Start of my 6th week

Last night I worked on night shift, and for the first time ever, I was taught how to check the fundus after birth, and I checked it myself once, too. I was thrilled that it’s actually there and palpable. I’ve always thought it’s crazy to try and feel for an organ inside the abdomen, and I didn’t believe I’d actually be able to feel anything. But I did!

I also learned in my reading that the #1 way to prevent tears during birth is a slow pushing stage. (And it’s actually better when the head emerges between contractions.) Last night I saw a physiologically “slow” (ie, absolutely normal) second stage. And no tearing 🙂 Which also helps there to be decreased blood loss.

My clinical experience

I’ve been in school for 5 weeks–today is Saturday; it’s the completion of the 5th week. Week one was Orientation Week.

I’ve worked 5 shifts in the birth room (one shift I worked in August, because I arrived early). I’ve observed 5 births here. While working birth room shifts, I also observe immediate postpartum care, the newborn exams, 24-hour postpartum observation, newborn screening and discharge. I also observe return mother-baby checks (each client is under the clinic care through 6 weeks postpartum).

I’ve worked 4 days in the regular prenatal care room, taking vitals and observing a midwife doing prenatal visits. One of those days was a day of initial prenatals (the mother’s first visit to the clinic during her current pregnancy).

I’ve stared learning to measure fundal height, palpation of the fetus and finding and timing heart tones using a doppler.

First day of clinicals

This Monday was my first day to work clinical prenatal shifts (I’ve already worked several birth shifts); our job was to take initial vital signs on the moms coming into their initial prenatal visit.

I do confess, I was very clumsy! The first woman who sat down, I needed to count her pulse, and my own heart was pounding so LOUDLY it was all I could hear!

I also was trying to take her blood pressure with my stethoscope head turned to the infant side, so no wonder I heard nothing, and a teacher pointed out that this was why.

I have so many emoticon faces going through my brain while writing this post!!!

To get through it, I learned to go slowly, and fortunately, there was no hurry as the initial interviews take a lot longer for each woman to complete. I calmed myself down, positioned my chair so it was easy for me to hold her hand/arm to take her pulse and count respirations. There were a few other gaffes.

But! I made steps of learning! I’m so thrilled. I asked a teaching midwife for help with one blood pressure– it takes a lot of coordination to count backwards with the dial while watching the dial and listening for her heart sounds to start. And the midwife said something that made it *click* in my head–what I was supposed to be expecting to hear.

So I have practiced again on some family members, and it’s getting easier to hear that first knock of the heart and remember the number and ignore extraneous crackles.

Also, another teaching midwife let me sit with her for the initial exams, taught me about their computer program for entering data, and let me practice measuring fundal height and palpating the baby and using a doppler to hear heart tones. I have since practiced on myself feeling my pubic bone for FH (fundal height) measurements).

Overall, it was an amazing 4-5 hours. I learned a lot in a friendly, safe environment.

I’m also working through a required reading list. I’ve finished 14 of 25 books, and I’m reading #15 and #16 currently. It’s a range of reading–biographies of midwives, different cultures of birth, various birth models, missions books, midwifery books, women’s physiology and cycles books.

I’m specifically trying to choose books I’ve not read before, and this gives me a lot of choices.

In this photo is one page of the required reading lists to choose from, and the bottom page is my own list so I can track how many I’ve read from each section, when I finished, the date I wrote then submitted the review. The purple highlighting marks what I have read; the yellow marks what I’m planning to read.

Being a midwifery student and Spiritual opposition

I have often wished that someone would have a blog or site devoted to midwife-wanna-be’s and midwifery students. Not about education, but about the condition of being a midwifery student or being *called* to midwifery but unable to pursue it currently. In my own path, I’ve come across very little to read or encourage myself while waiting indefinitely. Also, there isn’t a lot for American home birth midwifery students about actually being a student and the issues relevant to actually being a student (there is literature and videos for those in England, for example). There is a growing body of texts about the student-preceptor relationship, which is a part of being a student in home birth midwifery, but it’s not really the same question.

Midwifery and being a midwife is a mixture of science, knowledge, developing intuition, and spirituality and spiritual warfare. So all this bears when one is a student.

I want to talk about the last because I don’t think many talk about this, but I think that actively being involved in childbirth puts a Christian inside a particular sphere where opposing spiritual forces are acting (I think this is true in other professions, too).

(Why is this such a spiritual sphere: I haven’t been able to think very deeply in this topic, honestly, though my life experiences put me in contact with the fuzzy edges of it. Historically, pregnant women (pregnancy itself), the act of childbirth, and small babies seem to be repeatedly attacked. I’m not sure why that is spiritually—but as God is the Creator, and pregnancy is how he creates eternal souls, and possibly going back to the curse of satan about “seed of the woman”– it is something opposed on a foundational level spiritually.)

Here are some examples of what I’m talking about, from the book Mamatoto: A Celebration of Birth by Carroll Dunham and The Body Shop Team, published in 1991, page 81:

“… there are parts of the world today where women’s reproductive rights are controlled by the state. In Romania under Ceausescu’s regime, every woman, married or not, was forced to breed, and produce five children. … scars of frequent illegal abortions (many without proper anesthetics) have left only 5 per cent of Bucharest women of childbearing age with healthy uteruses.

“Tibetans today suffer a chilling form of genocide by the Chinese, who have forcibly occupied their country since 1950. Tibetan women are checked each month for pregnancies. On each neighborhood block in the capital, Lhasa, a female government official monitors menstrual cycles. Any Tibetan female discovered to be pregnanct is taken to the hospital for an abortion. By the end of 1989, 87,000 women had been sterilized in Qinghai province in central Asia. The Chinese government’s terrifying justification of these genocidal practices may be found in its official report on family planning policy: ‘It is much more common to find in their population persons who are mentally retarded, short of statue, dwarfs and insane.’”

Actually wanting to go into this sphere of work is opposed spiritually, and so is the student becoming the midwife God has created her to be. There are a lot of ways to be derailed, deformed, or distracted.

But I don’t think it’s all negative. There are powerful forces of God guiding and protecting women (and consequently their families) who are in this work. I consider how many times I’ve “had a funeral” for this midwifery life calling, how many times I’ve even actively tried to beat this interest and desire out of myself, and I see how God has protected this somehow, even from myself. It gives me hope, a glimpse of God’s power in guiding this process.

In another way of looking at this role and the spiritual elements one encounters:

Midwifery is the skills and actual personality of the midwife actively defending/protecting pregnant women, their births, their young. The essence and skills of midwifery protect those in these natural states; that is also to say, the natural vulnerability of these states needs protection. The physical process needs protection, as does the untouchable parts of pregnancy and birth– the souls and psyches.

But becoming and growing in that protective role is challenging, to say the least.

Somehow, in choosing this profession, one is choosing to try an become capable to face the ideologies, systems, politics, and people that do harm, and, as this deals directly with the creation of new life and eternal souls, it is a spiritual realm with spiritual opposition that one has to directly act in.

This verse below describes part of what a student midwife is becoming–the *heart* and actions– it sounds so sweet and nurturing, and it is. But there’s so much acting and being (the power of skill and philosophy) of the shepherd underneath these small clues:

Midwifery-missions required reading

I received a list of required reading books while we were in Romania, probably in May. So I slowly started reading through it. So far, I’ve read 7 of the 25 books, and reading through my 8th book currently.

I like these books. They are interesting, and they play off of one another–one book gives principles, another has an illustration of that in another context; they mention each other and how they were influenced by ideas. I find them personally and professionally interesting.

After each book, I write a review to submit.

Birth in extreme conditions

This is a brief article written for a Russian-/Ukrainian-speaking audience during the War in 2022.

In the classic movie, “Gone with the Wind,” the beautiful heroine, Scarlett O’Hara, has gone in search of Dr. Meade. Scarlett’s friend is in labor, and Scarlett wants him to come attend the labor, as he usually would. She finds him working in an enormous field of wounded soldiers.

He refuses to come help with the birth, saying that he is more needed to help with the hundreds of dying soldiers, and he says a line I love: “Don’t worry, child. There’s nothing to bringing a baby.”

“Don’t worry, child. There’s nothing to bringing a baby.”

I don’t want to make light of having a baby, but what the doctor (and perhaps culture in general) understood is that childbirth is a self-starting and self-completing process that usually needs very little intervention.

If you find yourself a pregnant refugee, or possibly pregnant and hiding, I want to remind you of important practices that will keep your pregnancy and birth as normal as possible.

Before childbirth:

  1. If you can evacuate to a safer place, do so immediately. Do not “wait and see.”
  2. Ask God for His personal protection over your pregnancy and birth, over your body and your baby. Ask Him for miracles on your behalf. He deeply loves and cares for you and your baby.
  3. Create playlists of music that honors God and encourages you. Find verses in the Bible that comfort you and record your voice reading them in one long recording that you can turn on and listen to during pregnancy and labor.
  4. Healthy eating is the number one way you can physically influence your pregnancy and birth to remain uncomplicated. You need to be eating, daily, approximately 2200-2500 healthy calories. You need a mix of carbohydrates (grains, potatoes, macaroni, etc.) with protein (meat, eggs, tvorog). At least 80grams/day of protein is a basic estimate. Eat small portions throughout the day.
  5. Find help, if at all possible. Contact a midwife or doula or someone who can answer your questions, even “attend” the birth with you by phone, hopefully by video.
  6.  Gather birth supplies—if you only have minimal supplies, you need some newspapers or clean rags for the water and blood that accompanies birth. Also have towels and blankets for the newborn—one to initially wipe away the wetness, then clean and dry ones to cover the baby.
  7. Spend time relaxing your belling while on your hands and knees. This can help facilitate good positioning for the baby.

During childbirth:

  1. Light eating and drinking during labor helps your muscles maintain energy. Remember to use the toilet because you don’t want a full bladder when pushing the baby out.
  2. Move during labor and change positions. Your baby has reflexes that he uses to navigate his way through the birth canal. Changing positions, rocking, standing, hands and knees—these movements of your body allow the baby freedom to get himself out.
  3. When you start feeling like you want to poop, that means the baby’s head is close, and your body will start pushing. Don’t lay on your back to push! Stand, be on hands and knees, or lay on your left side if you must lie down.
  4. Don’t force pushing. During labor, the uterus muscles have been drawing upward, gathering at the top, exactly to push the baby out. Just follow the sensations that your body gives you. Pushing with force can cause tearing. (Vertical positions allow the baby to exit naturally without forceful pushing.)
  5. Whoever is with you will need to be able to catch the baby. Once the head is out, that person might want to check if there is the cord around the neck. This is perfectly normal, and if it is, it can be slipped off over the head. The body will slide out pretty fast and be very wet, so be ready 😊
  6. Put the baby on your stomach/breast. Rest. Talk to your baby. Feel all the relief and love God designed you to feel at this moment.
  7. Caregiver can check the baby’s breathing. He might sneeze out mucus. If you have a bulb syringe you can carefully suction the mouth then nose if needed. Rub his back to help stimulate breathing if needed. At this time the baby has to push all the fluid out of his lung sacs (alveoli) to start breathing, so some crying can help with that, but it’s not essential. The baby should be pink in color.

Placenta:

  1. There is no reason to cut the cord. You can wait almost indefinitely, and the blood in the placenta is the baby’s blood and will flow to him, helping him survive and adapt.
  2. The placenta should come out any time from 7 to 30 minutes after the birth (this is a general rule, not an aggressive standard). Don’t pull on the cord or aggressively try to remove the placenta! This is very dangerous because it can cause excessive bleeding. After birth, the uterus continues contracting and will expel the placenta itself. This phase might be confusing to some parents, so please have someone to call who can help.
  3. It’s important that the caregiver monitor how mom is doing. About too much blood loss: hemorrhage might happen suddenly, but usually it is too much bleeding over a period of hours in the immediate postpartum. When the body loses too much blood, it goes into shock to preserve itself, and intervention is needed. The signs of shock: pulse of over 90 bpm (the heart is pumping faster to compensate for less blood in the veins), pale skin and cold sweat; lowered body temperature; low blood pressure: systolic (upper number) is less than 100). This most likely will not be an issue. but it’s better have someone you can call on the phone for help if needed or even if you just need reassurance.

“You created my inmost being; you knit me together in my mother’s womb.” We often think of this verse when we think about the child we are carrying. But let’s pause and meditate on how this verse describes you, mother; it describes your body, created with the ability to carry, birth, and breastfeed this child. God is with you.

Shto takoye “akusherka” v zapadnom smisle

Что такое «акушерка» в западном смысле?

Когда различные культуры «встречаются», мы испытываем любопытство, интерес, конфликт, романтику, критику, осуждение, принятие, любовь, приспособление, и появляется что-то новое.

Я знаю, что в этом видео есть миллион грамматических ошибок, но надеюсь, вам все равно понравится и что вы найдете что-то интересное. Я показываю оборудование акушерки домашних родов, как она работает с женщинами на протяжении всей беременности, родов и послеродового периода, а также видеоклип моих вторых родов.

Планирование семьи, 3: неожиданная беременность против нежелательной беременности

У меня было две неожиданные беременности, но не было нежелательных беременностей. Я думаю, что, поскольку я столько лет размышляла о позиции “за жизни” по отношению к беременности, я на более глубоком уровне усвоила приоритеты Бога – принимать детей и быть открытым для жизни несмотря на последствия. Это часть заповедей Бога, на которой я сосредоточился. (Другие лучше сосредотачиваются и выполняют другие команды, с которыми я борюсь.)

Когда бывает у нас неожиданная беременность, есть выбор – сосредоточусь ли я на этой беременности как на нежелательной для меня? Или я собираюсь принять неожиданное и изменить свои планы?

Чем раньше женщина сможет принять, тем легче будет эмоциональный стань.

Но я хочу остановиться на минуту, чтобы сосредоточиться на этой борьбе–принимать неожиданно. Так заманчиво рассердиться из-за неожиданной беременности, глубоко разозлиться по этому поводу. Чтобы чувствовать себя использованным. Чувствовать, что все остальные (особенно мой муж) живут счастливой жизнью, но я? Я должна подавить все свои идеи и желания и время, и подчиниться ограничениям этой беременности, грудного вскармливания и отдачи любви/себя другому ребенку.

Некоторые женщины застревают в этом круговороте. Я скажу, что не каждая женщина борется с этим – у некоторых женщин есть жизнь, в которую они могут легче вписать еще одного ребенка.

Но когда женщина борется с виной, гневом, жалостью к себе – действительно кажется правдой, что эта беременность совершенно несправедлива. Изменить эти мысли и легко и сложно.

Я научилась всегда идти прямо к Богу, когда хочу кого-то обвинить (в не греховном контексте – и забеременеть после секса – это не грех. В греховном контексте, все похож, но есть нюансы). Почему прямиком к Богу? Это помогает мне принять обстоятельства моей жизни. Бог мог бы очень легко это изменить. Ему было бы так легко что-то изменить. Но … Он этого не меняет; Он позволяет это; Он ДЕЛАЕТ это. И я знаю, что Бог абсолютно добр ко мне. Он имеет самую глубокую любовь ко мне из всех, кто мог бы меня любить. Его любовь абсолютно безупречна, безгрешна, бескорыстна. Так что в любом случае я сразу обращаюсь к Богу. Принимаю факт, что Он делает мне добро, и есть хорошая цель в этом для меня. Принятие становится вопросом моего послушания.

Я также научилась перестать думать, что у мужчины нет «цены, которую он должен заплатить» за еще одного ребенка. Кажется, ему намного проще – он просто работает на той же работе/карьере, его жизнь просто продолжается так была, верно? Для ответственного человека это неправда. И мне пришлось признать, что мой муж несет почти такой же вес, как и я – конечно, он не беременен и не кормит грудью. Но за это ему нужно “платить” мне (так сказать) с его силой и нашим доходом. Теперь у него есть ребенок, которого ему нужно любить, дружить, направлять, обеспечивать …

И отчасти я просто согласна с тем, что для меня, как для женщины, иметь детей – это другое дело, если я собираюсь подчиняться своим собственным ожиданиям в отношении воспитания детей и особым обстоятельствам жизни и общества, в котором я живу (и ВСЕМ людям приходится работать со своими жизненными ограничениями и обстоятельствами, не только мне, и не только беременным женщинам).

Это некоторые мысли, которые помогли мне пережить благословение и борьбу за детей в греховном мире. Я лично отложила карьерные мечты, чтобы вырастить своих детей, и я понимаю эту жертву на личном уровне. У меня есть карьерные желания, которые не сочетаются с воспитанием детей и конкретной культурой и жизненными обстоятельствами, в которых я живу.

Это определенно того стоило, хотя и болезненно. И меня утешает то, что Бог привел меня в эту жизнь, и Он доволен ею.

Планирование семьи, 2

Интим обычно приводит к детям. Замечательно, как это сделал Бог. Я знаю, что греховный мир так часто делает это ужасным, но, как и планировалось, это действительно замечательно.

Довольно рано в нашем браке я перестала «планировать» семью (т.е., количество детей), и я работала над тем, чтобы сохранять открытое сердце для рождения детей. Позже мне пришлось открыть свое сердце, чтобы больше не иметь детей.

Мое “планирование семьи” стало … не уж так планировать и более просто сохранять открытое сердце по отношению к воле Бога в этом вопросе.

Это сложно сделать. Я хотела спланировать годы, когда буду занят детьми. Я хотела увидеть конец. Думаю, что сейчас я вижу конец, но я все еще открыта.

Не думаю, что правильно ценю материнство. Это, наверное, самое плодотворное и ценное, что я делаю, и все же эмоционально я не чувствую, что это правда. Думаю, через 10, 20, 30 лет, оглядываясь назад, я пойму лучше. Я буду тогда почувствовать его ценность.

В ранние годы, когда я хотела категорично подходить к жизненным вопросам, я прошла этап, когда я была убеждена, что у людей должно быть много детей. Но эта фаза превратилась в благодать, в понимание того, что Бог не просто желает огромное количество детей ради самого себя. Он хочет общаться с нами. Он обращается к нам во время беременности, родов, на этапах развития ребенка. Он приближается к нам, неся с нами условия жизни в грешном мире.

И когда я думаю о том, как мы были созданы для жизни в семьях, в взаимоотношениях, я думаю, что это Его воля, чтобы я познала любовь, привязанность, и полноту тесной связи с другими. Это Его воля, чтобы я испытала годы постепенного обучения детей все более и более глубоким истинам о Нем, о мире. Вера, истина и детство – это просто удивительное сочетание, которое можно испытать как родитель..

Как интересно, что Бог ведет вечную душу через фазы детства. Это все просто … грандиозно. Его план и Его творение непостижимо. ❤