Wednesday, May 15, 2013

physical midwifery

Today I am pondering the physical demands of my sort of midwifery, at the primary maternity care end of the professional spectrum.  This means that I, the midwife am committed to being with woman, regardless of time or place. 

It means that I accept phone calls at any hour, and that I am prepared to get in my car and go to a woman who calls me. 
It means that I lug my equipment - the case with supplies; the oxygen cylinder; the bag and mask; the baby scales ... up flights or stairs, or wherever they need to be. 
It means that I have no idea when I will be home again; that I have to organise my private life so that my absences are manageable within my family. 
It means that I need strategies for driving home safely after a long night on the job, so that I don't fall asleep at the wheel.
It means that when my ageing body complains, with aches and pains in shoulder, or foot, or wherever, I am prepared to carefully consider my capacity to continue in my profession.

But, you might say, it's the birthing woman who is physical.  She's the only one who can give birth.  She's the only one who can breastfeed and nurture and love that baby as mother.

Yes.  Birthing is the essence of phyiscality.

When I studied midwifery we were taught about the 3 'p's:
  • the passage (birth canal)
  • the power (contractions of uterus and mother's expulsive efforts)
  • the passenger (the baby)
Then someone added another 'p': the psyche - the mother's emotional and psychological acceptance of birthing, including the impact of fear and anxiety (adrenaline and other fight-or-flight hormones) on the process.


You might think that being a midwife is a matter of sitting on your hands, or better still, knitting. 

When I was working as a midwife in a hospital the physical demands of my job included traversing long corridors to check on the women in my care, or to answer the 'buzzer'.  It included manual lifting of women from theatre trolleys to beds, or positioning women who couldn't move themselves.  It included leaning across the bed to assist babies with breastfeeding, or to extract minute amounts of liquid gold colostrum from breasts of new mothers.

Today my office is in my home, and I spend much of my time here.  I am glad I don't have the physical demands of mainstream hospital midwifery to deal with.  I'm glad I don't need to work night shifts, although some of the best times for being with woman in hospital are in the wee hours. 

I'm glad I have strength sufficient for the task.

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