Book Review: Born for Life

When I am planning to travel  I  usually  find  a  couple  of  books  for my kindle.  I prefer hard copy books most of the time,  but when traveling   e-books are a great option.

I saw the title online, Born for Life: A Midwifes’s Story, and was immediately drawn to it. It is a gem of a book.

Julie Watson writes a memoir about childbirth, her own and the many women she provided care for in New Zealand. She began her career in maternity care as a nurse aid in a small rural hospital. Some of the scenes reminded me of my early jobs as a nursing assistant.

She includes practices that are now outdated and no longer recommended—sugar water for infants, high forceps deliveries and more.

When she was 37 years old she studied to become first a registered nurse and then a midwife. As she approached her training she wrote this about the Nurses Amendment Act that was passed in New Zealand in 1990 and made the independent practice of midwifery legal.

The emphasis was on the midwife and the woman being in partnership, making decisions together about the care given. It was a model of equal power, rather than of a health professional telling the woman what to do and what would happen to her. Power was now given to women, which was so different from my own [childbirth] experience.

Ms. Watson began her practice in a hospital setting and then moved on to become an independent midwife with her own practice. She attended women in the home and in the hospital. Like so many other places in the world her practice as an independent midwife was seen as a threat to the business of birth.

For women interested in midwifery, it is a fascinating read.

Childbirth

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Finding an Enduring Loyalty

The Five Minute Friday writing community looks forward to the prompt that Kate Motaung gives each week. We pause to think about the word and then write as ideas begin to flow. This week the prompt is: LOYAL

The dictionary offers this, as a definition of loyal: faithful to a cause, ideal or custom.

Over the years I have found a variety of causes to invest in.

During my college years, and after I graduated from the University of Michigan, I have been a loyal fan of the football team. My family is amused by my attachment to college football. I must admit that I am a little uncomfortable with the big business aspect, but I continue to cheer for my team.

After practicing as a labor & delivery nurse for a few years I was drawn to the Lamaze movement. I took Lamaze classes during my first pregnancy and later became certified as a Lamaze teacher. I taught for 18 years and received feedback from my students.

Sometimes students felt that the Lamaze techniques just didn’t work when their labor was induced. Interventions and the hospital environment were overwhelming. As induced labor and epidurals became more common, interest in the Lamaze method began to fade.

And then I made decision to leave the hospital labor/delivery unit and join a group of physicians and midwives that were attending home birth.  I observed that women were more able to relax and work with their labor in the home environment.   I loved working  in  the  home  environment and promoted home birth to my daughters.

But it is true that sometimes the hospital is needed. Sometimes interventions are needed that require the equipment in the hospital. I would like to see better communication and teamwork between home birth attendants and hospital staff.

Each of these ideals has limitations.

Currently I am reading a biography of  Susannah Surgeon  (book  to  be released September 4). Susannah and her husband, Charles, shared a faithful loyalty to the gospel. They worked together as a team with a love for the Lord God.

The best and most enduring loyalty is to the gospel, to God’s love and plan of salvation. I want this to be my passion.

You can visit the Five Minute Friday Community and read more reflections on LOYAL by clicking here.

Midwife: With Woman

With my third pregnancy I chose a new medical practice. I chose a practice that included an ob-gyn doctor and a certified nurse midwife. Even though my previous births were cesarean sections, followed by complications I wanted the perspective of a midwife in my care.

During my prenatal visits I saw the doctor a couple times, but the majority of my appointments were with the midwife. We talked about my history and the current pregnancy. We discussed whether I should go into labor (some benefits for baby) or schedule the cesarean section (optimal for having all medical personnel ready).

Unfortunately I had both a horizontal and vertical scars on my uterus. At one time I was advised to avoid another pregnancy. We talked through the risks and eventually I agreed with the midwife that it would be better to schedule the surgery.

The day of surgery my midwife was in the operating room with me. Her role was emotional support. My husband was there too.

Midwives have a special place in childbirth care. Their training, skills and practice are focused on the health of women and infants. They are more sensitive to the emotional aspects of labor and birth.

The term midwife originated in Middle English, the combination of mid [with] and wife [woman]. To be a midwife is to be with woman.

Midwife: With Woman
Midwife gives Virgin Mary first bath: courtesy of http://welcomecollection.org

The prompt for the Five Minute Friday community is: WOMAN

Reflecting on Childbirth Practices: Will We See More Respect for Midwives?

In the introduction to the book, Modern Mothers in the Heartland, a speech by Dr. Caroline Hedger is referenced. In 1920 Dr. Caroline Hedger gave a speech entitled, “The Relation of Health to Progress”. Like reformers of the time she was calling attention to the health of women and children.

A broad coalition of public health practitioners, social welfare advocates, and women’s rights supporters argued that a sound and democratic future depended upon mothers’ ability to produce  and  maintain  a  robust  citizenry.1

It seems to me that this is still a valid concern.

In an autobiography, Dr. Bertha Van Hoosen wrote about her experience as an obstetrician.

Midwifery exacts a toll of the mental, physical, and emotional reserves of the physician that is comparable to no other specialty, and for this reason, in solving the problem of obstetrical anesthesia, the obstetrician should be considered along with the expectant mother and baby.   For  fifteen  years  after I began practice I delivered patients in their homes, and regardless of assistance it was I, the doctor, upon whom the morale of the patient and family rested. I was called when labor was evident, and I never left my patient until she had been delivered . . . Hospitalization of the obstetric patient decreases the time and inconvenience of the physician by seventy-five percent.2

Dr. Van Hoosen was a proponent of twilight sleep and devised methods to keep disoriented and combative patients in their beds: adult cribs, a patient gown that had one long sleeve that trapped both arms and delivery tables with restraints.

When I began working as a labor nurse at a hospital in Detroit twilight sleep was being phased out, but the labor room still had beds with high side rails that were like those of a crib. Delivery tables still had wrist restraints as well as stirrups with restraints for legs.

These female physicians in the early 1900s worked hard for women and children’s health. Yet, it is unfortunate that trained midwives were sidelined at this time. Midwives and doctors had different skills and perspectives; they could have benefited from working together. As the medical profession grew the gap between midwives and doctors expanded.

I subscribe to Midwifery Today. The summer issue has an article titled, “The Way of Birth”. The author wrote: My friend and assistant midwife in the 1970s, Deni and I would walk the concrete paths of Kansas City, Missouri, and point out who was under the care of a board-certified obstetrician . . . We predicted then what we are living today: that few babies would be born “under the stars”. We predicted that we would see conception become a medical procedure not unlike what we watched happen to birth. That the body of a woman and the making, growing, birthing, and feeding of a baby would be delivered into the hands of medicine and machines. And men. 3

My recent mail included a publication, Panacea, from the University of Michigan School of Nursing. I was pleased to see an article4about the accomplishment of midwives in Liberia. Inspired by midwife Jody Lori, Maternity Waiting Homes have been established in Liberia in an effort to reduce maternal and infant deaths. Expectant mothers come to the homes, which are located close to health clinics, in the last few weeks of pregnancy.

It is my hope that the midwife model of birth would gain greater respect in the United States. Have you given birth? What was your experience like?

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1Curry, Lynne, Modern Mothers in the Heartland: Gender Health, and Progress in Illinois, 1900 – 1930, Columbus, Ohio: Ohio State University Press, 1999, p.1

2Van Hoosen, Bertha, Petticoat Surgeon, New York: Pellegrini & Cudahy Publishers, 1947, p. 272 -273.

3Sister Morning Star, “The Way of Birth”, Midwifery Today, Summer 2018, Issue 126, p. 21

4Meyers, Jaime, “The Road to Maternal Health”, Panacea, School of Nursing University of Michigan, summer 2018, p. 8-11

Joy Restored

Childbirth practices had changed since I began my career as a labor and delivery nurse. The use of pitocin to hasten birth had become common. The rate of cesarean section had risen from 15% to 30%. I saw a full term infant die after inappropriate use of pitocin. I didn’t like my role as nurse, and I told my husband that I wasn’t sure that I could continue.

I was aware of a group of doctors and midwives that attended homebirth. I interviewed with them and chose to take a cut in pay to work with them. It was refreshing to attend women in their homes, supporting them as they labored.

Women were more relaxed, and the family was often involved. I saw that God had given women the ability to give birth. I saw the strength of women. Sometimes intervention was necessary. Hospitals are important and are equipped to handle complications. We transferred about 5 to 10% of the women to the hospital.

The four years that I participated in home birth restored my joy as a nurse. When we are burdened and lose our joy, we may need a new perspective. I am thankful that God led me to take the home birth position (something that I never dreamed I would do).

This lesson stays with me. I need to step back from hard situations and ask God to give me a new perspective. He will restore our joy and renew us in the roles he has given us.

How about you? Could you benefit from a new perspective?

I am joining  the Five Minute Friday community of writers. Our one word prompt this week is: RESTORE

Different Environments: New Perspectives

I am joining the writing community, Five Minute Friday, today. We write for five minutes (or sometimes a little more). The prompt today is: ADAPT

Family - Bouquet

 

It was a decision I came to after much thought, choosing to work with physicians and midwives that attended home birth. I had worked in the hospital for many years.

I continued to work in the hospital labor/delivery unit on a  per  diem   basis, while taking weekend call for the home birth group.   Nurse colleagues in the hospital who knew about my second job warned me to keep quiet. Don’t tell any of the doctors.

There is a big divide and limited communication between hospital based birth attendants and home birth attendants. Home birth practitioners are reluctant to transfer patients to the hospital until absolutely necessary. Hospital staff only see the home birth patients that are in crisis. They don’t see the healthy births that take place at home.

I learned so much attending labor patients in their home. I carried supplies that might be needed (IV fluids, oxygen), and arrived at the home when a woman was in early labor. I assessed her and encouraged her to rest in early labor. As labor progressed I helped her with positions changes, suggested a warm shower and offered massage. I made sure she stayed hydrated and nourished.

It was so much easier for a woman to work with labor in her home. (I had taught Lamaze classes, but rarely saw such focus and ability to cope with labor in the hospital setting.)

It was my job to notify the doctor of any problems, and to update him on the progress of labor(so that he/she would arrive in time) . Of course, sometimes a woman needed the interventions available in the hospital. Sometimes I urged the doctor to transfer the patient. A couple of times I rode to the hospital with a labor patient needing intervention.

Hospital staff and home birth practitioners could benefit from switching places. They could learn skills from each other and develop better communication.

As I worked with a foot in both settings, I tried to adapt what I had learned in the home to the hospital setting. The home setting had given me new perspectives on birth.

Call the Midwife: the Spiritual Aspect of Childbirth

It is the 7thseason of Call the Midwife, and I make time to watch it. This weeks episode had me in tears. Death is hard, but I am glad that the current series has reflections on faith. When it first aired I wondered how close it was to the book that it is based on.

In the fall of 2012 I wrote this blog post:

If you liked the new program, Call the Midwife, airing on PBS, you will like the memoir written by Jennifer Worth. A few years ago I came across The Midwife: A Memoir of Birth, Joy and Hard Times. Jennifer was a midwife for the east end of London in the 1950s. The TV program is based on her book.

The PBS program is accurate in presenting episodes described in the book. I did go back to check the validity of the  premature  birth  story.    According to the memoir the baby was born at 28 weeks gestation after the mother had taken a bad fall. Despite being very sick and weak the mother refused to let the medical staff take the baby to the hospital.

She kept the baby on her chest, skin to skin. She expressed colostrum from her breasts, and every half hour she used a little glass tube to drip the colostrum into the tiny baby’s mouth. By instinct she was keeping the baby warm and nourished.

This was a 1950s example of kangaroo care motivated by maternal love and instinct.

Jennifer Worth recorded that the baby survived without impairment.

The program left out spiritual messages in the book. As a young midwife, Ms. Worth was frightened by the situations that she was thrust into. She wrote how the prayers of the nuns gave her calmness. Ms. Worth gave insight into the emotions she had while preparing to attend the premature birth.

She wrote: The knowledge that sister Julienne would be praying for us had an extraordinary effect. All the tension and anxiety left me, and I felt calm and confident. I had learned to respect the power of prayer. What change had come over the headstrong young girl who, only a year earlier, had found the whole idea of prayer to be a joke?

Prayer was part of my home birth experiences. At times the husband prayed. Occasionally I prayed.  Although I am not a poet I wrote some lines to remember the  scene  at a birth I attended, assisting a physician.

Labor pains came gently
through the night.
Morning light streamed
on her rocking chair.

Her labor intensified.
She walked, clutched my arm,
And listened for
encouraging words.

Her movements
were intuitive. She labored
with position changes
and firm massage.

She knelt down
and asked me to pray.
No pain medication.
She asked me to pray.

I prayed as she moaned
And released her body
To surging waves of pain
Her body pushed.

A circle of crown,
head and shoulders,
a baby girl was born
in the afternoon glow.

Childbirth is a time to lean into God.

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Talking About Sex

On Thursday evenings I look forward to seeing the prompt  that  Kate   Motaung has chosen for Five Minute Friday. I enjoy linking up with this community of writers and seeing where the word takes us. Today’s prompt is: INTENTIONAL

I was born in the 1950s, before the b.c. pill became widely available

My mother had five of us. The women in my church had anywhere from three to five, maybe six children. My aunt had six children.

I was just out of nursing school when Roe v. Wade legalized abortion. I still remember the young woman that was brought in to the  labor and delivery unit where I was working. She was there for a saline induction and as I understood what was happening, I was horrified. The baby would die before being delivered.

The next day I went to the nurse manager and told her that I could never be assigned an abortion case. I wrote a letter about my conviction, and it was placed in my file at work.

I grew up in a different age. The sexual revolution has made things seem common, things that are harmful to women.

I want my granddaughters to know that they should protect their bodies. I want them to know that sex is a deep bond reserved for marriage. It is just one part of a life-long commitment to one man.

I want them to know that sometimes pregnancy is a surprise,  but  it  is  always a gift. Motherhood is hard; it is a self-sacrificing role, but it has many joys. It is a time to get close to God. A time to lean in to Him for strength and guidance.

I will tell them.

All Life is Precious

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A Thanksgiving Birthday

This year I cooked the turkey on Wednesday, a day before Thanksgiving. I scooped out the stuffing and put it in a casserole dish. I deboned the meat and placed it in a  large  baking  dish.   I  put  the  bones in  the  freezer, planning to make broth sometime in the next week.

Turkey

When my daughter and her family came for Thanksgiving my meal was ready. I said to her, “This worked well. I think I might want to do this again.”

She gave me a peculiar look and said, “You cooked the turkey on Wednesday last year too.”

“I did?”

“Mom, the baby was due and we didn’t know when I was going to go into labor. You made the turkey ahead and brought it over on Thanksgiving.”

And then I remembered. She did go into labor late in the day on Thanksgiving. Sometime during the early morning hours of the next day she went to the hospital with her husband—and I went along as extra support.

The birth of my youngest grandson was beautiful. The doctor commented that he wasn’t really needed. Everything proceeded smoothly.

I remember the birth of this little boy,  now  turning  one  year  old.  Memory of the Thanksgiving dinner has faded into the background.

But I think I will keep the tradition of cooking the bird on Wednesday.

This post is linked to Five Minute Friday. Every Friday Kate Motaung gives a word prompt. And then we write for five minutes. Today’s prompt is FAMILIAR.  Visit this community and join the fun by clicking here.

The Midwife’s Story

A number of years ago I read an article about a Finnish midwife. In 1909 she had been at the center of a court case, determining the legality of midwifery in Massachusetts. She had been arrested a number of times (despite the fact that her statistics for live births were better than most doctors practicing in the area).

I was struck by her determination, her sisu, in serving childbearing women in Gardner, Massachusetts. Why did she persist after multiple court appearances and a three-month sentence in the House of Corrections?

Her persistence fascinated me. So I began researching her life. I visited Gardner, Massachusetts and found her burial place in the Crystal Lake Cemetery. During the trip that my husband and I made to Finland, I visited the parish where she lived. The church records listed the significant dates in her life.

The court cases that were brought against Hanna influenced the decline of midwifery in the first half of the twentieth century. I am in the process of writing her story.

This post is linked to Five Minute Friday. Every Friday Kate Motaung gives a word prompt. And then we write for five minutes. Today’s prompt is STORY.  Visit this writing community by clicking here.