After attending births for a while, some stories begin repeating themselves. Every caregiver’s eccentricities begin to become apparent. A doula begins to learn that one doctor seems to caution every mother about big babies. One midwife insists that every mother wears a belly band after 32 weeks to keep baby from flipping into breech position. One practitioner wants to know that everyone’s membranes have ruptured, whether naturally or artificially, by the time she’s six centimeters, while another is adamantly opposed to breaking anyone’s membranes at all. Another midwife gives each patient “the shoulder distocia talk.” One lactation consultant hates nipple shields, while another sends every client home with one. Why, when practice is supposed to be evidence-based, does this happen?
I explain it to my clients this way – Everybody has a Nervous Nelly. A Nervous Nelly is a set of circumstances that makes our red flags go up. It’s a moment that holds the potential to have our inner self sweating and wringing her hands with worry. As birthworkers, our experiences and our memories make up a huge part of who we are in our work. There’s more to birth work than “just the facts.” The wisdom that comes from our experiences plays a huge role in the decisions we make and the advice we give.
Anyone who works with birth for a significant amount of time has probably been part of a story that she doesn’t want to see repeated. So, she learns more about it, looks into the details of why it may have happened, and learns what may prevent it from happening again. This becomes the advice that is given to everyone. It becomes part of the client education that is given in the future.
It’s important to know your own Nervous Nelly, and talk about it with others. I have this conversation with every client, and I own openly and honestly that my personal Nervous Nelly is the mama who knows that her water broke, and isn’t willing to tell her practitioner about it. Why? Because once many years ago, after a beautiful and uncomplicated birth, I was pulled aside (into the newborn nursery, in front of tiny babies, no less) and screamed at (at top volume) by a doctor who was furious that this had happened – that I knew the mama’s water broke that morning, and she didn’t. Now, I didn’t know that the doctor hadn’t been told – I had asked my client, as I ask everyone, if she had called the practice to let the doctor know she was in labor, and was told “yes.” That doesn’t matter. The fact is, I knew relevant information that the doctor didn’t. Now, I’m much more clear in my guidelines – if it’s important enough to tell me, it’s important enough to tell your doctor or midwife. If the fear is that a practitioner won’t be supportive, it’s important to me now that a client learns this early on, so that she can choose a practice that she trusts enough to tell the truth. So, we talk a lot at first appointments about how to choose a practitioner that a client can trust. One rough experience, one time, with one doctor, changed the way I will deal with every client now and in the future.
Doctors and midwives are the same way. One powerful experience, one time, changes the way he or she thinks. This isn’t “bad” or “wrong”, it’s just part of what makes each of us unique. We’re all human. Our experiences become part of who we are. Sometimes statistics matter less than what we’ve seen with our own eyes. It doesn’t matter if the risk is one in a thousand – if you’ve seen the one, whatever that one may be, you likely don’t want to see it repeated, and are more inclined to actively prevent it from happening to someone else, ever again. The resulting advice may not always be factually accurate, but it almost always stems from compassion and caring.
Know and befriend your own Nervous Nelly. Let that inner wisdom guide you into becoming better at what you do. Know that everyone else has a Nervous Nelly, too, and allow the compassion that comes from this understanding to transform you into a being a better communicator with everyone on the birth team.
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