Sunday, May 3, 2015

All Hail the Queen

(This story shared with permission.) No, not that Queen!  But mad props to the Duchess of Cambridge for being delivered by Black Midwives! While that historic birth was happening, another was going on right here in Missouri outside the view of cameras and media.  A Black working class  woman, appropriately named, Queen, gave birth to her third child in her own house, UNASSISTED, save one quiet witness- me.  Queen labored all alone in her home, keeping in touch with me by text from the time her water broke at her job on Friday afternoon until I joined her in the wee hours of Saturday morning.  I arrived at her home at 2:30am to find Queen laboring naked in her living room.  Signs of active labor were clear.  She was alone in the house, her other two children were spending the weekend at their father's home. The lights were dim, and smooth mellow jazz blasted from a CD.  A shower curtain covered the carpeted floor.  Pillows and cushions were piled on the floor near the sofa to make a resting place. Bottles of water and juice loitered about the room.
She labored on her feet and on all fours.  She moaned quietly through her contractions which came with efficient regularity.  I sat on her sofa and said nothing and did nothing as she continued her labor just exactly as she had been doing before I arrived.

I had met Queen less than two weeks ago.   She called me asking for an appointment to see because she was referred to me by a city bus driver!  She was clear that she wanted an unassisted home birth.  She showed up at the appointed time and I listened to her story; she had had two hospital births that had left her feeling traumatized and she simply refused to return.  She was knowledgeable about the risks and had breastfed her other two babies.  I sat stunned as I listened to her.  This was the woman I had been waiting for.  I wasn't even sure she existed.  A Black woman from my own community who through her own knowing and knowledge seeking understood and believed that she could birth her baby simply, with ease, in her own home.  I nearly wept with joy.  We have been so beaten down and subjugated in birth that I almost never encounter women from my own community who believe they can birth their babies without medical intervention, guidance, or surveillance.  I was so excited, I almost ruined Queen's birth.  She had not sought out prenatal care.  At first I insisted she see my preceptor midwife, get labs and a sonagram done.  She wanted me to be there for her birth, but at first I didn't know how to do that, except in the context of a midwifery student. She acquiesced.   I was in essence forcing midwifery upon her.  Then I read this Facebook post by my friend Ameena Ali Jones: "Birth workers, please...I beg you....STOP TELLING MOTHERS THAT THEY HAVE TO DO ANYTHING!!!!!!! All she is required to do is Labor and birth...THATS IT!!!"  It was as if she wrote it directly to me.  I took it to heart, repented of my deeply rooted dependence on the birth machine.  Queen was willing to do all that I asked because I was doing the asking but then it hit me from Ameena's post that I was not honoring Queen's wishes for an unassisted birth at all- I was just gently coaxing her into the kind of birth I wanted to do. I had made it about me- about my comfort- the very thing I accuse physicians, and midwives in hospitals of doing all the time to the women of my community.  I apologized to Queen.  I cancelled the appointment with my preceptor.  I told Queen I would be happy to come alongside and witness her birth.  I would not come as a midwife (because I am not one yet) but I would come as a companion and sit beside her as witness to her birth.   Her water broke the next day.

As I sat on the sofa in the tidy little bungalow, Queen labored beautifully.  I had no supplies with me.  I didn't even interject encouragements like, 'you can do it' or 'you're doing great'  She did not need even that.  She did it all on her own.  About 30 minutes after my arrival, she began to bear down.  She was kneeling down with her head resting on the sofa. She stood and began to push.  I moved in closer and took several pictures with my phone.  By the time I moved from the sofa to her side, the baby's head was already out.  I grabbed a nearby towel and gently caught the baby and laid it down between Queen's legs.  She wanted to know if it was a boy or girl, but I told her it was not my place to say.  She scooped her baby up and after five minutes of oohing and ahhhing, she gently unwrapped the towel to reveal the gender.  The baby cooed and later cried all from the safety of her mother's arms. I marveled as Queen never even sat down but began to nurse her baby standing naked in her living room. After 30 minutes her placenta came out, we then burned the cord and tied it with the shoestring Queen provided.  I watched over the baby,  as Queen showered, then tucked them both into bed.

As the sun rose beckoning a new day, I drove home and left Queen with her baby nursing in her arms.  I realized that I want more of this, more dependence on the mother's own knowing and wisdom.  Earlier the previous day I had attended a town hall meeting on maternal mortality.  Talking heads from our state capital were in town to present on current disheartening trends- expert statisticians and epidemiologists who would have believed that the answer to those problems lie in exactly what Queen did NOT do; more medical surveillance, more technological control, more dependence on the cult of expertise.  I began to see things differently on that ride home.  Queen was her own best hope.  Not the state experts, not even me.  Women taking back their births, even from the so called experts is what will save them. Listening to all the experts in the room made it clear: THEY HAVE NO IDEA HOW TO HELP US.  We just die, and they just throw up their hands.  Even worse, they think its our fault we are dying- they don't even see their own culpability.    The answer lies with us, not with them. Self reliance and self management within our own cultural context will save us, not waiting around for dominant others to fix us. Am I saying that unassisted birth will fix health disparities?  No, but I'm no longer willing to rule out that it has a useful role.  Today, all of Queen's female relatives are rethinking everything they think they ever knew about birth... with all my millions of classes I teach, I couldn't work that kind of magic.