This post is one in a series of pieces RH Reality Check is publishing to highlight National Midwifery Week 2010 (Oct 3- 9).
My first experience with a laboring woman (my aunt) left me running for my room and making a pact with God. If boys and sex were what caused that pain, I promised I would never have either. I asked God to protect me from both. I was nine years old.
My next experience with birth came ten years later. I was a junior nursing student at Georgetown University at the beginning of my OB clinical rotation. My classmates and I were being assigned patients and our clinical instructor said:
“There is a patient who is in very early labor; only one centimeter dilated. It is her first baby and the charge nurse does not think she will deliver while we are here. But – she is alone, and nervous, and she really needs someone who can be with her and talk to her.”
Being the loquacious person I am, everyone immediately looked at me and it was unanimously decided that she would be my patient. Lo and behold, four hours later I was the only student to witness the miracle of birth that day and it was an awe-inspiring experience to say the least. The new mother was grateful for my presence and I was delighted. The registered nurse I worked with was fabulous. The entire experience was unforgettable. I knew right then - I wanted to be a labor and delivery nurse.
In 1995, I began working as a labor and delivery nurse at a public, teaching hospital. We served the highest-risk patients of the city. We were often understaffed and overwhelmed with the number of deliveries. While working there, reality set in. Maternity care was not always the quiet, comfortable, pleasant experience I witnessed as a Georgetown nursing student. It could also be tough, rough, gritty, and scary. It tested my stamina, my sense of humor, my skill set, and my knowledge base. It made me take a close look at my personal prejudices and ideas around birth, race, drug addiction, women, men, sex, and relationships. It forced me to examine the truth of who I was and opened my eyes to a world of joy, heartache, life, death and more.
Because this hospital was a teaching facility, many of the women unfortunately became teaching fodder. Their prenatal care was impersonal. They were simply numbers in a box. Patients were offered no prenatal education, were ill-informed and often arrived not able to tell us if they were a “T” or an “L” patient, each letter representing a different residency program. I was always amazed by this. I would think to myself, “I know these women are not stupid. Why are they unable to remember one letter?” I attempted to raise this concern to coworkers and was given the “Oh you know these young, uneducated, minority, drug addict, etc …” type of comments. I had my doubts. It didn’t make sense to me. These girls, and women, were not stupid and I knew that. Still, I was confused.
I knew there had to be another way. I knew that laboring women with absolutely no familiarity with their provider was wrong. I knew all the screaming and yelling, the bright lights, the long pushing, and loud counting was not right. I knew it was not right that doctors had not a clue as to the name of their female patients. I didn’t know how to make things right but I was sure – in my soul, in my spirit, in my gut – that there had to be another way. Something different, something better. Birth was not meant to be this way. Babies were not meant to be brought into the world amidst such chaos.
And then it happened.
In this often chaotic environment, among the many crash cesarean sections, crack-addicted babies and “baby mama dramas,” among the tears and laughter, the joy and the pain I caught my first baby (and my second, and third, and fourth….). It was in this same environment that I witnessed my first midwifery-attended birth. And again, like the life-changing experience I had when I was a student at Georgetown, I knew immediately that midwifery was my calling. This midwifery delivery was so different from the loud, rushed, impersonal resident deliveries to which I had become accustomed. I had always known there had to be another way and finally I was there to witness it. I was overjoyed.
That was just the beginning. Fast forward to 1997 and there I sat: the youngest in a class of twelve midwifery students at Emory University in Atlanta.
While studying midwifery, I learned that I had a great-great aunt who had been a community midwife. Midwifery was in my blood. I learned that when treated with respect, as a person and not as a number, women and girls of any race, of all socioeconomic classes and of any age could vocalize their wishes, and create an empowering birthing experience. I learned that when women feel respected and genuinely cared for they will keep prenatal appointments and ask questions, and learn about birth - all of which improves birth outcomes. I learned that I was not in control. I learned that birth is an intricate interplay between mother, fetus, and the universe which should not be feared but respected. I learned that there was another way. It was called Midwifery.
Because of a number of necessary professional choices, today I sit once again working as a labor and delivery RN while longing to get back to practicing as a midwife. The current climate in my state for practicing midwifery is not the best and opportunities for working as a midwife are few and far between. I was recently assured of this by a physician who said with venom,
“Nicole you are a midwife?! Well, you know, midwives have a very bad reputation in this city.”
This was in response to me asking her if she needed any help in her office. For a nurse practitioner, “Yes,” she said. But for a midwife? Absolutely not! I felt like it was 1940 and she was calling me the “N” word. But no. It was the “M” word and her tone was just as negative.
Regardless of the “reputation” of midwives in this city and around the country in many places, I am proud to call myself a midwife. I believe that it is truly a calling and I feel blessed to have received it. Often, as I work as a labor and delivery RN, I am asked “I heard you used to be a midwife?” I tell them, there is no “used to.” While I continue to temporarily work in the role of an RN, the spirit, the energy, the way of birth that I believe in has never left me. I continue to be “with women.” I am a midwife and I am proud.