I am worrying about being observed in labor. I’m worrying about being tampered with. Surely these worries come from what I know about hospital birth – the home births I have seen as a doula have been totally different. But still.
I’m worried that she will want to listen to the fetal heart rate too frequently. I’m worried that she will ask me questions. I’m worried that she will watch me. I’m worried she will tell me something that directly contradicts my body’s intuition. I’m worried that it will come to the moment of birth, and I will realize suddenly with that uncontrollable heaving that I desperately need to be alone in this primal moment, and I either won’t have words to ask her to leave, or worse, that I will ask but she won’t leave.
I recently supported a beautiful, instinctive, unmedicated hospital labor which became, at the moment of crowning, a heavily observed, seriously disturbed birth that resulted in major perineal lacerations. The slightly larger than average size of the baby was blamed but I don’t believe it for a minute. The common rhetoric around perineal tears is one of physics: maternal position, being able to feel pushing vs. epidural, fetal head circumference, supportive maneuvers, etc. But if labor and the process of opening the body and the cervix is a question of physics AND spirit, body AND emotion, how can the moment of birth, with its potential associated traumas (physical and spiritual), be merely a question of physics, geometry and material tensile strength and flexibility?
The midwife can only support and protect from disturbance the process of labor and transition, while the woman is the one who has to do the actual work, and the midwife can only support and protect from disturbance the work that the woman’s mind, body, perineum, fetus, fears and reflexes, etc must do to prevent major tearing. Just as the midwife should be able to acknowledge when her observing presence or touch is hindering the labor process, she should be able to acknowledge when her observation or touch may lead to tension and tearing. It must be a very tricky thing to be able to discern these things, and likewise to discern those rare cases when an intervention would be truly helpful. I feel that it might just be safer for me not to be observed during that critical moment.