west sub Story

In July I had the privilege of attending a beautiful birth at the hospital I used to work at - West Suburban Hospital on the boarder of Oak Park and Chicago’s Austin neighborhood.

For the first three years of my doula career, I worked at PCC Community Wellness, a Federally Qualified Health Center (FQHC) as what’s called a “community based doula”. When a doula is “community based” instead of private, they are typically funded by an organization that is offering doulas to their participants or clients, as opposed to the client hiring and paying the doula directly. In my case, my job was working in a Suboxone clinic for women with Substance Use Disorder. The ins and outs of that work are a blog post for another day, but while there I learned A LOT about a lot of things, including what a midwifery-led delivery model looks like. (The white saviorism that inspired me to take a job like this in the first place is also a blog post for another day)

In the three years that I worked at PCC inside West Suburban, I somehow convinced my boss that I needed to attend birth with the midwives for clients that weren’t covered by my grant funding. Since our clients where always high risk and delivering with OBs, I wasn’t seeing unmedicated births ever. I also was rarely seeing a birth that wasn’t either induced or precipitous, which shows the way that stress, trauma and poverty can effect pregnancy health. Not to mention my caseload was only 13 people per YEAR, which was not enough births for me as a young doula.

We called it part of my professional development or continuing education or something. And bam, I was able to take a few births per month with the PCC Midwives. Now that I’m working as a private doula and attending births all over the city, I didn’t know how spoiled I was there. The PCC Midwives are given a lot of autonomy over their births. I saw things at PCC that I now know are totally unheard of in other hospitals. People pushing while sitting on the toilet, inductions starting with 24 hours of cytotec without pitocin, women hanging out at 9cm for almost 10 hours without being bothered (shout out to the amazing Jeanine Valrie Logan who was managing this birth and blew me away with her trust of the human body. Check out her work to open the Chicago South Side Birth Center Heres://blockclubchicago.org/2022/05/13/with-south-side-birth-center-chicago-midwife-aims-to-create-utopia-of-black-birth-workers-to-combat-disparities-in-maternal-health/).

I had been missing the cowboy vibes of West Sub in my private work, so I was really happy to go back there in July for my first birth since leaving. There was something about the midwives being at a low resource hospital, and very underpaid, but able to practice in a way that was meaningful to them, that gave births there an unmistakable air of spaciousness. If those midwives ever felt pressure from their colleagues to intervene in births, they didn’t pass that pressure on to their clients.

So back to this birth last month.

I had a deeper connection to this client and her wife than usual. She had a trauma history that led us to do extra prenatal visits. In these visits we talked about birth, trauma, interventions, and just generally get to know each other so she was comfortable. These are normal topics of my usual 1-2 prenatals, but the three of us were able to really go in depth.

On their baby day, we arrived at the hospital after about 6 hours of me laboring with them at their house. I couldn’t tell if she was in transition and close to having her baby or if she was in a long early stage. Labor progress is often mysterious when someone’s contraction pattern slows down, but she was dissociating due to her trauma history (which we were prepared for) and that low-affectation made it harder for me to assess where she might be.

When we arrived at the hospital, the midwife wasn’t sure either. And while our shared uncertainty didn’t necessarily make my job any easier, it did boost my confidence that we would figure it out together. And that the baby would be born eventually, just like always. But why were we unsure, you might ask? Why didn’t the midwife just check her? Because this client had a history of severe sexual trauma and requested limited cervical exams.

She also didn’t want an IV or continuous fetal monitoring.

She also had controlled gestational diabetes and the baby was measuring in the 99th percentile for size.

And her water had been broken for over 12 hours.

But they let her be IV-less and monitor-less and get in a big jacuzzi tub with me on one side and her wife on the other, holding her hands through each contraction.

It was so special to be reminded of how peaceful and gracious a hospital birth can be, when the model of care is led by midwifery and the midwives are free to practice how they want. Because neither me nor the midwife could tell if she was 3cm or 10cm. But we didn’t need to know, because everything was looking safe and perfectly normal, and there was no need to intervene.

The contrast between a low-resource midwifery-led practice like West Sub, and a rich hospital like Northwestern Prentice is stark. It was a contrast I was not prepared for when I entered private doula work. In my first few months I was shocked by “med-wives”, as they are deemed in the natural birth world (midwives who practice like OBs), encouraging people to come to the hospital the minute their water breaks. Or encouraging 39 week inductions. Or coercing someone to push on their back because they “can see more progress when you’re on your back”.

So this birth at West Suburban stretched on, and after a few hours in the tub, Katy the midwife suggested she get out for a bit and see if some movement could help. She ended up going to the shower with her wife and the nurse. Katy and I put our heads together and discussed the fact that we were both knee-deep in uncertainty and hope. As we discussed the need for more information, a cervical exam was almost certainly the right thing to do, our mama cried out from the bathroom that she felt like she needed to poop.

There’s nothing more glorious for a doula to hear, really.

Katy and I looked at each other like “God, I hope that’s real”. (If you don’t know, sometimes people in labor feel like they need to poop right before they push because the baby’s head is pushing on their rectum. Yeah- it’s that low.) Sometimes it’s the head, and sometimes it’s actually just poop.

Both moms came out of the bathroom and over to the bed where Katy and I were sitting. The birthing mom said she was ready for a cervical exam, and we agreed.

Commence what felt like the longest cervical exam of my life.

Right before they came out of the bathroom, Katy and I were preparing for a long birth story, whispering to each other “she might only be like 3-4 centimeters” and “I hope we are wrong but this could still be early labor”. So I was waiting on baited breath during the exam. Katy, the pro she is, kept a completely neutral face as she felt the client’s cervix.
”One more second, sorry about all the pressure, you’re doing great, let me know if that’s too much and I’ll stop”.

She pulled her hand away and finally smiled. “You’re 10 centimeters! If you feel the urge to push go for it.”

I could have cried. I might have cried, actually, I don’t remember. It was so beautiful. It was such a relief. It was such a reminder that birth is a process worth trusting, worth leaving alone if you can. The human body is miraculous and babies are meant to be born. It’s nature’s way.

And this baby was born, in all her glory. The birthing mother pushed a few times, spontaneously, and rested in between. Her non-birthing mother caught her and was the first person to touch her. No shoulder distocia, perfect APGAR scores, and not even Large for Gestational Age. Her moms were so happy, and everyone in the room was glowing with joy, warmth and peace.

It was like my soul was a dry sponge newly soaked. I felt so rejuvenated and in love with birth. That birth wasn’t about me, but it was just what I needed.

I’m not sure I have a conclusion to this post except to say that I’m grateful for the spectrum of experiences that my work offers. I’m grateful for the midwives at PCC, and I’m grateful that Chicago has some of the best hospitals in the world for high risk pregnancies- like Northwestern Prentice. I’m especially grateful for that client who gave me the gift of returning to West Suburban for a glorious birth. I wish this latitude and grace for all of my clients, whether their birth is straightforward or takes lots of turns.