Cleaning Up: My Checklist

Standing in front of her deep laundry tub, the cement floor beneath my socked feet is as cold as the frozen earth outside.  A ten gallon bucket full of dirty towels, a set of queen size sheets and night gown awaits my attention.  The battery powered lantern I brought with me casts shadows all around. Latex gloved hands work quickly to accomplish the task. 

Typical Amish laundry tub, wringer and spinner.

My post-birth laundering takes me to a variety of types of wash rooms.  Dark empty basements full of spiders with just a garden hose for water.  Bright sun filled, well organized and perfectly clean laundry rooms one step out of the main living area.  Vanity sinks that are too small to hold the bulky towel I am wrestling to rinse, without flooding the floor.  Bathtubs that cause my back to ache from leaning over to get to the spigot.  This folks is the adventure of home
birth.  Each set up different, most without electricity, all with their unique challenges. 

Have you ever doused a bloody towel with hydrogen peroxide?  It bubbles and foams like a mini volcano.  My boys would love this, well until they realize its birth blood. Cold water rinses out the blood, hot water for the meconium (black tarry baby's first poo) stains.  Tomorrow the new mama’s “maid” will come to help with the actual washing of this load.

My great great Grandmother Annie Kaufman tended the birthing and dying of her rural Amish and Mennonite community.  The thought of her distracts me, and for a moment we work side by side set to the task. Once spot cleaned, I scrub, wring out and set it to soak.  Treating all post-birth laundry is one of the jobs on my Birth Assistant check list. 

My other tasks following a birth?  You would likely guess things like tidying the birth room, cleaning and dressing the baby, restocking the midwife’s bag.  There are also clerical responsibilities of charting, filling out forms for birth certificate, and newspaper announcements. Sometimes I sit bedside and do some teaching- what to expect in the next 24 hours, how to care for the newborn and mother. 

One of my favorites is fixing the post-birth feast.  Pancakes, peanut and butter sandwich, reheating leftovers with a side of fruit, yogurt and juice.  I regularly hear my fried eggs and buttered toast are the best.  My ego takes that with a grain of salt, almost anything will taste amazing after a birth.   

If you check my resume I am far over qualified for my job of cleaning, cooking and laundry.  Being over qualified though, doesn't make it less enjoyable.  My attention to detail allows a new mother and father to rest and enjoy their new baby instead of tidying the house. My extra set of hands gives time for the midwife to focus on the clinical postpartum details. A birth assistant is a part of a team.  A team with a worthy goal. And it makes all the scrubbing and soaking worthwhile. 

The Last with Laura

Remember that feeling during your senior year of high school, the urgency to treasure every last?  The last pep rally, the last home game, the last bonfire- so much effort to remember and preserve the moment.  The last before everything changes.  I feel a bit like that with my birth work.  I am in the home stretch, closing in on crossing a threshold.

When that 4 am call came, “Can you come?  She is laboring and it will soon be time.” I knew I had to go.  It is one of these lasts.  Not any different than the other 30+ times in many ways.  Sweet Amish couple working to welcome their first child in their home with my favorite midwife.  I couldn’t, wouldn’t say “NO”. 

It was dark still on my early morning drive across two counties.   The roads full of first shift factory workers reporting for duty.  As I pulled into Earl and Eva’s Bremen home the spectacular sun was just breaking over the trees.  When I looked back to the east, the farm fields and silhouetted treetops softly wrapped in a low fog. The sun pushing up, orange and yellow- the new day arriving.  I stopped and took a picture.  Because that’s what you do when it is a last, capture the moment.  A perfect symbol for how I was feeling. 

The midwife greeted me with gratitude for my willingness to leave sleep to come help her.  Weariness hung on her like a soft t-shirt.  “This is my third night birth in three days.” She says with a palm to her forehead and a sigh.  I’ve worked with Laura long enough to know what this means.  My role at this birth will to be the fresh eyes, the active hand (or in this case foot) holder, the energizing encouragement for both the midwife and the birthing couple. 

Once briefed on the setup of the home and the progress of the client’s labor, I took some time to listen to Laura catch me up on all that she’d been doing for the last few days.  I am her Listener.  I have been for years, but not until recently did I realize how important a role it is for us both.  I love to hear the inner workings of her job, the agony as well as the joys. It makes me feel connected still to the clients and birthwork that seem to be drifting away from me.

Laura needs a Listener.  She has a wonderful group of friends and family that support her, I don’t mean to say I stand alone.  But I think I am different.  I know the clients, I know birth, the local culture and religion and I know Laura.  For seven years I spent 8-12 hours a week working for her practice.  During that time I had many opportunities to observe her at her best and worst, and all that is in between.  Words cannot express what I have learned from Laura.  Medically she is so sharp, spot on in her intuition and decision making.  Not afraid to tell her clients the truth of their situation even if it is not what they want to hear.  I love to hear her processing through a client’s care.

Sure she has a rough exterior.  Those of you who have had a 3 am conversation with her know she can be a bit short and gruff- ok not just at 3 am but any old day.  But what others don’t see is that underneath that tough shell she has such a soft heart.  She loves us.  The women she serves, the women that work along side her, the babies she holds.  She loves us all.  And I fear the price of that love is so high. 

A midwife’s life is often glamorized.  Saccharine sweet moments of welcoming new babies mixed in with her role as protector, guide, friend, and confidant.  It is no wonder midwives often are put on a pedestal, worshiped.  A midwife plays such an important role in the life of a woman.  She is the one ushering her through the pregnancy and birth.  And while there are many wonderful moments dreamy and ideal- there are also long lonely times, difficult decisions, bad outcomes, clients that text and call intruding into her personal life, all-consuming responsibility and a never ending list of client’s needs.  By the nature of this job, one can easily lose their footing and find themselves in need of some serious time off. I understand her need to make a change.

We are all perched on top of a cushy queen size bed.  I am sitting on my knees in the middle of the mattress at the mother’s feet.  Laura sits on the edge of the bed, head down in her hands resting until the next contraction.  The mother and father are huddled together at the head of the bed.  Her eyes are closed, their hands clasped together but relaxed, waiting. The contraction takes hold, mother tenses breathes-relaxes and then pushes.  Laura and I each hold onto her feet, helping her curl around her belly.  The bed is made up in anticipation of the birth, a waterproof plastic drop cloth covers the mattress under the fitted sheet.  It shifts and crunches with our movements. Once the push passes, the mother flops back onto her pillows and we all resume our waiting. 

At that moment I take a mental picture, all in our places waiting.  Laura so tired, so ready to sleep, yet patiently waiting.  Eva unsure and exhausted, sweating and glowing with Earl by her side.  And me, fighting the nagging notion that this may very well be the last time I am privileged to assist Laura at a birth.  Soaking in the moment, breathing gratitude for all I have learned about midwifery, birth and myself in my relationship with Laura.  Holding the moment.

Sure enough the moment passed.  Baby girl was born.  I made coffee and eggs.  Mom nursed baby.  Laura slipped up stairs to sleep.  I cleaned up.  Everyone stable and satisfied I left.  I drove home.  I cried.  I know it was our last.

In her pause. In her pace. In her own power it is happening.

I am waiting. Sitting on a hand loomed throw rug on the floor in front of her kitchen sink. The eighteen by eighteen inch ceramic tiles are immaculately clean.  There are no crumbs along the kickboard of her floor.  I checked.

She is sitting in the lotus position, naked, soaking in the warm water of the blue inflated birth tub that sits where her dinner table usually is.  Her thick brown hair is piled on top of her head.  Calm faced she moves only as the contraction builds.  Breathing with concentration she leans back and reaches for her husband's hands, all without opening her eyes.  It is hard to trust my sense of time in a space like this.  The last ten minutes feel like an hour, the last hours feel like just ten minutes.  

Arriving only for the advanced stage of labor, I should be fresh with energy.  But it is middle of the night.  She began contracting early this morning, labored calmly through the day cleaning her house. This is her first child and she is prepared to patiently wait and work through the process. 

As I left my house in the dark star filled night I texted the midwife.  “Is there coffee?”  The midwife’s reply, “She’s making some for us now.” 

I scroll to the previous text message received from the midwife, 25 minutes earlier that says, “Jenny is 8-9 cm! I just got here.  Whenever you are able, you might head this direction. J” Seriously? Transitional and still the hostess. 

Her husband later confirmed that she set the water to boil and quickly returned to the depths of labor giving him some brief directions on how to finish the process.  The coffee was warm and caffeinated, fulfilled its purpose.

We wait; the midwife, myself the birth assistant, the husband and mama each contraction taking its time.  She rests about five minutes between each.  I am reminded how hard it can be to wait for the body to birth.  Doing nothing sometimes takes more effort than doing something.  Her bag of waters not yet broken, cushions her baby’s head from intense contact with her cervix.  This makes for a more gentle rhythm of contractions.  In this case it also means slower progress, teetering on the verge of pushing for an hour instead of minutes.

Many practitioners would encourage intervention to “move things along”.  Breaking the water, coaching hard pushing, getting the job done in half the time.  Midwives and mothers entertain this approach, enticed by the goal within sight and relief to be done.  It is a sprint to the end versus the leisurely walk. This midwife discussed with Jenny and her husband the option.  They decided to wait. She enjoyed the rest between her contractions and was in no hurry. No sprinting needed. It is a leisurely stroll.

As I waited I scribbled down some notes wanting to remember these thoughts.  I wrote, “Really, it is happening.  In her pause. In her pace. In her own power it is happening.” So I waited.  An hour and a half later the baby was born.