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I remember an episode of "Real Sex" when they showed a woman teaching partners (mostly men) how to help their women get into corsets. It was extremely erotic and I loved watching as the women, naked, slipped into the loosed satin and silk fabric with the laces dangling. While I could see there was a pattern there somewhere, the rhythm of the string was such that it wasn't entirely structured - sort of hunched over each other and unruly.

Some of the women on the segment were showbiz gorgeous with flaming red lipstick, high taut breasts and tight behinds. Others, though, looked more like me and I relished that they really made corsets that fit women my size (I was much bigger then). I loved seeing the squishy thighs and the overflowing boobs and the thick waists melting into piles of hip-flesh, all being slid into the fabric of sex and seduction. It was delicious!

The instructor asked the women to stand and hold onto something firmly as their partners stood behind them slowly untangling the laces. Some women had white laces while others had black. Some corsets were a slutty red with black lace trim and others a dainty pink with rosebuds decorating the decolletage. I loved the deep purples with sequins and bugle beads; I could imagine myself with peacock make-up to match. I chuckled seeing how many virgin white corsets were in that room.

The leather corsets caught my attention most of all, however. The smell of leather resides in my mind always and I squinted so I could place myself in that woman's body, imagining the feel of sweat as I was smooshed into the corset in the first place, much less anticipating the cinching that was about to take place. Leather straps replaced laces, straps that wouldn't loosen nearly as easily as cotton strings. A leather corset said so much more than just, "I'm gonna be sexy tonight." It also says, "I'm gonna be naughty tonight," too.

The partners were instructed to begin pulling the corset ties, from the bottom, then the top, all working towards the waist, working, working to make the waist smaller and smaller. Some of the partners timidly plucked at the strings until the teacher wandered by and showed the young men how to pull those laces with a hefty yank. The women groaned sensuously as they clung to the four-poster bed or the column in the center of the room. Other partners weren't shy about tightening those laces at all and everyone smiled as they seemed to deftly run their fingers up and down the maze of ever-tightening lace behind the women's backs.

Before long, women stood tall with their corsets closed, breasts aloft, hips floating outward and waists several inches smaller than when they'd walked into the room two hours earlier. What delicious foreplay was that, eh?

As a midwife, I have prided myself on my laxity and my easy-going-ness. I don't require a lot of things - don't like or need to do vaginal exams (unless they are necessary), don't require a lot of testing, stuff like that. But, in watching myself as a midwife over the past couple of years, I also see places where I could use some corsetry. I am now beginning to be laced up.

My apprentice and I are re-doing all the files, making them easier to fetch for us. They were set up for someone who was three receptionists ago and made zero sense to us, so we've been on the floor and re-doing it all.

The main part we did was put the drawer that holds the chart guts in order so that it's easier to make charts and find something if you need it. The system there was before was amazingly harsh, so we are happy happy to now know where things go in the chart and if we choose to move things around, all we need to do is lift the file and move it in the drawer and it shall be done when we make charts, too.

We also worked some on the PRN files (as needed). I want to utilize those a lot more. Those are the files that hold extra information regarding things like herpes or grandparents supporting breastfeeding... stuff like that. I have about 80 million different things I want to write to put in the PRN section, but don't think that's going to happen as soon as I'd like it to. Maybe trying to do one or two things a month? (I'm still trying to get those Standards written!)

On our Checklist that is at the front of the chart, the weeks of pregnancy is at the end of the line. I want that at the front of the line instead. I don't like missing when I should be discussing GTT ahead of time or when GBS testing is coming up and I haven't talked about it yet. Sadly, I have missed a couple of things because I have been too lax - I was late offering a GBS test to a client (by a week) and did that with a GTT, too. Neither woman wanted the tests, but still.

So, my apprentice and I are moving the number of weeks that the tests are to be done to the front of the line and then what we are going to do or the test's name... like this:

___ 24 weeks - discuss upcoming GTT
___ 28 weeks - GTT - done/refused

I've been really lax about things like the prenatal panel at the beginning of pregnancy and the late pregnancy CBC, too. I can't even tell you why. I've decided not to do that anymore. They are now requirements to work with me. CBC with Differential and Platelets by 34 weeks. Yes, I know they can change, but I want some sort of something to go by.

Because of experiences with Paps during pregnancy, I am very, very skittish about doing them, so forego them for the most part. Because I am not all up in a woman's coochie, I also don't do a Chlamydia and Gonorrhea culture. As I read this, I am baffled at my own stupidity. Rarely does a woman choose to put erythromycin in her baby's eyes; it's a damn good thing none of them has gone blind, isn't it. No more laxity. The laces are being cinched here, too. (I have worried all night about this issue, so came in at 4am to go through charts and see if I was really as neglectful as I thought I was. Apparently not. All but one client had previous care with someone else and came to me with their labs. The other person refused the Pap/GC/Chlamydia - I did offer it at the first prenatal. Is my self-deprecation showing?)

It's so crazy. It's not like I don't know how to do any of this stuff. I have done hundreds and hundreds of exams. It isn't difficult. It doesn't embarrass me. It's not hard to teach my apprentice. It's not inconvenient.

But, I think I know what at least part of what it is. I am trying to be so respectful of women's space, I just don't even go into it - at the risk of not doing the things they are hiring me for!

As I discuss what kind of corset to buy for my practice, I worry about what the clients will say. What if they get mad at me? What if they think I am too hands-on? Too pushy? Too technical? I own an holistic healthcare office, for goodness sake, why do I require blood work? What if they don't choose me? Or worse, leave me after they have already chosen me? What about the other hands-off midwives... what are they going to say about me? That I don't trust birth anymore? That I let a few births scare me into Technocratic Birth and why don't I just go be a Medwife now?

Conversely, why haven't I worried about what the majority of midwives would think? "You nut! Why aren't you drawing blood/doing an exam/taking a culture/asking for her compliance?"

The last months' births, including the zippity doo dah birth in the bathtub (of which I have barely spoken of since) have dramatically changed me. I struggle with believing in myself. I have GOT to stop second guessing myself. My client that had the cesarean a few days ago had a doctor come in and do a vaginal exam and proclaim within a few moments' time: That baby can't come out that way. Why can't I be so sure of myself? Why do I have to have second opinions when I know damn well what I am doing/thinking/feeling? When will I grow up and stop asking someone to validate me?

Yesterday was Yom Kippur, the New Year for us Jews. I didn't go to Temple which must be some serious Jewish going to hell thing I'm sure. Instead, I was lacing my corset here at work.

My apprentice, the wonderful, beautiful thing that she is, helped me so much when we were talking about "tightening up" the practice's protocols. I sighed saying how I just hated the thought of making it all seem so structured and immobile - and then saw the picture of the corset, so beautiful and satiny and glittery and loved it! Then, as I was waxing poetic about the corset imagery and that kind of tightening up the standards of care, she tosses in, "and yet, you can still breathe." I blinked and looked at her. She was right! I could have tight, tight, tight and then move around where I needed to - the women were the ones that could tell me what they wanted. We could make them as tight as we wanted to, with bones even, yet the women would control how tight the actual lacing was strung.

Don't want a Pap? No problem! No GTT? No problem! My job is to offer. Discuss and offer. Not ignore. Not be flip. But to be present and presume they will want it unless otherwise instructed. (That doesn't mean "undress, today is your GBS test" kind of thing, either. It means to believe they will want to remain healthy and whole and to discuss the entirety of a test or screen or make sure they research it for themselves.)

Again, the two requirements will remain the Prenatal Panel (1st blood panel, not with HIV) and the CBC with Diff and Plats by 34 weeks. The rest we can work with.

So, my lacings are a tad uncoordinated, but, what do you think? Can you see me squished into my leather corset with my hips spilling out the undercarriage? Can you see me adjusting the tightness of the bodice? Can you see how uncomfortable some people are seeing me in the corset and how they walk away with their eyes averted? Do you see how some people love the thing and come closer, wanting to touch?

I can't be The Midwife for everyone. I have to be The Midwife I Am. As this New Year begins, let me begin again at being who I am. All tied up in a pretty leather bow.

(Students, it must be bizarre to read that a practicing midwife still struggles with such issues. Believe me, it is embarrassing as hell! But, my apprentice and assistant encouraged me to share and said it was okay to, said it wasn't shameful to acknowledge my human-ness and my desire to shift my practice because of experiences. If I weren't changing, then it would be shameful. They also told me if I were dangerous, they wouldn't be attending births with me, so that made me feel less horrible. Isn't it amazing how much one can learn from one's students? Ha! Who is the student anyway?)

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Reader Comments (13)

ok so organizing charts and records are now going to forever more reside in the "sexy" part of my mind
thanks for the laughs....
mistress Barb

October 3, 2006 | Unregistered CommenterAnonymous

Just a day or two ago I posted on a discussion board that being certified as a doula was only the beginning of my learning curve - after every birth I've been asking "What could I have done differently?" "What do I need to put in place for next time?" "What do I need to be softer about? firmer about?" Not in the sense of second guessing myself, but of making sure that I am always learning and growing.

So good for you Barb, for being willing to examine your self, and what you do.

And that corset imagery... its beautiful!

October 4, 2006 | Unregistered CommenterSarahthedoula

Careful with the "presume they will want it unless otherwise instructed". This is exactly how I ended with my c/s. I never knew that I could say no to anything I didn't want. I unconsciously assumed that if it was offered, I should do it because a Midwife/Nurse/Dr was telling me to to so. If only I knew I could decline 41w 5d induction! If only I new I could decline VE's! If only.... The past is what it is and I can only change the future. I can tell you now, I'll be *very* conservative in my choice for prenatal care. (My point is, make sure your Mom's know that they can decline *anything* they don't want!)

October 4, 2006 | Unregistered CommenterAngela

It is so refreshing, your attitude...so many midwives have the guise of infallibility. Sometimes so much that it approaches Obstetric madness. Your openess wins many hearts and minds.

October 4, 2006 | Unregistered CommenterSunshine

Why not test for HIV? Is there a good reason NOT to?

(My midwife did, which I am fine with!)

October 4, 2006 | Unregistered CommenterAnonymous

I wholey support and admire a midwife who can be so honest and humble about her mistakes and how and where she can afford to grow. Humility, imo, ranks up there as being one of the most admirable qualities a person of authority (ie, teacher) can have. :)

October 4, 2006 | Unregistered Commenterladyelms

"I worry about what the clients will say. What if they get mad at me? What if they think I am too hands-on? Too pushy? Too technical? I own an holistic healthcare office, for goodness sake, why do I require blood work? What if they don't choose me? Or worse, leave me after they have already chosen me?"

Gosh, all this doubt and equivocation from a woman who fantasizes about leather corsets!?!

(I'm grinning and winking here.)

Perhaps having one of these under your sensible midwife togs will boost your confidence? Just tryin' to help!



October 5, 2006 | Unregistered CommenterLucina

ok so I answered before but to be serious -- I feel safe going without many things- but it is not fair to not offer, standard of care does exist and clients come from all walks of life with all sorts of differing wants- what if there is a detectible treatable thing I miss just out of bias and ignorance- this is not my life and not my choices to make-- there are only a few sticking points- I want to listen to a baby-- most of the midwives I have known who have not listened or couldn't hear with their fetalscope also have a baby death associated with that kind of practice- the deaths may or maynot be preventible but because a problem could have been detected and I missed it I really don't want to live through this kind of guilt --as for clients who will walk away because you offer standard of care? what clients would that be? Nothing is manditory but everything is possible- now there may be somethings that I would not want to do blind- and it would be a case by case situation--
the problems with testing is when people require all test of all clients...

October 6, 2006 | Unregistered CommenterAnonymous

And I can't hear with a fetoscope so *only* listen with a doppler. I won't fake it with a fetoscope for anyone. I do have some standards. Well, I have a LOT of standards. I have had women not choose me because I won't listen with a fetoscope and that is their choice, but I won't compromise the health of their child because of my inability to hear with what they want me to listen with. Know what I mean?

And as far as not testing for HIV, what I meant was testing blanketly for HIV... that I won't include it as a routine part of my prenatal panel, but will offer it to women as a choice instead of a requirement. I spent too many years as an HIV counselor to insist that women hand over their HIV status and let me just put it in their charts without their thinking about it. I might be the naive one since it's discussed as readily as the color of one's eyes anymore, but it's a sticking point with me and I try and respect a woman's privacy where I can.

October 6, 2006 | Unregistered CommenterNavelgazing Midwife

Angela: I think it's hard to impart what I mean, but I'll try to explain. I won't just say, "It's time for your GTT today, here, drink this." Not like that.

But, at 20 weeks, give the GTT hand-out. At 24 weeks, ask if they have any questions about the hand-out and if they have researched any more about the screen. If they have or haven't, I will explain a little more about the why's of the screen and the standards of medical and midwifery models of care and the alternatives available. I'll ask her to research more again before she comes to the next visit and at the 28 week visit, I'll ask her what she wants to do.

What I want her to do is to be well-informed, not peripherally informed like a medical patient is peripherally informed. I think that sometimes women come to midwives and they let midwives make the decisions the same way they let doctors make decisions for them. I don't want to be one of those midwives anymore.

Does that make more sense?

I think I will lose some clients who don't want to think about "all that stuff," but I think some will be glad I am expanding their repetoire of information and encouraging more autonomy.

I think THAT is the ultimate goal in all of this is autonomy, too. I think that too often I feel I bear the brunt of women's choices and I need to remember they make choices I have no control over. If I could talk about all of this during the pregnancy, it would help when it comes down to the wire during labor and birth.

I don't know if that makes any sense or not. It does to me, though.

October 6, 2006 | Unregistered CommenterNavelgazing Midwife

I agree with the HIV not one I really want to offer routine- and now there is a push here to make it part of some form of required testing... I am just not liking it

you have had an ongoing theme this past few moths of getting your forms and then the rest of the paper business together - great to be working on things that need to be put in order.
Now I have another question about business do you have a biller or do you do your own billing?

October 6, 2006 | Unregistered CommenterAnonymous

Happily, we have our own professional biller. She is great! She is paid 7% of what she is able to get back for clients and she specializes in holistic healthcare. She's even gotten reimbursement for colonics... how cool is that?

October 7, 2006 | Unregistered CommenterNavelgazing Midwife

Because of a comment on meconium in this post, I was wondering how old mec has to be to be considered "old." I have had 5 births, and all have had mec. Two were called "old mec." I know that my 5th had stained fingernails and skin from the mec. My ob said the placenta sent to pathology surprisingly didn't show much seeping from mec, but that baby did show it on her body. It took maybe a week before all the mec was off her fingernails (at least). Her belly button looked funny and yellow to me. I have had no complications myself that I know of to cause this mec, and in fact, have managed to have bearable labors with short pushing stages in all labors. Maybe my contractions are strong and cause the baby mec (but I haven't had a baby officially stressed since the first born). My bp was a tad high in at least the last two pregnancies, but never beyond borderline, so I don't know if that's it or not. I am never puffy or passing protein, no preeclamsia. Wish I knew why I get mec every time! They take the baby for suctioning and such because of this in the hospital...

October 10, 2006 | Unregistered CommenterAnonymous

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