Midwifery


Perspective is a mysterious thing: a thousand people crossing a single bridge is a thousand people crossing a thousand bridges. We can only see the world through our own eyes; none of us is exempt.

When I first graduated, doctors were a cult, and immersed in it as I was, I would not have thought of it as such. We were doctors and they -everybody else- were, well, others. And at the time, I remember well that the very idea of entrusting the care and delivery of a woman to someone outside of the medical profession was anathema. We were the Guardians of science, and only we realized that things could go horribly wrong in a pregnancy if not guided by someone on a first-name basis with disease -someone not necessarily experienced with the vagaries of the process, but one who could at least recognize that it was going wrong and take an alternate path to its successful resolution: forceps, arcane manuevers, Caesarian Sections… Of course the obstetrician was never as threatened as the family practitioner because only we could perform the complicated stuff. Our training was longer, more intensive. Put another way, we were even more indoctrinated.

Why do we fear the other side? Why is there an other side? I suppose we mistrust those who come from different traditions -those whose perspectives do not entirely conform to what we have been taught. We are parochial creatures; it’s where our comfort lies. Seldom do we have the patience -or wisdom- to attempt to frame the world differently. And why should we, if we believe we possess the Truth, that we alone walk the Path? But of course we don’t. There are as many paths as there are destinations and how dare any of us assume we know the best one?

I am reminded of a patient I saw in consultation earlier in my career than I care to remember. She was in her second pregnancy and had been referred to me by a family doctor in town because she had required a Caesarian Section for her first child. She was only four feet ten inches tall and as the doctor had tried to explain to her, the first baby was too large for her pelvis, so the second would be as well. But she wanted to go to a midwife for her antenatal care. What was the harm? As she explained to me, if the second baby didn’t fit and the labour didn’t progress, the midwife would be able to refer her to the obstetrician on call and she’d have the Caesarian then: win-win.

“But doesn’t it bother you that you may go through all that work and distress for nothing?” I asked, incredulous at the very idea, and clearly insensitive to what she was trying to tell me.

I remember she sat up straight in the chair and stared at me, equally incredulously. “For nothing? Doctor, no offense, but do you see why I want to go to a midwife?”

I didn’t understand it for a long time. I had to mature enough to realize that although we both wanted the same thing -a healthy baby- there were different routes to the same place. One of my favourite poems describes it best, I think. Do you remember the one by Robert Frost: The Road Not Taken? It starts: Two roads diverged in a yellow wood/ And sorry I could not travel both…

And how it ends? Two roads diverged in a yellow wood, and I-/I took the one less traveled by,/And that has made all the difference.

I don’t mean to suggest that one of them is better, or preferable, or even less chosen, merely that I shall be telling this with a sigh/ Somewhere ages and ages hence.

I suppose I should have known…

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