Year in Review, Part 2: Care

A year ago today, I was dining on a steady rotation of strawberry jell-o, chicken broth, and chunks of watermelon.

This is because a year ago yesterday, I had a nasty stomach bug that had rendered me unable to handle any food or drink for a whole night and day. Aside from the misery of a 24-hour stomach bug, I was having contractions. It's not surprising; it's why there's folk wisdom out there that says you could theoretically induce labor by downing a castor oil and orange juice smoothie. If your digestive system is rumbling, your uterus might decide to play along. Mine did.

So after a night of no sleep (me) and election-season-induced sleeping-like-the-dead (Brian, who didn't even realize I was up and sick), we called the Birth Center at about 5 am. I hesitated to do this, because I was fairly certain it wasn't real labor, and I didn't want to be one of those crazies who calls at the drop of a hat as soon as she hits full-term. Still, I knew there was a risk that I'd get dehydrated, and that's no good for mama or baby. I looked at their handy "when to call" checklist, which listed "illness," so I took them at their word . Peggy, the midwife on call, said to come in. I think we packed a bag, but I knew I wasn't going to have a baby that day.

I didn't, of course. What did happen was this: they monitored my contractions, which were faint and very far-between. They reassured me constantly that I did the right thing by coming in. And they got me all set up in the living room adjacent to the birthing suites, snuggled under a blanket on the couch with an I.V. and a cup of ice chips. I drifted in and out of sleep while Brian tried to find something worth watching on daytime network T.V. Every once in a while, they tested my urine to make sure I was getting sufficiently rehydrated. Eventually, I was. And once I was able to keep a glass of water down, they sent me home.

This is what I loved about the Birth Center. I loved my care during birth, to be sure. But what I find myself continuing to marvel about is the the way I felt completely at ease through my entire pregnancy, even the parts where I was barfing my brains out. They could have sent me elsewhere once they realized there was almost no chance that labor was imminent. They didn't have to devote a student midwife to the job of nursing me through an ordinary stomach bug. And perhaps I got lucky, and they wouldn't have been able to do those things at all if there was more than one laboring woman in the building at the time. Regardless: what a revelation, to not even have to set foot in a waiting room-- to have the receptionist call me by my first name when I trudged in the front door, puke bag in hand-- to immediately be ushered to a comfortable room where one person would look after me (and my husband) the entire day.

The routine appointments, too, were top notch. We never had to wait more than a few minutes for the midwife to be ready for us. Once she did, we always had an entire half hour to ask questions, go over any medical or technical matters like the prenatal screening options available to us, get information on newborn care and breastfeeding, and listen to that quick little heartbeat for as long as we wanted. On top of all that-- and this is so important-- I was actively encouraged to be a full participant in my own care. They taught me how to test my own urine for sugar and protein levels, and read my own chart, and understand every detail of the physiological process of birth. Nothing was done without a thorough explanation of why it was being done. There was nothing assembly-line about it.

Only once did I have a negative interaction. One midwife gave me a really hard time about gaining a lot of weight one month. It ruffled my feathers to the extent that I intentionally avoided scheduling subsequent appointments with her for quite a long time. But when it came down to it, she redeemed herself and then some; it turned out she was the one who saw us for all of the appointments and testing that occurred after the due date, as I went further and further overdue and we had to talk about the possibility of a Pitocin induction at the hospital. She was frank about the reality of it, but reassuring and very kind. She also connected us to a pregnancy-friendly acupuncturist.

Lucky for control-freak me, the induction was avoided, and you know the rest. Just hours after my bring-on-the-contractions needlework, my water broke and 13 hours later, Lea was born. We had the Birth Center delivery we'd been hoping for, and I couldn't have been happier with the experience. I know I'm tremendously lucky, I do. I thank God for the day of Lea's birth for a million reasons, and the fact that things went pretty much just as planned is a huge one. I know that I could have easily required a medical induction or even a c-section, and that ending up at the hospital could have been the reality for me as it is for about 20% of Birth Center clients. But the other great thing about that system is that Birth Center midwives have hospital privileges at Bryn Mawr, so they can stay by your side and even continue to be your primary caregiver for a lot of things. I do believe that even if I'd ended up with every intervention known to obstetrics, I would have felt very good about the care I received from those women. In fact, one of the things that moved me the most was the attention paid (at a breastfeeding support group meeting) to the complicated feelings of disappointment and even grief expressed by women who were healing from c-sections. It's a feeling I couldn't relate to, but I knew for sure that the group's facilitator was making a difference to those new mothers whose plans had to change.

I know, I know. Enough with the love-fest. But I can't help myself. How can I give too much credit to the team of people who helped transform me from a terrified girl who got pregnant about five years too soon to a confident woman, ready to fully embrace the transition to motherhood? By making me feel capable of handling pregnancy and labor with the strength of mind and body that I already had, my caregivers in turn helped assure me that I was capable too of feeding and soothing a newborn, of nurturing and stimulating an infant, of encouraging and protecting a toddler, and of every task ahead of me as a mother.

This is why midwifery matters to me: it's not just about how the baby gets out, it's really not. It's about how the woman becomes a mother. In giving birth, she is born. Maybe that's a philosophy that's way too out there for some, and I'm ok with that. I don't pretend that this approach is right or even interesting to every mother, and I have no delusions that free-standing birth centers are the way of the future for the majority of even routine pregnancies. But I hope that the number of women for whom it's an option continues to grow, and perhaps it's something I'll even be a part of from the other end one day. It's worth thinking about. Hell, I'm still thinking about it every day, a whole year later. Maybe I am onto something after all.