LEAVING THE CARE OF MY MIDWIVES
by SARAH C. ROSSMASSLER
Tom and I made the very careful and, for us, very clear-cut decision to have our third child under the care of a homebirth midwife. The decision was easy for us, because the idea of having the child at home fit with where we were as a family. We had moved to a new community about a year earlier hoping to live more simply, more thoughtfully and more intentionally. We wanted to not accept the status quo, but to follow our own course that may or may not have been the societally accepted path. It was also easy because, as a nurse, I had begun working for a visiting nurse and hospice organization, providing home care for people who were ill or dying. This role and work showed me first-hand how natural, safe and true I felt helping people stay in their homes during the difficult time when most people are transferred from family and community to doctors and institutions.
We met Tanya and immediately knew that she was the midwife for us — she was warm and upbeat, and exuded a calm confidence. She had honed her pitch for worried prospective clients: Yes, she carried oxygen, Methergine, Pitocin. No, her numbers for transfers weren't that high. She told us how many babies she had caught and what the plan of care would be. I remember vaguely feeling nauseous and hearing her tell all this to Tom. I staggered out of the room quietly to vomit and she alone knew where I had been when I returned — she met me in the hall with some mouthwash from her bag. Instinctually and without fanfare, she began helping me: knowing what I needed, wanted and craved, even before I did. All the qualifications didn't matter to me — as a pregnant woman I felt the openness in her way, trusted my gut and knew I was in good hands. We signed on immediately.
Now to the task of returning to our lives and fielding the questions that inevitably arose from concerned friends and family. Is she licensed? What happens if this? If that? And of course the worries about "the mess." Aren't you being foolhardy? Isn't it safer to be in the hospital where they can care for you and the baby if something goes fantastically wrong? Wouldn't it just make more sense to have the baby in the hospital so it will be covered by insurance?
During one of my prenatal visits Tanya gave us an assignment to write down what we liked and disliked about our previous births, both of which took place in the hospital. This way, she would be able to get to know us better and avoid anything that had made us uncomfortable previously. She was struck by one comment I made in my list: I feared that the sense of "feeling special" by being the patient in the hospital would be lost by having the baby at home. No one would have a bracelet with my name on it, and nurses and doctors, aides and others would not be attending to me and the baby.
Little did I know that the opposite of this fear would come to fruition. Tanya and her midwife partner Lucinda witnessing and sharing with Tom, my Mom and me my most vulnerable and my strongest moments makes me feel closer to them than I ever imagined. They made me feel so special that I am clinging to that feeling with all my might. In fact, I'm scared to let them go because of how special they made me feel. Tanya knows me — regardless of the time of day, she answers me. As a midwife, she wants to help me. Not because she's on duty or it's her shift, but because that is what she does.
I remember feeling worried as we had my first "home visit" that the house should be clean and my girls well-behaved — as if they were guests to impress. I clearly understand that perfection is indeed the booby-prize; not only is it unattainable, but striving for it is isolating. These women, as I do in home care, live in the world of reality—of blood and poop, dog hair and dishes in the sink that can wait. And they do wait, while we breathe in the milky breath of our newborns and listen attentively to our children's adventures at school. Having someone see you for what you really are in the privacy of your own home isn't intrusive—it's liberating and refreshing. The trick is to accept that they aren't judging but being who they are and in turn asking you to be yourself.
I'm incredibly proud of what I did on that rainy morning when Branch was born. I laugh as I remember shouting at Tanya, "Help me!" and her response, "I am helping you!" She got in my face when necessary and let me be alone with the pain when nothing else could be done.
When I look at the pictures of our birth I realize that she's holding my hand throughout the majority of my most painful contractions and when I was pushing Branch out. I think to myself, didn't she need that hand? Then I assume that she felt that the comfort of holding her hand was worth more to me than whatever else she might have done with it at that time. I would guess that she was right. To the untrained eye Tanya may have looked like she didn't "do" that much—at least that's the way she made it seem. When she wanted to do an internal exam, it wasn't a production. When she wanted to check the baby, velcro was not involved nor was repositioning for her ease. Branch's newborn exam took place on the bed beside me, narrated for our comfort and understanding.
Tanya assured the safe arrival of Branch, but she has also launched me on a new journey—having confidence in my body, my thoughts and my feelings. She showed me that trusting my instinct is possible and constructive. Amidst all the care I received is the focus of their midwifery care: that the woman herself—body and spirit—is capable, strong and ultimately the "expert." Childbirth is normalized, the woman and her family are empowered and the majesty of each part of the process is cherished.
Our son's birth was the opposite of the industrial birth I experienced: It was highly personal, gentle and respectful. The pain of the labor and my being in it with these women has drawn me close to them, and they do not fear or retreat from this closeness. Childbirth can be an opportunity for a woman to experience the miracle and beauty of our humanness; its capacity for intense pain, ecstasy, desire and inner strength. Traveling to the hospital has become part of the lore of modern birth—packing the bag, a rattled husband driving too fast, being sent home. My care came to my home, enabling us to avoid all of the stresses of transfer.
When Branch was born Tanya quickly placed him on my chest. His umbilical cord was still intact, attaching him to me. After several minutes I asked if we should cut the cord. Tanya said that no, we could wait for a while, that the placenta was still giving him oxygen from my circulating blood and that leaving it would give him a "little extra oxygen." I look back on those extra few minutes fondly—a transition between being his sole life blood and the time when he would venture into the world as a separate being.
Now, as I attempt to separate from my midwives, I can see the parallel: They had given me some extra time after his birth to feel supported. They stopped by my house in the early weeks of Branch's life, brimming with reassurance, advice and unhurried visits, at a time when a new mom can feel overwhelmed and weepy from the emotions of new roles and family redefinition. I am so fortunate to have access to all of this genuine support at such a vulnerable time.
Lots of people have labeled me "brave" when they learn we had a homebirth without the possibility of pain medication. I disagree. My midwives taught me that childbirth is not something to fear — something requiring bravery, but instead an experience to embrace lovingly, with awareness and the capacity to shout out loud from my core. I trade fear for what it is we did in our bedroom — the conscious, orgasmic pain, feelings and mess. I trade a sterile, painless event with a discreet beginning and end for what I gained from the experience: the personal understanding that I can do it, and access to women with generous listening skills and birthing expertise. I trade these priceless things for "nothing out of pocket." Now, yes, I do need a dose of bravery, as I miss the intensity of attachment to these women, and have to muster confidence to let them realize I am okay and finally cut the ties that bind.
What is missing in our society that causes me such difficulty in ending this relationship? Why are these women working on the fringes of accepted practice? My midwives accompanied me on my physically demanding and decidedly emotional voyage into motherhood, and they replied to my questions and fears not with statistics or official positions from governing bodies but with womanly wisdom, empathy and non-judgmental options. Homebirth midwifery represents an answer to some of the fundamental breakdowns in our current society: to choose simplicity over complexity, connection to others over isolation and dissociation, and personal responsibility over, litigiousness, fear and reliance on experts.
Can I merely treasure our time together as a fond memory? I feel the potency of my feelings diminishing—as Lucinda listens, as Tanya's visits become less frequent, as I write these words, as Tom returns to work and as the weather changes, I am swept into the daily activities of my family. Can I return to the place I have been, at peace with Branch at my breast, yet simultaneously eager to return to the hustle and bustle of life as a wife, mom, friend, sister, nurse? Can I begin to see that more moments of pure joy and ecstasy are still to come—different ones than the ones I am clinging to — and that the impermanence of this moment, or the next, or the next, defines life?
Sarah Rossmassler is the mother of three children, including her new son, Branch, who was born in October of this year. She works part-time as a visiting nurse and spends her free time with her husband, Tom and their families. They live in Hatfield, in western Massachusetts.