Sweet Sweet Practice...Lessons Learned

Today was my first day back to Yoga Squared since last Sunday. Y2 is my home away from home. It has been my constant in a world full of chaos and disorder. I have been practicing there for almost two years, in the morning, six days a week. This is the first time I have missed a week straight of morning practice. This has caused me great anxiety and sadness. My yoga practice is my center. It grounds me. It teaches me how to deal.

A few weeks ago I blogged about the plateau in my practice. That I had hit a lull and a stillness. Today's practice, however, was completely the opposite. I was thrilled to have my alarm go off this morning, and wasnt even agitated when the parkway was closed and I had to divert around the city. When I arrived I was greeted by just the person I wanted to see, Karen, one of my teachers. Her face has met me at the door so many mornings, but this morning brought such relief. She asked me how I was and I spilled the beans. It was then that she said exactly what I needed to hear. "This is good for you. It is temporary and is just what you need." There was no concern about my dedication to the practice or lack of trying to make it to the studio, all that was there was love. Have I been looking at this all wrong? I have been so disheartened by not making it to the studio. So angry at the disruption in my life. Frustration about my lack of control. Oh, Karen...she knows me too well. There is a lesson here, isnt there? I will learn something from all this. Maybe to let go of what I cannot control. I cannot change my schedule. It is what it is, and I must do what I can do. In those words Karen gave me permission to relax and try to accept where I am. Who knew it was not as tragic as I created it to be. Practice was so so sweet today. Juicy from start to finish.

I realized this morning as I practiced, that it is not just about the physical practice of yoga. When I could not practice this week at the studio, I practiced alone at home, but it is not the same. I felt it deeply today, while on my mat, that I had come in touch with what makes morning practice at Y2 so special and transformative. It is the people. We come together as this collective whole, committed to practicing together. We meld our breath into one. I gather so much energy and strength from my friends and fellow practitioners. When I am low their energy lifts me, and in turn I hope I lift them. Our struggles, on and off the mat, become a group effort. There is a connection that is almost tangible. It sounds so cheesy and corny, and I am sure that the impact does not translate into words, but to sweat, learn, grow, struggle together is immeasurable.

8 Dont Mean A Thing

I just returned home from my second 24hr shift at the hospital, and I have to say that is went better thank the first; however, this could be due to the fact that (and I say this with love and great sarcasm) God is preventing these women from going into labor till after the holiday on Monday. Thing were somewhat low-key during the day. I got to do my first actual post-partum rounds, as this is something that is not present in home birth. I think I will really enjoy postpartum rounds, especially if I can see patients whose delivery I attended (or perineums I sutured). Because of my experience at HUP as a laborist and the fact that only two of our home birth mamas had lacerations, I rarely got to see how my suturing panned out.

I had one delivery during call. I got my first crash course in the phenomenon of “I have given birth to 8 other children and yet I am still super anxious.” Around 7pm the woman and her husband came in stating that her contractions were 10 minutes apart, but that she wanted to come in for fear she would go fast. She stated that she wanted an epidural because she was exhausted and tired. From the start her worrying and anxiety began to fly off the charts. She wanted to epidural, but was so concerned about potential negative effects for all parties involved. We decided to first check her and find out how far a long she was….8cm. AWESOME (I have to say I really enjoy it when women come in this far a long). We decided that a spinal was probably the best route…quick acting, since she was probably going to progress pretty quickly. The procedure of getting the spinal amplified her anxiety. It was beginning to take on a life of its own. I just wanted to hug her and squeeze all her concerns out. Once we got her settled and comfortable, she happened to mention that she had take a Motrin the other day for a headache. My preceptor asked if that was the only time, and she said yes, but then proceeded to be very upset about the potential effects on the baby from one time use of Motrin after 32wks. My preceptor did an incredible job working to put her at ease. Soon after she began to experience increased pressure and when I checked her the baby was very low, +2, and she was ready to push. We gowned up, quickly thank God, and within two pushes her baby was out. The umbilical cord had a very interesting vessel structure where the two arteries were squiggly and “spiraly.” Very interesting. I am also starting to think that everyone in this population has trailing membranes. Got to love the ring forceps. Her birth was beautiful. Perfect. And no effects from the Motrin on baby:)

I learned a lot with this woman. Just because she has done this before does not mean that she doesnt need support, guidance, and compassion. Take nothing for granted. Be present with women. Loving kindness and 5minutes of explanation can make a world of difference.

I love working with my preceptor, but I am having a hard time connecting with the women. There is such a huge divide between the world that I live in and the world of these patients. In writing that, it seems odd because most of the patients I have worked with through out midwifery school are very different from me. I am not sure what the difference is when working with these women. I have never before felt that I could not connect with my patients. I have always been able to find some common ground from which to meet them on. My ability to talk and put women at ease is something that I am proud of, and is one way I can distract women from the fact that I am a student. I am really having a hard time with this. I already get nervous about my skills and whether or not women will find me to be a competent provider, but I always felt that I could rely on my personal skills. I feel sunk. At a loss for words. I have so much to learn about this culture and belief system, a whole new vocabulary, a whole new everything. For me, midwifery is all about the connection, the bond and the relationship we get to develop with women and their families, and I am sad that I am struggling with this during integration. I am sure, or I am hoping, that this will get better.

A New Language

Monday was my first day of Integration. My first day with a new preceptor. My first day with a totally unique population of women. For discretion sake, I will not share what population of women I am working with or where I am; however, lets just say that it is like I entered a totally different world, with a whole new set of customs, rules, and beliefs. The first day of clinical is always scary. What will my preceptor be like? Will she agree with the way I do things? Will she think I am an idiot? But this first day was all that plus the deeply seated fear that I would offend the women, not out of meanness, but out of sheer "obliviousness." I know very little about this population, and I could tell they were a bit hesitant to have a student, so combine all this up equals severe anxiety and a headache.

I did office hours first and then headed over to the hospital for a 24hr shift. My first official 24hr shift. The midwifery practice delivers in a small community hospital, that is very different from my huge tertiary-care hospital and home birth experience of last semester. This are "quiet" and not as chaotic, and there are actually a lot of niceties, such as jacuzzi tubs, birth balls and telemetry (so that women can be on the monitor but not tethered to a machine:). When we arrived there were two women in labor, one was only 3cm dilated and the other was about 6cm dilated. The first mom was really uncomfortable and had a platelet level of 103, which is only 3 above the cutoff for an epidural, so she got her epidural and got some rest. The other mom got an epidural as well and then we all just "hung out."

I managed to get in about 45min of sleep in a room down the hall while my preceptor slept in the call-room. When she came and got me she said one of the mom's was ready to push. This birth was observation only, as the mom did not want me to actually deliver her baby. This ended up being ok because her baby was OP (facing sunny-side up...which is really hard to push out a baby in this position). I have never seen a woman push so awesomely (i dont know if that is a real word). She was a champ! But no matter how hard she pushed her baby never really came down. Combine this with the fact that she had ruptured for moderate to thick meconium, we consulted the doc to come and assist with forceps. With just a little help and a small episiotomy mom was able to push baby right out....face up staring at all of us:)

After mom got settled and we checked on our other mom (who was plugging along very nicely despite getting an epidural during the latent phase of labor) we heading back to bed for about 2hrs. I was awoke by my preceptor who told me two more mom's had arrived in labor. Oh my! I think at this point all of the rooms were full! And, it wasnt even a full moon. I got to completely manage one patient who had come in at 8cm. While talking with her, I found out that her favorite birth experience was her one baby that had been born in the car because she was able to move around as she wanted. How awesome is that (and at the same time isnt that sad that the only way she was able to have a birth the was she wanted to was in her car on the way to the hospital) !? I sat with her, rubbed her back, and allowed her to just move and shake as she wanted. Her face absolutely lit up when I suggested a birth ball. She loved it! And so, I caught her baby, with her on hands and knees. She did beautifully! Her baby was big, healthy, and very cute. She cried. I cried. She thanked me. I thanked her.

I was tired. I was exhausted. 24hr shifts are no joke and a long ride home only adds to the fatigue. I am caught at the moment between loving everything and being totally overwhelmed. My yoga practice has suffered greatly and being sick doesnt help anything. I have been thrown a bit off-kilter. I have not yet found myself in this whole semester of Integration. I know it will come, but at the moment I feel a bit lost. Grasping at straws. But I do know, that every birth is worth all the fatigue, tears, anxiety, and fear. It will all come to pass. I must trust that these next two months will work themselves out and that I will not loose myself in the shuffle.

PS. I sent my application to the yoga shala in India today! One step closer to my trip in January.

Limitations

These past two weeks have been a flurry of activity. Between the engagement, wedding planning (yes I am compulsive and have already began planning), and school starting back for my last and final semester, I have felt very little time to stop and breathe. I feel almost behind in some way. Not caught up. Scattered. I keep a "To Do" list on a bright blue post-it note in my appointment book that just seems to getting longer and not much getting checked off.

I was on my mat the other day, practicing in the corner (which has a very calming effect for some reason) and I began to think. Yes, thinking on the mat...something that I try to get away from. My mind is often a whirl of constant thoughts, concerns, anxieties. While for some people their bodies are their limitations, like their hamstrings are tight or their back hurts, for others it is their minds that present the limitations. I am in the latter of the two. Years of gymnastics have conditioned my bdy to be flexible and strong, and while it has also left me with some injuries that often rear their ugly heads from time to time, it is my mind that gets in the way. I think and over-analyze everything. I am constantly scrutinizing my practice, my asanas, my life in general. As I head into this coming semester with a new preceptor and a new clinical site, I am thinking about all that can go wrong. Not wrong with birth, but wrong with me. What will I forget? What will I mess up? What chapter in Varney’s will I skip over in my brain? I know this is ridiculous. I know deep down inside that I have gained a lot of skills and know how to manage a lot of different situations, but just like on my mat, my mind is my limitation.

In looking back at last semester I am trying to remind myself of the big over-arching things I have learned. Here they are:

1. If you just sit back and watch, birth will happen...especially if you trust it

2. Always, always, always bring a second pair of scrubs to a water birth

3. Never underestimate a 5th time mom with a small baby...they can be a shoulder dystocia

4. 3rd babies are stubborn and love to follow their own path. All bets are off!

5. I do not like to rupture membranes

6. No woman has an estimated blood loss of 150cc

7. Tug-of-war is a great way to get a first-time mom to deliver

8. 4 hours of pushing is exhausting (for the mom too:), but with a little Beyonce is the background to motivate mom it is all good

9. A "test push" can most definitely deliver a baby

10. I love midwifery

Arrested in the Reflecting Pool

It has been a few days and I had my next post all planned out. I was going to share lessons learned from this past semester of baby catching, but as luck would have it, that was sabotaged. But for god reason.

Mark and I went to DC on Monday. I love DC. There is something about it that stirs my inner patriot. The patriot that fights against the system, changes what needs to be changed, and storms against injustice. It reminds me what I value, choice, freedom, and equality. DC invigorates my deep desire to change the world around me and makes me thankful for all the people that fought for those who had no voice. I love DC.

Mark knows this. He always laughs a little when I stand on my soap box and proclaim the power that DC has over me. My ever present optimism makes him giggle.

We have been planning this trip for a while. I am off for a week from school and Mark has Monday's off. The intention of out trip was to go and photograph the new WWII memorial that is on the Mall. His great grandfather landed on D-Day, and so Mark wanted to put together an album to give to him for his 90th birthday in November. So, we dragged ourselves out of bed at the crack of dawn and headed out. When we got there, we headed straight for the Mall, working our way from the Capitol Building, to the Washington Memorial, then on the the WWII Memorial, Vietnam Memorial, and finally the Lincoln Memorial. As we headed back down the steps of the Lincoln Memorial, Mark mentioned that he wanted to get a picture in front of the reflecting pool. When his grandmother was in the military she was arrested for swimming in the reflecting pool...how awesome! I hate pictures. I always resist when it comes to taking photos. I suggested that I could just take Mark's picture, but he played the "you always say we have no pictures of the two of us" card. I gave up. He found a couple to take the picture and I unwillingly took my spot at the end of the reflecting pool. After on picture, Mark asked the guy to take one more, and that is when he got on his knee! And asked me to marry him! Who knew?! Apparently everyone but me.

The past few days have been a blur of excitement and planning. We wanted to get married next fall, and like the anal retentive person I am, I knew we had to get a place asap. After looking at only two places we found the perfect place for our ceremony and reception! It called the Phoenixville Foundry. It is a refurbished steel foundry, that is the perfect mix of industrial meets modern/elegant. To add to the space, both my grandfather and Mark's great grandfather were both steel mill workers. So, the date is final October 23, 2010. 10-23-10!!

I now have much more to blog about, weddings, babies, India, oh my!

As promised, my next post will be all about babies!