The Midwife

The Midwife

The midwife, Jessica Mairs, has  the quick wit and clever demeanor I have always found helpful in midwives of whom I have known exactly one.

Jessica Mairs

We met at a New Age hangout called Summer Thymes near downtown Grass Valley. Oh heck, since I’m giving a plug, I might as well go all the way; Summer Thymes is adjacent to the bowling alley, and everybody knows where that is. There’s only one. Bowling alley. Hey, folks, it’s Grass Valley. CALIFORNIA.

Okay, after a pleasant bit of chit chat and bowls of delicious chicken soup in a broth of coconut curry, which we had ordered from the counter at Summer Thymes. Near the bowling alley. We got down to it.

I proposed this problem to Jessica:

You survive civilization-ending cataclysm and find yourself as the only midwife in a farming village of two hundred people. You have no electricity. You have no contact with the outside world, if there is an outside world, and you doubt it. You have no pharmaceuticals beyond that which the village grows for itself or makes for itself. You have the hand instruments a professional midwife would have in her kit, and you have years of training and the experience of one hundred and eighty real home births.

Perhaps more important, you have around you a team of seven, including a talented registered nurse who also brings a master’s degree in Acupuncture, a homeopathic healer with broad skills in Ayurvedic, Holistic, and First Nation Native medicine, a veteran Herbalist, and three interns (midwifery, herbal medicine, and dentistry).
Your kit includes basic surgical implements (scalpels, clamps, and sutures, etc), instruments designed for delivering babies (fetoscope, Pinard horn, and forceps, etc.). You also have access to the registered nurse’s instruments and skills (blood pressure cuff, stethoscope, syringes, etc.) Because there is no refrigeration, limited sterilization, and no way to match blood, you are not able to employ IVs or transfusions. No X-rays, no ultrasound, no antibiotics, no C-sections. No transfers to the hospital. You are it, the end of the line, all there is. The one-and-only midwife. You.

It’s bare bones midwifery, but you have that crackerjack team around you, and you are, yourself, brilliant.

You will need to be.

From the beginning, Janabai Shepherd does not want the baby, but, supported by her mother and friends, she decides to carry it, the parasite, to term, and then give it away to the first person who will take it. You have a different opinion about the best course of action, but you are wise enough to keep it to yourself. Janabai, slight of build and narrow in the saddle, has every conceivable difficulty during her pregnancy.

Trace the sequence of her “difficulties” and describe what you do to respond.

In her final trimester, you confine Janabai to bed, and prepare for a train wreck delivery, during which there is a very real risk that the mother, or baby, or both might die. The predicted delivery day approaches, and passes.

Describe what you do to try to induce labor.

Labor begins, and it is, as you feared, a nightmare.

Describe a sequence of events during which everything that can go wrong, does go wrong, for both mother and baby.

Describe the terror you feel as you realize you are losing the battle.

Describe the extreme measures you take to save at least one of the lives in your hands.

Then, at the end, when you have resuscitated the infant, and quelled the mother’s uterine hemorrhage, and saved her life as well, describe what you do now to keep Janabai alive, bring her back to health, and care for the baby girl while her mother is recovering.

Describe how you feel when the baby takes her first breath and squalls.

Describe how you feel when you have stopped the hemorrhage with your bare hands, and you have hope, at last, that the mother might make it.

My gratitude to Jessica Mairs for being so generous with her time and for being  so quick to “get it.”  Here’s the link to her practice, Sierra Homebirth.

Okay.  Sure.  Here’s the link to Summer Thymes.  In Grass Valley. CALIFORNIA.