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In Praise of Midwives

IMG_0364.JPGA fact: a gynecological exam is never going to rank up there with gelato, foot rubs, or clean sheets on the “life’s pleasures” lists. Even the word “speculum” can make a gal wince.

And while I am certainly not a fan of those exams, I have to say that I look forward to my annual visits to my “lady doctor,” who also tended to me during my two pregnancies (and one miscarriage).  I found Sylvie a long time ago, in a faraway land called Beingingraduateschool. I spent a year or so in that land using NYU’s fabulous “health services,” a walk-in clinic that played fast and loose with the ideas of both “health” and “service.” (Imagine sitting in the communal waiting room for the gynecologist, clad only in your paper “robe.” At least it was a women’s only waiting room – a small concession – but the door opened onto the main waiting room, where I every now and then caught sight of my undergraduate students. Truly a lovely experience.)

Sylvie – the first midwife I’d ever met outside of books – had a comfy chair for pre-exam conversation in her office; the cold metal stirrups on the exam table were gloved with potholders, so as not to chill tootsies; and most importantly, she gave my questions all the time they needed. 

I suppose as with everything, there are good midwives and mediocre midwives; I just seem to have found a really good one. Proof? In a city like ours, where just about every decision gets made on the basis of which train you’d take or if it’s possible to get a cab, I stayed with her from an office close to NYU’s campus, up to the Upper West Side, and now to Columbus Circle. In short, I’ve followed her uptown and cross-town.

Women always used to use midwives when they had babies, but in the late 19th century, as obstetrics become a more “scientific” profession, women were pushed out of the field and midwifery became a marginalized and denigrated occupation. Women who could afford it were encouraged to have their children in the “twilight sleep” of anesthesia, to be attended by a staff of (male) doctors, and to have their children in the safe space of a hospital. Midwives were dismissed as the last refuge of ignorant women, and midwife training programs all but died out.

In recent decades, however, that trend has shifted: there are now a number of midwife programs, including one at Columbia, and there are several midwifery practices in the city. Some studies say that the rate of unnecessary c-sections is significantly lower if a midwife is in attendance at a birth – but there is still a significant bias against midwives in the medical profession.

I felt that bias when I was pregnant with Liam. I’d gone to Sylvie for a regular check-up and she’d put her hands on my not-very-big belly and said “hmm…you know, let’s just be sure and have you get an ultra-sound.” She suspected, without any fancy instruments, that perhaps my pregnancy wasn’t proceeding as it should.

Sure enough, the ultra-sound proved that in fact, Burbage (as we called Liam in utero), wasn’t growing as he should, which the ultra-sound doctor brilliantly summarized as my having “a crappy placenta.” This paragon of bedside manners, after so bluntly dismissing my inner organs, went on to ask me who my obstetrician was and when I said I had a midwife, she looked at me as if I’d said that my pregnancy was being attended by a veterinarian. “Oh,” she said, after a long pause. “A midwife.” As Sylvie, somehow, were at the root of what was wrong with my baby.

The doctor who eventually performed the very necessary c-section that saved Liam’s life had a different opinion: it was Sylvie and her good hands, he said, who was responsible for Liam being as healthy as he was – she caught the problem early and made sure that we were monitored carefully.  Sylvie delivered Caleb, too, and watched with me through gestational diabetes, through a due-date that came and went, and then a labor process that, even with pitocin, took WAY longer than it should have (and broke my tailbone – yes it can happen).

She’s followed the growth of each boy and those annual checkups (still on a table with potholder-covered stirrups) have become conversations about our respective children, about life in New York, about her thriving practice, and whatever good book we’re currently reading.

Yesterday, Liam and I went to Prospect Park to celebrate the 1000th baby delivered by Midwifery of Manhattan (MOM, get it?). Spread out under the green fluffy trees of Nethermead field were M.O.M’s children: from kids on the verge of college to newborns, including Sylvie’s first grandchild.  Liam didn’t really appreciate the celebration (or the lack of ice cream), but I thought it was amazing.

In light of the wanton destruction of Dr. Tiller last week, the celebration of 1000 births seemed also an affirmation of a woman’s right to her own body: the births being celebrated were wanted birth; the parents wanted to be parents.

I don’t know what numbers Liam and Caleb are in the count to 1000, but having them be in that number (like the saints!) makes me think that they have a guardian angel watching over them from somewhere in the vicinity of Columbus Circle.

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