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Entries in Dr. Wonderful (6)

Saturday
Dec082007

Letters of Thanks to Dr. Wonderful - leave them here

Dr. Wonderful,

Since working with you, I have found a new joy in birth, midwifery. I find that when I have to bring a client in to the hospital or when they have to see you during the pregnancy, I am absolutely confident that they are getting the best care any woman could ever have.

Your kindness, your gentleness, your - dare I say - love for the women you serve radiates from your name, your face and your voice. That you touch women, hold them, weep with them goes beyond any dream of what I could hope a physician to be. That you genuinely believe in women is apparent and echoes through everything you do and say. You really are a midwife in OB's clothing. Why can't we have the majority of OB's like you, Dr. Wonderful? Why can't the others "get" that they are the ones in the wrong and you are the one in the right?

I hear through the grapevine that doctors are getting more and more pissed at your growing, fawning clients. I hear they are unhappy that you spend so much time with your clients, that you are so personal with them, that you don't have the proper OB boundaries. I am here to tell you women LOVE what you offer and to please, please don't let them beat you down. Please don't let them make you change. Please don't let your heart harden because of the partriarchal bullshit they try to throw all over you. YOU are right. THEY are wrong. YOUR style of midwifery... er, obstetrics... is phenomenal, beautiful, tremendous. Your style should be the model for all the others. If the others want fawning clients, let them melt the steel around their hearts first.

I hear that after this last birth, you were being accused of doing homebirths. Uh, that they were accusingly asking you if you were doing homebirths. Like it is some illegal crime. I pray their mean spirits don't dampen your generous one. I hope you don't push us midwives away because of the stupidity of the people you work with. If you need us to say something different when we see you in the hospital, then just let me know, please. I never want to make things hard for you. That you are openly kind to all people, midwives included, is one major reason so many clients flock to you. Most hospital staff are so cold, if not out-and-out hostile, to midwives, it scares them to see a doctor speak kindly to us. It's another ploy of manipulation to maintain the status quo. Our clients have to contend with that every day of the year! I'm sorry they are playing the same game with you. I pray that you don't pull away because of their cruel stupidity.

I can't thank you enough, so I am opening this space to let others thank you, too. You need to know how much we love you, how we wish we could clone you, how important you are in ALL of our lives - even the women and babies who will never know your hands or voice. Through my pictures and writing A Birth Unfolds... and the pictures here and here, women can know you better than they probably know their own OB's. Images speak volumes.

Thank you for everything. I am always in your service.

Barbara E. Herrera, LM, CPM

Saturday
Dec082007

Open Letter to the Nasty Nurse

Why did you have to make things so hard on my client? Why couldn’t you have just been kind and do your job without causing so much of a ruckus, as subtle as you think it was.

I get that you don’t have a fondness for midwives or homebirth, but to stonewall my client so many times, to try to manipulate her behavior with threats and out-and-out lies is inexcusable.

You caused my client to feel like she had no chance to turn her baby to the proper position. You lied saying “no face presentation is ever born vaginally” even though our doctor had just explained the difference between a mentum posterior and mentum anterior and that sometimes, when given a chance at non-intervention, babies can turn to the proper position. She knew her doctor didn’t lie, so that must mean that you did. It took a few minutes to get her to a place of believing that you didn’t know what you were talking about, that her doctor would not lead her astray by making her wait to have some inevitable cesarean just to be mean.

When my client confided in me that she couldn’t believe the words, “I want an epidural!” ever came out of her mouth, I began explaining to her that part of that was she was in a hospital and she knew it would be accessible there, whereas in the home, she wouldn’t ask for one because it wouldn’t be available. Your snorty laugh about my saying it was because we were in the hospital was uncalled for and unprofessional. We didn’t need your nasal commentary. I was soothing my client. Your job was to do the paperwork.

When my client came back in from her cesarean birth, you continued your run of snottiness and rudeness. Yes, it was mostly directed towards me, but they were caught in the undertow of your bitterness.

You had no right to manipulate the energy surrounding their decisions about the baby into your personal vendetta to get them to comply. They didn’t want you to poke their baby for a glucose test, told you they wanted to wait and think about it. Sure, your protocols are to do a glucose stick when the baby is above 4000 grams, but when a parent says they don’t want something – and obviously know what they are talking about – your job is to either have them sign AMA and then shut up about it – or just shut up about it without your own agenda smooshing around them, especially since they didn’t even have to sign any AMA forms regarding the test.

The penultimate insult came when my client, who had been breastfeeding successfully during your dinner break (when we had the marvelous nurse from another natural birth I’d done at your hospital) was made to feel perhaps she hadn’t nursed so well as you ignored, over and over, the comments that the baby had already latched on and nursed. You told my client she needed to burp the baby and switch sides. When it was made aware to you that my assistant and I were La Leche League leaders and we were happy to help her nurse, you put on gloves, came over to my client, grabbed her breast and began shoving it into the baby’s mouth. My apprentice tried to tell you she would help. I stated she could help mom nurse. My client even said, several times, “Let Donna do it. Donna can help me,” and all you did was continue to pull on my client’s nipple and my apprentice decided she wasn’t going to play tug-of-war with a newborn, so she let the baby go and we all watched as you struggled to breastfeed an already full baby. What made you think you needed to take over that situation? Why were you so hell-bent on being the one to help this mom breastfeed, especially after we listened to you complain several times about how behind you were in your paperwork? Why didn’t you just do your paperwork? What you did was bordering on assault. Do you realize that?

When my client explained they didn't want to bathe the baby, you tried, in several ways, to convince them they needed to. The most amusing way was explaining the nurses would be inconvenienced by having to put on gloves to touch the baby. Like that was going to convince them? Guess again.

Why were you so territorial? Did you think I was going to come in and take your job away from you? I didn’t even challenge your amazingly stupid remarks or block your attacking moves. I stayed in my place, tending to my client. Why were you so threatened by a lowly midwife? So flustered you don’t even remember if you zero’d the scale when weighing the baby? Why did you have to make it sound like no one knew anything, but you? What is in your personality that makes you think you are so fabulous and everyone else, even the doctor, didn’t know shit? Over and over, you showed your ignorance, your intolerance, your rudeness.

I knew it was time to leave when we were talking about the baby's resuscitation during the birth and you made a comment about a student respiratory tech being there. You left that comment dangling and I asked if the student was in charge of the resuscitation and you snottily looked at me and asked, "What do you think?" I knew the answer, and told you as much, but I needed you to tell my clients lest, for the rest of their lives, they wonder if THAT was the reason there was faltering at the bag and mask portion of the resuscitation. You turned to my clients and said, "No, the student wasn't involved." That's all they needed. There's nothing worse than having questions for a lifetime and not being able to have them answered. Your patience in answering them would have been much appreciated. Instead, your crankiness was unnecessary and noted.

Do you know how many times we rolled our eyes at you? Do you know how ridiculous you sounded? Looked?

I hope after this you have the beginnings of the clue.

Monday
Aug202007

Thanking Dr. Wonderful

Several people have asked if I thank Dr. Wonderful and it makes me smile because OF COURSE I DO! Over and over, I find ways to thank him and show him my appreciation that he is who he is and that he is so willing to go so far to make women's experiences as beautiful as possible in the climate that exists today.

You see, Dr. Wonderful doesn't get much support from OB peers for what he does and how he practices. His support comes from CNMs and LMs and the moms he serves. So we hold him up high. He is so humble in his heart, it's easy being around him. He teary-eyed accepts the loving accolades heaped upon him.

One of my other clients sent him to the blog piece I wrote a couple of days ago and when I saw him on Friday, he was so, so touched by what I wrote... well, he just had the nicest things to say.

(I saw him on Friday because I was referring a woman to him, but she cancelled 2 hours pre-appt. and I called and asked if I could still come anyway and they said I could!)

I brought Dr. Wonderful cd's of the two births I'd attended with him and we talked the birth we'd just done together.

I also brought him a gift he really, really seemed to adore.

See the picture at the top? I had that REALLY enlarged, mounted and laminated and will have my Sarah go in and put it on his wall.

Dr. Wonderful collects monkeys... but loves primates in general. This pictures is an 8-year old Lowland Silverback Gorilla from Animal Kingdom in Orlando that I took specifically for him when I was there earlier this year.

I've given him a toy screaming, flying monkey, too, before. He thought that was hysterical.

His walls need art. I can offer art. Pictures, I can give him.

In this age when so many probably want to pick at him as if he was the seed bell in a parakeet cage, I hope to foster his kindness and *only* have to tap into his knowledge/skill/privilege infrequently. It is my hope, anyway.

The question has also come up... do I fawn over him? No. I have far too much to do in my life. But, I do expend the proper amount of energy on someone deserving and who's knowledge/skill/privilege I can certainly use in my life. And I believe I have a lot to offer his practice, too. (I have an acupuncturist, chiropractors, childbirth educator, doulas, massage therapists - and ME as a monitrice!)
Give and take and give and take and give and take and give....

Thanks all around!

Wednesday
Aug152007

A Birth Unfolds in Photos & Words

Needing to change to a hospital birth late in pregnancy, my client was able to change to Dr. Wonderful who works at one of the two Baby-Friendly hospitals in our city. His promise to help her have a marvelous natural birth in the hospital wasn't bullshit; his words are Truth.

This first picture, however, demonstrates what occurred when mom was admitted to the hospital. The baby's baseline fetal heart tones were about 100, albeit somewhat reactive. FHTs during the pregnancy were 140's-150's, so 100's were somewhat disconcerting. Dr. Wonderful was called in.

This photo shows mom's sister laying on hands and giving loving energy. Mom is talking to the baby, letting her know she is safe and all is well... dad, as we can see, is concerned, but hanging in there. Mom has oxygen on her and technology all around.


The (wonderful, amazing) nurse (we had) did a vaginal exam and found mom to be 3 cm. The nurse and I began preparing mom for a cesarean - physically and emotionally. I explained the cesarean procedure, the epidural... and the nurse said the anesthesiologist would do a spinal because the spinal would be faster... and I explained things to dad, tried to get his garb for him to put on, but we were busy getting consents signed and all. Waiting for the doctor seemed endless. Fetal heart tones were dipping into the 90's and not getting any higher than 110 with accelerations. I kept calm, but was clear and sharp with the information.

My dear doctor was on the phone at the nurse's station when I went out to go ask his ETA and our nurse said, "Do you want to talk to him?" and I emphatically said, "YES!" before the other nurse hung up and said he was on his way in.

Dr. Wonderful floated into the room like a silk scarf on perfumed air, filled with more confidence and hope than I carried - more like a midwife than I was at that moment.

He did a vaginal exam and immediately, the baby's heart rate jumped to 148! She loved his touch on her head. Oh, and how I did, too. Mom had also progressed to 6 cm. in the last 30 minutes. Amazing!

Tears fell from my eyes as I watched the baby's heart rate settle back down into the low 100's (90's/100's) and the doctor suggested taking a whiff of oxygen every few minutes when she felt like it instead of keeping it on all the time like she had been. He also told her she didn't have to lie on her left side... to move wherever she wanted to - oh, how she wanted to be on her hands and knees! He said the baby was just low, having a vagal response and there was no need for a cesarean at all.

And me, thinking he needed a scalpel. How precipitous I would have been as a surgeon! Thank the goddess it wasn't me making that decision.

The entire labor, my client was extremely vocal, so much so that at one point, the people next door banged on the wall, presumedly to make her be quiet. She, so high in her Laborland (her word), made passing notice, "What's that?" - not, "Oh, am I too loud?" I was so friggin' amused, I joined her howls, getting even louder than her for a few contractions lest she be worried at all about the sounds (she wasn't). No nurse came in to tell her/us to be quiet - that she was scaring the other women or that she was using all her energy in the wrong way or anything. She just howled her baby on down. Yummy!

And so mom moves onto her hands and knees... squats at times, rocks at times... even once jumped up onto her haunches from hands and knees!

I love, Love, LOVE this photo. It speaks of the beauty a hospital birth can actually attain when given a chance with the right doctors, nurses and hospital. And supportive midwife as doula.

smile

Because we thought she would need a cesarean, we had mom take off her gorgeous Hawaiian dress and mom was then naked. The great nurse handed mom a hospital gown once mom knew she was going to stay laboring in that room and she promptly took the gown, put it in front of her and puked all over it. I thought I was going to pee in my pants from laughing so hard. No one ever offered her another gown.


Dr. Wonderful and Nurse Fantastic are seen below with mom as she feels her baby's head as it descends into her vagina. The doctor is on her left side, on the bed; the nurse, kneeling on the floor. Most of the time, I was where the nurse was, but occassionally moved to take photos. Notice that mom's belts have been removed... this is easily many, many minutes before the birth. We/I held the monitor to her belly instead of her having to contend with the strap at the end. I held the monitor on her belly for most of labor so she was able to move around, too. I much prefer hand cramps to a mom's immobilization.

Mom had a couple of exams. The nurse asked to do an exam when mom had an urge to push, but I discouraged it, so she went away. When mom thought she was pushing, I asked her to feel for herself and she felt for the head and it was, indeed there. I couldn't see (my head was down under her, lying on the bed), so Dr. Wonderful just rested his hand on her perineum for one second and said, "Yup, baby's right there," and removed his hand.


I was inches away from mom's perineum as the baby was coming towards the earth and this was the last photo right before Dr. Wonderful put his hands in the way and covered the head as the baby was being born. (I'm going to have to speak to him about that!) This series of minute forward motion head shots is so incredible because I can see the capillaries stretching/breaking in mom's vulva as the head descends. Who knew all that happened!

The baby girl, tightly squeezing out... her head had been suffused, so her body is quite white. The doctor does have gloves on, but they are surgical gloves, so it almost looks like he doesn't have any on at all. He is not pulling her at all, but allowing her to come out all on her own. He is very gentle on "his" babies... allowing them to do their own thing and never pulling on them. In fact, I was more concerned about a stuck shoulder than he was. He smiled at me when I put the camera down and asked if he needed help. I'm laughing at how funny that must have sounded to him now, but at the time - and how accessible he is to me - it doesn't sound absurd at all. He just smiled and the baby came out nice and slow... slipping out roll by roll by roll... all 8 pounds 8 ounces of her.

Before the baby was born, the nurse came up to me and asked, "Does mom and dad want Vitamin K and Erythromin for the baby?" and I answered they did not and thanks for asking. She didn't bat an eye and nothing more was said about it. When things got closer, I let mom and dad know things had already been covered regarding the baby. They were glad they didn't have to do it. Me, too! How cool to have a nurse come to me, eh?

Because the baby had a tight squeeze and because there was a goodly sized caput, I was wondering if the baby might not need Vitamin K after all. Dr. Wonderful checked the baby over and said, "Nahhhh, she's fine."

blink

Do you see the doctor in this picture? He's the one not in scrubs. The one in the yellow shirt.

Dad wasn't sure about catching, was going to help me catch when we were having a homebirth, but wasn't so sure about it at the hospital. Once there, though, I'd talked him into helping the doc and even had him practice washing his hands with the fancy foot soap and water thingie at the sink. Once the doctor was there, though, he was more nervous, but as things got closer, I put my midwife voice on and said, "You will only birth this child ONE TIME, so I HIGHLY suggest..." and that was as far as I needed to go before he jumped up and washed his hands and got ready to help the doc catch his baby.

The picture below is the beautiful photo of dad (who does NOT have gloves on, thank goodness!) assisting Dr. Wonderful with his newborn daughter.


In 24 years and 8 months of assisting women in birth in the hospital, I have never seen a woman birth on hands and knees. I've never seen an OB or a CNM allow a woman to birth in the hands and knees position. I have never seen an OB do a vaginal exam on a woman in any position except on her back until this birth when this doctor did a vaginal exam with mom on her hands and knees. I actually wondered if he could even find her vagina with her on her hands and knees! He didn't have any problems at all. Shocking. I think I've seen a CNM do a vaginal exam on a woman in an "alternative" position maybe 20 times in all these years, so even that is a sad commentary. I tell women I can find their vagina or fetal heart tones if they are hanging from chandeliers! How did I get so good at it? PRACTICE!

Anyway, so here my client has her baby on her hands and knees... her husband helps the doc catch and it is amazingly wonderful, but now mom needs to see her new daughter. How does that happen?

In most hospital worlds (as if any of the above would have happened in the first place), the cord would be cut, mom would be flipped over, the bed would be broken, mom would have her feet placed in the stirrups so she could have her vagina checked and she'd get her baby that way.

Instead, Dr. Wonderful, who's not wearing scrubs and only a pair of surgical gloves, doesn't cut the cord and knows how important it is to just give mom her kidlet says, "Okay, mom... here comes your daughter... ready?" And then passes her between her legs.

I love, Love, LOVE that I have this picture! There won't be many times in my life that I will have a photo such as this. This is a DOCTOR (I know, I shouldn't be shocked anymore, should I? But I am. I am mostly shocked that I am blessed to be in the same room and photographing such an awe-inspiring event that brings hope to hospital birth everywhere).

Nothing needs to be said about a mother's love. This picture is my desktop right now. I think this is one of the best pictures I have ever done showing a mother and child. I get shivers just looking at it! The shadows are perfect, the lights... the IV... all of it... her daughter isn't even 3 minutes old in this picture.

I end the series with a tender surprise photo I took of Dr. Wonderful with my client. He embraced her, then she him. He with tears in his eyes and both of them whispering thanks to each other.

To have witnessed the cruelty and evil of so many other (un)care providers in over two decades of birth work, I splash in the absolute pleasure of experiencing birth in a hospital with my guard down, not worrying about saving my client from having her birth plan ripped to shreds or having her baby taken from her by Child Protective Services for being one of "those" mothers. There's always so much to watch out for in the hospital... we all have to be Cerberus to feel safe (and even that isn't nearly enough, now is it?).

So, it just seemed so important to demonstrate how it CAN be. It might not be for anyone else in the world but this one mom - or the moms who get this one amazing doctor - but if this one man can exist, then there is hope in hospital birth. It doesn't mean hospital birth replaces homebirth at all. My client needed to birth in the hospital for a very serious reason and she was so amazingly gracious about moving to the hospital to deliver there. So, if some women do have to deliver in the hospital... isn't it a good thing to have hope?

I live for hope.

Baby Madeline Joyous was born August 12, 2007 at 2:41 am after 6 hours of labor.

She is gorgeous!

(more pics of the baby to come when I take some)

Monday
Jun252007

Garden Laboring

Mom at 7+ centimeters, walking in the Meditation Garden at the hospital. She is working towards a VBAC, has had AROM, has a saline lock in place on her left wrist, is wearing a Telemetry Unit (see it on the lower right of the picture, hanging like a purse off her shoulder) that continuously monitors the baby via the external belts as if she were sitting in the bed and is enjoying the company of her family, her monitrice, her husband, her doctor and the sun, wind and sky.

 

They wanted to put her in a hospital gown when we first got there, but she had that cute black top on. I suggested a sarong, but she didn't have one. I carry two so's I can help with mal-positioned babies during labor, so offered her the Mickey one or the non-Mickey one; she chose the non-Mickey one. She looks so much better dressed like this than in a hospital gown, don't you think? All women should dress in tank tops and sarongs in labor. Let's make hospitals carry sarongs, eh?

The laboring mom and me, the Tie-Dyed Monitrice.

The laboring mom and Dr. Wonderful! He's actually hugging the mom - and hugged all of us several times. He isn't afraid of getting "too attached" to his patients, obviously. I honestly believe he is a midwife in obstetrician's clothing. I am so blessed to know this man!

Mom did have a successful VBAC - 10 hours after her AROM with about an hour of pushing. She was told she would never be able to push out any sized child, yet pushed out an Occiput Posterior baby without any bony damage to either herself or her baby. Imagine that! Don't you love when women prove OBs wrong?!

Sunday
Jun242007

VBAC Success!

Story to come...

BUT, this will be one of the most amazing and glorious stories EVER that I have told.

Highlights:

- Mom labored, walking outside in a garden with continuous monitoring almost the entire labor.

- Dr. Wonderful stayed with us and talked and laughed and told stories almost the entire time.

- The cesarean doctor said the mom's pelvis would never be able to "tolerate" a baby coming through it. She birthed a posterior baby this time (Direct OP delivery).

- Mom had a Saline Lock - that's it.

- We had a nurse to ourselves who was so wonderful - except for one time when she was infuriating - and I'll tell you about that, too. (How come we had to have that one time when she was infuriating? She was glorious the rest of the time!!)

- Mom did not have any pitocin shot into her postpartum.

- I got to take care of the baby on mom's belly immediately postpartum, ensuring the baby was treated gently and respectfully.

- The doctor wanted the family to be able to use their iPod in the room so went and bought an iPod docking station.

- I was able to discuss things with the doctor when the family was having alone time in the garden that will make my practice infinitely easier, safer and more incredible for myself and my clients. I am floating today about the VBAC and my experience with the birth and my discussions with the doctor!

Who knew birth could be like this in the hospital?!?

Wheeeeeeeeeeeeeeeee!!!!!!!!!!!!!!!!!