Mothers, Girls and Flowers

As a nurse and mom I follow news about life and health. I am encouraged because New Jersey has a new campaign, Nurture NJ, to improve the health of mothers and their infants. One of the goals is to reduce unnecessary cesarean sections by employing midwives to attend women throughout their labor.

Another move to support life occurred in Ohio. Ohio recently passed a bill to prohibit abortion based on a diagnosis of possible down syndrome in an unborn baby. It was good to see adults with down syndrome testify before legislators.

I enjoy books that point to the value of all life. Hazel Gaynor has written a novel, A Memory of Violets, about the flower girls that worked on the streets of London.

Violets

The book is based on the true story of a philanthropist, John Groom. Mr. Groom organized an orphanage for crippled and disabled girls during the late 1800s. The ragged and destitute girls had been supporting themselves by selling flowers.

Mr. Groom instituted an artificial flower business. The girls employed by Mr. Groom were trained to make artificial flowers. These young women, many of them disabled, produced the flowers for Queen Alexandra’s Rose Day. This is the background of the novel.

We hear about human trafficking in the news. Girls and young women are trapped in a sex trade. It is an evil business. This novel, in contrast, is a story of goodness.

It was refreshing to read about the efforts to build up the skills and independence of impoverished young women. The story has interesting twists and turns. The characters, Tilly, Florrie and Rosie, are nicely drawn.

This post is part of #Write28Days. To see all the posts in this series, click here.

A Remarkable Woman Doctor

One of the women I admire provided care to childbearing women in their homes. For four years I worked in a home birth practice that followed the principles of care taught by Dr. Beatrice Tucker.

Dr. Beatrice Tucker was the remarkable woman who directed the Chicago Maternity Center from 1931 to 1973.  She had been the first woman resident doctor at the University of Chicago Lying-In Hospital in 1922.

She studied under Dr. J. DeLee who had opened the Chicago Maternity Center. It is ironic that Dr. Tucker once worked under Dr. DeLee.

 As Dr. DeLee’s career progressed he promoted the use of forceps for delivery, twilight sleep (an amnesiac type medication) and episiotomies.  He was highly influential in the developing field of obstetrics, and sadly he was outspoken in his disparagement of midwives.

Even though obstetricians were moving toward aggressive control of labor and birth, Dr. Tucker supported the natural progression of labor and birth.  In her management of the Chicago Maternity Center she set a standard for safe home birth.  

During the Maternity Center’s peak activity (between 1929 and 1941) an average of 360 births took place each month. During her tenure at the Chicago Maternity Center she participated in over 100,000 births.

The Tuscaloosa News (12/3/1975) ran a story about Dr. Tucker.  The article begins: “Shortly after her 78th birthday, Dr. Beatrice E. Tucker reluctantly came out of quasi-retirement to deliver a baby at the mother’s home.  It was a rather easy affair in a clean apartment . . .”

Later in the article she is quoted as saying “Most doctors have never seen a baby born at home and they don’t know how to do it.”  Dr. Tucker was a strong woman willing to go against the current of medical trends to provide safe and economical care to women.  

This post is part of Write28Days. To see the other posts in this series click here.

A Joyful Answer to Prayer

When I assisted at home births I became more aware of the spiritual nature of childbirth. When labor reached a peak intensity, when the woman felt she couldn’t get through one more contraction, she asked for prayer. Sometimes the husband prayed or one of the attendants. I was asked to pray.

Prayer gave the woman the confidence to release herself to the waves of contractions that were bringing the baby to birth. As I thought about it, it seemed right. In the moments before birth the mother was leaning in to God for assistance.

Prayers rarely took place in the hospital but I remember one. A young woman was in labor.  As I worked with her to alleviate her pain I noticed her anxiety.  She received an epidural for pain management and I hoped it would help her to relax. 

A short while later she grabbed my hand, her eyes wild.  “I am afraid,” she said.  “The pain is much less but I am afraid.” 

This young woman had a circle of friends that had come to the hospital with her. One friend offered to read scripture, but she replied, “No, no I can’t concentrate. I want to pray.” 

In a loud voice she confessed her inadequacy and asked God to help her.  A short while later she gave birth to a healthy boy.  With baby in arms, this new mother gazed at her infant with joy and wonder.

photo credit: T. Adriaenssen

I sought the Lord, and he answered me and delivered me from all my fears. Those who look to him are radiant, and their faces shall never be ashamed. Psalm 34: 4-5

This post is part of #Write28Days and is linked to Five Minute Friday.

Birth in a Hotel Room?

Why would a woman decide to give birth in a hotel? Yesterday WGN News reported 0n a birth that took place in a hotel. The midwife called 911 because the mother needed additional treatment after the baby was born (the baby was healthy). The police were wondering why and how this could happen.

I have some thoughts about this. After working in hospital labor/delivery units for many years, I took weekend call for a home birth practice staffed by doctors and midwives. I learned about different approaches to birth care.

In the hospital I worked within the medical model of birth care. When I assisted the home birth practice, we worked with a physiological model of birth care. Certified nurse midwives or CNMs are trained in the medical model. Certified professional midwives or CPMs are trained to support physiological birth.

In the medical model of birth the doctor or midwife manages the birth process, sometimes aggressively. It includes electronic fetal monitoring, induced or stimulated labor, artificial rupture of membranes, pain control with narcotics and/or epidural anesthesia. All of these interventions have some risk and may lead to more interventions.

The physiological model of birth allows labor to progress without intervention. The baby’s heart rate is monitored intermittently by doppler. The mother’s blood pressure and temperature is monitored. The birth attendant makes sure that the laboring woman stays hydrated with water, juice, tea or broth. 

In the home setting I learned that pain was a signal that helped to direct both the mother and attendant. Simple measures to relieve pain were employed—compresses, massage, change of position, a warm shower, a birth tub. The type of pain could be a sign of the baby’s position or the stage of labor and helped with decisions.

In Illinois certified nurse midwives can attend home births if they have a doctor backing up their practice. But CNMs mainly practice in the hospital and CPMs are illegal in Illinois. It is difficult for a woman to find a midwife for home birth. Perhaps the hotel was a meeting place for midwife and client that lived a distance from each other.

Illinois does not license certified professional midwives, although neighboring states do. CPMs receive their certification through classes and apprentice training (different from nursing school).

Some women prefer to deliver in a home setting instead of the hospital—they prefer to avoid or limit interventions. The prefer the privacy and quiet of home. They want to respond to cues from their body with support and guidance. When I worked in home birth, many of the women had previously delivered in the hospital. Some had been traumatized by the experience.

For years the midwives in Illinois have lobbied for regulation and licensure for CPMs. Licensure would set standards for CPMs. It would insure that the midwife was qualified to attend births and set guidelines for hospital transfer.

Pediatricians in Illinois are against home birth. My observation was that infants had less blood sugar and temperature problems at home than what I saw in the hospital. In the home infants were placed immediately skin to skin with mother. The immediate contact with mother assisted the establishment of breastfeeding.

Hospital or home–each place has advantages and disadvantages. Some women prefer to give birth in the hospital. Others prefer to give birth at home with a midwife. I think women should have a choice. 

This post is part of #Write28Days. To view the other posts in this series click here.

When Pain Leads to Prayer

After Eve disobeyed God in the Garden of Eden God said, I will greatly increase your pain in childbearing; withpain you will give birth to children. Genesis 3:16

Was this a punishment or a way of reminding Eve to seek God’s help?

In my own life, periods of suffering have motivated me to communicate with God. When our son was diagnosed with leukemia I experienced great emotional pain. I learned to open my heart and ask God the questions that were weighing heavily. The Psalms were helpful in guiding my prayers. I prayed for God’s help and guidance.

Pain can cause us to pause and seek help.  

For a period of time I attended women who labored and gave birth at home. As labor intensified they sometimes prayed. One mother asked her husband to pray. Another mama asked me to pray.

As I observed the prayers I saw faith and motherhood in a new way. Beginning motherhood with a prayer for God’s help was right.

Christmas is coming. Do you wonder about the birth of Jesus? Certainly Mary experienced pain. What was it like for Mary?

Mary and Manger

Yes, there was pain and stress but God demonstrated great love and grace in the incarnation.

Jesus experienced the ultimate pain as he approached death on the cross. He prayed in the Garden of Gethsemane. “Father if you are willing, take this cup from me; yet not my will but yours be done.” An angel from heaven appeared to him and strengthened him. And being in anguish he prayed more earnestly, and his sweat was like drops of blood falling to the ground. Luke 22: 42-44

Pain, prayer and love are connected.

The prompt for the Five Minute Friday community is: WITH

The manger scene is courtesy of FreeVintageArt.com

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

Sharing this post with Booknificent Thursday and   Tuesdays with a Twist

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?

If you enjoyed this post I hope you subscribe to my blog and visit my facebook page.

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