Nizhoni Institute of Midwifery: Keynote Speech, Graduation

12232895_10153898794774349_9130565740440579426_oNizhoni Institute of Midwifery:  Keynote Speech, Graduation
Nicole Morales,  San Diego, CA :    November 7, 2015.

Introduction:  I was asked to tell about my journey as a Nizhoni student.  But my journey as a Nizhoni graduate and alum, really started before Nizhoni and in some ways that time period framed my journey and made it possible long before me.

We could literally go back as far as the unspoken legacy of silence with the burning of witches because women were taught to be silent to survive, or to the indigenous and immigrant midwives who practiced and learned from the previous generations, or the Shepard Towner Act and its attempt to eradicate black Grand Midwives of the south in disguise of licensure and safety, while enforcing the removal of traditional practices for modern ones. I know even mentioning these time periods may seem irrelevant to you as a midwife, but the unspoken agreements about birth and a woman’s body have been unconsciously handed down from generation to generation and as birth workers they effect us. For upon whose shoulder do we stand, and upon yours, whom will you support?

Not long ago, I heard the stories of the beginnings of what is currently the mainstream home birth movement they say it was like droplets of water across the nation where women refused to go into the hospital to birth. This was a time when “evidence based” and “risk assessment” weren’t terms in use.  (oral story telling)

I believe it was Maggie Bennet who told the story about how what is now the culture of mainstream midwifery came about like water droplets across the nation which of course caused ripples to form as well.  This is of course my takeaway and not her words exactly.   Women just got sick of the abuse in the hospital and decided to stay home.  For many they had the baby and thought, well, that was way better than the hospital.  So then they told their friends and some too stayed home, and some didn’t.  Soon people realized that if they had help from a particular woman in the community that they’d be less likely to transfer due to fear.  So that woman started going to many births.  And as water droplets across the nation, they started networking, these women.   Some of these women may have gone to hundreds of births before calling themselves a midwife.  Some had worked with the Grand Midwives of the south, others with home birth doctors or Native midwives to this region, some had been in Guatamala or Mexico, the UK or other countries and they began to tell about how they could deal with complications.    Even the history of California Association of Midwives came out of this networking.  In fact they began to self-certify midwives who were able to demonstrate knowledge of how to take care of emergency situations. (MANA conference opening cermonies, Asilimar, 2009)  This is of course before the rise of  “evidence-based birth” and “risk assessment.”

Fast forward some years :  When I had my first baby it was a time period between licensure and legality.  I decided to have my baby at home and after a long labor, I did it. Afterwards, in awe, began to delve into midwifery.  It was in this time period where my initial agreements about midwifery grew – I watched my midwife go to prison, I knew families who had home births of twins and breeches  -These families,  so many were passionate, and home birth and nursing was beyond a political act.

When I accepted the call to be a midwife or realized I was becoming a midwife, I somehow thought I could just self- study myself into being a midwife. I eventually went to a midwifery conference in  Oaxaca, where I met another woman from San Diego who told me about a group of students in a school together.  This is when I discovered “Marlas’ basement.”  It was quite cold in that basement, but we had similar modules that you have had to help out with my need for interaction and learning.   This was Nizhoni before it became Nizhoni.  Becoming a midwife ended up being a journey in itself rather than the destination.  I was the first Nizhoni student to use the school as my route to take the NARM.  Darynee Blount had already taken the California Challenge and gotten licensed before officially graduating.

Each of us have a calling to do this work to stay with women in those tough places.   It has to be a calling for the hours we work and the positions we get into, and we obviously don’t do this work for the money!    One thing I want to impart is that the moment you have this calling whether it be 20 years ago or the day you applied for midwifery school, the applied learning of what you take to a birth starts then, on that day.  In that moment.  Not just the first day of school.    In just the same way,  the learning doesn’t stop the day you finish midwifery school or pass the NARM.  You will NEVER know it all.  And that is ok.  Humility is your friend alongside your confidence.  You may not know the answer now or in 20 years, but you know where to find it or know someone who does if there is even an answer to find.  You create a network of other midwives, birth workers, medical professionals or healers and they’ll have your back.  They’ll be there to answer your call as you will be for them.  I believe it was my first birth as a licensed midwife where I had sticky shoulders and a baby that didn’t transition well and I transferred an hour postpartum just to come back home sooner, for various reasons,  than I would have liked.  And I needed a network.  A network of midwives to call for opinions, a craniosacral therapist who came to my mother and baby in need, a lactation consultant to spend those extra hours with the mother.  It was a learning curve of knowing that mom could be supported and it didn’t have to be all me, alone.  Sometimes you realize you build these networks for particular mothers earlier than later.  Sometimes you don’t know until that moment right after the birth that you need them, but you reach out and they are there.

And alongside personal networks for support and other resources,  there are the midwives that have come before us as this is an ancient practice.  The midwives upon whose shoulders we stand.  The older or more experienced women hold us up.  There is much we don’t know about the tools and resources of midwives from years ago.  They may have been rooted in storytelling or body balancing or just the memory of mothers being with birth from the time they were born.  For the midwives of that time period, we can guess the importance of intuition, the understanding of when to do things or not – as much more was on the line without medical support being down the street.  There is knowledge that we are still tapping into of those before us.  Knowledge to be tapped into of those still around us.   And this knowledge can  come to us when we don’t have time to move our networks into motion.   There is no time to consult for a shoulder dystocia or a surprise breech birth with trapped arms or a hemorrhage.  Or maybe it is just the understanding of when we have to transfer or move be it a baby or a mom and that time is of the essence.  Some midwives talk about that moment when they look over their shoulder for their preceptor years after they’ve been on their own even though they know she is not there.   I remember the story of Naoli Vinaver Lopez at a conference I was at, again this is paraphrased and from my memory (oral story):

She was telling a story about how she had two different practices.  One practice was with the women in the mountains where she rarely brought an assistant with her as all was most usually quite smooth and went well.  But with the births in the city, she brought an assistant and she brought more equipment.  When she became a midwife, her biggest fear was that of a retained placenta.  And the day came several years into her practice, where a VBAC mother birthed her baby at home, but after the birth, the placenta didn’t come.  The mom began to bleed.  This was it.  The moment she had thought about for years.  Then, suddenly she could feel wings sprouting from her back made of the all of the midwives who had come before her, and they gave her words. The words like a lover in which she knew exactly what to say and do.  And she let the mother know that her hand was so much smaller than the baby and she reached up and followed the cord and found an acreta and she transported.  She knew exactly what she needed to do. 

(Naoli Vinaver Lopez, 2009, Midwifery Today, Eugene)  

So if you all learned anything from your first class with me, Medical Terminology, it probably wasn’t exactly medical terminology, but a story that I told called “Sealskin Soulskin.”  In fact, you may still have a seal hanging around your house.    I was thinking of telling it again tonight.  If you remember:  “Sealskin, Soulskin”  was about an old fisherman :

(oral story)

There was once a lonely fisherman who went out fishing and came back to a cold house, whereas others went to warm homes with families.  One night he was on a walk further from home than usual when he came upon some strange movement in a secluded area next to the Sea.  He carefully got closer and closer and realized there were a group of women, naked, dancing in the moonlight.  He watched them struck by their beauty.  As he crept closer, he stepped on something and looked down.  He had stepped on what looked like fur but felt like skin.  It was a seal pelt.  As he stood up he knocked over some rocks on a ledge and the women saw him.  They all scattered and grabbed their pelts and jumped back into the Sea.  All except for one.  She continued to look for hers, and then, finally, she noticed he was holding it.  She walked up to him and he said to her, as he was so taken by her pure beauty, “Please, please stay.  Stay and be my wife.”  Now the woman saw his loneliness and although she thought about running to the water, she was also curious.   “Please, stay and in 7 years you can return to the Sea and I will give you your pelt.”  She eventually agreed, and she became his wife.  

Over the next 7 years they built a life together.  She bore a son, Ooruk and he had grown into a child.  But the seal woman started to limp.   Her skin began to dry and crack.  Her eyesight became dim.  One night as Ooruk lay in bed to sleep, he could hear his parents arguing.  The fisherman said, “No, I will not give you your pelt.  You are just going to leave me and your son?  How could you?”  

The woman began to cry,  “ Look at me, I am dying.  My skin is drying.  My body is becoming weak.  Please, that was our agreement.”  The fisherman said, “I won’t give it to you as I threw it out into the Sea years ago.”  The Seal woman began to cry.  Ooruk heard her and felt bad for his mother although he didn’t want to see her leave.  That night in his sleep, Ooruk was awakened by something or someone calling his name.  “OOOORRRruk…..Ooooruk.”  He got out of bed and put on his coat.  He slipped out the door into the wind and snow as he continued to hear the voice call his name.  Down the hill on the shore sat an old seal.  The old seal had something on the ground in front of him.  Ooruk climbed down and saw what laid before this Grandfather Seal was a pelt.  And he knew as he picked it up and smelled it, it was his mother’s.  Without thinking, he turned around and ran through the storm and back to the house to find his mother had just opened the door looking for him.  He ran into her and she immediately saw what he was holding.  And without a word she grabbed both the pelt in one hand and the boy in the other and ran.  She ran quickly to the shoreline slipping on her pelt.  Her son was asking, “are you going to leave me?” 

 She stopped and breathed into her hands.  Then she held it to his mouth.  He too breathed in, and then she grabbed him and they dove down under the water where he could breathe.  Ooruk and his mother swam to her home where he met the Grandfather Seal and stayed in this underworld learning the ways of those who lived under the water.  He stayed there 7 days and nights.  But Ooruk and others knew that he couldn’t stay there with them.  He was of the upper world.   On the day he was to leave, his mother and Grandfather took him to the shore.  She told Ooruk, “Only touch the things that I have made.”  And with that she kissed him goodbye, and Ooruk returned to the village.  Today Ooruk is the storyteller, the drummer, the healer.  And they say if you happen to be out around sunset, you will many times see him in his canoe and he’ll seem to be talking to one particular female seal.  

And thus we had our story, our template, for Medical Terminology and your role as a medial woman, the woman who is able to cross from the soul world to the overculture and back again.  (Inuit version of story from Clarissa P. Estes Women Who Runs with the Wolves , and some from a version of Pam Englands but neither exactly)

I believe I discussed how medical terminology was important for you to be able to communicate with nurses and doctors for mutual respect.  That medical terminology could assist you in translating records for a mother who couldn’t decipher them.  In talking with colleagues one could gain specificity in the understanding of anatomy or health history using medical terminology.    But what I didn’t discuss that day about the story was the dialectical version of it.  If we were learning medical terminology as the language of the upper world, than what was the language of the birth space and birthing woman?  Where is our module for that?  I can hope in normal birth you learned about the sounds of the woman or the external movements or even things she might say or not say.  But what of that internal experience of both her and you?  What is that language, as it is quite an ancient one?   How can we as a midwifery community begin to develop and acknowledge that internal language that accesses intuition as a skill in and of itself?   That language that we may only be able to feel in our body or our heart or soul as we entrain with the birthing woman.  This vocabulary has been developing from the time you heard your calling and such learning will continue if you open yourself to it.  Yet, whether acknowledged or not, you already have those tools. With attention you may continue to recognize them and acknowledge them as valuable resources for the craft.   Part of crossing from one world to another and sitting under the water with the mother expands that skills subset of a deeper language.

And, as the seal woman, take great care of yourself.  Realize, if you have been out of the water too long without your pelt.  Realize if your skin is getting dry and cracking and your eyesight dim.  Take time for self-care so that you can hear or feel and be present with this language of birth.  The legacy of self-care tends to be quite spotty with midwifery.

I really do believe the work we do is radical or revolutionary be it at a busy birth center or home birth.  Radical as it can challenge entrenched silencing of women in this culture. Radical as it can be based on quality care and individualization on physical, emotional, mental and even spiritual levels. Radical as the statistics show that midwifery can be an answer for the rising infant mortality rate that disproportionately affects African and Native American families.  Radical as birth can change the paradigm of a long term relationship between the mother and her child with positive lifelong effects.  Midwifery can facilitate connection.   Connection can facilitate health.

And in some ways this shouldn’t be radical, it should be everyday and accepted as the norm.  Many say that in the mainstreaming of midwives in this culture, the radical nature of midwifery will eventually cease to exist. I don’t believe this as those moments of transformation that may be everyday miracles, those moments of empowerment or triumph are revolutionary whether they happen at 1.4% or 30% or 100% of the birthing population.   It is upon recognizing its radical nature of connection that the impact on lives stands out.

Some say that we may have to compromise some of the historical tenets of midwifery or shave off some of the experiences for modern practice and new laws.   Some worry that the new generation of midwives may be deskilled due to the medicalization and compartmentalization of attempts of and mainstreaming.  Some worry that we are losing the craft. I sometimes worry that we are losing our craft.  We can still gather information and even get to know parts that aren’t everyday.  I personally still strive to hold these parts sacred that can be shaved off to fit into what is limiting midwifery in California today.  Let us continue to gather skills.  We have women whose shoulders we stand upon who will come when we call.  We have the language we can truly  listen to from underneath the water, from that soul world , so we can truly listen to and feel and witness and draw from that inner knowing.  We have networks and resources and fellow students or peer midwives possibly working around the world or even in our own backyard with invaluable insights.  May we all continue to uphold this holistic craft of midwifery across the range and variations of protocols or experiences and know that those whose shoulders you stand upon are ready and needing you to take the baton, climb up,  and honor it.  It is your turn.  Hear their voice as soon it will be yours.