What is it about some women that makes them feel like they need a man, even when that man tries so hard to show them that they don’t want them? I have contemplated this question over and over, consulting counselors, priests, self-help books, other women in bad relationships, and the answer still evades me. The hope and promise of a changed man, one that realizes that he has lost the best thing he ever had, that will now love and cherish you forever, is like the carrot for the horse. Always within site, but never within reach. After a miserable week of crying and moping I scheduled an appointment with a counselor, and one with the surgeon to discuss removal of my bad gallbladder. It was then that I realized my health insurance was with my husbands employer, or former employer, and had now been cancelled.

My work schedule needed therapy, in the way of another midwife. Dr. Miller had hired a third physician, Dr. Grady, and he was a breath of fresh air. He was younger, and full of positive energy. He was the perfect complement to Dr. Miller. He believed in me, and what I do, and that’s all I hoped for with new physicians. Now I needed help with my part of the practice as well. I presented my request to the physicians, and they agreed that I could not keep up this pace. I placed an ad on a website, and in what seemed like a matter of hours I had a resume to review. Susan lived in Columbus, Ohio, but grew up in Louisville. Her mother was still local, she was interested in moving back to the area to be closer to her, and she was looking for a midwifery job. My daughter Kayla had become interested in modeling, and she had registered for a modeling workshop in Dayton, Ohio the following weekend. I arranged to meet Susan in Columbus on the trip to Dayton to interview and discuss my practice. The interview went fabulous. We shared our love of women’s health, our belief in birth and the process of birth, and in the power and strength of women. I shared with her the intricacies of my practice, the wonderful patients that I protect and support, my impossible schedule, the multiple personalities of my collaborative physicians, my failing marriage, and my hope for a successful partnership with a fellow midwife. She was intrigued by all of it, and promised to follow up within the week to arrange to visit our office and meet with the owners.

As much as I wanted help in my practice to allow more time off, I feared allowing someone else charge of my patients. I felt responsible for the committments and promises I made to these families. They had invited me into the most private and intimate moments of their lives, trusted me to honor their birth plans and assist them with realizing their dreams of an empowered birth, shared their birth journey with their family and friends to promote my midwifery practice, and many had become lifelong friends in the process. The thought of another midwife seemed analogous to asking someone else to raise your child, and trusting that they would do it as well as you would. They have their own personality, different ways of doing things, different cultural norms, but in the end they want to raise your child as their own and encourage its mental and physical growth. This was Susan.

A few months into our new working relationship I realized that though we both shared our love of birth, we had very different ideas of the working relationship between midwives, nurses, and physicians. Susan had never worked as a labor nurse, so she had no understanding of the pressures the job held or the responsibility the labor nurses assumed, and tensions began to arise between her and some of the staff. Questions and concerns started coming to me regarding comments she would make to the nurses. Physicians felt that she would overstep her bounds. While I had always wanted to fit in with everyone and relished in small wins for changes in policies, Susan pushed harder for quicker change. It’s not that she was wrong, she was just different.

I still had a large following of patients that requested me for their birth. It became clear to me that the feelings I experienced from missing the births of my patients was all about me. Our patients were reporting wonderful birth experiences, and many were requesting appointments with Susan instead of me. She was building a clientelle from my clients, just like I built mine from Dr. Miller’s. We were building a midwifery practice, and there was room in it for our similarities and our differences. I started listening to the nurses complaints about Susan, and trying to incorporate some of her methods into my own practice, and in turn it molded into the “midwifery way”, instead of Susan’s way or Beth’s way. I realized I needed to break out of my “please everyone” mode, and start to develop my own style, and gain respect for my own differences. I started to grow as a midwife.

While I was finishing up a birth one morning, a nurse came into the room and whispered to me that another of my patients had just come in and she was completely dilated. “We can’t find the heartbeat,” she mouthed to me as she shot me a worried look. “Get ultrasound up here,” I quietly said. “We are almost finished here.” After praising this momma for her hard work and beautiful baby, I slipped out to go attend to my other momma. As I walked into the room she was pushing through a contraction as the ultrasound tech patiently tried to get the needed pictures of the baby’s heart. I could see the motionless heart on the screen, and I stroked the patient’s hair as her contraction ended, applied a cool cloth to her face, and told her we needed to talk. My tone got her husband’s attention. “You are very close to delivery, and I need to tell you that I do not think this baby will be ok when it is born. The ultrasound indicates that the heart is not beating.” Silence filled the room. Minutes passed without a contraction, despite the fact that they were coming every 2 minutes just before I came into the room. The two of them just stared at each other, tears filling their eyes. They hugged, and cried for a time. I told them that we might see a reason once the baby was born, but we may not. I quickly talked through their options for seeing, holding, bonding, pictures, & spiritual support following the birth so that I could best serve their needs in this terrible situation. Once the options were briefly explored, I supported her to resume pushing to birth her baby. The term “silent birth” is so telling. Birth is always celebrated as the the cry of the baby fills the air. Birth without a cry is a somber experience. No one knows what to say, what to do. There is no preparation for this event. We look for obvious reasons; cord accidents, placenta problems, fetal anomolies. But the majority of times we have no clear explanation. In this case the umbilical cord was wrapped and twisted on itself, so I was able to show them and explain the problem. We talked about beautiful eye lashes, dark hair, perfect face, dad’s nose, mom’s chin cleft. The baby was swaddled in blankets and the family was left alone to bond, and grieve. And grieve they did.

When people hear that I am a midwife, they smile and say things like, “That must be the best job in the world, delivering babies!” And they would be right most of the time. However, I feel that the best part of the job is being “with women”, during the most wonderful day of their lives, or supporting them and helping them through the worst.