The Farm - Amish Country

The Farm Midwifery Center provides services beyond the gates in Summertown, Tennessee. Many families, like my daughter and her husband come and stay there for the birth of their babies. Other local families seeking a home birth call on this practice for their care.  Another large group that is served by these amazing midwives are the Amish women and families in nearby Lawrenceburg.

In the birth stories told in Ina May Gaskin's books are writing about attending these births. Anytime we would go into town you would see the horse and buggies. We'd see Amish families at the chiropractor's office and shipping in Walmart and Kroger, everything from their groceries to a mattress to lumber transported by this version of real horse power.  We were about 2 weeks into our stay at The Farm.  At the end of our usual weekly prenatal visit Carol asked me if I would like to go with her the next day as she made her rounds to several Amish homes.  It was of course a YES! What an opportunity!

Carol Nelson is a midwife, but she is also a nurse. Her "beside manner" is personal, warm, and from the heart.  It's very much about relationships and trust as well as the medical side of the practice. Holistic. Calling on the first family was a gentleman in the last stage of prostate cancer. As she cared for him in the privacy of this patriarch's bedroom I had the opportunity to visit at length with a young woman in her early 30's about her life and the births of her 7 children. The youngest was a sweet little girl, about 5 who was very shy. I was an outsider, English,  and she was not sure about me. She nibbled on a baggie of dry cereal as her mother and I talked. We lived vastly different lives and yet we shared several things in common. We talked about the births of our children, having chickenpox while pregnant, sewing (a treadle sewing machine was close by), dealing with fibromyalgia. A few other young children, cousins, would pop their head in the front door every so often during the visit. Although she had heard of Georgia she had no concept of where it was located, even though our state borders Tennessee. She had never been outside her community. Schooling is only to 8th grade or age 14, whichever comes first. They feel that any further knowledge will undermine their beliefs and is pointless. Carol spent plenty of time with this sick man, made him more comfortable, taught his son how to care for him, left them with catheter supplies and instructions. The man's wife provided hot water from the wood burning stove and a basin for Carol to wash her hands before we left. This family had heavy hearts caring for their very ill loved one.  

This first house we had seen a few days before on our way to neighboring farm where we bought fresh eggs, milk, and meat. From the outside this Amish home was a bit scary looking, like something on a movie set. Rambling, pieced together and worn. A muddy dirt drive and chickens running about here and there.  Clothes lines and a washing machine on a porch...a non-electric washing machine like I remember from my grandparents home over 50 years ago. Inside was neat and very warm from a wood stove in the center of the home.  Simple. Walls were all white with the plain wide boards for trim painted a dark shade of blueish gray. Windows were plain and clean, trimmed with similar plain boards and paint. Wood floors, kerosene lamps here and there for lighting at night.  Pegboards held hats, bonnets and extra aprons.  No knickknacks or other decorative items in these homes. No pictures other than a large calendar which hung on the wall of each home. No comfy sofas or recliners in these homes, only straight back chairs and an Amish built rocker. 

The next home was on the other side of the tracks, so to speak. We stopped and spoke to the husband on the road as we were on our way in and he was on his way out. These people all know Carol.  They recognize her car as we would approach, and she knows them. This home was larger, seemed newer. In addition to the wood burning stove in the center of the home was a simple closed stairway leading upstairs. We stayed downstairs but I was curious about what was above! A late teen or 20 something daughter was busy washing dishes in the next room while we were there. I saw her entering with water, heard her working and saw her exit but we never spoke.  No running water. No electricity.  Water from the outside, hand pumped and heated on the stove. dishes washed in a basin using handmade lye soap.  

The woman we were there to see needed some blood work, ordered by her doctor. She was in her early 50's, had diabetes, some blood pressure issues. Very friendly and talkative, simple but well spoken. We all three chatted  for a bit while Carol did the blood draw and took her blood pressure, recording information with pen and paper pulled from her bag.  We could have left it at that but it is about the relationship with this community. The conversation continued about various family members and what was going on with their health, with their pregnancies. Carol was also finding out important information about who was expecting and although second hand, how they were handling a difficult pregnancy. I was just taking it all in. Trying to figure out the genealogy of the characters and follow the plot was interesting to say the least! Was it okay for her daughter to continue to take buggy rides with her history of miscarriage and this pregnancy of multiples?  This was better than anything on reality TV!

In their world they do not use the modern conveniences that we take for granted. At one point in our conversation this wife and mother couldn't remember a detail about something with her daughter's health and went to a large oak desk for a stack of letters tucked away in a drawer. She found the letter and the information to ask Carol. She would relay this to her daughter. This was a flashback for me. I remember when long distance was rather expensive and something you wouldn't do every day, maybe once a week and then we'd watch the time to avoid a large phone bill. Back in the day I lived far away from my parents and we wrote actual letters like those on a regular basis. I kept many of those cards and letters, now in a box in the attic. Trying to imagine not being able to pick up the phone and call my parents or text and call my kids, but solely rely on paper, pen and postage stamps sort of blew my mind!  I'm grateful that we are able to communicate easily and often but I do appreciate the handwritten letter or note.

As we left I noticed the freshly washed dishes laid out. It was not meant to be the look of an Instagram post simplicity and beauty was there. It would have been so wrong for me to take a picture. My mind knew I needed to remember that moment.  Clean stacked dishes neatly arranged on a plain but sturdy wood table. Serving and mixing spoons hung on a wood pegboard at eye level with a plain white cloth, gathered on a sting or wire, like a small curtain between the utensils and the wall.  

The last home was to see a young expectant mother. This was her third baby. A young toddler was napping and snoring on the floor on a pillow while we talked. A baby girl was asleep in a crib in the parent's bedroom.  This was the first prenatal visit for this pregnancy. She was unsure of how far along she was and had had only one period after the birth of the last baby 8 months ago. She was about the same age as my granddaughter. This young mom went to the out house to provide her urine sample. Carol talked to her about the importance of keeping her blood pressure and blood sugar under control, nutrition, vitamins and supplements. In another "we take for granted" moment I thought about all that is at our fingertips with education. We have an endless supply of information about pregnancy and all things related. Carol was needing to gently guide this "experienced" young mother so that she would have a healthier pregnancy this go around. We moved to the bedroom for a brief exam. From her measurement, LMP, symptoms, Carol estimated this baby to be due in late July. Late July with no air conditioning, heavy dark clothing, two young babies to care for in the meantime. It made me appreciate central AC and a lot of other things!

The only toy I saw was a faceless cloth doll.  Faceless as to not make an idol or graven image. The baby girl was wearing the same style dress as the other women and girls, even at this young age.    Dark blue, long sleeves, long skirt on the dress, head covered, no shoes but long black socks.  Cloth diaper.  Cloth diapers and washing without the aid of hot running water and electricity.  Carol told me that they'd often hang diapers that were not soiled but (urine) wet diapers on the line to dry and reuse. A terry washcloth folded to a triangle was safety pinned to the dress front as a bib.  Another safety pin was tied with a piece of yarn and tied to a pacifier. Safety pins and lots of straight pins hold their clothing together, even their underwear. Women's clothing does not use any buttons although men are allowed.  No zippers, no elastic, no bras. Men and boys use suspenders only, never a belt.  Shoes for men, women and children are totally utilitarian, heavy black boots, thick black socks. 

We stopped at a clinic on the way back to drop off the blood samples of the day and my head was swimming with all that I had witnessed. Carol was as patient with me and my questions as she was with Sara and every person we had seen that day. She called the physician that cares for the first two people we had seen. Listening to the conversation between them on speaker phone I heard what I already knew about this amazing woman, that she is an extremely valuable healthcare provider and connection to the Amish community!

I know that I was given an extremely rare opportunity.  This day was one of the many priceless gifts bestowed on me during my time in TN.  I was invited to journey to a foreign land inside the borders of rural Tennessee.  It was an incredible privileged and honor and I will forever be grateful to Carol Nelson for inviting me and to the Amish families who allowed me into their homes.    

While I wasn't directly doing "doula" work on this outing I grew to appreciate Carol even more and want to incorporate building trust and relationships with those that I work with, not simply to attend a birth. The way of life within that community is very different than what we are used to and there are many challenges as a result, yet she is able to care and guide in a non-judgmental way. Her gentle approach and peaceful bedside manner provide a unique quality of care I hope to strive for in my practice.  


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