Tuesday, December 14, 2010

Balancing Body and Heart

One of many lessons I am sure I will need to learn and possibly re-learn. I got a call tonight from a family member. She thought she was having a miscarriage. She was sobbing, scared, uncertain, hoping for some understanding. I asked her to explain what happened. I asked her how she felt. She told me how her body was feeling. I tried again. I asked how she felt emotionally. She said she felt like something was wrong.

Given her history, I told her to always follow her gut and to go to the hospital. I asked if there was anyone I could call for her. I spoke to her fiance and told him to get ready and go. I told them that neither of them caused this, if it was indeed a miscarriage, and that there was nothing they could do to prevent it.

They live in another state, so taking care of the body was the easy part, but did I give enough emotional support? I listened. I told of my own miscarriage. I let her know what to expect at the hospital. I reminded her that I love her. I insisted that she did nothing wrong. I told her that her body was doing the right thing. All this and maybe I skipped something? Maybe we talked about her body too much. Maybe not enough. This is a delicate balance. One I hope to someday be eloquently accomplished at.

The First One, Officially

I wrote this for a Women and Gender Studies Class. Honestly, I can't remember what I named them in my first post about them, so here they are Sunshine and Joseph. This happened quite a while ago, but I am also a student at ASU, so my studies get in the way of my blogging...

I had only met the expectant couple, Sunshine and Joseph*, twice before labor began. Molly, my preceptor, and I began our drive to Sedona on a warm October Sunday morning. We arrived at their small compound around fourteen hundred hours. Joseph greeted us at the door and walked away, leaving us to fend for ourselves. Molly was familiar with the house, so I followed her lead to the restroom then the sitting room where Sunshine was waiting. The sitting room faces the wild sage brush speckled, red rock cliffs of Oak Creek Canyon. I envisioned the ideal, serene birth Sunshine wanted to have, candles lighting the twilight dark, Enya softly chanting nonsense from the corner stereo. Jade, a boy child according to the Spirit Guides, would be born at the first light of dawn in the birthing tub, facing east, filled with warm, lavender-scented water; the sun and the son would arrive together to greet the new day.


Sunshine is tall woman with long wild brown hair she lets flow down her back and over her shoulders. Her voice is childlike, with a volume barely above the whisper of a summer breeze. I had to strain to hear the questions she was asking Molly. Molly had warned me on our two hour drive that many of the questions Sunshine and Joseph would ask were questions they had asked many times already. Brianna, Molly’s ten year old daughter chimed in from the back seat, “Yeah, like where the cervix is located.” Children of midwives are often very knowledgeable of female parts years before their peers. As if on queue, Joseph began relaying to Molly that Sunshine had definitely “opened up” since the last time Molly was there. Molly, as she had done in the past, asked Joseph if he had done a pelvic exam on Sunshine. To which he answered yes, he eye balled her “down there” with a flashlight, like he had been doing all nine months, and this week, it was certainly “more open.” I suppressed my laughter as instructed. 


During that visit as with the next, Joseph sat in a corner and asserted himself from there. In that first hour, he made Sunshine take a handful of B vitamins, eat a banana, drink two glasses of pregnancy tea and a glass of milk and molasses, a remedy he heard would induce labor. Even after both Molly and I disputed the claim of molasses as a labor inducer, Joseph tried to give Sunshine another glass of molasses milk. Joseph and Sunshine had calculated their own due date by recalling Sunshine’s last menstrual cycle. During this first visit, according to their dates, Sunshine was nearing forty-one weeks. By law, Molly cannot deliver a baby at home after forty-two weeks without the mother getting a biophysical exam and the exam only buys three extra home birth days. This exam includes an ultrasound, which, because of high electronegative activity, both Sunshine and Joseph opposed. At the second visit, a week later, Sunshine and Joseph revisited the due date, determined that when they thought they had become pregnant, was impossible because Joseph was in L.A. that weekend. They added a week to the date and Molly had them sign a waiver saying that she was not responsible. At the end of the second visit, Sunshine showed me where the food for labor was located, how to work the very expensive water filter with it’s four different pH settings and where the cake for the birth celebration was to be laid out and thawed.


A week before the actual birth, Molly called and put me on alert. Warm up contractions had begun with some regularity. First labors can be very fast or extremely drawn out. As a midwife, I need to be available and ready to take the call whenever it comes, night or day, exams and lectures aside. After the initial ‘get ready’ phone call, I changed Molly’s ringtone to the obnoxious alarm tone that I use to wake myself up in the morning. I also spoke to two of my professors and explained what I was doing because I had two exams scheduled in the coming week. Additionally, I had to make plans for my own children. If labor began on a week night, I had a friend who would care for them at night, but I had to find them a ride to school. If labor began on a weekend that I had them, my partner would take care of them, but if I wasn’t back by the time she had to go to work, I needed to have someone there. I waited for a week and a half, with anxiety, anticipation, excitement and slight fear of what I may not know. Although this was not the first birth I attended, it was the first where I had a role in the medical side. 


Thursday night, in the parking lot of the frozen yogurt joint I just indulged myself at, my alarm clock ringer “eeeeerrrrrrr....eeeerrrrrrrr.....eeeerrrrrrrr’d” at me. It was time. The contractions were five minutes apart, Joseph was antsy and Sunshine was yelling in the background. My overnight bag had been packed for a week with clean jeans, an extra toothbrush, snacks and clean underwear. A half of an hour later, I was on my way to Sedona for the third time in less than three weeks; this time to usher a perfect baby into this unforgiving, beautiful world. When we arrived, Joseph was distant as usual. The house had been smudged with a sage and the sounds of Enya were wafting from the bedroom. Sunshine was in the birthing tub, laboring away. Four hours into her labor and two hours after we arrived, Molly checked Sunshine. She was 2-3 centimeters dilated. There she remained for ten more hours. While her contractions increased in intensity, her cervix remained stubbornly set. Sunshine’s mom, Ashley, ran into the bedroom with news that couldn’t wait to be told; Brie, the psychic advisor, close friend and friend to the spirits had called. A message of great importance was to be relayed. “Brie says to say that she has sent half a million angels here and the room is glowing pink!”  


Dawn broke with Joseph voicing his concerns about labor lasting too long. Molly and I listened to Joseph’s concerns and tried explaining to him that when he gets scared, he may also be scaring Sunshine. We both believed that this was one of the reasons Sunshine’s cervix did not dilate much further. Storm clouds began swirling black and gray behind the rocks that I had watched the sun peak from behind just hours before. Enya had been long ago replaced by Sarah McLaughlin. By eleven in the morning, Joseph’s mood had changed from elation to exhaustion and disappointment, my stomach was protesting it’s emptiness loudly, Sunshine had lost all track of time, as many laboring women do, and Molly was snoozing on the couch. Sleep when you can, that’s a rule in midwifery.


At twenty-three hundred hours, twenty-six hours into her labor, the family made the decision to go to the hospital. In Arizona, the law states thats once a family has said they want to go to the hospital, the midwife must immediately take them. There is no changing of the mind, by either the midwife or the parent. Sunshine, who had been laboring in the cat/cow position for the last two hours, looked me in the eye and told me I was not to let Joseph drive. He was too emotional. Also, could I grab her purple underwear? I coordinated drivers and cars, plus mapped the way to Flagstaff Medical Center. The convoy left the house in less than thirty minutes. The roads were wet. As we ascended the mountain, the fog thickened and visibility was only a few feet ahead. 


The longer than usual drive to the hospital seemed to relax Sunshine. Joseph insisted that it was all the oxygen the trees were putting off. There was no use arguing that although the trees are putting off oxygen, we were at a much higher elevation and the oxygen level was lower. Instead, we let him talk the nurse into letting him hit the O2 mask. Having had hospital births myself, I expected and prepared Sunshine for the invasive procedures I knew would begin. To my surprise, the hospital has a very lenient birth policy. Every nurse that came on with us that night asked to see the birth plan. They followed every last word. Molly and I no longer had the roll of primary caregiver, but were instead patient advocates. For the most part we found that we were not needed anymore, but always included by the staff, including the doctor. Joseph needed us more than Sunshine did now. When Sunshine disrobed, Joseph exclaimed that she must have dilated from all the oxygen the trees were exhaling! The nurse told him she thought he was hilarious. Molly and I walked away to laugh because he was being serious. What he was seeing was her labia swelling. It fell on me to explain to him, again, the position of the cervix. I think he understood that time. 


In the wee hours of the second morning, Sunshine was enduring hard labor in the shower, while Molly and I were supporting her. From the room we heard Uncle Kevin begin to weep in happiness and fatigue, followed by Joseph’s cries of, “Why God? Why?” Molly gave me a “your turn” look and I went out to console him before he got Sunshine tense and afraid again. I sat at Joseph’s feet and asked him if he wanted to say a prayer. The only prayer I know, besides the Our Father, is the Serenity Prayer, so that is what we said, then we took the prayer apart and really look at what we were praying for. He was finally peaceful for the rest of the birth. 


Sunshine decided that she should have her bag of waters broken and when the fluid came out, it was the consistency of pea soup. The baby had released his bowels. This happens at times of stress. The color and texture of the meconium, as it is called, indicated that the baby had been in this environment for days, maybe up to a week, according to the doctor. Changing the due date and refusing the biomedical exam could have grave consequences for this family. After her water was broken, Sunshine’s contractions were perfect for pushing, but as she began to push, the baby’s heart beat slowed down considerably. Once it slowed so far that the nurse couldn’t find it. 


Brie, the psychic had been checking in by phone regularly and had another message to give Sunshine; this time I was to deliver it. “Alira says to let her take over from here. She says to tell you that the room is blue and her heart is purple. That you would know what that means.” Sunshine’s head lolled to the side as she glanced at me and pushed again. When a baby is born in their meconium, special suctioning has to take place immediately after birth, preferably before the baby takes a breath. The baby was born at fourteen hundred and fourteen hours. She was suctioned and given to her father with a clean bill of health. Three times had to be recorded for purposes of Vedic astrology, the time of crowning, the time of birth and the time the cord is cut. Alira Blu was born out of her home to grateful and tired parents, delirious midwives and joyful hospital staff. Incidentally, the Alira of the psychic realm was Sunshine’s imaginary friend in childhood; now her Spirit Guide in adulthood. At the post natal checkup, Alira and family were thriving. The only thing amiss is that apparently Alira can fly around the room and talk. I saw no such evidence, but birth is a miracle, so why not post birth astral projection?