Where to go from here? Because I feel a little lost after these last intense weeks of up-and-down emotions, of writings and reflections on matters so close to my heart and so difficult to articulate, perhaps going back to the story of my pregnancy might help me get oriented. (This is not to say that I am not still having plenty of up’s and down’s, strange happenings, feelings and thoughts, but let’s circle back around to all that at a later time.)
One of my passions in life is making connections. I particularly love creating the conditions for unlikely connections between people. I believe that honest, trusting, reciprocal human relationship is real magic. When we can share something of who we are and how we see the world in an authentic way, especially across distance and difference, something becomes possible that wasn’t before. We create our futures by relating, collaborating, truth-speaking and putting aside our egos.
Almost a month ago, my friend Diana had an awesome baby girl named Lúa. I went over to meet her and bring them chocolate chip cookies only a couple days after the birth. It was amazing! Diana and I realized that we had both seen the same OBGYN. As we made these connections and talked about our experiences of pregnancy and birth, I was reminded of an aspiration that I had had in the early months: to be a bridge between the traditional allopathic world of obstetrics and gynecology and the world of midwifery, homebirth and “alternative” medicines.
Honestly, this aspiration would never even occurred to me if it weren’t for the curiosity and open-mindedness of our doctor. She’s a younger practitioner in Oaxaca with impossibly positive energy and impeccable style. While her schooling and experience led her down a fairly common allopathic medicinal path, she’s interested in non-pharmaceutical and non-invasive “alternative” practices for women’s health. I’ve been seeing this OBGYN for about two and half years. I originally went to her for fertility treatment. She’s known for a while that I teach yoga and that Yeyo and I often turn to plants or other natural remedies before we opt for a pharmacological solution.
In the beginning of the pregnancy, my doctor would usually send me home from every visit with two or three prescriptions. Many of these were “just-in-case” ´scripts: in case you have nausea… in case you have more severe heartburn… in case you start bleeding. I often didn’t get them filled. At our second check-up, we started talking about options she could offer patients who she thought might benefit from alternative approaches. She wanted to know about the midwifery community, about circles for pregnant women, prenatal yoga and massage, herbs, acupuncture. She was interested in all of it.
Yeyo was involved with the formation of one of the most well-known midwifery schools in Oaxaca, so we had plenty to share. We met up with my doctor for tea in January and talked about the school, its curriculum, the founders and their struggle to maintain legitimacy, even in a region where wise traditional healers continue practicing and delivering babies as they have for centuries. I made her a resource list of the midwives, doulas, massage practitioners, yoga teachers, acupuncturists, herbalists, of the courses and classes and circles for pregnant and nursing women that I knew about. I thought it’d be great if more of the allopathic medical world supported the idea of homebirths, herbs, energy and breathwork and general accompaniment of pregnant and birthing women. There are only a handful of doctors who are willing to work with midwives in the city of Oaxaca.
At about the same time that we began this dialogue, I had my first appointment with a midwife. It was long. About two hours long, actually. (I later noticed that midwives tend to work on a very strechy timetable. I suppose this comes in real handy when a birth either happens very quickly or takes many days.) I felt a little intimidated when I left that first appointment. I was given options for my pregnancy: doctor led, midwife supported; both midwife and doctor, working in tandem, midwife led, doctor supported. It was made very clear to me that obstetricians and midwives have two completely different worldviews. I felt a little suspicious of my doctor, a little unsure of why I was taking progesterone, convinced that I wasn’t eating the right diet for pregnancy and almost 100% sure we wouldn’t be able to afford to have both a midwife and a doctor.
In the following weeks, I had a few more encounters with the community of midwives in Oaxaca. I attended a couple of dialogue/support circles for pregnant women and left feeling exhausted the first time and pretty pissed off the second time. (Some of this, I know, has to do with the fact that I am a host of conversation and these circles were facilitated in a way that I found challenging.) I recognize that midwives everywhere have had to fight for and protect their practice before the hegemony of allopathic regimens and treatments, belief-systems and patriarchal practices of many hospital births. However, in a way, I feel like this need to protect and defend midwifery has really shut down the possibility of further fruitful collaboration with the allopathic medical community.
There was a young couple in one of the circles that was seeing the same OBGYN that we were. They mentioned that although they were planning a homebirth, they wanted their doctor to be there. I felt that the midwives facilitating the circle were concerned with this prospect. They seemed to take a defensive posture, stating, “If you want to have a doctor present at a home birth, you must understand why she would be there, what would her role be. There needs to be clarity about who is in charge of the process, who has the authority.” I wholeheartedly agree with most of what was said, it was more the tone that I was challenged by. The midwives didn’t appear to have much curiosity about how they might benefit as a community by having more allopathic practitioner allies. All of this was surprising for me because of the openness and eagerness I had experienced with by OBGYN.
I settled on a midwife a few months later, an acquaintance, and one of the teachers for our birth prep class. She is a very calm and compassionate person. I appreciated her reassuring confidence and wide breadth of knowledge from acupuncture and Chinese medicine to Bach Flowers and local herbs. AND I continued to see my doctor and an ultrasound specialist on a fairly regular basis. During the sixth month, I sent an email introducing my midwife and my doctor. Neither said it was necessary to meet in person, but I wanted them to have a way to communicate if need be. And they did meet. They met at my doctor’s office when my midwife accompanied a new mother to a pediatric appointment. My doctor also had some experiences attending other births with women on my team of midwives. It seemed like she was really getting some first-hand experiences in the world of natural childbirth.
Sadly, the next time my doctor and midwife met was the day before Rafael’s birth, the day we didn’t find the heartbeat with the Doppler at my midwife’s office and we rushed to the clinic … where the ultrasound also failed to detect a heartbeat. After that, I asked, “What happens now?” The doctora said that I could still have a homebirth if I wanted to. She explained that I could be induced with Misoprostol but that the labor would be painful and potentially very long. Or, I could have a C-section. As we left, I told Yeyo and my midwife that I definitely wanted to have the baby vaginally (or at least try) and that I wished to labor at home but deliver at the hospital.
So, in the end, my doctor was there at the birth. My labor was very short (and very painful, as promised). Rafael was already descending down the birth canal when we arrived at the hospital. The doctora arrived after I was already pushing so there was really no allopathic medical intervention possible at that time (though I would have given a limb for an epidural at any point in that last hour of labor). She sat so quietly on the back of the couch, wearing an outfit I’d never seen her in before: her delivery digs. Her hair was pulled back by a wide headband and a light sweater covered hospital scrubs. She let the midwives, my doula and Yeyo do it all.
When she came back to check on me several hours after the birth, she was back to her usual appearance: makeup, stylish bright dress and low heels. She didn’t say much. She explained that she thought that Rafa died because of a slow leak of amniotic fluid that was not detected in time. She said I could go home in the afternoon and reminded me that we needed to check on the hyperplasia that had been detected when we removed the polyps from my uterus last year. That was it.
Because Rafael died, I feel like I failed in so many ways. I feel like I let the world down. I also feel like my aspiration to bring together allopathic medical practitioners and midwives. doulas and other “alternative” communities in the field of pregnancy and child birth failed. I felt like it was my fault that our son died because when I had a small leakage of what might have been amniotic fluid I went to the midwife instead of for an ultrasound. I felt certain that now my OBGYN would shy away from working with midwives because of the way things turned out for me. I felt I failed at my intention of being a bridge between these two worlds.
I talked a lot with my midwives and doula and with Yeyo after the birth. They shared with me their impressions of the experience. But when I went into see my doctor again, about six weeks later, she said nothing about the death of our baby. Not even, “I’m so sorry.” This was excruciatingly painful for me. I felt that my experience of being pregnant and giving birth had been completely negated. On the advice of my wonderful therapist and my mom, I did not give up. I had a close enough relationship with my doctor to reach out to her after a while and say, “Hey, that really was tough for me… when you didn’t say anything about Rafael’s death.” I invited her out for drinks to talk about it.
We got together and we had a great conversation. She explained to me that she didn’t know where I was emotionally and didn’t want to risk upsetting me by bringing up the death and birth of our son. I told her how hard it was for me that she didn’t acknowledge what happened, especially because she was present at the birth. I understand that her training and background perhaps made her apprehensive to talk about what happened. I asked her how she experienced Rafa’s birth. She told me that the handful of midwife-attended deliveries that she had been present for (including mine) had been watershed moments for her. She had seen how birthing mothers could be the protagonists of their experience and what it was like to truly support the process of bringing life into this world in a humanized, compassionate way.
I now understand a bit why my doctor didn’t say anything about Rafa’s death or birth, but still feel that it is better to ask grieving parents how we are feeling and if we want to talk about our experiences, rather than trying to “protect” us by saying nothing at all. If I feel too sensitive or like I don’t want to discuss it, I am free to say that. But choosing not to ask feels like a negation of my experience and that hurts. I said it in the first post I wrote back in September and I’ll reiterate here: please ask me about Rafa, my pregnancy, the birth, the grief, the process. Your curiosity keeps me alive and present to my healing. For that, I am very grateful.
In the end, I tried to be a bridge between two distinct worldviews, to create an opportunity for more support and solidarity between doctors, nurses, hospital staff and doulas, midwives, prenatal massage therapists and yoga instructors. What I realize now, though, months after the stillbirth of my son, is that I cannot do the work of bridging alone. It is not an egocentric, heroic endeavor. We only create connections of this type through the willingness and open-mindedness of many people. I do hope that the number of midwives open to collaborating with OBGYNs and the number of doctors willing to support natural homebirths, doulas and midwifery multiplies in the coming years. I recognize that collaboration is challenging, especially when coming from very distinct and apparently opposing perspectives. But I believe women, babies, fathers, doctors, families, nurses, midwives, hospital staff and more could benefit from further cooperation between these two worlds. I think that this would only lead to more options for women and families, which seems like it would be beneficial for all of us.