from what i hear there are a lot of paths through midwifery.  i seemed to have carved my own.

i am not sure why my life has gone in this direction, why my midwifery path seems to be more like a labyrinth rather than a straight line.

i know that some go to college.  and then work in a birth center or apprentice.  and then hang out their shingle announcing themselves as midwives.  that path must work for some folk.  although i also know that a lot of those midwives arent still working as midwives three years after they hang out their ‘open for business’ sign.

some are self taught and apprentice under a more experienced midwife for a few years.  and then become a full fledged midwife.

me?  i started witnessing unassisted births.  and studied.  then i gave birth.  and studied some more.  then worked as a doula in the hopitals.  and studied some more.


the insecurity comes into my thoughts when i think about how i do not have a piece of paper that i can show saying: i know this.  i see how external validation is really nice to give you that ego boost when you are feeling low.

and i know that there is a stage of learning when you know just enough to be dangerous.  i know it most dramatically from doing accompaniment work in war zones.  watching ‘newbies’ run around with their theories and their ideals and then freak the fuck out when something happened that didnt fit their knowledge.  the world is a wild place.

lately ive had these weird fear about hemorrhage in the third stage.  i think its because i read so much about losing blood and i dont carry pit.  for a couple of weeks i was really questioning my own competency.  whether i had enough experience.  the risks! the motherfucking risks! dead baby!  dead mama!  dead midwife!

you get the picture…


finally i had to look myself in the face and say, there is no security.  there is no safety.  life is a wild adventure.  that is your spirit speaking through you, telling you that it is only blood.  it is only bones.  it is only muscle.  it is only skin.  it is only breath.  it is only you.  you are not that important.  you are just there to witness a miracle.  motherhood is something that we pass on from person to person.  but being a mama is something that we become ourselves.  and in the end every midwife must become herself in her own way.

you do it this way, on this strange path, because your spirit is the most humble, when it is the most wild and human.   this is the space you hold, you say, with every moment that you can, this space is wild.  in this space, mama, you can become who you need to be to bring life into this world.

you are not a traditional midwife.  nor are you an academic midwife.  nor are you an irresponsible one.  you are the stars and the wind.  you are as illegal as freedom.

fuck security.  security is low hanging fruit.  reach for the sun.

in more practical terms:

my notes:

when you see the possible beginnings of hemorrhage (mama is shaky and losing color, feeling dizzy, uterus feels soft and squishy and the fundus is still high, half a liter of blood or more,)

–breathe.  feel the fear and the adrenaline. slow down.   be honest.

and in no particular order, but a good dose of observation:

–skin to skin (hormones)

–together–visualize the uterus becoming smaller and harder, the placenta sliding out (if it is still retained), the body stopping the bleeding

–fundal massage (if uterus is squishy and soft, off centered to create a contraction)

–sp1 acupressure

–cayenne pepper (increases circulation)

–ingest small piece of placenta (hormones)

–shepherds purse (can cause heavy clotting)

–gentle cord traction (partially separated placenta)

–look at placenta for missing pieces

–maybe cytotec for excessive hemorrhage