What a midwife should not do: A lesson in destroying bonding.



I
was in midwifery training, doing an internship on the Texas – Mexico border at
a clinic in 1989. There were 7 of us in my class. I had been a lay midwife
working in Wisconsin among some of the Plain settlements there. The rural Midwest
is known for its Amish, Mennonite and Hutterian colonies scattered throughout
the countryside. This population in particular was very much under-served
medically, for a whole combination of reasons. At the same time it became
apparent, to me at least, that what I was doing might be risky and I did not
feel at all confident with my skills level, so I wrote a grant for a Bush
Leadership Fellowship and got it, going back to school after 5 children. It was
very excited – for me at least. My husband David had recently completed his
Masters and I was so very eager to go back to school; he even agreed to the
whole crazy plan. (He is one of those rare saints).



The
clinic saw over 20 women a day, mostly from Ciudad, Juarez which is across the Texas
border within walking distance. We were on the El Paso side. For those who had
the proper documents, it was easy to cross the border and visit the clinic. For
those who didn’t have the paper work, it wasn’t impossible. If you could manage
to have a baby in the United States, however, you had an instant IN. We even
had to keep the birth certificates in a locked safe because they were such a
valuable commodity. On the black market they could sell for $10,000 or more I
was told. So if you had a baby on our
side, then you could get papers. You could even work in the U.S. legally. But
there is the border. On the U.S. side they check everything, often stripping
down cars, and even people, it was rumored. On the Mexican side it was a whole
different story: one ‘official’ dozing in a chair with his sombrero tipped over
his face shielding him from the sun. When he was awake you’d get waved through
without even producing I.D. Sometimes he just slept and you walked past.
To
get to the U.S. when you don’t yet have papers, you just wait on the bank of
the Rio Grande below the bridge where the customs guys are. The guys who run
the inner tubes back and forth have lookouts up above signaling when the coast
is clear (of border patrol cops). When they say go, you get pulled across,
climb under one of the chain link fences and up the opposite bank, hopefully
before getting caught. So, many of our clients arrived covered in mud. Usually
we just showed them to the shower. Sometimes women came already in labor. Most
had enough time to clean up before 2nd stage and pushing, but every
so often we’d catch a baby in the shower.
We
saw all sorts of mommies-to-be: 14 year olds, 45 year olds, healthy,
undernourished, educated, illiterate, even some women doctors chose to deliver
their own babies at our clinic because they recognized the superior level of
hygiene in comparison to the Mexican hospitals. Between contractions you could
see them fingering a Chux pad or a disposable syringe, wondering if this was a
first for them.
One
sweltering day, when I was “on first”, meaning I could ‘catch’ babies on my
shift under the supervision of one of the instructors while less senior
students would be assisting me, a first time mom came in active labor. We
roomed her and got everything ready. She walked around awhile, rested for a
bit, and did pretty well in general. She was very quiet and didn’t have a lot
of family there, compared to some of the birth-day parties some families had.
Finally
the baby came, an 8 pound boy who cried right away. I plopped him on her tummy
and my breath caught. At that moment I noticed his feet: splayed big toe, feet
extending upright almost touching the tibia. I froze. I looked up and noticed
the low tiny ears, the big tongue, the stubby fingers – it was all there. I
tried to smile, but I doubt if I did a very convincing job. Mom was quiet,
taking it all in, not overly excited or even happy. Now, 25 years later, I
can’t remember a dad in the picture, but he must have been around somewhere.
While
she was being cleaned up I asked if we could take baby back to be weighed
(which I never do now – we have all night to weigh him, in the room if at all).
I wrapped him up, a beautiful, dark, furry little boy. Hair on his head, all
over his back, chubby fuzzy arms. I cuddled him and burst into tears when we
got to the lab. I looked again: there were the Simian lines on his hands. Damn.
Why her? Why now?
I
had heard all the horror stories about Mexico. Macho Mexican husbands expect
perfect kids. They abandon wives who cannot produce them. And she was only 18.
And a first baby. Deformed, not perfect kids go into institutions in these
countries. They are an embarrassment. But I had to do something for this little
guy. My little guy.
I
enlisted the clinic’s translator. I talked with my supervisor and laid out a
fool-proof plan. We would inform the mom before she went home that we would
line up all the best referrals to all the best services we could find in the
city and make sure he got the best start possible. We would tell her that she
could advocate for him and would have our full support. We would educate her
and make her a real champion for these children. Yeah, right.
She
didn’t know what Downs even was. The translator did her best but the fact was
that in her eyes he was retarded. I don’t remember her crying. She was just
silent. She listened and held him, not particularly close. I assured her we
would have more information when she came back for her 3 day follow-up visit. I
hugged her goodbye before she left that evening.
She
did come back for the next appointment and the one after that. I made a big
fuss over him each time, telling her that this was one of my very favorite
babies. Between her visits I grilled the staff, trying to find out how we would
know if he was going to be placed in an institution. How would we know? I even
entertained the thought of adopting him myself should the family decide to do
that. 
Finally,
I had to let go. They had no reason to return to the clinic and we had no way
of knowing where they went once they crossed that bridge for the last time. A
week later I ‘caught’ another beautiful baby with Downs. This time I didn’t say
anything. I made sure mommy and baby were skin-to-skin and bonding. I kissed
her and told her what a beautiful baby she had and what a good job she had
done. I told her that her husband should be so very proud of her. He beamed
when I said that. I stitched her up, cleaned up the bed and went back to the
lab and cried. I knew then I had blown it the first time. Now I knew I should
have just let them bond. Nothing else. Let her fall in love with her baby and
think he is the smartest baby in the world. When she takes him to kindergarten
and someone tells her he isn’t smart, that he actually may be retarded, well,
by then she will love him so much (and so will his dad) that they’ll do
anything to help him.   
I
am older and wiser, but I still cry when I think of my little guy, and I can’t
tell him I am sorry. 
©
Stephanie Sorensen 2012

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