I recently had the pleasure of working with an eager medical student at the hospital. She was like a sponge, soaking up as much knowledge as possible during her eight-hour shift.
That day, I happened to be caring for what is fondly known on labor and delivery as a “real midwife-y patient.” My patient, a first-time mom, was laboring naturally with few interventions and no epidural or pain medication. Her husband was rubbing her back as she sat on the birth ball and breathed and rocked through contractions. The dim lights and soft music in her room created a very peaceful atmosphere on the otherwise chaotic labor floor.
As my patient advanced into harder labor, she chose to get into the shower for a while. The nurse and I took turns checking the baby’s heartbeat with a doppler every 15 minutes before, during and after a contraction. After about an hour, the medical student pulled me aside and said, “What do we do now?”
When I answered, “We wait, and we keep doing what we’re doing,” she looked surprised. “But we’re not DOING anything really,” she said. “Shouldn’t we get her into bed and break her water or give her some pitocin?”
I chuckled and told her she was learning a very difficult skill that day with me – the art of doing nothing, the art of waiting. This can be one of the most difficult parts of being a provider. We are trained to identify problems, to treat what ails and to fix what is broken. The words “let’s wait, watch and see what happens” can feel frustratingly like inaction, or even like a cop out.
In most aspects of my life, I’m a “doer,” always on the move. I rarely take the time to sit and reflect and do nothing. But midwifery, along with my yoga practice, has shown me the surprising beauty and reward of doing nothing. Sometimes I will physically sit on my hands at the hospital to remind myself to wait and watch.
Labor, particularly one that is left to progress naturally without intervention, can be a perfect time to remind myself and teach new doctors that not everything needs to be managed. Babies can and will be born without pitocin, without artificial rupture of membranes, without cervical checks every two hours and without a doctor or midwife trying to make things happen according to their timeline.
Often, the best thing I can do for a laboring mom is sit silently by her side, whispering words of encouragement or wiping her forehead with a cool washcloth. She or the baby will let me know when it’s time to do something more.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.