Ok, so I could probably write a whole range of feelings I have after leaving the 'normal' births I have attended so far.  (FYI, by 'normal', I basically mean very low medical management if any, and baby coming out vaginally with no assistance.)  I feel elated for the mom mostly.  Happy that I had some part in helping this birth experience turn out 'normal' and more of what she had hoped for.  It is a special day. 

So two things bother me after these lovely births.  One - I usually feel a little sad oddly.  Yes, sad.  I cannot help but think of the moms I've worked with and labored with for hours on end only to have their births not turn out 'normal' for whatever the reason.  Some because of interventions that she made an un- or under-informed choice on thanks to some nurse, midwife, OB who just wanted her to follow the standard because it was easier for THEM, NOT better for the mom, some because of interventions she was not given ANY choice on, and some FOR NO REASON AT ALL.  But regardless of the reason why some births didn't turn out 'normal', I still think back on them and feel sad that they didn't go better.  And I tell myself that as long as the mom was happy with her birth or was able to make peace with it, then it is a success.  Things happen for a reason, I tell myself.  She needed that experience for some reason I'll never know.  And I take a deep breath and accept the differences in my clients' births, hoping that I did all I could.  

Two - The MOST frustrating part seems to be after the birth.  It more than bothers me when a CNM who just supported this amazing woman through an unmedicated normal delivery handles this new life like he or she is a piece of meat - not even a person.  I cringe the way they grab and hold the little baby, without even welcoming he or she to the world, never speaking to the baby at all, and talking loudly to other staff (about the next thing that bothers me).  Here goes.  Immediately after the baby is out, they are only concerned with getting the tools to clamp and cut the cord - literally within seconds after the birth.  Then the cord is cut without mom even being asked or noticing (she's usually a little consumed at the time, go figure!) And then they put the baby on mom's chest for skin to skin (this is a newer standard apparently - yay!) and then almost immediately start creating a nervous energy about the placenta needing to come out.  And so far, I have yet to see a placenta not pulled out.  They called it a 'gentle tug' at my last three births when the mom says, "OW, WHAT ARE YOU DOING, that HURTS!". JEEZ!  I am always stupidly surprised each time this comes true again and again.  What happened to that patience you showed through the labor?  I almost cannot watch it happen, it is so disturbing to me.  I just want to reach out and stop her hand from pulling on the cord.  Or yell, "STOP!"  I feel this is very wrong.  It is never gentle, it is hard - that has always been a lie in my experience.  It is more dangerous, very unnatural, and totally unnecessary.  It is only done to 'wrap things up' with one mom and move onto the next.  Time and convenience. They all want to DO something finally.  Like after not having the chance to DO anything to speed up the mom's labor with any intervention and now that this baby finally came, and mom doesn't seem to care anymore, they can do to her whatever they want to FINISH things.  And honestly, the last two that were pulled out had long trailing membranes that seemed to just come and come.  Not a fan.  I am particularly sensitive when I hear "It should be out by now" or answering a mom's question of "how long should it take?", with "oh, within 10 minutes."  Well, with my second baby - born at home, my placenta took it's time... a little over 1 hour.  At that time, I was getting uncomfortable laying there through the contractions still coming. Eventually, I started feeling like I wanted to do something to get it out.  So, in order to get into a squat, I decided to finally cut his cord and let someone hold him while I squatted and pushed the placenta out.  My midwife never pulled on the cord or suggested that anything was abnormal or being rushed. 

Ok, I got it off my chest.  I have to figure out a way to accept this kind of care happening once in a while, but overall, I think I have learned to make it a point to discuss these 'after birth issues' with each mom at our last prenatal visit.  They may not be equally important to the care throughout labor and birth, but nonetheless - it is something the mom should also be aware of and have a CHOICE about.  If I know it is fine with her and she's informed about the why's and why not's, I think I can watch a cord being cut immediately and a placenta being pulled out with less anxiety.