First week in Bali
I arrived to my little house behind BS about a week ago. It is lovely to hear birds all day today in the communal compound shared with Eka's family, during my day off. It smells of incense and I have made my morning ginger tea. I don't mind waking at 6am from the sounds of roosters and dogs, because I fall to sleep usually around 8pm when not working at the clinic. So far, it has been a pleasure to get to know the midwives, rub their backs, see how everything works around the clinic. I observed one woman's labor and another woman's birth on my first weekend here. And this past week I assisted another woman in labor for a full day. It was a beautiful connection and I felt so at home supporting her with massage, and including her partner in my care and attention. Whapio, my holistic midwifery teacher, calls it TEA- time, energy and attention. This is the work I provide, and this is what I love.
The Indonesian midwives ask me if I am here to train like the other midwife students here getting their "numbers" for midwifery school back in the states. I say, no not really, although I am here to learn and grow, and provide what I know, and experience this new way and culture. I did learn yesterday from my new American midwife friend Andrea, how to moxa a woman's feet in labor. That was rad. And I do get excited about taking blood pressure and heart tones at some point, when the time feels right. In general though, I am the doula, and it feels explosively right. I feel like a life doula, all the time.
It is a gift to be here, to watch the rhythm of the Indonesian midwives, to be accepted by them, taken in, welcomed, and in return I honor their ways and truths daily. To be with woman, does not equal, to be with midwife. It is to be with woman. So to be with anyone, is to hear them, see them, feel them. Not to expect them to be with you. In this way, I sit with these midwives just as I sit with my clients in NY. Seeing them unique, beautiful, in their own way, and worthy of respect.
I am a midwife in my own heart, but to begin to speak with labels just doesn't sit right with me. I am a woman, who works with woman, and women, and men too, and I embody this work as LOVE, love in its fullest meaning and potential. Where love's origin lives, I sit with woman, and there only.
All of my mama's births deserve a written account, and this is the first time I'll actually write publicly about one. Most births are emotional, yet this one particularly hit my heart, even while labor was moving. It was my first VBAC client who was actually "allowed" to go into labor. Last Sunday she called me with news that her water had broken at 230am. I listened and realized she hadn't felt labor actually begin so I talked her back to sleep and checked in every few hours. By 9am she was feeling quite nervous and I reminded her of the option of homeopathy to ignite contractions. She checked in with herself and began treatment immediately.
When I arrived to her home at noon to see what was going on, I found her at the table chatting with her sister, timing contractions. I asked if we could go to her bedroom alone and do some massage. She lay down and I began to use pressure points and took her through some deep relaxing breaths to get her focused and calm. Her contractions got regular immediately and were 3-6min apart, 60sec in length for a couple hrs while we spent time there. Her husband joined us occasionally, brought her some chamomile tea, and was in awe of the peace she was in, compared to the first labor where they rushed to the hospital with the first early irregular contraction patterns.
This mama let go with each contraction with her tears, sounds and breath. I reminded her that that was so good, to keep letting go, to continue tapping into her baby and this unique labor. I wasn't sure if stuff was coming up from the past labor or if she was nervous about this one or what. All I knew was that I was her friend, sitting beside her and helping her body open and her labor to move. It was beautiful. It felt good to be there after phone support all night.
We stayed at home laboring until we decided to go the hospital at 3pm. She started touching her lower pelvic area during contractions which made me think the baby could be close; it was her second child and in birth #1 she did labor to 9cm. So we left and all were comfortable with that.
We arrived and parked and she decided she wanted to labor outside for a while, so it was until 5pm that we labored in the sunshine outside Cornell's hospital doors. Her water seriously broke on her exit from the car so it was hard for me to believe her water had broken the night before too! Contractions were already 2-3 min apart and 60-90sec in length while we were laboring outside. She was so strong and willing. She danced. She swayed. We ate lentil soup. She loved being out there and free.
When we arrived upstairs to triage she was surprised to be checked at 2cm. She was feeling so much pelvic pressure and just didn't think it could be right. I've found that telling women where they are cervix-wise or anything numerically-speaking just doesn't work for them most of the time. It puts them in a rut. It takes them out of their center. It makes them believe someone else knows more about their labor than they do. It takes their power away.
It took a bit for her to get over the news and finally she remembered that her real focus was the work ahead of her. She asked for what she wanted: she got her telemetry room and was able to walk around and labor on her feet. Our nurse all night and into the morning was a graduating midwife from SUNY Downstate. All was well. When residents came in who made her feel uncomfortable she simply told them to leave.
She labored for a long while until 1am with very intense contractions, with her husband's love, my supportive words, massage, and all of our affirmations. We thought her baby might be coming. The midwife even brought in the delivery tool cart. At midnight though, she was checked at 3cm and then decided on an epidural. She needed to sleep; she needed to let go. By 8am, she was checked at 4cm, and feeling a lot of pain still. With top off of medication after top off and hitting her epidural button 3x an hour, she still was in pain. I've never seen a woman in that much pain. It was confusing. I've been with women who get relief from epidurals, not the opposite. The anesthesiologists came in to help but the pressure of the baby was just too much. I wasn't sure what was going on. Moments like these make me want to call Ina May.
When checked at 4/5cm still at 11am, the new doctor on the floor really wanted to go ahead with a cesarean birth. The baby's heart rate was dipping quite a bit, and even though it may look normal to some, it wasn't looking good to the doctor who was taking in mind that she had been in labor for already 24hrs with much regularity. With almost 4hrs of no cervical change, he didn't want the baby to go through another whole day of distress. My client had a really hard time with that proposal though, even though she was having a hard time herself going forward with the labor because of her discomfort.
It was so tricky for her to accept his proposal after a cesarean birth 3 years before where she blames drugs completely for her labor stalling and causing fetal distress. During this whole labor, every time they administered a drug she'd ask if it would affect her labor. The doctors gently told her it wouldn't but she knew so deep down what she believed to be true: the opposite. She knew though that during this labor the drugs were her ally because of this intense discomfort. And so she felt so conflicted with the choice to use them and the belief that using them would "cause" a cesarean birth. Yet even so, I know her feelings before entering the OR spoke as: "I did it, I tried, yes, I've been through so much, something is going on here and I don't know what but I'm going to follow my gut, even though I didn't want this".
I don't know the reasons for everything, but I do know she went through a labor like never before, and that is what she wanted. She was amazing, she was determined, she was so strong. She has something to look back on to make her proud, to remind her of her strength and beauty. When she looked at me before heading into the OR, and said directly to me, "Erica, I could not have done this without you. I would not have been able to do this without you, thank you for all you have done, thank you for everything, ", that just means too much to me. It put me into tears right in front of her own. Moments like that open and transform, all of the people involved at the birth.
Blessings onto this beautiful mama. Blessings onto this child. Blessings onto this family. Blessings onto that which moves us and guides us right. Blessings onto that which we don't understand.
Home from Naoli's ranch- my journey with a traditional/professional midwife in Mexico...
I arrived to Naoli's ranch on the morning of April 18th, to find myself with 14 extraordinary women from Europe, Canada, the US and Mexico, who came together to learn The Art and Science of Traditional Birth Practices and Philosophies of Mexico. What a gift to be together as we explored the emotional, physiological, and spiritual aspects of the natural labor process. Most of us are not mothers, yet we are birth workers new and old, with a keen understanding of what it means to help someone "walk the path" that we have walked ourselves. But if we haven't had our own children, how have we walked the path that they are on as pregnant women, you may ask?
When a woman is walking in her pregnancy, she may fear the "unknown" in a general sense and may be anxious as a result. Or she may be fearing something very specific such as not being able to open because her mother didn't open during her own labor. She has carried her mother's story for years and is about to carry it into her own labor if she doesn't return it back to her mother beforehand. A woman may also remember the trauma of abuse or a painful loss in her life- an abortion, a miscarriage, the death of a loved one. No matter what she is carrying, if she has succeeded in keeping it hidden throughout her pregnancy from herself or others, suddenly toward the end of her pregnancy her midwife may notice something, and gently ask her what's going on. This ability of the midwife to intuit and to listen and for the mother to open is key in their relationship and for the process of labor to flow.
The midwife herself knows from her own life experience that transformation happens with an open heart and mind and body. She knows that women open when they feel safe, when they are given the space they need to navigate in their own way. Surely the midwife has walked the road of pain, loss, and healing in her own way. Or she has been through labor herself. However she has experience transformation, she herself has done her work and continues to do her work. And she herself comes from a mother who has come from a mother. We all hold memories and information about birth and how we and or ancestors were born. When you are called as a midwife, you pave the road for women to open, to receive and to let go all at the same time, to take the leap of faith and dive forward into a place of openess and love. It is the only way to give birth.
A wise birth attendant listens closely to what is needed in each moment in pregnancy, labor, birth and postpartum. When we are "with women" we are midwifing them through the veil and to the other side. This does not mean we hold their hand each time. Sometimes it means we witness, and sometimes we use our tools. But we always listen, and this is how we know and discern. At Naoli's workshop , many stories were shared around the idea of women facing their "stuff" before labor even begins, and if not, they will for sure face them on the big day. Either way, we must face them ourselves. Partnering with a practitioner who is sensitive to the needs and process of the laboring woman makes birth outcomes much more humanized, loving, and joyful. In labor, the opening of the cervix correlates to the opening of the heart, and the gate in which women walk forward into their new life as Mother, with courage, curiosity, and strength.
The territory of birth has grown ten-fold for me since leaving 2 weeks ago. The miracle of life is found in birth and it includes our whole lives and those of our mother and father and grandfathers. Birth brings life and death together and shows us in some way how they share the same bed at night. As we each live our lives and then one day die, there is also a part of us that dies each time we give birth, or witness a birth. Thus with each birth, every person present is reborn, and enters a part of their heart they have not known yet. With each new baby born, the mother goes deeper. And her midwife as well.
One of the activities we shared together was called "vaginal exams without violence." We experienced first hand how to guide the practitioner based on our comfort and how it feels to actually be safe in the hands of another during an exam. It brought up deeply stored memories of abuse for many women by family members and medical practitioners. Their stories included the aggressive touch by practitioners during normal vaginal exams and the unnecessary mistreatment they had lived in their labor and postpartum as mothers themselves. We were healed as we shared and listened. We were healed as we experienced something mysterious and curious in each other. For many of us, it was the first time we had done an exam on anyone. I think one of my favorite parts of the retreat was when one woman's very young daughters came in to listen to the end of our talk each day. They were little women engaging and taking in the art of womanhood. It would be beautiful to see more mothers introducing their daughters at a young age to the beauty and mystery of the female body and spirit.
We spent time in nature learning about the naturalness and joy of pregnancy and birth. We rejuvenated in hot springs next to a river where cows and chickens roamed the hills. Naoli showed us how to massage a woman in postpartum with river stones and wooden bread rollers. We practiced on each other and were asked by the public how much we were charging! Naoli told us the story of when she was a young girl and how she made her friend take a 9hr rafting ride with her down the same river we were on. The next time she went she had a bigger following, which included her father, whose raft got poked somehow and so he had to have his finger holding the hole closed the whole way down the river for hours! Naoli is a breath of fresh air. She says, "The only thing you should expect of your birth, is that it will be wonderful."
We were welcome into her home, into her life; we met her partner, her children, her mother, and lived on the land for 10 days where hundreds of women have come to birth in her presence with love and JOY. We laughed, we cried, we shared our wounds and secrets, and we raised our hands to let each other know that we had been there as well. We sat in a traditional temazcal together and placed that which did not serve us into a stone and said thank you and goodbye and threw it into the fire. We shared a home together on Naoli's ranch and bathed outside separated by walls of bamboo. We ate beautiful meals of flower soup, huitlacoche, and every other kind of exquisite traditional Mexican cuisine known to mankind.
When a woman had birthed on our third day there, we were able to make homeopathic tinctures using a tiny piece of the fresh placenta, drying the rest for placenta encapsulation. We also made a drum with the amnio bag and a beautiful dried heart with the whole umbilical cord. We painted pregnant mama's bellies, as an alternative to ultra sounds, after measuring them through touch and listening to the baby's and the placenta's movement through a fetascope. No matter how big we painted them, we were reminded that no baby is ever too big to come out.
In Naoli's 18 years of practice, she has never transferred because a baby could not fit through the pelvis. We learned how to open the pelvis with our hands and with the use of the rebozo, and how to position the mother in case the baby is not coming down smoothly in case of a dystocia. But even more important, we spoke of her freedom to move on her own in labor so that she may hear loudly from her own inner wisdom where and how and when she shall be in order to bring her baby down as he should. We also practiced rebozo techniques for shifting a posterior baby, and "closing" the mother in postpartum. We made a hot chocolate with medicinal herbs for postpartum, a salve for stretch marks and aloe suppositories for hemorrhoids. We named the 40 day period one of healing and we promised we would help women understand the importance of resting and being with their baby during this delicate time of adjustment and new beginning.
I come back to my home in NYC ready to walk with my Mamas, to honor birth and the love that makes it happen. I come back with much curiosity and a heart wide open with joy to share. I invite you to come with me.
Erica is a Childbirth Doula in NYC. Her present focus is on the postpartum period.