Joy and Janet raise some good questions. Personally, I'm grateful for
Einstein who teaches us that time and space are illusions :-)
My guess is that sometimes women need time to process out of their 'issues'
and so can circle around at 8cms, or with anterior lip ;-) the midwives
code for buying time
My impression is that feeling an internal sense of safety is a biggie where
ever the birth is supposed to be happening
My experience, understanding and reading from various sources (plus those
late night midwife raves) would suggest that women who have experienced
abuse, whether consciously remembered or not often stall at various stages
in labour and those of us who don't feel all that wonderful at the idea of
being a mother can stall and hold for ages (and even go backwards cervical
dilatation wise, with the fetal head corkscrewing out of the pelvis or going
asynclitic when the muscles of the pelvic floor tighten in resistance) when
those first sensations of bowel pressure get triggered. Relationship issues
impact upon birthing both negatively and positively and many a homebirth
midwife maintains that labour is (most often) increased one hour for each
extra support person there is present.
It is a huge challenge to maintain faith and trust in women's processes -
spiritual, mental and physical and whilst operating concurrently in the
parallel universe, intervene as appropriate and necessary, and all the while
maintaining deep respect for where women are at and what they want and how
things go. To me, that is what midwifery is all about. Walking the hyphen
between the worlds. The 'and'.
Some stories that come to mind include:
On a night shift as a casual, cared for a woman who was having her fourth
baby and taking AGES - wasn't going quick enough for her - wanted to lie on
the bed and have birth happen - baby was OP. I suggested she squat and talk
her baby round - looked at me like I was mad and made a half hearted attempt
to do so - I asked her what she was thinking, she told me "my baby's coming,
my baby's coming' she didn't seem to speak or move with that focused
clarity implied by that message, so I asked her 'what is the other half of
you thinking?" she looked at me with a startled look of recognition and,
after a moment said "I'm fighting with myself". I suggested she invite that
other part of her to join the bit that wanted to birth her baby and help her
give birth beautifully. She did and with the next contraction, squatted
down very purposefully and the waters broke. She birthed her baby
beautifully with the next couple of contractions. She said after the birth
when we were discussing what happened, that until I had asked that question,
she didn't realise she was in two minds about having the baby. The question
helped her to become conscious of what was going on inside her and to take
action.
Another situation involved a women in her third pregnancy (two live healthy
beautiful children) I had cared for as a private practitioner. She was a
sweet, loving, kinda sad woman, whose husband was lazy and incredibly self
indulgent. This woman was forever making excuses for him and mopping up
around him in all aspects of their life together. She chose to birth in
hospital and laboured well. Then the signs indicated it was time to birth
the baby. No go. Every position, every possible combination of whatever
was given a go. Nope. No birth. At one stage, she looked at me imploringly
and said "I'm sick of being the strong one. I just want someone to help
me". She wanted forceps and so the obstetrician helped her and she was
grateful.
Another was a young woman (hospital client) a natural health person with a
naturopath husband. Her husband's first wife had had the dream homebirth.
Accomplished, perfect - all well. The partner thought normal birth was
easy and was scathing about intervention of any kind. He wasn't really
present with his new partner - he was distant and blas� about birth and the
effect it had on women. His first experience was so 'easy', he couldn't see
what all the drama was about. He appeared dismissive of his present
partner's experience. This young woman had read everything, had support
people, was fully focused on it all being natural and went into labour at 41
weeks and didn't progress. Was exhausted and upset that it wasn't
happening. Wanted it to happen for 'him'. She began to feel victimised by
her birth experience. Discussed possible options and he had to make the
decision about the epidural. Had an epidural and didn't progress.
Contractions were tumultuous and strong, no progress. She was tired and
becoming distressed. Long labour, did everything possible. He ended up
demanding a caesarean. Caesarean uneventful, beautiful baby boy. Her
recovery was spectacular, she was up and about with ease in a day. Breastfed
perfectly and was very happy with the whole thing. He was devoted, waiting
on her hand and foot and full of concern for her welfare. He had a whole
new appreciation of birth.
Another poignant story is a young woman whose first baby died in labour -
literally monitored to death. I cared for her as a private midwife (with a
wonderful obstetrician as backup) in her second pregnancy which was full of
exploration about safety and feelings of grief. She did NOT want a monitor
in labour with her second baby. As I was listening with auscultation in
early labour - I heard decelerations - we discussed possibilities and to
exclude cord presentation involvement, I examined her and she was three
centimetres dilated and the head was -2, no cord. I suggested the monitor
and went out to get one. As I came back in, pulling the monitor with me,
the woman was pushing and her beautiful healthy girl (cord around the neck)
was born a couple of contractions later. She later told me there was no
way she wanted that monitor on and knew she had to get that baby out!
There are many more stories and each one a rich vignette of human potential
and possibilities. Each story - each woman - each couple we meet and work
with show us the incredible wonderful diversity of experience and response.
It comes back to partnership, exploring knowledge and options, invoking each
person's repertoire of coping skills, it involves choice and control and
information sharing; it demands love faith and trust and a safety net to
optimise outcomes for women and their babies.
Often there are no answers to the questions we ask, there are always more
questions.
Celebrating women's innate birthing intelligence
Carolyn
"No pessimist ever discovered the secrets of the stars, or sailed to an
uncharted land, or opened a new heaven to the human spirit"
Helen Keller
--
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