The Sharps Box

“Be aware of your surroundings and listen to any noises close by and far away.”

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“Without judgement”

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 “They are just there”

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“It's just life unfolding moment by moment and it’s all good”

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“It all just is what it is”

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 “It’s only when we judge it that it becomes something else”

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“It’s only when we judge it that we make it personal, that we make it ‘me’ or ‘mine’”

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“Can you come from a place of curiosity instead?”

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“If you can do that, life becomes a joy”

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The voice of Esther Eckhart from Eckhart Yoga in my living room this morning as I was lying in Savasana. Armpits sweaty, my breathing still regulating from the physical practice, I listened as the sounds painted the picture of the more mundane aspects of my life and it was beautiful. 

Radio 6 was playing in the kitchen. I remembered that the radio seems to switch itself on at around 9:30 and I don’t know why. There was the voice of the DJ and beneath it or on top of it, I couldn’t be sure, I started to notice the sound of passing cars. 

The washing machine was dealing with cleaning the sheets from yesterday’s massage clinic and I felt grateful for it. For a moment I wondered what life would be like if I had to make it to the river with my washboard and a bar of soap.

‘First I do the yoga, then I do the things’ (the slogan on my T-shirt) is a lot easier to implement when my washing machine and dishwasher are slogging away on my behalf. 

I was on my own in the house and apart from knowing that Gerald and Lena had both left for work, I also couldn’t feel their energy close by. Thinking of them I felt a wave of love flooding through and I smiled.

At that moment my life felt perfect despite the shift and life lesson I am currently navigating. Just a little less than an hour ago, over breakfast,  I was grappling with one of the big questions that come with being self-employed in the space that my business occupies and Gerald offered me an insight that revealed not only his steadfastness in standing by my side, always, but also his wisdom.

He’s a keeper.

He’s my valentine I thought lying there on my mat, breathing deeply and calmly and filling my entire rib cage, even the ‘armpit chest’, the area that can only be expanded with dedicated practice. Oops, there it was after all, the judgement! That sense of pride I felt momentarily at having figured out how to fill the armpit chest revealed why yoga is a journey. I worked at letting go of the attachment to ‘getting better’ at yoga and drifted back into meditation.

Back to the breath. 

“Don’t get too attached to any one thought, just let each of them float on” is a cue that I frequently give my own yoga students in Savasana. 

“I am breathing in” on each inhale.

“I am breathing out” on each exhale.

Those where my only two thoughts for the next few breaths until I could start listening again. Only the sounds this time, no judgement. The goal: just listen to what is and be.

I settled. My mind was still.

Listening to the noises that provided the soundscape to this particular moment in my life, I lay in full surrender to what is and it felt BIG.

I felt only ACCEPTANCE - for everything and everyone.

Namaste.

Now that I am sitting down to writing, I realise once more, that the R.O.A.D. To Birth method is absolutely a result of my lived experience and my R.O.A.D. acronym applies to my own life as much as it applies to birth and to my clients’ journeys. 

Just this morning I 

R - Recognised and Released a fear,

O - Overcame an obstacle (my own inner chatterbox), 

A - Accepted what I can’t control and 

D - Did the darn work (aka step on that yoga mat, get uncomfortable so that I can feel good the rest of the day).

And when I checked my messages on the phone, one of my clients had shared the news of the birth of her baby in our WhatsApp group.

‘...I binged Nicole’s ROAD programme in the weeks leading up to my due date and I’m SO glad I did...’

Doubts gone. My deepest gratitude to this mama, to Gerald and to Yoga!

Self-employment, particularly in the birth realm, is challenging. Once you take away the structure that is offered by regulators and institutions, the whole thing can feel like a bit of a freefall and you really do need grounding. Personally I am very lucky. I have Gerald and a group of solid people in my life, not least the beautiful soul who pointed me in the direction of Eckhart Yoga (thank you!), and I also have an established self-love and reflective practice through that yoga. 

Occasionally I doubt myself on my path, I get scared and then I get reminded of why I have given up the advantages of regulation and employment; The price of staying on board was too high for me personally.

Yesterday, on Valentine’s Day, was such an occasion. 

It all started with an old sharps box. I found it in my boot when I emptied the car to collect my German friends from the bus stop, luggage and all. It then lived on the third step of our staircase for three weeks until Gerald asked me what it was doing there.

In a strange way that sharps box now represented the entire 18 years of my midwifery career. When I think of these 18 years (three of them as a student midwife), my mind is usually drawn to the very best part of it all: 

My years on the Caseload Midwifery Team. 

I can hand on heart say that those were my happiest years as a midwife in the NHS - by far!

It was the time that I felt I was truly working for the women and their families and not for the institution. Although we were still upholding protocols and policies that are not designed to be aligned ‘with women’ and their innate physiology, I felt that our priority was to support the women in their choices albeit within the narrow understanding of ‘normal’ at the time (an understanding that has since narrowed further). 

It was as close as I’d ever get to being ‘with woman’ whilst also working in the National Health Service and I loved it. 

The rest of my time I spent on labour wards, midwife led units, postnatal wards, antenatal wards and in community midwifery. 

I figure the sharps box is from my last stint cruising around the community as a 'bank midwife' in January and February of last year. I didn’t enjoy it at all. So much had changed from the days when we still had time to support the bigger picture that every baby is born into. It seemed then that it was not just about ticking the right boxes but about listening to each individual. It wasn’t perfect but it was a lot better than what it is now.

In my very early days as a student midwife, we sometimes even accepted a cup of tea when it was offered. And it was during those occasions, that the bigger picture often  revealed itself. A quick flick through my old diary reminded me of a mother I visited with my mentor in 2006. This mum found out that she had a blood clot the same day that she found out she was pregnant. Her pregnancy had been one of so much anxiety and she needed to talk about it. We accepted the cup of tea and listened. Our mum and baby checks flowed naturally as she told us the things we would have asked her about herself and her two day old baby. Her own mother was visiting from the far away land that they were all from and she was understandably worried about her daughter, her baby. We learned that there was a family history of blood clots and that this new granny, who was having everything translated back and forth, had had a blood clot too during one of her pregnancies. We all admired the cute new baby, a girl. There was so much love in the room and also worry and while we couldn’t take that away, only reassure them that she was taking the right treatment and that her clot had dispersed, the fact that we took the time to sit over a cuppa and listen provided some relief, showed that we cared. They thanked us many times during the next few visits for taking the time.

I learned that day that every new mum, dad (or second mama), siblings, grandparents; they all can need containment during those early days with a new baby. Bringing a new baby into the family will inevitably bring up anxieties, ancestral heritage and realign the family into something entirely new. A new human has entered the world encircled by the immediate family and radiating their presence into the universe from there. 

As much as a midwife knows the skills to support pregnancy and birth within the medical paradigm, the midwife also bears witness to the constant universal shift that each new life represents and last year, doing community visits, rushing from one house to the next so that I could be back in time to do booking scans, a clinic or ‘liaison’ (taking a note of all the ‘new discharges’), all I felt was pressure. There was no time.

No wonder adding home births into this mix causes friction. 

If you are feeling ‘a vibe’ when you mention the idea of a home birth, mama, this is why!

When Gerald asked if he could dump the sharps box in the bin I decided it was time to sort it out. So I bought some pink, plain and chocolate doughnuts as a little Valentine’s Day treat for my former colleagues and I finally undertook to leave the sharps box back in the hospital.

I was a little worried about how I’d feel walking back through those doors, no longer a cog in the maternity machine. 

Would I feel like a stranger? 

I needn’t have worried, in many ways it was like coming home. Three of my favourite colleagues of many years were there, welcoming me (and the doughnuts) with open arms. There even was a moment for a quick catch-up. 

On the way out the enormity of what I have given up rolled over me. I had missed those women and I felt so much gratitude for having been a part of this community. I could remember poignant moments with each of them. After all we have witnessed the emergence of new life together. It’s hard to convey the bond you feel with colleagues you’ve been on night shift with ushering in new life or who you have fallen back on to break bad news to a family during a first scan appointment. 

On the way home I felt a sense of sadness. I felt sad because I had chosen to never be ‘a midwife’ among these beautiful women again.

Then I was stopped at a set of traffic lights and I saw this billboard:

Woahhh. There it was! 

I remembered my own birth experience and how I eventually consented to things I didn’t want because I was too tired to fight.

This billboard from the DoH is to promote a sexual and domestic abuse helpline and though the comparison is stark (and I feel very uncomfortable with it, still), the parallels are undeniable. Maternity workers deal in the the most personal sphere in a woman’s timeline; Birth is the ultimate culmination in the sexual act of procreation. It involves our most intimate body parts and coercion has no place in it. Seeing this billboard, I remembered one of Billy Harrigan’s posts on Instagram last week about how much trauma the industrial maternity complex produces. Her message has been that obstetric coercion is, at least in part, the reason why far too many women come out hurt to the point of avoiding future pregnancies. Having been at the receiving end of sexual coercion and obstetric coercion, I can see the parallels and I know that I am not alone in this. 

I don’t think that it is possible to avoid trauma altogether. I also don’t think that trauma is only ever caused by the people in your birth space, it can be the experience of birth itself that overwhelms you. When birth is taken out of the medical realm this does not seem to be the norm though, mostly women perceive it as powerful and they love to remember it. We need to pay heed to this and adjust our view of birth as innately traumatic and get back to supporting its unfolding as a life event rather than a medical event. The job of being a midwife or doctor in today’s maternity system is a hard slog. It is so important to reflect on your communication and to hold yourself accountable for not manipulating women into complying with guidelines ’to protect your registration’. I’ve been there myself and I can think of a few occasions where I would communicate differently given the chance.

Sadly, I do still hear about questionable strategies from maternity staff to enforce policies when women decline routine care. Looking at that billboard I remembered the accounts of three of my clients who recently told me stories of attempts to coerce them and of unkind and seemingly uncaring staff who appeared to take personal offence at the choices these mothers were making.

I remembered how out of integrity I felt when working in that environment and how even the most seemingly benign interventions started to feel wrong to me, even when I had the consent from the woman. Most importantly I sensed that upholding the woman over the institution caused a kind of tension that I was no longer willing to have in my life.

The midwife I have never met, who contacted me only days ago in response to one of my blogs and told me of her struggles popped into my head and I realised that nothing has changed since I left, certainly not for the better.

Protocols, guidelines, not enough staff, disillusionment for not being able to spend enough time and disillusionment with midwifery as an institution is a common theme at the coalface of regulated midwifery. My former colleagues are feeling it and I feel for them because the way out, though ultimately available to everyone, isn’t easy. 

I made my choice and as the traffic lights changed from red to green and I drove on from the billboard I breathed deeply and let go of another bit of my attachment to how my life used to be. 

Today, I feel anticipation and excitement to continue on my path of serving women and of showing them the ROAD to a positive, powerful birth.

Will you come on the ROAD with me? Send me an email to [email protected]