messy business

let's face it: i'm in the messy business of labor and birth. to the ever-so-naive optimist, i have the wonderful opportunity of welcoming life into this world, taking part in a beautiful phenomenon. and to you, dear optimist, i can say i agree. but not until recently have i really acknowledged how uncomfortable, nasty, and plain ol' messy the process leading to this "miracle" is.

i attribute the delay in this realization to two factors.

1. the vagina, cervix, breasts...these are what i work with EVERY day. they are for me what a lesson plan is for a teacher, a mixing bowl is for a baker. "tools," if you will.

2. the things that come out of the vagina, cervix, breasts, and more often than not, the anus...again, everyday working material.

so i guess you could say i've just come to expect the physiology of laboring patients, giving high praise for "messiness" since messiness, after all, means baby is coming! but then, to a degree, i've also put patients' feelings on the wayside, instead rooting for bloody show, mucus plugs, and amniotic fluid.

thanks to two recent (and memorable) patients vocalizing their discomforts, fears, and embarrassment related to giving life, i have a new perspective on this whole messiness thing.

case 1: she broke her bag of water. was confused - is this pee or amniotic fluid? kept asking: why am i still leaking? when will this end? felt extremely uncomfortable with the constant dribbling down her legs. could not stay in bed - and rightly so - because she always felt wet. the old me would say: great! breaking your bag of water helps the baby descend and blah blah blah. and then i would change her pad. but hearing her discomforts made me put myself in her shoes. i would HATE to be leaking constantly. feeling incontinent. amniotic fluid or not, i would refuse to sit in a pool of it in bed. eww.

case 2: she was pushing. both legs were held up by me and her husband. the full shebang exposed for the imminent delivery. i guided her pushing efforts by telling her to imagine having a bowel movement. feel the pressure and push toward the rectum. she pushed perfectly - every effort bringing the baby down, and of course, poo. she knew it, felt it, and was mortified. all her focus shifted to "oh my gosh, i'm pooping," "this is so gross," "don't tell anyone." the old me would say: this is great! you are pushing exactly where you should. don't worry about the poo, i'll clean it. what matters is that you are making progress. but seeing how humiliated she was, i realized i would also HATE to poo in front of everyone. in bed. and then have someone else clean it. oh, and the mere thought of bringing my baby into this world with the stench of my feces...eww.

and so now, to make the long story short, i have utmost respect for these women who not only give life, but also suffer the messiness of this business. from this moment forward, i will imagine what they feel, put myself in their uncomfortable and embarrassed shoes, and do everything in my power to assure them that messiness is great, but your feelings are so so SO important!