Birth of a Midwife

Birth of a Midwife
As a nurse, I was brand new to labor and delivery–and I was on my third night shift in a row. Walking back from a quick break, I was called over by the charge nurse.
“You have the next admit from triage,” she told me. “She’s a live one–and so is her family. They’re carnies.”
“What’s that?” I asked, bewildered.
“You know, the people who do the circus and carnival circuit–gypsies,” she said, innocently using a term that is now considered derogatory, but was then often applied to the nomadic ethnic group known as Roma. “She’s going natural.”

I felt a quiver of anxiety. When it came to giving labor support, I’d created a high bar for myself. I hadn’t yet gone through childbirth myself, but for my patients’ sake, I assumed that I needed to exude a certain confidence. The real test came when a woman in the throes of a contraction would ask, “Well…do you have any kids yourself?” This challenge felt as great to me as any clinical ordeal I’d ever faced.
Okay, I can do this, I told myself, taking a deep breath.
This was a busy Saturday night. It was a State Fair weekend, late summer of ’89, in Albuquerque, New Mexico. Plenty of pregnant women were arriving in triage, dehydrated from their day in the sun. The night had been a string of false labors. The protocol was simple: Hydrate, rest and reassess, then out the door.
I tracked down my new patient by following the howling sound that was emanating from a small labor room. There’s no baby warmer in there, I thought to myself. When the baby is close to being born, we’ll have to move the mom to the back delivery room, near the OR.
I reflected nervously that I didn’t look forward to transferring the woman to the stretcher at the end of her labor, when the baby’s head would nearly be crowning. And I have to remember to call the doctor to the birth on time….
I walked into the room. A young woman lay in the bed, a sheet draped over her belly. A large group of women packed closely around her, their voices boisterous, all giving advice at the same time. Whenever she had a contraction, their howling rose and fell, mirroring its arc.
The women ranged widely in age. The eldest sat in the only chair, close by the bed, her wide skirt flowing to the ground, silver hair braided and tucked under a kerchief. Most of them wore headscarves, long skirts and jangly necklaces. To me, they looked like villagers from Old Europe. In between scattered English words, I heard another language rising up with each contraction.
What are they speaking? I thought, perplexed.
The baby’s father stood in a corner, head down, back to the wall, overshadowed by all the females. He wore jeans and a muscle T-shirt; I imagined him working the Tilt-a-Whirl or the Scrambler at the fair. Here, he looked no more than a baby himself, quiet and innocent amid the cacophony.
I waited for a pause between contractions, then introduced myself.
The mother-to-be was seventeen, and petite except for her belly. This was her first baby. Labor had started while she was making food at a fairgrounds concession stand; moving closer, I smelled the grease in her long hair. Beyond briefly answering my questions, she didn’t pay me much attention and never looked my way.
Remembering my checklist of things to review, I jumped into action. Vitals, baby’s heart rate, admission paperwork. I did a quick listen to the baby’s heartbeat with the fetal heart monitor, and it sounded great. The mom didn’t want to wear the fetal monitor belts, so I let that one go. When checked in, she’d been seven centimeters dilated–from then, birth could happen within minutes, in two hours or anytime in between. She was acting wild and woolly–writhing back and forth and grabbing onto the bedrails.
“Can I check your cervix now, to see how far along you are?” I asked.
No answer.
“Help her!” the women ordered. I grabbed a cold washcloth and pressed it to the young woman’s head. Her writhing was making me nervous.
Another contraction came, and I raised the monitor to check the baby’s heart rate. The girl pushed my hand away.
“Baby is coming!” she cried.
Several women stepped forward and placed their hands on her swollen belly. I feared they were going to physically help to push the baby out. Even with my limited experience, I knew this was not a good thing.
I grabbed some sterile gloves and pressed the emergency light for extra help. The charge nurse ran in, looked at the patient, then gave me a quick, sharp stare.
“I just paged the doctor on call,” she said. “We have to go to the back for her to deliver. Routine is routine.”
“I don’t think we have time,” I said.

The young woman was getting very focused, grunting and bearing down, and I quickly pulled the sheet aside. There was no doctor in sight.

The charge nurse snatched the gloves from my hand and prepared to do a nurse catch. Raw, unbridled energy rose up in the room as the women resumed howling.

Eyes wide, I stood locked in place. The young woman took charge and pushed instinctively.
The doctor walked in briskly–just in time to see the baby emerge, slippery as a fish, and slide into the nurse’s hands.
A strange music came to my ears. The women’s howling had changed to celebratory ululating: “Lu, lu, lu, lu, lu, lu, luuuuuuuu….Lu, lu, lu, lu, lu, lu, luuuuuuu….”
The door was half open, I realized. Several other nurses peered in, drawn by the wild energy spilling out into the corridor.
The young mama lay quietly, surrounded by her womenfolk. Now, for the first time, I was able to catch her eye. I elbowed my way to her side, and she let me take her blood pressure. I reflected on how refreshingly free of protocol this birth had been. The baby stayed cuddled with its mama, with no bright lights, no drama of moving to the delivery room. This lively family group had swept in and unabashedly made this place their own.
I asked where they’d originally come from.
“Romania,” they answered.
Of course, I thought, nodding. Roma culture had indeed raised the power and dignity in this room.

This birth experience was phenomenally transformative for me. Here, for the first time, I’d witnessed women raising their voices together to join with the woman in labor, not in the least trying to sugarcoat her labor pains by maintaining the giant hush common to other births.

Something shifted in me. I saw that not only is birth to be honored as a life event, it is to be honored as an elemental community experience, in which it truly takes a village.

In the coming years, I took charge myself, and became a midwife. I cherish the popular midwife saying “Trust Birth.” Following this precept has taken me to places in the human experience where I find surprise again and again.
Today, I pause to honor the way in which I was humbled–and taught–by the primal birth energy of the Roma.

SPECIAL FEATURE: MEET THE AUTHOR

Hear the author comment on her story.

About the author:
Rebecca Leeman is a certified nurse-midwife at Women’s Specialists of New Mexico (WSNM), a large private practice in Albuquerque, NM. Her early years of midwifery were spent in the Pueblo of Zuni at an Indian Health Service hospital. She teaches infant massage to parents and collaborates with other healthcare professionals on perinatal mental health. Recently returning to creative writing after years of parenting three boys, she has written “Ask the Midwife” pieces on the WSNM website and last year had a “Readers Write” piece published in The Sun. She also writes poetry for herself and for grief support groups. “This story was inspired by my reflections on twenty-eight years of midwifing and on what first motivated me to take the reins within this field of service.”

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Comments

12 thoughts on “Birth of a Midwife”

  1. What a wonderful story. As a Labor and Delivery nurse I had the pleasure and opportunity to be involved in many births with you

  2. What a wonderful story for me to read as I meet my new family I am visiting in Lima Peru, new daughter in law and 5 yr old grand daughter. Little one does not really see me yet. She is shy. Thank you.

  3. A superb story.

    I am so impressed by how this young nurse midwife responded.

    I just wish that med schools &
    hospitals would circulate this piece to both students & doctors.

  4. Margaret Schock

    This is a beautifully written story…and it brought back memories from when I was a young medical technologist working my first job in a small hospital in Alabama, Late one night I was privileged to witness the Roma family gathering as their King was dying…the head nurse cleared the area, giving the grieving family room to gather and to perform their important candlelight ritual. It was a moving scene, one that I shall never forget. Thank you, Rebecca Leeman, for sharing this moving story.

  5. To Rebecca Leeman, CNM
    Your story of your part in the Roma extended family’s [very] emotional support of their young primigravida’s delivery is a testimonial to the joys [mostly] of midwives around the world–where midwives are the primary clinicians in childbirth.
    In the USA, not so much…often resulting in impatient decision-making and excessive invasion in birth, which as you say, should be trusted.

    As a young general practitioner in rural Papua New Guinea, my best first teachers were the hospital’s midwives, partograms and all.

    I also share your appreciation of Zuni-Ramah IHS; my first medical job was nearby in the Navajo nation in 1969.

    Greetings to Larry Leeman MD; the two of you are gifts to women who want their birth attendants to be both natural, yet highly prepared for anything…

    1. Thank you for an inspiring story of the collective power of women’s voices and women joining together. It is the raw power that does not dominate, but rather gives birth to thoughts, ideas, ideals and babies.

    2. Thank you Ronald. I appreciate your comments a lot. I have shared this with Larry. I worked at Gallup Indian Medical Center in 1992, as well as in Zuni. Rich beginnings.

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