Monday, 22 October 2012

Birth from the perspective of a midwifery student (conference presentation)

A month ago I had the honour of making a presentation at the Ontario Student Midwives Conference at Ryerson University.  As a midwifery student, currently on maternity leave, it was a great opportunity to reconnect with old friends, and meet in-person virtual friends.  It was also a tough place to be given the tenuous position I have as an actual student (more on that another time), and given my topic.  I had submitted two proposals and both were accepted.  One, was an editorial piece I've been working on for a while but a presentation I didn't actually get a chance to make due to a mini family crisis when my 3 year old dislocated her elbow! The other, was this piece below, one that I cried when writing but somehow managed to get through without crying.  Though, I made many of my fellow classmates tear up. Keep in mind, this was written to be spoken, and to be listened to for about ten minutes so it is long and the tone may be a little different from my "blog" writing.

Being a midwifery student is hard work.  Maybe harder then we thought it would be.  Maybe not.  Those of us who are mamas have so much to re-learn, how to see things from the other side, how not to interject every five minutes with “During my births…in my pregnancy…when I was breastfeeding’  and those who aren’t mamas have to learn that they are not at a disadvantage so stop feeling like that and move on!  I do remember, in my first year, during With Woman actually, thinking, how amazing it would be to have all of this information before having a baby.  To be able to tap into all of these extra resources, and wealth of knowledge.  Um, yeah, not so much.

As I was preparing to write this presentation I spoke (aka, Facebook’d) with a few mamas from the program.  They had vastly different experiences from me and from each other.  Planned home birth.  Planned hospital birth.  Things went according to plan.  They didn’t feel like they’d had any amount of pressure or expectations as an MEPer.  Maybe it was just me then? And then I read an amazing paper by one of my classmates.  She had looked into the experience of giving birth as a birth professional.  Of the women she had surveyed, all of them a birth professional of one kind or another, many had felt that there was a certain expectation around the kind of birth they were going to have, felt that there knowledge both helped and hindered them, and that it was hard to not be in control. 

Now, I’m a planner.  To a fault.  But I had worked really hard at not having a birth plan, though every one does to a certain extent.  I felt I had learned a lot about myself, my body, the way I give birth, and my babies during my first two pregnancies and births and during this pregnancy.  Unbeknownst to me at the time, I would come to learn a lot more about myself.

My girls...and Mark like to dress up as Superheroes. And as a mama you feel like one. I obviously have an innate power, two really: the ability to incubate and nurture a human life inside my very own body and the awesomeness that is lactating boobs!
So when things went a little sideways with my planned home birth I felt like Supergirl faced with kryptonite. Actually no, I wasn't on the ground squirming in pain, I was more like WonderWwoman being harnassed by her own lasso. In case you don't know, that's her main weakness.
I initially though of this analogy to bring some humor to my story, keep myself from crying, but the more I thought about it the more accurate it seemed. As a mama-midwifery student aka Wonder Woman, it was my own knowledge that was tying me up and forcing me into the ambulance and to the hospital. From a midwifery student perspective, that was the ultimate villain's lair. But from a regular mama perspective, it was the extra knowledge, the extra help from fellow students, the "extra" that was tying me up and imprisoning me in my decisions.

You see, non midwifery types, still amazing mamas of three, Breastfeeding, baby wearing, loving their kids mamas, they did not understand why I was so defeated at having given birth in a hospital and having stayed there for 23.5 hours. They understood that it had not been part of the plan; but these women, whom I didn't know all that well, simply said " but you made the right decision for your baby. You didn't really have a choice. Not one where one or more of the outcomes would have been acceptable.". My friends, the students, they all had a lot of different things to say. Sympathy instead of empathy, sorrow instead of support, shock instead of agreement.

So why didn’t I have a homebirth? Poop.  I suppose the more appropriate way to say it, is that there was meconium.  A lot of it.  Thick, pea soup sludge seeping into the birthing pool. 

And the reason I had to stay at the hospital was a GBS positive screen with insufficient amount of antibiotics administered prior to delivery. And here’s what I have to say to my fellow midwifery students:  Stop.  Stop thinking about the odds ratios, the research, the facts, the myths, and the alternatives.  As your classmate, I know now, and knew then all of that information. But what I also knew, was that the institution I gave birth in had a mandatory 24-hour stay policy for mamas and newborns with a GBS positive screen or they would call CAS. 

CAS.  These three little letters.  Letters every parent – good or bad – dreads hearing.  Imagine, if you will, having just given birth to a beautiful, perfect little girl.  A beautiful birth.  An emotional high.  Conflicting emotions – the “wrong” kind of feelings are bubbling below the surface but you are pushing them down as you stare into the eyes – are they hazel?  Are they brown? – of your daughter.  Your midwives doing post partum things.  Your partner, leaning over you and your babe, kissing your head, pushing back your hair.  And all of a sudden arrangements are being made for you to stay overnight.  It doesn’t matter that the odds of your baby being affected by GBS are 1 in 300 to 1 in 1000.  It doesn't matter that you had some IV antibiotics.  You are free to go.  But if you check your beloved newborn out against medical orders, you will awake to Children’s Aid Society at your doorstep.  Now, consider again all of the informed choice, research, self-rightousness, strength, mama-bear protectiveness of not just your two older girls sleeping soundly at home, but of this new life you have never been away from.  And imagine, for a full minute, the idea of a stranger holding that baby and seriously considering that you are unfit.  

Being a midwifery student can really screw with your head and your heart sometimes and this was one of those times.  I knew my baby was fine, and safe.  I knew what to look for.  I knew the odds.  I knew my rights.  And I knew that my girls were going to wake up and be surprised at best, heartbroken at worst, that I wasn't there with the new baby.  But none of that compares to the even the most remote possibility of having to deal with CAS bureaucracy within the first 24 hours of my newborn’s existence.  I mean, honestly, I wasn't planning on letting the grandparents in the door!

As I prepared for this presentation I was searching for images and I came across the cover for a children's book about homebirth. And I came across gorgeous waterbirth photographs including ones of mamas with all of their children clambering to look at the newest sibling. And looking at these images, breaks my heart.  Every. Single. Time.  And there is no excuse for it.  When I speak to my partner, when I go over my story, when I speak to other mamas who aren't in the midwifery circle, it’s not really a big deal.  I had a beautiful labour.  I had a beautiful birth.  But most importantly, I had a beautiful baby girl.  But the fact that I read that damn book every single night for months, watched homebirth videos, and practiced birthing sounds and positions with my girls – all for nothing, that breaks my heart.  And, you can argue that they are young so they are fine.  To which I say, my middle monkey, she had to be reminded that we got to keep our baby.  And my oldest monkey who saw the middle one born, was also heartbroken and angry and we had a good long cry about it together. It’s hard to hear about other people’s wonderful water births with their children present because I didn't get that.  But that’s the midwifery student in me.  The mama in me, is grateful for having three healthy daughters.

 Sometimes I think that I’m not going to ever fully get over disappointing my girls by not having a homebirth for them.  And then, Mark reminds me that my girls are six and under and that sometime much sooner than I would like I will disappoint them in what appears to be a frivolous way to me – like, saying no to an Abercrombit Fitch sweatshirt, or to party they want to go to – and that will be the moment that sticks with them not that they missed Baby C’s birth. So, while many mamas probably dread the conflict of the teen years, I say, bring it on, it will totally  help me heal!  

So what does it mean to give birth while an MEP student? And what doesn’t it mean?
  • Maybe because I wasn’t in Clinical Skills with my peeps, it didn’t result in numerous belly palpations, pulse takings, fundal measurements or fetascope listenings.
  • It did mean that during Bruce’s lecture when he put up the graph of oral contraception – the one explaining why you have to take your pill at the same time every morning – even if you just hosted the end of the year party and your children aren't home to wake you up - that 50% of the class will turn around to shoot you a knowing look, and laugh.
  • It does mean that at least twice you will be told you are huge and you will wonder how a future midwife feels like that’s an okay thing to a pregnant woman
  • It does mean that you have a plethora of information –far more than even a well educated mama
  • It means that you have expectations of being with a midwife, most likely a doula, that you will not freak out, that you will not request pain relief,
  • It does mean when you go for your ultrasound and the technician makes assumptions about your sexual orientation, your desire to have the baby, the man in the suit being your husband, you hear Nadya’s voice in your head gently reminding you how you should never ever make those assumptions.
  • It may or may not mean that you will cook and serve a delightful vegan meal for a dozen or so of your closest friends and family who all invade your house immediately.  Personally I came home and crammed my belly full of braised pork shoulder curry and rice.  And a Strongbow. And didn’t let anyone in the door for 48 hours.
  • It means that when you are stuck in the hospital bed checking your facebook, one of your school friends will notice that you are at the same hospital she is making rounds in and will be the first to visit you.
  • It means you can argue with the pediatrician and convince her to let you leave the hospital early.
  • But it also means the L&D nurse will call you “one of them” for not letting her bathe your baby.
  • It means that when you are forced to make a quick decision, it’s no longer impulse nor even informed choice that is guiding you, but information overload, and graphic visuals, anecdotes,  facts and figures clouding your brain.  And that no matter which way you lean, someone you go to school with, will offer their unsolicited opinion telling you that it was a misinformed decision.  And they do so because of the information in their head, not as a judgment, but it comes out very much as a judgment and a sentence “Guilty of not fulfilling the MEP student edict of perfect home birth!”  "Guilty of allowing the institution to dictate what you could do!"  "Guilty of submitting to the will of non-midwives!” 
  • It doesn't mean that any of your decisions would have been different. Because you are a mama first.
  • It doesn't mean that you are at a disadvantage.
  • It doesn't mean that you are being judged.
  • It doesn't mean that you failed in some way.  Unless you know, you actually failed.  But despite my hormone addled brain, I managed to pull off decent to hey-not-bad grades in my courses!
  • It does mean that you will receive lots of love from wonderful women who will make the trek all the way to Mississauga just to visit you and your girls.

Baby C is my baby Hulk.  That is to say, she’s a happy baby, until she's not.  (And you don't want to make her angry.) Which is to say she is perfectly healthy.  Ultimately, there is no guarantee that she would have been had I stood my ground and not gone to the hospital.  But just looking at her, while she nurses, or laughs, or yells at the floor for not letting her defy gravity, I can’t say that I would make any decision differently except for – and this is the most contentious issue – maybe, just maybe, planning on a hospital birth.  If I’d planned a hospital birth with my girls present then they would have been there for the birth.  But, that wasn't really the images and experience I wanted for them, for me, for us.  R has one homebirth under her belt already, and while L will never get to see a sibling being born at home, neither will Baby C just by being the baby.  But, I figure most of my friends and classmates are younger then me and a few of them will probably have babies of their own one day – so hopefully, they can witness that.  You don’t mind do you ladies? 

1 comment:

  1. I was one of the front row students with tears in my eyes! I'm really interested in hearing more about your "tenuous position I have as an actual student (more on that another time)". I'm in year 1 of 6 of the MEP and I hope to have at least one more baby. Of course, I'd also like to graduate some day! Thanks so much for sharing your story with us all.