The primary tool I reach for in my Mary Poppins magical midwifery bag is the supremely simple one – the almost too simple one – of smart lifestyle choices. Good health is necessary for birthing safely at home. Good health is necessary to our pursuit of a meaningful life, too! This post is about the value of cultivating that good health.
I was approached and hired by a young Amish family in the autumn of 2005. I was still early on in my midwifery career then – Renee and Adam’s son, little Peter, born beneath the full moon of 2006’s Valentine’s Day, was my 208th birth. I learned some valuable lessons while serving them. I learned it isn’t nearly enough to tell a mom, “now, it’s important you that you eat healthy food and that you exercise adequately and that you take your supplements.” I learned while facing the multifarious disaster of Renee’s state of health as it unraveled before my eyes, that it’s essential I explore with my clients what exactly I mean by healthy food and adequate exercise and supplements, and, very basically, to then pester them at every visit regarding their application of what I’ve taught them.
I spent his mama’s labor privately scandalized to discover her home without a speck of real food – the cupboards and refrigerator were filled with heavily processed items ranging from various diet drinks to Cheet-Os to sugar cereals, while no less than four dessert dishes lined the countertops. Renee labored nicely enough, but she sustained a dreadful tear as she birthed her son, then trickle-bled until I nearly despaired of getting it stopped at home. Peter was healthy, but “puny” as the Amish are want to say, and prone to grow chilly – a thing I’ve only battled three or four times in my years attending births. My assistant and I worked to the point of exhaustion to secure stability for the two, then stayed for hours upon hours past the usual three to four post birth. We left the family happy and in good condition, only to find Renee showing signs of postpartum infection when we returned for our next visit! I shuttled her immediately off to the hospital – the only time I’ve ever had to transfer a woman for an infection. Through the following weeks everyone recovered well, but I was horrified – even so traumatized by the experience, I determined I’d never attend this woman again. I probed a bit further into the details of her lifestyle as I paid my visits, and, as kindly as I could, explained my position. “Renee, those papers I pass out about diet and exercise and supplements, they really aren’t suggestions. Midwives only serve low-risk moms at home and, though risk factors are generally determined per medical conditions such as high blood pressure or gestational diabetes, a substandard state of health can truly be a liability, too. I hate to say it, but have to tell you, I won’t be comfortable serving as your midwife again, as much as I’ve enjoyed getting to know you and your sweet family.” Renee indicated she understood.
Needless to say, I was startled to hear Renee’s voice on the line a mere nine months later, and even more surprised to hear tell me she was pregnant and wondering when I could come on by. As I sat back shocked, she went on to tell me they’d also moved out of the region I generally served by a good twenty or so miles further south. When I found my tongue, I said, “Renee, it’s nice to hear from you again, and I’m flattered by your request, but I wasn’t kidding when I said I’d not be comfortable serving you a second time. I mean, for me to even consider serving you, I’d need your sworn oath to alter your lifestyle to MY specifications, plus I’d insist on your permission to pester you mercilessly about how well you comply. And on top of all that, you’ve moved outside my service radius, so I’d charge you $200.00 more.” I expected Renee to say, “I see,” and move on to make other arrangements. Instead, she said, “Okay! Kim, I’ll do all you say! And we’ll gladly pay more! When can you come?”
Tentatively, we began care, and, true to her word, Renee made dramatic improvements. I was very happy with the results, and she seemed to be, too, and, though Titus was a bit dusky upon his arrival, his birth in the summertime of 2007 was beautiful, and he was beautiful – big and vigorous. Renee didn’t tear and she didn’t bleed, and my assistant and I left her afterward well-pleased.
And so we were surprised to arrive at Renee and Titus’s first postpartum visit to find Titus rather darkly colored and breathing a bit rapidly. It was subtle, but, again, I sent the family off to the hospital. Adam called that evening to report the doctor had said the baby was most likely infected because he’d been born at home. I said, “don’t you believe it, Adam. Something isn’t right with your son.”
Adam had quite a story to tell at his next call.
Doctor after doctor had come and gone after his initial admission, examining Titus and puzzling over him as it became increasingly clear that whatever was troubling the boy, infection wasn’t it. Finally, the staff at the tiny, rural hospital called Bronson Methodist Hospital’s Neonatal Intensive Care Unit, and an ambulance was sent to fetch him.
That afternoon, some twenty-four hours after I’d sent him to the local hospital, the ambulance arrived, the NICU team loaded Titus onto it, and they started for Kalamazoo. Not halfway there, however, Titus crashed. The NICU team called for the University of Michigan Health System’s Life Flight team while they worked feverishly to revive him. Upon his admission to U of M, Titus was discovered to have a case of transposed blood vessels – a mix up of the vessels leading to and from his heart, lungs, and oxygen-starved body. He was scheduled for open heart surgery, and shortly thereafter a bright purple line marked the center of his soft, white chest.
We all felt very strongly that the quality of health Renee had provided Titus per her diligence to my demands and nagging, at the least, allowed him to sail through his early challenges with relative ease and, at the most, may even have saved his priceless life. Renee has since maintained an excellent state of health, and I was blessed with the opportunity to serve her through the births – through the happily uneventful births – of her next three babies before I made my move to Colorado.
With this little tale in mind, I, first, encourage you to take seriously and steward well the gift of your amazing health and life. It’s the only one you’ll ever get and, though we tend to take our health for granted, when our health is threatened and we find ourselves teetering upon the fine edge of life and death, any little thing may make the difference in outcome. Second, I welcome you to take full advantage of the availability of my little book. It’s the product of years – a project I began almost twenty years ago as a youthful apprentice, and it’s morphed from a little handful of fluttering papers to a stack of 60 some pages. And I offer it with joy to your health, and even to the fulfillment of your dreams and your destiny!
Here’s an interesting video clip produced by the University of Michigan’s Mott’s Children’s Hospital about a method they’ve developed to support preterm babies. They mimic the womb environment and re-establish the fetal circulatory system. This was how U of M treated Titus initially! His fetal circulatory system was re-established, and he was supported that way for two weeks in order to allow him to gain the strength he needed to endure surgery.
As ever, the names of mom, dad, and babies are changed.
The helicopter photo and the ambulance photo are from istock photo.
All other photos were taken by Kim Woodard Osterholzer.
Thank you so much for the gift of your time!
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Kim Woodard Osterholzer, Colorado Springs Homebirth Midwife and Author
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