Photo by NASA

Midwifery Today, Issue 139, Autumn 2021.
Join Midwifery Today Join Midwifery Today Online Membership

Numerous studies have been done researching the impact of stress on birthing women and how it can affect labor and the newborn. Statistics continue to confirm the relationship of cortisol and adrenaline with an increase in postpartum hemorrhage, fetal distress in labor, and the need for post-birth resuscitative measures. This is not that kind of article.

I’ve been attending home births since the late 1990s, mostly in California. As a homebirth midwife I see a lot of normal, uncomplicated, gentle births. Birth is challenging in its own right. Making mothers and bringing babies Earthside takes all the strength, surrender, and willpower women have to get to the other side. Yet, physiologically, birth is normal. It happens. The body opens; the baby descends, is born, and breathes. The placenta releases and the uterus contracts. A new family is born.

Yes, there can be complications. Yes, I have seen plenty in my years attending births. However, in the last year and a half, that number has jumped significantly. I have seen more babies needing help coming into their bodies immediately following birth in 2020 than in the last 15 years of birth work combined. I have had more postpartum bleeds and more transfers for “failure to descend in second stage” than I’d ever seen previously. I have sent multiparous clients into the hospital to transfer at 10 cm because their babies refused to come down. I have retrieved sticky placentas and breathed for newborns while they hovered between realms. I have used all my skills and all the medications that I carry as a midwife and I am grateful for them.

Does this mean birth is dangerous? Does this mean the days of candlelit births with no intervention don’t exist anymore? No, it doesn’t. I still believe wholeheartedly in homebirth as a safe option. I still know in my bones that birth is normal, that babies come out, and that intervention is the exception. I still accept each new client with full intention of a gentle, intervention-free homebirth and postpartum. What it does inspire, however, is a deeper look into stress—not only personal stress but collective stress—and the outcomes on birthing women and their babies.

I want to look at the energetic effect and what we as a culture and as midwives can do to support our clients in an age when global stress is a huge factor. Globally, we are in a pandemic, and here in California we have raging fires every year while living in a drought worse than any other. Racial and LGBTQ+ disparities lead to more stress, while financial stability for many is tenuous at best. Fear is rampant in our culture and in our world. Fear of survival, illness, pain, loss, birth, and death. The fear of bringing new life into an unstable world is real and tangible, but we’re not talking about it. Of course it will affect our birthing clients, and of course it will affect the babies gestating and being born during this time.

The Covid-19 pandemic is a symptom of an earth and its people out of balance. We are interconnected. People rely on the earth and her resources to survive and, likewise, the earth relies on her people to nurture her, care for her, and live in balance with the elements. This is also true in the microcosm of a pregnant woman and her baby. The pregnant woman is the nurturer, and the baby needs to live and grow in equilibrium with her mother in order to continue to grow safely and be born with balance and ease. They are one, mamatoto, as we are also one with our Earth mother.

So, what can we do? As midwives, we have worked hard to obtain recognition as clinical care providers for maternal health. We have studied for years, worked hard for our license and certification status, and strive to create community standards of care that will be recognized as competent, sufficient, and ultimately better for the health and well-being of our clients and their babies.

We guide our clients in healthy diet choices and give them information on ways to stay safe and have a healthy pregnancy. We run tests and help them prepare for birth. We talk to them about having support so they can rest in bed with their babies after birth and heal. We help them have a bonding breastfeeding relationship with their babies. We monitor their bodies and their babies and we support their labors with skill and care. We care for our clients by teaching them to care for themselves—by giving their birth back to them.

We have come a long way and yet, historically, we are not only caregivers, but families’ guide and guardian in all things reproductive health. We are the wisdom keepers, medicine women, les sages-femmes. In this realm our care encompasses the emotional and spiritual health as well as the physical.

In this new world we live in, it’s up to us to weave both of these modalities together. To integrate not only compassionate clinical care, but spiritual and emotional safety. We will all address this in different ways, and our clients will need us to.

When I was a student midwife, some of my preceptor midwives would do a “cobweb cleaning” prenatal visit around 36 weeks of pregnancy. We would open the conversation to whatever fears or concerns the client might be having around her upcoming birth. We would allow room for her to fully express herself, without having to fix it, and address any questions she had about things that arose. It often led to an amazing release in the client and her partnership. Perhaps some of you are still doing this. What kind of change would we see in clients if we did this earlier in their pregnancies and again later? What about in the babies?

There are other ways, too. Small pieces of the sacred enmeshed into clinical practice. Creating altars, birth mandalas, affirmations, and gentle touch. Making room to remind these babies and their very special mothers that they are safe, every time we palpate a belly, listen to heart tones, or take a blood pressure reading. Using our words as magic in a mundane world.

Ritual has always been part of the cultural celebration of motherhood. Midwives often facilitated these rituals: ceremonies that celebrate the mother and honor the baby who will be born. Ceremonies that hold the dyad and create a safe place for them to grow, birth, and bond. How can we fit ceremony back into our practices in a busy, overwhelming world? How can we not?

In the push to be recognized as clinical care providers are we forgetting to weave ceremony into our practice? Are we allowing for enough self care in ourselves to be available for our clients? I know many of us in solo practice are exhausted, with barely any time for ourselves or our families.

How can we integrate the ritual and clinical in a way that nourishes both our clients and ourselves? How can we let these new babies being born know that the world is still a safe place to come into? How can we hold our pregnant clients in a way that says “you’re safe, let go, I’ve got you,” while similarly saying the same to ourselves?

Many statements at the beginning of the pandemic proclaimed 2020 the year of the midwife. They said that our time is now. I don’t think it’s just because people need holistic choices in birth, although that is also true. I think it’s because the world is screaming for balance. Balance of the energetic and the physical. A way to weave the seen and unseen in a loving, kind, compassionate way. The spiritual and the clinical. Who better to be given that purpose than midwives—the guardians of the gateway to new life, to new generations?