What an amazing call shift. Here is Joyce and I the next morning after our exciting FIRSTs!!

The total count is up to fourteen births!!

Ok, three were observations; two vaginal births and one cesarean. I stood beside the operating physician and watched on with fascination and a bit of distress. It is a powerful sight to see a woman's uterus in her doctor's hands. A different kind of birth. Still a trail. Still painful. Still a beautiful baby. Still a new mother and father to THIS baby. Thank goddess for sterile technique!

The shift started with a beautiful water birth. A young woman who had an epidural with her previous birth. She didn't like not feeling her legs, not being able to go to the bathroom or how the contractions slowed down after the epidural took effect. 21 hours of .... rest basically. Her husband slept, she watched TV. I've seen several women take the opportunity at this point to update their facebook with the status of the latest vaginal exam! This time, this young woman wanted something different. So she floated in the birthing tub with the lights low. We kept it quiet. She breathed deep and moaned with contractions. In between she opened her eyes, or not. Talked a little, or not. She was aware, felt everything and enjoyed it thoroughly. I hadn't attended a water birth since my own birth of Sebastian, over 10 years ago! I remember it like yesterday, the warmth, the boyancy, the intensity of him moving through me and the shock of his birth. I sat by this young woman and was so present. Remembering. Being with her. The true essence of midwifery.

I got to catch this baby. I was a little akward since it was hard to see, and it's different under water, but all was well. And beautiful, really. She told me soon after the birth that I was awesome. "No," I said, "YOU are awesome". We truly appreciated each other. We had a nice post-partum visit as well. She was so happy with her birth and so empowered. She was enjoying telling her birth story, and will many, many more times. With joy.

The final birth of the day was to a young Christian woman who was having her 4th child. She was quiet, peaceful and prayerful. Her other 3 children came to be part of the birth, and only left when it was close to birthing time. She closed her eyes during contractions and barely moved. She told me later that during this time she had to lay still and just let the word "pain" run through her mind. When the contractions got stronger and saying "pain" wasn't enough, then she began to pray- to her heavenly father. Quietly- we didn't hear. By then she was complete and fully dilated. I did an amniotomy and thought it felt "funny", but these days there are still lots of things that do. (Happily, more and more all the time that I can decipher what I'm feeling, and it's not just "funny" :) Joyce checked just as baby was beginning to really descend. We got ready and I was poised to catch. My dear preceptor, Joyce was on the other side. Soon she was crowning. And wow, was it a bald.... oh my god, it's a butt!!! We didn't know she was breech. Doctor called, but the breech was being born quickly! I stepped back, Joyce stepped forward and with seeming ease and confidence guided the breech, lets, arms, shoulders and finally (and without a hitch THANK GOD), the head. I say seeming because she had never delivered a breech baby before! Neither had the doctor! Many midwives will never see this. Often these deliveries go well, but when they don't, it's horrific. That's why we don't do them vaginally anymore. Unless you're on the Farm in Tennessee with Ina May and her expert grandmother midwives.

I talked with the mother of this baby the next day, and she was so pleased with how everything went. She enjoyed her two midwives "two for one, it was great!" and felt that the birth went smoothly. She had declined an IV because she wanted no interventions, so a cesarean was clearly her last choice. She was very relieved that she was able to birth her little girl vaginally. She did not seem alarmed or disturbed that a breech birth is potentially more dangerous. Her faith is so strong, that she just knew God was moving through all of us and that the evening had unfolded according to plan. God's plan, not ours. It was another rare and beautiful birth. What a blessing.

The next morning this mother and I prayed together. She invited me in a very respectful and unassuming manner. Our traditions are different, but we both have strong faith and had prayed at the same moment, silently as her daughter was born. After sharing a moment like that, I felt open to sitting with her and her sleeping babe and giving thanks. She led a heartfelt and gracious blessing and asked for guidance and gifts for me on this path. She said she will miss me. She also told me never to cut my glorious long hair. I told her I will never forget her or her daughter's birth.

These stories are the ones that fill me and move me along this path. Birth moments are filled with the extremes of terror and grace. I have seen several points along the spectrum and will see many more. I love this work. It is real. The connections with people are profound, and especially so when they can be long lasting.

I'm beginning to be able to imagine the ties I will have as a midwife within my community when the families I serve are neighbors and many of the babies I see will have passed through my hands. I know that much of my joy and inspiration will come not only from those brief and powerful encounters, but also from the ongoing relationships that will be forged. It will be so good to take these skills and follow my path back home.......

Seven

Seven... such a good number. Seven is good luck. There are seven sacred teachings, seven directions (when you include above, below and within) and now, seven sweet babies that have passed through my hands in their first moments of life on the outside.

I've found a lovely little spot in LaCrosse (on 115 S 4th St) called the Root Note, which is where I'm sitting now after drinking a delicious coffee, eating edamame and lentil soup and busting out an Advanced Women's Health forum post.

I came off a 24 hour call this morning at 8am. Three births in those 24 hours. We were blessed to attend these lovely, relatively non-interventionist births. The women all labored beautifully with courage and determination.

Is there any other way to birth, really?

Actually, there is. I've seen several women now birth in complete terror. These women have likely suffered much pain, abuse and neglect in their lifetimes. Their births seem to represent an unfortunate and inevitable ordeal when they have to fight (yet again) to live through. There tend to be many medical interventions involved in such births, and as an attendant, I am more likely to feel that I am trying in vain to rescue her from her ordeal by numbing the pain and helping her to get it over quickly. There were moments when I felt, sadly, that I may be contributing further to a sense of violation. Of course I hope that my gentle presence, selective touch and competent execution of interventions eases the distress, but I'm not convinced. Even though these births may end with a healthy mom and baby, they are hard emotionally.

There CAN BE a significant difference between experiencing the pain and labor of birth, and suffering.

For some, it is one and the same.

For others, it is not at all. I've seen women birth in quiet confidence. These women are usually well supported and healthy in their minds and spirits. If their bodies are healthy as well, it's even better. They accept the pain and instead of working against it, they seem to work WITH it. As opposed to being reduced by it, they are made bigger by it. One of the most awe inspiring aspects of attending births is in bearing witness to women stepping into their power. When they are able to do this, you can actually see a woman draw out her inner most courage and to move from a place of utter strength. I have goosebumps as I write these words... just thinking about it has such an affect on me. In these cases, my role as an attendant is to step back and hold the space. It's easy to want to step in and take a "management" role, even in these births. After all, that's what we're trained to do, and enculturated to believe that we CAN do. It's a fine line though. We don't want to step in too far and risk taking the power out of the mother's hands.

Like anything, it is a spectrum; not absolute. For we can never truly take the power out of any woman who has ever given birth to any baby in any way, however, we can do things which may reduce it unnecessarily.

What I'm finding is that it is this last point; the necessity of intervention which is at the cusp of any management decision. Working in this medical center among obstetricians and specialists of all flavors, what I'm learning is that there are plenty of situations in which a pleathora of interventions are vital. Critical situations happen and we are very blessed to live in time and place where we have the means to correct them. I do not question the value of these, nor the importance of team work among health care providers of all types. These are essential, always.

What is interesting as a midwifery student and young woman with 32 years of life experience is to learn about that fine line between intervening on behalf of the woman (and her baby) and allowing her to intervene for herself (and her own family). There's a dance and balance around trusting the machines and tests that monitor her health and of trusting her. It is never black & white and I am but a baby to this profession. I cannot and will never claim to perfect the balance. However, I can feel that I am already deeply engaged in my efforts to do just that.

I am enjoying my life in LaCrosse; my current home away from home. My housemates and mentors are all kind and generous. My room is a cozy, winter cave and the dogs are sweet. I took them for a long walk along the Black River last weekend and now we're bonded. Casi is the black one and Keena is the white one.

My family back in Ashland is doing well, even without me! My dear friend says Sebastian is doing well NOT because my presence is not vital to him, but rather because I have raised him up well, in a close circle of family and friends who not only take good care of him, but also enable him to feel confident and safe even when I am far away. At first I scoffed at this and wished that my absence was more painful (not really, but this is the ego response) but as I think about it more and from my true self, I realize that this notion pleases me emensely. As a single mother, the best thing I can do for my boy is to do... just what it seems I'm doing! I want him to feel secure with plenty of people who are not me. Afterall, the days of me being the sole important adult in his life are gone. We are blessed with a close family and extended circle of friends who are like family. We are part of a community which raises up our children together. This is a great way to raise kids. I want him to feel secure in himself in every situation and setting- for that will serve him well.

I also want him to know about the challenges and joys that come with pursuing your dreams. He knows about hard work, sacrifice, discipline and success. He has seen me push through numerous challenges AND become happier and more myself through it all. He sees that life is not easy and that's ok. We live with joy and appreciation and work through the hard times. It's good to know that we can both continue to thrive even with distance between us. This is a beautiful and deep revelation- that I could not have come to without this experience.

So, in answer to people's concerned questions of how I and he are doing these days, the glad answer is: we're both doing VERY WELL. AND, we both look forward to this summer when I return home.

***Kudos to the ones who are putting their hearts and souls into caring for him; my parents and Tom.

Baby catcher!!!

Dear friends & family, after ten long years of working towards becoming a nurse-midwife, I can proudly say, I have passed through the threshold. I caught two babies this weekend!

Their warm, wet bodies passed through MY hands for one brief, magical moment before going back to their mothers. It was every bit as amazing as I imagined it would be. The first baby, a little boy, born to a zen-like birthing mother and her sweet, quiet husband. She came in at 7 cm. still talking and smiling between contractions and during them, would close her eyes, wrinkle her brow and breathe. It wasn't until she was pushing that she grabbed my arm and made some noise. He came quickly and was born though a tight cord loop. My preceptor had her hands on mine and we caught together. The dad didn't want to cut the cord (in fact once he greeted his boy and kissed his wife, he went and laid down on the floor... ) so I cut it.

What an honor and joy to have this be my first birth. Like a kiss on the forehead from Creator- a sweet and gentle greeting at the door as I walked into my new role. The part that was hard for me emotionally about this birth was that when the mama reached for my hand while she was pushing, I couldn't take it. I had sterile gloves on and I had to keep both hands ready for her baby. I gave her my arm, and then a nurse took her hand. I felt the sweet, painful jolt from my life as a doula, to that of a midwife.

The next woman came in laboring hard and absolutely terrified. She is young and came in with her young friend. She screamed and cried and begged for an epidural from the moment she walked through the door. A history of use and social complications, she was barely hanging on. I stayed with her and she was able to breathe slower with guidance, and appreciated some touch, but not too much. The nurses were busy admitting her, finding baby on the monitors, calling the anesthesiologist, who got there in 1/2 hour or so, and by then she was shaking, crying. Baby's heart rate didn't look good so as soon as the epidural went in, so did an internal scalp electrode. Baby was right there and the cervix wasn't. We struggled to glove in time, forget the gowns. This time my preceptor stood beside me but kept her hands down. I caught this little girl on my own, already feeling more comfortable! No cord, small baby. Mom was expecting a boy!

Oh friends, I do feel like a Midwife now. I wasn't sure if the first catch would change me that quickly, but it did. It has. I feel at once more content, more whole and filled with even more joy. I didn't want to leave the hospital (after being awake for almost 30 hours...). After so many years of anticipation, I would have been happy to stay another 30 hours.... to continue being with women and greeting new life into my hands. Thankfully, my preceptor and the next midwife coming in advised me to let someone who was fresh take over. I didn't even realize how tired it was. It didn't even hit me until almost 2 days later... and has taken another day to recover. So much energy expended, so much adrenaline and bliss pumping through my veins. I love this work every bit as much as I knew I would. But I think a part of me wondered if I really would.... if I really could...... well, the answer is a resounding YES!!!! Yes! Yes! and more Yes!!!

I am eager and open and surprised and comforted by how naturally it all seems to be coming.

Don't get me wrong, it's not easy. I'm pushing myself to my limits to enter into this new role with grace and skill. I'm working hard, AND it's coming naturally. Like it always has, really.

I've known since I was 17 and dancing in the cedar lodge in a ceremony in Pic River, Canada. The direction of the fires was to help the young people find their path, their calling in life. My mom took me to this ceremony, bless her. I wonder if I would have found it if I hadn't been dancing and praying in that lodge? It was very quiet; Midwife. Like a whisper in my ear, only it went straight into my heart. I heard it. Felt it. Told my mother. Held it quietly for several years and pursued doula training at 19 to get closer to birth and see if it was indeed, "my thing".

Most of you reading this know that indeed, I have confirmed hundreds of times over that it IS indeed, My Thing. What I am here to do. This is my work, by path, my passion. I am so blessed.

I went to the shores of the Black River at sundown the day I first caught babies, with tobacco in my hand and gave thanks. Gave thanks for all of it. For the day, the families, the people in my life who support me on this path- ALL OF YOU, my son and my mother and father, my teachers and lovers, best friends and co-workers. For my health, my hands, my heart and for every guided step along the way. I am so blessed.

First week

I am surviving, and even thriving in my first week of clinicals! I've gotten oriented to the clinic and hospital, and have already spent 1 1/2 full days in clinic and one night on the OB floor. Tomorrow and Saturday I have 24 hour call shifts. I am sleeping and eating when I can and thanking my lucky stars that I am young, healthy and relatively hearty. This is wonderful, challenging work. I am still mostly in observational mode, but have been handed the speculum more than once now, and am becoming comfortable with measuring bellies and finding fetal heart tones! We have seen women for pre-natal and post-partum appts., birth control consults and checks, post-miscarriage care, depression, unexplained bleeding and cramping etc. etc.
I am finally getting around to studying for my two classes (Advanced women's health and Health Policy) and may even cook a meal this week!
I am so glad to have the opportunity to live with Pam & Connie and Kasey & Keena the dogs. They are all dear and welcoming. I feel at home, which is such a comfort, being so far from my own!! I miss my boy and dear folk in the Chequamegon Bay. Everyone says he's doing great even in my absence (imagine that!! :). No surprise. He's got good care and a whole community looking out for him.
Off to go study some more, and then sleep before tomorrow! Pray for births!
Lots of love to all- and please comment so I know you're out there! -Erin

On my way

It was a wonderful several day stay in Madison; my sweet limbo between home and LaCrosse- my new temporary home and training grounds. My dear friends Rhea & Graham (who are expecting their first baby in July and celebrating their marriage in Mexico on Valentines- YAY) lent me their home and fridge for the time. We visited, shared and debated over yummy food and drink. I saw my dear old friend Heather (who is expecting again in June! Her oldest just turned 6- YAY AL!!) and family friends, my extended family, Sue, Maury & Jon. Mostly I sat by myself at Ma cha and drank tea. Reflected. Sat. Wrote. Prepared. Felt. Enjoyed.

I feel myself in a way I havn't in a long time- just to have a bit more space and time to myself that I'm used to.

I forget how much I need this. It's good- and the timing is right.

I drove from Madison to LaCrosse last night. What a gorgeous drive into the driftless area of Wisconsin! I had no idea my state had this many curves!! They're all hiding down here in the corner. Lushous. Jawdropping sunset to boot- the picture doesn't do it justice, of course. Listened to Paul Winter's Common Ground (thank you Tom)- an etherial way to enter this new stage in my life.

I arrived to the open arms and warm home of my new friends, Pam & Connie. Pam is my clinical preceptor, clinical coordinator, course faculty and now, housemate! Luckily, she is fabulous and they have made me feel at home instantly. Their friends Katheren & Lisa came over for supper and the five of us made wonderful pasta and drank a bit of delicious red wine! I unpacked my new room and set my pictures around me. I had mail already and went to bed feeling content and sure, again, that I am on my path.

Today I've discovered the town a bit and found the co-op. I am at the Jule coffee shop on Pearl street and learning my new ropes. Tomorrow I start clinicals.

have a full heart and a slightly nervous belly. I miss home, and am finding joy here already.

So far, so good!! Love to everyone, and I'll keep you posted!

Erin Hannah.

Spiraling grace

I've been smiling to myself a lot in the last 2 days.
Most recently I smiled to have found my blog again- [inspired by my dear friend, doula, musician, writer and blogger, Heidi Howes http://heidihowes.wordpress.com/] and read my last entry, made just over a year ago, entitled "Grace".
Let me tell you about where I am right now. Sitting on cushions, drinking Jasmine Pearl tea at my favorite tea house in Madison http://machateahouse.com/machahome.html in a steel blue room with red curtains (any one who knows me well, knows that these are my favorite colors together- like the lake and blood) and a sign over the door that says "Grace."
I am overlooking Monroe St. at snow coming down at a steady pace. I used to walk this street on my way to grade school every day with my dad. I had to half-run to keep up with his long stride. I'd stop at the corner drug store to buy lemon heads for 10 cents as a young child, and then when I was a little older, would stop on the way home to see what sundry things were happening under "the bridge". Some of you may know what I'm referring to. First kisses come to mind.
Like a homing pigeon, I always seem to come back to this part of town, where I and my grandma grew up. In the same beautiful house on Adams Street.
My first 5 jobs were on this street. I met Sebastian's dad on this street. I almost got hit by a car on this street. I walked to Orange Tree with my best friends and bought stickers to trade on this street. Bought sweet clothes for my baby at Wild Child on this street. http://www.wildchildclothes.com/ And now, I find solace on this street. Alone with my thoughts and full heart. Was quiet, now people talking. Mucklucks sitting in the corner; reminding me of the Northwoods, my home now.

The place where my son is, my parents are, my best friend and my love are. Taking down Christmas trees, making fires in the wigwam, skiing, sharing meals, loving me over the miles.
My community. "My people" as we used to say at UU camp; the ones who make up your circle. My doula sisters. Amazing women and one man who choose to volunteer their time and give their hearts serving families as they birth their children. These doulas are on call for their clients, visit them in their homes, advocate for housing improvements, assist with breastfeeding, stay at the hospital with them while they birth, sometimes for days or go to stay in their homes and care for other children, cook, massage, listen to women as they prepare to or recover from birth. They take buses to visits if they don't have a car and sometimes get snowed in. They go to social service apts. and write birth stories and take photos and advocate and hold space.
This is what makes our community strong. We care for each other. We don't do it for money, we do it because it's the right thing to do. I am so proud to do this work, this way.
I am so appreciative of my family, and the families of the doulas who support this work in every way; they care for the children, give rides, pick up dropped tasks and make tea for us when we return home, weary and tired. See? We care for each other.

And there are so many ways to care for. I used to think literally about care- as in physical care, given from one who is trained to one who is vulnerable. I am understanding now more and more that it is so much broader, deeper and sublime than this. Those who make paintings- create beauty. Beauty brings peace, joy and fulfillment to ourselves and others. Those who play music evoke heat, solice and energy in our tired or bored selves. Those who collect trash free of us our debris, those who fix computers allow us to do our work. Those who stay in the home raising children and teaching are protecting our collective futures. Those who pray for us all day, guarding our salvation and our collective sanctuaries. The philosophers, writers, thinkers, keeping our minds sharp and provoking us to avoid subservience. The police who keep order and the lawyers who challenge it. There are so many ways to care. Quiet, loud. Easy, challenging. Sweet and brutal. Steel blue and blood red.

We are given gifts from the Creator, our own flavor of caring. Our flare that we embody as we live out our days. I am so blessed to know that I am a midwife. A mother. A writer, a photographer, a dancer, a spiritual being, having a human experience. I am so blessed.

I had tea with my grandmother Lucia this morning. She is a beautiful woman with my blue eyes who actually grew taller in her 70s as a result of her regular ballet practice. She started at the age of 40, and stopped dancing at the age of 80. At 76 she could still put leg up on the barre. I was 21 when I went to class with her, and I could not put my leg up on the barre. Needless to say, she is my inspiration.
My grandpa sat upstairs quietly sleeping in his chair while we talked. He can't tell his story anymore. He doesn't remember it. But she does.
She told me about their lives when he was in in medical school in the 1940's. They lived in Chicago, Trinidad and Denver. They met because their families were friends, but really got to know each other over a dead cat in their pre-med comparative anatomy class. My grandmother abandoned med school when my grandpa proposed to her, "without a second thought" she said. Yes, she would have enjoyed being a doctor (one of the few women docs at the time. Her doctor, incidentally, was the first woman OB doc in Madison), but she had no doubt that she would marry my granpa support his pediatric practice, and raise her 4 children.
I asked her about my grandpa's medical practice, and was intreagued with what she told me. He, like his father, "Grandpa Kent" was a pediatrician in private practice. He had his own office space and own patients. He would see clients in the office during the day, and those who needed house calls would call their home, leave a message with grandma (who also handled the books for the practice) and when he got home, he would call everyone back and then eat dinner (or not) with the family, and head out to see sick kids. She said he never took off his suit, until he got into bed at night. And even then, he left it by the bed, so it would be ready if he had to go in the middle of the night. He was on call for his patients all the time. He would go out nearly every night and on Fridays, when Margaret would come over and take care of the children so they could go out, he would leave his name at the desk of wherever they went, so his patients could track him down. He accepted trades, and my grandma says there were plenty of times he didn't charge patients when he knew they couldn't afford it. There were no insurance companies back then, just direct payment for services. My grandma remembers that a standard visit was $7. Wow. He stopped practicing in 1968. His father before him had the same type of practice, plus a radio show and book, "Let's talk about your baby", written from the baby's point of view, giving tips to his/her nanny on how to care for it. House calls. Generosity. Service. Care. Selflessness and sacrifice. Balance, and grace.
I asked my grandma if that was hard for her, with 4 children, to be home alone with them so much and her husband off caring for other people's children. She seemed a little surprised by my question. "Well, no, not really" she said. "I always enjoyed our time together when we had it. We were very blessed.". Indeed.
I love these stories, and know that I come from this, and am proud to carry on this legacy of caring for people when and were they need it. In their homes. Lending strength to individuals, and therefore, the community.
With, Grace.

Hannah, the word for Grace in an ancient Hebrew language.
Also the name of my Mother's great-grandma, a midwife and Norweigan homesteader in North Dakota.
My middle name with two "h"s added.


With love, on this quiet, snowy day between meals and conversations,
Erin Hannah Tenney