Garnering trust

20130821 QuoteToday, I walked onto the floor, and the Resident was so happy to see me that she was near tears. It sounded like it had been a difficult night, and she really wanted my help with room two, who was about to have her baby right before sign-out. I took off my coat and walked in, led by nurses with whom I have never worked but knew enough that they were staying over sign-out for this woman and her baby. She trusted, I trusted, they trusted.I made it for the end of sign-out, and let my Attending know that I would take care of rooms 8 and 10, both in active labor. She said, Great!, and then went to her scheduled surgeries. She trusted.Room 10 had her baby without anyone knowing besides the woman, the baby, the nurse and I. Trust.Room 8 was at the same number of centimeters later in the morning that she was early on, but many other factors about her labor had changed during that time, and I wasn't worried. I was, in fact, confident. My Attending came back to the floor, and questioned her labor, with her voice and her questions showing that she was very concerned about needing to squeeze her in for a c-section with a busy surgical schedule. The Chief Resident chimed in, asking about internal monitoring and labor adequacy. I explained all the reasons why I thought she was fine, she had plenty of room for the baby, and the strip was the picture of perfection. They conferred quietly together while I charted on other patients, and then came back with more discussions. They didn't trust.I went and stayed in her room, letting the nurse know I'd call her when things were close. I knew the baby would be big, but knew it would be fine. And I trusted, and the nurse trusted.After a while in the room with her and her partner, I started to question what I was trusting. Her body? The baby? Normal birth? My intuition? My training? The birth goddess? I couldn't name it, but I trusted.And then I started questioning why they were questioning me. I average 4 births per shift, I always, always, let my Attending know when I'm uncomfortable or concerned. Always. She has come to trust me when I say that something is not working. Should not the opposite be true? Shouldn't they trust me when I say I have used every approach I know and I'm out of options, as well as trust me when I say that I know everything is fine?Then, in decompressing on the way home with my the endless listening potential of my partner, came to the realization that their lack of trust is not about me. They did not trust themselves, they did not trust her pelvis, they did not trust the baby, they did not trust birth. They did not trust me as a midwife, or my intuition, or my training. They had no trust.She had a beautiful birth. A beautiful baby. And a nurse and a midwife who knew, and trusted, in all of that and in each other and in handling the unexpected. And she trusted us.My hands are the compilation, the memory, the knowledge of all of the midwives whose hands have taught me the art of baby catching. And I trust in that, wholeheartedly. And I trust that I will continue to listen to my intuition, and even when that is wrong, I trust that I will be prepared for the surprises that can happen at a birth. Because, in the end, I trust birth, I trust women, and I trust myself.

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