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Lifeguards and Midwives Rule

September 15, 2011

Genny White

“Midwives are like life guards.” I did not say it, but I wish I did. Midwives are like life guards. There I said it. The work of the midwife and the life guard are similar. The number one need of a laboring woman is privacy and the best thing a midwife can do is to give that woman the privacy she needs in order to move through her childbirth experience, yet at the same time, be present to observe the process of birth and intervene when necessary, much like the life guard must continuously observe what is happening without actually entering the water, and engaging in the swimmers’ activities, Yet all the while be prepared to dive in, and intervene whenever it becomes necessary. The life guard’s presence adds security to an afternoon spent at beach, without being an obstacle in the beach goer’s experience.
In the last month there have been a slew of media reports of dramatic rescues carried out by life guards and rescue swimmers. The Orange County register reports that lifeguards pulled a man out of the water in critical condition after he jumped into the water off the Huntington Beach Pier. In the August issue of JEMS the journal of EMS professionals featured Gene Hall’s Case of the month, “In Over His Head” documenting the elaborate rescue efforts that went into effect after a surfer was knocked to the ocean floor by a 30 foot wave and rendered unconscious. The synchronized efforts of immediate responders, responding ems agencies and air transport that delivered the victim to Stanford Medical Center all collaborated and achieved saving the life of the surfer.

Perhaps most dramatic is the miraculous save of 12-year-old Dale Ostrander, the young boy pulled lifeless (w/o pulse and in respiratory arrest) from the pacific ocean after being under water for 20 minutes. As soon as the boy’s body reached land resuscitation efforts were started and only 30 minutes later after delivery of the boy at the hospital did his pulse return. Dale was yanked away by a rip tide on Aug 10 and presently his parents report that their son is sitting up in bed eating, walking and has spoken some words. And then there was my rescue, yes I was rescued on Aug 4 this year, though I was never in any panic mind you, and no media reports exist.

What follows is my account of my rescue that took place on August 4: It was a bright and sunny Southern CA summer afternoon, and Phillip and I headed out to the beach with 4 people and 3 bogey boards. I passed on the opportunity to have a bogey board donning on my speedo professional goggles and headed off in the surf for my own summer swimming fun. After some time swimming solo; I came along Phillip and his bogey board. I swam over and we shared the bogey board. He occupied the left end of the board and me, the right end. We shared face to face one singular bogey board. It was the perfect afternoon the water droplets sparkled and cast sun beams of many colors off my love’s face and bald head, his blue eyes matched with the hue of the sky and the ocean. We laughed, we played we were like kids enjoying the magic of the surf. We held on to the board. We did a couple of 360s and barrel rolls, but just laughed when we found ourselves upright again. And then: the big one hit! I was separated from the board and from Phillip. When the turbulence of the wave stopped, I did note that Phillip and his board were a small speck and some distance away from me. I was not alarmed…I reasoned that I would just swim my way back to him. So I took a deep breath and plunged beneath the waves to make my way toward his direction. Bash I was hit by a wave and when I surfaced, egad I was now even further away from the man in Neon orange swim trunks and the bogey board than before; I was swimming up against a wall. OK I settled this is not working, my next plan of attack forget Phillip and just swim back to the shore. This time and the next 3 or more times I took a deep breath dove beneath the waves and swam like gang busters toward the shore, only to make 10 feet of head way and then be pushed back 16 more. Never once was I panicking, mind you. It did enter my mind that if I did not make any progress sooner or later I would have to raise my hand up, as to say Yep come and get me, I’m a goner.

Out of my range of sight I happened to notice someone on what appeared to be a red surf board. Good I thought. I will swim over to him and see if he might be interested in giving me a push to shore. Next wave I dove and now swam like gang busters in the direction of my peripheral siting. The waves stopped churning and there was no red surf board. Oh well I mused back to making my way toward shore. I am in no danger. My head is above water. When all of a sudden my moment of surreal splendor was broke by Life Guard Johnny Bravo’s voice, “Excuse me, Mam, are you in need of any assistance? I pondered the question and responded well now that you mention it; I cannot get back to shore. I had not considered that this might be problematic. He said, “You are in an under tow and the tide is going out. Here he exclaimed hold on to this,” as he threw me the red rescue tube. Ahhh, it was a rescue tube not a red surf board he was riding. So he threw me the line and pulled me to safety when I could get my feet on the ground. I shouted to my rescuer that I was now good to wave him onward —  bam, I was knocked to my feet by the wave behind me. Ok, never mind, you can pull me another few feet.

When he was convinced that I was now in the safety zone, he turned around and assessed the situation. I said thanks and was about to be on my way when he asked about my friend.  He said “what about your friend, is he alright?” I looked back at the breaking waves and saw my husband with the bogey board gliding merrily and happily over the waves. I looked back at the guardian of the beach and said he does not seem to be in any distress but you may keep an eye on him if you want to.

Later when Phillip and I were reunited I asked him if he were aware that I was rescued. He said, “No,” but by his darndest he just did not understand why I would just let go of the board and go off swimming on my own like that. No, he was not worried about me — he reasoned that I was a seasoned and good swimmer.

But let’s get back to Johnny Bravo. He did his job, he assessed the situation and he left me with my self-esteem and self-confidence still in tack. I turned from our conversation on the shore and returned to my afternoon at the beach; mind you much more conscientious of venturing too far off from shore. I was not shamed, humiliated or made to feel less significant or competent. I got too far out and he brought me back into acceptable parameters, and if I had required any resuscitation efforts I am sure he would have moved as fast as flies to molasses to begin full on board compressions and resuscitation efforts.

When we have to intervene with the natural course of labor can we do so in such a way as to position the child-bearing couple into acceptable parameters with a minimal of interruption in the natural process? Can we get in, get the job done and then disappear into the background unless our knowledge or skills are called upon again?

So my mind is whirling from these saves from the surf and I have many questions for my life guard and midwifery friends.  When do we decide to intervene, How do we intervene, what level of intervention is necessary?  Do our surfers / child bearing women need a full on board resuscitative efforts with full on board CPR, or will throwing them a line and pulling them away from the gulf until they can get there feet back on the ground be all that is necessary?    Are health care providers quick to jump in and intervene with surgery when all that is necessary may be a position change, or to get the mother up and moving, or into a squat position?  Are we jumping to the full on board resuscitation efforts when all that is really necessary is to throw someone the line and bring them back into a wave pattern that is not caring them off?  When do we intervene? and at what level do we intervene.  When is it more advantageous to the childbearing couple Mother and Baby to interrupt the process as it is unfolding and when is it best to leave the laboring woman alone to figure out how to cope with the surf of labor.  Is it possible that we can get in, pull the woman to a safe zone and then back out of the picture with minimal distraction? When do we intervene?  What Level do we intervene, and how do we intervene?  Are we able to intervene in such a way that a woman may feel confident to go back into the ocean and continue in her afternoon in the surf being assured that if she deviates course that assistance will be there, and that if her course continues to unfold without danger she will be left to herself?  I think that we can learn a lot from our life guard friends.

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