, she went in to labour, laboured and delivered her beautiful boy within 5 hours!. Her birth was beautiful and powerful and as she wanted it to be, hers.
After her labour she told me that she felt she could manage in the tough times of the labour because I was there. I understood this to not be about ego stroking but more about the work we had done together to prepare for the labour itself. This work and the relationship we built in that time was a great support to her. Of course the question is, what if I was unable to make it to her birth? Would she still have had such quick and successful first birth? I can not answer that one, but I was there and it was a beautiful experience for everyone present, for the most part.
The second experience was with a lovely young first time mum who was actually very relaxed with her whole process. I believe she took me on as her midwife because I showed the same confidence in her that she had in herself. Her husband on the other hand was very nervous and not as confident in the idea of home birth. over the 7 weeks we had together, I listened to all of his worries, doubts and fears. I supplied him with as much information and evidence based literature I could find to support his learning process and I always welcomed his enquiries with respect and dignity. I did my up most to make sure he understood that I was there for him as well as his partner and that he understood that I was only the support. This birth was theirs and his role was second only the hers in the whole experience. He was worried he would not know what to do when the time came but I always assured him that he had what he needed to support her. I could see this in their relationship and I had no doubt he would be brilliant.
In the end he said he felt secure with the home birth because he knew I was supporting them. His wife laboured and gave birth in 3 hours. He was a fantastic support, just an absolute star. She was secure to let go and labour in part because he was really happy that we were all together. The question arises again, if I had not been there would it have made a difference?
Having had 3 children myself and having spoken to many mums about their experiences, I know with out a doubt that the person supporting you in labour will effect you and your labour. If you feel judged, not supported, watched or just uncomfortable with the people in your space, this can slow your labour. So I guess if I had not been there they would have had a very different experience indeed. But I was there and that is my point.
I know there are some who would say that if we become too close to our clients we can actually take their birthing experience away from them. I agree with this. It is a fine line to be that professional friend or lose your self in that relationship and lose your professional objectivity. I have been there but I am lucky to work in a team and am supported by other professionals who can help me keep things clear.
At times I do get to close to my clients and our relationship changes from professional friends to actual my friends. I do not regret this or feel it is something to be afraid of. We can find friends in the strangest places. It does not happen often. What usually happens it that the mums move on in their lives. They may come back for following births and that’s a great joy.
I am fully aware that my work situation as a midwife in my practise if nothing like what happens in hospitals or in community midwife, although I have seen lovely relationships with community midwives and their ladies. From my point of view I have all the time in the world for my clients and it makes it easier to develop the relationship that supports these quick and successful births. But I am not convinced that its about just one person. I think it is more about the mothers feeling listened to and supported by who ever is caring for them, from the start of their pregnancy until birth and six weeks after.
I feel its about midwives being allowed to be midwives and not being forced into the role of obstetric nurses by a sausage grinder system that is just coping with one birth after another. I do not believe any of us become midwives to end up working in that kind of away. Of course we can talk about financial constraints and targets and all of these very real things but in the end it comes down to the midwife to remember that every women is just that a woman, and like us, needs caring for and dare I say it, love or at least respect from her midwife. Its not always easy to find it in ourselves to give out and some women may not be very lovable, but the process she is undergoing is. Its the process of bringing life into this world and no matter how many scans or tests we do, its still and awesome thing to be a part of.
I remember as a student, well I was so very lucky to have some of the best mentors in the world I am sure, but my community midwife mentors really taught me that no matter what the time or financial constraints midwifery was truly about being with women. I marvelled at how my mentors could make a booking appointment feel more like a chat, just by offering a cup of tea to the mum. Or how with a book full of visits, no mum was ever made to feel rushed or a burden. How going the extra mile was a daily occurrence and how mums would joyfully come back to have their consecutive babies with my mentors greeting them as old friends with a feeling of coming home in a kind of a way.
Honestly, these midwives kept my spirit alive as a student and I am what the kind of midwife I am because of them.
Its not as easy to bring that personal experience of support to mums in the hospital setting, but I was also so fortunate to work with midwives who had this gift in spades. There were many times when on a busy ward with all hell breaking lose and our ward having to close because we were full to capacity that our ladies never knew a thing about it. Once my mentors entered our ladies room all the stress was left outside and a beautiful loving birthing space was created and maintained by these amazing midwives.
In those times as well, births flowed and women birthed well.
What we give is so important no matter where we are. Its woman to woman and I have found even though I may be exhausted, when I give I really receive it back to give some more.
Any thoughts?
The Barcelona Midwife 