Watching Cynthia go through the emotional turmoil of a bad outcome in the second episode of Season 2 brought my worst fear to light. Most of the time, midwifery is a truly wonderful, joyous profession. We get to be there to witness new babies come into the world. We witness that intimate moment where a new family is created. However, along with the good can come the bad, and bad outcomes during pregnancy, childbirth and infancy are especially difficult to grasp.

Being a relatively new midwife myself, I wish I could say that I’ve never seen a poor outcome. However, much like Chummy, I have always felt that international work was something I was called to do. I had the opportunity to travel to Liberia last year, when I was in my final semester of midwifery school at the University of Michigan. Another student and I went with a faculty midwife and a group of researchers for two weeks, where they would collect their research, and the other student and I would work with the Liberian midwives in the hospitals.

We were thrown into an unfamiliar, uncomfortable setting almost immediately. With temperatures in the mid-90s and constant humidity, we were physically uncomfortable, too. We had to get used to a new culture, and on top of that, had a difficult time communicating with patients because they couldn’t understand our accents. I can’t imagine what we must have looked like to the women who came into birth! The labor rooms were just one big open room with many beds. Everyone labored together, but family members were not allowed in. Now, here are these two very pale, American girls, wanting to sit at your bedside, talk with you, rub your back, and of course, catch your baby. Some people just gave us looks or were hesitant; all of them definitely thought we were strange! One woman in particular, I will never forget. She may have thought we were crazy to begin with, but it was only minutes before we were standing together at the bedside, sweaty forehead to sweaty forehead, in a familiar birth dance.

It wasn’t long before she was ready to push her baby out. The midwives and I had been listening to her baby throughout labor with the pinard horn, just like the midwives use on the show. Everything seemed to be going well. When the baby was born, she didn’t cry and looked a dusky shade of blue, but was breathing. With the limited resources we had, we tried everything we could, but the baby did not improve. I can imagine how Cynthia must have felt when she looked at little Thomas Kelly in the crib. That sinking feeling, knowing that you are doing everything in your power, using all of your knowledge acquired through schooling, but it’s still not enough.

Despite this being a very emotionally grueling experience, it was important for me, like Cynthia, to have the support of my colleagues. Cynthia felt as though she couldn’t trust her instincts anymore, and was questioning whether or not doing something differently could have changed baby Thomas’s outcome. I felt the same way, and I was glad that the midwife and nurse who were on the trip with us had experience with similar situations. I’m forever grateful for the comfort and compassion they showed both the mother and us students who were caring for her. I am so relieved that the other student midwife and I were able to have that sacred time with this mother and her baby: laboring with her, helping her feel safe and staying with her through the entire ordeal, keeping her updated on what we were doing and why. If we hadn’t been there, this mother likely would not have had the same level of support, because the culture and way of doing things in Liberia is so different than we are used to in the United States.

Support and counseling are extremely important after a loss. If you or someone you know may benefit from grief counseling or a support group, please look back at Tish's post for more on the Compassionate Care and Understanding During Loss Support Group.

Andrea Altomaro (MS, RN, CNM) has been nurse-midwife for the past three years and is currently working for the Henry Ford Health System. Before becoming a midwife, she worked as a nurse in the emergency department and also in labor and delivery.
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