Saturday, August 23, 2008
Stories of a Midwife
(Above, Tia Ann with baby Maia on her birth-day.)
Most of us who are mothers can admit that our parenting is affected by our family life. Yes, I've already had those moments where I realize I sound like my mother. But interestingly, one of the important influences on my mothering is actually my younger sister. I say this is interesting because (having just been married in June of this year) she is not yet a mother. My sis, however, has been closely involved with Maia since the day she was born - and even earlier.
Ann took pre-med classes (in addition to her anthropology major) as an undergrad, but it didn't take her long to realize that she didn't really want to be a doctor. What she wanted to do was catch babies and attend to pregnant women. So, following a year of service in Puerto Rico, she started an M.S.N. program and three years later emerged as a C.N.M. (certified nurse midwife). She's been working about one year full-time now as a midwife. And she's now caught about 120 babies. Maia was the first catch recorded in her birth book. At that time, Ann was still a student and working part time as a labor and delivery nurse. But, thanks to my 36 hour labor with Maia, she had plenty of time to drive seven hours south, go to my last prenatal visit with us, and be there with us throughout the labor and delivery. My husband always says he's not sure he could have made it through it all without Ann. :)
Having a midwife as a sister has made me very attuned to the issues surrounding prenatal care, labor, and delivery. Ann always has stories to share with me about her latest catch or the challenges of attending to undocumented patients. I have to say that her stories as a midwife are a great improvement over her stories as a labor and delivery nurse. The latter often featured stories of (obviously unnecessary) routine episiotomies, on-call doctors missing deliveries, doctors and patients getting into shouting matches, epidural encouragement, and the likes. Now that Ann is the one catching, the stories are more often encouraging: a streak of four deliveries without the woman tearing! the latest natural delivery! teaching moments with medical residents! noticing an important condition in a woman that really helped her and her baby!
When I was talking to my sister last week, however, she was telling me about her latest four catches. The one that stood out to me (and her) was a child who was the gestational age of Eva. That's roughly 26 weeks, and obviously far from term. The mother had haemophilus influenza (you might be more familiar with "hib," the vaccine for this), and somehow (I'm not sure how/why), this led to pre-term labor that was truly unstoppable. Given that the woman was a high-risk case, Ann found herself surrounded by various doctors (obstetrics, neonatal) at the delivery. "Careful with the head!" one of them instructed her. I'm pretty sure that Ann is ALWAYS careful with the head, but oh, well. Ann said her reaction upon seeing the head was actually that she wanted to push the baby back in and tell him not to come out yet. But of course she caught the little guy- around two pounds. He's been in the NICU ever since, and she checks on him when she's at the hospital. His prognosis is not so good.
After hearing the story, I patted my belly and told Eva that I didn't want to see her until December. But the story really stuck with me, and it led me thinking beyond the affective mother reflections to issues of medical practice. See, Ann's stories don't just influence my motherhood thoughts, but also my moral theologian thoughts. I can't find the quotation, but I'm pretty sure a theologian mom once told me that in her medical ethics class they had a discussion on Mother Teresa's claim that NICUs are idolatrous of life. Ironically, just days after debating this with her class, she went into pre-term labor with her twins, and both of them ended up in the NICU for a fair amount of time. They're fantastic kids, and I'm pretty sure she can't imagine life without them.
Clearly we want to value the life of such children; we acknowledge them as persons in need of our care. But when does such value and respect for life become an idolatry of life? And how do we avoid thinking about it in utilitarian terms, i.e. how many millions of children who die of malnutrition worldwide could be saved by the money spent on a single NICU in one month (it's a lot, believe me)?
As a pregnant woman - and a theologian mom - these thoughts turn back on me, and I have to ask myself, how would I handle it if Eva were born tonight? How would I make prudential judgment on what kind of care she should receive? Could I let go of her, if I had to do so? And would I be grounded enough (vertically and horizontally) to grieve well?
I can't say it's always fun to reflect on my sister's stories, but I do think it's valuable. I praise God for her work and ministry as a midwife, and I pray that baby Eva stay warm and cozy inside of me for a few more months.