Clinic is never dull! Last week, we had a day of SROM (spontaneous rupture of membranes) checks...when a Mama thinks her water may have broken, so she comes in for us to verify one way or the other. Something was in the air, and tricking ladies into thinking their water broke, cause none of them were. I had one lady tell me she never thought that hearing she had peed her pants would be good news! Ah, pregnancy and the sheer glamour of it.
Today, I wrote my first prescription for the NuvaRing! I know, kinda silly. Our client population doesn't usually vote for hormonal based contraception like the "pill" or "patch" or "ring", instead we do A LOT of IUD's, Natural Family Planning and diaphragms. But for this Mama is was just the right fit. We all had a chuckle that I had to look up how to write out the script.
Palpating a glorious 37 week belly and finding the baby to be breech...argh! Supporting the family through this discovery, encouraging and educating about the options...positional interventions, acupuncture, external version. And talking about what happens if these things don't work. We are blessed to have an OB in our area who does vaginal breech births and I am eternally grateful to be able to send these Mama's his way.
Meeting all the soon to be big brothers and sisters. Having them help "check their baby" by holding the doppler and having them palpate that crazy belly. Meeting soon to be grandparents and reassuring them that the birth center is "legit" and alleviating their worries.
Having to tell a Mama that she has Gestational Hypertension and can't have her babe with us. Comforting her and her family, explaining why this means she "risks out" and what that all entails. Answering her questions and giving her lots of TLC.
never, never dull
Thursday, February 17, 2011
Monday, February 14, 2011
argh...
Call shift induced insomnia is so lame!!! I had a lot of trouble with this months ago, but had managed to mostly cope with it....until last night!! I was a rare evening when I actually didn't get many phone calls and therefore could have slept.....ah, well I gues that it comes with the territory....
Sunday, February 13, 2011
the sunny side
I had been at the birth center alllll day and was TIRED. (We had had two gorgeous little ones in the morning, more about those births later as they were both difficult.) Since the previous births had been tough...I had had some serious adrenaline highs and then crashes...which makes for a tired that is a little more intense. The nurse was also on the same boat.
It was the typical labor of a first time Mama. Her first stage took almost 15 hours, but had progressed at a nice steady pace and flow. Mama's spirits had remained intact and positive throughout. She came to the center at the appropriate time and labored well. Being with her definitely helped to wake us up...along with some super caffeine charged tea that the nurse compared to crack! (And it was quite effective.) Mama had a mild urge to push so I checked her cervix; barely a rim of cervix and a bulging bag of waters at +2 station, with a baby head close behind. In my exhaustion, I offered to AROM, in my mind I wanted to speed things up....something I am not proud of! Wisely, Mama declined. Then, a short time later while sitting on the toilet, her water spontaneously ruptured and she was ready to push for real. Her second stage was 39 minutes, a couple of times the baby heart tones dipped a touch so we changed positions with good results and ended up semi-reclining in the bed. Then there was a lovely crown, followed by the birth of a direct OP baby! The nurse said, "I thought something looked funny and then realised it was because the baby was looking up at me!" Her labor had progressed so nicely, she never had any of the classic "OP labor" symptoms...it was amazing. I have heard of this happening, but had just never seen it myself. So, it does happen! Believe me, I have experienced, many times, the classic "OP labor" and all of the associated dysfunctions and extra pain. And then, there is this one that just kinda snuck up on us. I could see why they are sometimes called "sunny side up" cause that sweet little sunny baby face was lookin right up at us!
It was the typical labor of a first time Mama. Her first stage took almost 15 hours, but had progressed at a nice steady pace and flow. Mama's spirits had remained intact and positive throughout. She came to the center at the appropriate time and labored well. Being with her definitely helped to wake us up...along with some super caffeine charged tea that the nurse compared to crack! (And it was quite effective.) Mama had a mild urge to push so I checked her cervix; barely a rim of cervix and a bulging bag of waters at +2 station, with a baby head close behind. In my exhaustion, I offered to AROM, in my mind I wanted to speed things up....something I am not proud of! Wisely, Mama declined. Then, a short time later while sitting on the toilet, her water spontaneously ruptured and she was ready to push for real. Her second stage was 39 minutes, a couple of times the baby heart tones dipped a touch so we changed positions with good results and ended up semi-reclining in the bed. Then there was a lovely crown, followed by the birth of a direct OP baby! The nurse said, "I thought something looked funny and then realised it was because the baby was looking up at me!" Her labor had progressed so nicely, she never had any of the classic "OP labor" symptoms...it was amazing. I have heard of this happening, but had just never seen it myself. So, it does happen! Believe me, I have experienced, many times, the classic "OP labor" and all of the associated dysfunctions and extra pain. And then, there is this one that just kinda snuck up on us. I could see why they are sometimes called "sunny side up" cause that sweet little sunny baby face was lookin right up at us!
Wednesday, February 9, 2011
never a dull moment...
Of course, its not only about catchin babies. I have to admit that I do have the "baby catching bug" and it was originally what brought me to midwifery. However, I definitely love the rest of my job as well.
Clinic days are often fast and never boring. I love meeting with our families for thier prenatal visits. I am blessed to be in a practice where I am able to spend time and get to know our clients. Meeting families for thier very first visit and welcoming them to our practice. The postpartum visits for the new families...the 2 day, the 1 week and the 6 week...being witness to the transformation of the mothers and fathers and family. Preconception visits to help women plan a healthy pregnancy from the very beginning. Well woman and contraception visits to help women learn about and take control of thier health and fertility. How can I not love this work? never a dull moment and always fulfilling....sometimes exhausting!...but worth every minute of it!
Clinic days are often fast and never boring. I love meeting with our families for thier prenatal visits. I am blessed to be in a practice where I am able to spend time and get to know our clients. Meeting families for thier very first visit and welcoming them to our practice. The postpartum visits for the new families...the 2 day, the 1 week and the 6 week...being witness to the transformation of the mothers and fathers and family. Preconception visits to help women plan a healthy pregnancy from the very beginning. Well woman and contraception visits to help women learn about and take control of thier health and fertility. How can I not love this work? never a dull moment and always fulfilling....sometimes exhausting!...but worth every minute of it!
Thursday, February 3, 2011
epiphany
The labor can best be described as full of grace. The Mama was focused and serene in her power, her husband was loving. She progressed steadily and evenly, spending time in the pool, walking, on the birth ball and in the bathroom. While on the toilet, she started pushing and we were witness to a shining crowning bag of water, which eventually broke on its own.
At some point during the second stage, the baby had some difficult moments. It was a time when I had to pull out the "inner drill sargent" and strongly coach mama through some intense directed pushing and position changes. Baby was talking and telling us that the birth time needed to come sooner rather than later. It is interesting to me how, in times of stress like these, the mind can compartmentalize different thought trains. In my heart, I knew that this mama and this baby could do this and that we were safe in pushing through. I also knew that 6 months ago, I would have "called it" and taken them to the hospital. This was an epiphany for me and one that I have been pondering for days. During some of my musings I have been fearful that I was "cowgirling" it...felling too cocky and being unsafe. Other times, I have been proud of myself for staying the course and helping them through. I spent time discussing all these feelings with my fellow midwives. It is a fine line and one that, now, I feel I did not cross in this situation.
In the end, a happy and healthy mama and dad took home a happy and healthy baby....which is always the goal of course. It is crucial to learn from experience, but to not let that experience get the best you...always a balancing act....
At some point during the second stage, the baby had some difficult moments. It was a time when I had to pull out the "inner drill sargent" and strongly coach mama through some intense directed pushing and position changes. Baby was talking and telling us that the birth time needed to come sooner rather than later. It is interesting to me how, in times of stress like these, the mind can compartmentalize different thought trains. In my heart, I knew that this mama and this baby could do this and that we were safe in pushing through. I also knew that 6 months ago, I would have "called it" and taken them to the hospital. This was an epiphany for me and one that I have been pondering for days. During some of my musings I have been fearful that I was "cowgirling" it...felling too cocky and being unsafe. Other times, I have been proud of myself for staying the course and helping them through. I spent time discussing all these feelings with my fellow midwives. It is a fine line and one that, now, I feel I did not cross in this situation.
In the end, a happy and healthy mama and dad took home a happy and healthy baby....which is always the goal of course. It is crucial to learn from experience, but to not let that experience get the best you...always a balancing act....
Saturday, January 29, 2011
sweet squishies
Whew, two sweet squishy babes early this morning. One girl and one boy...and a nice way to get out of the land of negative....
But my mind does still wander, this time to the babes. How do we welcome our new generation to this earth? I can't hope but believe that when newborns are welcomed in love, respect, beauty and strength, it leaves an impression. That they are starting off on the "right" foot. Clearly, empowered birth will not change all of the world's woes....but it could go along way toward starting. Ensuring empowered birth is much more than fostering the few months of pregnancy, the hours involved in the birth and the postpartum time. Empowered birth requires that young boys and girls are nurtured and grown in environments that honor and respect thier bodies and that has they grow to young men and women they respect each other. That girls are raised hearing strong, positive stories about the power and wisdom of thier bodies. An environment that honors birth, is one that honors women and children...and when we honor women and children we honor all life. And that! is a start toward ending the woes of the world!
Ok, so there is one of my 'waxing philosphic' moments. I guess that is what sweet squishy babies do to me.....
But my mind does still wander, this time to the babes. How do we welcome our new generation to this earth? I can't hope but believe that when newborns are welcomed in love, respect, beauty and strength, it leaves an impression. That they are starting off on the "right" foot. Clearly, empowered birth will not change all of the world's woes....but it could go along way toward starting. Ensuring empowered birth is much more than fostering the few months of pregnancy, the hours involved in the birth and the postpartum time. Empowered birth requires that young boys and girls are nurtured and grown in environments that honor and respect thier bodies and that has they grow to young men and women they respect each other. That girls are raised hearing strong, positive stories about the power and wisdom of thier bodies. An environment that honors birth, is one that honors women and children...and when we honor women and children we honor all life. And that! is a start toward ending the woes of the world!
Ok, so there is one of my 'waxing philosphic' moments. I guess that is what sweet squishy babies do to me.....
Friday, January 28, 2011
a little rant
We have been sooooo quiet! I know, I know...don't rock the boat or jinx anything, but it is getting ridiculous. My fingers are getting a serious itch. I have drained and filled, due to lack of use, too many birth pools. All of this 'free time' has lead my mind to wander.....
Recently, I had an orientation (kinda like an open house for the center) with a lot of great attendees. It was a good crowd, with lots of good questions and interaction. At the end of these sessions, I always stick around for people to speak with me privately if need be. A very nice couple approached me and as she started to tell me her story/ask her question, she started to cry. She is early in her prgnancy and has had some spotting. The "care" she has been receiving from her care provider (an OB doc who she has been seeing her whole adult life) sounds less than stellar. Don't get me wrong, it sounds like all the clinical bases have been covered...but the emotional ones have been abandoned. My initial instinct was to reach out and touch her, give a hug, a tissue and some comfort....which I did, even though I didn't really know her. Then we all talked through her experience, I answered questions as best I could, and held her hand. We spent all of 5 minutes together and at the end she said that I "had given her more care and compassion" than her doctor ever had! Me, who is basically a complete stranger!
This is so disheartening. How can we empower women to demand and get the care they deserve? This story is so common in our culture....we need to encourage and foster change. Don't get me wrong, I am not bashing doctors...there are fantastic, kind doctors out there; just like there are not so great midwives out there. It's just that, all too often, as "patients" women will accept horrible care as "normal". Aarrgghh!
Whew, I have to pull out of the negative, or I could go on and on down that road! Clearly, I need to catch some sweet, squishy babies and get back in the positive zone. Hopefully tonight!!
Recently, I had an orientation (kinda like an open house for the center) with a lot of great attendees. It was a good crowd, with lots of good questions and interaction. At the end of these sessions, I always stick around for people to speak with me privately if need be. A very nice couple approached me and as she started to tell me her story/ask her question, she started to cry. She is early in her prgnancy and has had some spotting. The "care" she has been receiving from her care provider (an OB doc who she has been seeing her whole adult life) sounds less than stellar. Don't get me wrong, it sounds like all the clinical bases have been covered...but the emotional ones have been abandoned. My initial instinct was to reach out and touch her, give a hug, a tissue and some comfort....which I did, even though I didn't really know her. Then we all talked through her experience, I answered questions as best I could, and held her hand. We spent all of 5 minutes together and at the end she said that I "had given her more care and compassion" than her doctor ever had! Me, who is basically a complete stranger!
This is so disheartening. How can we empower women to demand and get the care they deserve? This story is so common in our culture....we need to encourage and foster change. Don't get me wrong, I am not bashing doctors...there are fantastic, kind doctors out there; just like there are not so great midwives out there. It's just that, all too often, as "patients" women will accept horrible care as "normal". Aarrgghh!
Whew, I have to pull out of the negative, or I could go on and on down that road! Clearly, I need to catch some sweet, squishy babies and get back in the positive zone. Hopefully tonight!!
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