Stories of a nurse midwife: Patient Akilah


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“You don’t remember me, do you?”

The auditorium of the convention center in Boston is filled with nurse-midwives, several thousand, I estimate.

Like songbirds, they come in all varieties. Peacocks, dressed in expensive summer suits with peep-toe wedges. Cardinals, in long paisley skirts and Birkenstocks. Wrens, in jeans and running shoes. One woman sitting in front of me wears a pink T-shirt that reads on the back: ”We have a secret. It’s not that birth is painful, but that women are strong.”

I sit toward the back of the huge hall, alone, at the annual conference of the American College of Nurse-Midwives. I wanted Tom to come, just for the experience, but he wasn’t up for it. None of the other midwives from West Virginia came either. They’re probably too busy delivering babies.

The woman sitting next to me, who looks to be in her late thirties, dressed in slacks, with an embroidered wool vest and long dangling beaded earrings, smiles and asks again, “You don’t remember me do you? It’s been a long time. You delivered my first baby when I was fifteen. I’m Serena. Serena Holt.”

I study the coffee-colored face and brown eyes. “Was this in Cleveland?” My first official paying job as a midwife was at Case Western University Hospital, where Tom did his ob-gyn residency.

The session has ended and the auditorium empties. “Yes, at Case. I was a single fifteen-year-old mother and you took care of me in labor and then helped me give birth naturally. I have two kids now. The one you delivered just started college. The other is still in high school.”

“I’m trying to remember. There have been thousands of births. Tell me something about your labor.”

“Well, it was a long one. My water broke at 3:00 a.m. and I came to the hospital with my grandmother. My folks had all but disowned me. Kicked me out when I told them I was pregnant, called me a tramp. I was living with Gram, but she had to work. She’d just gotten on with the Board of Ed and couldn’t afford a day off. My water was leaking, but I wasn’t having hard contractions yet, still in latent phase.

“You sat with me all day, a scared kid, all alone. You entertained me with stories of the hippie days and how you became a midwife. You told me about other young girls like me, who’d gone on to college and made something of themselves.

“I’ve always remembered this one thing you said… I often use the same words with my patients: ‘Labor is like playing cards. You don’t get to choose the hand you’re dealt. You just play the game the best you can… Life’s like that, too.’

“Anyway, once the contractions finally kicked in, I went fast. My grandmother made it back to the hospital and then my parents showed up. You wouldn’t let them in the birthing room until after the baby was born, said it would distract me, that I had to concentrate on getting my job done. The baby was posterior and my back hurt like hell, but you got me through.

“That day changed my life. I named my little boy Akilah. It means ‘wise.’ You believed in me when no one else did, and here I am.” She dips her head and passes her hands in front of her body as if introducing someone rare and beautiful.

“I finished high school, started community college, went into nursing, got my master’s degree and became a nurse-midwife because of you. When I was an RN in labor and delivery at Case Western University Hospital, we nurses used to tell stories about you after you left, funny things you did with the patients. We called you the wisewoman.”

“The wisewoman?” I almost choke. In many countries the title “midwife” means wisewoman, but I am a child staggering through life. I wipe the corner of my eye and give my fellow midwife a hug. Life is a journey and you never know whose life you may touch.

“Akilah” is an excerpt from Arms Wide Open: A Midwife’s Journey by author and midwife Patricia Harman.

Patricia Harman
Patricia Harman, CNM, has published in the Journal of Midwifery and Women’s Health and Journal of Sigma Theta Tau for Nursing Scholarship as well as in alternative publications. She is a regular presenter at national midwifery conferences. Her first book, "The Blue Cotton Gown" (Beacon / 7291-2 / $16.00 pb), was published to acclaim. Harman lives and works near Morgantown, West Virginia, and has three sons.

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