It’s early February, when I get a text from my friend Janis that the next day is looking good for me to accompany her for part of her workday. Janis is a local midwife in Waterloo, Ontario. I contacted her before Christmas to let me know when timing might work for me to shadow her for a half day. Since my goal with this project is to share stories of how the womb affects our lives, I want to include the perspective of people whose work involves the womb. I continue to hope I might attend an actual birth for this project down the road. Understandably, the last thing many people want is for some stranger, with a camera no less, to invade the inner sanctum that is the birth experience. But Friday, Janis tells me, I get to accompany her on a Day 1 post-partum checkup of a local couple and their newborn. The next morning, after dropping my son to school, I meet Janis at the clinic where she works in Uptown Waterloo. We chat briefly in her office as a couple shows up with their newborn. She explains who I am and asks if they’re willing to allow me to document a bit of her checkup? They graciously smile and consent.
I met Janis when I first moved to Waterloo, Ontario, in October 2010. We bonded over the fact we are both single moms in an area where many of our friends and their colleagues are in two-parent situations. Shortly after I relocated to this area in 2010, Janis began her study in Hamilton, Ontario, to become a certified midwife. The process takes four long, rigorous years of study and Janis explains that, upon graduation, she is hired almost immediately in Cambridge, Ontario. By December 2013, she is hired by a new local clinic much closer to home. The clinic currently has six midwives and runs as two teams of three midwives. This enables an approach in which there is one midwife on call, another as backup and a third taking a much-needed break before being on call again. Janis tells me this is the framework most clinics are now moving towards. When she first began in Cambridge after graduating, she was on call 24 days a month. A system of sharing workload with two other midwives works much better for everyone involved, including their clientele.
As I climb into her minivan and we set off from the clinic, Janis explains that for a Day 1 visit, midwives like a family to stay at home post-birth as much as possible so a home visit is part of their service. On the drive, we chat about how perceptions of midwifery have changed and advanced over the last decade or more in the region and in general. She tells me most people are aware now that the option to have a midwife doesn’t mean you must have a home birth or even a natural birth; that midwives can accompany any scenario at hospital or home.
According to Canadian Association of Midwives, numbers show that a higher number of ‘midwife-led’ occurred in Ontario during 2015-2016, while British Columbia leads in terms of percentage of midwife-led births performed per province/territory. A birth that is considered ‘midwife-led” refers to instances in which a midwife has been the primary caregiver during pregnancy and birth.
I ask Janis whether any misinformation still occurs about midwifery compared to a decade ago. She tells me greater awareness is happening, though not as a result of midwifery clinics leading information campaigns. In fact, with the demand for midwife care outweighing the number of midwives available to deliver care, most clinics she knows of have neither the need nor the time to promote what they do in order to gain clientele. “Waitlists remain high. Demand is primarily word-of-mouth,” she tells me. “It’s why I considered becoming a midwife myself. I had a midwife for all three of my children. My first was delivered in hospital, but I was able to experience home birth with the next two. I had such a positive experience, I knew it was what I wanted to pursue as a career.”
On the way to the post-partum visit, Janis gets a phone-call from another client with questions. While on call, the job is pretty much non-stop, but she assures me the hectic pace is generously overcompensated by the fact that the career is incredibly fulfilling.
We pull up and I step out into knee-deep snow. At the door, we are greeted by the family dog who is also adjusting to the presence of a day-old newborn in the home. Janis checks in with day-old parents and baby addressing any initial concerns and questions. During a “First 24 Hours” home visit, a midwife will check the new mother’s blood pressure and assess bleeding. Baby is also assessed for potential jaundice, whether the belly button is healing and potential presence of heart murmurs which are impossible to detect during the birth process. “Night Two is a doozy,” she explains. ” The first night, babies’ tummies are still full of amniotic fluid so they rarely exhibit hunger until the second night. Often a new mom’s milk hasn’t yet kicked in, so it can be a challenge to new parents and to baby.”
Observing Janis, I am in awe at her patience and the walking encyclopedia she has become. She is both professional and personable as she effortlessly pulls facts, statistics, advice and personal anecdotes from thin air to set the minds of these new parents at ease. She is not the only one inspiring awe. I feel indebted to this young couple who are generous enough to let me eavesdrop and capture their first day as parents. I recall being completely spent by my own birth experience and the chaos of my home upon returning from hospital when all your focus is upon your newborn and not receiving visitors. They appear so calm, though admittedly it might be just exhaustion. Still, I am grateful for the opportunity to capture Janis at her work and to be allowed to document part of their first 24 hours with their new daughter.
There is no capturing in text the awe of being in the presence of life so new and fragile. After close to a decade of infertility struggle to finally become a mother, I know how much of a miracle a newborn is, but it’s nice to have the chance to experience that evidence again, even vicariously. My heartfelt thanks to both Janis and her clients for the reminder.