Thursday, January 31, 2008

You like?

Had the most fabulous shopping find.

Ruby. Silk. Beaded. Bias cut. My size. AND 70% off.

A dream come true. Be still my heart!

I've got one heck of a March coming up. 3 weddings and a formal retirement do in Japan. This frock is for the wedding in Melbourne at the end of March. The invitation says Lounge suit. I'm sure this fabulous little number will be appropriate.

Now all I need is a cast iron girdle. :o)

Tuesday, January 29, 2008

A kindred spirit.

Found this fantastic midwifery blog. Check her out with this recent post. So eloquent, so reasoned, so steeped in wisdom and understanding as a woman, mother and professional midwife.

Kneeling woman.

Sunday, January 27, 2008

Wanted: A baby

Hmm, having a lean patch in the baby department :(

I have looked after heaps of women and couples...but no baby in my hands. Sigh. They just aren't ready to birth when its time for me to go home, or I'm doing tea relief in the room and they're not mine anyway, or there are a new batch of resident doctors around who need to get up to speed on catching again really quick so THEY are allocated for the birth - they aim for one per shift! (that'd be nice). There have been lots of emergency CS lately too.

This week I have had 3 consecutive women birth a few hours after I go home and have 1. a young mum with a spontaneous labour and just one shot of morphine on board have a massive shoulder dystocia and a very flat baby (ow, very scary for Mum and midwife - its like trying to get the video out of the slot sideways and the shoulders get stuck on the pubic arch) 2. a CS for non-dilation and an unstable lie and known growth restriction and fetal anomalies, baby still in nursery and 3. a vacuum birth and a PPH and the poor woman is very traumatised and pale and can barely look at her son.

Today I have had a pretty easy shift. We were quiet and all wandered around asking the others if we could help them out, interspersed with emergencies that removed all the doctors just when you needed them! I had one woman who kept me busy near the end of shift, but helped out with another couple who did get a baby and I got to spend a bit of time with them - cute baby, a bit lopsided but sweet natured, wide-eyed and alert.

Such is midwifery. I think I'm starting to get the hang of it. I'm on nights again from next weekend so I hope to see some baby birthings then!

Wish me luck!

Sunday, January 20, 2008

We got our money's worth

We've spent a lot of the weeekend outdoors (it seems).

Yesterday there was a community meeting about some imminent redevelopment located near us, part of a major plan that started 11 years ago. The lastest phase involves the end of our street and has implications for traffic flow past our house, as well as for the visual impact of development in the area. The meeting was held in an area called The Common - a very yuppie-ish landscaped area, although there were very few young people present. We walked 2 km to the site. It had been a while since I had been there and I was pleased with how the plantings had developed and the sense of peace and ease I had while there. An oasis in the middle of some very expensive real estate, crammed cheek by jowl on old industrial land. Making squillions of dollars annually for the council in rates, compared to the peppercorn rent that used to be charged for the site.
The meeting itself was very dull, with no answers, just exhortations to read the plans and make our comments (which we had already done). Still ... it was a nice walk and very pleasant in the shade. Today we ventured out to a town south of Perth called Mandurah. Over the last 4 years the state government has been building the railroad to link this booming residential area with the big city, along with the other mushrooming suburbs along the way. They call it the Southeren Corridor. It involved tearing up a large major street in the city to build an underground section and 2 downtown stations, as well as realigning the Northern line to meet the new stations. It was a major deal, and the minister involved collected no end of flak and bitterness for her role in it.
Well Allanah - it is a testament to you! Loved the idea all along - we are big fans of the train system, and knew it would be brilliant - and it is!

Being a Sunday there was a Family ticket deal where 2 adults and up to 5 kids/pensioners could travel ALL DAY for $8.10. Yes, you read it right- eight dollars and ten cents.
So ... we set off from our place at 10.28 and headed to the city, changed trains to Mandurah, travelled 80km south in airconditioned comfort, seeing some lovely rural sights including some mini-pinnacles. We arrived and had lunch at a large shopping centre/mall. We got a bit confused about buses to take us around the (over-run) township but then ended up on the free shuttle bus to the estuary foreshore,
where we saw an exhibit of Dr Seuss prints at the Performing Arts Centre, ate ice-cream and snow-cones, (Don's was green) and, in keeping with my latest theme, found a heart sculpture. We bought a light-house magnet, a pottery toothbrush holder from a local craft stall, and earrings for some newly pierced ears, listened to Louisiana cajun music, saw cute seagulls and blue skies, A trip through the backstreets of Mandurah and back to the new train station and a stress-free trip back up the freeway to Perth. A quick platform change entering the old station via a new underground connection that utilises my favourite part of the architecture and we were home again at 4.38pm. This is how the cat greeted us at the back door. She's such a scruff - her name is Phoenix. BBQ snags for dinner, what more could you want?

(For the record I could do with some new achilles tendons, these ones are giving me the pip.)

Wednesday, January 16, 2008

As safe as life gets.

I've had an interesting week. Only 3 shifts really, 24 hours in my life, but full of those twists and turns of fate I mentioned before.

One of the reasons I entered midwifery was to be 'with woman' through it all. This week I have.

In my portfolio I stated that I looked forward to celebrating the everyday but unique miracle of birth with the women and families in my care. But I know I can really make a difference to families experiencing a different outcome through disability or bereavement.

This is the lemonade I can make. And this week, for the first time, I was handed the lemons in my professional capacity. And I am quietly very proud of the care I gave. I work in a great place too, that has built up superb practices for families experiencing loss.

Day 1. A couple from a rural town, baby a bit small at anatomy scan, should be repeated in a few weeks. They have 4 kids and not a lot of money. And the car broke down, and it was Xmas, and it was hot, and school holidays. Its 4 weeks until they can get to the nearest scanner 100kms away to have a scan that shows the baby has died. They drive to our city, leave the kids with her sister (single mum of 4 - looking after 8 kids under 12 for however long it takes to birth this babe). They're pretty stressed and sad, but brave. They cry a bit when I talk with them about the siblings, and give them a small handmade bear for each sibling in memory of this little one. To the Mum I give a handknitted and embroidered heart, something beautiful I felt she would need / cherish to remember this baby. And to the Dad I gave a velvet heart that he could keep in his pocket as a touchstone. We talked about the painted memory boxes we give to families and how they may wish to keep all the things in it after a while, along with the quilts we give families for their little ones. I started her labour off, and went off shift. By the time I returned the next day they had had their tiny daughter and returned home. The little one will be remembered by name at a monthly service at our hospital, but they will have her ashes in a tiny little butterfly box to be kept closer to them. I was distressed to hear from the midwife who took over their care that she felt they had delayed reporting lack of fetal movements in order to get the Federal money for a birth over 20 weeks, and that they seemed more interested in going outside for a smoke immediately after the birth than in their baby. I completely disagreed with her opinion, and gently told her so. 4 days after the scan concerned they qualified for the money, and were well within the recommended repeat period. Besides they were genuinely shocked to hear they would receive the money for a stillbirth. In addition, nicotine is a fierce addiction, especially when stressed - perhaps by a cynical midwife.

Day 2. Entered to find a 14 minute old boy about to be taken to the nursery for some breathing support and investigation of known renal and cardiac anomalies. Dad and the morning midwife headed off with him, leaving me and another midwife who had lent a hand with Mum and an overjoyed grandmother. Yes, overjoyed. They were a migrant family who had spent years in a refugee camp in Africa and for them to have a new child and grandchild born in a peaceful country with ready access to a neonatal nursery, a clean bed to birth in and food arriving on a tray within 30 mins was a complete blessing to them and they broke out in song and a shuffling dance, praising God because He was so good. It was a joy to behold, and very moving because these people get it. Praise God indeed. They would have the best care for their son and he would probably be with them by the evening, and she was unlikely to bleed to death or lose him to infection or hunger. It was uplifting, and we were all delighted to be a small part of it, and even today talking about it again and reporting it to the other midwives we were a bit misty. And they were all a bit jealous (even the cynical ones).

Later in the day I got to care for a couple having their first child, whom I had met twice before. She was fed-up and had high blood pressure and the time had come to just get it over with! I was disappointed to not be able to care for them overnight and when I started work this morning they had just gone up to theatre for a trial of forceps - which worked - it was a tight squeeze. At last he was born. They resisted the urge to call him Mud for all the trouble he had given her in pregnancy, and I was happy to visit them later in the day and at last give him a cuddle. She was most relieved it was all over and vowed he would be an only child!

Day 3. In some ways the most challenging day. Today I cared for another woman experiencing a perinatal loss. Her baby had also died suddenly in utero at around 5-ish months, and had been born the previous day. In our unit these families often spend the whole postnatal admission with us, rather than transfer to a ward with lots of crying babies. They can spend as much time with their babies as they want, family can visit and we take photos and prepare memory boxes as I described before. Today was the day she was going home. It was a hard day for her, and my job for the day was to bring her baby in and out to her and her family, take photos and to complete the (extra) mountain of paperwork associated with a bereavement. It was quite confronting. It required great linguistic sensitivity. But I felt OK. His Mum was quite practical about the realities of a very small and soft body. Distressed and concerned for him and his comfort as a mother always is, but practical. She took part fully in the memory and grief process. His sisters had written letters for him, she told him stories about the family he would meet in the next place. He had teddies and hearts and his quilt, and his name card with a long and thoughtful name that connected him with his family, who loved him and would miss his presence in their lives. His sisters and grandmother saw him briefly, we took some photos of the family group, and him with his quilt which his mother would keep with his smell on it. It was very sad, but an honour to work with them. They left soon after, carrying their painted box with butterflies, expressing gratitude for the fact that a midwife would come to see her at home for the next few days to continue her postnatal care.

These are memories that link our lives. Mine, and theirs. I was one of the few people who got to see, hold and dress that child in this world. My finger pressed the shutter on the camera, creating the precious memories that help that family KNOW that child existed in this world. For a few short days. The quilters who make the Blankets of Love, the folk-art painters who donate the painted boxes, the craft groups who donate the handmade and knitted garments that the babies are dressed and wrapped in, the teddies and hearts. The families who donate more little teddies in memory of their little ones who were with them only briefly. Its all a work of heart.

Too many people forget that having a baby is as safe as life gets. Not everyone gets to keep and hold their children every day.

Our lives are made in these small hours. Cherish them. And each other.

Tuesday, January 15, 2008

Works in progress

We've all got them. Some of us have rooms full of them.

I consider myself to be one.

Which will I attend to today?

The winner of yesterday's WIP lottery was the swap-journal - it was due to be posted to MB (Hi MB) in the Mojave Desert of CA - don'tcha just love the sound of that? The Mojave desert. Mo-har-vay. With Joshua trees and all. Mmmm Mmm. We passed through the Joshua Tree Forest in Arizona on our recent trip to the Grand Canyon- but the video I took is stuck in the video camera - long story.
I mostly made the journal two weeks ago using fabric I have had stashed for around ten years. I took my colour choice from a post of MB's about 'if I can't live near the ocean I will surround myself with blue'. I also know she has been having a rough family time lately so wanted it (the journal) to seem a bit dreamy in quality. And so this marbled style fabric seemed the go.

I'm quite pleased with it. It has free motion embroidery / quilting all over it with words about journalling using thread I previously used to quilt my daughter's underwater quilt (more of the ocean theme).
To finish it off I made a cord from some toning threads and made Chinese frog closures. I thought it would be fiendishly difficult as I am essentially quite knot challenged, but I was shocked to be able to use my first effort on the cover! See? This is the front edge.And that's the back looped over the front frog button. Phew. Along with a bundle of a few Aussie scenery books (probably not suitable for airmail posting but what the heck) and a chocolate or two and it was OFF!

Another WIP off the list! Making space for another one to be planned, cut out, ... left ... halfway through.... interrupted, sigh.

Its a good thing that fabric is non-perishable. That way our stashes last forever! I do have so many textile plans. I will have to live until I am ninety to get them all done - as long as I still have my eyesight and my marbles...

I think I'm regaining my marbles, by the way :)

Tuesday, January 8, 2008

Little wonders

I had a day at work today that has left me very reflective about the privilege of being a midwife, and very moved to be honest. As I drove later in the day I heard this song on the radio that about summed it up.

Little Wonders, sung by Rob Thomas from

Let it go, let it roll right off your shoulder

don't you know the hardest part is over

let it in, let your clarity define you

in the end we will only just remember how it feels

Our lives are made in these small hours,

these little wonders, these twists & turns of fate

time falls away, but these small hours,

these small hours still remain

Let it slide, let your troubles fall behind you

let it shine until you feel it all around you

and i don't mind if it's me you need to turn to

we'll get by, it's the heart that really matters in the end

Our lives are made, in these small hours

these little wonders, these twists & turns of fate

time falls away, but these small hours,

these small hours still remain

All of my regret will wash away somehow

but i can not forget the way i feel right now in these small hours

these little wonders, these twists & turns of fate

time falls away but these small hours, these small hours, still remain was a morning shift and I entered a room to a woman struggling with a less than ideal epidural. Probably heading for a C-section as she was 'stuck' at 8cm. She'd had two previous vaginal births so it was a shame that after labouring spontaneously she would not go the full way. However with epidural tweaking of drugs we began to win, and when the Doc came back 30 mins later she was suddenly fully dilated and a head was close-ish. Yippee!

Unfortunately there it stayed for an hour and a half. Mum pushed really well, and moved around alot, which should have freed up the little tacker to descend but he wasn't coming out to play! We could see his head regularly but it didn't get any closer. She was scared, and tired and I turned her on her side, covered her with a warm blanket and gave her a big hug for a minute or so and promised her we would birth this baby, in this room, pretty soon. I called the doc back, and finally, as she was about to examine her, the head started to emerge properly. Yay! A slow and gentle birth, intact perineum (a first for this mum) now just wait for the placenta. And wait. For 15 minutes. Out it comes. For once I examined it there and then on the bed, suspiciously wondering if there was any reason it had taken so long - no, definitely complete, no bits missing. But then...

Trickle, stop, pour, stop, gush, stop, spurt...oh shit... Waaaay too much blood all of a sudden. Hit the bell, warn the parents the room is about to fill up with people and I want it to! Thank God it does. 2300mls later it stopped. That's close to 4 pints of blood. Out of one small woman. She was pretty pale. And shocked. But alive - because we all worked hard in a well rehearsed manner to keep her alive with drugs and fluids and massage to get that uterus firmly contracted instead of the flabby (bleeding) sack it kept trying to resemble.

The dad was really calm and brave. He happened to be holding the little one as it happened and just took himself off to one side and turned his back to us (I later found out that he wasn't good with blood). Various midwives would have a brief encouraging word with him as they stepped around him and his new son (who had been pretty grunty and mucousy at birth and I was already a bit concerned about). But he coped fine cuddled up with his dad.

The storm troopers left after 35 minutes and we got her bed changed (and weighed the extra blood in the linen for the final loss total) and after a nap of an hour she woke up and had a big cuddle of her boy, all 4kg of him (8lbs 8 1/2 oz). He was a sweetie, and she declared him well worth the effort and the drama, and was very grateful for the small blessing of an intact perineum! She headed off to the special care unit with bub, and may need transfusions but is alive to tell the tale.

I love to see a normal spontaneous birth. But I trained bloody hard in order to be capable of responding to emergencies such as that one. We hope we never need our training. But by God I'm grateful to have it. And access to drugs that save women's lives.

We saved a woman's life today. Just one. Many more throughout the world were not so lucky.

Our lives are made in these small hours, these twists and turns of fate.

And these little wonders still remain.
P.S. This is my friend Jo -2 previous PPHs - and her husband Iain and son Thomas - who I caught - in the caul - with no PPH.
I love being a midwife.

Tuesday, January 1, 2008

Happy listmaking

Happy 2008.

There...that sounds like a plan doesn't it?

Natalie over at Chicken Blog made an inspiring post a few days ago (as is her frequent habit, love that woman and her blog), and talked about 'don't believe everything you think'. She has also spread the idea of a list of '10 achievements I'm glad I did' from various other bloggers. So...catching that bug, and in no particular order here are mine.

1. Went back to uni and studied nursing and midwifery. Good Plan. Very rewarding, very fulfilling, a perfect match for me. It combines all of my interests and skills.
2. Having my two children. They have been the making of me in many ways.
3. Got into quilting and craft. Another very fulfilling part of my life. I'll have a go at anything.
4. Journalling. An outlet and an inlet into my life and myself.
5. Travelled. Been to lots of places. Seen amazing things (the Northern lights, a Tibetan Buddhist temple in India with 100 monks chanting in full regalia). Did a lot in 2007. And plan to do more. This year we return to Japan for a brief visit. Love it.
6. Qualified for mother's camp. Great people. Lifelong friends. Shared experiences. Punya homework (you had to be there - long adult story). It has changed my life.
7. Made a decision to revive my marriage. Falls into the 'don't believe everything you think' category. Major pay-off in the 'for better or worse' category. Those vows mean alot to me. As they should. Every year (and day lately) I appreciate Don more and more.
8. Danced. Anywhere, anytime. Used to be a professional dancer (for real). Also delighted to have been a belly dancer in my 30's. If you ask me what I am, I am a dancer and a midwife.
9. Flew on a trapeze. 4 times. Weighing 102kg. With a somersault dismount. Yeh. Such a physical high. Terrifying but exhilarating. There are photos!
10. Got involved. With lots of things that came my way, mostly as a volunteer. Rich personal rewards. Who'd be bored?

Hmm, suspicious that none of the above involves keeping a tidy house - did you spot that? I haven't noticed it on anyone else's list either.

Looked after a couple having their first baby today. Pushed for hours, finally got that dear boy out with forceps up in theatre. Gorgeous little fella just shy of 9lbs. Huge head. Tears of joy (even I misted up a bit-Dad was blubbing). A vaginal birth achieved with a huge effort from the woman, me, and all the team. Good assessment, a tight fit, but achieved. Phew.

Wonder what their list of 10 things will be?