On Becoming a Grandma Midwife
Over the last several years more and more of my midwife friends have told beautiful stories of attending the births of their grandchildren. I have loved hearing these stories and hoped that I might someday have my own version. On the other hand, totally believing in a woman's right to choose her own path also means not having expectations. My oldest son and his wife have been married for ten years, and have led busy lives with fulfilling careers. It was not a given, from my point of view, that being a grandmother was in my future. Last fall, when Johnny and Mary told me that they were pregnant, I was delighted. But I was thrilled when they announced their plans to have their baby at home. However, the best was yet to come! My daughter-in-law asked me to be her midwife. In spite of the fact that we live on opposite coasts, Mary and Johnny were able to fly to California for occasional prenatals and they kept her records with her as she took primary responsibility for her own care, seeing a wonderful midwife in Connecticut and setting up physician back-up at her local hospital. This is the story of a birth in our family that is beautiful in the way all birth are beautiful and different for me because it involved my own son, his wife and a baby whose presence is bound to change our family.

My daughter-in-law gave birth beautifully on the morning of the vernal equinox into my hands and hers with my Johnny at her side being the perfect champion, husband and father that every midwife would want her son to be. Like many births, this beautiful moment was hard won, not according to plan and only the middle of a long adventure. Mary was due March 25 and I arrived the evening of the 14th. On the 15th, Mary's waters broke. We noticed that the deer were gathering across the creek and at one point I counted fifteen deer parading by. Of course we expected labor to begin any moment. Her friends hurried to get on flights from California and Baltimore, hoping that they would make it in time. The weekend came and went with no labor, but some good meals and fun. One friend, Beth had to go back home since she is a lawyer and had to be in court on Monday. Finally, on Tuesday morning at 3:00am, Mary began to have contractions. I found her rocking in a chair, looking out into the woods early in the morning. Her remaining friend, Emily, and I left to find a good coffee source and a bookstore so we could buy books for the baby. When we returned at noon, Mary was laboring in the tub with Johnny's arms around her. At first, I thought that the other midwife might not make it and was really glad that I had brought at least a modified birth kit. As it turned out, they had realized that things were moving quickly and had called Donna Vidam, who lives in Hartford, an hour away. She and I had never met, but we were like old friends immediately and were a great team.

Mary got a huge break in her contractions. In fact, we were all surprised when she didn't have contractions for over an hour. And when they did start up again, they were not pushing contractions. Mary remarked that she felt that she had done this part already. We did check her for the first time at this point and she was definitely complete with the baby at station zero. Things kind of stayed that way for the next 12 hours. We were pretty casual at first, and then we tried everything that either one of us knew or could invent. In and out of the water, resting, walking, eating, being in bed, herbs, shaking, pelvic presses, whatever! Finally, Mary said, "Enough!" She and Johnny decided that while she was not exhausted, she was beginning to see the end of the rope and didn't want to get there. At that point, the baby was a bit asynclitic, but almost AP.

Now, a hospital transport was out of both Donna's and my frame of reference. She was away from her town and I was not even in my own state. When my son called the back up doctor, his on-call colleague was appalled: "What, she's been pushing for more than two hours? She needs a C-section!" She also knew nothing about being back-up for a homebirth. Things were looking pretty dicey, but Mary felt that we had been trying to birth this baby for fifteen hours with no success and she felt we needed to do something different. So we put chips on all of our shoulders and went off to the hospital clear that no c-section was going to happen to this mother.

One nice moment was going up the elevator with Mary in a wheelchair. Suddenly, we all felt the urge to just touch her, and in so doing, we formed a little circle of energy that
everyone recognized and commented on. I do believe that this was our power circle that we carried into the hospital and which surrounded the whole birth from that point on.

Johnny and Mary were wonderfully business-like and articulate in explaining that, while they understood the dismay of the back up doctor in being exposed to a situation for which she was not prepared, still they had to insist on refusing her care. The nurse tried to explain that the first thing to do was assess, and then decide the course of care. I explained to her that I was very aware that sometimes while the "assessment" was happening, surgery was being prepared down the hall and that that would never do for this situation. I believe that she mentally threw up her hands at this point and asked us what we wanted. Donna and I agreed that Mary needed a little power nap and asked for phentanyl. Mary refused an IV, said that the fetal monitor was OK, asked for a different doctor and for her midwives to run the show. The nurses were really wonderful and supportive from then on. They did get the orders from the on-call doc, but told her that she shouldn't come into our room. Unfortunately, this hospital doesn't use phentanyl. But they did give her just one shot IM of Demerol. Mary was able to doze for about two hours between contractions.

Another nice time that I remember was sitting in that cold room in the dark. Johnny was on the bed with Mary, and Donna, Emily and I were trying to keep warm and rest a little. Mary, because she was working, was the only one who was warm. But she was still in the middle of our circle. As soon as it began to get light (that old pineal gland always kicks in a dawn) Mary started to push. Donna and I would look under the sheet to watch her bottom bulge. I told Mary that sooner or later they were going to discover that she was having a baby and all hell was going to break loose. Remember, we had no doctor yet. I suggested that she ask them not to break down the bed, but to let her keep laboring that way. Sure enough, the next contraction caught her when the nurse was in the room and the on-call doctor had to come into the room. Mary politely informed her that lying on her side was the first thing that had worked in the last fifteen hours and she was not willing to move and that she was going to deliver in this way. The doctor, to her credit, said, " Well, she had never seen anybody have her baby on her side," but she "guessed it could work."

Meanwhile, the night nurse informed us that there was a shift change happening and that they were 'interviewing' on coming staff to find the "coolest" nurse. So, nurse Sam (very cool indeed) joined us and, best of all, Mary's own doctor arrived. He, being aware of all the relationships, announced that he felt that I should go ahead and manage the delivery. Donna and I had already been doing hot packs and oil anyway. As it turned out, the doctor stood back out of our way and the nurse stood against the door. The doctor was heard to say, "We are not talking about this to anyone!" Afterwards, they complimented us on the loveliness of the whole thing and said that it was a real treat to watch Mary and her midwives and family welcome the baby.

Connor was born at 8:07 and we were back home well before noon. As we drove into the driveway we were greeted by a delegation of five deer standing in a semicircle at the edge of the yard. It is fun to think that they were there to greet little Connor.

Mary feels wonderful about the birth. We were all disappointed that it was such hard work and that it didn't happen at home, but Mary said many times that it felt like a natural birth to her and that she had to remind herself about the drug. Having no IV hook ups kept her from being confined in any way. She certainly did whatever she wanted to do at the hospital. Mary refers to the hospital as a sidestep for a little energy boost in an otherwise nice home birth.

Mary did have to pay a hefty price for that nap, I'm sorry to say. Demerol is a really hard-core narcotic and Connor was not able to suck, let alone nurse, for nearly four days. It takes four days for Demerol to go through the mother's milk and 24 hours more to clear the baby's system. It was really amazing to be there hour after hour to experience this process first hand. Connor did not respond to any stimuli for at least 48 hours. The first to come was a very disorganized and erratic sucking pattern. Although Mary got an electric pump, she was unable to get any thing out to feed Connor. So, another amazing thing happened. Beth, Mary's best friend since kindergarten came to the rescue. Beth, who had had to go home earlier because of having to be in court now drove six hours from Baltimore with a pair of breasts chock full of toddler milk, to share with Mary's baby. It was so touching to see these women interact. As children in school, Mary Beth and Mary Rose had shortened their names to Beth and Mey Rose and still call each other by those names. As Beth came in the door, she asked, "What shall I do first?" John said, "Feed the boy." Beth said, "Mey Rose?" Mary, answered, "By all means!" and Connor got his first real meal from that soft, experienced breast. He never would take Beth's breast again, but Mary and Beth got into bed with Connor between them and every two hours they pumped and fed him with an eyedropper. Beth stayed for two days and left behind a third day's worth of milk to support what Mary was now able to pump.

Somewhere on the third day, we all recognized that Mary and Johnny were going to be OK and needed to be alone with Connor. I sure didn't want to transition from amazing midwife to aggravating mother-in-law! Emily went to visit relatives, Beth drove home and I took off in a hot rented car to visit Penfield Chester in Mass. and then Judy Luce in Vermont. By the time I returned to Westport three days later, Connor was a nonstop nursing critter.

We shopped for a tree to over the placenta, toured cute New England towns and I searched out where I thought that Martha Steward must live. It turns out that her street, Turkey Hill Road, is about a ten-minute walk from my kids. Now there are not usually any fences around there, but there is one house with a very big stone perimeter. That was a clue. But the real reason I' m sure that was Martha's place is that all the shrubs leading to the front door were neatly covered with carefully tailored burlap winter coats. I also understand why her garden is so beautiful on TV. That big fence keeps those flower and shrub eating deer out!

Mostly we sat around and admired the baby. I suggested the name Hart which means deer (or Horned God) and that is how my grandson has come to have a little pagan in his name.

It was quite an interesting experience being midwife to family. I really thought that this birth would be just a little family affair and instead it was right up there with challenges in every step of the way. I found myself evaluating whether or not I was being a good midwife (I was) and also a good Mother (I think so) I feel like I missed some of the magic just because the whole thing was so long and started when I was still on jet lag. I was really grateful that Donna Vidam was there also. It was so helpful to have another experienced there who saw things in pretty much the same way as I did. It was a long time before I could see Connor, not as any six and a half pound baby, but as my relative, and actually, a really cute baby that looks a lot like his father did. I didn't spend much time worrying during the process because we were busy doing the work of midwifery, working through each challenge as it came. However, my midwife Self certainly dominated my mother Self. The need to be an objective and creative problem solver for so many days in a row was taxing. I'm glad that I was able to be there for a couple of days without stress before I came home.

I've been to several births since I came home, so I have had a chance to practice my new perspective as a true granny midwife. I do feel like a rite of passage has happened for me as well as Mary, John and Connor and like all rites of passage it is multifaceted and will bear contemplation for a long time to come. I feel a new link with the heritage of traditional midwifery because, certainly, one way that midwives developed was out of service to their own families. I am so glad that in our modern tradition of midwifery, it is expected and anticipated that we will attend our children at birth. I am so humbled and grateful that my children included me in this precious event.