I’ve always been a goal setter and love having something out there to walk toward. Setting goals came easy to me, sort of like being good at math. It was hard for me to understand people who didn’t do the same. So I marched along in life going after one goal, then another, mostly modest and attainable: nurse, wife, mother, traveler, writer. I’ve found it motivating and satisfying. But using goals as a measure of self-worth goes all to hell when something goes wrong and you question your whole identity.

Take divorce. I never saw myself getting divorced. Definitely not in the plan. Screwed up the whole goal thing. Definitely had a goal of NOT being divorced. I had to do a quick shift there and set other goals. Let’s see…hold on to my children’s home. There was one. Stop crying, there was another. Let go of all the hurt, anger, resentment and mistrust of every male on the planet. That was a biggie. Get my kids through college, alone. Stuff like that. So I did all that, with a lot of help from my friends and family, many of whom just let me cry for hours on end without running away. I’m very grateful to them. You know who you are.

My husband’s affair wasn’t conventional as affairs go. I could have forgiven a plain old affair. But it was way worse than that and I knew the marriage was over. It was incredibly painful to be betrayed by the person you trusted most in the world. The humiliation, I thought, was too much to bear. But I had five kids who were not enjoying watching me cry, and as my daughter pointed out, I wasn’t the only one suffering. He left everyone, not just me, though at the time I felt I deserved more sympathy than anyone else. And it is a small town here. People knew what he was doing, who he was with, and didn’t tell me.  I felt the humiliation was public.

Once the emotional devastation subsided, I set another goal. I was going to be happy again. I would not be a bitter middle-aged woman who couldn’t get over it. I’d let go of the money (my money) he took. He could eat the money, talk to the money, make love to the money for all I cared. All yours, asshole. Friends told me to get a private investigator to see where it went. Family would speculate about what he did with it. But I had all I could do to get through my days, and decided to let it go. I actually felt sorry for him as the secrets consumed him. (There was progress!) I had a whole life ahead of me, a clear conscience, dear true friends, and I was going to make the most of it. I decided to give all the energy I’d put into the marriage into people who needed my skills. And it was incredibly healing. And I love the life I created from that mess.

When I watched Hillary Clinton walk from the White House aside her daughter and husband after a public humiliation that made mine look like child’s play, my heart broke for her. The whole world was judging her, not just a small town. I watched her bear it, get over it, and go on to use her gifts for the good of women everywhere, and thought, you go girl. I listen to people, who have had their own marital infidelities, judge that woman and I think what goddamn hypocrites. And these are not people voting for Trump. These are educated Democrats judging a woman for her husband’s actions. They also judge her for having a goal of being president like it’s a bad thing. When I heard a Bernie supporter say with contempt, “Come on. She has always wanted this.” as if being the most qualified candidate ever shouldn’t be a reason to run for president. I asked, “Why is that a bad thing? ” To have a goal? A historical, attainable, realistic goal? Why? Because she is a woman? Was my lifelong goal to be a nurse judged the same way? No? Why? Because it was conventional and non-threatening?

She’s flip flopped, he said. She’s inconsistent.

I’d always said I would never, NEVER, stay with someone who cheated on me. But when faced with that reality, I reconsidered. The first time he cheated, I stayed. I shocked myself with how I was willing to abandon a stand I had taken so vehemently. But that is life. We don’t know how we’ll react until we are faced with situations. Hypothetical is easy. To experience, educate, process, reconsider, and make an evolved choice is not flip flopping. It’s being educated. It’s weighing all the options and making an educated choice. That is not a bad thing.

When I have gone to lobby my congress people about women’s issues, I sincerely hoped they would listen to me, become educated and maybe change their stance based on new information. God, maybe even vote in an evolved way. Is this flip flopping? I don’t believe so.

I’ve seen comments this week by a teacher criticizing Hillary for benefitting from a system that is flawed. Question. Is taking a paycheck benefitting? Because this (very good) teacher  takes a paycheck from a very flawed education system. She works within that system and I am grateful to her, because she’s a great teacher. And I wonder what would happen to our (yes, flawed) public education system if all the good teachers decided they would no longer work in a flawed system and went out and taught in some hypothetical utopia. Who would pay for that? The poor kids? The elite? Really.  I’m confused by this reasoning.

Bernie Sanders is a good man. He’s smart and compassionate and honorable. I love Vermont. It’s a nice place to live and I’m grateful to him for representing the good people there. I love that he speaks his mind and has energized young voters.  Yay. Keep it up. And if he is the nominee, I will vote for him.

But I want the candidate whose goal is going to change the lives of women forever. She has the intelligence and strength to do it.

I love that she has goals that don’t sell herself short.

I think, maybe, we all should consider doing the same.

We’ve got a thing with the number 21 in our family. My two oldest children were born on the 21st of the month, though their due dates were no where near there, and when I went into labor with my third child on the 20th I thought I’d be in for a long day, sure he’d wait until after midnight to arrive. But he showed us his little feisty spirit at 4:19 that afternoon, eleven days late. Two years later the twins were born, eleven days early, on the first of the month and we added that to the 20 to make 21 again. It amused us for some reason.

We’ve been waiting all week for the newest family member to make his appearance and when I woke yesterday morning, the 21st popped into my psyche and I thought it might be today. And it was. A healthy, strapping, baby boy slid into my hands this morning after a long night. Now, as I try to stay awake to write, I can’t stop thinking again about what we’ve done to childbirth in our culture and I want to run away to a place where it all makes sense. I know I should sleep before taking a stand, lest it turn to another rant, but I can’t. Last night I listened to more buzzing and beeping than I heard in all the Star Wars movies combined. Flashing lights and what seemed like sirens blaring as my daughter started to doze, and this laboring woman is forced to adjust herself to make the beeping stop, the staff more comfortable, the electronic beasts fed. What on earth has our medical culture done to humanity?

I’ve been working in a bubble for 23 years. My little community hospital has it’s share of alarms, but nothing like what I spent the night listening to. In the name of safety we terrorize our ill and vulnerable just at the point when it’s impossible to say, “I’ll take my business elsewhere.” An uncomfortable blood pressure cuff must stay attached so the nurse doesn’t have to come in every half hour? I shook my head sadly as my daughter looked up at me. I would have taken it off, but thought I’d be kicked out for breaking the staff-convenience rule. There was already a power struggle going on and I didn’t want a passive/aggressive punishment doled out because I took a stand on it. And then I thought to myself, look what you’re doing! Acquiescing to keep from having my daughter punished! What have I become? Of course, I was in foreign territory. They easily could have told me I couldn’t catch that baby, so I let it be. Choose my battles, give in, let the asses get wider as they sit at the desk, listening for the alarm before they get up to see what’s happening. I’m too tired to rant this week and really should stop.

I thought about how I encourage people to advocate for themselves in the system, and here I was, attending an event I have a lot of expertise in, and I was intimidated by the staff. How on earth can people ever advocate for themselves when they are vulnerable? Yes, one can do their homework and interview providers to find one they trust and an institution that shares their values, but when it comes down to labor, women are subjected to call schedules and the available provider may be someone they’ve never met. The shift may change and your empathetic nurse may be replaced by a control freak with insecurities she tortures women with. One never knows. And there you are, fully dilated and at the mercy of someone in love with their machines. The don’t-cross-me-or-you’ll-regret-it types. And common sense seems a thing of the past. And normal doesn’t seem to exist. And a mantra rings through my brain –– get me out of here. I wax nostalgic about settings without technology, where human contact and clinical experience reign. I just don’t know where I belong anymore.

And I think of women who have no choices. Women who must drive hours to find a facility to care for them. Those women make no demands; they can’t afford to. They have no voice because they are the most vulnerable of all. They are poor. They have few resources and those are dwindling. I wonder what it would take to offer them some common decency: ice chips, a bag to vomit in, some privacy, some tenderness. How much further would that go than a blaring alarm announcing an abnormal blood pressure that we induced? The solution eludes us and women have no choice but to accept it.

And sweet baby James emerges, and I look up at the stiff expressions and smile. I see the tight lips soften as we welcome him, hug, cheer, and cry. And they see we are not evil. And I focus on this miracle and celebrate the effort it took and the strength of women who, even when they are managing a phenomenal physical feat, consider others, and obey the rules because they have to.

It’s time women. There’s a sister nearby who needs you. Reach out.

I’m wondering if there are any women out there who can relate to this:  You see something that needs to be done around the house. Or maybe you have an idea about how something could work better. Or you suggest something be fixed before the house collapses. Or maybe you want a vacation. So you toss the idea to your spouse in a nonchalant, non-threatening manner. You get no response. Then the situation worsens and you try again: “Hey, the steps are now starting to rot! We are losing money with these drafty windows! The roof is leaking! I’m burnt out and this marriage is in question!” You say this with a more urgency, perhaps even a few tears, or a broken glass or two. In response, you hear an argument so lame you stare in disbelief: “That’s not rotting! We save money when the energy is inefficient! I know a leaking roof when I see it, and that’s not leaking! We can’t afford a vacation because you spend too much money on food!”  Or words to that effect. You grit your teeth.  You question your ability to choose a mate. You try to remember what drew you to this relationship in the first place.

And then one day the step actually cracks as his fat Uncle Charlie steps on it and nearly falls. Your man (without shame) says, “Honey, we need to get this step fixed before someone gets hurt!” or His brother in law starts talking about how they had an energy audit and now they are saving five thousand dollars a year, and he turns to you and says, “You know, we really should look at how much heat we are losing in this house.” or During a heavy rain the roof starts leaking on his old baseball card collection and he comes downstairs and announces that this has been put off too long! He’s calling a roofer to look at this right now! (Or, tells you to call.) or After three weeks of no sex and no conversation he says, “You know, I’ve been thinking. Why don’t we go away for a vacation? It might be fun!”

As if it were all his idea.

If this happens early in the marriage you get into a big fight about whose idea it was in the first place. And you list all the times you TOLD HIM THIS, which, he has conveniently forgotten, and this wastes another day or two until you come to some truce and the chore finally gets done. But as the years go on, you think it’s not worth it and sit back and let him take the fucking credit for thinking of it and get the fucking roof fixed. It’s just easier.

Well. I just read an article about how doctors are urging more patience for laboring women. In an attempt to reduce the c-section rate, doctors are now urging more patience in labor.  This was the title of the article: Doctors Urge Patience, And Longer Labor To Reduce C-Section.   Excuse me while I let off a little steam here…..Are you fucking kidding me???? Now DOCTORS are saying it and it’s fucking news????  Have midwives been ripping their hair out trying to protect women from this very group who were mutilating them for centuries??? Have we been jumping up and down saying this for….FOREVER??? What the FUCK? Were any doctors quoted saying, “Gee, our nurse-midwives have been trying to tell us this but we didn’t listen.  Now that women are dying in record numbers in this country from unnecessary surgery, we decided to take a look at reducing the c-section rate…and act like it was all our idea.”  Uh, no.  I haven’t heard that.

So now what do we do? Should we look at them adoringly and say, “Wow, what an interesting observation! You are so smart for figuring this out!” Is it just not worth it? Just get the job done? Give it up for the cause? Give them the credit? Holy shit.

Which brings me again to…Hillary Clinton. Bernie Sanders is the new messiah for saying the same fucking thing Hillary Clinton has been working on for decades and now it’s fucking news. She’s gotten things done for years

while someone else takes the credit. Health care reform? She wrote it. It happens to women ALL THE TIME. We’ve been socialized since birth to allow it and we end up settling for being glad it eventually gets done. Let them have the credit.

It’s just easier.

Holy shit.

I first started being appalled with what happens to women in our health care system in the 70’s when I was in nursing school. When I did my obstetrical rotation I’d leave my shift feeling as if I’d been in a torture chamber. There’d be four or more women laboring in one room with flimsy curtains between them, many of them screaming and alone. It was the dawn of allowing fathers (or any support person) into the delivery area, and only then when they had taken a required course. It wasn’t a widespread practice.  I guess fathers were still pacing the waiting room reading magazines and smoking. I don’t know; I never saw them.

Laboring women were not allowed to eat or drink “in case they needed surgery”. The nurses, all in starched white uniforms and caps, were scolding many of them for sucking on their washcloths trying to moisten their mouths. I was horrified. I wanted to comfort those women somehow but had no idea what to do. If I was supposed to be learning from the nurses, it was about charting, drawing up medications, hanging IVs, opening gloves for the doctors, and I thought, “I am never going into obstetrics.” That was about the last place I thought I could have a satisfying nursing career.

Soon after graduating, I joined the Peace Corps and went to Malawi as a public health nurse where the nurses were also midwives. I watched Malawian midwives, with very few resources, care for women in a much different way than our system did. They gathered around women during labor and childbirth. The assumption was it was a normal process, and most of the time it was. It was so different from my experience in a health care system that was supposedly the best in the world. I realized that our system had no idea what natural childbirth really was. I went from thinking I was going to the developing world to bring our superior skills and left feeling like I had to bring reason and common sense back home. I wanted to become a midwife and help change things for women here.

As the women’s movement grew in this country, and women started demanding more humane treatment, midwives offering home birth offered an alternative to a medicalized birth. In my opinion, these midwives were incredibly brave. Home birth was illegal in most states and many midwives were prosecuted. These were (and are) skilled women, dedicated to other women, staying true to their values and beliefs, and offering women an alternative to, what I considered, barbaric treatment in hospitals. I thought I’d join the revolution and do home birth. I thought it was the only way to make a difference. I had no desire to be part of a system that seemed so intent on abusing women for money; scaring them into acquiescing to procedures they didn’t need.

In graduate school I had my my first exposure to nurse-midwives working within our traditional medical system. We had a variety of clinical experiences, some in big teaching hospitals where practices of denying women rights was widespread. I watched nurse-midwives advocate for those woman. I watched how hard they had to work to convince medical residents, attending physicians, and often nurses, to wait a little longer before going to surgery.  I watched them care for poor women with the same tenderness they showed wealthy women. I saw their frustrations when their skill and expertise was usurped by someone higher up the food chain. I did not think I wanted a life of that frustration. I told my professors I wanted to graduate and set up a home birth practice where it all made sense. Where women are treated they way they should be. In my practice, women would be like-minded, agree with my philosophy, eat well, WANT their pregnancy, breastfeed. We’d all live happily ever after. That was the dream. And when I was feeling all self-righteous and spouting off this long term plan of saving the world by caring for a tiny select few, my professor said, “But Linda, it’s in the hospitals where midwives can make a difference. We can change the system from the inside.” Hmm. There was food for thought. I thought about the gratitude I saw in the women’s eyes when they had an advocate in a system that swallowed them.  I remembered what women’s lives were like in obstetrics before midwives worked in the system. Perhaps it was a way to make a difference. Get in there, do a good job, show we are safe providers, read the literature, argue intelligently for changes in policy, show our outcomes are superior, and offer women an option inside the system.

That’s what I did. And it isn’t always easy.  In fact, it’s been very difficult working in a system that is so (and I use this word deliberately) corrupted by money, power, and discrimination. But over the years I have seen tremendous progress in improvements for women’s rights within the system. It’s no where near where it should be, but it is a boatload better than where it was. Over the years nurse-midwives have been accused by some home-birth midwives of selling out; that we were just as bad as the medical establishment because we worked within it; that we had no idea what natural birth really was. We got that from one side while getting shit on by doctors on the other.

Do I have ties to the system? Of course. I got a paycheck. I got a retirement plan. I got paid vacation. I also got a ton of grief and frustration. But I was part of a profession that helped change things for women who chose to use that system. I’ve seen our profession go from an insignificant number who were marginalized and discriminated against, to running entire facilities. Nurse-midwives now teach medical residents, slowly changing the medicalized notion of birth. That is light years ahead of where we started.

Which brings me to Hillary Clinton. When I hear her being criminalized for having “ties to the system” my back goes up instantly. She’s condemned for trying to change things from within with liberals crying out that this is not possible. I think of having to fight for my own professional life in a different corrupt system, and I disagree. Yes, it takes a huge toll. Yes, it may take years. Yes, people will misrepresent you and misinterpret your motives. And yes, it will be worth it.

Do I wish we could dismantle the entire medical system and start from scratch where everyone is treated the way I believe they should be treated and the pharmaceutical industry is prosecuted for drug dealing the way heroin dealers are? Yes. Is that going to happen? No. Do I wish we had one single-payor health care system? Yes. No one wants that more than me. Is that going to happen overnight with one election? No. Do we have a candidate with ties to the system who can build on the progress we’ve made in that area? Yes. And it’s a woman with ties to the system.

I’m in awe of her. I believe she is the hope for women everywhere. I’m with her.