Sunday, August 30, 2009

a baby born

Normal birth does not belong to any particular group of people, any special lifestyle, or set of beliefs. Normal birth does not happen as a result of any particular course of childbirth education, reading any book, or getting instruction from any birthing teacher.

A beautiful young woman gave birth to her first child on Friday, in a fashionable suburban unit in a medium-density housing estate. The home has very little 'garden', and no shovel or other tool to dig a hole in the earth to bury the placenta, so I brought the placenta home to my garden.

The significant features in the labour and birth of this baby girl were, from a midwife's point of view, as near to ideal as I could hope for:

• A healthy mother
• Baby in an optimal position, back on the Left, head engaged from about 36 weeks
• Spontaneous onset of labour at 40 weeks +11 days in the early morning
• Labour became strong, and mother felt an urge to push by about midday
• Baby was born through water before 2pm in good condition
• Mother sat on the couch, with baby skin-to-skin, cord uncut, for the next hour or so, while baby searched for and took the breast.
• The placenta was birthed spontaneously about an hour after the birth. Mother’s blood group was Rhesus negative, so cord blood was collected from the vessels on the placenta. The pathology company’s courier came to the home and took the cord and maternal blood to the laboratory.
• There was minimal blood loss.
• There was a small first degree perineal tear which was not sutured.

This birth will be recorded in the Victorian government health department's perinatal data for 2009 as an unassisted vaginal birth, a homebirth attended privately by a midwife as the primary professional care provider, a water birth, and all the detail specific to this mother and child. I have chosen to put this birth on the record because the uncomplicated, normal, physiological birth often goes unnoticed.

The second midwife who assisted me in this birth is a recent graduate from one of the Bachelor of Midwifery programs in Melbourne. This is a midwife who will be able to carry authentic midwifery knowledge and skill into future decades.

A midwife's skill, working in harmony with each birthing woman, is like a dance. Most of the time the woman leads, and the midwife accompanies. There are moments when the woman experiences huge challenges that threaten to overwhelm her, when the midwife takes the lead. This truth was recorded many years ago:

You are a midwife.
You are assisting at someone else’s birth.
Do good without show or fuss.
Facilitate what is happening
rather than what you think ought to be happening.
If you must, take the lead.
Lead so that the mother is helped,
yet still free and in charge.
When the babe is born the mother will rightly say
“We did it ourselves”.
Attributed to Tao Te Ching, about 2000 years ago.

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