Friday, November 16, 2007

I was at home tonight, channel surfing on the television. I found a movie just starting, Erin Brockovich. I wanted something to watch while I was organizing some papers, so I started watching it. It's sad. Sometimes, I feel like Erin Brockovich in a different kind of way. Here is my Erin Brockovich story.
I was in Hobby Lobby tonight and a woman I had never spoken to called me on cell phone. She told me she was supposed to have a c-section today, but she didn't show up for it. She said she had a c-section with her first baby 6 years ago. Now she is pregnant again with her second baby. She has been going to a doctor who originally said she could try for a vaginal birth. Unfortunately, her due date was yesterday, and her time was up. Her doctor said she can't let her go over her due date, especially since next week is Thanksgiving and she is planning to go out of town. So the woman who called me somehow found the courage to disobey her doctor and not show up for the c-section. Her plan now is to wait until she goes into labor and stay home as long as possible, until she feels an urge to push and go to the hospital and take whatever doctor she gets. She spoke to someone who recommended she call me. So she called me and told me her story.
Maybe I should have just said, I'm sorry, I can't help you. It's pitiful that so many American women are in this situation. I don't know if I can help her. I do know it's a terrible situation that I've heard about over and over again. Unnecessary surgery hurts women and families. It's wrong.

Monday, November 12, 2007

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Daydreams

When I help with a difficult birth such as the one I described in the last post, it makes me question whether or not I should remain a midwife. Should it be up to me to hold the life of a baby in my hands? The baby I delivered yesterday was born to a woman with no risk factors. He wasn't too big, not extremely overdue, no meconium, she was in good health. However, he had to be resuscitated. But if I don't do it- who will? She could be with a midwife without as much experience or at a hospital where he would immediately have his cord cut and taken away from his mom and probably still be in NICU.
If I was not a midwife, I would like to work in a bakery or a flower shop, making pretty things. I would only work part time just to have some spending money. I would stay up late whenever I wanted. I would go camping with my boys at least once a month. I would hang out at the library and exercise or walk my dog every day. I would clean out my closet and use my sewing machine more often.
Oh, it's time to wake up. I'll do all that some time in the future. I can do those things when I retire. But now it's not time to retire. I still have a mission to help more women and babies and families and hold a place for an alternative to hospital birth. Most of the time, I love being a midwife and I consider it a privilege. It just shakes me up sometimes to realize what an awesome responsibility I hold in my hands.

A difficult birth

When I come back to this blog, I know I am more of a midwife than a writer. I make time in my life to be a midwife, but rarely make time to write. So many things have happened since I last wrote and I'm mad at myself for not making the time to write about it. So here I am now to give an update.
I'm at home today listening to NPR on the radio with my cat lying in a basket nearby. it's wonderful to have some time to write. I helped deliver two babies yesterday. It always amazes me how babies are born in little groups. The babies yesterday were at 6:16 am (after a long night for us all), and 5:09 pm. The mother of the second baby is a woman I am close to. I helped her with her first baby as well and have also helped with some of her friends babies. I like her family because it reminds me of my own. She called me yesterday morning to let me know she was in labor. I was already at the birth center with my first client, so she said she would be there in a little while. In the meantime, my other client went home and I got the birth room cleaned and ready to use again.
When she got there, she was doing great- really working well with each strong contraction- breathing and walking and not complaining- just working hard. She is in good health and had a perfectly sized baby- three days past her due date. I checked her vital signs and listened to her baby- everything sounded great. At 1:00, I checked and she was 8 cm with bulging membranes and we were all so excited to know her baby would be here soon. Her first labor had been kind of long. We were all hoping this one would not take so long.
So she got in the birth tub to relax. She continued working well with her contractions. But time went on , and she did not have an urge to push. After about two hours she got out of the tub to lie on the bed because she was getting very tired. I checked again and she was 9 cm, but the front part of her cervix was swollen. Her water broke when I did that exam and it was clear. I felt confident that the baby would come right on down and out with the water out of the way. So she went on with her labor working really hard. I was surprised that her completely normal pregnancy and labor so far had not resulted in birth. During all this time, I was checking her vital signs and listening to her baby with the dopler intermittantly. He always sounded fine. She would occasionally get an urge to push, but it would not last. I knew something was blocking his way. I checked again and her cervix was swollen even more. I was worried now, because there isn't much I can do to stop the swelling except change the mom's position frequently and put ice on the cervix. She was already moving all over the place, so I decided to try to put some ice on the cervix to reduce it. From that time on, I was very busy working with her with every contraction. The ice definitely helped. She got on her hands and knees to put pressure on the front part of her cervix and soon had a true urge to push. The baby's heartbeat went down to the 120's, but still in the normal range. I think it was because his head was being molded.
Finally, we could see his head as she pushed. He certainly didn't glide out. She had to push hard every time to make a little progress. The baby's heart rate remained in the normal range. And now he was crowning. I waited for the next contraction and his head came halfway out. Ok, push him out- but she couldn't she didn't have another contraction or an urge to push. I rubbed her uterus vigorously to stimulate another contraction-I asked her husband to rub her nipples to release some oxytocin. Still no contraction- just push anyway!!!So she pushed with all her might and he came on through. There was a cord around his neck and I quickly looped it off. He came out limp and white and not moving. It is my worst nightmare to see a baby like that.
I immediately rubbed him and suctioned him with the bulb syringe and he moved and coughed a little. My assistant got the oxygen. It took a minute to get the o2 going, but we gave him some. He had a good heartbeat, but still not breathing on his own. I gave him a few puffs with the ambu bag, and finally he started breathing on his own. His color improved and he opened his eyes. His life came back to him! He was so precious and we were all so thankful for him to be alive. His apgars were 4, 9, and 10. Now today he is at home with his parents and big brother and grandparents.

Sunday, September 23, 2007

Glad to be home

I just took a two hour nap. I hardly ever sleep for more than 20 minutes except at night. I was really tired. I'm thankful to be at home today. I got home this morning at 9:00 and immediately changed clothes and went to church. I teach Sunday school and the kids were in a program I didn't want to miss. I need some time off, at least a day. I'm not complaining, but I've got to regroup before I can go any further, so I'm very thankful to be at home today.

I've helped with 4 babies in the last 10 days- all really good births. I consider a good birth one that ends up in a healthy mother and a healthy baby and we don't have to go to the hospital. Not that births we have to go to the hospital for are not good- it's just very hard on us all, but sometimes it's all we can do.

Of the 4 babies born recently, two were to first time moms. It's always a big relief to help guide them safely through that first birth. The one last night took all day yesterday- from 1:30 a.m. to 11:26 pm last night. She started out very quiet, but got loud by the end of the day. It was an especially sweet birth for me because I had delivered 2 babies for this family before- the grandmother of the baby two youngest children. It's wonderful to see a new generation that appreciates midwives. The grandfather of the baby was there all day. It reminded me of when I delivered his two youngest sons. That was 8 and 10 years ago. Time flies. He and I talked politics for awhile this morning. He's a republican, I'm a democrat. It was good to talk to him and know that there are good people on both sides of the aisle.

The other first baby I helped with last week was such a good birth for a first time mom. It's so unfair how some women have it so easy and some have it so hard. I am happy to help women become mothers and families being formed. I am more convinced than ever that the best way to do that is with a home or birth center birth.

I went to Killeen to deliver a baby this week. The mother is a friend and a client and it was the 4th baby I have delivered for this family. Her due date was Sept. 29th and I was hoping all the other babies for September would all be delivered by the time she went into labor. It didn't happen that way. Her water broke at the grocery store, 10 days early. She called me as soon as she got home and told me what had happened. I told her to lie down and stay there. I had also just gotten home from the grocery store. Within 5 minutes, I had put up ,my groceries, gathered some clothes and got into the car and started driving. It took me 4 hours to get there, and she only got up once to use the restroom. When I got there, she got up and started moving around. She immediately started having strong regular contractions and had the baby an hour and a half later. We had made arrangements for another midwife who lives close and is not so busy, to go to her if I could not come or didn't get there in time. It turned out she had another birth that night. When I was driving up there, I never felt worried or stressed. I knew if I was supposed to be there, I would make it. It turned out perfectly. I believe the Lord guides and directs and protects me.

The main thing on my mind today is my baby I had 17 years ago. His birthday is tomorrow. My water broke at 4:30 on a Sunday afternoon and he was born at home at 12:45 am the next day. I am getting ready to go and make him a pumpkin birthday pie (that's what he wants). He is a good son, never have had any problems with him. On his birthday, it was very hot in the day and a cool front came through during the night. I always look forward to his birthday because I want the cool weather. I went outside for a few minutes before I came up here to write. All my plants are practically burnt up from neglect. I watered them all. It's nice to be home.

Sunday, September 9, 2007

Being a Writer

I don't have my midwife hat on tonight. I think some people think I am always at the Birth Center waiting for the next woman in labor, but I also have a life outside of that. I am out of town now, and I have my daughter hat on right now. I am in Amarillo, Texas at my mom's house as I write this. I am here for my stepdad's funeral. He died of bone cancer. He suffered a lot at the end and it was a blessing for him to pass on. I'm glad to be here with my family for this funeral, this ritual. It is good to be with my family. I love to be here, but my husband doesn't and we got into an argument about that today. I don't like to be away from my clients when they have their babies, but when someone close to you dies, it can't be helped. No one has had a baby since I've been gone as far as I know. Hope they will wait until I get back, but babies don't care about my trips. They come when they are ready.

My sons (age 14 and 17) were talking today about a story we heard on NPR about why women read more than men, and why old people like to read more than young ones. It started an interesting discussion. We talked about what kind of books we like to read. I told them I want to be a writer. They both said, "Why???" Why would anyone write if they don't have to? I told them because you are the only one who can write your story. I want to write, but I don't make much time to write. This blog will have to do for now. I just finished reading a really good book called, Without a Map, by Meredith Hall. It is a story about a woman who got pregnant in 1967 when she was 16 and gave her baby up for adoption. He eventually found her when he was 21. That book really touched a cord within me. I was 16 when I had my first baby, but I didn't give him up for adoption. Anyway, reading that book made me feel like I want to write a book about my life.

Tuesday, August 28, 2007

A Good Outcome

I'm home from Austin and had my hearing with the Board of Nursing today. It was a good outcome. I will have to be on probation for two years, but I can maintain my license and continue to run my birth center. I am so happy!!!!! I feel like I've had the weight of the world lifted off of me. It is truly a happy day. Having a midwife, or being a midwife is something no one should take for granted, because it is something that can be taken away.
The hearing was difficult, but it went well overall and I have to admit they were reasonable. They gave me plenty of time to tell my side of the story. They allowed Pat to speak some. It was comforting just to have her and my husband in the room. The thing that helped me the most was all the letters my clients wrote for me. When I was in the waiting room, about to go in, I just imagined all my clients that wrote letters around me and protecting me, and I didn't feel afraid. They did take the letters and I think they read at least some of them. The one I put on top was one from my client who is the next one due. She wrote a great letter comparing her 1st hospital birth to her three home births. Even though she doesn't have a college degree, she wrote from the heart and it was very touching.
I feel like I can go forward now. I can buy a new doppler that I've been needing and I can plan for the future again. This is a day I've been dreading and it has turned out good. I love my life and my work. I hope I will be able to help a lot more women before it's all over. I think in the end, this will make my practice stronger. I am forming an alliance with another nurse-midwife in order to meet the terms of my probation. That is a good thing for me and my clients.
One thing I've decided to do as a result of this is to start a legal defense fund for midwives in Texas. I think having an attorney definitely helped me today. I'm going to have a big party in the fall and charge everyone a little something to come to raise money for the fund. Sometimes good things come from adversity.

Monday, August 27, 2007

Late night on the computer

I go to Austin tomorrow for my hearing with the Board of Nursing. I'm up late tonight printing out my speech and printing all the letters I've received from friends and clients. The letters are overwhelming. I feel like I'm at my funeral and hearing what people are saying about me. But it's even better, because I'm not dead. I'm about as alive as I've ever been.
Reading all these letters has given me a lot of strength to stand up for myself and my profession of midwifery. It means a lot to a lot of people. I'm still a little scared, mainly because of all the bad stories I've heard from other nurses who have had to go before the Board. I guess it's like a woman having her first baby who has heard a lot of scary stories. My midwife friend, Pat, is going with me. My husband is also going. He should have been a lawyer. He can twist anything around to his advantage. I know they will help me through it.
We had a new baby at the birth center yesterday. It reminded me of why I do this. It was a woman who had her first baby and about 14 hours of labor. She never gave up. Had the cutest 8 lb. baby girl, the first grandbaby on both sides. Her mother was so worried about her and her husband was so proud of her. It was so wonderful when the baby finally came out and we all knew we didn't have to worry about going to the hospital. I think she would have been cut for sure there.
Well, I'll close and see what tomorrow holds. Jackie

Friday, August 24, 2007

A Good Day

I feel like I retrieved a treasure today. I asked some of my previous clients to write letters on my behalf that I could present to the Board of Nursing. They responded with so many letters that I feel overwhelmed with their confidence in me. It gives me the courage I need to stand up for myself next Tuesday at my hearing. I hope the Board of Nursing will look at these letters. They are powerful and passionate. It's what happens when women are empowered and appreciate it.

I had a good day in many ways today. Got a lot done at the office during the day and a good evening at home with my family. My boys came home from a trip to Oregon yesterday. They went to see our 2 older sons who live in Eugene. It's good to have them home and makes me realize again what a blessing it is to be a mother. We've been busy getting school clothes and supplies and getting ready for school to start. A weird thing happened when we were at Walgreens. A guy came in right behind us and robbed the store! I don't think he got much money, but he sure shook the place up. I saw him look at me when I got out of my car, and I thought he was acting kind of weird, but I didn't think that much about it, and then he came in a few minutes later and told the girl at the counter to give him all her money which she promptly did. My son and I were already down an aisle and all we heard was a lot of commotion as soon as he ran out. Never had that happen before.

I got to be part of a conference call today to help choose a new Course Coordinator for ATM. The women that have applied for the job are all incredible and makes me feel good about the future midwives in Texas. One girl we interviewed is so enthusiastic about being a midwife. She reminds me of myself 10 years ago, but she's even smarter and better. One of my clients came to see me today and then stayed at the office awhile just to talk. She is a doula. She is pregnant and her baby is due in August with her 4th baby. She is very smart. The other day, my husband was talking about one of our sons becoming an engineer and I was feeling sorry for myself because I don't have any daughters to follow in my footsteps. Today I realized I have lots of women who are kind of like my daughters who want to become midwives and doulas, and childbirth educators. There are lots of women who see value in what I do and that makes me very happy.

Camellia and Debbie and I were all at the office today. I can't help but wonder what is going to happen in the future. Will we be able to keep going after this week? I'm worried about the hearing on Tuesday. I'm going to spend some time tomorrow preparing for it.

Monday, August 20, 2007

Legal Problems looming

I'm starting this blog today as I listen to a story about VBAC on NPR in the background. I've wanted to do this for a really long time. I want to write about all my ups and downs as a midwife.
This has been a particularly up and down day. It started out at 3:00 am this morning with one of my clients who I've been expecting to call any day. She told me she was in labor and I got up and got ready to go. I arrived at her home at 3:50 am and she was in strong labor when I arrived. I called my assisitant, Camellia to come asap. She had a beautiful baby on the birth stool at 4:50 am. Just had time to get things set up and ready before the baby came. A wonderful birth with a wonderful family and precious baby girl.
Stayed at her home until about 11am (rested between 9-10). All was well there. Went next to see a client who lives on a boat in Galveston Bay. Another beautiful family that just had their 3rd baby. They were both tired- the baby kept them up most of the night, but still very happy with their newborn son. Did the baby's newborn screen and weighed him and checked for jaundice. All well there, so went on down the road. Stopped at Neptune's Subs in Seabrook- one of my favorite places to eat. Told the owner they have 2 new baby residents in the area. They were all happy.
Got to my office/ birth center about 2pm. Tired but happy about a fulfilling days work. Got into my e-mail and found out I have a hearing scheduled to defend my license next Tuesday, August 28th. This is when I decided to start a blog. I need somewhere to let my clients and friends know what is happening with me and my legal situations and how difficult this is to cope with. I don't want to whine and moan. I want to tell my side of the story. All my life when I have been in difficult situations, my best therapy has been to write about it, so that is what I am going to do here. Will post more about my case soon.
Jackie