Self-Preservation

     In my quietness and time of reflection I find many things floating through my mind.  Really, I am just thankful to have the time to reflect at all.  The semester has been a crazy busy one, some of the craziness inflicted upon self and other craziness inflicted by others.  I have made it a point to rise at dawn so that I may throw my corn mill after saying my morning prayers.  This is all part of me trying regain the inner peace and balance that has been misplaced during this past semester.  I find myself wanting to be in a state of meditation and complete peacefulness so that I may have the energy to take on what lye's ahead.  As comforting spending time with my family was, the holidays are anything but relaxing.  I have to remind myself that what is important during these crazy times is "time and memories."  Aside from the crazy holiday shopping, what will my kids remember most?  Surely, not the number of gifts they got, but that we were together trying to keep the spirit of Santa alive, because as they have grown older, they have become more suspicious.
      While on my holiday travels I found myself revisiting old hurts, which was not part of my relaxation plan, but still it was there.  Its like in its own time capsule that seems to want to open itself up for me every time I visit. How is it possible that I have grown from these events and yet for others they continue to be a cause for future burden at which they then try and rob me of my peace.  As much as I want to bring a greater peace to all that it has hurt, I know I can't.  I am greatly disappointed by this revelation.  Yes, yes those who really want change and healing will find it in their best interest to make those changes.  They can not be forced.  However, it is very hard for me to leave those who still like to stew in their own pity to move forward in my life.  Perhaps it is also why midwifery chose me and I chose it.  To have hope that change is possible is a gift in itself.  I always hold out hope that those that I love with find their way and see beyond their own pain.  It is the same hope that I hold out for all women.  Change is possible.  Perhaps some would say that this idea of doing the same thing again and again hoping for a different outcome is "insanity." And in some ways it is, but some people need that and for some the outcome is different. 
       Aside from dealing with old hurts, I am getting closer to reaching my goal...graduation, for now I am looking forward to the next leg of my journey.  I will be in Chinle, AZ working with my tribe.  I am very excited about this.  To finally be in a place where our traditional healing practices go hand in hand with western medicine.  I know something bigger than me awaits me there, but I'm trying not to get myself worked up over it.  I am doing my best to take whatever happens as it comes my way with patience. The down side to this is that I will be away from my family for two months.  I know I will miss them terrible and I hope that while we are creating memories, this one will not be a sad one for them.  I know my husband will do a bang up job of being their for all of us, I just can't let the guilt eat me alive that I will be away from my babies for that length of time.  My choices of my reality are not easy ones to make nor to live with, but I know there is a reason for them. 

    My prayer to self " to maintain and restore peace, love, kindness, humbleness, and harmony within my self and with my family"
     

Fear

      While receiving my training I have seen many..many..many situations where a woman's mind will not allow her to release her baby nor her placenta.  However, the minute you tell her she needs to think about letting the baby or placenta come down and out....hello..the baby is born or the placenta is released.  Truly this is just one example.  As to why women tend to hold on to these things....its FEAR.  There has been a lot of research about the effects of fear, you don't need me to tell you what they are, because most likely you have experienced FEAR in one form or another that has stopped you in your tracks.Or for some, it has pissed you off enough to push you forward rather than backwards.  I think that one step in the forward direction where you are surpassing that fear is an important one and a vital one for personal growth.
     It seems women these days no longer want to experience this personal growth they can gain from getting through this Fear they have over childbirth.  I'm not saying women are any less for choosing an epidural for painless childbirth over the ones who chose to do it without.  What I am saying is each individual woman has her own personal reasons for her choice.  I think the media has done a pretty good job of striking the fear in women that childbirth is scary and they should be afraid.  I also think that other women sharing their experiences have also scared women into not letting their minds believe in there bodies.  Let me say that again...."not letting their minds believe in there bodies."  This concept that I am talking about can actually be applied to varies difficult events in our lives.  I mean you could probably look back at your life and remember specific situations where you did push yourself to overcome the emotional pain or physical pain you were feeling at that moment. For some this achievement is a goal and for others it is not.  It's at that moment where you realize..hey..I can do this..or I am doing this...or...I didn't realize I had it in me to push myself.  Its almost like a whole new world opens up for you.  When I see the media giving you another reason to be afraid.  You know what I hear..."You are not strong enough."  and the scary thing for me is..we believe it......Well until there is that one moment where we find out that we are strong enough.  I firmly believe that certain events in our lives happen for a reason and are opportunities for personal growth.  Whether or not we chose to use that event as an opportunity for growth is entirely an individual choice. 

Heart Burn

          I have to say, I've had one of the most interesting weeks.  Yet, again I am amazed at the magnitude of how social circumstances can manifest as "heart burn."  It seems that women today continue to be afflicted by their circumstances while maintaining some sort of balance in their lives.  While looking at the bigger issue, it is no wonder one of the major causes of death for women is cardiac related.  Do we really take our emotional issues to heart?  Or is it socially acceptable to place an outward appearance of strength and stability, when really you are doing your best to just get out of bed every morning? At which, emotional instability begins to manifest itself in other physical forms. It seems that women's health issues need to be addressed from a feminist perspective, which would explore and incorporate a woman's health from within the context of how women live their lives, collectively and individually within a patriarchal society.  This perspective incorporates social, environmental, and economic aspects of women's health, which is vital to understanding how women are able to achieve health and well-being (Womens Gynecological Health, 2006).

          With that said, I wanted to shed some light on some of the issues that women are facing today.  I think for those of us who are health care providers or working within health care, these women are usually the ones that continue to come in to be seen for varies health issues during pregnancy or for other gynecological crises.  When taking a closer look at their background you may find that they have an extensive social history ranging anywhere from depression, anxiety, abuse, homelessness, and the list goes on and on....Some of these women may have partners that are in and out of their lives, but they continue to bare the burden of raising their families alone and with little resources.  So again, are we really treating "heart burn" or is it a physical manifestation of their circumstances?  Apparently, 60% of patients coming into primary care have clinically significant mental health issues. Furthermore, while researching barriers to prenatal care among the Native American population in New Mexico I was somewhat surprised to find that among the top five reasons Native American women may not seek out prenatal care or there is a lack of prenatal care, are belief systems, family dysfunction and low socioeconomic status.  Findings that supported these reasons were that there was association with lack of transportation and childcare, traditional belief systems and family dynamics. 
          Obviously these issues are so complex that a 15 minute visit with your physician, midwife, or nurse-practitioner will most likely not fix the problem.  So what will?  Unfortunately, I do not have that answer for you.  I think it is important to keep a running dialogue among health care providers so that there is an awareness of the issues that our Native American communities are facing.  I realize seeing at least 20 patients on a daily bases with varies complex health issues can numb your senses as to what is going on in the home setting for these women, but some level of understanding and sensitivity needs to be maintained.  Because, when you see these women, you are not just treating heart burn.

Outreach

          One of the purposes of my blog was to give first hand knowledge of what it is like to go through a midwifery program from a Navajo perspective.  Upon entering the graduate program I was amazed to find that even though 75% of all Native American women in the U.S. received women's health care from midwives, there is only a limited amount of Native American Nurse Midwives that practice in the United States at this time.  Currently in our state of New Mexico there is only one Native American Nurse Midwife practicing.  Why does this matter?   Long before Indian Health Services became part of the "normal" childbirth rituals for our Native women, a majority of our childbirth practices was provided in the home and usually by a family member who was knowledgeable about traditional childbirth practices.  Over time these traditional childbirth practices have been abandoned and a "Blessing Way Ceremony" was replaced by a doctors visit. I realize that historically Indian Health Services was necessary to help correct the increasing loss of mothers and babies to illness prenatally, postnatally, and in labor.  However in the process it seems there has been very little meshing of our traditional philosophies and way's of life with the Indian Health Services model of care.  As a good mentor of mine has said.." there is no INDIAN in Indian Health Services."   
          I believe that most Native American providers will find themselves in a unique position to walk between the two worlds of our traditional healers philosophies and the western medicinal philosophies.  We have something to offer with a unique perspective that only we can understand and provide to the communities we are helping. So for those few individuals who find themselves walking this path, I wanted to help nurture that drive with my experiences and knowledge.  This is why I find it vital to encourage Native American women to consider Nurse-Midwifery as a path for them. I realize up to this point I have talked about things from an emotional perspective rather than specific experiences, but really it has been the emotions that have been most memorable.  Unexpectedly I have found a deeper connection with my own culture and a deeper respect for our traditional philosophies as it applies to pregnancy and childbirth.  I am amazed at how vital our traditional teachings are and how immersed in the care of our bodies and minds they are.  It is our traditional philosophies that carry us and that shape our minds to view the world in a different way.  It is with this perspective I want to share in the care of women.
          For me, part of the journey is to help educate young students about Midwifery.  As a young student in high school I never realized ones ability to impact others.  I looked up to those who were known leaders, but I never considered myself as one.  I have to say, I don't think I would have been ready for this role if it wasn't for my children and husband who have helped mold me into a woman who speaks up.  Even the very challenging events in my life have taught me to speak up and not get stepped on.  My point is, know matter your circumstances, you have many opportunities to grow from them.  You can't let your circumstances keep you from reaching your potential.  We all know that Native Americans have been marginalized for years, but that shouldn't be an excuse to marginalize ourselves and never see beyond our own circumstances.  I think for a Native American high school student to connect with someone who grew up under similar circumstances who now is in a position to lead in any field of education or profession can be very empowering.  It is kinda like..I am here now, but I want to be there later.  Now how do I get there?  Planting the seed is just the first step.  Personally, I am not surprised to see and hear that more and more Native Americans are entering health fields.  Based on my personal observation most of us excel with hands on learning.  We tend to do more listening then talking. Perhaps we have our ancestors to thank for that.  Lets just say our instincts have been rooted in our understanding of nature and natural life cycles. 
          It may be that what I'm talking about is already known by many, its just no one is talking about it.  Which I consider another Native American trait, we know what is going on, but don't expect us to always be talking about it.  All I know is...this indian is talking about it.

Mentorship

         As much as it was my drive that has gotten me this far, it has been certain individuals in my life that have helped me along.  I can't really say I did this all by myself, because I haven't.  Growing up in a traditional blended family I have to say I took direction from varies individuals in my life.  My grandmothers for one have always been a stable memory in my life.  Both women had qualities that just living day to day life has instilled in them.  My grandmother Mary was sweet and soft, but she had a certain level of strength in her spirit.  She spoke only Navajo and as a young girl I only understood a few words when she spoke to me. The amazing thing is as much of a life force as she was for me as a child, her spirit and memory are more of a life force for me now.  My grandmother Virgina was also a soft memory for me, she had a certain warmth in her smile.  Both women passed before I was old enough to really comprehend how much influence they had over me.  During the time they were in my life, there presence was the security was I seeking, the security that I was wanted and loved.  I think even though their time with me was short, what they hoped to pass on to their granddaughter has taken hold..love, strength, security.

        My teenage years were turbulent ones.  I think there is something to be said about surviving teen years.  I was at the point in my young adult life where I was letting my insecurities eat me alive and at the same time dealing with past hurts.  I felt as small and insignificant as a rock on the ground.  It was during this time that I really considered ending my life.  I had actually considered it on several occasions, but it was on one of these occasions I met Margie.  I remember going to school that day and walking to the counselors office and admitting that I was considering ending my life.  I thought counselor meant mental help, but actually this lady could only help with college placement...So she directed me to Margie who was a childrens counselor.  She happened to be visiting our school that day to meet with other students.  It wasn't so much what she said to me that changed things for me.  Of course she listened to me, but she took me under her wing.  I went to her home on occasion for just visits, she took me to meet her parents and brothers in Southern New Mexico. We talked about all her degrees and just life in general.  I remember being in awe, here was a grown independent woman who took care of herself.  This lady had it together.  I remember thinking, this is who I want to be.  This one woman has no idea what she saved me from.

       Throughout my young life I have been fortunate enough to have many more influential people come into my life.  Some of them have only been in my life for a short time, but others will continue to be influential as long as I breath.  I am comforted in knowing that with each person that comes into my life, there is always a lesson to be learned.  Even as I talk and connect with my preceptors while deciding on our plan of action for each women in our care.  What is it that they want me to know?  What skills are they trying to help me sharpen so that I may be ready to deal with similar issues in the future?  As hard as it may be to be the student it is equally hard to be the teacher.  I'd like to say I take direction well, but on some sensitive issues, I don't take direction very well at all.  I think when you have a good relationship with your mentor you are willing to share your insecurities with them and hopefully they will help you see your way out of them.  I'd like to think that the spirit world sends these special people your way so that they help you in your journey through life. All I know is...I am here.

The First Push

            I'm finding it hard to put the words together to describe all the emotions I've had since this part of my journey has taken on a life of its own.  Most of the time I'm calm and collected, but sometimes that little piece of insecurity likes to show itself.  I can imagine it is similar for a woman who has an initial plan to have a natural unmedicated birth and then once the waves of contractions start to get more intense she may doubt her ability to cope with whats ahead.  Its that one brief moment where you loose control and let the flood of insecurities take hold.  Thankfully, that moment for me has come and gone, but most importantly my "sisters" where there to rope me in and provide the support I needed to push forward.  That single moment where they held my hand and looked me in the eye and said "You got this" was all it took.  Its moments like these where one person or several people can change a life and help bring a new one into it.
           My first week of clinical intrapartum has been filled with many varied experiences and opportunities for me to provide the support my sisters gave me at my time of need to women in their time of need.  When first introducing myself to a family I find it necessary to "feel" the room.  The best way for me to describe this is to feel the energy everyone is giving off.  Some people give off warm energy where as others may put up a wall.  I find that taping into this energy and finding my place in it all is the most important piece of information.  Some like to call it trust and I agree that trust is part of it, but really it is much more.  I have found that there is different energy surrounding each birth, some are calm and full of intimacy, where as others are chaotic.
            Finding my place in their space is how I decide on what kind of support I'm going to provide.  This is where it starts...the training, putting the pieces together, working towards the common goal of any birth, safe delivery of their baby.  I feel I rely heavily on my raw intuition and weigh the pros and cons of any intervention at this early stage.  I know that the diagnostic knowledge and management will come in time and that I need to be patient with myself.  Aside from being completely present at each of these births, my time away from the hospital is spent replenishing my energy and spirit so that I may return ready for the next birth.  Unfortunately this clinical rotation has taken me away from the one thing that does replenish my spirit and energy.....my family. I know this time away will not last forever, but I am comforted that they are still well cared for in my absence.
               For now I make the most of my time being home with my family.  I take small pleasures in making school lunches, talking to my children about their day at school and making sure my husband knows he is a rock star in my eyes...because without them I could not do this.

Traditional Health and Spiritual Mentorship

               Aside from clinical skills and didactic learning what I least expected was my deep and profound interest in traditional medicine and healing practices.  Even though I grew up on the boarder edge of my reservation our Navajo traditional healing practices have always been apart of my life.  However, while growing up specific prayers and taboos were never clearly explained to me and  it is only recently that I have taken an interest in the meanings behind what the elders having been telling me for years.  I am happy to say that while at the tender age of 12 my mother made it a priority for me to have my Kinaaldá or Navajo puberty ceremony.  This ceremony is a representation of Changing Women and signifies a young girls transformation from childhood into womenhood. Changing Women, the most honored of all Navajo Holy people, was the first women to undergo this ceremony. I didn't know it then, but this ceremony was a milestone for me and I still have memories of that night.  The memories from that night I hold dear to my heart and I hope to one day have a Kinaaldá for my daughter.  Each prayer and song in this ceremony have proven to provide strength in my ability to be a mother and to give justice to the essence of womanhood.  I feel to deny my daughter the same opportunity for a life long foundation would mean that I am not carrying on my duty as a woman.

       On my way to becoming a mother I experienced a very personal loss of three babies.  My losses occurred early in pregnancy, but never the less they were a loss.  After the third loss, I decided that I needed healing from a medicine man.  He was able to restore balance and harmony within my womb by a ceremony called "Blessingway."  This ceremony combines positive, beauty and goodness concepts within a person.  Traditional health has a belief and understanding that any specific health problem doesn't only have outward physical manifestations, it can take form in other ways.  We have an understanding that one must have proper conduct to have a relationship with all in ones environment.  Our thoughts, prayers, and mannerisms effect more than just ourselves, it can affect an unborn child and our family relations.

        It is hard for me to say when my interest was sparked and a deeper realization of what my future would entail was revealed.  I find comfort in that I am being guided by a force bigger than myself and that certain individuals have been placed in my life to mentor me on my journey.  I find it even more interesting that those special women are related to me by my clan and have been my auntie and grandmother long before I new them.  Perhaps a predestined relationship that only could be reveled to me now that I am in a place to receive knowledge.

      With each step I take towards my future my desire and interest grows stronger in returning to my traditional ways so that I may have it within myself to help convey this way of life to families I care for.  This realization is a big surprise to me and yet it feels like this was my path all along.  Who knew I had it in me to be this person?