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Focus on the Midwife - Our Healthcare Provider Series

8/8/2017

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Linda Stahl has been working with pregnant women and babies for over twenty years, first as a childbirth educator and doula, and later as a midwife.  Linda feels that being a midwife is central to who she is. It is a committed vocation, which is deeply satisfying. Linda enjoys making relationships with her clients and supporting them in their remarkable experience. A baby brings huge transitions physically and emotionally on every level, and navigating that experience with women is very rewarding. Linda enjoys knowing mothers well; caring for them with compassion and helping them have a safe and satisfying birth.

How long have you been a midwife and approximately how many births have you attended?

I started my training as a midwife in 1995 in England, and over the years I've been at the births of about 2000 babies (I think).  I wanted to be the sort of person who counted each one, and I certainly did for the first few hundred, but I have to kind of average it out throughout the years.  I can't give you an exact number!

Where have you practiced as a midwife?

I worked in England for 5 years.  My first home birth was mine (I have to add my babies in here) - that was in England and she was born in the Oxford University Halls of Residence, and then I went home to Nova Scotia with that little baby and had my second 15 months later at home.


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Linda and her midwife and mentor at her home birth.
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Linda and Stephanie.
When I wanted to start practicing midwifery again the most sensible thing to do was to go to Ontario to work where the midwifery system was already established, whereas in Nova Scotia there were no applicable laws and systems in place.  Once my babies were 9 months and 2 years old I moved to Ontario to work here.  I spent about 7 years doing a lot of home deliveries in Amish and Mennonite communities in Southwest Ontario.  It was then, along with one of my students Stephanie (who had been working for about two years) that we decided to open a practice in a new place.  That new place would ultimately be Orangeville, which was where my husband was living at the time.
Orangeville  was such a wonderful community and had such a desire to have us here.  The community was so organized and supportive, so we felt really compelled to come here.  We opened our clinic in 2009, and now we're 5 midwives.

What was it that inspired you to become a midwife?

The first time I heard the word "midwife", I knew that's exactly who I am.

I was 19 - so that would have been around 1989.  I knew through high school that there was something I was supposed to do for babies.  I had passion as a teenager for babies - absolutely loved them.  As I went through University and did more Women's Studies, it pulled those two passions together.  So, when I heard the word "midwife" I just knew that was the thing.  But how to be that, I didn't know, because that just didn't exist in my community as far as an education.
Midwifery was just beginning, so I got involved in the doula community, the birthing community.  I was young and it felt kind of odd to be 19 or 20 years old and wanting to be at births.  I aimed to help people who really needed me which were teen moms. With teen moms, sometimes their boyfriends are done with them, or they have fallen out with their mothers because of the pregnancy, so I started supporting anyone who was pregnant who needed someone to be with them for labour, delivery, postpartum, whatever they wanted - I had all the time in the world for that - this has not changed - and that was over 25 years ago.
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What is your favourite part of the work?

The labours themselves.  Being with people.  Trying to figure out how it is that they want to go through their birth.  Trying to read their feelings and their body language, hints, hopes, fears, and trying to figure out how I can get that for them, or shelter them into getting the experience that they want - whatever that is.  Whether the woman needs the "stereotypical" midwife experience - waterbirth, bongos, dreadlocks, tie die - whatever she wants, I'm that.  If she feels safer with the lab coat, and seeing all of the equipment laid out and systems in place, I'm that midwife too.  I want to be able to help people feel comfortable.  I do try to challenge people's feelings a little bit as well.  Just enough to try to bring them as close as I can get them to feeling comfortable enough to birth as safely and quickly as they can.

I like labour.  I like delivery - but I like labour.  I like being with people as they're getting through this.  I'm always amazed at how incredibly powerful and brave women are.  It always feels like an enormous thing to have a baby, whether it's a booked caesarean, and putting yourself out there to trust that all of these people are going to take good care of you and do everything right - respectfully, kindly and to the best of their ability - that's putting yourself out there.   It's also putting yourself out there to create solitude for yourself in a birthing environment, to do it alone without anyone touching you or being in your personal space, trying to create those feelings of privacy or independence - all of those things are amazing to me.

What is the most challenging part of your work?

Missing being with my own children - sometimes. You can hear my voice partially wobble as I say that!  Sometimes there are circumstances where I don't get to see my own kids, and do their things.  I have a fear "what if they need me and I can't leave", or what if they have a special event that I need to go to but that somehow can't happen... 
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We have an amazing group of midwives and we are all very connected and close to the staff at the hospital and we know each other well, so most of the time I can do all of the things that I need to do.  It's more the unexpected need of a child of my own.  I could be working all night which is normal and regular, but then perhaps the next day I cannot get up and help them get ready for school.

I balance that out by saying that I have very classic "midwife kids" - I find children of midwives are very proud of what their mom does.  It presents a lot of challenges for them, but I see that they get it.  When you have a parent who works in service to other people, that is her main job.  I want my kids to know that they don't come first - it's sad, but it's true.  The same can be said for the OB, the anesthetist, the nurse, the doula.  What comes first is "with woman" and that's what midwife means - "with woman".  So she comes first and she is depending on you to know that on her day and in her moment you are all there 100% just for her, you're not distracted, your mind isn't anywhere else, you're all in it just for her.  I think that's a good way to live, I hope it's a good way to live!

Tell us about your amazing team at the Midwives of Headwater Hills

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STEPHANIE
Oh Stephanie! It isn't possible to have a better partner than Stephanie!  She fills in the blanks that I leave out.  She balances out my side of things.  She has strengths where I have weaknesses, I have strengths where she has weaknesses.  We make all decisions together.  We make no decisions without the other person feeling comfortable with them.
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From a clinical perspective, at births, I can read what she is thinking and feeling without making any eye contact.  I can tell by how she's wording something, how she will turn her body or behave, I can tell by the way she is documenting something where her thoughts are on how this labour is progressing.  It's a very connected sisterhood in a way, but without the difficulties of sisterhood.  We are a fantastic match.  She said years ago to someone else that "Linda is the 'safe thing'" and that is actually how I feel about her as well!  I feel like my business partnership and my midwife partnership with her IS the safe thing.  We've got each other figured out.  I'm certainly not going to work without her.  If she retires, I want to retire.  We come in, we go out! 
MELISSA
​Melissa is passionate.  She holds the space.  She's a lovely hippie!  She is clever, kind - she is a workhorse.  She can go and go and go!  When Melissa started with us she would look to see what things she could do and then she would do them - that was fantastic!

​EMILIA
​She is also another fantastic worker.  She's a great mom - as long as she can make cookies she feels like everything is in order! She is well organized, connected with her kids, she has what appears to me to be a lot of kids - there are 4 of them.  They are really active and involved and somehow she gets them everywhere they need to be and is able to do her job and miss nothing.  I found it a lot to have 2 kids and she's got 4! 

ALINA
She is our new midwife who is a great worker, laid back, smart, articulate, kind.  She doesn't occupy a lot of space in birth.  Her character focuses so much on the woman and the team, that she gets everything done, forgets nothing.  She also likes to laugh and says yes when there is work to be done.  She is great!

JEN
I love Jen!  She tolerates so much from us.  She makes me look like the president!!  Jen has a great sense of humour, which is really important to me because my sense of humour is off the wall.  I love that she gets that.  She seems to accept that when we get busy she takes care of all of us.  She does her best to get the best appointments for people.  Her job has  a lot of challenges but she does it and she is very kind.  She is compassionate.  Over the last year, I've had some very hard times filled with grief and when I have crumpled up she just puts her arms around me - I've cried all over her! 

MAURNING
Maurning is our doula, meaning that when we first opened the practice there were LOTS of challenges as we were figuring out how to make great relationships with our hospital, which worked unbelievably well.  But, in the early days it was very stressful.  So Mourning came with us to meetings, she was there at marches.  Her compassion for us was really high - she really gets our job.  Clinically she is very savvy.  She is patient with women, with us.  There doesn't seem to be anything that you can do wrong.  She takes whatever you've said or done and makes it grande.  She's always good for a hug and loves education.  She is always willing to help.
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We are all very human.  We have our own lives and things that happen to us.  It's nice to work in an environment where we take care of one another.  I definitely feel that from my sister midwives - that we are looking out for one another.

If you could give one piece of advice to an expecting mother, what would it be?

One piece - oh my goodness!
What is the piece of advice for - labour, birth, motherhood?  I'm going to pick motherhood, because that's the big one!  The pregnancy and labour and the breastfeeding, those are all days to put together.  It does impact the experience of motherhood to a really high degree, but the actual transition from being one person to two people and then having that little person that's in you separate and outside you but connected for the rest of your lives: that is a thing that I can't really advise on or prepare for.  Sometimes mothers get that at the moment of delivery.  That's why you see that rush of glee and that crazy adoration that they have.  Sometimes it happens a little later as you learn to fall in love with your baby.  Like any love relationship, it can be instant or take time to develop.

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I don't know how to give advice for that, other than that it is something that I can't describe to you - how you will feel about this person until you've got them in your arms and somehow be prepared to open your mind and your whole self to this being a very different life than you've ever experienced before.  It's a permanent kind of love which connects you to your baby, to the rest of your community and to compassion for other mothers.

Do you have any words of wisdom to expecting partners?

To cultivate tolerance, to treat the mother as your precious person.  To make every effort to take care of her first (and the baby of course).  But to focus all of your efforts on trying to make everything as easy as you possibly can for her.

A piece of parenting advice to parents of a newborn:

Hold the baby. 

If you could ask for one thing from the government to help you do your job better, what would it be (provincial or federal)?

This is a big question, but the answer is money - it's money, not because I need more pay, I have enough.  I can pay for my car, my house, I can put my kids in dancing and horses.  I have enough in that way.  What I need more money for, is to make my life less stressful and painful in losses.  I would like to have enough so that I can afford to have more help around the house - it's really hard for mothers of small kids.  Mine are growing up now, but I remember clearly giving half of my salary to the nanny - you have to have a nanny or some other 24/7 child care.  You need a lot of money for childcare and to pay them with dignity.
If you have a partner, it's very hard for them to support the midwife in the raising of the kids.  If your partner has a business or a job they come after midwifery, after kids, I mean they come so very last that their chance of succeeding in a business is unlikely.  So basically, we need more pay to help with housing, childcare... we go through cars and car repairs.  Time and travel is a big deal for midwives.  It's practical things like that would make a big difference.  It is so exhausting to come home and find that the dinner you got out last night is still on the counter top (now rotten), the house is a mess, the kids are god knows where (did anyone pick my kid up from dance?) - because that's what happens!  That's the stuff that stresses me out as a mom because you can't get 24 hour childcare and house work - and who picked up the groceries?
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As far as what the government can do to make our lives easier from a hospital, birth centre or homebirth point of view is making the places that people have babies as accessible as possible for everyone.  For families to have babies together.  I don't care where you have your baby, I just want it to be easily accessible and for your midwife to have full access to every resource in the hospital.  No caps, no holding midwives back.  We are VERY lucky in Orangeville.  Our midwives deliver something like 25% of the babies in our area, but it's not like that in other areas.  They are holding them back and capping them.  Making more midwives for more women.

What about from a legislative perspective, any thoughts?

Not exactly legislative... I don't really think about those things in the bigger picture.  I think mostly about access.  There are many midwifery practices in Ontario that have to wait list people regularly - that's really hard, to turn someone away.  We need more midwives.

What tip do you have for doulas?

One thing I'm always concerned with doulas - I always feel like doulas work twice the hours that midwives do.  We joke that they go out at mucous plug - because they feel like they can call you at the beginning of all things.  Which is good.  A phone call is fine.  But, I do worry about doulas attending at 0-3 cm (which could be a dozen hours). 

So my tip:  prepare your clients well for what 0-3 will feel like, and don't whip everything out of your bag before 3cm! I mean, sometimes you do need that.  I've had people who were suffering terribly at 1cm (and I'm one of them, I wanted to die at 1cm, so I get that).  I have great compassion for that labouring person.  But I also don't want the doula to wear herself down that when she goes through transition that you're tired too.  Prepare your clients as best as you can so that they can do some self coping so that the doula can make it to 2 hours postpartum. 

Doulas are also working for so little.  I know that things have improved for doulas since the days when they did it for free or for $100 bucks or something, but still, it's honestly, a labour intensive job!

What is the most important thing you want the general public to know and understand about midwifery care?

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I want them to know the two sides of midwifery care.  One is the one I've focused on for this interview:  our commitment and passion to women - the ART of midwifery. I also want people to understand the science of midwifery too - how highly trained midwives are on so many different levels.  The number of years we spend studying, the intensity that we put into this job, the preparedness that we have for outcomes that are not positive.  Midwives are very very well prepared to resuscitate your baby, to stop you from bleeding, to turn a breech baby, to be there at your cesarean, to receive your baby, to intubate your baby - that really high skill set.  We can work in solitude if we have to, we can work in a team.  Our safety mechanism and set up is really superb. 
There is NOBODY that is better trained to make sure that you and your baby stay safe from the beginning of pregnancy, from a home birth, to being a part of a really good highly medicalized well organized team of professionals - midwives are that.  We do all of those things.  It's our responsibility to not just take care of the mother, baby and extended family, but to connect that whole team together and make that system work, and it works really beautifully.

That's the bit that I don't think people understand - how pivotal the midwife is in the working of the team and in our close connection with our hospital and EMS services.  That goes everywhere from being the hand holder to being the person who is there who can actually prevent harm to the mom and the baby.

A special thank you to Midwife Linda Stahl for making time for our interview and for being the first Healthcare provider to be featured in our new blog series.


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