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    Laboring: Stories of a New York City Hospital Midwife

    By Karen B. Burgin, CNM, LM

    Over the years since I entered midwifery, I have read many books, both fiction and non-fiction, that attempt to portray the essence of what it is to be a midwife.  As I finished each one I was still looking for something—if only the author could have captured what midwifery was really like for me. Now, in Laboring: Stories of a New York City Hospital Midwife, we have that book.

    Ellen Cohen’s compelling stories of everyday life in a city hospital, and the many encounters between midwives and patients, rang so true that when I finished the book, in one day, I felt I had just relived my own life in midwifery.   The details may differ, but those who have cared for patients in large urban hospital settings will recognize their own experiences and gain a renewed appreciation of what we do and why we do it. And, thanks to Cohen’s clear descriptive narrative style, readers who are not midwives can fully share in that appreciation.

    The opening chapter sets the tone. Cohen hears a commotion in triage and finds that a schizophrenic woman in active labor has just been brought in. “Mia” (names are changed to protect patients’ privacy) is confounding all the other personnel who attempt to subject her to routine OB procedures. Cohen approaches her and successfully guides her through the birth of a normal baby boy, even though this involves the patient’s smearing feces on herself, jumping out of the labor bed, and running into the hall, where she lies down on the floor and tries to hit everyone who comes near her. Cohen safely delivers the baby and then has to contend with an attending psychiatrist who arrives two hours late for a consult and demands to talk only to “the physician responsible for this patient.” After setting him straight, the stressed-out midwife allows herself to withdraw to the locker room for the necessary relief of tears. The story is all the more poignant when Cohen confides that she herself has a son afflicted by schizophrenia.

    From this opening Cohen (a pseudonym to protect her family’s privacy) takes the reader back to her life as a young mother and the blossoming of her desire to become a midwife.  As she relates the steps she took to achieve her goals, she skillfully weaves in many details about midwifery and birth, which will prove particularly helpful to the lay reader. As we follow her into her nursing career a major theme emerges:  she never loses sight of the value of others on the health care team, providing continuous examples of positive encounters with a variety of personnel.  And when the occasional mean head nurse or negative resident appears, Cohen deals with them and moves on. Her intent in writing this story is to affirm her experience, not to grind axes.

    Cohen successfully graduates from midwifery school and begins a career that encompasses the full scope of midwifery—she works in city hospitals, private institutions, and a program specifically geared toward the care of HIV positive women. She becomes competent in Spanish so that she can provide better care. She also uses her sign language skills to care for deaf women.  We are treated to a broad sampling of the daily workings of a large city hospital, including frantic preparation for JCAHO inspection, the crucial role of the housekeeping staff, the delicious potlucks held on any possible occasion, the personnel lounge with its lunchtime soap-opera viewing crowd.  Cohen tells about her own experience of the 9/11/2001 attack on the World Trade Center and the precipitous unintended home birth of her own grandchild--she arrives at her daughter’s apartment to greet a healthy newborn and a very surprised new mom. Through Cohen’s eyes we share the feelings and hardships of HIV-positive women, and the fears of one provider who wasn’t sure whether or not a bloody needle had penetrated a glove.  A number of admirable midwives, nurses, doctors and auxiliary personnel Cohen meets along the way are given full credit for their essential roles.

    Like the opening story of Mia, the many subsequent birth stories in this book are told with clarity, compassion, humor and cultural sensitivity, with the focus always on the woman and her family.  Early in the book Cohen expresses her aim in aspiring to become a midwife:  “I would bring empathetic and empowering care to birthing mothers, my hands and voice the gentle instruments I could offer my sisters in their most vulnerable, and most powerful, moments.” This book bears witness that she has achieved that goal.

    Posted By Lillian Dalke | 12/28/2013 11:29:12 AM