I just wrapped up my last day on OB call (ever?!). It feels surreal, as I made the decision and posted
many months ago (poem pasted below) about my plans to "retire" from birth work with Open Door. My last shift was actually a back-up call only for high-risk patients or surgeries/complicated births for a bright, new midwife, Hannah, who is starting with our prenatal program. It was met with some phone calls and guidance for work she was doing, but no births or even in-person services necessary, which was a perfect (gentle, out with a whimper, not a bang) way to mark changing of the guards!
I likely have (two weeks ago) "caught" my last baby ever (delivered by an emergent cesarean after which I could not locate my wedding ring, which I apparently flung off in the scramble to get scrubbed, until it fell out of my scrubs pant leg [? trapped in my bra?] about 12 hours later!). I got thrown in to care for a family I didn't know, but whose trust I did build through the process and (good baby) outcome; however, the absence of true prenatal connection reminded me that I am more human than just a baby-catcher and the loss of continuity in our practice was the deal-breaker for me to continue to work in this system.
Who knows if I'll ever deliver a baby on the sidewalk, airplane, or other (or become a midwife as I probably should have been in the first place!). Catching babies probably is like riding a bike, although prenatal care and management of medical complications of pregnancy evolves. But if one is a doctor who stops attending hospital births, one loses the ability to keep or reestablish "privileges" pretty quickly (after about two years) and I probably cannot "un-retire" (AHEM, Lindsey Vonn!), so it's pretty clear that I will be out of the scene forever.
I had a lot more tears back earlier in the year, when I was praying over the weighty decision (albeit right for me) to pivot to a new chapter-- birth work has certainly been for me the best and most fulfilling part of medicine. Now, I'm truly so happy to leave the 2 a.m. baby-catching to other professionals -- the release of the anxiety and hypervigilance of on-call work in exchange for more presence in parenting/relationships and more sleep is truly a huge relief. Attending so many wonderful births for the last many (almost twenty if you include residency!) years has truly been a joy and a privilege, but when it became more stressful than meaningful (and I was absolutely dreading my days being ON), I knew it was time to step away. I am truly at peace with the plan, and "celebrated" today (no other fanfare planned!) with a long post-call run to Eureka's Target and back (~14 miles)!
Emily P. Freeman's words in Annie B. Jones' Ordinary Time, a book I recently read, spoke really loudly to me: "To be human is to know what it feels like to sit all the way down for the long haul, to stand all the way up and leave rooms that no longer fit, and to carry the sorrows and celebrations that may accompany both."
I also loved what Jen Hatmaker wrote in her new memoir, Awake: "What if Mary Oliver is right and this is our one wild and precious life? What if we don't really get any days back, and this whole life is ours either to grind our way through or throw our arms open for delight, for wonder, for joy and beauty and connection? What if we keep putting off happiness until later and later never comes? What if we hang doggedly to 'surely this thing will eventually get better' but it doesn't? Are we really just helpless recipients of stalled, drained, broken things, or do we have some agency? What if a life exists so full we would barely recognize it against our hustle and exhaustion and emptiness? Have we settled when we don't have to? What if there is a different path, a different pace, a different peace? Apparently people can choose the life they want."
I have chosen. A new chapter begins. I'm on a new path. Life goes on....
My poem from May 2025: LIFE GOES ON
The miracle of birth,
of welcoming new life,
is something that not many have the privilege to witness.
So many years,
So many babies,
So many mothers,
So many families.
So many connections--
as a result, many familiar faces
seen at the park,
at the library,
at the market,
at the school,
in the community,
so many of them now dear friends.
Once newborns, now children, growing alongside my own,
as life goes on.
So many tears--
from mothers,
from fathers,
and wailing infants.
Happy, joyous tears,
as well as tears of grief and loss.
Some from patients,
and many my own.
So many happy days,
and some of the hardest to bear,
when some of those babies didn't breathe.
There were more patients to care for.
Life somehow goes on.
Countless hours at the bedside,
during marathon labors,
96-hour call stretches,
long nights and weekends,
(and then clinic the next day),
all while missing my own babies at home,
and taking so much time to recover.
Too stressed to snuggle.
"Mama, you're too tired to play with us!"
ringing in my ears,
as their lives (without me present) went on.
Trapped in a call schedule for a more than a decade,
working weekends, nights, and holidays,
missing weddings,
anniversaries,
birthdays,
Christmas mornings,
family travel,
bedtimes,
rest,
and freedom.
Honored to be present at families' major life moments,
but knowing that it comes at a great cost,
feeling so often as my own life
was passing me by.
Sleep interrupted,
2 a.m. phone calls,
rushed drives to the hospital for precipitous births.
Emergency after emergency,
decels,
distress,
hypertension,
hemorrhages,
C-sections,
vacuums,
twins
(and even a few breeches!).
Adrenaline, cortisol
constantly flooding the body,
rushing, yet trying to stay calm,
the oppressive weight of hypervigilance
stealing the present,
and so often squeezing out the joy.
And then there came a heavy transition.
Loss of choice.
Loss of autonomy.
Loss of stability.
Loss of continuity.
to join a large group,
a major hospital.
The interpersonal connections-- so vital to trust,
and meaning,
lost in the broken system.
Too-short office visits to check the boxes,
going through the motions,
patients treated as interchangeable,
more as numbers,
pathology, and problem lists,
than humans.
Depersonalization.
Disorganization.
Distance.
Quantity, not quality.
Shift work,
not soul work.
The job not only hard, and very different,
but also feeling deeply wrong.
The long days--and nights--
now too much to bear.
We have been conditioned to
stick it out. To persevere,
regardless of the cost,
to show resilience,
even if your soul despairs.
To have grit, and not quit,
lest we seem selfish,
not hardworking.
To withstand moral injury,
without the space or time to heal,
even while we try to heal and care for others.
But if only we could all have the choice,
to leave the tyranny of toxic expectations,
and relinquish the guilt,
in favor of the grace of escape
(knowing "when to hold 'em,
fold 'em,
walk away,
and when to run" (1).
For only when our schedule aligns with our values,
will we begin to know peace (2).
Midlife-
is where I am.
Life half over (if I'm lucky).
It's been a devastating decision,
a hard good-bye,
to release what has been my life's most rewarding work,
a huge part of my identity,
my calling,
a gift (to others and to me).
Birth work a unique type of medical care,
a special way to demonstrate and share love.
But the body keeps the score,
and gives a definitive sign that it's soon time to step away --
from being there for so many of those very first moments and breaths --
to being present for and living more of my own.
“You're replaceable everywhere but home."
Loved ones, social connections,
the ultimate keys to a meaningful life.
Rest can be resistance,
Change is inevitable,
but suffering is optional.
A boundary is a type of self-care.
One can continue to love and care for families and this community--
sparing (and honoring) one's own life (and family) as well.
A chapter closes.
Life is not over, but takes a different path.
It is not necessarily an end of a career,
but rather the light bending into a new direction.
Maybe once out of the rain,
I will once again be able to feel the warm blessing of the sun.
Feeling the glimmers of hope at what the future holds,
even as I step into the unknown,
which may even bring more joy than what lies behind,
my "one wild and precious life" (3) goes on.
1. Don Schlitz/Kenny Rogers, “The Gambler”
2. Steven Covey
3. Mary Oliver, “The Summer Day”
