Listen and Learn

Students are eager to learn and eager to listen. When that stops and they start yakking, it all changes. Sometimes it is as much the student that learns as the mentor themselves. Birth is the time when all the energies of the heavens and the earth open and we are standing at the portal. As a midwifery student, reverence your experience and your mentors. They are sharing with you something very special to them. The mother who gives you the opportunity to learn is giving a great gift indeed. She is allowing you to grow and to progress into what she choose to have attend her at her birth. Celebrate them and their courage and remain humble about all you do in midwifery for it will constantly keep teaching you if you are willing to learn.

Birth can be Amazing!!!

Every woman has her journey through birth. Some celebrate it and others walk a path of great healing. When a woman has been born by C/section she has no memory of birth and may have to traverse this uncharted trail with few road signs. Birth is imprinted in us. Whether we have been born with nature, drugs or surgery.  As a midwife it is helpful to understand who a woman is and how she was birthed. You can be a guide to her along her path without telling her where to go but giving her guidance. You can not lead her but you can walk by her side reminding her that she is on the right path.
 Some women can have a birth that they find simply Amazing to experience. Even for us as midwives it can be an amazing experience with them No matter how a woman births she heals the past, creates the future and becomes the very best of herself. You are there to hold space for her to experience her own truth so long as it is serving her and she gets to the baby safely. Be good listeners and listen to the unspoken words that need to be voiced. Encourage her to voice her feelings when a birth is struggling to find its rudder.

One mom asked me today if I am every afraid of birth? I said no, I trust birth and it shows me that, but then birth is not about me, it is about her. Two babies later and she finally trusts birth. Both born at home.

Suturing and the fun begins!

Our midwifery groupies came prepared to learn the art of suturing this week. In midwifery, we believe and have seen the results of helping women to maintain an intact perineum. Women are meant to stretch and blossom open to let their babies slide on through. We have learned that an open mouth and throat have a synergestic relationship with an open cervix and open bottom.  It is hard to relax your bottom when your face is all scruntched up.  Women want their perineums to stay whole. We as midwives understand that women are also created to allow things to give in the right places at the right time if the baby needs them too.  Episiotomies that create an opening by cutting the perienum is perhapes easier to sew but much more difficult to heal from. There is more pain and discomfort for a woman for sometimes months afterwards.

When a woman's own body lets a small separation occur, it has given it's self the ability to heal back together better. Sometimes these saperations need a little anchor to help them stay in place until the body can knit the tissue back together again. Yes there may not be a perfect straight line to sew back together. In fact that perfect straight line is harder for the body to keep in one place so that it heals.  And all too often a cut becomes a bigger tear.

So as midwives we learn to approximate tissue back to it's normal place. We anchor it with suturing thread and we give numbing medication to the area if needed to help with discomfort.

The midwifery students are practicing on roasts using sutures and instruments with sterile fields and yes even head lamps. We cut a hole out to simulate a yoni and asked them to do interrupted, basting, and figure 8s. The week before we did knot tying with instruments and yarn.

Nothing can replace the actual experience of a womans yoni and the real thing but this helps eveyone to get familiar with the feel of the instruments and the mechanics of suturing without having to do it the first time on a freshly birthed mom.

Apprenticeship is still the art of midwifery. Sisterhood among students and midwives and among the midwifery community as a whole, is the heart of the midwifery. 

Students and their gloves

A baby just isn't a baby without that beautiful organ the placenta. Here are out students getting into it with a placenta. Gloves you know are always important to the work. Here you see the membranes. Placentas are actual the babies. Some people forget that this is something that the baby made and it was life sustaining. They are facinating and no two are alike. Like a snowflake or a raindrop they are as individual and the individual they come with. The cord is this amazing spiral that allows it to stretch. The cord attaches firmly to the placenta like the roots of a very wise and strong tree. Thank yo placenta for doing the work of a whole planet for the creation of a universe.

Two Babies and Blisfully Beautiful

This week a set of twins were born at home in the water. This mother was full of trust in her body and her babies. The team of midwives, working together to one , stay out of her way and the other to watch over the well being of mom and babies. A beautiful labor, a sweet and simple birth with power and conviction. They were scooped up, loved abundantly by mom, dad and family, Mom took to two like she had done this many times before. This picture is of her and her babies, next to each other at 30 hours old. They were calm and gentle babies who had marinated in a loving mothers hormones.

Women share their excitement and their well being with their babies both during pregnancy, birth and breast feeding. When a mother believes in this process then her babies do to. Her birth is smooth and straight forward. And her mothering is too. Twins can be smooth and straight forward in the same way that a singleton can. Yes there is important issues to watch over during the prenatal time , birth and post partum. When the babies are growing well, moms BP is good, she births after 37 weeks, and the presenting baby is head down, each baby has it's own amnion, then the rest is usually good. There must be trust on the mothers and the midwives part.  It is wise for a midwife to have at least one other midwife and experience assistant there if not two. You have three people to watch over so you need three skilled care providers, just in case each needs attention. You need two complete set ups for babies and that includes two O2 tanks and resusitation set ups and everyone is certified in NRP.  It is best if one of the midwives has already done a breech birth and that all have reviewed breech.

Twins and breeches are a variation of normal. So long as your know what is normal for each and what the condraindications are for each. The one of importance is skill level of the midwife. The other is the babies as mentioned above.

Remember that two babies bring a large site of placenta so bleeding is an important element to watch. After birth cramps are much worse for most multips for good reason. Then there is the work of breast feeding two and the demands that time is on a mother. If she has had babies before especially at home, things will go well. It is important to watch their weight and help mom to be aware that often one baby may be more of an aggressive asker and the other may not. She will learn to know her babies and know what their temperment is. Keeping track of pees and poops helps. The other help is someone to take care of the mother. To be sure she eats and drinks and her time demands may challenger her to be able to.

So when that opportunity comes to you as a student or as a midwife. Follow with another midwife who has gone before you. Let your community know you want to take on a set of twins and would they support you and follow with you. That way you have all the insight of your community to help you. After you have done a handful you will get more familiar with it.

Size is not what it is all about

HBAC with celebration

Gotta love those feet

A mothers love is full and heartfelt

Some babies are big and some are small. Some moms are big women and some are small. But what if there is a big baby and a small mom? What about a mom who is having a HBAC? What about a mothers love for her baby and the will to birth well. Birth is designed to work even if know one was there. So why are we there then. Because sometimes there is a need for the skills a midwife knows and must use  to keep everyone safe. But some midwives can be NEEDED at births too much. Becoming a midwife means you understand what to do and when to do it. Your best births are when you are needed most as good clean up and assesment of normal. But when those births come that need your skills and your wisdom, use it wisely. Make good decisions and always remember to support the mother in her wisdom and her progress. Your words are powerful at birth. I saw a twins birth on a DVD recently and the midwife said to the mother " your at 8 cm you go stuck at 6 cm last time".  Can you guess what happened next? She was stuck at 8cm for 8 hours. Use your words carefully women.

Some are just meant to be big

Some labors are slow and some are fast. What makes them that way is dependant on the woman, her hormones, her babies position and her emotions. When a labor is slow and there is lots of help with repositioning the head with doola hoolas and with homeopathy and walking. Patience and perseverance of the mother is what works. " I am not a quiter" she says. Does that mean we as midwives support her in continuing at home? Yes if all is well and baby is happy and mom is still got energy. When all is said and done and the baby is born lusty and well with a nucal hand, it is then that you know the woman was right, she was determined to succeed and when she says she needs to get up and move, believe her. It is her body and baby that she is listening too.

My mom and me worked good together.

Sometimes you have to help a woman know when the path will not lead her to her best goal. That is where you are her guide to trusting the process that this birth is leading. The more you expect the best the more often the best will happen. Instill that in the women you work with. And remember the oxytocin works best if you keep the women inside herself and quiet.  Babies come out.

Trust..... it IS what is takes to be a midwife.

Women must find within themselves the ability to trust what they and their body and baby know to give birth. For some this is easier than others. For some it comes as a huge milestone of life and when they get there, it is an amazing triumph with tears of accomplishment. Sometimes even we as midwives cry for the gratitude that we were there to support and hold space for this woman to learn the trust within her.

We as midwives must trust too. To trust means to know what is the safe parameters and to support the process of a woman so far as she and the baby are safe. This is why you learn to know how to assess what is safe and what is not. When to help a woman move forward and when she is moving forward all on her own.

Patience is important in being a midwife and so is wisdom to know when too much patience may lead to an out come less favorable. Patience can bring a baby down into the pelvis and wisdom can ensure it comes down safely. Women need help to be patient and persistant sometimes. You are the wise woman that reminds her of the path she has choosen to go on especially when she is deviating from that and is looking to you to guide her back. Patience is also the wise woman who waits and does not intervine when the mother is on her path and it is working and you must just wait. The baby will come.

I want to impart to you the ability to make wise decisions when to wait, when to be patient and when to give guidance to a woman who needs it. Listen to her, listen to your wisdom, listen to what you have learned and make a good call. When you do, the baby will come, mom will feel empowered and there will be positive outcomes.

Timing is Everything

I have wondered how a midwife decides to start becoming one. I know for me it was because someone invited me to a birth at home. For many I think it is when they have a baby at home. Because this is such an empowering experience they desire to tell the world because it has changed their life. Many woman will go to classes and learn and especially be passionate at telling others about this option. Some have had both hospital and home births and want other women to understand the difference and why they must choose home.

But every woman has her own path to follow, her own journey to walk. Like birth, know one can carry her there. She must walk this on her own two feet. There she will have supporters that will guide her to keep her on the path which leads to the best experience, she must trust that path that will lead her to the goal, serving women who also choose to walk on their own two feet to their babies.

Some women want to stand on a box and put down the medical establishment by validating that they do things that cause problems. But the work of a midwife is to support women in learning about their own power and bodies and to support them to keep them healthy and well. A midwife is there to walk along side a woman to keep safety and hold space for trust in birth and her baby. We are not midwives because our work is to put down the medical establishment. That is not only a waste of time and energy but energy goes where attention flows. We as midwives and students must focus our energies toward the goals. Building the maternity care which supports normal healthy women and babies in having optimum outcomes.

A cute picture

 We get to spend time with women who are totally in there power and then see the most beautiful sites in the world. A small little newborn. Then we acctualy get to remember that we were there to welcome them when they made there first cry, their first look into their moms eyes. We get to celebrate the beginning of life and the miraculous experience that this is. Yes we get tired, yes our family has to sacrafice for us to do this work, yes we never know what kind of chocolate this birth will be like, yet we trust, we love and we give our love no mater what.

 Women must trust themselves and their baby. They must trust their midwives. They learn to trust nature.  They learn to mother and trust their mothering.

Thank you women and babies for allowing us each to learn, grow, understand and trust life as it begins. You a students are on this journey to KNOW that birth is trust worth and expect it to be. You are on this journey to learn how to know when to support, when to help and when to stay out of the way. You must learn to recognize when to stay home and when not to. Learning to trust brings everyone into their truth at a birth. When you prepare them ahead of time that this is their work, they can accept their work, own it and walk with it. It is only them that can do it, not you.

Sometimes the baby is trying to tell you something

So it is a head postiton and a taught bag. The cervix sometimes can only do so much without the help of the baby. When the cervix is 6-7 cm for a week then you get lots of contractions and the water bag is taught and the dilation is going no where...... maybe it's time to break the bag. Swooosh and out the baby comes in 20 mins. A wise midwife once said " the waters gotta break sometime". The most important thing is to know the right time to do that so that the baby comes and all is well. As students you will learn when the right time is and yes you will have times when you are not sure. Remember this, if the cervix is dialated to 6-7 and the mom is contracting so that the bag gets a bubble of taught and there is no progress, consider it. If you transport because of a "lack of progress" the first thing they are going to do when you get there is break the bag and have the baby. Baby must be head down and at a -1 to 0 station too. Then swoosh the baby is out. Be smart, review what you have at hand and then be a midwife and get the baby born.
Oh an on a more humorous note... I really like the hard black tubs we use. Then are sturdy and rarely spring a leak. Yes they have had a leak of two but the blow up tubs are just asking to have a hole. The tub we used got three holes before we ever even birthed in it. Off to the store at midnight to find patch kits which ended up being a metal water proof tape because we couldn't find any. Now mind you the company will send another tub but that is not something a baby is willing to be patient for.

Wisdom of nature or patience is a key

I pass along the wisdom of nature that like turtles who grow in their shells and must hatch themselves, so must most human babies. As I am awaiting the birth of yet another " grandbaby or niece" I am reminded by the wisdom of her knowing that time is important to allow all good to come about at her birth. I believe that we also have an agenda to bring to the table and life must dictate some of it.

To induce or not to induce is a question. Unless a woman is overdue or her blood pressure is questionable  by midwifery standards,  why then would be induce a woman. Is 280 days the perfect day for every human baby to be born? No! The clock is an illusion and the timing is dependant on many factors. First that so as a woman lives so shall she give birth. Who is she and how does she do things in life. Second, what is the moon up to? It does play a part as does some cosmic door that opens and lets people in and out. Third, what are the emotional drives that move a woman to her path? Every woman is different. The path to ten centimeters is different for every woman and every baby. No two are alike. The only thing we know is that they do.