The journey or the destination?

A couple days before I finished up my last job I had to request some paperwork from a nurse in our maternity unit. She is a nurse that I worked with in my days up there and one whose passion in caring for laboring and postpartum moms and their families is evident to anyone who sees her at work. While she was in my office delivering the requested paperwork one of my colleagues (a nurse who had five homebirths, a decision she made after her experience as a nursing student during the scopalamine & forceps era) asked this woman about the unit and in so asking mentioned our high c-section rate and whether this nurse thought we’d ever be able to lower the rate. Oh no, was the response, that will never happen here. She then went on to say that she could understand the driving factors having been involved in a suit herself… that she would now prefer a “healthy baby” rather than take a “risk” with anything that has the potential to be abnormal (quotes mine). She told us how she tells expectant families that, “It’s not about the journey, it’s about having a healthy baby at the end.” I could have cried.

Of course the healthy baby/mother/family is the ultimate goal. I don’t deny that. But to discount the value of the journey to becoming a family?!?! That statement broke my heart. The journey is key to the experience, in my opinion. This isn’t to say that a mother who has had to endure a c-section should feel as though she has failed. Of course we should buoy those mothers up and assure them that while they may not have had a “normal” birth that their body still did an incredible thing to bring that child into the world. C-sections have allowed us to have happy outcomes from situations which would have otherwise been less than positive and no mother should feel like a failure if her child needed to be born through surgery. I think of another coworker who had two children vaginally and had to have a c-section for her third after failed attempts to stall premature labor at 32 weeks with a plummeting fetal heart rate… I can assure you that she worked just as hard to give birth to a healthy baby as a woman experiencing normal labor at 40 weeks no matter the route of entry into the world!

But… having experienced being a nurse at the bedside of women laboring naturally (I use the term “naturally” rather loosely seeing as I rarely witnessed a birth that did not involve pitocin or epidural, so let’s consider “natural” to mean “vaginal”) I cannot underscore the value of the process of labor. To have a mother look over at me and say, “I’m doing it, I’m pushing this baby out!” is amazing. The empowerment she feels and the awe at her body’s abilities is amazing. I have seen fathers of babies, mothers of mothers say, “I can’t believe she just did that, I am so proud of her.” I have seen the joy and awe in the families’ eyes when they first see a baby crowning. It was awesome for me as a nurse, someone involved in the family’s life for just a few days. I can only imagine (not having given birth myself) what it must feel like for the family itself. So to say that the journey doesn’t matter? Well, yes and no. Let’s just say that while the destination is the important part, we must not become cavalier about the journey.

I think about a recent trip I took… it took 12 hours of driving through areas I had never seen before. It seemed long and arduous at times when all we wanted to do was get there already. But the roads there… I saw scenery I had never seen before. I had conversations with a friend that I would never have had otherwise, because when else do you get to have uninterrupted time with nothing else to do? The time spent at our destination was amazing and wonderful, but the trip there and back was a key part of the event. It would not have been the same experience had I just teleported myself to the destination (not that that’s possible, but you see the point I’m making).

As healthcare providers we are not only caring for the body. We are given the charge to care for psyches, as well. For a nurse, obstetrician, or midwife witnessing birth is an ordinary day. But for that mother, for that family, it is an extraordinary day and it is our job to help the family honor that momentous day. So don’t tell me that the journey doesn’t matter. Whatever the journey is, it matters!

(Note: I am completely omitting the fact that evidence shows that cesarean birth is not, in fact, the “risk-free” alternative to any potential complication of the birth process. As with all births, each case must be evaluated on an individual basis and the risks and benefits of the various choices weighed carefully. I chose not to go off on that tangent today!)

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