Always a Midwife
Midwifery Today, Issue 138, Summer 2021.
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I sit here at my computer, remembering my years as a working midwife. I still consider myself a midwife, but I am now retired. I will never stop being a midwife, even though I am not in practice any more. Midwifery is a part of my life that will never change.
I started out as a labor-and-delivery nurse. I caught my first baby when a doctor did not get there in time and all the residents were tied up with a c-section. I don’t recall being worried. It was exciting and very fast. I basically caught the baby like it was a football, flying out of her mama. The doctor walked in just as I caught the baby, proceeded to examine her for tears, and delivered the placenta. There were no tears, and he just said “good job” as he took over.
I felt like I was walking on air. I couldn’t believe how wonderful I felt. I had given birth three times and cared for countless laboring and delivering women, but nothing was like that feeling. I was hooked.
I knew that I could not deliver babies as a labor nurse, but I didn’t know how else to do it. I had three kids, not much money, and had to work full time to make ends meet, so I could not go to medical school and become a doctor. I felt like I would not be a doctor, but I loved my job and, over the years, I had other births where the doctor couldn’t make it. I had no idea that there were midwives back then—until a nurse brought a book to work, as a joke.
The book was Spiritual Midwifery, by Ina May Gaskin. The nurses passed it around, until I got it. I devoured it. It had never occurred to me to be a midwife, but here was a book about women who had taught themselves and were actively practicing. After I read it, I wanted be a midwife. I didn’t know how to do it, but I decided to try to figure out.
I did figure it out and, after several years, I was admitted into the midwifery program at University of Medicine and Dentistry of New Jersey. My education was full of firsts for me. Caring for pregnant women, my first speculum exam, writing orders, and, although I had caught babies several times, actually being the person who was making the decisions without a doctor waiting in the wings. I was lucky that I had spent all those years working as a nurse, since I worked at a hospital that was a high-risk pregnancy center. I learned all about high risk, emergencies, and working independently. I had been a charge nurse, a helicopter transport nurse, and a critical care nurse—all for pregnant women. As a midwife, I learned about a woman who was having a normal labor and a quiet, powerful birth.
I had been a nurse since 1980. I started practicing as a midwife in 1995. I started in a very busy practice, with an obstetrician, two family practice doctors, and two midwives. I next went to a practice with midwives and obstetricians, and finally ended up in a community clinic, staying there until my retirement.
Most of the women I cared for were poor, homeless, addicted, or mentally ill. Some of the women were victims of domestic violence from their partners. They were often prostituting themselves to pay for food and drugs. They had pimps who took most of what they earned and then sent them back out to get more money. Many were in jail. Most of them had multiple STDs. We also cared for refugees and legal and illegal immigrants, who rarely spoke English.
These women were some of the strongest, bravest women that I had ever known. Most people don’t think of women like them as strong and brave, but seeing how hard they worked—to just scrape by, live with their addictions, and survive in a world that most people never even have to think about—opened my eyes and my heart to admire their resilience, honesty, and strength. The sad part of this is that they didn’t think of themselves in that way, so one of my jobs was to try to empower them and offer them options to help themselves.
One of my most important jobs was to support them throughout their labor and birth. I never had a homebirth practice. All of the births I attended were in the hospital. Most of the women I served did not have a home—other than a tent or shelter—and most would risk out of a homebirth. Although I always had wanted to attend a homebirth, I never would have given up my practice in order to do it. Those women were very dear to me and needed a midwife much more than anyone.
I also had wonderful nurses who also believed in normal birth and backup doctors who respected my way of practicing. It did involve a few compromises. The protocol involved a 20-minute monitor strip on admission, but after that I took the monitor off. The women were able to walk, shower, labor in the tub, eat, and drink. They labored and gave birth in whatever position they chose. Their births were all the more beautiful because they had their choices respected. Most had unmedicated births, although, if they insisted on pain management, it was not withheld. Most had their female family members with them, if they were able, and if they had no family, usually several female friends were there. Their partner, whether a man or a woman, was usually with them, also.
I have attended several stillbirths over the years. The sadness was welcomed and understood. There was never an attempt to diminish it or tell them it was for the best, or whatever silly platitudes people use to disguise their discomfort with death. The mother of the stillborn baby cried, held her baby, and, often, when she finally slept, she still held the baby close to her. There was such a quiet dignity to these women, that I felt honored to witness it.
I decided to retire a few months before I turned 70, after a little more than 20 years as a midwife. It was a very hard decision, but I wanted to be able to spend my remaining years with things that I never had time for as a midwife. My daughter wanted me to move to Maine to live on her and her husband’s farm, with my horse and the goats, pigs, chickens, and ducks. Consequently, I moved to my little house on the farm, where my dog can run and I can spend more time with them. I left wonderful women I had been serving to a younger, experienced midwife.
Now I have my memories of wonderful births, strong women, sad births, women who disappeared after they gave birth and left their babies to be adopted, women I still worry about, and women whom I know have lifted themselves out of their circumstances. I am proud of and grateful to each and every one of them. They taught me so much, lifted me up, made me privately cry, made me examine my beliefs, and enriched my soul. I am proud of them, no matter what happened, and I hope that they are proud of themselves. I hope they remember that moment of pride when they feel beaten and that the memory helps them go on.
Now, on warm, clear, moonless nights, I sit outside in my yard and look at the constellations, the Milky Way, and the shooting stars, and remember my wonderful years as a midwife and the women who gave me so much.