Thursday, July 30, 2009

You gave birth ineffably, O All-pure, to the Maker of all things who delivers mortals from the ancient curse and the corruption of death

This post should be dated August 7th, but I published it from a draft begun on July 30th, so it appears out of order. Oh well. I'll figure that out sometime.

While we waited hours for the Amish birth, I had to begin charting almost as soon as we arrived in the home of the twin birth. I had just enough time to look around to gauge what kind of family we were with. The history of the world timeline on the wall (beginning with The Creation of the World in 3,000 B.C.), the Bible memorization awards prominently featured on the wall, and the Homeschool Legal Defense Association magazines on the back of the toilet immediately assured me that I was surrounded by a textbook homeschooling, homebirthing, AWANA-clubbing family. I fought myself to keep from assuming that this family was populated by suburban versions of just the sort of children that I grew up with in the country. These were people whom I had never met and whom I had to deal with as individuals, dismissing my childhood associations.

Once again, the details of the births themselves have dissolved. Perhaps they would not be that interesting anyway, they are mostly numbers and none of them can communicate how extraordinarily strong the birthing mother was. She was five foot tall, and could not have weighed more than 110 pounds before her pregnancy. But she was surely fifty pounds heavier when I first saw her, absolutely bulging. Some pregnant women look like they have a beachball in their stomach. This woman looked as though she had swallowed two watermelons. Her skin was stretched so tensely that I almost feared it would give way before she gave birth. She was the picture of "about to pop." Although she was under overwhelming stress, she nodded at me politely when she walked from the bathroom to the birthing stool, belly in arms: "Thank you for coming. Glad you could make it."

Most Holy Theotokos, save us!
It is truly meet to bless thee, O Theotokos!Ever blessed and most pure, and the mother of our God,
more honourable than the cherubim,
and more glorious beyond compare than the seraphim,
without defilement thou gavest birth to God the Word!
True Theotokos, we magnify thee!

From my scribe's seat on the floor, this tiny naked woman towered on her birth stool like a queen. Her husband sat behind her to hold her erect. A doula friend massaged and whispered at her side. Elizabeth, her Amish helper, another midwife, a twelve year old daughter and I were arrayed beneath her. The room was thick with anticipation, full of ladies in waiting. The mother was at the helm of this atmosphere. An experienced birther five times over, she established the perfect relationship between self-control and abandon.

Hail Mary, full of grace, the Lord is with thee!
Blessed art thou amongst women,
and blessed is the fruit of thy womb,
for thou hast born the Saviour of our souls!

While another woman is laboring, it's impossible not to feel as though you are participating in it. I wonder if it is the same for men present at births. Although I was physically doing nothing to help her push out that baby, Elizabeth's firm voice seemed to be commanding me to breathe along with the mother. "Hold that breath. Fill yourself up. Push with your diaphragm." I could not feel the waves of pain washing over her, but I could see them and I wanted to channel them into their end. The rhythm of flexion and relaxation drew me in, and the only way that I knew to give myself to her effort was to pray secretly, mostly to the Theotokos (as the most perfect God-bearing child-bearer), but in times when I could not summon such long prayers I simply said:

Make haste, O Lord! O Lord, make haste!

I remember the births from inside this prayer-time, so that once again the events seem to be streaks of impression rather than the neat chart that I wrote down. I know that the twins were born almost exactly one hour apart. First a girl, then a boy. If birthing one 7 lb, 10 oz baby isn't enough a workout for you, try repeating the exact same process one hour later, with the emotional and physical exhaustion of the first still upon you. The first birth had drained her, and the baby girl was asking for attention which she couldn't afford to give. Giving herself into nursing and gazing at her daughter would take her mind off of the son still inside of her. Her contractions slowed and lost intensity until Elizabeth sternly reminded her to "Get that baby off of your breast and push this baby out!" The baby was given to me, and I felt the emotional interruption as well when I tried to get back into praying with the mother's rhythm while holding this perfect, firm, squirming baby which I knew I would not get to hold again.

The son was born in much the same way as the daughter, without any problems and of a hefty size, especially for twins. The mother allowed herself to collapse after the son, and because she had hemorrhaged after births before, the midwife team administered an IV to her and gave her Citotek, a drug which induces uterine contractions. In hospitals this drug is used to induce labor, but many midwives use it after birth to cause the uterus to become firm and prevent hemorrhaging. Of course this is a felony.

There was no need for me in the room any longer. The IV dripped into the mother, who nursed her son. The 12 year old daughter and I took the baby girl out into the kitchen and we made scrambled eggs for everyone. It was good for the mother to eat after her efforts, but it was perhaps even better for the 12 year old to have something to do. The strangest part of the day for me occured in this scrambling-time. The daughter ("Esther") asked me what church I went to. I replied that I was Orthodox, but my family went to a non-denominational Protestant church, and that I grew up in AWANAs memorizing the very same Bible verses that she did.

Apparently, this pedigree was not good enough for Esther. She asked me next,
What are you going to say to Jesus when you get to heaven and he asks you why he should let you in?

I was completely taken aback by her boldness, and confused by her question, so I fumbled and stuttered and finally said "I suppose I'll say 'Lord have mercy.'" I knew that this was not the answer that she wanted, and indeed she continued to question me:

Well, if you died right now, would you go to heaven or hell?

Do you know about what Jesus did? He died on the cross for you. And then do you know what he did? He rose from the dead. Do you know why? He did it for you, to pay for your sins.

I wasn't sure how to respond to all of this. I was brought up to think the way that she was thinking, along very simplistic, economic lines, imagining that I had incurred some kind of debt against God's bank, and before I was admitted into heaven (an everlasting church service), I would have to come up with some way to get back in the black. But of course, the debt was far too great for me to ever pay, so Christ gave his life in order that I might not forbear my loan.

I knew that unless I gave her this kind of account, she would not believe that I was a Christian, and would continue to attempt to alert me to my great debt. How was I to respond? She was only 12, and in her mind she was doing me a great service. My answers probably seemed vague and dangerous to her. I felt that I should not capitulate to her questions, because it seemed that to do so would be denying everything that God has granted me to learn. But it also was not my job to save her, in the way that she thought it was hers to save me. It was her house, and this was a special and precious day for her family. I was not on a mission trip.

So I answered carefully. What does it mean to be saved? It is not a one time deal that you make with God, but a lifetime of repentance and prayer and throwing yourself upon the mercy of God and the saints. (I tried to avoid mentioning the saints and Mary as little as possible, because I knew she would just think I was an idol-worshipper.) I even used the same Bible verses that she was itching to throw at me-- I was an AWANA kid, so I knew Ephesians 2:8-9. She was frustrated that I did not fit into her carefully delineated categories of "Unsaved" and "Saved," and that I denied her financial language of redemption, choosing instead to speak of healing and wholeness. I was struck with her audacity and persistence, and her steeled devotion to what her parents had taught her. I was saddened, too, because if I had been a little bolder and ruder at 12, I could have been offending strangers too. I had only moments ago been praying fervently for her mother, but if I had told Esther that I was praying to Mary, rather than Christ Himself, she would have probably run to tell her mom that an idol-worshipper was praying unclean things upon her.

We don't need an intercessor, we just talk straight to Jesus.

Do you make up your prayers yourself or do you read them from a book? That doesn't seem much like praying, to read from a book!

Sin is like making cookies! You can have all the ingredients just right and if you put in rotten butter, your cookies will taste yucky!

Lord have mercy.

The babies were beautiful, the mother was strong, the father was funny, the children were sweet and well-meaning. But I drove home shaking, upon the verge of weeping. Nothing bad had happened, I had not messed up anything, it was a perfect and remarkable birth. But something about Esther scared me, and taught me another difficult truth about Elizabeth's profession: everybody is out to save the midwife. Make sure your hands are clean before you touch my mother. You can put your whole soul into someone else's birth, but be careful because it will be under great scrutiny.

Monday, July 27, 2009

O precious soil that grew the corn untilled

I thought that since I stupidly drank a cup of coffee at 9 pm (for social reasons) I would take advantage of this time to try to write about the births that I saw. I haven't been able to describe the experiences verbally to anyone since they occurred. I feel bad about this because I know my mother was anxious to learn what I thought of it, but somehow I just have not been able to put it into words. It's something I've been "treasuring in my heart," but it might be time to try to give an account of it.

The first birth was an Amish one. Looking back, it's just a series of impressions to me-- the hushed farmhouse full of darkness and silence; the hours spent quietly and nervously waiting in the living room while the mother lay with her husband, trying to bring back her contractions; then the wide eyed scurrying about, directed by Elizabeth's calm, firm voice. "Mallory, bring me that tray." Despite my hyper-attentive state, I froze at the first command given directly to me. "Mallory, give me the tray." She brought me back to reality and I obeyed.

It was my job to chart the times of all of the birth occurences: crowning, head, baby, placenta, cord cut. I also was to make notes on the mother's position during all of this, when she moved, what kind of perineal guidance was given, whether her wiry bearded husband was stimulating her nipples, etc.

Even though I wrote all of these things down, I don't remember any of them. I remember that she was too short for her feet to reach the floor from either the toilet or the birth stool, so we put stacks of towels under her feet. She still didn't feel stable enough to push, so she lay on her back as her husband and Elizabeth's Amish assistant pushed her knees back to her shoulders. I will never forget the low, fundamental groan she produced as she pushed: was it from her diaphragm, or was it her bones creaking under the strain of birth? It could not have been from her mouth. Her sweet rosy face could not have cried out so.

For most of the night, I had been stationed outside of the bedroom, angled so that I could see Elizabeth, the mother and the clock, but so that I was unseen. I had not met the mother before and I didn't want my presence to disturb her. As she began to push and moan, though, I was clearly the least of her concerns, so I moved into the room and positioned myself at the end of the bed with a clear view.

Maybe the reason I haven't been able to give an account so far is this: As that baby's wrinkly, gooey blue head emerged into Elizabeth's hands, my entire consciousness was centered in receiving it. No matter how much "context" I try to give, I will always fail in describing that moment because it seemed too large for the sequence in which it fell. The breath in which it happened was the longest breath of my life thus far, although according to the clock it was over in an instant. There is no frame of reference for birth.

A boy was born, and after that I don't remember very much besides blood. Blood was everywhere. It took us quite a while to clean up and we had to wait for a long time for the mother to stop bleeding. She was fine, the baby was fine, the father was delighted (in a quiet Amish way) in his son. At five in the morning I walked out into the July moonlight, breathed the warm sweet-corn air very deeply, and wanted to cry.

Twin birth later, this turned out long.

Sunday, July 26, 2009

full-time jobs

Today I attended my first "All-Parish Meeting." The purpose was mainly to ratify a new budget in which we cut almost all beneficence in order to be able to pay our priest half of what the OCA stipulates for our area. Father David has supplemented this income by farming for the last 22 years (or rather, this income has poorly supplemented his farming.) But during the last eight months he has been recuperating from serious back surgery, which makes priestly offices exhausting and farming entirely impossible. Unfortunately, St. Stephen's is a very small parish and has never been able to offer a priest full-time pay with their tithes. As Father David was very careful to point out, there is no such thing as a part-time priest, no matter what he is paid. Holy Week's more-than-daily services aside, there is no day of the week or time of day when he can remove his cassock (figuratively) and cease praying.

I thought of Elizabeth when he spoke of this, because a midwife submits herself to a similar yoke. While she is concerned daily with preserving the sanctity of other women's families, stepping lightly amidst their beliefs and concerns, the sign on her own door is never flipped to "Closed." Her religious convictions are frequently called into question, she must always answer her phone, and no time of the night is sacred. (In fact, since uterine activity is highest at night, it seems that she must fall asleep under the assumption that she will be awoken.) When I called Elizabeth's house at the beginning of my internship, I asked her 13-year-old son when she usually worked: "Pretty much all the time."

Through all of this the midwife must strike a balance between detachment and investment in her clients' lives. She is a professional, and must protect her business, especially in states such as Indiana where she must practice under-the-radar. This may mean refusing to give care to certain women who appear at-risk of complication. Additionally, clients can become very dependent on the midwife for emotional support long after the birth, which is outside the scope of her practice. On the other hand, as I spoke of in my last post, the midwife's standard of care requires the ability to see each patient as a whole person with feelings, beliefs, hopes, a history, and a soul, rather than as a chart or a walking lawsuit. It seems to me that she must begin to love every woman she cares for. How she does it, I don't know.

I'd like to know for myself even though I will never be a priest and perhaps never a midwife. How far does one offer oneself to others? Is it ever at the expense of one's own soul? Is there a boundary at all? At one time you could have found me at Christian Doormats Anonymous, but now I think I should strive to err in that direction rather than not. I've been swinging between those two extremes most of my life. Father Dave and Elizabeth are a good picture of the mean.

Saturday, July 25, 2009

Prenatal Conversations

Because my school does not afford its students much in the way of practical life experience, the ARIEL internship program was created in order to prove to students that one's career can indeed be enriched and augmented by a liberal arts education. The program offers stipends to students in order to facilitate summer internships and apprenticeships, and asks only that the recipients write an essay about their experience.

I received an ARIEL stipend to help me while I apprentice with a midwife. This midwife in fact assisted my mother at my own birth, and my four subsequent siblings' births. She now works primarily with Amish families, but her clientele is fairly diverse besides.

I've been living at home this summer, in the green country, and thanks to ARIEL have not needed to get a second job besides my apprenticeship. (Since the midwife hasn't needed me terribly often, I'm almost finished with War and Peace). I thought I should try to write about some of the things that I have seen and learned, since $500 of my stipend is held hostage until I turn in that essay. I'll do bits at a time.

I'll call my midwife ... hm. Phanarete was the name of Socrates' mother, who was a midwife. That doesn't roll off the tongue quite as easily as "Elizabeth." I don't want to use her real name because midwifery is currently illegal in the state of Indiana.

For most of the summer, I attended pre-natal visits with Elizabeth and sat quietly. I was introduced to each client as "our intern," and after a brief smile I disappeared from the expectant mother's awareness. I silently charted blood pressure, weight, hemoglobin, and other factors which Elizabeth tested. She doesn't have ultrasound equipment, and the only sorts of "testing" she really does are for hemoglobin levels, blood type, and various elements present in urine. Most of the information-gathering that she does is verbal. It's surprising how much someone wise can learn from the simple question "How are you feeling?" She weaves this questioning into a conversation about canning fruits, breastfeeding other children, how Amos' farrier business is doing, whether the Stoltzfuses got a good deal on the horse they bought at the auction, and the garden. Because Elizabeth lives in the same rural community as the Amish, she is aware of the country happenings that her clients care about, and they trust her. Pregnancy is not an isolated illness to the Amish, rather it is another part of life that is certainly special but doesn't mean that the green beans don't need to be cleaned.

Elizabeth can't make prescriptions for pharmaceuticals, but she does make suggestions for vitamins, minerals and herbs that will help with various aches and pains of pregnancy. Calcium for leg cramps, red raspberry leaf tea for uterine strength, and iron to get hemoglobin scores high enough to eliminate the threat of a post partum hemorrhage. Wear stockings, even in summer time, to keep varicose veins under control. Massage the perineum with olive oil to aid in stretching during birth. Most of this advice seems like a no-brainer-- many problems in the body are caused by a deficiency or excess of the various nutrients which allow the organs to function. A growing baby skews that balance, sometimes more quickly than a pregnant mother realizes, so Elizabeth reminds her that the way she's feeling is a natural reaction to those imbalances.

Elizabeth also feels the mother's bare stomach to determine the position of the baby. It isn't difficult for experienced hands to discern where the head and other parts are. If she finds that it is in a difficult breech position close to term, she advises the mother to lie upside down on an ironing board leaned against the sofa. Usually this turns the baby into a more deliverable position.

I am not well acquainted with the modern medical model of care. I spent very little time at the doctor's office as a child and my hospital experience has been limited to ER visits. I wish I were better able to compare Elizabeth's model of care to that of a typical general practitioner, or better yet an OB/GYN, but I can't. It seems completely normal to me because it is the kind of "naturopathy" that I was raised with (in fact my mother often repeated Elizabeth's words to me as a child). I'll write more later about the births I saw, statistics, the legal situation, and the difficulties and rewards of being a midwife that I observed.

World Premiere!

I've decided to blog again.

I used to have a LiveJournal but I concluded after three years that it was corrupting my soul. (This was before Facebook got its claws into my soul.)

Too many people were reading it, I was writing about things that were too private, I was writing things that I would never say out loud, and I was obsessing over what people thought of what I said. Just as having a digital camera caused me to see every beautiful thing in a two inch LCD screen, my life had swiftly become this xkcd comic. Since then, Facebook has picked up the slack on an even pettier scale. "This would make a great status update." Thank goodness I don't have Twitter.

So I'm very apprehensive about starting this blog, because I have been slowly regaining my independence from the internet and my ability to be present in the present. But I want to become a better writer, and I think a blog could help me. I can write a good essay about a book. I know that much. Or at least I have written one. As for letters, emails and my journal, though, I've found that since I wrote that one good essay I have been very unsatisfied with what comes from my pen and my mouth! My "lazy" writing isn't very good, and I think the only cure for that is to practice writing spontaneously, holding myself to a higher standard than I have been before. I would like to get to the point where I can write something "off the cuff" and it's good. If, as I grumpily shout every morning over the dreadful local paper, "I could write better than this with my hands tied behind my back!" I should practice writing no-hands.

We'll see if that plays out.

Another hope: If I discipline my faculty of speech on the static page, perhaps this rigor will move to my mouth. For knowing so little, I sure do talk a lot. I'm no voice crying in the wilderness, I'm more of a car horn adding to the din of the city.

It's hard to decide what parameters to set. I want to say "No complaining," but the world is messy and I'm 21 and there are things to be mourned. I want to say "No preaching about Orthodoxy," but it's new to me and I'm trying to figure it out.

We'll see. If I find myself lying awake at night composing blog entries, I'll stop. Ugh. Blogs can make you fat, too.