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.