Sandi Doughton - Becoming a Midwife

M ASTERS AT W ORK

B ECOMING A N EUROSURGEON

B ECOMING A V ETERINARIAN

B ECOMING A V ENTURE C APITALIST

B ECOMING A H AIRSTYLIST

B ECOMING A R EAL E STATE A GENT

B ECOMING A M ARINE B IOLOGIST

B ECOMING AN E THICAL H ACKER

B ECOMING A L IFE C OACH

B ECOMING A Y OGA I NSTRUCTOR

B ECOMING A R ESTAURATEUR

B ECOMING A P RIVATE I NVESTIGATOR

B ECOMING A B AKER

ALSO AVAILABLE

B ECOMING A S OMMELIER

B ECOMING A C URATOR

B ECOMING AN A RCHITECT

B ECOMING A F ASHION D ESIGNER

B ECOMING A S PORTS A GENT

B ECOMING AN I NTERIOR D ESIGNER

B ECOMING A F IREFIGHTER

B ECOMING A N URSE

B ECOMING A V IDEO G AME D ESIGNER

B ECOMING A M IDWIFE

B ECOMING A T EACHER

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Names and other identifying information of some of the patients profiled in this book have been changed to protect their privacy. Patients actual names are used only if I have received permission to do so.

First Simon & Schuster hardcover edition December 2020

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Illustrations by Donna Mehalko

Jacket design by Alison Forner

Image of baby by Martinussumbaji / Envato Market;

Image of stethoscope by Kathykonkle / Getty Images

Library of Congress Cataloging-in-Publication Data

Names: Doughton, Sandi, author.

Title: Becoming a midwife / Sandi Doughton.

Description: First Simon & Schuster hardcover edition. | New York : Simon & Schuster, 2020. | Series: Masters at work | Includes bibliographical references. |

Identifiers: LCCN 2020032861 (print) | LCCN 2020032862 (ebook) | ISBN 9781982141431 (hardcover) | ISBN 9781982141448 (ebook)

Subjects: LCSH: Kopas, Mary Lou. | University of Washington. Medical Center. | MidwivesWashington (State)Seattle. | MidwivesWashington (State)SeattleBiography. | MidwiferyVocational guidanceUnited States.

Classification: LCC RG962.S43 D68 2020 (print) | LCC RG962.S43 (ebook) | DDC 618.2009797/772dc23

LC record available at https://lccn.loc.gov/2020032861

LC ebook record available at https://lccn.loc.gov/2020032862

ISBN 978-1-9821-4143-1

ISBN 978-1-9821-4144-8 (ebook)

F OR MY MOTHER , J O A NNE K OEHLER I DONT KNOW HOW YOU DID IT, BUT YOU DID .

B y the time the call comes in at 2:30 p.m., Mary Lou Kopas has already helped three women give birth.

The first was Monique, at 8:30 a.m. Aided by an anesthetic called an epidural, she pushed for a scant half hour after her water broke before delivering her second child into Kopass hands. The little girl needed a few puffs from a neonatal respirator to boost her breathing but now is nursing with gusto.

Next was Sofia, who had hoped for an unmedicated birth until three days of labor left her ragged and exhausted. She opted for an epidural, which allowed her to sleep for a few hours. The delivery went fine, but a bit of placenta refused to detach from the uterus. Kopas couldnt dislodge it, nor could the obstetrician she called for assistance. Facing the risk of hemorrhage, the new mother was whisked to the operating room, where Kopas helped the surgeon perform a procedure to remove tissue from the uterus called a D&C: dilation and curettage.

Then came Nayantara. After four hours of labor, she delivered her first child, a boy, without pain medication. That one was very nice, Kopas says, smiling. The baby just glided out.

Back-to-back-to-back babies arent the normal order of business at University of Washington Medical CenterNorthwest, where Kopas leads a team of six certified nurse-midwives. I might get a day this busy once a year, she says, plopping into a chair after the third birthand just before the phone rings.

On the line is Amie-June Brumble, a thirty-seven-year-old law firm supervisor nearing the due date for her second child. She tells Kopas shes been having sporadic contractions since early morning but isnt sure whether they signal the start of active labor.

Kopas hasnt eaten anything but a handful of hazelnuts since breakfast. Shes barely had time to pee. But as she chats with the expectant mother, her voice is unhurried and calm. Theres no hint of stress, no indication she has been running nonstop for nearly eight hours. The patient doesnt care how busy you are, Kopas explains later. Your job is to be there for her, to give her your full attention.

In that way, midwifery has changed little from its ancient roots. Derived from Old English, the word midwife means with woman. Centuries later, thats still how Kopas defines her basic commitment to patients: It means being there with her no matter what happens.

Following in the footsteps of midwives through the ages, Kopas helps women navigate the joys, terrors, and transformations of pregnancy and birthexperiences that rank among humanitys most primal. But midwifery today is backed by the power of modern medicine. While midwives of old had no formal training and helped women deliver at home, nurse-midwives like Kopas are highly educated professionals who work mostly in hospitals. They offer their patients the personalized, holistic care that is the hallmark of midwiferyand the peace of mind that comes from knowing surgeons and state-of-the-art resources are close at hand if needed.

Thats why Brumble chose the UW midwives for both her pregnancies. She knew she didnt want a typical hospital experience, with bright lights and medical staff rushing in and out and an obstetrician she might never have met before. She wanted to see if she could give birth naturally, with no pressure from busy doctors to speed up her labor or dull the pain with drugs.

I didnt want to be treated as a medical emergency, Brumble explained during a prenatal checkup with Kopas two weeks earlier. I felt that this was an experience that has been common to women, of women and for women throughout our species history, and I wanted to have a more personal connection with it. But she also wanted quick access to medical care if anything went wrong.

Now, on the phone with Kopas, she describes contractions that started off mild and irregular but have been getting stronger and closer together. Before her first sons birth three and a half years ago, Brumble and her husband packed a bag with fuzzy slippers, music, and snacks to help her through labor. But the baby came so fast they barely made it to the hospital in time. The bag sat in the car, forgotten, until long after the birth. Brumble doesnt want to repeat that experience, but shes wary of jumping the gun. And, she tells Kopas, shes not sure her insurance will cover a hospital visit for a false alarm.