Wednesday, July 17, 2013

How Being a Midwife Made Me a Better Doctor-{Cross Post}

I think that sometimes, it's like birth workers are on one side or another: medical hospital birth with an OB vs. unmedicated birthing center or home birth with a midwife. Unfortunately, the lines are quite clear and when you "pick a side" you don't often get to switch-especially if you're in labor.

Of course, a mother who is at a home birth can transfer to a hospital, but I've not heard of a mother laboring in the hospital transferring to a home birth. There are, of course, some hospitals that think well of laboring mothers and have a good understanding of the birthing process. In these hospitals women are able to eat food, move around and birth in a way that is comfortable and natural. More often than not, though, women who birth in hospitals are offered (and sometimes not) interventions like pitocin or an epidural that can sometimes slow the natural rhythms of birth.

I don't believe that these doctors are purposefully trying to interfere with the natural process of birth (which does take some time!), I think there are a lot of factors contributing to the rise of interventions and subsequent unscheduled c-sections and they're not to do with the mother, in my opinion.

Doctors and hospitals are over booked and L&D rooms are a hot commodity. When you've got a large city with a lot of women in labor, there simply isn't time to let a mother labor for 24, 36 or 48 hours. Another factor is that some doctors have never experienced an un-medicated natural birth. This is something that Ina May Gaskin talks about in her books and lectures a lot and was a snip-it in the documentary The Business of Being Born.

In my opinion medical schools and the training are the culprit. Imagine of all medical students did what Dr.Aviv Romm did? What if all OBs trained as midwives? Can you imagine how differently birth would look in our country?

I have many professional titles and roles: physician, midwife, herbalist, author, teacher. Of these, being a midwife most informs and enhances all of what I do and who I am.
Midwife literally means “with woman.” But it also means, “to bring forth.” Midwives listen, coach, cheerlead, care, reassure, support, and speak truth. At my best, I am a midwife in all contexts – not just to the women I serve, but to my partner, my children, my friends, my patients. At my best I bring forth their best – their strength, confidence, and belief that they can do it. And as a midwife I am able to be patient about whether this happens quietly or with loud screaming! At my best I am deeply present and listen closely to what the people in my life are telling me. And I listen to the unsaid, as well.
When I graduated from medical school at Yale I was given an award as the most promising primary care physician in my state for that year. This was not a result of what I learned during my medical education. Being a midwife for 20 plus years prior to medical training imbued in me the art of caring that should accompany doctoring but too often doesnt. As a physician I care for my patients with the compassion, deep presence, and heart of a midwife, whether they are giving birth or being treated for pneumonia, whether they are trying to nurse their newborn for the first time, or have suffered a stroke, leukemia, or are in their last days of their life. And because the demonstration of presence and compassion is more rare than common amongst physicians, it was noticed.
It is my understanding and internalization of the midwifery model of care, which places a partnership model and a patient-centered model first and which treats the body as wise and self-healing rather than as a machine that requires repair that makes me the physician I am. It is being a midwife that informs the care in the health care I provide to all of my patients. And it is this true caring that inspires me to do what it best for my patients, and to truly know who they are as people, not diseases.
I not only midwife my patients, but their families at their hospital bedsides and in clinic rooms. I care just as I would for an anxious expectant father or other children at a birth. I bring the whole family in.

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