God is in the Midst of Her...

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…