Hannah, from Milliner's Dream, wrote a piece asking what doulas did when they were on call (I'm a Doula on-call so I...(fill-in-the-blank)) and while I commented, it became obvious a separate post about my own on-call, pre-birth, going to a birth, being at a birth and post-birth rituals might be fun to write. Thanks to Hannah for a really good prompt!
- Being a midwife differs from being a doula in that I am always on-call. Always. I might not be on-call to go to a birth, but I might find myself in the ER at 3am with a client experiencing abdominal pain at 20 weeks pregnant. Being on-call is always in the back of my mind. The only time I am not on physical-call, but am still on phone-call is when I am on vacation. I do pay another midwife to be on-call for me while gone, but clients still always feel more comfortable calling their own midwife. I have never gone on vacation and not had something serious (from lack of fetal movement to miscarriage) happen to a client. It is something I knew would happen and accepted as a part of my life when I chose to be a midwife. I get cranky when women complain about clients calling them because YOU ASKED FOR IT! Suck it up and be pleasant to your clients no matter what time of day or night.
- Because of this on-call thing, I try really hard not to get exhausted. Being sick, I sleep in weird patches anyway, but even at Disneyland or far from home, I will nap when tired. The First Aid offices at Disney parks know me well. If I am tired at night, I won't finish a movie the family is watching. If I am tired at the movie theater, I sleep on my partner's shoulder or lap if it isn't crowded. If I am driving, I pull over and drag out the pillow and blanket I keep in the car and nap as long as I need to. At the office, I sleep in the bed my partner put in one of the offices at work for me when I had the DVT and spinal meningitis 18 months ago. Even at births, I nap frequently and allow my assistants to labor sit while I get rest.
All my clients know this reality of my being easily fatigued. They also know that when they need me, I am there. Present, awake and ready to act in any way necessary. I have never failed a client, even with that DVT and meningitis.
- I've gone through phases of what to wear to a birth. For awhile, I wore scrubs, but fun ones. I enjoy having kids pick out which scrubs I wear to the birth - it gives them a sense of control over the birth time as well as allowing them to recognize me in the middle of the night when they are still sleepy.
Lately, however, I have been wearing one of a trio of cute knee-length skirts with bike shorts underneath them. When it was cold, I wore the skirt with leggings. Since I'm fat, the skirt covers the jiggling thighs and the undercover lets me get in all those gymnastic positions midwives get into. All three skirts are dark and I'll match them with a midwifery top or another loose and comfortable shirt. I match my underwear and my bra (usually black) and then bring fluffy socks along while wearing Birkenstocks - either sandals or the purple or black plastic Birkies I clomp around in.
I pick my outfit at 36 weeks (of the woman's pregnancy) and lay it out every single night. I put earrings and watch with it, too.
In the morning, I gather it all together (sometimes putting it in a bag, usually not) and put it in the car, only to be returned to the dresser top at night once again.
- I make sure my cell phone is at the head of my bed and plugged into the charger. I also bring my pager to bed, but my phone works fine around most of the county, so it isn't such a giant issue. I take it with me anyway. The last thing I do before leaving the house is make sure I have my phone.
- If I am drinking Diet Coke, I keep a 6-pack for myself in the garage fridge - everyone knows not to touch them! I'll grab one on the way out. If I don't have any at home, I'll stop at 7-11 before heading to the highway.
- I used to make food before going to bed to take with me if I were called, but that got ridiculous. I somehow acted as if there were no stores within 100 miles of where I was going and they certainly weren't open at any time of day or night. I also stored huge amounts of food in my car - canned soups, cans of chicken and tuna, dried fruit, dried soups and couscous, mints, teas, water, and more. I was ready for any serious emergency! I have since removed all the food I never touched in more than 2 year's time.
- Before going to sleep, almost like my sweet-dream-prayer, I practice neonatal resuscitation. 1 & 2 &amp; 3 & bag - 1 & 2 & 3 & bag (the pattern was recently changed to no break in CPR while pressing the Ambu-bag - I am practicing that way now).
- While on-call, I do not watch the news. I never watch scary movies or listen to horrible stories, real or imagined. When my partner was a cop, I never listened to her stories of ick - leaving others who didn't mind listen to her.
I have this belief that women in birth are open vessels. I believe that as long as women are bleeding or nursing, they are open to the plethora of thoughts, beliefs, images, and feelings people carry around with them. While most people probably carry around positive thoughts, too many are filled with angst, pain, sorrow, and evil. Brushing by these people in the supermarket can make us shiver or have a moment's negative thought. I believe that women bleeding or nursing are more open to holding onto those negatives - not because they want to, but because their open cervices, healing uteri, and lactating breasts are locations of emotional magnetism.
I don't know where this belief came from, but it has served my clients as I am better able to convince them to not go to Wal-Mart, the Fair or the mall during the first couple of weeks postpartum. I don't try to scare them with this belief, but offer just enough to let them know how vulnerable they are. They aren't invalids, but I do highly encourage staying in the house for a couple of weeks. By offering the image of vulnerability, it helps them be particular about whom they invite into their home, too. Just like in labor, emotional vampires hover around waiting to suck the energy from kind and generous spirits.
(Quite the segue around why I don't watch scary movies or the news pre-birth!)
Going to a Birth
- When I am called and am on my way to a birth, the main thing I do is practice neonatal resuscitation.
- I put gentle music on - NEVER listen to the news or standard radio. I'll listen to Yanni's Ethnicity, Enya, Andreas Vollenweider... something with minimal words, but maximum power and positive-ness.
- Even if I drive fast, I am on high alert for things going on around me.
- I sometimes talk to my assistant while driving, always about the birth at hand.
- Before I walk into a client's house, no matter what has gone on getting to the birth - an argument at home, an accident I passed along the way, horrible traffic, a flat tire - I take a deep and cleansing breath, say a prayer of thanks for being there, ask for guidance and health, and walk in quietly, listening before moving.
At the Birth
- When I walk in the door, I kick off my shoes and drop my keys in the soles. Almost all homes ask that shoes are removed, so that is never a problem. I put my keys in the soles so I know exactly where they are should we have to leave quickly with a transport or transfer.
- Entering the birth room, I move slowly and quietly. I prefer staying close to the floor, allowing the mother and partner to be the tallest in the room. This is an interesting quirk I've developed and am not sure where it came from, but it's important to me to keep the birthing family in the prominent position of power.
- If I read during labor, it is always good stuff. I try not to read midwifery texts, but have when there is a student around.
- If I write, I write pleasant things. I work to not complain or say not-so-nice things to family, in emails, or anywhere else.
- I stay off the phone as much as possible - talking only to other clients who need me. I remove myself from the area before talking to her.
- I do not talk about the other client to the client standing there (even if they know each other, which isn't uncommon). I made that mistake once when one client called worried the baby had stopped moving and I could have crammed the words back in my mouth the second they fell out because it was totally inappropriate to mention something scary serious like that to a woman in early labor. I still feel my face get red with shame about that stupid mistake.
- I always have a change or two of clothes. Most of us carry Hospital Clothes that we change into should we transfer/transport to the hospital. I have very nice scrubs that I change into or a dress. Depends on how fat I am.
- I work on paperwork throughout labor. Some midwives are superstitious and won't fill out transport paperwork because it seems an assumption that a transport will occur. I know midwives who won't fill in any of the birth certificate for a similar reason. I have a quirk that I won't fill in the birth date even if mom is in second stage and it's 4am. I always wait until after the birth to fill that date in.
After the Birth
Most postpartum activities are of necessity, not of ritual. Cleaning, charting, taking care of mom and baby - all these are normal parts of the immediate postpartum period.
- On the way home, I play something LOUD and sing - often Disney songs - and I sing in joy and with animation. If the birth was difficult, I will cry at the same time, but I always try to sing in joy.
- It isn't uncommon to talk to the assistant on the way home, too. Decompressing as much as possible so both of us can sleep once home is very helpful. If there was a transfer/transport, the assistant is long home (after cleaning the client's home) and I will call to fill in the outcome so she can sleep more deeply.
- Once home, I strip off my clothes in the garage. I toss everything into the washer, start it and walk naked into the house, right into the shower in my room. I moan with joyous pleasure at hot (or cold, depending on the birth) water and scrub myself silly.
- If it's cold outside, I will turn the electric mattress cover on before getting into the shower and once out, dry off and slip under the covers, making sure the cell phone is plugged in at my head.
I might have missed some rituals, but that's a pretty good look into the quirkiness of my birthing mind. Hope you enjoyed the trip!