I was trained as a doula, and although I don’t practice as
one anymore, I love the meaning of the word: a woman who serves. That’s what I
see my role as a midwife’s assistant as, more than anything.
I assist two midwives currently. As an assistant, I am CPR
certified and am seeking to become NRP certified. I generally attend only
births and not prenatal or postpartum visits. Occasionally I will attend a
prenatal or two so the parents can meet me before the birth. I am paid by the
midwives I assist to be an extra set of hands, which usually means taking fetal
heart tones, charting, giving her instruments as needed, cleaning up, etc.
Sometimes I will check on a client in early labor for the midwife, so she doesn’t
have to make the drive.
Labors can be long, and it’s important the midwife has a
support person there for her, so that she is at her best when “the big moment”
arrives. That means she can rest while I check fetal heart tones and chart
through the early and active phases of labor.
When I arrive at a birth, the first thing I do is check the
fetal heart tones. I observe the mother
for a contraction or two before and after I check, that way I can report to the
midwife how labor is progressing, and whether or not she needs to rush to the
birth site. After charting my arrival and the baby’s heart tones, I begin
setting up the birth kit. This means making sure that all the items the midwife
has requested the clients provide are available and in one place, as well as
preparing the birth tray as much as possible without the midwife’s tools. Once
all that is done, I sit down and relax with my knitting and/or a book. Normally
mothers want to be left alone, which is part of why they chose to have a
homebirth. I understand and respect that, as a mother and birth professional.
After the midwife arrives, I will bring her bags in and
finish setting up the birth tray, with her tools, medicines, etc. She normally
will go and check on the mother, which I observe and chart for her. After that
we settle in together with our books, phones, etc. Sometimes we’ll visit, but
normally we’re quiet and just sit. Every hour or so in early labor I will get
up and check on the mother, check fetal heart tones, quietly watch a few
contractions, and chart everything. One thing I really appreciated on my labor
charts, as a mother, was the positional changes related to time. You really
lose track of time while laboring, and it’s nice to have that record.
After many hours the
rhythm of labor begins to change, and we
begin to check in on the mother a little more often to observe and get fetal
heart tones. If the baby is posterior, many times the mother begins to get
discouraged at her lack of progress. At this point the midwife or I will
provide ideas, normally positional changes to try, or asking if they have eaten
or drank, and urinated. Sometimes the mother begins to have a hard time “staying
on top of” contractions. I like to encourage them at this point, to let them
know that I know they can do it. Again, this is done when I come in to get
fetal heart tones, and observe a contraction or two. Unless the mother requests
we stay nearby, the midwife and I tend to stay out of the way, unless we have
specific duties to attend to. I really hate bothering mothers in labor and feel
like quite the bother coming in to get heart tones. It is a vital part of
attending a birth though, so I try to do it as unobtrusively as possible. It’s a special time in a couple’s life, and we
don’t want to interfere with their laboring relationship.
When it’s finally time for the baby to be born, I sit beside
the midwife ready to grab whatever she needs. I make sure the blankets and
towels are in my lap, ready for her when needed. I provide gauze, oil for
perineal massage, compresses, and anything else she asks for, including tools
and meds when needed.
After the baby is born, I begin the clean-up phase while the
mother and baby begin to bond. I will make sure any blood is cleaned up, all
laundry is ready to go in the wash, and the trash is collected. I load up the
midwife’s car with the equipment that she’s done with and then sit and read
until we are ready to do the newborn exam and postpartum exam. I chart both of
those exams for the midwife, and once she has gone over the warning signs to
watch for, we are ready to leave.
All in all, the biggest time commitment of being a midwife’s
assistant is sitting and waiting!
