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Breeching the Plan
I have had a lot on my mind today. This morning I finally got around to reading the accounts of the Virgina CPM who tragically lost two breech babies within a 6-wk period. It was a really sobering experience for me to read the statement from the medical board, and really expanding to read the blog from the other midwife. When I first sat down to read about it, I thought I would find an account in which the parents/hospital were to blame and/or there was nothing the midwife could have done, because I am partial to midwives, they can do no wrong, right? WRONG! This midwife made some decisions that I feel (in my limited knowledge) were questionable, and a few that I think were outright dangerous. *I fully acknowledge that I wasn't there and can't fairly judge, but the point I'm making is that I surprised myself that I was surprised that midwives could make poor decisions at all*. And then I went on to read the commentary from the other midwife, about her own surprise breech delivery, and how she transported to the hospital (which I think was absolutely the right thing to do considering her lack of experience and the volatile legal climate), and about how she doesn't want to learn to attend vaginal breeches. Interesting.
I have always planned on pursuing experience in attending breeches and twin births. I think that it's important that these skills are preserved, because I believe in most cases breech and twin deliveries can be healthy and normal, and women should not be forced to have cesareans if it is safe to deliver these babies vaginally. But I must admit that it was scary to read that blog and to think about those breeches gone wrong. Head entrapment...cord compression...death. Wow. That's a really big deal. And it's convicting too, because we constantly bad-mouth (or at least I do) OB's for not trusting birth, but...I guess sometimes you really can't? But I know in the fiber of my being that birth CAN be trusted...I think it's really about balance. It's about trusting birth, but it's also about RESPECTING it, and having the humility to accept that sometimes it doesn't result in a healthy mother and baby. I read through the comments after the author's post, and I was particularly intrigued by the one that pointed out the following: we regard it as prudent when a midwife isn't comfortable accepting responsibility for breeches, but we think it's unacceptable when an OB isn't comfortable accepting responsibility for VBAC's? It does seem like a catch-22 to me. I enthusiastically support VBAC and know that it is generally so much safer than repeat cesarean...but aren't vaginal breeches also safer (for the mom) than cesereans? I know I'm playing devil's advocate here...I'm processing...all of a sudden I'm more aware that birth politics and practice styles are sooooo much more gray than black & white.
Also on my mind today is the phone conversation I had with Steff. It was really good for my heart. She suggested that maybe I hold off on getting a (nursing) job until after the legislation session is over. The thought had occurred to me before, but there's just something about someone else suggesting something to you, ya know? It was like I was granted permission to consider this scandalous idea of not taking a hospital nursing job. My mom is going to be nervous/upset already when I finally tell her that I am going to be the "new Mary," imagine if I tell her I'm not going to get a job! She'd blow her top! I know I am an adult (as bizarre as that sounds) and have the freedom to make decisions without my mother's approval, but I keep forgetting. My whole life I have had to ask my parents' permission. So I'm still getting used to the fact that I no longer need permission from anyone to run my own life :) It would just be so great if I could make my work at the Capitol my only work. It certainly should be my only work, it's so incredibly important. But how will I buy my groceries and pay my rent? I wonder if I can get a computer job I could do from home on my own time like Steff said...maybe I could do something for The Crossing...or work at Barnes and Noble and spend all my paychecks on books I won't have time to read? :) And I could purchase my own health insurance if necessary? What a concept. It IS just so insane to think about working full time as a new lobbyist AND a new nurse and never go anywhere except the Capitol and the hospital. I think I might go totally insane. I am not the type of person who intentionally over-books herself. Ever. I know that rest is vital and I make time for it. No decisions yet regarding post-graduation employment, but I now have been affirmed that putting off employment wouldn't be crazy, and I will continue to freely explore my options...
And what a sweet end to a thought-provoking day: my baby sister just called to tell me she is going to write her first college paper about midwifery and homebirth. She said everyone has to write about a controversial topic, and she wanted to call me to make sure midwifery would qualify, because "there are no good arguments AGAINST midwifery, right Halley?" It was so incredibly precious and uplifting...my heart may be bleeding with pride.
I have always planned on pursuing experience in attending breeches and twin births. I think that it's important that these skills are preserved, because I believe in most cases breech and twin deliveries can be healthy and normal, and women should not be forced to have cesareans if it is safe to deliver these babies vaginally. But I must admit that it was scary to read that blog and to think about those breeches gone wrong. Head entrapment...cord compression...death. Wow. That's a really big deal. And it's convicting too, because we constantly bad-mouth (or at least I do) OB's for not trusting birth, but...I guess sometimes you really can't? But I know in the fiber of my being that birth CAN be trusted...I think it's really about balance. It's about trusting birth, but it's also about RESPECTING it, and having the humility to accept that sometimes it doesn't result in a healthy mother and baby. I read through the comments after the author's post, and I was particularly intrigued by the one that pointed out the following: we regard it as prudent when a midwife isn't comfortable accepting responsibility for breeches, but we think it's unacceptable when an OB isn't comfortable accepting responsibility for VBAC's? It does seem like a catch-22 to me. I enthusiastically support VBAC and know that it is generally so much safer than repeat cesarean...but aren't vaginal breeches also safer (for the mom) than cesereans? I know I'm playing devil's advocate here...I'm processing...all of a sudden I'm more aware that birth politics and practice styles are sooooo much more gray than black & white.
Also on my mind today is the phone conversation I had with Steff. It was really good for my heart. She suggested that maybe I hold off on getting a (nursing) job until after the legislation session is over. The thought had occurred to me before, but there's just something about someone else suggesting something to you, ya know? It was like I was granted permission to consider this scandalous idea of not taking a hospital nursing job. My mom is going to be nervous/upset already when I finally tell her that I am going to be the "new Mary," imagine if I tell her I'm not going to get a job! She'd blow her top! I know I am an adult (as bizarre as that sounds) and have the freedom to make decisions without my mother's approval, but I keep forgetting. My whole life I have had to ask my parents' permission. So I'm still getting used to the fact that I no longer need permission from anyone to run my own life :) It would just be so great if I could make my work at the Capitol my only work. It certainly should be my only work, it's so incredibly important. But how will I buy my groceries and pay my rent? I wonder if I can get a computer job I could do from home on my own time like Steff said...maybe I could do something for The Crossing...or work at Barnes and Noble and spend all my paychecks on books I won't have time to read? :) And I could purchase my own health insurance if necessary? What a concept. It IS just so insane to think about working full time as a new lobbyist AND a new nurse and never go anywhere except the Capitol and the hospital. I think I might go totally insane. I am not the type of person who intentionally over-books herself. Ever. I know that rest is vital and I make time for it. No decisions yet regarding post-graduation employment, but I now have been affirmed that putting off employment wouldn't be crazy, and I will continue to freely explore my options...
And what a sweet end to a thought-provoking day: my baby sister just called to tell me she is going to write her first college paper about midwifery and homebirth. She said everyone has to write about a controversial topic, and she wanted to call me to make sure midwifery would qualify, because "there are no good arguments AGAINST midwifery, right Halley?" It was so incredibly precious and uplifting...my heart may be bleeding with pride.