Tears fell silently as my patient digested the news that after a three-day induction, a caesarean birth was now being recommended by the physician and her midwife (what a betrayal!).

I could see the fear and heartbreak settle across her face. She didn’t protest. She didn’t ask for one more hour or one more cervical exam. She simply lowered her head, closed her eyes, and quietly cried. Across the room, her husband looked exhausted. The writing had been on the wall since I walked into her room that morning. She had arrived two days earlier because she had passed her due date, but as he quietly explained, the entire journey had felt like pushing a boulder uphill. Every centimetre of dilation had been painfully hard won. She seemed determined not to see where her labor had taken her. He seemed like a man waiting for someone else to give his wife permission to tap out.

Once the doctor finished reviewing the risks and benefits of surgery and everyone left the room, I pulled a chair to her bedside and took her hand. She still wouldn’t look at me. As I searched for something to say, one familiar sentence rose instinctively to the front of my mind. The most important thing is that your baby’s okay.

My chest tightened.

Those words had been spoken over me years earlier after my own first birth, another long induction that ended in an unexpected caesarean section. I remember lying in a hospital bed surrounded by nurses who repeated them again and again, every time hoping to ease the ache they saw in my eyes. I was grateful that my daughter was healthy (and scared shitless honestly). I loved her. But alongside that gratitude lived something I didn’t have words for. My mind knew I had every reason to celebrate. My heart was breaking anyway.

Grief made itself at home inside me that day. It unpacked its bags, settled into the corners of my spirit, and became the happiest squatter imaginable. For nearly two years it lingered, disguised as postpartum depression, disappointment, guilt, and a shame I could barely name. Looking back now, I realize I wasn’t only grieving the birth I had lost. I was grieving the woman I thought I would become through it.

So when I tell you that I recognized my patient’s tears, what I really mean is that I had walked this road before her. I knew the landscape because years earlier I had gotten lost there myself. “I am so sorry that you’re sad,” I told her. “And I know there isn’t anything I can say that’s going to make you feel better right now.” Crickets. “This sucks,” I continued. “Somehow it feels like you’ve failed, like there’s something wrong with your body. I know that’s probably where your mind is going.” A tear escaped from beneath her closed eyelids. I’m flailing over here.“ What I can promise you is this: we have done everything we know how to do. I don’t recommend a caesarean lightly. It’s still morning. I’m here for twenty-four hours. Trust me, I’m not recommending surgery so I can go on vacation.” She laughed despite herself. Thank you Jesus. “I promise that the doctor and I will be in the operating room together. We’ll do everything in our power to keep you and your baby safe. Then I’ll come see you afterward. I’ll help you breastfeed. I’ll sit with you while you tell me everything you’re feeling, whether that’s relief, gratitude, disappointment, anger, or all of them at once. I’ve got you.” She looked up at me for the first time. “Thank you,” she whispered.

As we wheeled her toward the operating room, I found myself wondering whether anyone had ever explained what an induction really is. We tend to speak about induction as though it’s simply the beginning of labour on someone else’s schedule, another item on the long list of things modern midwifery and obstetrics can safely manage. Sometimes it absolutely is the right decision. There are pregnancies in which waiting places a mother or her baby at unnecessary risk, and in those moments induction is not only appropriate but lifesaving. Yet somewhere along the way, we have begun talking about it as though it were merely a date on the calendar rather than an intervention that changes the physiology of birth itself.

As a midwife, I find it fascinating (mind-boggling, really) that we speak about birth with such certainty. We have protocols, algorithms, and flow charts. We know which medication to start, how quickly to increase the dose, when to rupture the membranes, when to recommend an epidural, when to place an internal monitor, and when to call the operating room. There is tremendous comfort in believing that if we simply follow the right sequence of steps, birth will unfold predictably. But birth has spent thousands of years reminding us that she refuses to be tamed. Every intervention redraws the map. Hormones respond. Contractions change. A baby’s position shifts. A mother’s body begins adapting to a new set of circumstances in ways we can measure and in ways we still can’t fully explain. Suddenly we are no longer witnessing the birth that might have unfolded on its own. We are navigating a different birth all together, one that looks familiar but plays by a new set of rules. Honestly, the longer I practice, the less convinced I am that we know birth at all. We know her patterns. We know some of her habits. But she’s less like a close friend than an acquaintance who still surprises us every time we meet. We’ve totally mistaken familiarity for mastery.

Looking at my patient that morning, I couldn’t honestly tell you why her labour had ended this way. Perhaps it was her baby’s position. Perhaps it was simply a pelvis and a baby that were never meant to fit together (more rare than people realize). Perhaps the induction altered the course in ways no one could have predicted. The truth is that none of us knows for sure. We have theories. We have probabilities. We have decades of research and centuries of experience. But sometimes the most honest answer midwives and doctors can offer is, we don’t know.

A healthy baby would soon be placed in her arms. That much I was almost certain of. What I also knew was that she would be carrying something invisible out of that operating room. Grief. Not the kind of grief we usually recognize. No one had died. Just the opposite in fact. Mom and baby were healthy and safe. Except that birth is never only a clinical outcome. It is also a story.

The following day I stopped by her postpartum room. She greeted me with a smile, her baby tucked peacefully against her chest. Breastfeeding was going well (thank God for small victories; we gotta take all the wins we can get!). Her incision looked beautiful. Her baby was healthy. By every metric we use in the hospital, she was doing well. So of course, you know that had to pull up a chair. These quiet postpartum visits have always been my favorite part of midwifery. The urgency has passed. The monitors have quieted. There is finally enough room for the conversation that should have begun hours earlier. “How are you doing with the disappointment of losing the dream of a vaginal birth?” Her smile disappeared and tears welled instantly. “I’m still sad,” she admitted. “I don’t know… it’s hard for me to move past it. I feel sad that I feel sad.” I didn’t remind her that she had a healthy baby even though, surprisingly, those words wanted to fly out of my mouth. Despite the urges for platitudes, (Every instinct I’d inherited from the medical world wanted to reassure her.) Instead, I listened. I encouraged her to tell her birth story over and over again until it slowly loosened grief’s grip on her heart. I encouraged her to find a mothers’ group where she could be surrounded by women willing to tell the truth about birth and motherhood. I reminded her that if the heaviness continued beyond those first weeks, she deserved help for that too.

When I left her room that day, I felt hopeful. Not because I believed her grief had disappeared. But because it finally had somewhere to exist. I’ve thought often about the sentence that echoed through my own hospital room years ago. “The most important thing is that your baby’s okay.” I get why we say it (duh). But perhaps what matters just as much is making room for everything else that arrives after birth: the gratitude, the relief, the joy, the disappointment, the shame, and the grief. None of those emotions cancel the others out. They simply remind us that becoming a mother is far more complicated than we’ve allowed women to admit.

Shame has a way of convincing us that we are alone. Grief whispers that no one else could possibly understand. But then one woman tells her story. Another quietly responds, “Me too.”

And somehow, even though the system wasn’t built for our complexities, we find each other anyway. We always do.

After Mexico lost, followed by the U.S., my enthusiasm for football dwindled just as quickly as it had awakened. Typical of the L.A. fair-weather fan that I am, I only watch professional soccer during the World Cup. Every four years, I suddenly become an expert on who was offside, what Messi is thinking as he misses a goal, which never happens, and why Memo Ochoa deserves to get out on the pitch and play even if he is ancient by football standards.

I went into today’s final apathetic about it all (leaning toward Argentina because they’re a latin american team), but quickly swung to the other side when I saw the Argentine players getting aggressive and yelling at the ref. All of a sudden, I was angry, committed, and cheering for Spain. Just like that, I was in it to win it, cheering along with the fans and yelling around the living room with my family.

It is honestly one of the most ridiculous and funny things in the world, how quickly we can go from not caring at all to being fully invested.

One of the things that made this World Cup especially beautiful was seeing how many teams were made up of cinnamon, chocolate, and vanilla hues. It made my spirit sing. If you want to see a microcosm of how the world is changing, you only have to watch a World Cup match.

At least, that is how it feels when I am hopeful.

But sometimes the old ways of the world, and its narrow thinking, find their way into the football-o-sphere to remind us that there is a thin line between love and hate. When a Paraguayan senator makes disgustingly racist remarks about Kylian Mbappé after her country loses to France, it makes you wonder how quickly admiration can curdle into ugliness.

One minute, we are wearing these players’ names across our backs and calling them national heroes. The next, someone is hurling racial slurs because a game did not end the way they wanted. And in the darkest version of this story, a player scores an own goal and is murdered days after returning home. (Rest in peace, Andrés Escobar. 1967–1994).

We love players while they’re giving us what we want. But the moment they stop delivering the sweet high of victory, we turn on them as if they kicked us in the shin and called our mama out her name. It’s as if the mere act of imperfection, call it being human, is all people need to behave less than human toward them.

Why are we so quick to welcome people when they give us something, and so quick to resent them when they cost us something?

This question reminded me of something that I had witnessed on my flight home the day before.

A young couple sitting in front of me had an eighteen-month-old who was not feeling his parents’ decision to travel the skies. He cried relentlessly. The longer he cried, the more I could see his parents unraveling. They cycled through every trick they had. Snacks. Toys. Walking the aisle. Whispering. Holding him close. Nothing worked for very long because, well... he was a baby. Eventually exhaustion won, and he fell asleep sprawled across his mom’s lap.

A few minutes later, both parents turned around.

“We’re so sorry.”

I smiled.

“Please don’t be sorry. He’s a baby. Maybe his ears hurt. Maybe he’s scared. I have three. We’ve all been there.”

They smiled slightly relieved, thanked me, and turned back around. But I couldn’t stop thinking about those two words.

We’re sorry.

Sorry for what?

For bringing a child onto an airplane? For existing in public? For raising a tiny human whose brain is doing exactly what eighteen-month-old brains are supposed to do? Before I had kids I used to judge babies too ya’ll. Not gonna lie.

As a midwife, I have the strange privilege of witnessing both ends of this story. I have stood in hundreds of delivery rooms where that very same child would have been celebrated. The first cry fills the room and suddenly everyone else is crying too (I “boo hoo” regularly). Grandparents wipe away tears. Nurses grin. Parents stare at this tiny person as if they’ve just watched the universe split open. Congratulations echoes around the room because somehow one word has to carry the weight of a miracle.

Eighteen months earlier, that little boy was almost certainly greeted with welcoming smiles and open arms. Eighteen months later, his parents felt compelled to apologize because he was acting exactly like an eighteen-month-old.

Somewhere between the delivery room and row twenty-two on an airplane, something changed. Not about him. About us.

The more I thought about it, the more I realized this wasn’t really a story about parenting (or football). It was a story about belonging. We seem remarkably good at celebrating people while they delight us and quietly withdrawing our grace the moment they inconvenience us. Athletes are national heroes until they miss the shot. Healthcare workers are heroes until the emergency department is running behind. Mothers are praised until motherhood becomes loud. Children are miracles until they start acting like children (aka Bebe’s kids).

The people themselves haven’t changed. Their humanity is exactly what it was before. What changes is our willingness to make room for it.

I wonder if somewhere along the way we started confusing convenience with virtue. We admire efficiency, quietness, productivity, self-sufficiency. We celebrate the people who don’t need much from us, who don’t slow us down, who don’t interrupt our schedules or make us uncomfortable. But human beings have never been particularly convenient. Birth is inconvenient. Toddlers are inconvenient (mine likes to bathe in the toilet lord help jesus). Teenagers are inconvenient. Aging is inconvenient. Illness is inconvenient. Love itself is inconvenient. Most of the people who have profoundly shaped my life did so precisely because they interrupted it.

Maybe that’s why those parents’ apology stayed with me long after the plane landed. No one had yelled at them. No one had even seemed particularly annoyed. They had simply internalized the script our culture hands parents: Keep your children quiet. Keep them small. Make sure they don’t bother anyone. Make sure they don’t take up too much room. Before y’all come for me, I’m not talking about the parents whose little heathens are running like Usain Bolt around my favorite restaurant while everyone else is trying to eat. Timmy still needs to sit his little butt down. What did Bernie Mac say? If you old enough to talk back you old enough to…..?

As I watched Spain lift the trophy today (just kidding I’d already changed the channel but you know what I mean), I couldn’t help but think that every one of those players was once the toddler someone carried through an airport. Someone celebrated their first cry. Someone lost sleep rocking them through the night. Someone probably apologized for them in a grocery store, a restaurant, or on an airplane.

That screaming toddler might become the next Messi. Or the next Lamine Yamal. Or the nurse who cares for you when you’re at your most vulnerable. Or the teacher who changes your daughter’s life. Maybe they’ll simply become the kind of person who loves their family well, coaches little league on the weekends, and leaves the world gentler than they found it.

We all say we want the next generation to thrive. Maybe that doesn’t begin with better schools, better coaches, or better opportunities. Maybe it begins much earlier than that. Maybe it begins by making enough room for children to be children, enough room for people to be human, and enough room for one another to exist without having to apologize for taking up space.

Because maybe this world wasn’t made for all of us, but let’s keep making room for one another anyway.

Amigos! I’m back. Sorry for leaving you without your favorite newsletter last Sunday, this Jackie of all trades was tired (and Mexico and the US lost in the world cup but I digress).

I started The In Between so that I could get in the habit of writing and to finally acknowledge the artist in me that I’ve ignored for most of my life. My goal was 52 essays in a year. Ambitious? But you know, I go hard and then, I hit a wall and it all falls apart. At least, that used to be my story. Now that I’m in my 40s, I know that I can stumble, or take a break, and then I can get back on the bike without feeling like it’s all or nothing (thank God that aging has come with some wisdom and not just sagging boobs and wrinkles).

But honestly, I still don’t have a great story or essay to write today. I’ve been working my butt off coaching a lot of babies into the world, raising these kids (who’s idea was it to have so many?), being a wife (I must really be acting a hot mess because my husband washed my hair for me yesterday which he does when the struggle is real), and holding it down as executive director like I really believe I got this on lock (1 point Olivia, imposter syndrome 0).

What I do have still, what I’ve always had are my wild thoughts. The In Between is my way of sharing my truly complicated, goofy, and curious self with anyone who needs a friend, a laugh, or some inspiration. So, today, I’m going to do just that. I’m going to share my thoughts in hopes that it gives you, my 27 loyal subscribers, a moment of levity that I know we could all use more of because adulting is ghetto as hell and it’s crazy out here in these streets.

People assume they know what midwives are thinking while they’re taking care of them. We’re not judging your body. We’re not secretly critiquing your birth plan (ok, maybe a little). We’re definitely not keeping score of how loud you screamed. A lady cussed “Fuuuuu***” while crowning once and I died laughing like “I know that’s right”! Mostly though, we’re focused on keeping you safe, protecting your dignity, and making sure your baby arrives smoothly.

So the other night, while supporting a woman through an unmedicated labor, I caught myself wondering: Why does labor have to hurt in the first place?

Not in the biblical sense (let’s not even). I mean biologically. Evolutionarily. What possible purpose could pain serve if the whole point is getting the baby out safely? Is it simply anatomy? Is it because a baby’s head is large and a pelvis is only so forgiving? Maybe it’s a signal. Maybe it’s meant to slow us down. Maybe pain is the body’s way of making sure we pay attention to one of the most profound transformations a human being can experience; it permanently changes us. Or maybe, and hear me out, it’s nature’s way of making sure we don’t accidentally have twenty-three children (built-in population control). If this is the case, God should revisit the design. Perhaps every tenth male orgasm could be painful (as hell) to make men nervous. You know? Spread the burden around a little.

The next wild thought I had was about poop. You read that right, POOP! Brace yourselves (just kidding. I’ll keep it clean).

If I had a dollar for every woman who apologized for pooping during labor, I’d have enough money to support my morning coffee habit. Morning skinny anyone? Ok, I’m having too much fun with this one.

Ladies, let me set you free.

We don’t care.

Actually, let me say that differently. We care deeply about you, but we don’t care that your body did exactly what bodies are designed to do. In fact, when it happens, it’s usually a pretty good sign that you’re pushing effectively. Your baby is making their way through the birth canal, everything is shifting exactly the way it should, and your body is doing what bodies have done for hundreds of thousands of years.

My job isn’t to announce it. My job is to protect your dignity.

So I do what every seasoned midwife, nurse, and labor nurse does. I quietly grab a wipe, clean you up before you even realize what happened, maybe spritz a little odor eliminator if needed, and keep cheering you on like nothing happened. The goal is that you stay focused on meeting your baby, not on worrying whether anyone noticed.

Which, of course, led my brain to another completely unnecessary question. Is this what they mean by ADHD brain?

Why does poop smell?

Seriously.

If it didn’t smell, would we even stress about it? What if it smelled like cotton candy? What if everyone’s poop had its own signature scent, like a fingerprint but worse? Some people would have a whole personality built around it. “Oh that’s definitely a Karen, smells like burnt popcorn and judgment.” I genuinely want to know why it smells at all. Evolution doesn’t usually waste energy. So why that smell? Is it a warning? Is it bacteria? Is it nature screaming, “Please don’t touch this”? If anybody reading this actually knows the answer, enlighten me, because now I’m invested.

Meanwhile, the woman in labor is apologizing over and over, convinced that we’re horrified by what just happened. Girl, I promise you, we’re not. You’re worried about pooping. I’m over here wondering if you’d feel the same shame and guilt if it smelled like Cool Water? CK one? Love Spell?

Anyway, these are the kinds of things that bounce around this midwife’s head during a long-ass hospital shift. While everyone else assumes I’m thinking about cervical exams or fetal stations, my brain has wandered off into evolutionary biology, population control, and whether poop would be less embarrassing if it smelled like cotton candy. I’ve never fully grown out of being a curious kid who asks too many questions. After forty-one years, I’ve embraced it because it’s entertaining as hell.

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Until the 1970s, most hospitals in the United States wouldn’t allow fathers into the delivery room. It’s wild when you think about it. A man could drive his wife to the hospital at three in the morning. He could pace the linoleum of the waiting room. He could stand close enough to hear her cry out through th…

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I was eight years old when I first learned that my body was a problem. At least, that’s what I thou…

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My mom said these words to me one winter morning while I was getting ready for work. I could hear a hint of worry in her voice but nothing alarming. “Mama, if it’s bad, let’s call 911.” Of course she brushed me off and…

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I was thirty-six weeks pregnant, two hundred and seventy-five pounds, and about to catch a baby in a tub of water. When the labor nurse called my room to inform me that a water birth patient had arrived, I immediately called my supervisor. I told her straight up: “There’s a water birth patient here and I’m not sure I can do this safely. If I squat down…

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There is a certain kind of day in the clinic that makes you question all of your life choices. You know the one. Eighteen to twenty-two patients, fifteen to twenty minute visit slots, a waiting room that never empties, and a chart list that refreshes like a bad dream. On those days you are not a midwife. You are a machine…

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I’m not gonna lie, when I walked on shift and heard I’d have to do postpartum rounds on top of managing laboring patients, I got a little attitude. The feeling of “the system just wants to work me to death” definitely came in strong at 7am lol.

Here’s the thing though, I love the fourth trimester. Those first twelve weeks postpartum are some of the most …

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