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The Story of Flying Spinach and Other Modern Obstetrical Tales

June 3, 2011

The Tale of Flying Spinach and Other Modern Obstetrical Tales
Genny White (sung to Gilligan’s Island theme music)

Just sit right back and you’ll hear a tale,
A tale of 3 women in women’s health care
That started from this tiny heart
Amidst an urban church

There was Suzy Q,
A Nurse to provide your Childbirth Education
There was Debby Sue, Who led her crew as a Perintalogy Consultant
With a firm grasp she steered her Labor and Delivery Suites.

There was Pammy Ann who had gotten tough,
Many years she worked as a nurse,
First in L&D, then NICU
Her courage could not be lost

Her Final assignment came to rest as a charge nurse for the incoming Trauma and the acquisition of an Organ Harvest Truly her courage could not be lost

This heart set fourth to gather the women in women’s health care that were there
With Suzy Q
Debby Sue too,
This Student midwife,
and Pammy Ann,
Here this vision of mine to see a Collaborative Group Effort for Women’s Health Care.

So this is the tale of Gathering thoughts in Collaborative Health Care
This is an issue that will be here for a long, long time,
We’ll have to make the best of things, and see each of our Sisters with Pride
It’s an uphill climb.

The Child Birth Educator and the Doula too,
Can do their very best,
To educate, inform and support the consumer,
In this child-bearing land.

No polarization, no bad attitudes,
let’s do our best, Nurse Providers, Midwifes and Obstetricians too support us with your helpful hand
Like Robinson Crusoe, to forge a whole new plan
Let’s not be as primitive as can be. Let’s escalate

So join here together my friends,
You’re sure to get a smile,
As we learn from one another
Here in “Women’s Health Care”

It’s been said of me that I’m and idealist that I am an optimist that I am naive but I like me and I believe that we can exist in a world without polarizations. I think it is best for all of us and for the childbearing families that we serve if we can just get along. What I am talking about is Collaborative Care.
I worshiped at a small suburban church. As I was finishing up our book on the role of men at childbirth, “Men At Birth” I thought about how nice it would be to have others that shared my faith participate at the spiritual level and pray for the works effectiveness and from a practical point I was interested in what my faithful sisters working in Maternal Infant Health would want to share with the childbearing community. So over the course of several months I approached these 3 ladies that I will call Suzy Q, Debby Sue and Pammi Ann.  All three are nurses.  Suzy Q is a Childbirth Education Instructor.  I crossed paths first with her.  Over the years, I have collected an enviable obstetrics and midwifery research library, complete with folders, charts , props and educational aides.  I shared this with her and asked if she could benefit from any of my volumes, illustrations, props or teaching guides.  “No, she said she had no care or desire for she said it was all just a job to her; no attachment for her, just show up and get her pay.  I thought it strange her acknowledgment to me that I possessed more knowledge on the subject of childbirth than she. She was comfortable there in her cushy tenure as the childbirth educator.  Her level of involvement was just show up there teach the class and score her pay. From this experience I crossed any future potential dialogs with her off my list regarding communication to childbearing families, I certainly would not want to be an obstacle to her on her free time.
Also there at this assembly there was a nurse who worked at one of the foremost hospitals in the region.  Her work was that of a perinatology nursing consultant, and she ran the suites of L&D, keeping the nurses informed of the newest developments and studies in perinatal health. Oh, yeah, I thought, as I grew to learn of her influence in this land of childbirth. With eager hands I asked if she would review our work and if she would care to share from her berth of knowledge to our nation’s childbearing couples. A quick review of our book she did lend, and with a quick exchange regarding our nations outlook with the c/section rate, the book she did return. I sent her an email link to our web site  to which I received a curt reply:  Good Luck with this do not bother me again. I was dumbfounded and discouraged. I was approaching her as a contemporary sharing a common place of worship. Weeks went past and I was bothered communion was served and my spirit was disquieted. My conscious could hear the exhortation that if you have un resolved fault with someone then first go and make peace with that person then come and share the communion table.  I looked around: no Debby Sue to be found, so that day I did participate, but made a mental note that things were not quit right and that I would resolve to take care of this right away.  A few more days passed and I made the phone call. Debby Sue, I was saddened by your email and wanted to meet with you face to face and learn more about what is going on. Can you do that meet with me? Yes, Debby Sue replied, and arrangements were made to meet at a café after church the following Sunday.  Debby Sue ordered the spinach salad; I had the Mediterranean chicken salad. I listened as Debby Sue shared her offense that we should suggest in our book that couples entering the hospital be prepared and need some means of guidance and preparation before entering the hospital to give birth.  This I listened to and paused Debby Sue; I said we do not spotlight the hospital as a place one needs guidance and preparation for in order to give birth; we give as much focus to the preparation for childbirth for childbirth in any setting a couple might choose. We advise being informed and prepared for childbirth wherever it may occur and we cover all birthing options in our book.  Hospital birth was not singled out as a place where guidance was needed. Debby Sue continued She said that she and her staff worked very hard to provide care to laboring women and that she did not like men who came in with questions and were looking out for the wishes of their spouses.  With her fork raised (and spinach flying through the air from it), she said that when men came in who were informed and looking out for their partners, that they (the men) put a wrench into the whole birthing process that she administered. I thought to myself,  “We’ll whose birth is it, and whose space is it.”  The space is being paid for by the childbearing couple and their insurance carrier, it would seem that what occurred in that space would go according to their wishes. But I just said, “Well, thank you so much for sharing your perspective with me. I am honored to have taken this time with you.”  Two days later, a thank you note was sent out stating much the same thing. Debby Sue never shared any lofty message to be conveyed to our nations childbearing couples except namely don’t get in her way, or in the way of her staff.

And finally there was Pammi Ann. Pammi Ann was a nurse of many years, and her mature face was marked with wisdom lines. Pammi started out in L&D, she worked in NICU, and in her final work she led the trauma team when an individual came in who was relegated to become an organ downer. Pammi Ann would stay with that living donor through ER through critical care right up until the very end of the organ harvest. Hey, Pammi Ann, I said I understand that you worked L&D and NICU too, I have written this book would you take a look and share with me your insights and what you think? She took that book and stole away the whole night of the church carnival; she found a nook and sat and read, and read and read. I finally asked as the night event was coming to a close, “I need my proof copy back.  So, Pammi Ann, what did you think.” Pammi was brimming with excitement and made remarks right then and there. Oh she especially liked the introduction to Health Care Professionals. She closed the book and wished me well. What would she want conveyed?  The fact that childbirth is a partnership with your birth team and that childbearing couples need to participate with their providers to have the safest and satisfying care.  With eyes dead ahead she looked at me and said, “When I started out working in L&D, we referred to people who wanted home birth and said ‘Pizza is for Home Deliveries not babies,’ but later I watched, and read and learned. My childbirths were all through but had I had the chance to have one more it would have been a home birth.”

“Thank you, Pammi Ann,” I said, with a smile.

Weeks went by, months went by and then night of horrors our own special daughter is in critical care now pronounced brain dead. Pammi Ann was right there. She walked right in and wrapped her arm around my waist and held me strong.  “Now what’s to be done?”  She reached right down and touched each limb, each arm, each leg, each hand and foot of my dear dying daughter: she worked them back and forth in each range of motion from dorsal and planter flexion of each foot — with tender care she did caresses each of my daughter’s lovely hands. There my brain dead daughter did lie with dignity and decorum, and there  Pammi Ann did abide. My daughter was cared for there, and she was not a cold slab of meat. What brought Pammi Ann there? Was it because she herself was a trauma nurse and had walked this journey to organ harvest oh so many times before? Maybe, but I think not, her coming was no easy ordeal; she came with her own children in tow. Possibly she even slide the security guard a $20 to keep an eye on her children, as she ventured to critical care. Pammi Ann was there because she knew what patient care was. She was there because she was Pammi Ann, and she simply knew how to “Be There.” Where were Suzy Q and Debby Sue?  Hadn’t they all come from the same place?

I want us all to work together to make this a better world for childbearing women and their families. It is a hallmark for both maturity and professionalism to be able to work together collaboratively. In the end it is what is best for the mothers we serve. I know that this is not going to happen overnight, but let us begin and utilize each opportunity we are presented with to esteem and value each and every one of us working to make a difference for childbearing women. We need to see that how we interrelate with different disciplines paints a larger picture than merely that single interaction. See the bigger picture. May we all grow to be like Pammi Ann. May we all be there for childbearing couples and there for one another.

Postscript: I want our readers to know that I know that Suzy Q does not reflect the whole of the nations childbirth educators, there are many instructors who feel passionate about what they teach and how they teach it.  Also I know that Debby Sue does not embody ever L&D Nurse and Nurse supervisor. We are each individuals each and every one of us is an individual. I believe these observations I have made have merit in the discussion of Collaborative Care.

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