Posted by Katy
There is an old fable told in the Public Health world that has been on my mind this week:
The villagers of Downstream lived peacefully by the river until one day, many years ago, a single man was found floating in the river. Good people, the villagers jumped to their feet, dragged the body from the river and were able to save the man. After the first bodies, many turned up in the river and quickly the rescuing mission became the primary work of many of the villagers. The villagers grew better at rescuing the bodies, swifter and wiser, and the village was very proud of their work. Despite their prowess at life saving, the number of people drowning in the river continued to increase until the villagers were not able to keep up and the numbers of dead bodies began to pile up. The villagers worked harder, learned more, trained more rescuers, put more resources into rescuing, but higher still the bodies piled. Until, one day the granddaughter of a wise old woman finally took the time to listen to her grandmother and began to hike upstream. The other villagers shook their heads at her and told her that people were dying while she chose not to help. It pained her to do nothing as the bodies floated by, but she was faithful to the wise woman and continued her journey until she reached the village of Upstream.
Midwifery in America has long been hip-to-hip with Public Health. Mary Breckinridge founded the first American midwifery service, the Frontier Nursing Service, in 1925 in the mountains of Kentucky and began a steady fad of midwifery being employed as an important tool to improve the health of communities. In New York City, the Maternity Center Association, now Childbirth Connections, was developed as an organization to improve the health of the people living in poverty in New York City. MCA started the first Nurse Midwifery program in New York in 1931.
Reflecting back on the personal statement I wrote to get into the nurse-midwifery program, public health was at the core of my deciding to be a midwife. Aside from the multitude of more soulful pulls to midwifery, I recognized midwifery as an opportunity to affect health on a larger scale. Pregnancy heightens the awareness of many women to the importance of healthy living. Pregnancy offers an opportunity to help women begin to make good decisions for their families, to teach their kids how to make healthy decisions, and to let that penetrate into the societies in which they live. Midwifery is directly engaged in the empowerment of women that has been shown in the history of development to drastically improve the health of communities.
Yet, clinicals often feel a far cry from this ideal. This week my preceptor and I saw patient after patient-- depo, IUD, 28 week visit, 6 week postpartum-- even moving as quickly as I could, the number of patients in the waiting room started to pile up. The visits were brief. The bare minimum was covered. A girl came in pregnant at 15, regressing into childhood in the face of pregnancy, she began to suck her thumb. A 40 year old came in, pregnant again, after she stopped taking the pill when the side effects got unbearable.
As I struggle to embrace my clinical experiences, that sometimes feel so much like rescuing bodies, I rest with the image of those frontier midwives in my mind, the wind blowing through our hair as we ride, horseback, to a birth; sit beside my sisters in New York; and remember that the roots of this profession lie nestled beside public health and the two have grown together in ways that I will see if I keep my eyes and heart open.
I will close with a quote:
"Courage doesn't always roar. Sometimes it is the quiet voice at the end of the day saying, 'I will try again tomorrow.'" --AA Milne via Christopher Robin via Melissa, a beautiful fellow midwifery student who brings courage and passion to my life.