July Community-Based Research Reflection Part II

At my last Birth Talks on Tuesday, the midwife/Associate Clinical Director announced it was my last one and the students began sharing some of their testimonials about their time with me as I shared the highs and lows of my experience here. One of the most challenging aspects I mentioned and would like to discuss here is how my status as a short-term student has at times felt stagnant and frustrating. I believe this is partly due to the fact that I'd like to continue progressing in my learning path here, but it's tough when it seems like other students don't know what to consider or classify you as and that because your role is confined to such a short period of time, so, too, is your learning and formation of relationships with others. While I have formed special relationships with many of the women at MLL, I have felt that some students have not opened up as much (which could be due to their personalities, of course) because I am here for a set period of time and it is unknown whether we'll see one another again. In terms of my restrictions as a short-term student (which have been few because MLL has allowed me to do SO much in eight weeks - I feel like I have been here for 3 months), my role in births has been different than I imagined.

I remember a specific time in the clinic during which two of the interns went to class and the 2nd quarter student stayed in the clinic to work with me. When discussing the birth rotation, she commented to the staff midwife that she was the only other person on that day, which made me feel that my role in births was disposable and unimportant. As soon as she realized I was on, she apologized, but I still feel that students are often unsure of my role and will ask if I'm working a 24-hour shift, which I've been doing steadily twice a week for the past two months. There have been few instances during which this has happened and these glitches in communication or understanding stand out more because I have felt and been told how valuable my help, energy, and dedication have been. I would have appreciated becoming more hands-on with birth as time went on, however (I know I helped catch the baby and I will be forever grateful for that!), and feel that my skills have started to become stagnant mostly serving as documenter all the time.

The other challenging aspect that I'd like to mention is that I'm not exactly sure how my research will be helpful to MLL. I don't feel this has been extensively discussed with the Assistant Academic Director, which is a bit worrisome because community-based research is for the progression and growth of the community partner. I believe communication between MLL and me will and needs to continue to clarify MLL's needs and what would be the most helpful for them to know and utilize in their development and maturation. MLL has been around since 1987 and is extremely rooted in the community, but that doesn't mean that positive alterations cannot still be made to improve the dissemination of information or services.

I would say the rewarding parts of this experience - becoming integrated into a community of women, learning how to do prenatal and postpartum citas, witnessing 16 births (hopefully more on Saturday - July has been slower than June, which always worries me because of what's happening in Juárez), attending classes, seeing, feeling, and absorbing the border, eating some amazing Mexican food (and meat!), receiving letters from Grammy Lo and my Mom every other day (and many other friends and family members) to put on my big windowsill, hearing Spanish and English spoken in the same sentence all the time, and learning more about who I am and want to be - far outweighs these minor discomforts and frustrations, however, and are memories that I will carry with me and be grateful for always.

4. What role has your faculty mentor played in guiding your work and helping you to address
any problems that you have faced?

My faculty mentor has been extremely helpful in providing commentary and feedback on my written fieldnotes and in sending me encouraging emails, especially in June when I was having such a hard time getting through. We haven't communicated with one another as much in July, mostly in the last two weeks, because I have shaky access to the Internet (yes, I'm sitting in my bathroom writing this right now), I am often gone all day and don't have time to compose emails, and I've switched to recording most of my fieldnotes and will share them with her when I return to CH. Despite our lessened communication, I know she's available when and if I need her and she has made herself open to me all summer, meeting with me during my trip to CH in early July, sending me many a hug across the miles, and reminding me that she's there for me by phone or email. She sent me a significant email about midway through July that has influenced my overall approach as my time in El Paso has wound down. She told me not to get too bogged down in the small details of day-to-day life here and to think of the bigger picture in terms of emergent themes in my research and how this experience has and will continue to affect me in terms of my career and growth as an individual. I continue to carry this advice with me whether I am conducting interviews and thinking about direct-entry midwifery on a national scale or am doing a prenatal cita and am incorrect measuring a fundal height, trying to look at the experience as a microcosm not only of relationships in the working world, but also for midwifery on national and international scales. This has been difficult to do with so many daily details to keep up with, but I appreciate her foresight and her encouragement in noting and exploring themes and ideas that interest or excite me the most. It will be nice to see her in person again soon, as I feel like it has been harder to connect through my fieldnotes and interviews since they are all on my audio recorder, and discuss the experience as a whole. Overall, however, I am so grateful for her time, energy, advice, and dedication and have really listened to and thought about her advice during my final weeks here.

5. In what ways have you needed to be flexible?
Yesterday was a perfect example of how flexibility is an important virtue when working with midwives (well, really anyone for that matter, but especially in a bustling birth center). I was supposed to do an interview with a student at 11am and was on my way to the birth center (stopped at the RR tracks as usual) when I received a text message from her saying she was tired and wanted to take a shower and rest a bit before class. We never ended up doing our interview, but I did interview one of the staff-in-training midwives and a student when the clinic was slower during the early evening hours. Both were interested in doing the interviews, as was the student who was unable yesterday, but often the actual time when an interview takes place is not what was originally planned. I remained closeby at Kinley's Coffee House (with my piece of chocolate cake), ready to go to the birth center whenever the stream of citas calmed down. This flexibility, patience, and not having a plan (especially when you really love having a plan) has been extremely important trying to coordinate interviews because everyone is busy, tired, and stretched for time, which makes it all the more crucial to respect the women's schedules and work with them for a time that is best. Many of the students are studying for the NARM (North American Registry of Midwives) exam and have told me they would like to do phone interviews after they have taken it on August 18. I never envisioned doing phone interviews, but am willing to do them to work around the hectic pace of the students' schedules and lives. I've learned to create basic sketches for the day, but to be prepared and open to the fact that I may not be able to record fieldnotes, post on the blog, or go to Mesilla (I really am going to go tomorrow) because I need to be available for the opportunity to interview if it arises. The process has helped me cultivate patience (which I have in abundance for certain things, but not others) and become more comfortable with fluidity, rather than rigidity in my day-to-day life.

I've also had to be flexible in my role at MLL. As I mentioned in my Week 7 post, it was important for me to be available as a floater two weekends ago so that the sick student would have time to recover. I always tell staff and students I am willing to play whatever role is most helpful in the flow of the clinic and it really translated into reality that weekend. While I mentioned in the question above that not having an assigned role can be challenging, it also carries with it fluidity that is helpful in a setting in which a birth may happen, but citas are still coming and everyone has their specific place they need to be. Having someone who can float and be in-between provides a sense of security and back-up that is not always possible when students have a specific role on the birth rotation and their experience is counting towards their certification and development as a midwife. I feel that I have been flexible in this way, especially as I've gained confidence and have had more time with the students and staff in July, and believe this is a beneficial outcropping of not having a strictly assigned role.

Thank you all for reading through this long post (I know all of them are) and for the quality of these questions that were created by APPLES students and staff in provoking deep reflection. I will likely not get to more blog posting until next week when I am traveling back to NC or have returned there because time is passing quickly here and I need to write 27 thank you notes to all of the staff and students! I look forward to seeing many of you soon and thanks again for being here with me all the way through and at the end of my journey (for now :)