The young woman was labouring hard when I arrived. Hers was a better-than-textbook first labour: she got up at 4:30 am; was having mild contractions every 7 or 8 minutes by breakfast time; accelerated into 3 contractions every 10 minutes by mid-morning; and felt like pushing before midday. After quickly arranging my few pieces of equipment I knelt beside the birth pool, checked the fetal heart rate after a contraction, and waited with her. When her eyes met mine, she whispered, "I'm glad you're here."
The home, a lovely old inner-suburban Melbourne cottage, seemed to embrace and welcome this birth. There was harmony and warmth in the exposed brick walls. The baltic pine floor boards showed the wear of many occupants over the years. The mild summer day, and a gentle breeze, gave support and energy to the work of childbirth. I learned later that the young woman's parents had lived in this home when their first child was born, and that several of the babies of this family had either been conceived there, or were brought there after birth.
"I'm glad you're here."
The mechanisms of birth proceeded without delay. The strong, expulsive effort of the womb, brought the little head to the vaginal opening. We had no mirrors or torches - we worked by feel rather than by sight. The mother's hand gave her all the information she needed. After the head had fully emerged we waited, then supported the baby as she came to the surface of the water, opened her lungs, and took her first breaths of air. After a brief rest we assisted the mother and her baby out of the pool, and they rested as we awaited the after-birth. There was no bleeding. There was no cause for concern at any time.
I reflected on that simple statement, "I'm glad you're here", as I completed the day's work, writing my notes and preparing the official birth documentation. I reflected on them again as I visited the home the next day.
"I'm glad you're here" was firstly a statement of the rightness of home as the setting for this birth. The young mother told me later that she would have found it very difficult to know when to travel, if she had been required to go to hospital.
It was also a statement of the rightness of the 'with woman' relationship. The partnership I have with that young woman is a unique and special bond.
Clearly, this birth did not rely on any special skill or treatment that I might have offered. Apart from putting my hand gently on the woman's leg when she felt a muscle cramp, I did very little. A new graduate midwife could have done everything that I did. The midwife attending a home birth relies more on the wonderful spontaneous actions of the woman's body, than on any midwifery act. The essence of midwifery is being, rather than doing.
"I'm glad you're here" says it all.