Choosing your midwife: "Hands on?" or "Hands off?" (part 1)

Part 1 "Hands on"

The very FIRST midwifery learning book I ever read was entitled "Heart and Hands."  This was a popular book for aspiring midwives in 1983.  Its title alone epitomizes the trend of midwifery care back then.  All of the midwives I knew, or had heard of, learned the art of Midwifery through apprenticeship or hands on experience.  This was the way it had been done for thousands of years.  I likewise was taught by being tucked under the wing of an experienced midwife, shadowing her as her sole apprentice and learning from hands on experience.  Of course College coursework and self study was an important part of my education, but it is through the hands on experience that I learned to truly be "with woman" as the word "midwife" is defined.  My mentor didn't teach me terminology, anatomy or human physiology.  I studied all of that in the years BEFORE becoming her apprentice.  She taught me the art.  She taught me to FEEL...with my heart...and with my hands.

When I had my first two children, in the hospital, only my young husband tried to help me do what we had learned in Lamaze class.  The doctor showed up just in time to cut an episiotomy, catch the baby, stitch me up and then disappear. 

My third was my first born at home.  My midwife (and her apprentice) labored beside me from the time I needed her, helping with tried and true techniques to reduce the pain and encourage steady progress.  She talked to me, touched me, soothed me and kept a protective vigilant watch over me and my baby.  I felt so safe and so loved.  She seemed to read my mind and say the exact thing I needed to hear at the exact time I needed to hear it.  It was amazing.  I recall one scene: Squatting on the floor, between my husband's knees as my midwife got into this funny, twisted position on the floor in order to hold hot towels on my perineum, check progress in that position and listen to the heartbeat.  I recall smiling and thinking, "What doctor would do this for me?"

Without difficulty or delay in progress, I delivered my 10 lb 4 oz son into three sets of waiting hands; mine, my husband's and my midwife's.  The skills and Spirit that she brought into our home, were truly a blessing.  I cannot describe how happy I was with my birth!  I seemed to walk on air for days after that and soon knew that I needed to be a part of this great work.  In my mind, she was the best; and I wanted to be just like her, so I set out to do just that.

Now it is the year 2014 and I regret to report that the trends in midwifery have changed.  One on one apprenticeships are becoming scarce.  More midwives are learning in classrooms and group observation.  They are doing very well on written exams, but we are losing the use of our heart and hands.  Because of this, some say that to use your hands is wrong. 

I have been midwife to 1,330 babies.  Every baby has been delivered safely.  My mentor has attended over 2,600 births, with the same safety record.  Back in the 80's, one never heard of bad home birth outcomes.  My own birth was part of a county-wide study of 1000 home vs 1000 low risk hospital births. In this study, not one baby was lost or damaged in the home birth group however one baby was lost and 16 sustained injuries in the hospital group.  Midwives were attentive and involved then.  Their skills were experienced and keen.  They could "read" a cervix and gain invaluable information to benefit the mother.  They could easily find a heartbeat and palpate a baby.  Their mentors taught them to pray and trust in God.  If progress was stalled, they figured out why and suggested solutions.  This is "Hands on" midwifery. This is "Women helping women" with women's most difficult, yet joyful work.  Side by side we strengthen one another through words and touch - those who have gone before, helping to calm the fears of the new mother, giving her confidence and drawing out her pain through the transfer of energy one to another.  How insane to believe that all mothers should conquer and "rise above" birth...alone!  Humans are not natural loners.  We are social beings.  We need each other! 

"Hands on" midwifery is also the understanding that we live in a mortal world where death and injury are constant threats.  Although we view birth as a natural and safe process, we are not oblivious to reality.  We "trust God," rather than "trust birth."  We trust that birth is HIS design; and when mortality causes problems, He will inspire us how to keep safe, those in our care.

(to be continued in part 2 "Hands off")

My best advice for pregnancy and childbirth

   Last week a family came to my home for a consultation.  They are expecting their 6th child and their oldest is only 8 years old.  As I admired their beautiful family and congratulated them on their pregnancy, I got the idea that maybe they could help me with an assignment I was working on. I had been invited to speak in church on the subject of "Teaching Children," so I asked them if they had any suggestions for my talk.

   The father replied with a chuckle, "Don't ask me.  Ask an expert on the subject.  Ask someone who doesn't have any children yet."

   Isn't it true and ironic that often times those who think themselves the "experts" are usually the ones who have the least experience?

   I have been attending out of hospital birth since 1985 and will, most likely, attend my 1,250th  birth tonight.  One may think, with all that experience, that I have earned "expert" status in the midwife world. However, it seems the more experienced I get, the more I realize how much I still need to learn AND the more criticism I get from the young "experts" in my field.

   The most important truth I have learned over all these years is that there IS indeed, a Father in Heaven who loves us.  He is the ultimate expert; and we can never become so "expert" at anything, that we cease to need Him.

   I am humbled by and grateful for all the wisdom that the Lord has blessed me with and look forward to more learning.  I am grateful to all the babies who have taught me, to all my clients (my best friends) who have trusted me, to my husband and children (also my best friends) who have supported me. I am grateful to the Lord for blessing me with 1,249 successful births.  It is truly a miracle which defies the odds.

  This blogspot is for the purpose of sharing the wisdom of the Granny midwives, those who have been delivering babies for many years, have given their lives to those whom they serve, have weathered persecutions, experienced great rewards as well as heartbreaks, have felt the presence of angels and experienced the miracle of prayer!

   The greatest wisdom and advice that I can give the reader is this:  Invite the Lord to be part of your pregnancy and to be present at your birth.  Ask Him to help you choose your midwife.  Listen to His inspirations and trust them.  Acknowledging His hand in all things will keep you safer, more comfortable and give you more joy in your experience than ANY other factor.

Elizabeth Smith, CPM, LDEM
Licensed and Certified Professional Midwife
In St. George, Utah