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	pregnancy & birth midwives & doulas

The Spiritual Midwife
By Ina May Gaskin
Issue 8 - 1978

The following discussion on spiritual energy is based on observations made at more then 750 birthings. We have found that there are laws of physics electricity or astronomy, whose influence on the progress of the birthing cannot be ignored.

The midwife of doctor attending births must be flexible enough to discover the way these laws work and learn how to work within them. pregnant and birthing mothers are elemental forces, in the same sense that gravity, thunderstorms , earthquakes, and hurricanes are elemental forces. In order to understand the laws of their energy flow, you have to love and respect them for their magnificence at the same time that you study them with the accuracy of a true scientist.

A midwife or obstetrician needs to understand about how the energy of childbirth flows-to not know is to be like a physicist who doesn't understand about gravity.

Every birth is Holy. I think that a midwife must be religious, because the energy she is dealing with is Holy. She needs to know that other people's energy is sacred.

Spiritual midwifery recognize that each and every birth is the birth of the christ child. The midwife's job is to do her best to bring both the mother and child through their passage alive and well and to see that the sacrament of birth is kept Holy. The vow of the midwife has to be that she will put out one hundred percent of her energy to the mother and the child that she is delivering until she is certain that they have safely made the passage. This means that she must put the welfare of the mother and child first, before that of herself and her own family, if she has to make a choice of that kind.

A spiritual midwife has an obligation to put out the same love to all children in her care regardless of size, shape, color, or parentage. We are all One.

The kid in front of you is just the same as your kid. We are all One.

By religious, I mean that compassion must be a way of life for her. Her religion has to come forth in her practice, in the way she makes her day-to-day, her moment-to-moment decisions. It cannot be just theory. Truly caring for people cannot be a part-time job.

During a birth there may be fantastic physical changes that you can't call anything but miraculous. This daily acquaintance with miracles - not in the sense that it would be devalued by its commonness, but that its sacredness be recognize - this familiarity with miracles has to be part of the tools of the midwife's trade. Great changes can be brought about with the passing of a few words between people or by the midwife's touching the women or baby in such a way that great physical change happen.

For this touch to carry the power that it must, the midwife must keep herself in a state of grace. She has to take spiritual vows just the same as a yogi or a monk or a nun takes inner vows that deal with how they carry out every aspect of there life. So must a midwife do this if she is to have touch that has any potency. A person who lives by a code that is congruent with life in compassion and truth actually keys in and agrees with the millions-of-years-old biological process of childbirth.

If the midwife finds habits in herself where she does not always behave as if we are all One, she must change these habits and replace them with better ones. A midwife must constantly put out effort to say compassionate, open and clear in her vision, for love and compassion and spiritual vision are the most important tools of her trade. She must know that she needs to. This is the spiritual discipline that she must maintain in order to be fit for her work, just as an Olympic athlete must keep his physical and mental discipline to say in top condition.

To one who understands the true body of shakti, or the female principle, it is obvious that she is very well-designed by God to be self-regulating.We are the perfect flower of eons of experiment-every single person alive has a perfectly unbroken line of ancestors who were able to have bebies naturally, back for several millions of years. We are the hand-select best at it. The spiritual midwife, therefor, is never without the real tools of her trade. She uses the millenia-old, God-given insight and intuition as her tools - in addition to, but often in place of, the hospital's technology, grugs and equipment.

One of the midwife's most valuable tools is the same intimate knowledge of the subtle physiology of the human body that is the province of yoga. The spiritual midwife brings about states of consciousness in ladies that allow physical energy transformations of great power, great beauty and great utility.

Although it is quite possible for a single lady who has never had a child to be a good midwife, it greatly. enhance a midwife's credibility if she is married and has a child naturally. Her job, by its nature, requires that she be a good marriage counselor.

At birthings she must be able to guide a couple. She encourages and supports what feels good, and must be aware when a couple needs to talk something out. She must be able to teach a couple ti give each other energy, if they need help. To do all this, she has to really know and love her husband, be his best friend and know how to give him some. If she has a solid, honest and loving relationship with her husband, she knows from her own experience what makes a good marriage, and her words will ring true. If she has had a child naturally, then she tends to have a better idea of what she's asking when she tells a laboring lady, "I know that you can do this. I've felt like you are feeling now."

A midwife must be in avid student of physiology and medicine. She should read and study constantly in a never-ending quest for new information. She should never assume that she knows every thing there is to know. A new pice of information she learned yesterday may be essential and life-saving tomorrow.

A midwife must have a deep love for other ladies. She knows that all ladies, including herself, are sometimes as elemental as the weather and the tides, and that they need each other's help and understanding. The true sisterhood of all ladies is not an abstract idea to her.

The spiritual midwife tries to find a way that she can practice without charging money, as this makes it easier to keep birthings spiritual her husband and/or her community may assume her support. If she is helping ladies for free, she has a better moral position if she needs to talk to a lady about her attitude.

In Zen Buddhism, they talk about your "original face." The Zen Master might say to a student: "Show me your original face." A midwife is an especially privileged person because she gets to see the original face of each child she helps to birth. The beauty and purity of the energy field that radiates from each child treated with proper respect is awesome and unforgettable.

Giving Prenatal Care
A program of good prenatal care is essential for the physical and spiritual welfare of the mother and baby. The father of the baby must also be included in this program so that he is well aware of the physiological and emotional changes his wife will be going through and how he can best support her during this special time. In some cultural situations, it is necessary for the midwife to prepare the entire family of the pregnant mother for the birth. The midwife needs to see the pregnant couple on a regular basis in order to get to know them well. She must make sure that all of her couples are well-prepared for labor, giving birth and accepting responsibility for a new life. If she is caring for several pregnant couples, it's a good idea for her to assemble and have educational discussions with them all together. This way they share with each other the benefits of their common experience—be community for each other.

Prenatal checkups should be given monthly starting from the probable diagnosis of pregnancy up to the last two months. During the eighth month, the checkups should be done biweekly. By the last month the midwife should have screened out any ladies who would not be good candidates for homebirthing and turn them over to the care of someone else with better facilities for their care. The criteria for a judging whether a home birth is safe or not is discussed later.

You need to have access to a good lab because there are certain tests it's a good idea to do in order to ensure the safe care of the mother and baby. These will be discussed later in the chapter.

Basic Equipment for Prenatal Care

1. fetoscope
2. blood pressure cuff
3. stethoscope
4. watch with a second hand
5. good set of scales for baby
6. scales for mother
7. strips for testing protein or glucose in urine
8. tape measure
9. regular and sterile examination gloves
10. betadine or some suitable antiseptic soap

The First Checkup
Get to know the mother (both parents if both are present) as well as you can. You are going to be very deeply involved with them, so a strong bond of trust and friendship is necessary. You have the responsibility of two lives in your hands. Notice how the parents feel about the coming baby and with each other. Help them walk with each other if you see that they need to. The first visit should include history-taking; a general physical examination as described below; and a pelvic examination to ascertain pregnancy and to determine pelvic measurements. You don't have to be rigid about the order in which you do any of these procedures. Sometimes a thorough stomach rub and a pelvic exam is the best way to begin. Sometimes it's best to get all your history taken first before you do a physical exam. You might even choose to postpone doing a pelvic exam for a week or two after your first meeting with a lady, so that you have a chance to win her trust first - particularly if she is a young, single lady.

it is important to keep thorough and accurate records of medical history and physical examination of each person in your care. These records are important both for your own reference and for intelligent communication with any doctor our midwife you might need to consult about any of your ladies.

History Taking
The Present Pregnancy
Find out the date of the first day of the last normal menstrual period. The probable date of delivery will be nine months and seven days after the first day of the last period. Find out about menstrual history up to the last period. If the mother has long cycles, a history of missed periods, or an irregular cycle, your calculations of her due date may not be very accurate. Some ladies experience a slight amount of bleeding after they become pregnant. This can be confused with the last normal period and throw your calculations off, so it is good to find out her history in as much detail as you can. Find out if there is morning sickness or not, and if so, how serious it is.

Record important illness, all medications, blood transfusions, allergies and drug sensitivities. Find out what contraceptive methods the mother has previously used and if fertility studies have been done.

Record past surgical history, include all operations and serious injuries, give dates. Note especially surgery or injury to pelvis, spine and abdomen.