Pregnant women do not exist in a vacuum. The stresses and needs of a woman’s family will affect her pregnancy and labor. I am continually amazed at how a woman can power through and do what needs to be done during a pregnancy and delivery.

In Season 2 Episode 6 of Call the Midwife, Jenny Lee has been assigned to care for Mr. Masterson who is in the final stages of congestive heart failure. Nurse Lee also finds another patient in his daughter Julia Masterson whose baby is due any day.

This episode made me recall one of my wonderful preceptors from my student midwife days who taught me how interconnected a pregnant woman is to her family. I helped care for a woman who was delivering her second baby. She kept coming in to the hospital for evaluation for possible labor and always ended up going home, dilated only one centimeter and not in active labor.

Finally on the third of four visits in as many nights, my wise preceptor sat down next to the women, held her hand and asked what was wrong. My preceptor did not preach on the signs of labor, or chide her for not knowing whether she was in labor or not. My preceptor asked the patient where her mother was and why she was afraid to let this baby out. The patient cried, her husband cried. The patient told us her mother was at another hospital dying of ovarian cancer and not expected to make it through the week.

The woman wondered out loud what she would do without her mother. It was always her mother who helped and guided her with her first baby. The patient cried and said she couldn’t let go and have this baby yet, not when she had to help her mother.

My midwife preceptor held the patient’s hand, let her talk and grieve for the anticipated loss of her mother. My preceptor then gently pointed out that this baby would come one day, maybe even in time to meet its grandmother. After a few more tears and some hugs, I checked the patient one more time to see if she had dilated any more. The woman was dilated to 6 centimeters, more than half way through labor.

I was a student, but I knew my first check only half an hour before had been correct. The patient came to terms with losing her mother and realized it was OK to let go of the baby. The patient went on to have a lovely delivery of a healthy baby a few hours later. The baby did get to meet its grandmother.

The joy and challenge of being a nurse midwife is to see the bonds that wrap around families, both good and bad. We are privileged to help usher in new members to a family.

(Elizabeth) Tish Roeske (CNM, MS, BSN, RN) is a nurse-midwife and has been practicing in Metro Detroit as a certified nurse-midwife for 20 years. Roeske graduated from Wayne State University with a Bachelor’s Degree in Nursing Science and from the University of Illinois-Chicago with a Master’s Degree in Science for Nurse-Midwife.
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