Rocking the Birth Dogma Boat

Taking a risk….

July 6, 2015
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This post is not about birth, but it is about women, and feminism, and how much truth we all hold in our relatively small bodies.  This is about sexual violence/childhood abuse shit, and something I’ve rarely shared with anyone.  I love the anonymity of the interwebs.  And I wanna state clearly for the record that though this is not birth-related, this is a midwifery post, in that it’s about safekeeping, women’s bodies, women’s stories, and the women who saved me by trusting me to save myself.

Things I don’t regret and probably never will……For J and Kathleen Hanna

My ex husband was one of the first people I ever told about the abuse I survived as a child, the grown man I trusted lingering on my child’s body, the grown hand slipped inside little girl shirts, grown arms pulling little girl bodies too close. I was 11. He was a teacher, celebrated for his dedication, his willingness to come in on Saturdays to spend time with little girls, especially those of us who knew early on we didn’t quite fit in, we weren’t maybe cut from the same mold as other little girls, the ones who needed extra attention, as he explained it anyway. He never raped me. My clothes mostly stayed on, save for hands that seemed stuck under fabric, hands he said were meant to reassure, meant to remind that though the edges of our little bodies reached past the mold, we were still worth reaching. Excellence in teaching. There was no harm, he said, and I knew it was my fault for sticking out, for breaking the mold with the edges of my little body that I knew even then was too big. Not too big in the sense of girls and dieting we worry about so much in the media, but too big in the sense of too much, too many feelings, too much person in my little girl body, too much noticing in a broken world. I brought it on myself.

And I kept going back every Saturday, most Saturdays, because of the birds. This man had taken over an empty classroom and made it into a makeshift menagerie. It was the late 80s, and things were less regulated, and each kid was assigned an animal to care for. In the fall and spring, animals went unfed and shit piled up in cages as our teacher organized outdoor kickball games for the girls, sitting on the sidelines with a grown man erection watching us run. The boys had free play as he encouraged female physical fitness, probably citing feminist principles or some shit that sounds good on paper. I was assigned to the birds. I had a breeding pair of cockatiels, ugly grey birds who reliably produced uglier bald babies every few months. Babies that needed to be hand-fed every few hours, and they often died, from neglect and from the danger inherent in being a little bird. I hated kickball, still do, and would halfheartedly run as far away from the ball as I could, imaging the birds helpless and hungry.   I was the kind of kid who absorbed emotion from the air, and felt it deeply.  I probably came out of my mother this way, into a family where emotion was dangerous, deadly maybe, something to be avoided at all costs. And there I was, feeling everything, brave and stupid and pathologically unable to run away, even though the school field was huge in relationship to my little girl body, endless almost.

But I imagined the mother bird building her nest in the old box hanging from her cage, laying her eggs and watching her helpless, hairless babies die. I held those stupid little birds in my hands, a whole bird body curled in the center of my palm, felt their budding quills, massaged their little bird bellies to help them digest the food I dripped into their beaks with an eyedropper, tried to protect them in a world that hadn’t protected me, and reasoned with my little girl mind that if I, a big human child, 80 pounds, with a head covered in curls I could hide behind, if I wasn’t safe, well, a littler bird-child, with no feathers or defenses, a little bird-child was at dire risk. So of course I came in on Saturdays. I wanted to protect the birds, and honestly I wanted to protect myself from laying awake at night worrying about bird hunger and injustice. When rumors started, he lost his job at the elementary school and became the girls’ basketball coach up at the high school.

By 10th grade, I had discovered alcohol and rebellion, a best friend who loved how much I was, how many feelings I absorbed from the air into my wild girl body, and how deeply I felt, how much I noticed and how much I loved, my big hands and my endless heart. We were the bad kids, the kids other peoples’ mothers warned them about, and we basked in it. I mostly basked in it, but also I just wanted to hide most of the time. I wanted a hand big enough to hold all of me,  hold me like a little bird, protected. I sat on the edge of the smoker’s benches at the edge of the athletic field, reading, retreating. My best friend taught me about music, riot grrrl and punk, and real feminism, looked at me and saw a new woman instead of a dying baby bird, saw through me to a girl child she would have protected if she had been there. Anyway, one day my best friend and I were drunk after school, and sitting on the same smoker’s benches, which lined the far end of the athletic field, and this man walked by, in his basketball jacket, deep in conversation with 2 men in suits, and I ran up to him. I don’t remember exactly what I said, but I remember talking. And telling the truth. I opened my hands and let the birds fly away, little baby bird-children who wanted protection and instead found truth, and flight.

The men in suits looked at me, dressed all in black and boots and obviously drunk at 4 o’clock on a school day, with wild curly hair, and they laughed. “Former student, Marc?” one of them said with a shake of his head. “A bad student”, and they laughed, and walked away, and my voice followed them. My truth followed them. They walked faster, tried to fly, tried to run, and stumbled, and walked, and I watched them walk away, laughing to each other and uncomfortable. Three days later, I told my mother. I told her everything, a stream of words. I remembered the feeling of the birds flying free from my hands, and I told my mother. I told my mother, and she stood up and walked away, left the room, and never looked back. She did the same thing 2 years later when I was date-raped and she couldn’t look at me, and she retreated. And I learned that truth makes people walk away, and I retreated. Back to my best friend, back to riot grrrl and punk and feminism, tried to hide my wild girl body behind my hair. And then I discovered sex, and tried to hide behind sex, gradually learning the power I have. Reclaiming the power I have. Learning that my body is not held in anyone’s hand. Learning to say no and yes, and make the decisions that were taken from me the first time around. And I grew up, made a life that didn’t beg for retreating, read less, drank less, felt just as much, absorbed as much emotion from the air, cried and laughed and felt with abandon.  Talked and flew with abandon. And then I got married and I got a dog. My ex-husband was an abuser and my dog absorbs emotions from the air, and feels as deeply as I do.

My ex-husband was like my mother, and he asked me why I didn’t fight, told me it must have been my fault because I let him, and I didn’t know how to explain what it is to be a little girl child who feels deeply and protects deeply with little girl reasoning and grown man hands reaching. My ex husband had slept with 3 women before me, and I never gave him a count, though I had also slept with 3 women, and many men, in my reclaiming. He told me I was crazy, that I was fucked up beyond belief, that I was a slut who drank and fucked my way through high school, which proved his virtue, rather than my depth. “No one has breasts in fifth grade,” he said, discrediting me, telling me I was too much, I grew too far outside the mold, I burdened him. My truth was dangerous. I was dangerous. And yet, my dog ran to me when she was scared of him. She curled her 50 pound body in my palm like a little bird, and told me to be safe, that we should be protected.  And my ex-husband wanted me to regret.

I do not regret. I do not regret my little girl body, my running over the edges of the mold, my depth. I don’t regret sex, or how many people I had sex with to learn that my wild girl body is mine, and mine alone, to decide with. I do not regret loving so deeply, loving those ugly baby birds. I do not regret making people uncomfortable with my truth, or with my love. I know I made people uncomfortable with both. I still do. I don’t regret it. I don’t regret drinking and retreating, and I don’t regret walking forward. I regret that my mother is a person who left the room and didn’t look back, but I don’t regret telling her. I regret the power dynamics and the patriarchy that let the men in suits run from my words, but I don’t regret flinging words at their backs as they retreated. I don’t regret shouting my story at their retreating backs.

I don’t regret opening my hands and letting the birds fly free, come what may in the big sky. This is the world we live in together. I want to free all the birds. I want to speak truth. I want to make a world where little girl children and the women they become need less protection, where we all feel a little more, where my dog and I and our wild bodies are safer. I’m holding my palms out, ready for the birds to land, ready to catch and cradle your story, and my story in my big hands and endless heart.


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I need a midwife

July 11, 2014
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And no, I’m not pregnant.  I’m not thinking of becoming pregnant any time soon, and I’ve put myself on the every 10 years plan for annual gyn exams, though I know there’s no evidence base.  I am, however, leaving a violent relationship, and I feel haunted.  On a practical level, I’ve landed after a long jump and a longer free fall: My sweet, sweet dog and I live in a small studio with a big bathtub in a new city, and I’ve tried very hard to make us un-traceable.  A beautiful woman with eyes that had seen it all went to court with me and held my hand gently while I applied for a restraining order.  Describing even the vaguest outline of what I’ve lived through in court was one of the hardest things I’ve ever done, and even harder the time my husband was there, yelling that I was crazy, psychotic, suffering from borderline personality disorder, abusing him, a compulsive liar, a bad wife, telling the judge that he had no authority over him and the courtroom filled up with people waiting to contest traffic tickets, asking for reduced fines,or  simply gawking as my marriage exploded and everything I had kept silent, rocked to sleep like it was a child, guarding silence, because he said that if I wasn’t silent, if anyone knew, my dog would die, and then everything I had kept silent spilled into that courtroom as people waiting to contest traffic tickets gawked, and suddenly it wasn’t silent.  My husband had stolen my dog and disappeared, because nothing hurt me more and nothing bought my silence as effectively as my fear for my best friend, that loving heart in a stocky body and waggy tail, and I didn’t have anywhere to go, he knew all my places, all my friends, and I feared for all of us.

And it is better now, or at least  in words. My dog is back; she ran in circles for 15 minutes when she saw me, ran up to the cop who had recovered her and offered him her stuffed monkey, then ran back to me and broke my glasses licking my face so exuberantly.  We are home now, in our new place. She licks my face every morning and the door is tripled locked and the alarm is set and I am on a high floor in a non-descript building in a new city.  My dog and I lay in our big bed each night and she cuddles close and I try to sleep.  I’m afraid of sleep and I fight it, stay up later and later watching the same 6 episodes of the same old TV shows, trying to imagine that I am small child in a small bedroom at the top of the stairs, wearing my dad’s soft undershirt like it’s a nightdress and the voices on TV are the voices of all the grown ups who love me gathered in the living room, talking about civil rights and a better world that my sister and I would inherit, if they could create it through their work and the work of others, all together, with hands joined around the world.  But I’m not a small child, and  the revolution my socialist parents longed for is yet to come, and they work in the corporate world now because the kids got hungry and youthful fire does not really burn all the oppressive structures to the ground so that the flowers can grow, and when I listen closely, I think I hear my husband’s footsteps on the ground, getting closer to finding us, even though I know in my head that it’s just the hum of the fridge and the whir of ceiling fan and the noises of my fear.

So I draw myself a bath and light a candle and remind myself that I am safer now.  I am safe enough to remember what happened.  I am safe enough to notice that my sweet little dog growls whenever a man walks towards me with a raised arm, or anything in his hands.  She cries in her sleep, and she tries to protect me from old men walking their grandchildren home from school.  I’m safe enough that silence is no longer my only option, and I am scared to speak. I’m safe enough to try to heal, to tell the story, and the story comes flooding back and I sit in my bathtub each night and cry.  I remember how sure I was that my dog was dead, and I cry for her body, though she sits right next to me and rests her head on the tub ledge.  I remember how hard I tried to make it better, how I let myself be dismissed over and over, how much I wanted a different ending, flowers growing strong in the ashy ground, how small I felt, how I distrusted myself, and then I remember how I broke the silence and the terror rises in my throat and I am not sure how to breathe.

And everyone has advice, everyone has a solution.  I need a support group, I need a new therapist, I should apply for the address confidentiality program, it’s important to make sure to renew my restraining order, did I get my dog microchipped? Have I tried mindfulness, or meditation, or some new miracle herb, or medication? Why aren’t I leaving work in the middle of the day to go to the women recovering from trauma yoga group? Do I need a referral? Do you have a pen? Can you write this down? Have you read the one book that explains why men do this? You need to focus on yourself and feel strong, and make sure you take care of yourself, take vitamins that cost more than I make, exercise, get a fucking pedicure, make sure to pay my bills.  Everyone has a solution, and the kind, kind woman who sat with me in court and made me really believe that I could speak because her eyes had seen it  all, she only does court accompaniment, not case management, and, that reminds me, you really should make sure you get connected to a domestic violence advocate, that you education your primary care doctor about domestic violence, that you read this other book and do affirmations or whatever the talisman, the charm, the ritual that you cling to in a complicated world where all the oppressive structures my parents fought still shine in the sun  flowers are still not growing from the ashes.

And so I need a midwife.  I was not this every day, or even most days, but I need a midwife who can simply sit with me as all the pain and fear of the last years leaks out of my body into my bathtub while my dog rests her head on the ledge.  I need a midwife to recognize that this hurts, and no magic charm will make it not hurt, no talisman will make it risk free.  And also, a clear strong voice saying that though Mary’s doula helped her through and though Karen loved the epidural, I am is me, and I don’t need a doula or an epidural or Karen or Mary’s dogma, I just need myself and my little dog and faith.  I am all I need, and there is no magic but me.

I need a midwife to sit with me, and not look away.  I need a midwife to remind me that every woman is scared, because this is scary, but also every woman is strong.  I need a midwife to smooth my hair back from my head and say that I am doing the work of arriving at the other side, and all I need is myself. I need a midwife to see me at my most scared, and not look away, not solve anything, not offer me a magic charm or a talisman to keep this pain and fear away so that she can also look away.  I need a midwife to look me in the eyes and tell me it’s nothing she’s never seen before, and I will land, and I will not be alone.  I need a midwife to tell me I’m worth it, I’m worth fighting for and I can keep fighting, keep surviving, and it will get easier and easier as I get stronger and stronger.

And with all our high level training, all our stopping bleeding and unsticking stuck babies, the strength of our model is that we don’t look away.  I want that midwife.  I may have to be her.


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Tell me I’m a good woman

February 19, 2012
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It’s been a while, and I am healing.  I have a new job, splitting my time between qualitative research and administration in an innovative center I am proud to belong to.  My bosses respect me, solicit my opinion, challenge me and ask me if I am being overloaded with work.  I’m thanked when I stay late, and paid overtime.  The hours are predictable, and the work is mostly interesting and challenging but doable.  My sister got a new puppy, and I am helping her address her wedding invitations tomorrow.  I have had the weekend off, and I am writing this with a drink in my hand.  I’m designing my thesis project and I am excited about it, and a little scared and overwhelmed, but mostly curious.  I’m doing participatory qualitative research with elderly women with intellectual disabilities, and  I want to do a good job, and do it ethically.  I want to say something new.  My man and I laugh, fight sometimes, and value each other deeply.  I sleep through the night every night.  A paper I wrote was just accepted at a conference, so I’m going to Canada in April to present it.  I’m slowly building a new career, starting again in a new world, making my name, just like I did as  new CPM. And this time I am doing it more consciously, strategically, lovingly, with dignity and self respect.  I want to be a change agent without feeling like I’m disappearing into the cause.  I want to go out on a limb for women without feeling like I’m one long birth away from falling over the edge, becoming unrecognizable to myself and my family, passion crossing over into mental illness like so many of our giants and grandmothers.  I want use my talent for controversy and challenge effectively, and I remind myself that I am worth it.  I’m starting to land.  I still feel like myself, only lighter….

I’m doing well, and most days midwifery is less of a gaping wound.  But it lies below the surface, and sometimes I wake my boyfriend up in the middle of the night.  Tell me I’m a good woman.  And he does, no matter how many times I ask.  Tell me I’m a good woman.  And that is what I want to write about now, being a good woman.  What is that? What are our unspoken assumptions behind this monolithic term? And what is our legacy, old history unaddressed determining our present? Tell me I’m a good woman. 

For me, this question pulls at my scars, and voices all the ways that midwifery has hurt me. I am no longer endlessly available-am I a good woman still? I have left this fight, and I am no longer willing to wear myself to the bone for a concept.  I value sleep, and I value myself above ill-defined yet critical needs that no one person can meet.  I try to think realistically before I say I can do anything.  Am I still a good woman?   I climbed down from the limb I was perched on, and I go to work every morning without gearing up for a fight.  Would a good woman have been stronger, fought harder with no thoughts of her own weary body?

And this wound is deeper than me.  I look at our legacy, what the midwifery world told me a good woman was: endlessly available, selfless beyond reason, emotional and never calculating, mostly invisible, mostly voiceless, ready to believe that a pregnant belly represents her highest potential for fullness, quiet and calm and marginalized.  But also white, Christian, or some new age version of black and white Christian spirituality,  able to work unpaid or for very little pay, dedicated, in the sense that she doesn’t have to go to work tomorrow for a paycheck and so can stay up soothing other women’s brows and holding other women’s hands all night.   And mostly when we picture this,  all the hands and brows in this picture are white, upper class, married to men.  Somehow this vision of the good dedicated woman is white, straight, Christian, married to a man, upper class.

And this is so problematic, on so many levels.  I think back to all the midwifery meetings where people who couldn’t come to a meeting at 10 am on a Wednesday, due to having jobs, were said to be choosing to be less dedicated, where when race came up at all, white women said that they weren’t racist but women of color should choose to come to the meeting if they cared about birth and their health, or, worse, about their civil rights.  This image of the good woman-dedicated, in the sense that she has enough disposable income to not need to be at a job at 10 am on a Wednesday, and willing to go out on a limb for women-in the sense that she is in enough of a position of privilege and power to choose the relative marginalization of unregulated home birth midwifery-is the enemy of inclusion.  So not only does the good woman hurt personally, it excludes.  It defines goodness by whiteness, by economic power, by class, and by invisibility.

And in this world where women still make 70 cents to the dollar, having the economic power to be “dedicated”, to stay up those nights, make those 10 am Wednesday meetings, work for little or no pay, well, being dedicated for so many women means being married to someone with the earnings to support you.  I know a few women who could financially support another person.  I know many, many men in this position.  (and let me be clear that this is not to knock men, or to say men work harder, but just to point out the deep structural inequity within which we try to be good women)  So the image of the good midwife, which I took as the image of the good woman, is white, straight, wealthy, married to a man, and impossible.  Not to mention anti-woman.  Yet I strove and strove and strove, like my immigrant great grandparents strove to be Americans, always a little out of reach.  I know this, and the image still haunts me.    Am I a good woman still?

Closing the wound, and backing away from a world that was so abusive to me, valuing myself enough to walk away from a world that was so abusive to me means redefining what it means to be a good woman.  It means finding my own terms, imaging a world so loving of women that we have better choices for what it means to be good.  This is not an individual fight, or an individual problem. This is all of us, men and women, waking up to a world where tell me I’m a good woman means tell me  I am strong, tell me I am worthwhile on all the days of my life, tell me I know my own worth, tell me that my all is enough, more than enough, and I am more than the children I bring forth. Tell me I am a good woman, and tell me what those words would mean in an inclusive, equitable world.  It is late and I cannot imagine the equitable world where the story of the good woman supports all women.  I can’t imagine what a good woman would be in a profession committed to addressing our scandalous legacy.


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Brave new world

November 12, 2011
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I did two things that scared me this weekend, and it is only Saturday afternoon.  The first one was easy-I was in an international fashion show at school to raise money for charity.  It was not my idea; a friend put me on the list and gave me a (tiny!) dress from Ghana to rock, and as the girl in line in front of me was halfway down the aisle-my cue to start walking-I froze.  It felt like every other emergency I have eve faced, catastrophic enough that a still, calm voice takes over and speaks in simple 3 word sentences, and you react.  Usually this still calm voice says things like “control the bleeding” “go for the anterior shoulder” “call 911” and “have the rescusitation tray ready.”  This time it said “channel Project Runway. Now walk.”  And so I did.  Terrified, I walked past 100 people in my tiny little dress, shaking my ass, pretending I was hoping to be America’s next top model, listening to that still, calm voice and thanking God that I was a midwife, used to reacting in emergencies, doing what needed to be done!

The second one was harder. For years, I have had the hands of a birth worker-dry from gloves and water birth tubs, with short plain nails so that no one gets hurt when I need to check a cervix or put antibiotics in a baby’s eyes.  My hands matched my identity.  Then I did my last postpartum with my last client a few days ago, and I told myself that I would get a manicure to celebrate.  I’ve been putting off this manicure, sensing that it will be a final goodbye, new nails and a new identity, no going back.   I’ve had maybe 3 manicures before in my life, usually for someone’s wedding, and I’ve always taken the polish off quickly after the vows are exchanged because I was always on call, with prenatals to do.  No more.

So I headed down to nail place in my neighborhood and picked out an audacious red completely inappropriate for the job interview I have on Tuesday.  The shop was fairly empty for a Saturday afternoon, with 3 manicurists and one client soaking her feet in the pedicure bath.  My manicurist was  hugely pregnant Vietnamese woman who hummed something that sounded like a cross between a lullaby and a longing-filled love ballad as she worked.  She touched me casually, like  my fingers were vegetables she was peeling in a kitchen full of women, and the work of her hands were secondary to the stories and laughter surrounding her.  Her hands were sure. I liked her.

She soaked my fingers and complained that I kept my nails so short.  Reflexively, I almost told her that I had to because I worked in health care, my standard answer for casual acquantences who ask me what I do, and I realized that I no longer work in health care.  I no longer do the work that defined me for most of my adult life.  I was sitting at a manicurist’s table getting my nails done an audacious shade of red because I am no longer a midwife.  My hands, drying on the table and cradled in the manicurist’s palms, my hands would never catch babies ever again.  Audaciously red, I no longer have midwife hands.

My classmate Malia got married right after midwifery school.  She timed her bridal shower to coincide with a national midwifery conference taking place in her hometown a few months after we graduated.  I walked in to the shower with two other girls I had gone to school with, and, as we introduced ourselves to Malia’s friends and relatives, one of her aunties ran to us.  “Let me see your hands,” she demanded.  “These are the hands that will welcome babies. These are midwife hands. Let me see your hands.”  In the light of Malia’s mother’s front room, our hands looked graceful, important, gentle, decisive and sure. Our hands seemed like a promise, a continuing and honoring of all that was good about women, hands that held yours in the dark, hands that would build a safe corner in a sad and uncertain world.  Midwife hands.

My hands, sitting on the manicurist’s table, are less elegant and carry less promise.  I thought about all my hands know, all the shoulder dystocia drills, exactly how quickly to push the barrel of a syringe so that it stings as little as possible, where exactly to rub on a labor woman’s back and how hard to knead, how to smooth hair away from a brow that is losing faith, gently restoring it.  I fought back the urge to cry, staring instead up at the wall behind the manicure station, a shelf of Budda statutes and a jade plant a foot above a shelf of nail chemicals.  The football game blared from the wall-mounted TV and the woman with her feet in the tub turned the pages of her magazine.  My manicurist hummed more softly, and started painting my final coat, resting my hand gently on her thumb.  I didn’t recognize my hands.  I wasn’t ready for my hands.

I thought I was ready for this change.  I have been telling myself every day that I am still me, and I am starting to believe it.  I am as valuable, as kind, as wise, as funny, as good to women and as worthwhile as I was as a midwife.  My therapist sister tells me that there is more to me than my job, even though it felt like my job became me as a midwife, and tells me to have faith through this transition.  She tells me I am still a good sister.  My boyfriend tells me I am a good woman whatever I do, and tells me I don’t need to do unsupported work that makes me feel crazy to be good.  He tells me I am worth investing in, and looking out for.  My mother emails me to tell me this is a good decision and she is proud of me.  My friends came to my party, got me drunk, made me cut an old telephone cord, and told me I was free, standing by me through a transition like I have stood by many a woman as she labors.   I taught a class about birth to 80 students, and talked about autonomy, control and systems change, and realized I was reaching as many women in three hours as I would in 3 years of attending births.  I want to believe all this, and most days I do.

So I look at my hands, and I try to re-frame this change. I don’t have midwife hands.  I have hands that will remember their own worth, trembling hands that will write books, and struggle to keep up taking notes during interviews, elegant hands that teach others, sure hands that will peel vegetables in a kitchen full of laughing women, gentle hands that will exchange rings with the man I love, hands that are still mine.  My hands will not cling to the dogma of a dying model like it is a life raft. My hands will hold uncertainty and complexity.  I will still be me, and I will still do good work.  I will still have the kind of hands that at their best make a safe corner in a sad and uncertain world, audaciously red hands that will hold yours in the dark.

And so it is really done.  Really over, and ready to begin, and I am scared, and trying to find the still, calm voice that tells me to stop the bleeding, walk down the aisle, trust myself…and define my hands by more than my job.


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Beginning Again

October 8, 2011
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It’s Jewish new year today, and ever since my party marking my new beginning last week, I feel renewed.  Let me say that more clearly: I feel like a new person, but I am actually more and more myself.  I am myself and only myself, as the endless responsibility for other people’s lives, and for fighting the good fight alone on a mountain, too much responsibility for any one person floats off my shoulders.  Suddenly I am responsible for me, for being good to my friends and family, for the hurtful things I say, for my inattention and my tardiness and my harsh judgments and my love of gossip.  All these things are under my control, and for the first time I can accept responsibility for what I am charged with, because it is all mine.  For the first time, my responsibilities fit on my shoulders and I feel light and free.  All the promises I’ve made are ones I can keep, if I set my mind to it.  All the expectations people have for me are ones I can meet, if I work hard.

I think about who I want to be in the world, and it is realistic, with hard work and patience and compassion for my endless and human ability to become distracted and make mistakes.  I look around, taking stock, and I am standing by a river with all the people who have held my hand, all the people who could not, and with this whole city full of people who have left their houses this morning with good intentions and too little time.  I am no longer up on a hill dying for a cause, and I am no longer alone and anonymous.  Life is short but I am not disposable.  I am good without giving myself away, and I am good in the context of realistic expectations.  It feels so good to be standing by a river as a woman, human and small, brave, hardworking and free to make mistakes.

And the good fight that I spent so many years fighting rages on up on a hill somewhere, and I ask atonement for my arrogance, for thinking life should somehow be lived as a lone martyr, when I have always believed that turning your back on a gift is the only true sin.  It is good down here by the river.  It is good to be surrounded by friends and family, and to make time for them, to let them come first.  It is good to sleep through the night.  It is good to find a way to be a woman that values women in all the seasons of our lives, that knows that bringing forth babies is just one example of the ways women bring forth life.  It is good to know I exist for more than filling empty bellies, and it is good to stand in a kitchen full of women who love me.  It is good to turn my phone off and sit down with a man who is good to me, and to feel the sun on my face before it hits the water. I will try very hard not to turn my back.  I will try very hard to be worthy of these gifts.

I had my dream again, women following me through the dusty hallways of an ancient castle, telling me they need their VBACs, telling me they cannot be a woman without their VBACs, and everywhere I turn was another woman with begging eyes.  And this time, I had the start of an answer.  I’m not sure how to create it, but I tried to say that being valued as a woman was bigger than being valued at birth, and I will work for a world that values women.  I will work for the kind of world where we can stand by a river together and mark the seasons of our lives, where we count for more than the babies we bring forth and plates we refill.  I will do this work without turning my back.  I will stand by the river, and I will be a woman who is not disposable, and that is all I can promise.  I will try very hard to be worthy of these gifts, and I will forgive myself for not knowing quite how, and what to do next.  I will come down off the hill, and I will be a woman who counts for more than birth, and slowly, slowly, I will find a way to make this a world where we are more than the babies we bring forth, where we are valued at all the seasons of our lives.

I want this to be a year of coming into my own, of learning to write books, of using my strengths and of watching my faults, of speaking in a strong and gentle voice, of listening well, of becoming braver.  But mostly I want to make sure I never again get so caught up in a fight that I turn my back on the gifts surrounding me.


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This is for my girls…

October 3, 2011
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I am sitting on my couch drinking coffee, looking at the pile of party dishes and loving my friends.  I have really great friends.  My friends are amazing. I have the best friends ever, and I have the kind of hangover that makes cleaning up from your party difficult, and so I am imagining a different kind of world for women, one where we are all held and midwifed through our lives, like my friends held and midwifed me last night.  I became a midwife because I wanted a world that loved women, and for a little while last night, I lived in one, and this vision of what could be is as compelling as the hangover making my head pound.

Since I was in midwifery school, I’ve heard that midwifery a concept is worth running my heart into the ground for because it values women, it supports women, and, by supporting women well during their pregnancies, it creates a world where women matter.  This is our dogma, our justification for chewing up providers and spitting them out in service of creating a world where women matter, and in our dogma we replicate the very things we are fighting by valuing pregnancy and the pregnant woman.  Let’s be clear: it is good and worthwhile to support pregnant women, as it is good and worthwhile to support women all the time.  But I was never the kind of midwife who was in it for the baby, and the underlying “support the vessel” message of investing in pregnant women because they are pregnant strikes me as patriarchal, to say the least.  Historically, women were always valued for their reproductive capacity, and women were worth investing in because they brought forth babies.  Pregnancy was the height of womanhood because women were disposable production units, and the carrying a baby gave a woman worth, made women worthwhile because the baby had worth. Good women were women who carried others.  And I am slowly and painfully learning a new way of being a woman, learning to have worth beyond my reproduction, beyond my ability to carry others.  And last night, in the arms of my friends, I was the kind of woman who mattered inherently, as who I was, beyond what I do for other people…

Last night was my Off-Call Forever Party, and the invitation went like this:

I caught my last baby and I’m off to new adventures and new ways of being, so it’s time for a party to mark the occasion.
It’ll be like a going away party, only with a tropical island (because I can go on trips now!), ugly babies (because I can finally call them ugly!), pajamas (as I sleep through the night every night!), a phone smashing station (because I can turn my phone off!), boats (because I can go on boats!), souvenir day planners (because I can make reliable plans!), a personal life (now that I can have one!) and lotsa lotsa booze (because I can drink!)
Please join me  in celebration as I give the midwife part of my self a good send-off. It’s good, it’s sad, it’s scary, it’s ultimately for the best, and it’s very, very drunk. 
I am still a Jew, so there will be plenty of food.  Please bring your favorite alcoholic beverage, or some good ol’ tequila, because some things never change.

I went all out: there was a tropical island station with an inflatable palm tree and mojitos, a sleeping through the night station with pajamas and coffee-based mixed drinks, a personal life station in my bedroom, jello shots in specimen cups, a placenta smoothie drink with strawberries representing the placenta, an ugly baby collage contest that was too close to judge, a phone smashing area and the kinds of friends who turn your couch into a boat, complete with a fan to make the sails blow as we head for open ocean, steering with an old basket, simply because I said I love boats, and I can finally go on boats, now that I am not a midwife….now that I am not a midwife.  And that was the lesson, that I am no longer a midwife, but I am stilled loved, I am still worthwhile, and I am still me, surrounded by women and laughter. In the arms of my friends, I became someone valuable and worth holding, and leaving midwifery because it devalues me became not just a valid choice, but the only choice that would value me like my friends do.

I throw a good party, but really what happened was my women friends gathered to midwife me through this transition, to hold my hands and value me and celebrate me as I find a new way of being a woman, as I learn that I don’t need to give myself away to prove my worth.  Minus the alcohol, I saw my friends doing for me everything I’ve done for laboring women at births, holding me close, looking in my eyes, nodding at me from across the room as I find the courage to walk forward, having endless faith in me as I doubt myself, loving me, and believing.

My friends made cards, encouraging me, welcoming all of me, celebrating me.  I’m so proud of you.  You can do this.  You’re brave and strong and you made the right decision.  This is hard and right.  We need your kind of woman.  My parents brought champagne, and my friend Vivian uncorked it at 11, telling me we had a lot to celebrate.  My friend Jessica told me to keep writing, and Gina told me she was has always felt so good and welcome in my house.  Sarah and Stephanie made everyone laugh, and Lee kept me on topic, finishing the stories I had been needing to tell, and Andrea put it in perspective.  Jessica drew people pooping in peace after I told that story of not even being able to use the restroom without someone needing me, calling me back again before I even have the chance to wash my hands.  Johanna set up the ugly baby contest, and said wise things. Lee and Jessica’s boat kicked so much ass, and my friends gathered around me, held me, welcomed me. My friends carried me through, and told me that even though I am the only one who can do the work of becoming, I do not need to be alone as I do it.  They looked me in the eye, and told me to be proud of where I’d been and where I was going, but mostly to be proud of who I am, more than anything else, because I have all I need inside me.  They believed in me, and their arms were like a nest holding me safe, making me brave.

It was late when everyone left, piling into a cab because the T had stopped running. And I called my boyfriend, drunkenly asked him to marry me, and told him that my friends are amazing, and that the world I’d always wanted for women happened in my apartment just now.  And I meant it, both things, in a moment of stunning clarity that made my head hurt and that has not gone away since I’ve sobered up.

So imagine: imagine if all women were held  like I was last night.  Imagine if all women were celebrated through all their transitions, not just the ones that brought forth babies.  Imagine if all women were midwifed into being more themselves, and loved for it.  Imagine if midwifery was not reserved for childbearing, and if midwifery defined women’s worth as expanding past the childbearing year, as every day of a woman’s life. There is so much we do that is worth midwifing.  Imagine if we were always midwifed through…..


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Something from last year

September 24, 2011
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I wrote this after a long birth and a long discussion with a good friend about what midwifery means, and whose stories are getting told.  I thought about it today when a student described another class where she was learning about how to improve “traditional birth attendants'” practices.   The literature she was reading and the studies she referenced were all done by men, men who had never given birth and men who presumed to speak for the TBAs, calling them TBAs and not midwives.  TBAs are midwives, and the realities of their practice often prevent their voices from being heard.  In light of my conversation, I would like to share it.

In the early morning hours I come home from a long home birth, a healthy baby, a safe passage, and all I want is sleep.  I’m hungry, and I can barely pour my bowl of cereal without spilling milk.  I eat as quickly as I can, and I crawl into bed.  Twenty-seven hours.  Twenty-seven hours of monitoring and supporting, whispering that it will be ok, nodding my head, thinking about safety and never breaking a woman’s gaze as she does the work of becoming a mother.  Twenty-seven hours receiving a new baby, watching over everyone’s health, cleaning blood off a brand new scalp, bringing baby to breast, smiling with my eyes always vigilant.  At the end of this night, sleep never seemed so good, and my bed is a haven.  I wake up as the sun is setting, having slept through the whole day, and I take out my journal and write this story.

I can write because I do at most 5 home births like this a month.  I consider this a busy home birth practice in Boston, in the United States, where there is so much infrastructure supporting my work, where I live down the street from my mother and my grandmother, whose house I go to for a real meal after this day spent sleeping.  I can write because after my long birth, I am not getting up for another one, not sleeping a few hours and waking up to a long line of women waiting for their prenatal visit.  I can write because if I cancel a prenatal visit to sleep, I know my client will still have access to health care.  I am not the only health care my clients have, so I can write.  I can spend the day writing if I want.

There were times in my life when I couldn’t write after every birth.  When I worked in a birth center on the U.S./Mexico border, and we had days with nine births in a row, and barely time to run to the restroom during a 24 hour shift, I couldn’t write at the end of those days.  My midwife friends in Haiti who go from birth to clinic to birth and joke that midwives never sleep do not write at the end of their endless days. My midwife friend in Guatemala single-handedly cares for the health care needs of three villages, spending endless days on the bus traveling down dusty roads to care for every woman who needs her; she does not write at the end of her long day, because she knows that if she sits down to write, she will fall asleep with her pen in hand, and her pen is a precious resource she uses to record all the births in all her villages, and all the deaths.

As a midwife myself, I know what it takes to write.  I know the feeling of staying up way too many hours to ensure the safety of mother and baby, only to sleep a few hours and do it again.  I know what it is to be running in 5 different directions at once, each direction a potential matter of life and death.  I know what it is to wish there was more of me, that I could somehow divide myself between everything that needs me without giving anything less than my all, knowing that even my all is never enough. I know what it is to feel that if I let myself sit down, I will sleep forever and to want so badly to sit down anyways, and to then have a woman walk in pushing with sky-high blood pressure at that very minute.  And while I am sure it is humanly possible to write at the end of that day, because I know that midwives have, I know that I need a different kind of day to write.  For me, it takes a break, time when no one is pushing, when my practice is slow, when no one needs me, when I can go the restroom without an ear out for that yell that lets you know the baby will be here very, very soon and that always seems to occur the second I close the restroom door.

Writing takes time, and writing takes support.  Writing my stories is something I can do now that my practice as a midwife is cushy and soft, now that the women I serve have other access to health care, now that I live down the street from my mother and grandmother who feed me.  Writing means no one is waiting for me to measure her belly or weigh her baby, and that I have the time to find words.  And knowing this makes me concerned about the midwifery stories that are reaching the world.  I am not the only midwife, and easier jobs like mine are not the only kind of midwifery.  I worry that telling the stories of only the midwives who have time to write paints an unbalanced picture, leaves out the midwifery stories that most need to be told.  Writing is a function of privilege, but midwifery means caring for every woman, everywhere.  I challenge us to honor the diversity of what it means to be a midwife, to make sure that the stories of the midwives too tired and overworked to write also make it into our collective story of what it is to be a midwife.  I challenge us to paint an inclusive picture of midwifery, to keep space for the stories that aren’t being written, because the midwife knows that if she sits down, she will fall asleep, and that the second her eyes close, someone will walk into her clinic, ready to push out a baby, and the midwife will need to be vigilant once again. And however we practice, this story belongs to all of us midwives, if we can make room to listen.


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“Because history left unaddressed becomes the present”

September 23, 2011
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This was a quote from my eighth grade history class, when we had a guest speaker come and talk about the holocaust.  So here is some midwifery history, a history we have not addressed:

NEJM ad

This is an ad from the New England Journal of Medicine at the turn of the last century.  Another ad from the same era showed a flattering picture of a clean White male doctor next to a stereotypical image of a dirty female African-American midwife, with a caption describing her as a former slave.  Bold text under the photos asked women who they would prefer to deliver their baby, with the obvious right choice being the male doctor.  This smear campaign against midwives was a prerequisite for moving birth to the hospital, and quite successful: In the late 1890’s, about 10% of births occurred in the hospital.  By the 1930’s, over 50% of all births, and 80% of urban births took place in hospital settings.

This was a huge shift, and moving birth to the hospital solidified the hospital itself as a real institution.  (This continues today, with birth representing over 25% of all hospitalizations, and providing a solid financial foundation that subsidizes all other hospital activities, and in many cases allows hospitals to keep their doors open.) Huge cultural shifts do not happen on their own, and in the classic telling of the story I learned in midwifery school, the demonized doctors wanted to make money off birth and gain control of women’s bodies, so they initiated a smear campaign against midwives, convincing the naive public in a matter of months to give up homebirth and midwifery care.  We love this mythology, that midwives were great and doctors were evil and we got screwed over, and it was personal.

However, the key element that’s been left out of the telling is the role of racism.  For birth to move to the hospital, women had to believe the smear campaign on a personal level, and that personal level was racism and anti-immigrant sentiment.  The U.S. at the turn of the last century was in the middle of a wave of new immigration in the north, cities filling up with “ethnic” immigrants who were considered dirty, impure, other, and certainly not White.  Reconstruction had done nothing to address the persistent racial tension and discrimination.  But our population was becoming more and more diverse, and it was not comfortable.

The smear campaign against midwives that moved birth to the hospital was effective because it drew up the racism, fear and anti-immigrant feels of the day.  Casting hospital birth as an elite “option”  with whiteness as a prerequisite allowed  privileged women to define themselves by how they gave birth.  Giving birth in the hospital was a badge of social standing, a statement of one’s worth.  Home was where the masses gave birth, attended by immigrant midwives from the old country, dirty Italians, Jews, Irishwomen.  Home was where women who couldn’t afford better gave birth, attended by ignorant midwives who were born into slavery and didn’t live much better once they were freed.  Midwives cared for everyone, no matter what.  Hospital birth became a way to prove one’s worth by distinguishing one’s self from everyone else.  Hospital birth meant you were not an immigrant, not African-American, not like everyone else, deserving of better.  In a country where being different from immigrants and from blacks was important, moving birth as a way of proving one’s whiteness and differentiating one’s self from the masses made sense. Racism made the shift possible.

And history left unaddressed becomes the present……..

So now we fast forward to our own time, when the natural birth movement is waging a less well funded smear campaign against hospital birth, and elite women are defining themselves by how they give birth, only this time it’s at home, away from the unenlightened masses “choosing” hospital birth.  We are more diverse than ever, and experiencing another wave of immigrants.  Race-based health disparities are our largest health problem, with discrimination determining the length of one’s life, and whose children survive childbirth and childhood.  But these are not midwifery issues-our issue is where women give birth, and we frame it as a choice, though very few women have access to all the choices.

In states like mine where midwives are not legally recognized, medicaid does not reimburse midwifery care, and midwives remain out of the reach of most women.  The hospital cares for everyone, not as well as the individualized care offered by midwives, maybe, or the spa treatments and supports offered by doulas, but cares for everyone nonetheless.  Except of course for the women who distinguish themselves from the masses by “choosing” home birth. To be different, better and above everyone else, women who can afford it “choose” homebirth, and look down on the masses-the rest of us who cannot afford midwifery care-as unenlightened and less deserving.

Watching the Business of Being Born, I noticed a sea of white faces in penthouses.  The message was clear-the granddaughters of the clean white doctor on the poster chose homebirth.  The granddaughters of the midwives in the poster, the former slaves and immigrant women who cared for everyone, no matter what, we give birth in hospitals, full of unnecessary intrusions into our bodies and our dignity, and somehow this is less of a midwifery issue than where the granddaughters of the clean white doctor give birth.  Great-grandchildren of the African-American midwives die at 4 times the rate of great-grandchildren of the white doctor, and this is less of a midwifery issue than where these great-grandchildren are born.

Birth and birth location has once again become a definer of identity in a racist age.  Birth has become a way to define yourself as more deserving, more worthy, better educated, and above all, different from the outsiders, the immigrants, the women of color, without quite saying it in those terms.  Homebirth, like hospital birth before it, has become an upper class white phenomenon, while the ideal of midwifery care for all falls to the wayside.

This is part of why I’m leaving this fight.  My heart is not in helping people with more than their fair share of the world’s power have empowered births, though I do feel everyone deserves an empowered birth.  But I do not want to repeat this history, and I welcome your thoughts on how to address history, how to stop history from repeating itself.


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Really leaving, not quite gone

September 23, 2011
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My last birth: I was sure she wouldn’t do it, wouldn’t go into labor, wouldn’t find it in her to give birth again when giving birth last time had been so traumatic.  I believed the objective evidence of my last vaginal exam, where her cervix was so posterior I could hardly find it, and so rigid I could hardly get a finger into the os to strip her membranes. I believed the weird blame-y new age psychology I am usually so suspicious of, that women somehow control their births (when birth is all about surrender, about learning you cannot control a damn thing), and she was choosing not to give birth.  I believed the false starts that ended in full stops would continue and slide into a big stall.  I believed that a woman who spoke in a little girl voice and refused to take the reins in her own life would not take the reins in labor, either.  I believed I would transport for another cesarean, and she would be mad and I would be mad and the doctor would be mad and it would end in one big fight.  It would end like it had begun, in one big fight.

And so she called me at 1 am a few nights back, and I went back to sleep, believing it would not happen.  And I drove to her house heavy-hearted, praying for the grace to transport gracefully, praying for the grace to know when enough was enough, the grace to leave gracefully.  And I prayed for safety, for hers and the baby’s and my own in this sad, sad legal climate and this awful, awful system, and I realized I felt I had escaped certain doom time and time again and it was probably too much to ask for my luck to hold, too arrogant to think I could escape certainty again.  I prayed my luck would hold.  I know, this is a negative statement about midwifery-I should be reassuring you that we are highly trained, and birth is as safe as life gets, and each safe birth is not a narrowly missed train wreck, a swerve exactly too soon, a phone call that keeps you in the house an extra five minutes before work, and out of the 10 car pile up that happened at exactly the time you usually enter the turnpike.  But I have spent the last years with too much responsibility for one set of shoulders laying squarely on mine, and every day has felt like a narrowly missed train wreck, a phone call that kept me in the house 5 minutes longer than usually as the cars piled up at my turnpike entrance, and so I prayed.  I prayed to once again narrowly miss the consequences of too much responsibility and too much arrogant faith in my all too human hands; I prayed to just once more answer the phone in time, to swerve my car at the last minute, to make it out without death and jail and loss that cannot even be explained, just felt.  I’m not a religious person, and I prayed.

And I got to her house, to her birth and she started pushing, and with every contraction she said “I can’t, I can’t do this any more.”  And she pulled at my arms and she pulled at my back and she dug her nails into my hands and pulled and pulled and pulled and I felt all the years of laboring women leaning on me and my injured back, and my slipped disc slipped further and my midwifery partner told me that my cortisone shots were doing lasting damage to my tissue integrity….and she started yelling for someone to get the baby out of her, and asking why no one would help her, and the only answer was that we couldn’t help, we would if we could, but she, and she alone, needs to get the baby out, and we will be by her side but it is all up to her, and her alone, and she yelled for us to help her, and she yelled for someone to get the baby out, and I looked her in they eyes and I said you have it in you to do this, _____.  You have everything you need to push out your baby. This is hard, and you can do this hard thing.  You are everything you need to do this hard thing.  And she yelled for someone to get the baby out,  and she begged for someone to help her, and no one could, because to give birth you need to walk alone, you need to know you are enough, you need to be your own island and your own planet with mountains and fresh streams, you need to stand up as just yourself, nothing more and nothing less, and answer to your own frailty and your own power, you need to climb your own mountain and push your own baby out and there is nothing, nothing I can do for you, except believe in you and let you tear my back to shreds.

And so I left her alone with my student, who will soon be a midwife, and my student said and did things I would not have done, so I know that I have been a good mentor and my student doesn’t need me anymore, and that was satisfying.  I sat in the kitchen with my midwifery partner, a woman I really love and respect, a woman I would want to catch my own baby if I ever had one, and gossiped, and watched my student come into her own.  I disagreed with her choices, but I knew they were valid, and I enjoyed the success of watching my student be her own kind of midwife, of watching her disagree with me.  I enjoyed the success of watching my student not need me. And still the baby didn’t come out and the mother yelled for someone to help her, for someone to get the baby out, please please someone get the baby out.  And no hero swooped in to rescue her from herself and her work, and there was no one stronger than her in the room, no savior except her own self, and no one else to do her work.  And she yelled, and she yelled, waiting for help, crying out that she couldn’t do it.

And finally I did the stuff I never do-I had her lay flat on her back and bring her knees up and her chin to her chest and push as I told her to while I felt the baby’s head move down and back, down and back with her pushes.  And it worked, she wanted the direction and the orders, gentle as I tried to be.  And the baby crowned and I switched places with my student, letting her catch the baby, and getting out of the way as best I could.  We put the baby on the mom’s chest and she cried, she sobbed, she said how it should have been like this with her first, who was born by (unnecessary) cesarean. And my student looked at her and said “you did it.”

If this was just a pro-midwifery blog, I would tell you that the baby was eight and half pounds, a pound heavier than the mother’s last child, born VBAC at home, born with a nuchal hand making the passage harder, born triumphantly, born letting the mother know that she can be powerful, that she can be an island and a planet with mountains and freshwater streams, that she is all powerful and worthwhile and strong.  And she is, she really is. And happy, she is so happy.  The depression that crippled her after her last birth has not sunk in, and she is grateful but distant to me, knowing that she herself pushed out her baby, she herself did it, she herself gave birth.

I want this to be just a pro-midwifery blog.  I want to celebrate what this woman did and fade into the background with my injured back.  I want to believe the cards and encouragement sent to me by my clients, telling me that I have changed the world, one birth at a time, one empowered woman at a time.  I’m not denying the work I have done, the way my client sobbed when her baby was born and she realized that she herself did it, the long night I spent telling her she had everything she needed to give birth, to be enough to push out her baby, herself and her alone.  I did all this, and she took that step partly because of the belief in my eyes.  Those triumphant sobs are something I have felt time and time again, though with things less tangible than a baby, watching a woman come into her own.  I, too, know the triumph of making something impossible feeling come into the light, and I know there is nothing more satisfying.  And yet, I am backing away.  And yet, this is the last time I will do all this, although I find myself midwifing friends through life and I have ultimate faith in my ability to stay up rubbing backs.

If this were just a pro-midwifery blog, I would be able to ignore the other side of this story, my injured back, my growing conviction that making myself invisible is a disservice to women,  that serving birth at the expense of myself hurts us all, the feeling of too much responsibility for only one person landing squarely on my shoulders, the arrogant faith in my all too human hands, the psychological tole of feeling like I narrowly missed a train wreck every day, the marginalization of our model, the blatant racism of my midwifery community, reliving history because we refuse to face it.  I feel weak for leaving and I wonder who will take my place: if I were stronger, wouldn’t I just stay up more nights, drive right to my turnpike entrance despite the 10 car pile up, flip my own car in service to the cause? If I were a good woman, wouldn’t I just believe that I don’t really count, that I should be seen and not heard? If I were a good woman, wouldn’t I ignore the racism and be content with narrowly defined and confining gender roles keeping me a servant? And I start to feel like I am justifying my choice, that I owe an explanation for wanting to leave, and I start to ignore my feeling that if I don’t get out, I will die, and I have to believe that I, too, am worth saving.  I have lost my ability to think clearly, and my life has just become avoiding the 10 car pile ups and train wrecks that but for the grace of god could have been me.  And not that life will ever be safe, but there is a pile-up on my entrance every day and my shoulders are not big enough to support all that weight.

I think about my client sobbing and saying how proud of herself she is, and I think I could stay here.  I could stay here forever, I could keep praying my luck holds, I could keep talking myself through the long nights. I could keep changing the world one birth at a time.  I could keep believing I am only enough when I am telling someone else she is enough.  There are no midwives surrounding me, telling me to climb that mountain, telling me I have everything I need to do this, to make this change, telling me I am enough, I am strong and worthwhile.  I am standing on a planet, on a mountain, and I am alone, and I am not sure I am enough.  I’m not sure I can justifying laboring out something that is not a baby, something that may never take life.  I continually swerve out of the way.

But I remember my student’s hand on the baby’s head as it crowned, and I remember my own triumphant sobs after bringing something less tangible than a baby to light.  I want a midwife to come along and do this change for me, instead of the sad wise voice saying only I can be this island, this planet with mountains and fresh water streams.  Only I can do this, and I will miss sitting on beds and floors and tub ledges and counters, giving my all to another woman, believing in her til the sun comes up and the baby crowns and she finds her own voice.  I will miss it.

I don’t know how to hold both-the worlds I have changed one birth at a time and the 10 car pile ups, my wavering commitment to myself, to becoming the kind of woman who is enough all the time and the triumphant sobs as another woman comes into her own.  How do I leave and take the nights like this with me, yet sleep through the night? How do I leave the fight without leaving the part of me that nods her head, satisfied, as her student comes into her own, the part of me that helps a woman become her own planet, her own mountain, her own freshwater stream? How do I hold it all? Is my planet big enough to contain both, and will I be able to avoid the traffic pile-ups once more, long enough to coast into this harbor on this island? If I am alone on this mountain, will I find my way down and past, when I am the only one who can do this, myself, alone?


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Enough Self Care

September 18, 2011
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I just read yet another blog about how being a birth worker is hard, exhausting and conducive to burn-out, and, predictably, it ended with the easy answer of self-care.  This answer upsets me more and more, because it personalizes a political problem, and lays the fault and responsibility for a systems-wide problem on individual shoulders.  Individual shoulders are too small to shoulder the burden alone, and asking them to, in my opinion, is a form of denial.  I can take all the bubble baths I want, and at the end of the day, I will still be a broken worker worn down by a broken system.  Until I have the political empowerment to see myself and my exhaustion in the larger context of gender-based oppression, I will continue to think it’s my fault.  Telling me to fix it with bubble baths and organic produce (which I can ill afford on a birth worker’s earnings) keeps an abusive system in place by making fixing it an individual responsibility. Worse, this focus on self-care keeps me in my place as a powerless woman who cannot effect real change, and who is solely and alone responsible for keeping a bad machine running.  Focusing on self care stops us from naming larger problems, and keeps us running around on a broken wheel.  Because I believe in the power of naming things, here is what I think will actually help:

  • Questioning the basic premises of our model through a gender lens.  Here is my take: our culture says that to be a good woman, you wear yourself to the bone serving men, who are inherently more worthy than women.  Now read that sentence again, only replace culture with the natural birth movement,  replace women with birthworker and replace men with pregnant woman.  To be a good birth worker,  you wear yourself to the bone serving pregnant women, who are inherently more worthy.  Yeah.  The natural birth movement, at least the natural birth movement started and continued by upper class white women, grew up at a time when these were the gender norms, and they didn’t really question these gender norms, thus inadvertently replicating them, though with different people occupying each role.  Because they didn’t question these gender roles too thoroughly, they also decided that pregnant women are the epitome of powerful womanhood, and that pregnancy is the time in a woman’s life when she should be celebrated, honored and supported.  As a woman who is more than my reproductive capacity, I find this offensive, though I can see how it grew out of a different era when things were even less equal.  Ending this premise, deciding that all women matter, whether or not our wombs are occupied, well, it might involve valuing birth workers, deciding that each member of the relationship has the same worth.  And knowing our own worth would involve changing the natural birth system, refusing to accept abusive and illegal working conditions, refusing to accept endless nights without sleep and the expectation of endless availability at the expense of ourselves. I would never date a man who expected me to be a ‘good woman” and serve him at the expense of myself, who thought that he was inherently more valuable than me because of his gender.  Why do I then accept a working model that asks me to serve my clients at the expense of myself, to be endlessly available, to consider pregnant women as worth more than me because of their condition? Let’s question the harmful gender roles we are perpetuating and move on to something better.
  • Taking a long, hard look at our working conditions, and realizing they are inhuman.  How many 30 hours births have I been the only doula or primary midwife at, staying awake the whole time? How many times have I told myself that the three hour nap I took yesterday is plenty of sleep?  Do I even know what a lunch break means? How many times have I been yelled at by hospital staff and sat meekly in the corner so that I take the brunt of it, and not my client? How many times have I driven home in a state of sleep deprivation worse than drunkenness? And how many clients have expected even more from me, bought the natural birth dogma that with the right attendant birth will be transformative, empowering, orgasmic, with no work of their own? (Like anything transformative, one must work for it, not expect it; one must be open to it, not try to control it) How many clients have blamed me for things beyond my control, and how many times have I apologized my ass off for it?  As immigrants and children of immigrants, my family worked for the unions, back when unions were new and things like 8 hour work days and safe working conditions were radical and hard-won.  I think sometimes that if my great-grandparents and grandparents could see my working conditions, they would roll in their graves and think I was turning my back on all their hard work as union members and organizers.  Let’s make the same kind of working conditions that the organized labor movement fought for standard within our industry.  We are worth it.
  • Questioning continuity of care, and our own egos in assuming women need it. When I ask birth attendants why they put up with the inhumane working conditions described above, they often say that they are committed to providing continuity of care, and that women deserve to know in advance who will be their doula or midwife.  I disagree. I imagine working in a practice group of 4-6 birthworkers who are all experienced, kind and compassionate, and giving women the security that on the day of their birth, they will get good care.  The woman with them will be awake enough to make good decisions, and to put her whole heart into supporting them.  No one in labor has ever cared if our kids go to the same school, if I voted as she did in the last election, or if I share her interest in scrapbooking, though these small connection points are often what make people hire me over someone else.  Instead, women in labor care if I know how to rub their butts exactly where it hurts most, if I am patient, if I am centered and present and calm.  This is how I am when I have slept, when I feel valued, when the relationship between me and my client is one of equally valuable individuals working together, rather than one of unequal gender based roles. This is not how I am at my third birth in 3 days, or at my third day of a long birth.  Birth workers who believe that women cannot give birth without them are just as dis-empowering as a maternity care system that believes women cannot give birth without careful monitoring, tubes, a doctor to tell them when and how to push, a giant light on their vagina, medications to start and stop labor and a cesarean room down the hall, for when the inevitable result of all this technology becomes “necessary” because a woman’s body clearly cannot do it on her own.  Women give birth with and without us, and, while I was good at my job, I never did anything that a trusted colleague couldn’t do.  So let’s cut the crap.  We are not as needed as we think we are-women need support, but not us personally.  And, perhaps, if we stopped feeding our egos by fostering dependence on us, personally, women might find themselves depending on their own strength, on themselves.  And the realization that one can count on oneself, more than the paid professional, more than the system, more than anything, well, that has carried many a woman through labor, and through life.
  • Committing to not tearing each other down, which means accepting that there is no one right way.  Maybe this means acknowledging our Christian roots, and recognizing the idea of a single true path as oppressive.  I hear so much gossip about who supports Vitamin K (and is therefore a bad person), who doesn’t transport for moderate meconium (and is therefore a bad person), who doesn’t refer to WIC (and is therefore a bad person), who does refer to WIC (and is therefore a bad person).  This is our gossip.  Let’s instead commit to gossiping about who’s getting a divorce, who is cheating on her wife, who is wearing a slutty outfit and who needs to buy some deodorant, and leave our practice decisions out of it.  There are many, many ways to be a midwife, and no hard and fast right and wrong-if there was, life would be easier to navigate, and we would come out on top more often.  Also, there is always someone who’s into some freaky sex thing if one truly needs to gossip.
  • Understanding and learning from the good parts of the health care system.  Mostly this lies in the fact that it is, in fact, a system, with many people working together.  When there is stress, it is distributed across 15 sets of shoulders, and when something goes wrong, the fault also falls to multiple people.  There are no lone wolves, and no one person walks around with the weight of the world (or at least the lives of this mom, and this baby) on their tired shoulders.  Humans are an interdependent species, and we did not evolve to stand alone.  Midwifery asks me to stand alone, time and time again, and that is enough weight to drown me, strong person that I am.  When transplant surgeons play god, they play god in a team, and when the president has a problem, he consults his cabinet.  Who are we to think we can play god alone? Let’s distribute the burden across a net of individuals, and let’s embrace systems that allow us to be interdependent, as humans are meant to be.
  • Commitment to mentoring and nurturing students, rather than being threatened by them, and putting a real system for making new birth workers into place.  We are getting old and burnt out, and so we make midwifery education out of reach for students.  We are marginalized and feel powerless, so we are abusive to our students.  We are territorial, and so we close rank and refuse to let anyone in.  We need students, and how we treat them says a lot about us.  We have power over students, and we abuse it.  But we are only as sustainable as the education we can provide, and only as kind as we treat those we have power over.  To me, our abuse of students says that we are not ready to grow our model, and we are afraid to become viable as a profession.  We will not, without students.  Maybe we are afraid to cede control, to open our profession to the different interpretations and ways of being that students bring.  Again, there is no one right way, and the only traditions that survive are the ones that can adapt and grow.  So let’s make room for what students have to offer.
  • Facing history, and growing our cultural skills.  Partly this would involve facing our history, and the racism at the foundation of our model, and I can see that this is threatening.  However, if we don’t face history, we become like the upstanding leader of my midwifery community who complained to me recently that women of color simply make bad decisions, and chose not to benefit from midwifery care, “and it is too bad they have such chips on their shoulders because their communities need midwifery.”  I tried to say that perhaps statements like hers are part of the reason that women of color comprise a very small portion of the women having home births.  And I sincerely question whether communities of color would benefit from this kind of midwifery.  The shame, to me, is that the natural birth movement has appropriated so much from communities of color, without giving credit where credit is due, and has tried to obliterate and forget so much history, retelling and obscuring stories to fit our own agendas, at the expense of women of color.  And then the natural birth movement sits back and wonders why women of color do not get involved! And not to say that there aren’t women of color involved in the natural birth movement, and having natural births-there certainly are-but as a movement, we lack understanding of history.  And in letting history lay, we repeat it.  Facing history is painful, but so is growth, and we need to grow our cultural skills if we want to be a viable profession.  Let’s at least begin to talk about cultural issues, and let’s acknowledge and address racism.  Let’s recognize racism as more harmful to women than induction, and fight racism in our community as hard as we fight the rising cesarean rate.

In summary, I want a job with humane working conditions that follow standard labor practices.  I want to spend a 12 hour day supporting women, and be on-call one or two weeks per month.  I want to share responsibility with a team of people, and I don’t want to shoulder more than is realistic.  I want to work in an environment that questions racism.  I want to create a version of midwifery that is viable and sustainable.  I want to address this as a community, rather than blaming (and thus isolating) individuals as they struggle with burn out and the de-valuing that is currently part of being a birth worker.

Scary as this sounds to say, I think I am a good midwife for questioning these things.  As I have said to countless women, you matter.  And I am committed to working for a system that celebrates the worth of every woman, pregnant or not.  I will be working from the sidelines because the vision I describe is so far away, and I am slowly learning to value myself.


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