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.