God is in the Midst of Her...

It was inexplicable and immediate. For so long, midwifery had been *it*, the thing I cared most about in this world, my love for Jesus incarnated. I tattooed “sage femme” under my breast, for crying out loud! In my soul, I WAS a midwife! And perhaps I still am; I do still and will always claim “wise woman;” I believe that is the Lord’s design. But being a midwife is no longer my greatest earthly identity. For almost 3 years I was first God’s child and Christ’s beloved, and secondly, I was a midwife. But today as I write this, I am first God’s child and Christ’s beloved, and secondly I am the woman who loves Jeremiah McWilliams.

This started playing out in my heart in July (probably about the time I first started writing this “Gestating Halley” series – it’s taken me this long to sort it all out). As of early July I had been dating Jeremiah for less than 3 months. (Heck, I’d KNOWN him for less than 3 months, period). It was quick. We hadn’t told each other yet that we were in love, but it happened soon after. I would sit in my mother’s kitchen in St. Louis and think out loud about my bewilderment. I told her numerous times I just couldn’t understand why working as a midwife’s apprentice wasn’t giving me the ultimate joy and fulfillment I expected. I also told her that for the life of me, I couldn’t “turn down” my desire to be with Jeremiah; I could not lessen it, I could not make it equivalent to my desire to attend births, and I could not mesh it nicely on the side. My desire to be with Jeremiah was greater, and it would not be squelched. My wonderfully intuitive mother listened to my ramblings with patience for several sessions. Then one day at the lunch table, she looked up at me and spoke truth that is still resonating: “You know, Halley, sometimes we have a hole in our hearts that we cannot fill, and until we are able to fill it with what it was meant for, we fill it with something else.” Suddenly, Clarity – that elusive but oh-so-gratifying angel – paid me a visit. “Are you saying that I had a Jeremiah-shaped hole in my heart that I was filling with midwifery?” I replied, flabbergasted. “That’s exactly what I’m saying.”

And so I told Julia in early August that I had to stop apprenticing with her for the time being, because I couldn't keep up with the crazy lifestyle I had assumed, and because I needed to figure a lot of stuff out. She was incredibly gracious and understanding, for which I am eternally grateful. It’s now mid-October and I’m still mulling that conversation with my mother over in my mind. It was so simple; it was so freeing; it was so true! It made a lot of sense then, and it makes even more sense now. I did not become a horrible, selfish person over the summer (as I wondered when I found myself hoping that no babies would be born on the precious nights I got to be with the man who understands me so easily and loves me so well). I do still have the willingness and the earnest desire to exhaust myself, inconvenience myself, and sacrifice myself for that which is dearest to my heart. But my deep love for birth is now in 3rd place, and at present, it’s a distant 3rd place. If you have been reading this entire story, I do not have to tell you that my passion for birth and mothering runs as deep as the Atlantic. And yet my love for Jeremiah has mightily overpowered it – there is no contest. So then, how deep and high and sure and true is my love for Jeremiah! It’s INCREDIBLE if you stop and think about it! :)

I want to be on-call for Jeremiah. I want to answer his 3am phone calls. I want to spend national holidays with him. I want a life with him! And I am more than willing – I am eager – to amend my dreams in order to blend them with his. He is my greatest dream, after all, and I will exhaust, inconvenience, and sacrifice myself for him. Jeremiah loves my dreams; he wants to see them all come true – it is for this reason I can securely put them in his hands. Jeremiah – the most amazing, selfless, incredible man in the whole world – wants to amend his own dreams in order to blend them with mine. We cherish each other’s hearts. We want to be together, and we are finding our way.

I feel certain in writing this that there will be at least one reader who will disapprove or even condemn me for this, perhaps in person, but more likely outside of my presence. They will say that I cannot let a man “take over” my dream of becoming a midwife, that I cannot change my plans “just because” I now have a man in my life. This perspective makes me sad. It is so misled, so ruthless, and so self-seeking. Recently I heard biblical love defined as “self-forgetfulness.” This term sums up well how I have come to feel about how my individual dreams and ambitions fit into a relationship. I can assuredly set my dreams – and therefore myself – gently to the side, forgetting my heart to an extent, because Jeremiah isn’t going to forget my heart. To the contrary, he loves my heart with great passion and tenderness, just as I love his. I will forget my dreams if I can see his fulfilled. I believe this is love. And as one, we kneel before the Cross with every longing of our hearts, and trust our Savior to knit us closer together and bring our hopes to fruition as He deems fit.

I also feel certain in writing this that most of you are my dear, dear friends, and want me to be happy and free and alive and well. (And I am! More than ever before in my life, I am!) I know you are the ones who, even if you hadn’t read this explanation of my heart’s overhauling, would still stand by me whether I was a midwife or not. Thank you for your kindness and unconditional friendship…makes me tear up to think of it! It is because I have come to believe that you love me for who I AM, and not for what I DO, that I can say that I am no longer going to be the least bit sheepish or apologetic about loving Jeremiah more than I love midwifery! I am going to REJOICE! REJOICE in the Lord always, I will say it again, REJOICE! (Philippians 4:4). Friends, I have found him whom my soul loves! (Song of Songs 3:4).

If I was going to rewrite Eric Church’s song “Love Your Love the Most” to reflect how I feel about Jeremiah in relation to how I feel about midwifery, it would go something like this:

“Yes I love tiny babies
And pregnant bellies too
I love a good sweet birth story, it rocks on Friday nights.
Hell yes I love my dreams, but I want you to know
Honey I love your love the most.”

http://www.youtube.com/watch?v=hlCGnGLlu64

And, so we are at the end of my gestation. I have been born as Jeremiah's love, and it feels amazing to breathe outside the womb. I might tell you I was post-dates, but God would tell you this birth happened exactly when He ordained, just as my birth as a Christian happened, and just as my births as a midwife, a mother, a grandmother, etc will happen, if and when God wills. But for now, I am quite content and ridiculously happy being madly in love with Jeremiah McWilliams. I don't have to have all the rest worked out -- after all, I'm just a newborn ;)

As 2008 began, I saw "The Business of Being Born" with my mom and my roommate Katie (and instantly turned two skeptics into staunch supporters). I can't say I learned anything new when I watched that movie (I had spent the past year researching maternity care!), but it did shake me up. It dawned on me that birth was not just something that affected ME as a career path, but something that would profoundly affect all the women I know and love -- most of whom live in Missouri, where midwifery was at the time a felony. In early February I discovered Friends of MO Midwives, our statewide advocacy organization. I decided quickly that I had to do my part to contribute to the legalization of midwifery in my home state. I made a batch of brownies and drove to Jefferson City for "Cookie Day." The Capitol loomed before me, and somehow it looked even bigger than it did on my 4th grade field trip. My heart pounding within me, I set foot into senators' and representatives' offices, gave them my brownies with a note "From an aspiring midwife" stapled to the bag, and asked to speak to them about the matter closest to my heart. I did not feel like a worthy authority at all, but I did know that doctors should not be slicing women's vaginas open without their permission or awareness. I knew that mothers -- not health care providers -- know what is best for their bodies and their babies. I told the elected officials what I knew and what I wanted. Although I know realize that some of the people who "listened" were just being politicians, it was enough to make me want to come back.

And I did come back. I came to the Capitol every Wednesday for the rest of the 2008 legislative session, and a couple times a week at the end. It worked out nicely because I didn't have any classes or clinicals on Wednesdays. However, at a crisis point towards the end of session, I called my nursing instructor the morning of our Thursday clinical and told her it was more important for me to be at the Capitol lobbying than for me to attend my mental health clinical. Part of me can't believe I had the gall to do that, but what's even more amazing is that my instructor agreed with me! Now that I think about it, making that phone call was an outward declaration of what I had been feeling about nursing school all along: indifference. I just didn't care about it very much. (I cared about doing well, but that had more to do with my disease of over-achievement than it did with a passion for nursing). What I did care about was justice, and safety, and excellent care for women and babies, and I knew that I would need a voice louder than an RN's to make a difference.

The 2008 legislative session ended in mid-May. It came down to the wire: the Senate waited until the afternoon of the last day of session to pass our licensure bill, and the House was not able to get it passed before the solemn hour of 6pm tolled. I cannot and will not speak of the politics involved, but it was messy and ugly. I prayed and prayed and prayed that our bill would be passed and midwifery would be legalized. But 6pm came, and midwives remained felons. I was numb. I was heartbroken. I couldn’t imagine how my friends felt, who had already spent four years at the Capitol trying to legalize midwifery, and had already tasted such bitter disappointment four times over. It was so unjust. But we still had a small glimmer of hope: at the end of the 2007 legislative session, a bill legalizing certified professional midwives (or someone holding “tocological certification”) was passed. When the state medical organizations realized what had happened, they challenged the law in court. We hired an attorney and fought back. Those big wigs assumed we were just a bunch of silly housewives, but they were about to learn we were a force to be reckoned with. When the 2008 session ended, the Missouri Supreme Court still had not ruled on the tocology law. And so we continued to wait.

I was cruising on the Mediterranean Sea with my mother when it happened. Knowing the Supreme Court was going to announce their decision any time, we (well, she, honestly) shelled out the cash so we could check our email on the cruise ship. It was about 3am in Missouri on June 25th when I logged in and saw the email that dumbfounded me and brought tears to my eyes: “MISSOURI WINS!!!” It couldn’t be! But it WAS! The Missouri Supreme Court had sensibly determined that the Missouri State Medical Association (MSMA) and the other physician groups didn’t have standing to sue, so they threw out the case, thereby making the tocology law immediately effective and making midwives instantly LEGAL!!! After half a century of Missouri women not having legal midwives, and Missouri midwives running from the law, justice was served. My mother and I spent the rest of our delightful European vacation on Cloud 9, and I knew I would not be returning to the same Missouri I had left.

I returned to a Missouri where midwives were legal, to a Missouri where my sisters and daughters could have homebirths with legal midwives, and a Missouri where I myself could BE a legal midwife. It was an awesome feeling. I do not have sufficient words to describe how huge that was, how huge that is, how huge that will always be. I started my final semester of nursing school, and I could no longer deny that my graduation from college was around the corner. Full-blown adulthood was screaming toward me like a bullet train, and every day went faster than the one which preceded it. Ever since I had first become interested in midwifery – two years before this time – I had thought about it in a future context. When I’m done with nursing school, then I will pursue midwifery. Or, when I’ve graduated college, then I can start midwifery school. All of a sudden, I could think about midwifery in a PRESENT context: the time has come! It’s here, it’s now! If I’m honest with myself, it was just as nerve-wracking as it was exciting.

I decided about this time that I was going to stop battling God over whether or not I should go to Newlife/the Philippines, and just take the cosmic hint, and apply. (I’m a little slow on the pick-up sometimes). Newlife started in the fall, like all schools do, so I knew I would have an awkward eight-month chunk between graduation and when my “real life” would begin. I quickly decided that I would get some “silly nursing job” to bridge the gap and save money for tuition. I applied at University Hospital here in Columbia, where I had done the majority of my clinicals. My classmates were all flustered about applying to ten different hospitals and getting a jump on things on September 1st. Myself, I applied for two University jobs in mid-October, roughly two months before graduation. I had two interviews, one with 5 West and one with Labor & Delivery (I’ve thought soooo many times, Maybe I could *change* L&D, maybe I could make it a whole different world all by myself…). But I always wake up from that fantasy pretty quickly. Plus they wanted me to work nights, which I could not do because I had already committed myself to lobbying at the Capital in the 2009 session at least two days a week. (Plus I have a firmly ingrained circadian rhythm).

I knew I had to take a “silly nursing job” that wouldn’t (a) get me fired, or (b) make me go home crying every night. I had already done my senior practicum on 5 West, so I knew the people and the protocols. It made for an easy transition. The patient population on 5 West comprised all things traumatic: car accidents, motorcycle accidents, gunshot wounds, knife wounds, horseback riding accidents, falls from ladders/balconies, you name it. It also included all things surgery: hernia repairs, gastric bypasses, dialysis accesses, appentdectomies (appendix removal), cholecystectomies (gallbladder removal), and surgical complications (chronic wounds that never heal). Nothing about this excited me; in fact I found it pretty lame. However – I had no ethical problems with trauma/surgery nursing either (at the time -- I do now, wouldn't you know it?), which is a LOT more than I could say for OB nursing!

I got my silly nursing job squared away with as little effort as possible as I poured myself into my Newlife application. I prayed over it. I wrote a book of an answer to each essay question (they said to be thorough!). I had multiple people read it and edit it. I finally submitted it in early February of 2009, right at the deadline. Meanwhile, graduation had come and gone, which was celebratory and awesome, yet surreal and frightening. Christmas had come and gone, and I felt like the happy-go-luckiness of childhood slipped permanently away from me, tossed to the curb with the wilting Christmas tree. I was stricken with fear. What had I been thinking? How could I possibly manage to work as a full-time staff nurse (which I had never done before) AND be a full-time lobbyist (which I had never done before)?? I felt very alone. January 5th came all too quickly, and, seemingly without my permission, my life crossed the threshold into “the real world.”

Part II: Finding Myself...Again. I'm back. Time to discuss what I hardly know how to put into words: the over-hauling of my heart and purpose that has taken place without my permission this summer. Honestly, I'm terrified to pen the words.

[This blog of self-discovery has turned out to be much lengthier than I anticipated, thus I am posting it in three sections. Here is the 1st chunk].

For the past three years, my soul has been aglow with the peace of knowing exactly what I wanted to do with my life: become a midwife. Most of my 23 years has been spent not knowing who I am at my core and trying desperately to discover it. But in the fall of 2006, I stumbled upon midwifery. I learned to my horror that millions of women are manipulated, traumatized, wounded, and needlessly cut open every day in our "modern" maternity system. I found out to my great happiness that there is another way, a beautiful, under-appreciated, constantly misunderstood, and sometimes illegal way to have a baby: at home with a midwife, a wise woman, by your side. And I instantly wanted to be a wise woman myself. Conception.

Gestation began as I started to nurture this dream within me. I quickly became engrossed with the study of all things birth. I joined Yahoo groups and email lists. I poured over advocacy websites and read every book I could get my hands on. First it was "Baby Catcher," by Peggy Vincent, a homebirth nurse-midwife's autobiography. I devoured it in 3 days; the initial story was about the first birth Peggy ever witnessed. She was a nursing student at the time, and so I felt a special connection to her from the start. Every birth story was beautiful in a unique way and I wanted more than anything to share in that beauty. The next thing I got my hands on was "Born in the USA: How a Broken Maternity System Must be Fixed to Put Women & Children First," by Marsden Wagner. In sharp contrast to "Baby Catcher," "Born in the USA" was an infuriating unveiling of our money-driven bloodbath of a maternity system. "Baby Catcher" warmed my heart and "Born in the USA" made my blood boil. I started nursing school in January of 2007 and I continued to study midwifery ravenously on the side.

During the summer of 2007 I witnessed a birth for the first time. I was working as a camp nurse at a Young Life camp in northern Georgia, and the secretary at the camp arranged for me to meet a friend of hers who happened to be a midwife. Charlotte* invited me over to eat cantelope and discuss all things birth. She told me she had three ladies due in July, and did I want to come to a birth if it was alright with the families? I was ecstatic!!! My dream come true!!! Charlotte called me a week or so later to let me know that one of her clients had agreed, and that she would call me as soon as she went into labor! It was 3AM July 20th when I got the call. We sped off into the Georgia mountains and my heart was racing with anticipation. Grace* labored beautifully with her husband at her side. The lights were low, the house was quiet, the children were sleeping. A sweet baby girl was born at 5:05AM, when she was ready, and she slipped gently from her mother's body into waiting hands on the bed she was made on. No one ever took that baby from her mother. There was no need. I was a silent observer and I took it all in with awe. I was so humbled. So overcome. So enchanted. I knew I would never be the same.

A couple months later I completed my OB rotation in nursing school. The contrast between home and hospital birth was stark and cruel. The second birth I ever saw was a cesarean section. I'll never forget seeing that woman's uterus sitting on top of her abdomen, silverly blue and sickly looking, with the fallopian tubes hanging off like chicken legs on either side. It was so violent, so taboo, and yet all too real. It will be reality for 31% of all the women who give birth in the US today. I'll never forget in OB lecture when we were learning about episiotomies (a surgical cut into the vaginal tissue toward the anus, done to enlarge the vaginal opening for delivery). Our instructor (a mother of 4) talked about episiotomies as if they were no big deal, mundane even. I raised my hand and tersely asked why informed consent was not required for doctors to perform episiotomies (read = surgery) on women. My instructor did not know what to say, and stammered through an answer about how episiotomies are simply part of the labor & delivery process, and a woman consents to a possible episiotomy when she starts receiving care from an obstetrician. (Hmmm I thought, I should keep that in mind if I ever see a cardiologist; I'll be consenting to open heart surgery by walking through the door!).

I should mention here that I started thinking about how and where I would pursue my midwifery education very early on, before my OB rotation, before I witnessed that beautiful homebirth in the Georgia mountains. I have always been a researcher. I have always been a scientist, wanting an answer for every question. (I really don’t know how people lived without the Internet!) I endlessly OBSESSED over what route I would take into midwifery: certified nurse-midwife (CNM), or certified professional midwife (CPM)? I would think to myself, Well, I’m going to be an RN anyways, so it really makes more sense to become a CNM, and it’s more socially acceptable, and it’s legal everywhere…but CNMs practice in hospitals, and pretty much have to do whatever their collaborating physician/hospital says. Two seconds later I would think, Well, then I should be a CPM instead. CPMs attend homebirths, which is what I want to do, and they often have more autonomy. But being a CPM might make me a felon, and the Board of Nursing won’t like me being a RN/CPM! What a quagmire! (OK, maybe I don’t use the word “quagmire” in my thoughts, but you get the picture.)

Eventually I decided that I was going to be a CPM, because homebirth was and is *so* important to me, and I just figured I’d move to a legal state, and the heck with the Board of Nursing. I POURED over CPM schools/distance learning programs/apprenticeship possibilities, but I was enchanted by one of the first I discovered: Newlife International School of Midwifery in Davao City, Philippines. It was everything I was looking for: the mission, the passion for women and babies, the passion for sharing Christ’s love, the clinical experiences and curriculum, the opportunity to learn about a different culture, the chance to stretch myself immensely and grow extravagantly as a professional, as a person, and as a believer. I was in love. Even so, the thought of uprooting my life and moving across the world for TWO YEARS terrified me. I would brush it aside…and the Lord would put it on my heart again…I would brush it aside…and the Lord would put it on my heart again. I did this repeatedly over the course of two years, unable to ever completely dismiss or embrace going to the Philippines. In the midst of my confusion, the action continued…

Many people question the safety of homebirth along this line of thinking: "Most births are okay, but things can go bad quickly, and when they do, don't you want to be in the hospital?"

Here are some expert responses to this question:

"Midwives are trained to recognize problems before they become emergent, and to stabilize the emergencies that come without warning, namely hemorrhage and fetal resuscitation. But the most powerful answer is really the Daviss and Johnson study, which looked at CPMs, (who were both licensed and unlicensed) and concluded that babies were born just as safely in their hands. So the argument that "things can go bad really quickly and it's better to be in a hospital" just isn't borne out by the data. Things can go bad and that's why it's important to have a trained birth attendant and *access* to emergency care." -- Jennifer Block, author of "Pushed: The Painful Truth about Childbirth and Modern Maternity Care"

"Hard things happen in life. Birth is no different. Are there things that could "go bad" at home that would be better handled in the hospital? Yes. But the surprising thing is that there are things that happen in the hospital that either wouldn't happen at home, (like hospital acquired infections, the complications of inductions or cesarean section) or would be better managed at home (shoulder dystocia, need for most newborn resuscitation). The honest truth is that the same number of hard things happen at home or in the hospital. Whenever hard things happen in the hospital, everyone presumes that "they did all they could" and so the outcome was inevitable. When hard things happen at home, everyone presumes it was BECAUSE they were at home and that the outcome would have been better in the hospital. Nobody can really play God--not doctors, not nurses, not hospitals, not midwives. The data is clear--the outcomes are equivalent (but different) in hospitals, birth centers, and homes (unless you count an unnecessary cesarean as maternal morbidity, then we really should be legislating that women ALL stay home)." -- Elizabeth Allemann, MD

"Here's the other thing I say--most of the emergencies that are handled during birth--whether in the hospital or at home or in a birthing center are managed with HANDS. Not machines or surgery, but with hands. Shoulder dystocia--turn the mother over, turn her again, ask her to stand, then the list of maneuvers (from the latin for hands) done with hands. Cord around the neck--removed or cut with hands or baby birthed through. Hemorrhage--manual removal of the placenta(again from the latin for hand), bimanual uterine massage, THEN drugs. Prolapsed cord--presenting part held off the cervix with a HAND until an emergency cesarean can be performed. Any one with average intelligence, clear intention, and enough experience can have skillful HANDS. The initial training--medical or midwifery or nursing or osteopathic or naturopathic--is important but fades quickly as the years of experience add up. I love to say in the right place when the "cord around the neck" thing comes up that there is no "remove the cord around the neck machine"." -- Elizabeth Allemann, MD

I attended my 16th birth yesterday, and it was a sweet sixteen. It was the 2nd homebirth I have attended, with 14 hospital births in between the homebirth bookends. Although I have witnessed 15 births prior to Peggy's, hers will remain with me for a very long time. It was her first baby, and that alone made it extra special. When I arrived at Peggy and Blake's house on Monday night, Peggy was a young married woman. She is just a few years older than me and I felt like she was a peer, that we were at somewhat similar stations in life and that I could identify with her. I shared hot chocolate and a bowl of ice cream with Peggy, Blake, and Peggy's mom Nancy, as we sat around and talked about our families, our faith, and how Blake and Peggy met. I was incredibly impressed with Blake's affection and attention to Peggy from the moment I walked in the door -- I hope I have a husband like that someday. I admired their humble and precious home, filled up with lots of love. Peggy's labor was just starting to become active, with increasingly intense contractions coming about every 5-7 minutes. Peggy was chatty and excited, and just as adorable as she could be too. She called her midwife to come over, and we continued getting to know one another.

The midwife and her apprentice arrived about 10PM, followed shortly by Peggy's friend Susan. The birth team was assembled. I didn't know it at the time, but it was the beginning of a long, challenging, and deeply rewarding experience. The midwife checked Peggy and found her to be 4cm, 90% effaced, and at -1 station. Peggy soon decided that she wanted to get into her birth tub in the kitchen. This was the first birth I have attended in which the mother used a pool for labor (and potentially birth). She labored like a warrior from the very beginning. She labored like a lady too -- even when labor was at its hardest, she still smiled between contractions and was so positive and sweet. The beginning of Peggy's active labor started with a concern: her baby's heart rate was in the 160's and 170's several times. The midwife explained to Peggy and Blake why these high heart tones were concerning, saying that over an hour of a rapid HR would cause fetal distress and require intervention. We were all scared. There were tears. Despite everyone's natural fear over this news, I now believe the Lord was preparing all of us, especially Peggy, for what was to come. He was building our trust in His sovereignty over the birth journey. The midwife administered a homeopathic, and we gathered around Peggy as Blake prayed for the baby's heart rate to stabilize. Jesus answered our prayers -- her heart rate was great from then on.

Peggy continued to labor. She took breaks from the pool and then would get back in. Nancy, the soon-to-be grandma, prepared snacks for everyone and was just the sweetest hostess the whole time. She was also a great support for Peggy, and mother and daughter seemed in tune throughout. Susan and I looked through the midwife's herbs and homeopathics and ooed and awed. I helped document on the labor flow sheet. I listened to heart tones. I smiled at Peggy and told her how marvelous she was doing and tried my best to exude love in every way. This was my first hands-on doula experience, and I was really shooting from the hip and praying God would make me as helpful as I hoped to be. I quickly picked up on the fact that Peggy did not need six people around her all the time. We took turns, with Blake and Nancy doing the majority of the direct labor support. I washed dishes. I boiled water and poured it into the birth pool (I snickered to myself every time I boiled water, it seemed so stereotypically homebirth). Susan, the apprentice, and I watched "The Bucket List" in Peggy's living room. We dozed off to sleep here and there, and Susan said she thought the baby would come by 3AM. Peggy got out of the pool around 2:30 and went into her bedroom. I fell asleep somewhere around that time and woke up at 4-something with my contacts glued to my eyeballs. During the interim, the midwife checked Peggy again and she was 6cm.

By 7AM Peggy was 8cm. She was doing it! She walked around some, but spent most of the time in her bedroom with Blake. We watched the end of the movie and Nancy made scrambled eggs. I started to get anxious that the baby wouldn't be born by 10AM, when I needed to leave to make it to Jeff City on time for an afternoon at the health dept for my community health class. When 9:30 arrived with no baby, I called my preceptor and told her my friend was having a baby and that I needed to come on Friday instead. At 10 the midwife checked Peggy again and reported disappointing news -- she had gone back to 7cm. Obviously this was discouraging news for Peggy. She was working SO hard. It didn't seem fair. A little while later, we invited Peggy to read some Bible verses with us to encourage her...Genesis 25:24, Luke 1:57, Isaiah 66:9 and others. We suggested a change of scenery and offered that it might help for Blake and Peggy to take a walk outside. Instead it turned out that everyone else went on the walk instead of Blake and Peggy, but that was fine too. We walked up and down the road, chasing their dog, while Peggy and Blake labored on the porch. Eventually the midwife got a text from Peggy saying she was getting back into the pool.

We returned from our walk as Peggy continued to labor like a warrior woman. We spent the afternoon somewhat in the background, as Blake stayed by his wife's side. The midwife spent some time talking to Peggy about her fears, as we wondered if unrealized or unspoken emotions were holding things back. Around 2PM, when it was very clear that the baby was not coming any time soon, I had to make a difficult decision. I needed to leave immediately if I wanted to make it to the Columbia party for Kurt Schaefer in time. One of the purposes of the party was for Schaefer to associate my name and face with the midwifery cause! I was supposed to be co-hosting the event, for goodness sakes! We had been planning it for weeks. But here I was, at Peggy's birth. Not yet a midwife by profession -- and thus not yet living on call -- I didn't know what to do. The midwife in attendence, as well as Mary, Elizabeth, and Susan, were just as kind as they could be. They told me they could not make the decision for me. I felt obligated to attend the party, no I WANTED to attend the party, the prospect of a senator who would listen to us was and is so exciting! But it made me ache to consider leaving Peggy. I didn't feel like an irreplaceable part of her support team. I know the midwife certainly didn't need me around. Part of me felt selfish for wanting to stay when I rationalized I was more directly needed in Columbia. But in the end, I didn't care about any of that. I was midwifing Peggy the best I knew how at the time, and every moment passed and every moment to come was so precious. I listened to my tears. I told Mary my heart needed to stay with this brave new mother in Springfield. I know it was the right decision...because as much as I care about "the cause," it means nothing to me compared to individual women and babies.

Around dinnertime, when Nancy had amazing lasagna baking in the oven, Peggy was becoming discouraged again. She was STILL 8 1/2cm. We decided to try some black and blue cohosh to make her contractions more effectual. One of the coolest parts of being at Peggy's labor and birth was how much the midwife counted me as a partner and asked for my opinion in all proposed changes to the plan. It was incredible and so affirming! I don't know the first thing about black and blue cohosh, but the midwife still cared what I thought! She is a very gentle and considerate woman, and treated her apprentice, Susan, and me with the greatest respect the whole time. Peggy and Blake consented to the black and blue. It worked quickly! Peggy's contractions soon become nearly overwhelming and brought her to tears. At this time, we took a more active role in labor support. We took turns holding her hand, resting our hands on her knees and rocking with her, offering her drinks of water and Emergen-C, and telling her how amazing she was doing. She labored sitting on the living room couch, standing or leaning on a chair occasionally, for the majority of the evening.

By 8 or 9PMish, she had no cervix left except for an anterior lip. At one point, we gave her some Pulsatile(?) to help dilate away the rest of the lip. Peggy labored much of the night on her bed, sitting or on hands and knees. It was a very, very difficult time for her. She was obviously exhausted, having been awake for over 36 hours and laboring actively for over 24. At one point she said in desperation, "I just want to go to the hospital and have a c-section!" My heart just broke for her. My goodness, it was sooo hard and soooo long. The midwife lovingly explained that first they would want to try Pitocin and attempt a vaginal delivery at the hospital too. Peggy continued to labor. Blake went into the other room to take a nap around 11ish, and we had a session of being solely "with woman." It was beautiful to watch Nancy labor with Peggy. It was beautiful to watch Blake with Peggy as well, very much so, but the mother-daughter beauty was special in a different way. We prayed. We waited. We slept.

I left the room to take a cat nap around 12:45. When I returned about 1:30, Peggy's water had clearly ruptured (it had been leaking for two days) and she was completed dilated! When the midwife reported the good news following the vaginal exam, I lost my birth composure and reverted back to my cheerleading days: I shouted "Woo hoo!" and pumped my fist in the air! Whoops :) Peggy, very lost in transition at this point but still surprisingly composed, said, shaking, "Praise the Lord!" She had the urge to push almost immediately. With Blake on her right and her mom on her left, she naturally pushed with each contraction for the next two hours. She was exhausted and doubted herself, but she had a renewed sense of purpose now. We reminded her that this too was normal. The midwife reminded her that although pushing was slow, it was steady: the pushing was going much better than the dilation had! We did some minimal breath coaching and suggested position changes and encouraged Peggy to feel the baby's head with her fingers, but for the most part, Peggy just followed her instincts as the midwife applied warm compresses to her perineum. It seemed like a short time (for us) from Push #1 til crowning, around 3:30AM. When Peggy told us she could feel the burn, and reached down to check her progress after a long time since her last check, her eyes opened wide and she said "Oh, wow!" when she felt that her baby's head was exposed nearly to it's widest diameter! It was a transformative moment -- all of a sudden, Peggy knew it was true: she really WAS about to become a mother!

With Blake in awe and Peggy in fierce determination, she pushed her baby's head out at 3:38, and the body at 3:39. As she emerged, we saw what the hold-up had been: she has a posterior nuchal hand, the little stinker! She had her hand on the back of her head, so it took a loooong time to achieve full dilation due to the lack of uniform compression of the head. But no matter -- Peggy did it anyway! Because of the positioning of the baby's hand, and the quick delivery of her body, her elbow shot out to the side as it passed through the birth canal, causing perineal and labial tears :( But I don't think Peggy noticed in the least. As soon as she had that sweet baby girl in her arms, everything else faded away. The look on her face was priceless. She was in complete joy and told us with her eyes that it had all been worth it. She and Blake held their daughter close and inspected her from her head to her cord to her toes. She was pink and screaming from the time she was born; we assigned her Apgars as 8 and 10. She was perfect. Peggy pronounced that her name was Nancy Mae, named after her own mother. Realizing what time (and day) it was, I said "Happy Birthday" to both mother and baby. Peggy was born on December 3rd herself, and now so was her daughter. How cool is that?

Peggy shot out her placenta in the first first contraction she had after delivering. It was so simple, and such a blessing, relieving Blake and Peggy's fears of placental complications. While Mom, Dad, and baby fell in love and figured out breastfeeding, the midwife cleaned up Peggy's perineum and inspected her tears. They appeared jagged and complex, as we realized it wasn't only a perineal tear. We conferred in the kitchen about what to do. The midwife asked me how my suturing skills were(!), to which I replied I had zero experience. (I can take stiches out...) We decided this was beyond everyone's skill level at the birth, and that we needed to call in reinforcements. Blake began trying to get a hold of a church friend of theirs, who happened to be an ER doc. He was unavailable, so as it turned out, Peggy and Blake had to make a trip to the hospital. It was unfortunate, but necessary. I found out later that the trip to the hospital went very well, and that mother and baby were doing fabulous, so I feel great that Peggy got the care she needed without hampering her beautiful birth experience. We loaded her up on Chlorophyl, helped her to the bathroom and into some clothes, and tucked her into the car. Grandma Nancy was more than happy to love on Baby Nancy during this time. I gave Peggy a hug before they set off, and she thanked me for being there. I didn't have any words at the time, but I wanted to tell her thank you for letting me witness her miracle (I thought of the words later, and sent her a Facebook message, silly as that is). I slept on her couch for two hours before driving back to Columbia, back to school, back to the land with decent radio stations. I thought about her miracle the whole time. She pushed a baby out, yes, which is totally and utterly amazing, but she also became a mother. More subtle, often unnoticed or undervalued, but completely spell-binding and transformative. She gave birth to herself as a mother. In an instant, she changed not only her physical form and external circumstances, but also her very soul, perspective, and purpose. She knew she couldn't do it. It was bigger and harder than anything she'd ever done in her life. It was impossible. But she DID do it! SHE DELIVERED her baby. When I arrived at her home on Monday night, she was a young married woman, and a lot like me. Now she knows the secrets of motherhood. Now she is a mother = a woman who can do anything.

Sixteen is sweet indeed.