after birth pains, part 2

If you are on MDC in the birth professionals forum, this will sound very familiar. It isn't plagiarism, it's me thinking out loud on Mothering. I felt like part 1 was not quite finished, that I hadn't completely thought through what bothers me about these situations. So, for me, here is the rest of the story:


I know it's a passing feeling of "what else could I have done?" However, I have thought quite a bit since my OP about why this bothers me and here's the crux of the matter.

I don't want to be the midwife who blames her clients for how the birth turns out. But, I need to back up a step further. I don't want to not have the skills or knowledge to give her the best possible chance at the birth she wants.
It is so easy after a birth that went poorly to say, "I did everything I could", but I always wonder if that's true. Was there some physical or psychological or emotional thing that I missed that would have made a difference? Have I just not investigated or studied enough to be sure that I know everything that would have made a difference?
Like Shelly (reikitiki) posted, I call her when I think the mom needs mothering during labor. Hand holding is not always my strong suit. I just think that although women need emotional support during labor and birth, it is still a path they must travel alone. Only they know how best to give birth.
The problem is that I know midwives who have, what in my opinion, are limited skills for dealing with difficult situations. They have a few things they will do and if that doesn't work it becomes the mom's fault when the labor doesn't progress. She is blamed for emotional blockages related to prior sexual abuse, ambivalence about motherhood, problems with her partner, not wanting the birth badly enough, and probably a whole host of other things.
When I am really tired and frustrated by my own lack of being able to change the physical situation, I have found myself wondering if there isn't something of that nature going on. What I have found every time I begin to think that way is that there was a very good reason why the birth wasn't straightforward and it usually had something to do with what the baby was doing. Things like being asynclitic or posterior, sucking on fingers, being really long bodied in a short waisted mom (think accordion fold rather than curled up).
The baby is the one person we can't do much about. I'm not positive that the mom's emotional state has all that much to do with the baby's positioning. I am sure that baby position has everything to do with how mom labors. It just doesn't seem fair to blame mom when she doesn't have any more control over the baby than we do, yet that is what sometimes happens.

I always regret afterward when I forget that point and have found myself thinking that mom's intentions for the birth were not what she told me they were. Yet, I can't think of a birth that ended as a transport where there wasn't truly some baby position thing or cord wrap thing that was actually the problem. And, I absolutely hate the idea that I may have doubted the mom's intentions and she feels blamed (like being broken) for something she had so little control over.

Like I said above, I don't want to be the midwife who blames her client for how the birth went. I may not be the most touchy-feely midwife, but I want women to know that I believed in them and their ability no matter what happens.