Sunday, September 7, 2008

Conferencing with the in-crowd

Yesterday was the conference for National Caesarean Awareness Day (NCAD).

It was organised locally by a fantastic group called Birthrites (link now repaired) who support woman after caesarean birth, and supported by a number of other sponsors including the Australian College of Midwives WA branch. It was attended by 77 registrants and held in the UWA Club in Crawley.

The theme of the day was "Getting clear about fear" and the speakers all discussed aspects of fear: women's fear of birth, professional fear, the illusion of control, the illusion of choice, experiencing a caesarean, planning the next birth after caesarean, psychophysical manifestations of fear, mythbusting the statistics used to deny women VBAC and so on. It was a marvellous day, very thought provoking, clarifying and inspiring. We all got to hang out together and have great discussions, great food and boost each other's energy.

NCAD Prizes were awarded to a midwife of the year, Sally Westbury, an independent midwife for her support of a woman wanting a VBA2C (a vaginal birth after 2 CS) which was achieved at home in a very culturally specific environment. The citation was superb. I was lucky enough to work for a few days with Sally in 2004 and greatly admired her down to earth style, I learned a lot from her. A second award was made to an obstetrician of the year for sensitive handling of a woman pursuing a VBAC in a hospital environment who, even though she ended up birthing by a repeat CS, felt Dr Sara Gibberd had been very kind, thoughtful and respectful of the woman at all stages of the labour and birth. The awards were well deserved by both.

Later this month I will be attending the national conference of the Australian College of Midwives in Queensland on the theme of Keeping Birth Normal. I'm sure it too will be invigorating and stimulating to take part in.

Work has been very busy this week. I only worked two shifts late in the week and will be on night shift from this Monday night. I worked with some really interesting couples, both overdue, one going for VBAC who ended up with a repeat CS after the cervix hadn't dilated after 9 hours of contractions. They were fairly OK about it, and were delighted that at least this time the husband would be present and the woman awake! Last time, in Korea, it was a general anaesthetic and she didn't see the baby for 2 days! The other couple were having their first baby and she was labouring spontaneously really well then got a bit stuck at 6 cm for 8 hours. I stayed as they were short staffed until after midnight, at which time they were going to put up some synto, but was pleased to see when I came the next morning that she pushed her baby out with no help just before 3am. Thank goodness it did the trick! I'm so pleased for them. They were such a nice couple.

Speaking of GA CS... young Zachary and his parents are doing well. I saw them all on Friday afternoon and he was being offered the breast! Both his chest tubes were out and he was nuzzling up and having a bit of a go. The SCN are taking such good care of them, I have seen the same nurses with them every time, they really could not be in better hands.

I also got to see an external cephalic version performed on Friday - where the doctor gently strokes and flips the baby from a breech position to a head-down position. I have always been elsewhere when one is happening, or the baby has been found to have already turned! It was really interesting to see performed, and it was good to palpate a breech so clearly. I wish there was more opportunity to get some breech experience in birthing, I've never attended (myself as primary accoucheur) a woman birthing a breech, although I have seen them done by others. I may have to wait a while :)

This time around I have been less distressed by working on LBS than I was when I first rotated there. I am certainly finding my feet. I am really enjoying being part of a team environment. Not team-style midwifery (although that would be great too), but feeling like a functioning member of staff. I'm really pleased to be getting to know my colleagues, and seeing how we all fit together and pull together in any crisis, or quiet time. I have taken pleasure lately in letting them know that I respect their skills and enjoy working with them. Some are surprised, but all are touched to be acknowledged. Not in a flashy way, just an aside to a patient (when seconding) about being in good hands, or 'I can't think of anyone I would rather have in a room in a tight spot'. I hope they don't think I'm weird that I give them this feedback. Maybe I come across as an over-thinking-brain (sigh, story of my life), but I do actively reflect on my practice and how I feel about each shift. Its important to give credit where it is due, and in a work environment where we are often under enormous pressure it is a small but vital courtesy to support one another.

Anyway.....I've been asked if I will consider doing some shifts in the Next Birth After Caesarean clinic at our hospital and I am very tempted. It is an area I am interested in, involves some antenatal work, and could lead to some caseload work, where I would be the primary midwife for a (bunch of) woma(e)n and follow her wherever she was in the hospital. It would mean less time to make Wild Women, and I have been commissioned to make 3 of them...I'll be having further talks I think. I could ease my way in.

In other news, we have a new side wall. Next-door is renovating and part of it involved the removal of a falling down asbestos fence and the building of a new you-beaut limestone wall for most of the length of the block. With the building demolition we have had no fence on that side for more than two months now, and in the last week it has been all go with the wall-building effort. There is now 300 tons of limestone between us and the neighbours, and a 150 ton hole in the bank balance, but it does look lovely. Next-door wanted their side to be flush faced and Perfect, especially at the part where they will have an outdoor room and eating area - close to our back door. We wanted our side to look more rustic and traditional. We both got what we wanted.

Hubby is beside himself with Spring delight planning the garden and patio renovations. Even I have had a look-in (and I don't do gardens or get my hands dirty) because it involves Entertaining and Roses - both of which I am entitled to an opinion on. The upshot is that the back patio - which looks HUGE - is to be gussied up with a pizza oven (long-term) and a new spot for the BBQ, with lighting etc, and the close patio will be reclaimed as a summer eating area, with a rejuvenated rose garden in between along with new ground covers and a wall-feature in the eating area. It is so nice to have our backyard privacy again. And I did get my hands slightly dirty today as I went to the nursery (gasp) and chose a new rose, and then helped to plant it!!!! I even chose some fun sunflowers to put along the western fence and planted those seeds too. You have now heard the sum-total of my gardening effort for the next 5 years. Seriously. I get to choose the wall-feature - I am thinking an old garden gate or an old wrought-iron shape/screen/something against the wall - I'll have fun visiting some scrap yards this week.

Have a good week!


Ella Westbury said...

Oh wow, it is so nice to see your lovely words about my mama (Sally Westbury) on your blog, obviously she is inspiring and wonderful in my eyes, so seeing other people say similar about her is cool. Hearing that she recieved this award, and around such an important issue was wonderful news.

I also just wanted to let you know, that your link to the Birthrites site is not correct, it should be (no .au)

Keep up the blogging :)

infomidwife said...

It was great to see you at the conference, it was a tremendous day - I will be looking out for your review on the Queensland conference - catch up soon

Laura Jane said...

Thanks Ella for dropping by and for the info about the dud link.I've got a lot of time for your Mum!

Aoplogies folks I'll fix it straight away

Lesley said...

More wonderful stuff! It's my first time back on a computer for ages, so calling in here first
Lots of love!