Baby Catcher: Chronicles of a Modern Midwife

\ Chapter One: You Have to Lie Down\ SEPTEMBER 1962\ DUKE UNIVERSITY, DURHAM, NORTH CAROLINA\ "Please lie down," I begged Zelda. "Please."\ Wearing nothing but a shiny coat of sweat, the young black woman stood upright on her hospital bed, stomping from the lumpy pillow to the foot rail and then back again. For the past fifteen minutes she'd been running laps on top of her bed, towering four feet above me as I raced along the floor with my arms outstretched in the futile hope that I might catch her if she fell.\ "It's against the rules to do that," I whined, aware of how prissy and juvenile I sounded, but I was just a student nurse, and I'd be in trouble if I couldn't control this crazy pregnant woman. I tried another line of reasoning. "You might hurt yourself, not to mention your baby." Yeah, that sounded better. But she wasn't buying it.\ Moaning, she sped to the head of the bed, tromped on the pillow with her callused feet, and grimaced as another labor pain began. Shaking her head from side to side, she banged on the wall with her thin hands. I watched the line of her vertebrae sway like beach grass in the wind while she dealt with the pain.\ "Lordy, lordy, sweet Jeeeesus, help me, Lord. Yes, Lord, stay with me and guiiiiide me. Mmm-hmm, yes, yes, sweet baaaaaby Jesus. Umm-hmmm..." As the contraction wound down, she murmured, "Thank you, thank you."\ She was twenty-two, in labor with her third child, and so skinny I could see the tendons in her arms and the sharp angles of bones in her face. Even with her belly sticking out in front, her hipbones jutting beneath the brown skin were easily visible. I saw the baby's knobby heels and elbows moving just below the surface of Zelda's taut abdomen. It was the only part of her that was big. It looked as though the child in her womb had drained all the nutrition out of her body and into its own, like sand in an hourglass moving from one chamber to another.\ Short of tackling her, I didn't think I could convince her to lie down, so I pulled up the safety rail but saw the low barrier would contribute nothing toward preventing a fall. I lowered it, shaking my head in confusion and wondering what Mrs. Purdue, my instructor, might say. But then I figured rules are rules, especially when you're a student nurse, so I hauled it up again. I saw Zelda's half-smile as she watched me from the head of the bed. Blushing, I could just imagine what she was thinking: up, down, up, down, what is this crazy white girl gonna do next?\ Then Zelda turned again and headed toward the foot of the bed, lurching and reeling above me, and I thought, Lord, she'll just trip over the bar and land on her head. So I lowered the rail and this time I left it down. Besides, it gave me better access to her. I thought maybe I could rebound her onto the bed like a basketball if she fell.\ Zelda mostly ignored me, and I knew I looked as ridiculous as I felt. Earlier that morning as I snapped up my denim-colored uniform, I had no hint I'd be assigned to an uncooperative woman who refused to follow the rules. A year on the medical and surgical floors where so many of the patients seemed to be suffering from rare or lethal diseases had left me wondering if perhaps I should transfer into elementary education. Maybe I wasn't cut out for nursing.\ But just the week before, I had discovered a passion for obstetrics. All it had taken was seeing my first delivery, and I knew I'd found a reason to stay in nursing school. Everything changed the day that little baby unfolded into the doctor's arm, threw his hands overhead, and screamed. It was more astonishing than any magician's stunt. Seeing a white dove fly free from a wizard's cupped hands paled in comparison to watching a glistening baby with pink fingernails and wet eyelashes appear from inside a woman's body. It wasn't magic. It was real. In that moment I knew I wanted to spend my life caring for women having babies.\ But now as I stared at Zelda, I thought, Maybe I should become a teacher after all.\ Hints about some Frenchman named Lamaze and a fad called Natural Childbirth bounced about in obstetrical circles, but doctors still believed the worst kinds of pain people experience are childbirth and kidney stones. Consequently, the few women whom I had seen give birth received narcotics during labor and breathed gas while pushing.\ But Zelda was different. Zelda refused pain medication. And Zelda was making my life miserable.\ "Just lemme outta this bed, girl. I need to walk these pains off, umm-hmm, you know what I'm talking about?" She slung one foot over the edge.\ I planted myself in front of her with my arms out. "Zelda, we can't have labor patients walking all around the department. Really, I can't let you out of the bed. Are you absolutely sure you don't want some pain medicine?"\ "Uh-uh, no needles for me. No, ma'am."\ "But it seems like it hurts a lot."\ "It wouldn't hurt so much if y'all would just lemme up. You had any kids?"\ Oooh, I wanted to lie. I wanted to say, 'Sure I've had kids, two of them, and I was a good patient who stayed in the hospital bed. I kept my skimpy hospital gown on the whole time, tied right up the back. And I was quiet,' but I didn't think she'd believe me. Although I'd just turned nineteen, I looked about fourteen. On top of the blue uniform I wore a pinafore, and the hospital laundry used so much starch that the skirt never moved, even when I bent my hips or knees. With my blond hair confined behind my neck, the effect was more Alice in Wonderland than mother-of-two.\ "No," I admitted, "I don't have any children. I'm not married yet."\ "Oh, well, shoot, honey, neither am I, but I've had me two babies. They was delivered by my granny down in Tennessee, and I can tell you, I'm going back to Granny Vida if I have another one. Mmm-hmm, I'm sure not comin' back to Mr. Duke's hospital. Mmm-mmm, no. Granny let me walk, see, yes, she let me walk and sing and dance my pains away. Ooooh, here come another one. Ohhhhh, Lordy, oh, sweet Jesus, umm-hmm, come to me and help me, mmm-hmm, yes, guide me and bring me up out of these troubled waters, up and into your arms. Ahhhhh, yeoooow, oh Baby Jeeeeeesus! Yes, yes, yes, yes...and I thank you."\ Wow, I thought, shaking my head, this woman sure read a different rulebook from all the other women I'd seen give birth. I'd just never even heard of anyone behaving like Zelda.\ I glanced for the umpteenth time at the doorway. Any minute Mrs. Purdue would swoop around the corner again. The instructors didn't leave us alone for more than half an hour in obstetrics, a service where conditions often change with dramatic suddenness.\ "Why you keep lookin' out that door, huh? Ain't nobody out there having a baby, is there?" She stood still and craned her neck to see past the bedside curtain.\ "No, it's just that my instructor'll be here soon...umm...and I don't think she's gonna, you know..."\ "What, girl? What you tryin' to say?" With one hand on her cocked hip, she peered at me with narrowed eyes. Staring straight ahead at her knobby knees, I knew that to her I was just a foolish white girl who'd never had a baby and wouldn't let her get up.\ "Zelda, I wish you'd lie down. I've never heard of anybody walking on the bed before."\ "Oh, I see. She gonna get mad at you for what I'm doin'. That it?"\ "Well..."\ "Tell you what. You ain't gonna let me outta this bed, right?" and I nodded so vigorously my cap slid toward my eyebrows and I had to pin it back in place. "I'm fine, honey, and trust me, I ain't gonna fall. So you just stand where you can see when she's acomin' and then you give me a sign, and I'll lay me down in this here bed quick as a face-slap upside the head. Ohlordlordlord, here comes another one and it's a biiiiiiig one. Oooooooh, yes, Jesus, Jesus, Jeeeeeeesus, oh Lord, raise me up unto the highest mountain where thy mercy shiiiiines the brightest. Yes, oh yes, my Saaaavior. Ummm-hmmm, oh my Lord. Lordy me...Whew, that'n' made me sweat some, girl, sure did."\ So that's what we did. When Mrs. Purdue's white uniform rustled toward us, Zelda slumped to the bed, and I yanked the sheet over her angular nakedness. She grabbed my fingers, and I stroked her forehead. When Mrs. Purdue bustled through the doorway with every teased poof of hair in place, Zelda and I presented a perfect picture of cooperation and competent nursing care. As soon as my instructor left, Zelda leapt to her feet and continued her pacing, pausing now and then to hum a churchy tune and drum her fingertips on the overhead light.\ Then Zelda winked at me, and as she flashed her smile full of crooked teeth I knew we were in it together, conspirators at a birth. An hour passed this way, and I smiled and nodded my head in rhythm to her Gospel chanting. And she was right. She didn't fall. I was the one who did the falling as I fell under her spell. It was as though I'd stumbled into a piney woods revival tent and been transported by the spirit of a new religion. She made the process look like so much fun, I almost wanted to dance with her.\ Then her dance changed. She turned her back to me and leaned her elbows against the dingy wall. In a slight crouch she stuck her bony bottom way out behind her and rotated it like a hula dancer. All the while she crooned to herself and beat on the wall with her fists. "Oh, Vida, Vida, Granny Vida. Help me, help me, oh, my Lord and Saaaaavior. I will lift up mine eyes unto the hills from...whence...cometh myyyyyyy help!!! Yeowy, ummm-hmmm, oh yes. Oh, my soul. Lord, now baby, don't you be takin' much longer, y'hear?"\ She glanced down and said, "Is it okay me making some noise, honey? Do they allow that around here in Mr. Duke's fancy hospital? I mean, havin' babies takes some talking, girl, you know?"\ I giggled and said, "Well, so far you're getting away with it, Zelda."\ "Thank you, sweetheart, thank you. I'll keep singin', but I'll try keepin' it soft, for your sake. Don't wanna get you in no trouble, no ma'am, 'cause you bein' real good to me. You gonna make a fine nurse, you know that?"\ About half an hour later her sounds changed again as she began to grunt and moan. A feral smell invaded the room. Puzzled, I watched while she squatted lower, pressing her hands on her thighs as sweat dripped from her chin and ran in glistening trickles down her back. She became very quiet, and now and then she gasped and held her breath. Bright shreds of bloody mucus dripped from her body, leaving scarlet smears on her legs and the sheet beneath her.\ Suddenly it occurred to me what she was doing. She was pushing her baby out, still standing on top of her bed.\ I grabbed her knees, trying to pull her down as I shrieked, "Zelda, you can't stay like that! Lie down! You have to lie down! What if the baby falls out?"\ She pushed at my hands, and her eyes locked onto mine. Between teeth clenched in a grimace, she said, "What if the baby falls out? What if...it...falls...out, is that what you said? Well, darlin' that's the whole point, ain't it?"\ I stared at her for a moment with my mouth hanging open as her words sank in.\ The whole point. Of course.\ But when she squatted lower and pushed harder, I jerked back to reality. "Oh, my God, I need to get the doctor," I muttered, turning away.\ Zelda's claw-like fingers stopped me. Radiating heat from the sweat and passion of birth, she pushed her face close to mine and rasped, "No. Nonononono, just leave it be. You can do it. Just you. You and me, girl."\ The blood left my face. My hands went numb as a cold stone of fear landed in my stomach. An instant one-way ticket right out of the university loomed before my eyes.\ But the next moment an army of nurses and doctors pushed past the curtain, propelling a stretcher ahead of them. Zelda's cries and grunts had been heard, and within half a minute they wrestled her onto the stretcher and whisked her toward the delivery room. She screamed and kicked and begged them to leave her alone, but there were too many of them. I followed behind, staring at her hand grabbing for me like a lifeline, a way out, a piece of floating debris on a stormy ocean.\ They rolled her from the gurney to the delivery table, tied her legs high in stirrups, strapped her hands at her sides with thick leather cuffs, and put a mask over her face. Zelda fought them at every turn. Like an octopus, she grew what seemed to be eight arms and legs and the nurses struggled to restrain her, throwing their full weight against her as she fought with the unholy strength of panic and despair.\ "She doesn't want drugs or gas," I whispered. "She just wants to do it her way."\ "What? Did you say something to me?" muttered the doctor with the gas mask, battling to keep it over Zelda's face while she slammed her head from side to side.\ "She doesn't want gas. She told me." I blushed beneath his stare. Student nurses didn't talk to doctors. Not ever.\ "Oh, Christ. She's a crazy woman, totally out of control. She's gotta have the gas or she'll do herself harm, and her baby, too. Wacko, goddam bitch."\ Zelda somehow wiggled one hand from the leather restraint. She tore the mask from her face, and it separated from the plastic tubing. Finding the hated mask free in her hand, Zelda threw it across the room where it crashed into the metal door of the sterile supply cabinet. Then she spit at the doctor and reached across to undo the strap that held her other hand down. Two nurses rushed forward, and I watched them yank both cuffs to their tightest link around her thin wrists.\ "Jesus Christ, why do we let these women breed?" growled the doctor standing between her legs. A quarter-sized patch of baby's hair shone in the glare of the overhead spotlight. Another push or two would do it.\ Zelda rolled her head toward me and looked into my soul.\ Tears clouded my eyes, and I bit my trembling lips. She mouthed the words, help me, as the anesthesiologist pulled another mask from the cabinet. Zelda took a huge gulp of air just before the mask descended. I saw the doctor crank the mixture higher, hoping to put her under before she attacked him again. But Zelda wasn't breathing.\ Slowly, slowly, the baby's head slipped free of her body, and then the rest of the little boy flip-flopped head over heels into the doctor's lap. I smiled down at Zelda. Her eyes bulged above the mask. She looked like she was about to explode.\ She knew the baby was out. So did the doctor. Why didn't he take the mask off her face? "It's born," I said to him, stating the obvious. "The baby's out."\ "I know, I know," and he pushed the dial even higher.\ Zelda realized he was determined to knock her out, no matter what, and she went wild again, tossing her head and making strangled sounds from beneath the cushioned mask. She kicked and bucked with every ounce of her strength but succeeded only in rattling the delivery table till I feared the bolts would shake loose.\ She couldn't keep it up forever, but her face turned deep purple before she finally sucked in a tremendous mouthful of the gas. Her fists and spine relaxed, and her head rolled to the side as she slumped into unconsciousness. When the doctor lifted the mask, dribbles of spit hung out the side of her slack mouth before dripping to the pillow.\ "Jeezis, I'm glad this one's over," growled the doctor.\ Invisible in my student uniform, I stood beside her as they untied her arms and legs and moved her onto the gurney. A tall nurse carried the bundled baby out the door, and I thought, Zelda doesn't even know it's a boy. I slipped my fingers into her loosely curled hand and held it as I watched another nurse jam a white sanitary pad between her dark and bloody thighs. When they stretched her legs out flat, her belly wrinkled like a deflated brown balloon and slumped between her angular hipbones.\ I stared at her a moment, and then I grabbed a sheet from the linen shelf and covered her nakedness, wanting to do more.\ So much more.\ Copyright © 2002 by Peggy Vincent

Part IAs it was in the beginning15You Have to Lie Down17Babies, Babies, Babies24Mrs. Purdue31The Hippie Effect39Part IIThe meditation of my heart47Painless Childbirth?49To Be or Not to Be55Only If You Can Be There60Fog67Adidas to Birkenstocks74Part IIIThe wine of astonishment81Rubber Ducky83Good News and Bad News87We Couldn't Have Done It Without Him94Huh?100Hallie's Reputation105Only What's Necessary111The Perineal Cry116Part IVNot only with our lips but in our lives123Spirit Baby I125Practice What You Preach128My Little Helper140Spirit Baby II148When Mom Is a Midwife152Part VWho walketh upon the wings of the wind159One More Soul161Pragmatism in Action166Sneak Attack174Uh-oh179A Friend185What Flowers Are These?191Labor's Not So Bad199Goose Abuse204Wall Art210It's Just So Interesting215Okay, Okay, Okay220Is My Mommy Happy?227Part VIDevices and desires231Wrongful Life233Cut Me!249You'd Better Sit Down258Part VIIThe measure of my days261Guardian Angel263Allah's Blessing270End of the Drought276You Can't Be Serious284I Just Forgot289Soccer Mom294Hello from Rosie301A Bitter Pill304Happy Birthday307Shift Work311Passing the Torch315Epilogue323The Current Situation325AppendicesIPearls of Wisdom327IIHome Birth Supplies328IIIStudies on Midwifery Safety330IVStatistics on the Economics of Midwifery332VResources333VISandi's Famous Caramels335

\ From Barnes & NobleA midwife recounts some of the thousands of births she has witnessed and assisted in this series of sometimes harrowing, often exhilarating, and always powerful vignettes. Vincent's writing, as well as her continued sense of awe, pulls readers right into the story, allowing them to experience the miracle of childbirth along with her. In addition to her tales from the front lines of the midwifery movement, Vincent's journey through the medical profession -- first as a delivery room nurse, then as a midwife -- provides a unique perspective on the course of women's liberation over the past several decades. Baby Catcher recalls a time when educated women could only aspire to become nurses, secretaries, or teachers; when welfare mothers were routinely given tubal ligations while still in a postdelivery haze; when fathers were not allowed in the delivery room and mothers were so heavily sedated they could barely be considered as being present for the births of their children. In doing so, the book poignantly captures the central idea of the alternative birthing movement: that women should reclaim the messy, painful, but altogether wondrous experience of giving birth.\ \ \ \ \ From the Publisher\ Anne Lamott author of Operating Instructions Baby Catcher is a celebration of life, a book of beautiful and passionate stories of birth -- and the mothers, fathers, families, and friends who assisted -- told by a midwife devoted to more tender and natural childbirth. This is an inspiring, important book.\ Chris Bohjalian author of Midwives and The Buffalo Soldier Peggy Vincent understands both the miracle and the mystery of birth, and she writes with an enthusiasm that is as inspirational as it is infectious.\ Cathy Luchetti author of Medicine Women and Children of the West Baby Catcher is a startling dive into virtual birth reality. When a "perineal cry" rings out, we nearly drop the book. When contractions knot up, we hold our breath. Page after page, we revel in astonishing new twists to an age-old plot, as Peggy Vincent delivers well-formed stories -- and children -- into the waiting world.\ Marsden Wagner, M.D., M.S.P.H. former director of Women's and Children's Health, World Health Organization Author Peggy Vincent paints vivid pictures of what childbirth can be when allowed to be the way it was meant to be, rather than the way physicians say it should be. Scientific data shows that a midwife-attended low-risk birth is as safe -- or safer -- than a physician-attended low-risk birth. Every woman should grow up knowing that someday she can have her own midwife, and every family should prepare for birth by reading this inspirational book.\ Ina May Gaskin, C.P.M. author of Spiritual Midwifery Peggy Vincent's memoir of her career as a nurse-midwife during the last decades of the twentieth century covers everything from her days as an independent home birth practitioner to a shift worker in a high-volume "birth assembly line" of a huge HMO hospital. It's entertaining, funny, informative, and quite moving.\ Adair Lara author of Hold Me Close, Let Me Go By turns hilarious, inspiring, celebratory, and frightening, Baby Catcher is a deeply human book -- warm, wise, and witty. I couldn't put this engaging page-turner down till I'd finished it.\ \ \ \ Publishers WeeklyIt was in nursing school at Duke in the 1960s that Vincent found her calling: delivering or "catching" babies. She moved to California and became a midwife, specializing in home births; over the course of 40 years, she brought some 2,000 babies into the world. There's a predictable plot structure to most of the stories she recounts: the initial meetings with the pregnant woman, the last-minute phone call once labor speeds up, the coping with contractions, the appearance of the baby's head, the wet newborn, the oven-warmed blankets, the celebratory meal afterwards. Despite the repetition, Vincent's account is a page-turner. It's not just the risk that something might go wrong (meaning a nail-biting trip to the hospital for an emergency cesarean), and not just the quirkiness of home birth settings (which can involve jealously raging house pets or leaky houseboats), but something inherent in the magic of birth itself. What sustains Vincent and her readers is this sense of standing ringside at the greatest miracle on earth. A solid writer, Vincent doesn't preach the virtues of unmedicated birthing; she just lays consistent stories of women doing it Christian Science moms, Muslim moms, spiritualist moms, lesbian moms, teen moms and just plain ordinary moms. With the midwife's axiom "birth is normal till proven otherwise" as a guiding principle, all these women have a chance to make childbirth a crowning moment in their own lives. Male readers may find this female-centered narrative off-putting, and mainstream readers might raise eyebrows at the inclusion of children in the birthing process, but Vincent addresses these issues fairly directly herself. Agent, Felicia Eth. (Apr.) Forecast: With appendices guiding readers to more technical resources, Vincent's latest baby is bound to be popular with women's health and alternative medicine readers. A cover blurb by Anne Lamott could break it out further. Copyright 2001 Cahners Business Information.\ \ \ \ \ Library JournalAn independent midwife specializing in home births, Vincent shares her insights into the profound complexities of both childbirth and the behemoth U.S. birth industry. Her vantage is that of a veteran maternity nurse and midwife who, from the 1960s through the early 1990s, practiced in almost every kind of birth setting, from homes to assembly-line hospitals. The reader witnesses the physical and emotional processes of birth through the care-provider's eyes as well as the heroic actions of mothers, midwives, and doctors as they save the lives of babies or confront the status quo in the healthcare system. The three decades of Vincent's practice saw momentous changes in maternity care, which has resulted in a more humane approach to childbirth in our culture. These stories offer a ground-level view of this evolution and also show areas (particularly liability and insurance) where further progress is badly needed. Including a bibliography of scientific studies on the safety of midwife-attended birth, this inspirational and highly informative book is recommended for all public libraries and specialized collections on women's or healthcare issues. Noemie Maxwell Vassilakis, Seattle Midwifery Sch. Copyright 2001 Cahners Business Information.\ \ \ \ \ School Library JournalAdult/High School-Vincent tells the story of her career from student nurse to delivery-nurse director of an alternative birth center to licensed midwife. Having delivered more than 3000 babies, she has riveting tales to tell about at-home births of women who celebrate their labors with midwife, family, and friends. She delivered a baby in the middle of a raging storm on a leaky sailboat, and tried not to deliver infants as she careened in ambulances and cars in last-minute runs to the hospital. As Vincent's career unfolded, she witnessed the attitudes of the medical establishment that seemed to fight every inch of progress women made in controlling their obstetric care. Readers will be rooting for each woman in childbirth and for Vincent's fight to legitimize midwifery. Future doctors, nurses, and health-care professionals, as well as future mothers and fathers, will want to read this warm and informative look at being a "baby catcher."- Jane S. Drabkin, Chinn Park Regional Library, Woodbridge, VA Copyright 2002 Cahners Business Information.\ \ \ \ \ Kirkus ReviewsA joyous account, packed with warm and wonderful stories, though tinged at the end with sorrow. Vincent was only a student nurse when she found her life's passion: obstetrics. When she began working in labor and delivery in 1970 at a Berkeley hospital, a revolution in women's health care was beginning. By 1977, her hospital had opened a birth center catering to women's wishes for a more natural and supportive environment in which to have their babies, and she became its nursing coordinator. After more than a decade as an obstetrical nurse, she went to midwifery school and opened a home-birthing practice as a certified nurse midwife. Most of the stories here recount her hilarious, unpredictable, sometimes hair-raising adventures delivering babies in women's homes, often surrounded by curious children, excited husbands, intrusive friends and relatives, and unhelpful pets. For one patient, giving birth is "like laying an egg"; for another, it's hours of hard labor; for all, it's an unforgettable experience. Ever resourceful and reassuring, Vincent thrives in the happy chaos and communal nature of home births. When her own third child is born at home, the crowd of friends and family includes her preadolescent son and daughter, who clamp and cut the cord. Vincent is an articulate advocate of a non-medical approach to birth, arguing persuasively against the notion that "all births are complicated until proven otherwise." Her own career parallels that of the independent nurse midwife movement in this country, its growth fostered by the rise of feminism, its decline brought on by financial pressures. In 1992, the only insurer of certified nurse midwives attending home births withdrew itscoverage, forcing them out of business. In a poignant epilogue, Vincent gives her books and supplies to a young Muslim woman about to become a midwife in Syria. An inspiring and hard-to-put-down celebration of natural childbirth.\ \