One Of These Things

For those of you who watched Sesame Street in the 1980’s you’ll remember the song so often included in the show:
 

“One of these things is not like the other,

One of these things does not belong.

Can you tell which things are not like the other?”

 Refresh your memory with this quick little clip.    https://www.youtube.com/watch?v=6b0ftfKFEJg

This jingle always comes to mind when I’m getting ready to leave my childbirth class. It’s easy to spot my red pea coat from the pile of black coats and sweaters. Picking up my red loafers, again from rows of paired black sneakers, it hits me- I am different than them.

“As a birth worker serving the Amish, I receive a certain amount of reverence and respect. As a non-Amish woman I am always just on the outside of inclusion; if that makes any sense. No matter how much time I spend serving, living and working among them I will never be one of them. Of course I don’t want to be Amish. Still a little part of my heart hurts knowing that my sacrifice of comfort and time, the gift of quality culturally sensitive care will never win me full belonging. I will never be inside the circle.” 

As I wrote these words last week tears came to my eyes.  The passage is part of a novel I am currently working on. When I started writing the paragraph they were just fiction.  As I sat back to read it I realized it to be my truth. And I cried.

Fourteen years ago when my husband and I bought our house we wanted a rural location and school district. Little did I know how I would become immersed in serving the Amish families in my neighborhood.  Literally my neighbors. I attended a birth just this morning for the family whose farm shares a property line with mine. And I love it. 

They appreciate and respect me and my professional wealth of knowledge. They call, send letters, flag me down when I am out running, stop me in the middle of Wal-mart. Together our children ride the bus, learn at school and play at home. It is a rich life.

Raised in a family, church and community where diversity in culture is embraced it has become a defining value for me. Both personally and professionally, I am comfortable and drawn to relationships with those different than myself. I find myself drawn to vocations that serve people from other cultures. Running a food pantry and financial assistance program, interpreting English to Spanish during a surgical operation, childbirth classes with the Amish-I have loved the diversity of each one.

And for the most part it works well. Culturally competent care stretches my muscles of compassion. Challenges me to look at life from outside my own view and appreciate the differences. I enjoy learning about other people’s experience of life. Being in their homes, eating their food, learning their language. I’ve learned so much and I am a better person for it. 

Now after all that would you believe me when I say that I still feel on the outside at times? And that that last bit of space between our worlds can really be a splinter in my palm. What would it be like to be one of them? Not to actually BE Amish, but to be the same? I don’t feel this way all the time. The tiny bit of hurt surfaces now and then. Mostly when I’ve been in on an intensely emotional experience. Like a baby dying, like a victorious birth hard won.

Sometimes I just want to belong.  Really belong.  Am I alone in this flip side of appreciating difference? Alone in my longing to be the same? 

How rude! Fathers-to-be who challenge me.

Matt is kicked back in the recliner. His cheeks chapped pink from the wind he states, “So are we gonna get this started or what?” Did I just get snarked at by an Amish man? “We will wait a few more minutes on the other couple, they just pulled in. I’m going to wait for them to put the horse in the barn.” I smile my sweetest fake smile I can manage.

–Wow ok, not used to this level of directness within the first hour of meeting.  I’m guessing he’s not too excited to be attending a childbirth class tonight. Well guess what buddy, I’m not either. I traveled 20 miles in near white-out conditions on icy roads at the “rush hour” on the Goshen-Plymouth trail to get here.  I left my family a half hour early just to arrive on time.  This man Matt makes me doubt it was worth the effort.

There are four couples signed up for this class.  We awkwardly sit on over stuffed couches and chairs and make small talk. It’s the first night of class in a series of four. It seems we are off to a rough start.  Half way through though I feel I have recovered and things are going well.  The women are bright eyed, nodding and following my every word. 

I turn from the marker board I am writing on my glance falling on Matt, who is soundly sleeping in his cozy recliner.  Again wow- actually sleeping.  I shouldn't be surprised; he did warn me this may happen.  Politely I noted the fresh pot of coffee available. Laughing he shook his head and waved me off, “Ha if I have coffee now I won’t be able to sleep once I get to bed.” Does napping during class effect your bedtime sleep also? I am having a hard time holding my tongue.

His wife Missy apologizes for her husband’s rudeness with her eyes.  My heart is softened a bit and I remind myself this isn't personal. This guy just really doesn't want to be in a childbirth class.

Over the course of my teaching career I've had about 300 couples in class. From time to time I come across a gem like this one. I get it- childbirth class is uncomfortable. He doesn't want to be here, but his wife “made” him come. It is cold. He worked hard today, has to get up at 3 am for work tomorrow. There are a number of possible reasons for his rudeness.  But those same reasons apply to us all, and we manage to be civil and polite. 

Writing about Matt brings another character to mind.  It was in my first year of teaching and I encountered a man I refer to as “The Heckler”. He was ruthless with me. 

What is a heckler exactly?  Remember the two old guys, Statler and Waldorf, from The Muppet Show? Professional hecklers quite funny if they aren't making fun of you. Glad they don't need childbirth classes.

Heckle: To try to embarrass and annoy (someone speaking

 or performing in public) by questions, gibes, or objections; badger.

My bearded heckler wasn't as lovable as a Muppet 

That sound like fun, no? I spent all my energy recovering from his jabs and maintaining the flow of the class. The other couples were offended and embarrassed for me. I’d dare say that they became angry with him by the end of it all. Any time the Heckler was out of ear shot they would apologize, “Please just ignore him. You are doing a great job. We (the Amish) don’t usually treat people like this.” I got several notes of gratitude and encouragement in the mail once the class was all wrapped up.

While I can’t recall all of his hurtful words I do remember the last class we were discussing caring for your newborn and I was discussing the idea of co-sleeping. “So if I roll over onto and kill my baby, I can tell myself, but Betsy said it was ok.” Yes folks, he was out of control. Another man in the class actually reprimanded him for that one. At some point I realized that this man likely treats his wife the same way. If this Amish man is so bold as to talk to a person of authority in public with disrespect, how does he treat his wife behind closed doors?  I shudder to think. 

So these men bruise my ego a bit.  Maybe they don’t like me.  Maybe it’s the setting and content of class.  No matter which, I continue on, honing my skills at public speaking and interactions with people of all sorts.  I believe that childbirth classes are vital for couples anticipating birth. I believe that whether he admits it later or not, he did benefit from participating in the class. Everyone benefits. If it’s just a handful who insist on being rude, there are approximately 295 more polite, attentive (mostly) and interested participants, then I can live with that. 

Next week I'm going to picture one of these two old gents reclined in the chair instead of Matt.  That should help it go better. 

Betsy, where have you been?

It's been awhile since I've posted.  My productivity has shifted to another project for the month.  I am busily working to rise to the challenge of writing 50,000 word first draft of a novel in the month of November.  This is a world-wide event, sponsored by NaNoWriMo.  Check out their website at: www.NaNoWriMo.org

As you may guess my novel includes birth stories! Its a non-fiction piece about a doula struggling to deal with the grief that childbearing years bring. Hmm, wonder where I got the idea for that? There is lots of other good stuff too, but only being half way through I can't give a more detailed summary.  Because I don't know all the details yet.

It's been hard to resist the urge to blog.  My pending file (not a literal file) holds the birth story of my grandfather, born at home in rural Illinois in early 20th century.  So hard to resist writing it.  But I must focus and be disciplined to reach my goal.

Thanks for understanding and for your support.  Blogging has given me the confidence to see myself as a writer and take risks. I've come a long way in one year.

Listener's Commentary on WVPE 88.1, our local NPR radio station, will play another one of my essays on Monday December 1 at 7:30 am and 12:30 pm. Tune into to hear it. This one is a story from my early years of doula work  with Maple City Health Care Center.

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 Poisonous Bloom

Turning south out of her lane I asked Nina how she felt about the approaching birth of her third child.  The next five minutes fill with her anxious weary words. “I just don’t know if I can do it again, the baby seems so big this time, I’m older and so uncomfortable, what if it won’t fit.  I dread the pain.”

“But your second daughter’s birth went so smoothly, nothing like the first.” I calmly reflect.  Eighteen months after her first traumatic birth, a second daughter Hannah Joy entered the world.  Hannah’s arrival was peaceful, calm, hard work, and victorious.  Nina’s second birth gave her a taste of how birth should be. So why was she still feeling such worry and doubt? The shadow her initiation into motherhood loomed large in her mind.  A black inky seed planted by Doc at her first birth, continuing in poisonous bloom. 

Nina’s fears trigger my own flashbacks from that first birth.  All of a sudden I’m no longer sitting in my parked car waiting for her to exit from the Chiropractor.   It’s five years since past now.  Seated side by side I drive my doula client Nina actively laboring to the hospital one county over.  Joe sits behind us, his face masked with false confidence.  Each mile traveled we are closer to the birth of his first child.

She labored patiently, opening about one centimeter per hour.  Her textbook progress pleased the nurse who checked in to adjust monitoring bands, smile for a few second and dash back to the desk.  Joe nervously tended to her needs. Walking side by side his arm around her waist, the powerful wave of contraction crested she leaned into him hard. 

By mid-afternoon the nurse pronounced Nina complete- 10 cm.  Nina was promptly saddled into the bed and encouraged to stay put.  After taking a few notes the nurse stated she was going to call “the Doc”.  “It is Sunday and I think he’s out fishing, I hope I can get ahold of him.”  She says more to herself than to us.

Turning to leave the room the nurse pauses with her hand on the door pull.  “Have her start to push.” She directs to me.  It was so casual the way she laid it there at my feet. The block I would stumble over and resent not seeing. This request to push started the official game clock.  A clock with a strict time limit, of which I was unaware. 

Nina was uncomfortable in bed, but didn’t feel any urge to push.  This natural urge referred to as “pushing pains” among the Amish, didn’t seem to come.  In my wisdom and experience it is best to welcome the rest a woman’s body takes at this point.  Rest because there is much work to come. 

I encouraged her to wait if she could and breathe through the contractions.  She was eager to push so we tried it a few times.  I could see she was at the threshold of the pushing stage, but just not quite ready to step over. 

Just the three of us in the room for that stretch of twenty minutes or so.  Joe holding one hand and I the other.  The nurse bustled back into the room dragging in the warmer and medication cabinet through open double doors.  “How’s she doing?” she asks as she bangs around the room her back to us.

“She’s doing well, getting good rest.”  I reply.  The nurse stops what she is doing and turns to me, “The Doc is on his way and will be up soon.  He wants her to be pushing.”  She directs me this time with more force and I begin to sense there is urgency in accomplishing this task. 

I’m in doula overdrive.  I coach her pushing.  The contractions are consistent and strong but only every 5 minutes.  She’s a “good pusher” as we birthy folks would say.  Strong, young and eager to meet her baby, she does good work, moving the baby lower with each push.  In this stage of birthing the baby’s soft malleable head is moving down in the mother’s body as she pushes.  Down through the boney opening of the pelvis, down through muscle and tissue.  Down during a push and sliding back in during her rest.  Two steps forward. One step back.

Normal.  Totally, absolutely normal.

Doc blusters into the room.  Camouflage pants and a grubby t-shirt.  His chubby short hands are rough and ugly.   He is only interested in the nurse’s assessment of the situation and addresses all communication to her.  No acknowledgment of my presence- I can handle that.  No acknowledgement of his patient- this irks me.  Look your patient in the eyes when you ask how she is doing!  Stop and shake the hand of this father to be who trusts your hands to safely deliver his first born.  Your ugly hands. 

He looks over the computer printouts of contractions, gathers his information from the computer display instead of the patient.  Gruffly he turns and exits the room.  I reach out to the nurse, who seems quite accustomed to his manner, to translate what just happened.  What can we expect?

“He’s going to change and scrub up.” She says busily preparing a sterile set up for the birth.  Drapes, spotlights, all manner of routine ridiculousness occupy her attention.  I am so glad I am there to look Nina in the eyes: to encourage her, to breath with her. 

Doc re-enters the room looking like one of Snow White’s dwarfs decked out in sky blue scrubs.  Directly he proceeds to do a vaginal exam.  Broadcasting his assessment without fanfare,  “That baby is too high up in there.  How long has she been pushing?” he asks the nurse who has now perched herself at his right hand.  She looks over the computer record to find his answer. 

“Only about thirty minutes.”  I say.  And for the first time doc turns and notices me sitting to his left.  “And WHO are you?” he is nearly snearing. “I’m her doula, and she’s only really been pushing about thirty minutes.” The nurse interrupts from the computer station across the room, “She’s been complete for an hour now- so pushing for an hour.”

“Unacceptable, she can’t do this,” doc grumbles under his breath.  I try again to interject that this labor is progressing at a normal rate and she HAS made progress in her half hour of effort. He doesn’t even turn his head to acknowledge my input. 

“Get the vacuum out” he says to the nurse.  My stomach lurches- this baby is way too high to get a suction cup on her soft head.  Would he really use it now?  She has time yet, the baby shows no signs of distress.

But she doesn’t have time.  The game clock, set and marked by Doc has run out of time.  The details of what transpired in the next 20 minutes include but are not limited to inappropriate clinical application of vacuum suction to an infant’s scalp, violation to the integrity of mother’s vagina.  Actions causing permanent emotional and physical trauma for this new mother, father and infant.  It brings tears to my eyes to this day, what I witnessed him do to her. 

When it plays over in my mind, like all traumas do, I am watching-frozen in disbelief. Washed with guilt I am unable to intervene or change the outcome. Frozen. Powerless. Afraid.

Janae Lynn 9 lbs 6 oz was pulled from her mother’s body around 5:35 pm that hot August Sunday.  She entered the world with a large purple/blue bruise on the top of her head.  This bruise remained inflamed and swollen for her whole first week.  Ripped open and then roughly repaired, her mother Nina had been initiated into motherhood. According to doc- this is just the way it is.  Unfortunately, he speaks his truth, this is how Doc does birth.  How many hundreds of times has he done this to Amish women over the years?  Women who trust his authority.  Women bound by their religion to turn the other check, leaving him protected of any legal repercussions from inappropriate and irresponsible clinical actions.

“She’s such a big baby.  It was so hard for her to fit through.  It may not work out so well the next time.” Doc says, finally looking Nina in the eyes.  Addressing the pale faced new father, “You saw how hard that was for her?  She wouldn’t have done it without my help.”  Doc is gloating.

I want to kick his shins, push him down, scream and yell, pour out justice for the violation I had just witnessed.  But I didn’t, couldn’t.

Nina exits the Chiropractor’s office waddling up to the passenger door and I return to the present moment.  Sunshine pushes through the windshield, yet the dark trauma of Janae’s birth hangs onto us both.  Our drive home is made in silence.  

Nina birthed her third child today.  He was welcomed into the waiting hands of a midwife at our local birth center.  I was not there to witness her victory, but tears come when Doris’s mom calls to tell me “It is done.”  She worked hard and she pushed out a 10 lb baby boy!  Several hours later, Doris calls me while I’m driving to town.  Her weak voice reports, “He is here.  It was A LOT of work. And I think this is it for me.”  Still tired from the task, reeling from sleep and blood loss, she isn’t celebrating yet.

So I celebrate for her.  The brilliant noon sun resonates off the yellow and orange maple leaves as I pass.  Appropriately bright, hopeful and celebratory color and it fills me with light.  I needed her victory too.  I needed to remember that there are providers that CARE about their patients.  That a woman’s body is capable of the task, that dignity and respect for a mother during her birth is not too much to ask.  I anticipate the moment when I will hold this “buster” of a baby tonight.  Ten pounds of celebration, wrapped in a sweet cotton cloth.  Nesteling him in my arms, I will hold him close.  Touching his soft dark hair I will whisper pray for his mama and hope of her healing.  

Unmarried Amish Teen Childbirth Class

Unwed Amish Teen

That happens?  A bit of clarification on that.  The women I refer to grew up Amish and are suspended in the stage of development called Rumspringa or “ Running Around”.  This tradition among the Amish community begins when an adolescent turns 16. During this time teens are free of all the rules and regulations of the church.  They live at home with their parents but are free to do as they please. The idea behind the practice, is that giving freedom allows the individuals to experience the “world” to better prepare them for the choice of baptism and joining the Amish church.
 The liberated teenagers experiment with driving, alcohol, technology, popular fashion, and sex. There is a continuum of how extreme this experimentation is lived out. Technically these pregnant teens in my class are not Amish.  But culturally they are. So “Unwed Amish Teen” is the term I use to distinguish them from my other students.   

What: One night Childbirth Prep Class

When: August 18 6-9 pm

Where: My basement family room

I busily prepared my home to host this group of unique expectant parents.  Looking at my housekeeping through the critical eye of an Amish woman I eliminate the kitchen counter clutter, sweep the carpets, and clean the mirrors. 

I arranged the furniture in my basement family room so that the two couples could see my marker board and the television.  DVD player queued up by my 11 year old son, materials assembled, content organized I was prepared for the evening class to arrive.

It’s 6:02 on my iPhone screen.  I anticipate an early arrival common for the first night of childbirth class, not so tonight. Two buggies slowly made their way thru my cul-de-sac and to the neighbor’s hitching post.  Relief!  They didn't back out. 

Forty seconds later my relief flopped into the pit of my stomach and became a ball of nerves.  Each buggy held a couple.  One is a young couple dressed in the Amish garb, she with swollen belly and he clean shaven baby faced- an overgrown boy.  Exiting the other buggy is a mid-life Amish man with beard and suspenders. As he ties his buggy horse to a nearby tree, his wife climbs down. Clearly they are not the other expectant couple I was anticipating, but the parents of the pregnant teen. 

I paced back into the kitchen where my husband and three children were finishing up their supper.  “There is an Amish dude with a beard and he looks like he is 40, and he is coming up the drive.”  My husband and children stared blankly back at me, they don’t understand my agitation. So I try again, “Her parents came along!  The teen mom, father of the baby and HER PARENTS- her AMISH PARENTS!” 

*Deep Breath* “Its okay Betsy, you know your stuff, if you act comfortable and calm they will be to.  This doesn't have to be a disaster.” the pep talk flashed through my mind. 

Another deep breath and I was out the front door to meet them coming up the sidewalk with a smile and welcoming handshake.  Upon introduction I remembered that it was the mother that had called to ask about the class on behalf of her daughter. She had even asked if she could come along as she would be the one supporting her daughter during the labor and birth.  Stupid me, it should have been obvious that if the mother comes the father would come too.  Amish women don’t go to meetings without the accompaniment of their husbands.  I shouldn't be so shocked that they actually did show up. Still this is a first for me.

We stood on my front walk introducing and small talking, waiting for the other couple to arrive.  As I visited with the parents, over their shoulder I noticed a beater car driving a bit too fast down the road.  He hit the brakes, spun a cloud of dust and managed to come to a stop safely in my drive. Now this, this is much more what I was expecting.  The driver stepped out dressed as a traditional American teen: jeans with holes, an Under Armour shirt, and a swoop of blond bangs across his face, cell phone in pocket.  His passenger in the car, Jolene, stepped out in a lovely bright blue Amish dress and bright white covering.  Her carefully sculpted eyebrows framed her matching blue eyes. When she smiled I saw her teeth were as white as her covering.  Her tanned face glowed with a touch of the end of pregnancy puff in her cheeks.

We all filed past my family now done eating their supper and clearing the table, to the basement.  I quickly arranged more seating and grabbed a few extra books.  Surprisingly they visited with each other with ease.  The presence of the older couple seemed to set me on edge more than the others.    

I start out with my large posters displaying the magnificent uterus containing a growing baby and begin to explain the intricate details of placentas, amniotic fluid and mucus plugs.  As I teach,  I make an effort to make eye contact with everyone individually.  Eye contact or lack of gives me a good feel for how comfortable they are with the content.  Are they tuned in and invested or grossed out and uncomfortable?  When I lock eyes with Jolene she stops me and asks me some detailed questions about the working of the placenta.

  –"YES!  She is with me here.  So I have at least one person tuned in", I think.

 Next I glance up to see the parents nodding and looking at each other and smiling.  The father shares how helpful it was for him to take a childbirth class when they were expecting their own first child 18 years ago.  “I have always been grateful to understand how it all works.”

  -"Sweet Jesus- I never get this much affirmation or dialogue with my other groups of properly married folks!" Does my smile give away my excitement? 

As I rolled through the anatomy of pregnancy and birth it became obvious the fathers of the baby were both extremely uncomfortable.  The sweet teen boy with swoopy bangs gives me a shy smile when I make a joke about not passing out when the baby is born.  The second teen father has removed his flip flops and is spinning himself side to side on my office chair, the booklet open in his lap and his eyes glued to it. 

-"This guy- Baby daddy #2 does not want to be here, and likely does not want this baby.   I’m too quick to judge him. Too harsh.  Really, how would I feel attending a childbirth class with my future father-in-law?  He needs grace.   I’ll get him to make eye contact with me and smile yet.  We've got two hours left." It's surprising how my own inner dialogue ticks along as I teach.

The words are rolling out of my mouth now.  Like muscle memory I can explain the dilating and thinning of the cervix without even thinking.  I've got the silly putty out, a warm humid room makes it challenging for me to keep it under my control.  My baby doll in one hand the silly putty cervix in the other, I apply a 4 cm dilated cervix to the crown of the baby’s head.  Working methodically through the progression of contractions and changing cervix I can’t help but notice that everyone in the room is entranced in what I am saying.  All but baby daddy #2.  Still barefoot, he has turned his chair away from me and is facing his girlfriend on the couch beside him.  Her right hand is extended and touching him on his knee. 

-"Hmmm, maybe things aren't so bleak for this couple after all. Wish I had a chance to get the back story- are they in love? Is he good to her? Will he support her once the baby is born? Do they plan to get married?", I'll likely never know.

“And now it’s the moment you have all been waiting for….the birth video.”  New level of awkwardness- the next 10 minutes these three couples will sit before my large 46 inch tv while a woman moans and sways through her labor.  Although the laboring woman is moderately dressed, she will be pushing a baby out of her vagina- while we watch.  My students tolerate the scenario well.  The grandparents-to-be, who I am sure haven’t ever watched anything on a screen this big, appear to be fascinated with the unfolding birth.  On my right the boy with the blond swooping bangs is a bit pale, but holding his girlfriend’s hand.  Flushed cheeked and sipping her ice water his girlfriend has a solid grip on his hand. 

Baby Daddy #2 noisily crunches his pretzels as the woman on the screen slips into the tub of water ready to push out her baby.  He is swaying again the way my 4 year old does when he sits in a swivel chair.  Left to right, back to the left- without even knowing he is doing it.  He feels me watching him, slows the swiveling office chair to a stop, but doesn't dare make eye contact. Still crunching pretzels.

-"I see why her mother is here tonight and planning to be the labor support for her daughter.  Baby daddy #2 is not up for the task alone. I wonder how characteristic this kind of family support is during an unexpected teen pregnancy?", I've seen this video a hundred times its a nice break for my voice. 

Drawing near to 9 pm it is time to wrap up.  Question and answer time rarely takes five minutes.  The grand-dad to be expresses his awe in all we have discussed.  “We attended a class when we were expecting her (touches daughter’s elbow) and have four children- but I still learned a lot tonight.” Smiling he turns to his wife.  Holding his gaze she adds, “It has been so long since I've thought on birthing.  This will be so helpful for us when her time comes.”  Leaning forward her gaze lands on her daughter’s swollen belly and smiles weakly. 

-I'm glad they came, somehow their presence added an ease to the group vibe. 

“My mom had 13 babies, many of my sisters have children already-so I thought I knew about birthing.” Says Jolene the Amish maiden dressed in blue.  “But I learned a lot and it makes more sense.  I’m not so scared now.” Her boyfriend, still holding her hand smiles at me and at her but doesn't say anything.  Later on he speaks his first and only words to me as he pays me with a crisp bill.  “Thanks for having us, it was good.”  

As the September days pass I instinctively look to the Birth Announcements in my local paper scanning for their names.  I expect a text message birth announcement from Jolene.  I'm disappointed, I never did get baby daddy #2 to make eye contact.    

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.