Reflections on Observed Births

Completing Phase 1

I have been working in the childbirth field going on 15 years. As a mother of 3, a doula,

a doula trainer and educator, birth never seizes to teach me. Birth teaches me to be humble, to

keep my eyes wide open, to take a breath and pause or to take a breath and react. Women teach

me to be patient, courageous and strong. The babies remind me that they too have a journey and

a will that must be respected.

I have observed births for many years, but since becoming a midwifery student, I feel I

have picked up a few different pairs of glasses through which I can try to see each participants

view. I try to put myself in the place of the mother and her family/partner (if they are present)

and observe their experiences. I try to think of the baby and how he/she is trying to make a trip

that involves fitting through tight quarters through strong, intermittent waves of energy that both

excite and exasperate him/her. I have been observing doctors and midwives in attendance for as

far back as I can remember, because their work has always fascinated me. Most recently,

however, I have been trying to put myself in the shoes of the midwife in primary care of her

client. What if that were me? How would I handle that situation? What would I say? how

would I react? How would I handle an emergency without panicking?

As I move further into midwifery school and attend more and more out of hospital births,

I am moved by the efficiency and grace of a womans body when she is given space, privacy, and

support to birth in her own environment. There is definitely wisdom to intervening little with a

normal pregnancy and labor, but watching closely. What resonates deeply with me about the
midwifery model of care is the individuality and continuity of care, as well as the shared decision

making that comes with knowing all your options. As I watch more midwifery births, I am

noticing that there are much fewer medical inductions and augmentations, yet still a very high

percentage of good outcomes. It seems that where the Western model of obstetrics is brilliant at

handling complications when they arise, they are not so great at preventing them. While I am

grateful for OBs and hospitals and I have great working relationships with birth professional in

my area, I feel that a low-risk, healthy woman can give birth safely out of the hospital with safety

parameters in place.

As I think about my future as a midwife and how I wish to practice, I have had some

clear inspirations come through over the course of my observed births. I believe that while I will

be an advocate of my clients birth wishes, I must be true to myself and not take a case if I am

not feeling 200% comfortable with it. For example, I was doula at a birth where the mom was

over 40 with GD, wanted a VBAC and was carrying twins. She found a midwife who was

comfortable providing care for her. She ended up transferring care to an OB at 30 weeks, as

complications became more evident. As a midwife, I would not have been comfortable taking

this woman into care for an OOH birth in the first place. There are too many components

making this woman high risk that I would not be comfortable with. Additionally, she lived 45

minutes away from the hospital. Her midwife was comfortable with these parameters, but

became less comfortable as the pregnancy progressed. It was sad to watch the mom so

disappointed when she had to switch care and have her babies in the hospital, but it was inspiring

to watch her midwife communicate with her in a caring, direct, and respectful manner. Her

midwife stayed in close contact with her up until 1 month postpartum. It was beautiful to watch

continuity of care in action even though the midwife was no longer the primary care-giver.
 I have realized that there are going to be times where my clients will be disappointed. I

feel as a midwife, it is paramount for me to know what to take-on and what to let go of, both

physically and emotionally. As my mentor often says, Atoosa, its not yours, let it go. I

have definitely observed a pattern in myself of wanting everything to be perfect, including how

the client(s) think of me. This is a defect of character I am working hard to remove. Childbirth

is a tough field to work in. One of my favorite midwives says, Its time to pull up your big-girl

panties, honey!. As a doula, I feel it was easier to make my clients 200% happy, for the most-

part. As a midwife, I am responsible for the life of 2 people, there is no time for people-pleasing

or trying too hard to be liked, 100% of the time.

Birth work is tolling- physically, emotionally, and spiritually. For me, challenges in

clinical work have included exhaustion, always feeling like I am behind the 8-ball with school,

and many, many question at births. I am very cognizant of self-care with a specific food plan,

vitamin, and exercise regimen. Sleep is also sacred. I feel blessed to have a clinical receptor

who allows time for de-brief after visits and births to allow for me to question, learn and grow.

For this, I feel incredibly blessed.