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Friday, September 30, 2011

settling in with babies

i'm liking the life that is emerging up here.

there are so many wonderful people that i get to be around.

i've got two new midwives that i've been working with now. i had my first day with peggy the other day. it was fun. figuring each other out.

i have deficits. charting. palpation. physical exam. holding babies. i can be awkward. damn not giving birth can sometimes pose a problem.

tangent #1: i was talking with christine ( friend, house-mate, amazing woman, birther, mother, baker and oh so much more) the other day about choice of birth providers and about the ability of a provider to give care when they have not birthed themselves. christine conceded that giving birth doesn't qualify someone to attend a birth, to be a good midwife, but for her, the way her care provider birthed was important. interesting to think about what women want versus what they need.  

there are other skills i need to focus on. 

working it out with new teachers, mentors, preceptors, mother midwives (whatever you want to call them!) is interesting. 

louisa is great. she gives good feedback. both when i do something right or when i get it wrong. we get on well. sarcastic. dry. i probably bore her with my introvertedness. ahh. probably bore her no more than i do most people that are subjected to my awkward silences. 

i'm encouraged by the confidence that both peggy and louisa have given me. a testament to my former training and to my midwife shell. 

tangent #2: is a student's teacher her midwife? is that a strange or irregular reference? i don't know, but shell will forever be my midwife. 

most of all i'm having a lot of fun. i've been to two births now. the last was real sweet. i was still trying to figure out my place. my role, what is expected, how i can integrate into the practice and the way my new midwives practice.

both are very open to having me practice skills on our clients. i'm not charting directly into the chart as of yet, which is a wee bit strange, but i appreciate it. i knew my charting was lacks, now i'm being directly challenged.

because in washington midwifery is so much more integrated into the mainstream maternity care system, midwives have to practice that way. there are just that many more hoops and standards to abide by. for good or bad.

i don't mind it. much of it appeals to the side of me that needs to make sure all the boxes and checked. that is very important.

i like lists and crossing them off.


Thursday, September 22, 2011

"Childbirth is PAIN! It canbe the healthy normal pain of labor and birth. Or it can be medically "painless birth" through anesthesia and/or cesarean with subsequent weeks to months of painful recovery while struggling to care for our newborn babies.
There is no escaping the pain. The choice we have is to work with pain and experience the satisfaction of birthing our babies, or to fight the pain."
The healthy pain of labor is natural, and a realization of our own personal power as women and mothers. It should be viewed as a milestone to be embraced, a rite of womanhood. The pain of major abdominal surgery is unnatural pain (a signal from our body that something is seriously wrong), and usurps our own power as women and mothers. It should be viewed as something to be avoided." 

- Barbara Brown-Hill, VBAC educator and birth assistant (in the vaginal birth after cesarean experience - Ed. Lynn Baptisiti Richards) 

Friday, September 16, 2011

new chapter

no this is not about prenatal vitamins.

i've been up in the pacific northwest now for two weeks.

i'm getting settled in. i finished last school session which was great. IV's, catheters, suturing....

for some reason i think i can manage a shoulder dystocia, assuming i can keep my shit together in that situation. again. growth after coming back from classes. it really is amazing how two weeks intensively spent with a strong group of women and wicked teachers can have that effect. very happy i'm in this program.

i'm in a different land now and attended my first birth.

meeting a woman for the first time in labour is something new to me. being welcomed into another families birth space is an honour. as an individual you can have a lot of influence over outcomes, attitudes and the energetic spirit of the birth room.

i met this family and melted. they were the sweetest couple. a couple in their late thirties having their first baby. a military family. not what i had expected.

i got the message in the afternoon. "want to come to a birth tonight?" me: "yeah"

of course i did!

i hadn't been to a birth in about two months.

i knew this was going to be a difficult birth. or a long one. one where the outcomes were unknown. baby was sitting really high. hadn't engaged. this isn't a normal situation for a first time mom. usually baby drops into the pelvis and gets comfortable at the end of pregnancy.

when i arrived the mother was in great spirits, but was definitely feeling her contractions. she was feeling it in her back. i never had a real good feel for baby, but it didn't seem posterior even though she was having classic signs of labour of posterior baby.

it was late at night, mom and baby were happy so we encouraged rest and privacy. there wasn't any need for monitoring yet. she was just beginning to efface and only slightly dilated.

she laboured over night and in the morning there had been little change.

she was in and out of the tub. she got active. she was a great sport. she walked stairs for 45min two by two. we chatted. she laboured on the toilet without complaint. she went for a half hour walk. no change in baby's position, not much change in her cervix.

both mother and baby were perfectly fine, but little sleep had been gotten, she was labouring hard and her ctx were 2-3 min apart and seemingly strong enough. but why weren't we seeing any change?

so my first birth up on the peninsula ended in a transport.

we needed access to more options. breaking her water wasn't really an option. i've gone from having three or four high level hospitals within 5 minutes of most home births to being out in the middle of no where, with the nearest hospital 45 min away and it doesn't even have a nursery, much less a NICU.

so this is what was amazing. i have never experienced a transport like this before.

the staff. one nurse. one doc. were fantastic. they were kind, welcoming, supportive. there was no sort of power struggle. everyone was sincerely on the mothers team. the staff an extension of the care she had been receiving. we arrived. the nurse got the mother in the tub, monitored the baby with a doppler and she didn't have a vaginal check for over an hour after arriving.

the tubs. the envy of any birth centre overlooked the harbour where there was a wooden boat festival. across the water were the cascade mountains and in the distance, canada.


the doctor and nurse treated me with respect. me just a student was consulted with and informed of the status of our client as though i were their peers.

through this birth i was introduced to a new perspective on midwifery care. in this area ~20% of births are attended by midwives at home. some midwives (LM's) have hospital access.

there are open (somewhat) lines of communication.

it's not perfect, but it's a hell of a lot different than arizona.

i'm so excited what the next year will bring.

oh and it can't hurt being back on the farm and being able to watch the sun rise over puget sound from our couch.