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Tuesday, December 17, 2013

young mother. we know your secret.

young mother.

body ripe with life.

you move and sway.

your body has been here before. it carries the knowledge of your ancestors.

young mother.

you fight the passage. you fight the progress.

surrounded by your tribe. you take each surge one at a time. wanting escape.

we sit and watch. we know your secret. we know your power. we know you can do it.

young mother.

find your rhythm. find your strength. settle into the recesses of the ancestral knowledge that lies deep within your core. let the surface go. let it all go. open. down. sway. rock. shift that baby lower in your loins. embrace it. we know your secret.

young mother.

you start to believe. the power of your tribe surounds you as your inner strength builds. you find your rhythm. slow dancing between surges, dropping into a squat as the intensity builds.

supported by your partner, your tribe in the corner. it is just the two of you. it has only ever been the two of you.

you close yourself away. physically and metaphorically. you take control and find your power. you believe. you sit and let the baby down. reaching. you let the baby into your hands. you bring your baby to meet the rest of us.

young mother.

we know your secret. you are powerful.

you did it.

Monday, December 16, 2013

technology and it's appropriate use. when pitocin and an epidural might be the right choice.

it's monday and four hours to midnight. no birth yet, but was paged to evaluate a mother with a potential pulmonary embolism.

what i'm about to write about may piss a bunch of people off. but i think it's important.

technology and it's appropriate use. when pitocin and an epidural might be the right choice.

i've been thinking about this recently. it's an ongoing dialogue really, but now that i have the use of pitocin and pain relief in my bag of tools it's become more relevant.

there have been a number of first time mothers with long labours recently. some who have used the resources a hospital offers without reticence and those who have chosen not to.

perhaps it's not appropriate to compare any labour to another, but it's interesting.

what happens when a mother chooses to avoid intervention in her labour, striving for a natural birth without intervention, and ends up with a cesarean? what would have happened had she opted for augmentation earlier? would the benefits of an epidural relaxed her pelvis enough to open up and let the baby down?

is the mother happier, knowing she did everything she possibly could have within her body and soul to labour that baby down and bring it into this realm? if the result is a cesarean, is this still a more satisfying birth experience than had she used these other tools or "interventions" earlier?

these are the questions in my mind.

i'm not an experienced midwife. i'm an entry level midwife and damn proud of it. i know my limitations and i'm open to learning. i'm open to a multidisciplinary approach. i'm open to using modern technologies that we are so privileged to have access to in north america.

my job now as a midwife who has these tools within her scope of practice is to use them effectively.

i am experienced enough to recognize when labour has become abnormal. if i couldn't then, well, i'm not ready to be a midwife.

the conflict of interest arises when my clinical judgement may disagree with the desires of the labouring mother.

ultimately, this is her birth, her body, her baby, her decision.

i can offer, suggest, recommend what i see as the appropriate course of action or what the available options are. but the decision is not mine to hold.

reflecting on a birth, however, i can't help to wonder. if the mother had taken my recommendation and utilized these "interventions" would she have had a vaginal birth?

this leads me to evaluate the current culture of birth in which we live, in which women live and are educated.

childbirth education, the media, books teach women how to say no to intervention. however, are they teaching them when saying yes, might be appropriate?

have we completely desensitized ourselves and abused these advancements to the point that the only option is saying no, because either a) women do not trust their care providers to use these tools judiciously and as needed, or b) women are taught that if they say yes to any intervention, they have failed. that putting themselves through hell and back, fighting, being that warrior goddess, means that they must say no to the point that their only option is surgery?

i see every mother as that warrior goddess. no matter how her birth story is written.

carrying, growing, and birthing life is the utmost human feat.

how can we get to a point where women not only trust in their bodies, but also in their care providers and the technology that is available?

how can we get to a point where care providers trust women's bodies, and not rely on these technologies to manage birth?

Monday, December 2, 2013

monday's are for births or week two

i was awoken at 5am to the midwife calling me that one of our mothers is in labour.

first home birth

she was so strong. so powerful. so thrilled. so amazed at herself.

i helped as she eased the baby's wrinkly head out on hands and knees.

she turned over, reached down and lifted her baby to her chest in pure surrender.

happy monday.


Sunday, December 1, 2013

week one or baptism by fire

it's 7:41am on sunday morning. most sane people are sleeping. me? i'm showered, have managed actually washed my hair (yes i do feel this is an accomplishment) and am dressed. i even have time to write before i head out to a postpartum visit.

i enjoy a little high productivity now and then, but i sure wish i was cozy in bed with no thoughts of getting out of it right now. oh well. i get to go snuggle a new baby and check on her momma.

i started monday with a bunch of meetings and being introduced to the new practice i'm with. i was also informed that a birth was likely to happen. day one, go.

this birth was definitely a baptism by fire. i'm not going to go into the details, but i definitely rode the learning curve with this one. it was a planned hospital birth and she did require pitocin and wanted an epidural. these are all very new things to me. new to me in the way that i was the one who remained guiding the birth.

i witness a woman with an epidural get out of bed and walk to the bathroom without much support. FREAKING WALKING EPIDURALS DO EXIST!!!

have to say i was impressed with that one.

this birth was eventful to say the least and i was so honoured be the one to receive this mommas baby after she triumphantly pushed.

births are about the families we serve. there is no question about that. but some experiences grow you in a way that needs to be recognized.
me having a grey's anatomy moment
in the staff change room

this was my first time in this hospital. i hadn't even had a tour. i was wearing scrubs. i was integrating myself into this new environment. this was a long labour. long. like epic. it took work. and in that process i was able to discover this new place in which i was to be an MRP (most responsible provider).

me. the most responsible provider here in a hospital? OK. i can do this. i have no idea where anything is.

nurses. i have the deepest respect for nurses, all that they do and all that they know.

i need them.

so that took the better part of my first three days. i didn't make it back to clinic until thursday.

they had me scheduled to take part in this obstetric training workshop for the hospital. nurses, family practice docs, OBs and midwives. all get the same information, so that everyone is on the same page.

730 saturday morning. who schedules workshops for 730 saturday morning?

it was good. a lot of what i already knew. reinforced some of the fetal surveillance that is new to me (i.e. interpreting EFM strips), but ultimately it was a great way in which to be seen by those working in the hospital.

one of my favourite moments of the day was when one of the residents looked over at me. she looked at my wrist. then whispers: is that a uterus? me: yep. resident: are you a midwife me: yep resident: that's hardcore.

relationship building moment. advice: make friends with residents. you never know when you are going to need them.

so today, this morning going to check on baby. wanting to sleep. this whole thing has been a shock to the system after being away from it for the last 5/6 months. finding a way to catch up on lost sleep. my family i'm staying with think it's great and laugh at the fact that they didn't see me for a few days. the midwife vampire. sleeping during the day, off throughout the night.

but i love it. i wouldn't have it any other way.

baptism by fire.