Wednesday, February 27, 2008

We now resume normal programming.

Well, Don is back and suddenly all seems right with the world.

It started on Sunday, waiting for his plane to arrive. I'd planned a bit of craft, a project to make Patty a new backpack. He's a pretty individual guy, and his old army surplus store canvas backpack had completely bitten the dust, so I had been planning a new customised one for him - a Janeydoll special (my etsy day I'll pull my finger out and release some stuff for public purchase).

I had thrifted various pieces of denim of all colours, including a very unusual pair of pants that were pieced from 6 different fabrics in denims and corduroys.
I measured the old bag and made a plan, I reused buckles from the old bag, but replaced straps with thrifted canvas belts. Not matched, but blending with the whole. The body was from some denim I had bought to make some pants for Patty 7 years ago, still languishing washed but uncut in the cupboard.
I reinforced and triple-stitched everything. I included back pockets, front pockets, side pockets and internal pockets, snaps and a drawstring cord. It was gorgeous. It took me 5 hours to make it!!!!!
I photographed it with a deal of pride (new camera). I put it aside waiting for him to come over and fall in love....and he said.."Woah! Unusual colours Mum!"
Gulp. "Hmm" he said....."Do you have any more of the checked black denim from the back? I like the stripe but its a bit too much. How about we have a stripe of/some of the pieced panel, but a large inserted piece of the plainer black check?"

This was the least invasive and un-picking alteration that could be made, so I agreed readily. Ten minutes later it was reborn.... and he was RIGHT! I still love it and it looks a bit less crafty-girly- my-Mum-made-me-a-bag-y. See? He would only let me take a quick photo this time.
All this while waiting for my husband's flight, which was diverted from Singapore to Jakarta due to an electrical fault. He finally arrived at 8.30pm, 5 hours late. But its sooooo good to have him home.

I went to work on Monday and GOT A BABY!!!!!!! A first time Mum who was being induced but who progressed really quickly. It was great to see. I had looked after one of her sisters about 9 months ago and caught her baby, and she too laboured very quickly. She was a bit scared to push, but I told her that "yep, this bit is scary, but if it feels scary you're doing it perfectly". So she just did the irresistible and pushed. He crowned slowly and there was only a small internal tear (which is up to God, not me). We were all very excited to welcome baby Xavier, born drug-free after less than an hour of established labour, all 3kg of him. A few stitches, minimal blood loss, never left his Mum's arms while she was being stitched up, pink and gorgeous and alert, gazing at his mum and she at him. Her parents were present for the birth and were very proud of her. I tell ya, those girls in that family birth beautifully. I was so chuffed to catch a baby, I was skipping around LBS high-fiving everyone, they all thought I was a complete loony! I was laughing with delight about whining without a birth and finally I had managed another one!

And not just one! The next day I was working in the assessment area, when a woman attended in earlyn labour after her waters had broken. She had had her last baby IN the assessment area after delaying coming to hospital. So this time she came earlier. There weren't enough staff around on LBS to attend her so I was sent with her...and was delighted to have another spontaneous birth two and a half hours later. She was an African woman, nearly fully veiled, who was delightful and spoke good English. I just encouraged her to walk around and listened in to baby every 20 mins or so. Things hotted up, and I had asked her to let me know when she felt like pushing, so when she did I examined her again and could feel a head of hair quite close to the world and no cervix left. After a few pushes there was no head on view, so I got her up and out of bed to walk a few steps and then she felt notable descent. Not wanting to birth while standing she got back onto the bed and this time there was head on view. She proceeded to gently push the head out followed by a plump little body and her new daughter was born, with much delight in the room. Again, a few internal stitches, but this time for her no episiotomy or major tear of her previously circumcised genitals (done by her grandmother when she was a small girl). She scoffed at the idea of sending her daughters back to Sudan for similar treatment..."they're not doing it nearly so much now, those old women! Its much better to leave them as Allah made them!"

Amen to that. She was an absolute delight to care for and her daughter weighed 4370g (9lbs 10-ish ozs). Woo-hoo! She fed lustily as soon as she could, to our delight. And every time 'aunty Laura' moved her so her Mum could eat lunch or to check her over she would protest loudly! The baby's real aunty in attendance and another friend were also great fun, and we were amused to discover that I would ask questions in English, just as they had been discussing the identical topic in Arabic. Women's business hey?

I had called a second midwife to be present for the birth as a witness, and an experienced clinical midwife arrived with a student midwife on her first day. It was her first witnessed birth, and I'm really pleased she saw that one, as it was well controlled and quite lovely, the woman was great and knew exactly what she was doing, and wasn't too loud or scary. Also it was the first birth I've had in ages where a doctor hasn't even entered the room. Not for any reason. Just midwives, doing their thing. Now I think of it, so was the birth part the day before. Just me and another midwife. Aah, that's better, normal birth IS possible on a good day. Once again I left skipping.

Speaking of what Allah makes...look at this morning's dawn....Don called me out to see it and we cuddled out on the back patio as these few minutes crossed the sky. Rosy and gorgeous hey?
Red sky in morning, sailors take warning. Its going to be 37 degrees today.
Then with a minute or so the blue sky was breaking through.

I don't think the cat (here bathed in rosy dawn glory) will spend too much longer on the neighbour's roof!
Have a great day. Stay cool.

PS Remember the woman I told you about last week, who I slow-danced with and she went on to birth with the night shift? She thanked me by name in a birth notice in the paper!!! I'm thrilled to bits - my first!

Friday, February 22, 2008

What a week

I try to take things one day at a time, but lately several lifetimes have hit me at once.

OK so its an old saying, but this week has been MAD! I don't know whether I'm Arthur or Martha.
Don's away. I've worked four shifts since Sunday. We seem to be a bit in 'shit magnet' mode. Nothing earth-shattering, but just stressful, and a lot to take in all at once. I'm not sleeping too well either, so if I seem a bit whiny...sorry.
My daughter has had a meltdown at TAFE and needs a Disability Support Advisor meeting - which had to wait until today because I've worked every day this week. Also last week our son Patty was told his co-lessee wasn't willing to sign with him again, so he would have to live elsewhere. Sigh. The Perth rental market is appallingly expensive and rare and it had taken 6 weeks for them to find that dogbox anyway. What a pain for him, rejection and facing the prospect of moving back home to his sister's music at deafening volumes on the other side of the wall from his bed. GAH! The gall of it. He says it's his only objection to moving back (do you hear the empty nest dream slipping away?).
So last Friday I had a wobbly nearly 19 year old, a downcast 22 year old, a cabin-fevered re-entry post nightshift me trying to figure out WHEN in March would be a good time to deal with all the appointments, weddings and required presents, travel away to Japan (and shop for host gifts) AND move our large son and his stuff back into a single room in our house at the exact time we were away, and have him start uni again doing 3 subjects for the first time in years, and work night shift....lah, lah, lah....feeling of rising panic.....

So, today, I was on my way to the TAFE appointment (via a lightning lunch with Lesley and the girls) and Steff messaged me to bring her correct kitchen shoes - Gah - already late - then on backtrack home I realised that I hadn't brought the whole Stephanie reports file I had got out to take to the meeting anyway - double Gah!

Flew in the door, grabbed stuff, got stuck in roadworks on way there, took a call from my rostering manager who had LOST my 5 months old note about going to Japan in the March roster and wanted me to work night shift in that fortnight O.M.G. (calm blue ocean, calm blue ocean). I could fit in 2 before I left and only had to do 3 afterwards if I did nightshift so I said yes.

Screeched up the driveway to TAFE 15 mins late, briefly tried again to call the DSA to tell her of lateness, and she answered this time - and told me she was stuck 3/4 hour away as she had just had a (minor) car accident and wasn't going to get back in time so we would have to reschedule. Phew. Threw daughter out of car again, pouting, back to class with money for the drink machine (small sop to sulks to prevent repeat of last weeks meltdown). Bye hon, pick you up at 9.15 tonight!

Drove home again, regretting having left lunch at all, sigh, but anticipating having some time to myself for the first time in 2 weeks. NO. Adorable son home, eating his way through food earmarked for other purposes, including my dinner of leftovers for when I was home by myself, praise the Lord! No such luck. Lucky his Mum loves him.
I then went to mark the nightshifts on my calendar and realised I had unwittingly agreed to work ALL OVER EASTER ON NIGHT SHIFT prior to going on holidays for 2 weeks. Sigh. Save me from myself, someone. Please. Anyone? What a moron. However as I had little other choices due to not being in the country for most of the roster I just chalked it up to shit happens and laughed. I did call her back and tell her that I was laughing at my own expense. Quite hard. If you don't laugh you'll cry. And it might (might) save me from eating so much chocolate - oh who am I kidding.... May I introduce my current coping method.

I also have a houseguest at the moment who is delightful and I never get to see enough of her (because she lives on the other side of the country), and now she is here I have worked 4 shifts since she arrived - go figure. She is with us because her daughter has had a prem baby last weekend. A dear little fellow called Max, who is sweet and scrawny, but his Mum has a good milk supply so hopefully he will be fattening up soon and be able to head home where they can enjoy him all to themselves (because that's where parents and babies should be). It is so good to have her here, as we live close to the maternity hospital and she can see the little family readily, and ask lots of questions about prem babies (some of which I can help with). She is also very warm and wise and is lovely with Steff who is missing her Dad and her morning routine of getting off to TAFE with him. And she knows what it is like to have a touchy daughter with little niggly habits, and doesn't interfere just helps debrief after the flurry is over. Always positive. Very wise.

Baby Max is about 5 weeks prem, and being so little I feel he needed a tiny cot-friend that doesn't dwarf him, so I made him a little rabbit. I had an old yukata (a Japanese bathrobe) with lovely fine stripes, and teamed it with some fine cotton twill. I got the pattern here. Isn't he sweet?
He has a dear little tail too. See?
I think i'll make his Mum and Dad a journal covered in that little stripe for their thoughts about the time of his birth.

I've also had a pretty average week at work, STILL no babies to call my own since Jan 6th (I'll whine and whine until I get one - you know this don't you? And then I'll want MORE). And I have only seen 2 normal births (one of which had a PPH as I described, and the student midwife got the birth) The other had a beautiful natural fast birth (her fourth, and the resident doctor got the birth) and then the Mum cried out "what's wrong with my baby's hand?" It turned out she had a congenital hand defect with fused and absent digits so it looked like a flipper. All else was fine, the baby vigorous, and fed quickly after birth, but I'll never forget the tone of shock in the mother's voice as she was the first to notice the individuality her daughter was born with. She was quite withdrawn for the next half an hour, then after the feed we checked her out thoroughly and Mum felt the finger bones within the hand and we started thinking she would have a very usable hand after a few tweaks and divisions of skin. Mum was cheering up a bit by then, and decided she wouldn't tell her husband until he came for a visit later that day. That was some really fast adaptation I witnessed. Good for her.

I've had a mum with really severe pre-eclampsia at 27-ish weeks who was too sick to wait and had to have the baby by CS that day. I also had another woman from the country by ambulance labouring with a transverse lying baby at 32 weeks who needed a CS quick smart! I had almost NOTHING with me and the poor little mite went to the nursery with a blood gas syringe wrapper around his leg stuck together with a Mum's label as his ID tag, and his history literally on the back of an envelope. I just smiled and handed him over real quick!

Yesterday I had another large woman in early labour following an induction for postdates. Her hubby sat on the couch and played an electronic game for the first two hours. I nearly kicked him. I needed all my skills to keep him engaged, but she was really willing to work with me, and we kept her out of bed and upright for hours at a time. I needed to hold the FHR on to her tummy most of the time, but she never once complained. She moved from bed to walking and swaying, and gradually really got going. I reminded her that just because she wasn't allowed to birth at her local hospital it didn't mean that she wasn't capable of giving birth beautifully, and that I loved the way she was doing all the right things, and staying upright, and working with me and her body to surrender to the process. I gradually drew him in to massage and support her on the birthing ball and reminded them that this was the completion of the togetherness that had created this baby. Things were going to get hot and heavy and they needed each other to stick with it. By the time I left he was firmly by her side, slightly in awe of the trance like state she was in, and the evident heavy breathing. However by the time I left the docs insisted on a fetal scalp electrode and an intrauterine pressure transducer for monitoring, which was effective, but she found painful. They also heavily recommended an epidural for her which she clearly hadn't wanted to have, but after having her rythm disturbed in that last 30 minutes by the examinations and invasive monitoring she was agreeing to. We had a big hug and a bit more slow dancing and I left her to the night staff with a prediction that she would have her baby vaginally around 1-ish in the morning and that she would show those docs that big gorgeous girls had beautiful bodies that could BIRTH!!!! This morning I woke and couldn't settle until I rang and found out the outcome - a vaginal birth at 1.52am!!! just on 4kg. A boy!! I was doing the happy dance! I'm so glad for them both, I really wish I could have been there. I almost feel I can claim him. She unfortunately had a PPH (which is an increased risk after heaps of syntocinon for induction) but it wasn't too catastrophic (only one litre, only :( poor love ). I am so proud of her.

I do love being a midwife, just not mid-machina. Slow dancing and whispering encouragement to that woman last night was the best shift I've had in ages. And still the docs barged in and took her over. Was it me? Was I not advocating strongly enough? Was I challenging them too much when I said I was happy to hold the FHR and palpate the contractions. Her progress was slow-ish but fine. Baby was OP, we were mobilising well, give us time and feck off! I only have 3 more shifts in LBS, and I am beginning to wonder whether I need to start looking for a move into a more low-risk environment - but who will support and work positively with high -risk women in that setting, and can I leave my stretched and exhausted sister midwives to struggle on without my additional shoulder to the wheel?

But where is that wheel heading? I want to put it in reverse! Who is steering? I am beginning to feel less in control in that environment. Sadly I know there are those who will say..."welcome to the real world" in a hard-bitten tone. I don't want to lose my enthusiasm, or my zeal, or my passion, but it is not always rewarded in the workplace, just regarded as a temporary oddity, or with pity waiting for me to wake up and surrender my passion to the machine. I feel under threat from the system. I don't want to abandon colleagues at the pointy end, it feels like a cop-out, but I don't want to lose my gloss or radiance. It must be possible to practise woman centred holistic care in these places. I have much thinking to do. In my spare time...

SO...sorry to whine so much. Its taken me nearly 2.5 hours to post this. You'll all (6 of you) turn off and un-link me, I don't blame you. I'm over myself too! I'll try and be more sunny next time you visit. (hmm ...I can hear the freezer calling).

I have nearly TWO more hours of me time !

Thursday, February 14, 2008

A Valentine's book meme

What does a 'meme' mean? And how is it pronounced?

Perhaps a slightly embarassing question to ask (but I'm trying to love it) as I have been tagged for a few memes lately, yet it seems only appropriate that I know how to say the word, even if I can already use it in a sentence.

Anyhoo, this one is a book meme. The instructions are.

1. Pick up the nearest book.
2. Turn to page 123.
3. Find the FIFTH sentence on the page.
4. Transcribe the next THREE sentences.
5. Tag another five people. Here goes...

The book is "Heart and Hands- a midwife's guide to pregnancy and birth" by Elizabeth Davis.

As you attend to the mother's perineum, remember to check the FHT. Early decels to 60BPM or severe bradycardia indicate that the baby should be born at once. Inform the mother that she must get the baby out quickly, and that you need her full attention and cooperation.

There ya go! That may verge on too much information! Be grateful you didn't get sentences 2-5!

I, who hasn't done this?...bear in mind that continuance is completely optional....Oh stuff it, anyone can do it if you feel like it! But I'm sure (when she gets a chance) Lesley would have something good on hand and maybe Sue, and perhaps Jenny Wren. Helen C may also want to play. I know that's only four. Too bad. No point tagging people who don't know I exist.

Don has left today for a trip to USA for 11 days :( It's quite tricky when he's away. I miss him heaps. As its Valentine's day today he put a notice in the paper for me. With hearts above it, saying he loved me now and always will. Aww...

We were engaged on Valentine's day in 1985. 23 years ago. A little more than half my lifetime ago...

Happy Valentine's day wherever you are.

much love to you all

Monday, February 11, 2008

Oooh thanks!

Apparently I am funky!

All I can say, Frogdancer, is it takes one to know one! Thanks, blush. Frogdancer (I'm sure she has a real name) is a witty teacher and parent extraordinaire to 4 fine boys.
I have no idea what one does with these things, but in turn I nominate from my daily reading list:

Lesley for her sense of style and exploration of the new

Natalie for her daily wisdom

Suse for her sense of humour

Jennifer for her title and eye for detail

Lisa for her phenomenal knitting abilities

Ali J for her upcoming talent

So there!

Resuming my life

Yawn...I'm coming off night shift again, which means staying up too late at night for a while until I can convince myself that no-one is about to come in through my front door in labour and expect me to catch their baby. What a thought!

I am a person who dreams about work when immersed in it intently. Which has its drawbacks when I wake up disoriented in the middle of the night to a darkened room, and spend a minute or so trying to sort out where the woman is, and how did I fall asleep on the job? and where is the monitor? Why is the room SO dark? Why can't I feel a fundus and bump and why isn't it contracting? Oh my God someone will think I'm negligent and how long has this woman/baby been unmidwifed?... Until my husband removes my hand from his non-fundus/bump (well, a bit bumpy) and says go back to sleep, dear, and I realize that I'm in my own bed and its dark because i sleep in the dark and get the picture.

I've always been a vivid dreamer with a tendency to sleep-acting-out. DH tells of me sitting bolt upright in bed one night early in our marriage and saying authoritatively " WE always use two detonators!" (don't ask me! I still have no idea). Or the time I insisted he get all the goats out of the room. I do recall fervently attempting to drag his thigh out of the bed and put it back in the cot, trying to figure out which end the baby's head was (the said child was already back in his cot after a breastfeed, but he was about the size of a man's thigh!).

Anyway... I'm slowly adjusting my body clock again. This is a new trick for me. I had never worked a night shift in my life before September 2006, and my colleagues laugh with incredulity (envy?) when I tell them, regaling me with tales of their teenage shifts being a second year student nurse and being in charge of wards of 40 old men in the night. Its fascinating to think of the change in practise in a generation or so, from hospital training to university based nursing. I have been an RN for 2 or so years and still never coordinated a shift, nor am I likely to in the forseeable future. I feel quite unprepared for such a role, but I suppose if I put my mind to it I could do it. Heavens - what a thought! It looks like a combination of keeping a finger on the pulse, being answerable to all above, and being answered to by all below, being the communal problem-solver and being reliant on the initiative and responsibility of the team on the floor. Predictability of situations, learned through experience, helps with anticipation of likely changing events. And so it is that after about 18 months in such an environment I am truly coming to understand the functioning of the place.

This may sound like an 'about bloody time' realisation to you, dear reader. But to me its a result of reflecting on my bemused pseudofunction within an, at times, unfathomable machine. I'm sure I have irritated the crap out of some of my colleagues with my innocence of ward function. I LOOK old and sensible, but I am a complete beginner in this field. Unlike many of my age peers in the hospital I do not come from a background of running wards at the age of 19, so I actually don't have a clue of many things. Sigh. I must be such a trial to them. I must do better.

What I HAVE been doing with my life is functioning outside the hospital system. Which is a skill in itself. And it does give me a sense of where the people in my care will be functioning when they return to their lives. So I do understand about early (and later) parenting challenges, and the loneliness of mothering a kid with colic or a disability, about playgroup, and child-care, and having sick and ageing relatives, about engaging endlessly with therapy services, about being part of a community, a school, support groups, hosting families from other cultures, and being a family assimilating into another community in another country. I've done it from a position of relative material comfort with a husband in a fairly well paid job, but I grew up in a less affluent family so I understand the difference. We've only ever been a one-car family, and until mid-2005 I had never worked full-time since becoming a mum. I've been very lucky to have had the luxury of being a mostly stay at home mum to my children.

So, hmm, what does this reflection achieve? Well, maybe its to remind me that I have not wasted my years, but have been accumulating knowledge and maybe some wisdom that I can share with people I work with. I want to be thoughtful about how I interact with people, I like to understand where they're coming from and find some commonality, or maybe be stimulated by the differences between us. I am rarely put off by difference, I'm usually curious about it. Always have been. Are you?

On my last 2 nights at work this weekend I cared for a woman who had a really high BMI. That's a Body Mass Index - a measure of a healthy bodyweight. Between 20-25 is considered healthy. [Calculated by dividing one's weight in kilograms by the height in metres squared e.g 68kg divided by (1.68 x 1.68) = 24 = OK] This woman's was 51. She was large. Really large. And was with us to have her labour induced at 38 weeks due to a previous stillbirth at term plus 5 days, her first baby. This was baby number 4. Numbers 2 and 3 were fine and dandy having also been induced at 38-39 weeks. She had had 3 vaginal births and although large had average blood pressure and no diabetes or anything.

I met her when the midwives were having difficulty maintaining contact with the baby's heartbeat. Baby was very active, and the woman's tummy made for a positioning barrier where we would normally have good contact with baby. It was a challenge, and she was fed-up with being treated like an obstacle to be got around. It was difficult to avoid the feeling she was being judged for her size. No midwife would ever want a woman to be so overweight, for herself let alone the challenges of parenting three small children, but the issue before us was that due to the measures being undertaken to induce labour she needed to be monitored for periods. And so we struggled on. I was lucky and managed to get a period of good trace so was able to undo the tethers, and let her settle down to sleep. The other midwives wanted to kiss me, as they had been frustrated for ages. It was pretty hard work and the woman was quite negative, however, I managed as a fresh face to jolly her out of herself and she was smiling when I left.

The second night I came on and she was still there, but was heading for a section as she hadn't dilated at all after 12 or so hours of hormones, and the baby's head was really high, and the cervix firmish and long. Bummer. She was quite distraught, and terrified, and mutinous, and wanted to just go home and go into labour herself. After I arrived and gave her a hug and we had a chat she started contracting more steadily and strongly and I encouraged her to get up and walk around, for a change of scene while we waited for theatre and in the sneaky hope that she would dilate suddenly and pop a baby out into my hands before we could get there! She had in fact not been out of bed much in the last day, which was surprising given that they were trying to get her into labour. It wouldn't be unheard of for a woman who had birthed before to have a fast spontaneous labour and do so. But she only spent 15 mins out before going back to bed.

She asked me to examine her after a half-hour to see if there had been any changes, and in fact there were! but sadly not enough to call it established labour and change the recommendation for CS. She reluctantly accepted the situation and we headed upstairs, where she had the spinal epidural and proceeded to have a beautiful, placid, vernix covered and rosebud-lipped baby girl before midnight. I was able to spend the whole time with her and her husband and new daughter and took her to the ward where we handed her to the care of a lovely warm ward midwife. She did say that the CS wasn't nearly as bad as she thought it would be, and she was delighted with her baby, and hoped she could at last get some sleep now after two days and nights in hospital! I hope she did.

I then returned to LBS and cried. I felt I had failed her as her midwife and should have fought harder for her to be given extra time to go into labour on her own, with walking and gravity, even though she was exhausted from lack of sleep. The baby's trace was fine. The coordinator did tell the doctors of the small changes after the decision, but there were not enough to change the outcome, and in fact when the baby was born she had a big bruise on the back of her head from being contracted against a hard unripe cervix all day. We had caused that injury, with our chemicals and hormones. Our reasons were that we wanted to avoid the outcome of a repeat unexplained stillbirth at term in that mother. But that meant that her body never had a chance to go into labour naturally again. And she has now had a CS at a very high BMI after an unsuccessful induction attempt (I refuse to call it a failed induction).

Her recovery will be very difficult. Her wound stands a high chance of becoming infected, and she is at risk of postnatal depression due both to her history and the surgical outcome of this pregnancy. Our hospital statistics will record her birth as one of those 'horror' outcomes where the hospital has to cope with doing CS on grossly obese women and needed extra staff to help transfer her to the theatre trolley at night time when staffing is already short, and an extra person to scrub in to hold up her tummy to get to the operation site. And aren't our theatre staff clever to devise systems to support the pendulous fat on these women? She will be a number and a BMI on a sheet somewhere.

But I know that she was really sensitive about her pendulous tummy. And preferred to hold it aside herself. And I will never know the reason she is so big, but I know that her body allowed her to conceive at that weight, and that she had made 3 babies already at that weight, so her body had adapted to it. I feel really sad that the fat was seen before the woman inside. The fat was less than ideal, but the woman needed our care. Yes she was prickly, and defensive, and scared, but she needed us to not judge her in that moment and just care for her.

A group of us sat around and talked about the issue of judging pregnant women on their size. I was a bit teary about it. And I still am now writing this. I hope I was with woman, not just that fat woman. I aim to be 'largely positive', while working to support women make better choices about their health and planning for child-bearing.

In the meantime I sure hope this woman leaves our care feeling she has received it.

Thursday, February 7, 2008

This is so cool.

Its raining. Hallejulah!
Today, Perth has received about its February average rainfall (the average is only 10mm, don't get too excited). It rained quite a bit in the night, and has drizzled most of the day, our first rain since Dec 16 last year. It is lovely to see big fat raindrops dripping from the shadecloth.
Ah, it is so cool at last. I actually managed a sleep this avo without the fan (I have night shift again tonight for the next 3 nights) so I am hopeful it will last for a few days.
In the meantime my yard looks like this ... all dark and overcast instead of dazzling and burning sunshine. This is the view out of my back door, onto next door's shed. I must show you more of our garden sometime. Have a happy Friday (or Thursday if that's where you are).

Wednesday, February 6, 2008

Sultry night at Cottesloe

Boy its hot here...
Last night DH persuaded me to take a drive to the beach (10 mins away) to escape the oppressive heat. It has been well over 30C for a week or so, and disgustingly hot at night. I'm on night shift at the moment so it is really gruelling to attempt daytime sleep when its 37C and dripping with humidity. Even in front of the fan. Sigh.

The weather bureau keeps promising thunderstorms and the sky keeps trying but no...
However it was gorgeous at Cottesloe at 8-ish in the evening. Not many people, just a wonderful sunset, and lots of photographers (surprise, surprise). Don of course is genetically unable to resist the urge to throw the body in.
He does love the beach, anytime, anywhere. When we were in Italy last year he even had an illicit swim on a private beach at Viareggio (we're Aussies, whaddya mean 'private beach'?)
I took these amateur snaps with my mobile phone... a bit wobbly when on zoom, but the colours! Can you see the fishermen on the groyne?
I'm reading blogs from Alaska, and MA, and Scotland and Norway and they all feature SNOW. Masses of snow. Sigh. (after 17 tries to insert a new paragraph at this point clearly AGAINST the wishes of Blogger who then posts it without one, just imagine a carriage return here...please). I'd like a bit of snow right about now. I bet they'd like a bit of sunset on Cottesloe Beach.

Sunday, February 3, 2008

Pink and pretty

I got one!

A baby - at last! Well, the student midwife technically got it as primary accoucheur, but I was hands on too, and it was lovely to see a birth again after a break of a few weeks.

I'm learning heaps.

Had a woman go to theatre the night before for a placental abruption - her trace looked pretty dodgy as I walked in the door and I now know that it was happening right there and then! Mum had just passed a large clot, but no further and contraction were weak. She wasn't sectioned for another 90 mins. The baby made it - just. Another 15 mins and she may not have. Even though she was premature she was in extra trouble due to the bleed and the parents were very grateful to have the nursery on hand. After removing lots of blood from her airways and stomach she was doing much better. Much examining of the trace and discussion of the clinical symptoms which in retrospect added up. A good timely call that saved a life. I learned a lot.

Later that same night I looked after another couple with baby no 1, who went on to birth a few hours into the day shift. Another nice normal birth, of a premature baby who wouldn't wait, but all OK.

My second night shift. A beautiful young mother and her partner, being induced, well overdue with baby no. 1 ( from Jan 19th!) who contracted heaps but was not distressed at all, and gently dilated a bit, but the last click of hormones got her well and truly going! Its one of those things you just can't convey without scaring the bejeesus out of them - that they kinda must get a bit intense before the finish line.

We turned the hormones off after 7 hours (at 4cm) as baby was getting a bit stressed, but she was finally off and racing. And yes, transition still sucks, but she just made it through, after begging for an epidural after an intense 20 mins. At 8cm I called the anaesthetist who arrived promptly and had the chat, but as she was about to sign she contracted and said "what was that?". It was a gush of amniotic fluid and a secondary mucous plug heralding the arrival of second stage!

She was excited to hear that she was fully dilated and happily waved goodbye to the anaesthetist. We got her up to quickly change the copious wet stuff beneath her and had a baby about 20 mins later!

I've never seen such an easy descent and second stage for a first-time Mum. It was lovely to see. She just pushed a bit as she wanted to, side lying, using a bit of gas, but baby was making her own way out and crowned slowly over 3 contractions. Mum gasped at that moment when the biggest bit has passed - such a sting, but such a relief. We waited for a minute for the head to rotate and gently drew her out helped by a couple of pushes and she was BORN! Baby Chloe had a little squawk before looking up at her delighted parents who quite rightly thought they were the cleverest people in the world for making such a gorgeous baby! Intact perineum (yay). . .

Followed (boo) by a PPH, dammit. I had called another midwife in as back-up during crowning to make up some extra hormones for a possible PPH. Once again I was onto it early and called the troops - the student midwife thought I was a bit quick, but I just had an inkling it was going to get worse. Sadly the midwife didn't make it up as there wasn't much blood by 8 mins after the birth when she left to register the birth, and she hadn't torn obviously. However I am starting to really trust that inkling! 1400 mls. Luckily she had been taking iron religiously and her haemoglobin was at an all time high prior to the birth. She wasn't feeling too bad considering.

The clinical midwife who was present at the birth said it was a lovely birth and she was shocked to hear about the PPH and confessed to not making up the extra as I requested. Which explained why, after I pushed the assist bell, the troops couldn't find the bag made up as I had requested and assumed HAD happened somewhere behind me while I was guiding the birth. Oh well. Baby Chloe hadn't left Mum and Dad's arms the whole time while we were messing around wading through blood at the other end so they barely noticed all the fuss as they drank their daughter in! She was so adorable with great big dark eyes, creamy pink skin, so alert and drug free and keen for a feed.

The day staff came on, there were kisses all round and many congratulations for being the cleverest primip we had seen (shame about the PPH).

Have you heard? I love being a midwife.