The wall and midwife know thyself

My clients came to me rather late in their pregnancy. They were 36 weeks gone and had found themselves unhappy with the concept of normal birth presented to them by their Spanish obstetrician. I have to say, I just fell in love with this couple. They were so sweet and in love. Their story was very romantic, meeting each other only a year previously but finding they grew up only one village  away from each other in their home country of Germany.

They were;, smart sensible, healthy, kind and funny. She was a long distance swimmer and very fit. I felt she would do very well in her labour. She was positive and pragmatic. She was happy to have a plan B to her home birth because she said she wanted to try but not suffer if she felt she could not do it. Fair enough! I felt them very open and really a breath of fresh air. As I still do.

Labour started on my daughters birth day. I had joked with them that they were not allowed to have baby on this day, but babies have their own time frame. Just as I was walking into the cinema with my daughter they rang to let me know that things were happening. It was early days so I put my phone on silent and let my daughter know that I may have had to leave if they rang. Children of homebirth midwives are so understanding, but I guess they have not much choice in the matter.

She managed to hold off calling me until 12 am the next morning when I went out to give support. They were beautiful and together. She was contracting well and things picked up with me there. Although this was first baby I felt very positive that things would move on well. She had a lot of back pain and I supported her with massage. In between contractions we chatted and got on as if we knew each other for years. It was a really lovely space to be in.

A few house later we filled the pool and she got in. She had always wanted to give birth in water and as she was a swimmer I could understand her real love of the pool. Once in she relaxed well but the back pain with each contraction worsened. She was able to manage much better in the pool and after an hour in the pool I rang my colleague to come out. I had not done a vaginal exam but felt there were other signs to show progress and she had a beautiful ‘purple line’ (http://gentlebirth.org/archives/birth.html) that showed her more than half way dilated. Things were moving on as I had thought and hoped.

My colleague arrived about an hour and a half later and my client was moving into transition (http://www.babycentre.co.uk/a177/the-stages-of-childbirth). She was coping so well with her contractions but her back pain was becoming a real source of suffering for her. She had prepared her self for labour but the pain she was experiencing in her back was sciatic and she could not equate this with labour pain. Two hours passed and as her endorphins took over and she began sleeping between contractions I knew we were coming to the end but the back pain was causing her to hold back. We continued on for an hour and a half with me talking her through each contraction. Once she was fully she tried many positions to alleviate her back pain but this was to no avail and at 10cm dilated we readied ourself to transfer to hospital. She had hit her wall and could go no further.

I have supported women who hit their walls many times. Sometimes we can push through and others we have to go in for an epidural  Each time this happens I feel very disappointed in them. I have to be honest because this is my reflection and this is the point of the blog. I am not comfortable with feeling but it is there. As a professional I understand my role, to be with women no matter what. As a homebirth midwife I have faith that any women with the right support can give birth at home and with our epidural, but I respect their right to change their mind.  Birth is not meant to be a torture. And of course as a mother I also understand hitting that wall and deciding to go the route of pain relief, because this is what I did with all my labours. I actually deeply regret those decisions I made. And this is what my disappointment comes from, its mine.

I did not become a midwife to heal some suffering I had for not achieving a full home births. I became a midwife to support women to have the best possible experience in pregnancy, labour, birth and as new mums. But I am a human being and I carry my own baggage. I am aware of it and I do not believe that I put it on my clients, but every time we transfer in for pain relief I feel that tinge in my heart. I want to tell them that they can make it, that it wont go on much longer, that if they don’t give up they will realize a strength in themselves they did not know they had. But of course I do’t say these things because I do not believe it is my place. I wish that my midwives had said them to me though, but I understand why they did not.

These are NOT our births, we are simply the support system. It is, I feel important for us to have hearts that will our women on but also to be very clear about our place. I sincerely do not believe that only a homebirth is a good birth or that epidurals are wrong. I believe that every woman should have a choice as to how she decides to give birth and that we as midwives should support out clients in their choices. Yes we have a role to educate about safety and health of mother and baby but the final decision is mums to make and our role is always to support.

So I feel my tinge and open my arms wide and embrace my clients and tell them how amazing they are,because they are. If they feel they have failed for asking for pain relief  I remind them how wonderful they were to get as far as they did. At times I share my story with them and tell them how there is no failure in birth. I remind them they are goddesses and  that the road they have traveled to hold their babies in their arms took great strength and power. I tell them they were wise and correct to do what was best for them in that time. I honestly believe this to be true, but I don’t feel this is the case for myself. When I think of the decisions I made in all three of my labours I feel a real feeling of failure and shame in a sense. I say all the things to myself that I say to my clients but it just rings hollow.

When I speak to friends about this, my feelings about my births, they all say I am too hard on myself but I am not so sure. What if my midwives had stepped over the line from support to pressure. Would I have thanked them? Would I have managed the home birth I so desired? Or would I have felt bullied and traumatized by their actions. Would my clients want me to push them more? I remember a friend telling me she wished her midwives had been more present with her, given her more direction. She said she felt overwhelmed and lost in her first birth. Where is the line for us as midwives? I have seen some midwives really push their women and felt very uncomfortable with the experience. But in my heart I wish I was pushed just that bit more. I know now how close I was to actually giving birth at home with my last child and I know that if I could have stayed the course just an hour or so longer I would have had my home birth. Instead I transferred into hospital and suffered deep emotional trauma in that experience. I ended up with postnatal depression and a life long regret.

Maybe its simply a individual thing, like most things in birth. Some women want and need to be pushed further and some midwives are the ones to do this. But strangely I am not that midwife and I am actually happy about that. Maybe if my experience had been different I would be one of those midwives, but I am not. What I am is amazed by the power of the women I support. I am in love with their process no matter what road they chose and proud to accompany them, in their own way, into their lives as mothers. As for my feelings about myself, well everyone has their battles with self value and I am no different. I know I am a brilliant mum and a good safe midwife and that makes me feel pretty good.

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