Tuesday, February 9, 2010

The Value Of An AAMI Education

A lot of the talk amongst the staff and students at AAMI centers around the idea of knowing what you need to know so you can stay hands off and have the ability to recognize and act upon abnormal events in labor should you need to.
As a doula I have attended hundreds of births. As a student midwife, I am in the first year of my clinical work. I recently attended a birth as a doula that illustrated over a dozen points for me about listening to mothers a their own best experts, taking care that technology does not exacerbate or even create problems, and responding to the person in front of me as a unique individual.
The birth was devastating for mother and baby because although we transferred into the hospital for higher level care, they largely ignored everything she said and did not connect the dots between the clinical symptoms she presented with and developed over the many hours she was under their care. She is living proof that the hospital mantra "healthy mother, healthy baby" undermines everything that is necessary and true in birth—there is so much more than just the final outcome to consider. I came to see that the comfort level of the staff and OBs was couched in the many print-outs, read-outs, and electronic alarms they surround themselves with. They believe they can save anyone and have no concern for keeping mothers and babies out of the situation where they need to be saved in the first place.
This birth, although wretched in nearly every way, was a pivotal point event for me as a midwife. I learned a lot about myself. Although the birth is a how-to manual of avoiding over-use of technology and under-use of human creativity and mindfulness, the main message for me did not come until I was talking about the birth 24 hours later with dad. He said to me that towards the end I was freaking him out because I was "psychic" about everything.
Here is my AAMI message. I was not psychic. I am knowledgeable. I have learned. I can incorporate. I am not afraid to take the time to observe and listen to mother. I have skills that have been developed which have instructed me to track symptoms and connect them to create a picture. I am trained in normal by being drilled in abnormal. the hospital staff are trained to treat abnormal symptoms with medicines which make the symptom—mother or baby's strongest communication to the provider about their state of being disappear. I am trained to listen to and honor mom's voice about her own health and the health of her baby. The hospital staff is trained to manage labor, delivery, mother and baby in a way which overrides mother's voice and discourages professional creative thought process in favor of what they "do" in a given circumstance. I was not psychic. I was smart, aware, thoughtful and present. This is AAMI training. The births where everything goes as expected: I always think—my AAMI training—look how we do nothing to interfere! But this birth gave me more awareness and insight into the value of the bone grinding quality and volume of academic work at AAMI that dozens of other births could ever have done for me. My intuition and experience have a great partner in the breadth and depth of knowledge AAMI has given me. And I am not even done with the course work yet.
Jodilyn Owen