Friday, May 8, 2009

"Just enough to hinder..."

I'm one of the rare women who got an apprenticeship before starting midwifery school. I'm totally lucky. Religious folks might call it the hand of God; I call it incredible serendipity and/or fortuitousness. I don't even think there was a formal asking or accepting. Leigh was new to the area and through auditing her childbirth class (which I was doing to fulfill a requirement to become a CBE) I met a few of her clients, and, as she didn't have an apprentice, I offered (or maybe she asked me?) to attend the births with her, and that was that. We attended a birth together and we appeared to drive well together (or at least, we both survived the high-speed race to get there) and so I got my TB test, enrolled in midwifery school, and became licensed in South Carolina as an apprentice. At some point Leigh started referring to me as her apprentice, and I started referring to myself as her apprentice. Voila.

From what I understand, it typically doesn't work that easily. Many women who choose distance midwifery school are students for a long time first, and then have to apply to become an apprentice, and interview and compete against other potential apprentices. Reading on my AAMI group about other students who are doing that -- I'm thrilled that becoming an apprentice and enrolling in school has been so easy for me.

What has been difficult is turning my brain into a midwife brain when I've been a doula for years. Or, I should say, when I've been a non-midwife for my entire life up until now. Even though I saw a CNM for my second pregnancy, and a licensed midwife for my third, my default brain is still amazingly medical. It's insidious; I think it's just from living in this country and talking to pregnant women. I believe 98% of women have hospital births, and so 98% of women are talking about doctors, inductions, pain medication, and other interventions, and they're NOT talking about nutrition during pregnancy, comfort measures for normal pregnancy discomforts, and spontaneous labor and birth. Now, many of my friends and acquaintances are that 2%, but still. It's hard to replace approximately 22 years of mainstream-ness (I would say I've become more crunchy and natural-minded in the last 7 years).

Also, many of the pregnancy and birth related things that I "know" aren't really things that I "know" but are things that I've seen or heard, like anecdotal evidence. I now need to do the research and really learn. For example, the Cochrane Collaboration does not specifically say that Cytotec causes uterine rupture; one study does say, however, that it hyperstimulates the uterus, which can lead to uterine rupture.

There's so much to learn! And I thought that being a doula would be an advantage but if it is, it's a very small advantage. Tiny. I like to talk a lot and recently I've been trying to STFU during prenatals unless I'm either making small talk ("What are you planning to name the baby?") or something that I really really really KNOW for a fact. There are a few things that I know. But there's way more I don't. It's probably like that 98%/2% statistic.

However, AAMI is a long program, and by South Carolina law, I cannot take the NARM until after I graduate (which is different than most other states, where you can take the NARM anytime you have fulfilled the clinical requirement) which will be in 2012. So I have plenty of time to learn. I'm already feeling more comfortable taking vitals on mom and baby, and I'm starting to get better at measuring fundal height. I'll get there.