Friday, June 27, 2008
I was assigned to a couple having their first baby, 10 days overdue, and being induced. I took handover from a lovely midwife who assured me the cervix was really soft and favourable, the head was low and now the waters were broken. They were really excited and smiley and chatty.
"So, this is the kick-off, eh?" the husband asked. I assured him they would not be getting out of this labour suite without a baby, and I planned to catch it before morning. She was having a few niggly contractions before I started the drip, but as I turned it up gradually over the next 2 hours the contractions started to get her attention and she became restless. She moved really instinctively, circling and rocking her hips, remaining upright, alternating standing with sitting and moving on the birth ball. He was a bit unsure of himself at first, and she kept assuring him she was fine, and there's nothing I need you to do yet, thanks hon. He settled into a chair and dozed briefly, but kept getting up and walking over to her. I encouraged him to stand behind her at the back of the ball in case it scooted out from under her, and to touch her between contractions.
We had discussed their birth plan, and they were really not keen for any analgesia other than a shot of opiate perhaps, and really didn't want an epidural at all. I asked her how many times she was allowed to beg me for one before I gave in. "Five" she stated very firmly. OK its a deal. We talked about how things were going to get hot, heavy and pretty intense at various points with smiles wiped off faces. Thats fine, they said. I told them I would do my level best to encourage her through the tough bits, and would let them know about the next bits as they approached. There would be a phase where she was gonna lose the plot for a bit, and swear and beg, feel shaky and sick and want to go home, but that it was normal and that I would be glad to see it, because it would mean she was progressing well. OK? Yep, that's OK, we agreed.
It was beautiful to behold. The only downer was that she had to be monitored due to the induction and drip and post-dates, but she was just marvellous, and didn't complain once about the monitoring. It was my problem, and my shoulder was pretty sore from reaching out to keep contact but it was worth it.
About 2.30am she started drawing within. By 3.30am she started saying that it really hurt and that she may need some analgesia. At 3.45 she asked for an epidural. "That's once" I said. She was starting to really dread the next contraction. We went into drawing her out mode, lots of praise and encouragement as she was starting to lose the plot. To hold her off I got all the equipment out for an epidural insertion. She had asked 3 times by now. It was becoming more difficult to monitor the baby with her movement and agitation, and the coordinator was hovering wanting to know why there were big areas of poor trace. As soon as she entered she could see why.
"I don't know yet if I can offer you an opiate shot or epidural - how about we examine you and see where we're at?" She readily agreed. Onto the bed for the first time. A quick examination and I attached a scalp clip to reduce the number of belts she needed - 5cm dilated - slightly less then I had expected behaviourally, but I really felt she was cracking on. Get up and go to the loo, keep that bladder empty, yes do a poo if you need to, make room for the baby. Hmm electrode not reading too well, and there's a lot of fetal heart changes with contractions. A passing middle rank doctor was called to review the trace and the electrode positioning on baby's head.
"Ahh, you're almost there" he smiled. 9cm now, 30 mins after the previous examination! Sorry hon, I grinned, no epidural - you'd be sitting on the baby's head before we could get it in! She was not quite amused, and was quite frowny for the next 10 minutes.
Then she started holding her breath and involuntarily pushing with contractions. It is quite something to witness, and to experience. You know how when you need to throw up and you have a few dry retches first? It is just like that. Irresistible. We had talked about this sensation, and I assured her she would know when it was time to push. Go ahead hon.
It didn't take long before there was bulging and twitching and unfolding occurring. It's wonderful to see. She was less impressed. Its often quite hard to push effectively at first, and to get into the pattern of understanding the downward/forward progress of the head within you. And she was still feeling pretty ripped off about having asked for analgesia and not getting any. So as the unfolding occurred she was not sure she liked it at all! We changed position regularly, encouraging her by reminding her that it was all in their birth plan to push in these positions! She found it hard to coordinate her breathing with pushing, and would let her energy go between pushes, which meant the head would slip back and she covered the same ground 3 times each contraction! Finally she got the hang of it, and asked how it could be speeded up. "By doing the scariest-feeling thing, and then going further!" I replied. "I'll tell you each step of the way what to expect next." Within the next two contractions we had head staying on view between bouts of pushing.
"OK," I said "this next bit is going to sting and burn. It will feel pretty crappy, but I'll talk you through it, so try to work with me and stick it out. It won't last long. And then there'll be this really great bit where the head is out and the relief is sensational. And then there's this fantastic bit where the rest slips out and it is the best feeling in the world. Ready?"
And it was just like that. God- she was wonderful. What a champ. At 5.29am her baby surfed out on a wave of amniotic fluid, to her gasp of triumph. I helped her lift him to her chest where she welcomed him with an introduction of "Hello my darling baby, I am your Mummy". After a minute or so she and her husband thought to ask, "Oh - is it a boy or a girl?" I helped her to reposition the babe so she could see his beautiful rosy scrotum. "Its a boy!" they cried to each other.
She needed a few stitches, which another midwife performed, and after an hour or so we weighed him - 3.670kg - 8lbs 1oz. She was as high as a kite, the baby was alert and calm, and they were all so proud of each other for making and birthing such a beautiful baby. A triumph all round.
"So ... you never did get to asking me five times" I said to her with a hug. "You are very good at this birthing business, you should do it again!" She laughed and said that the head just out, and the slipping out bits were just as I had described them! Fantastic!
It was such a delight to look after them, and I saw them again on the postnatal ward the next night. Baby was starting to feed quite well, and she was really calm and confident, and still on a high after the birth.
And so was I. I am starting to feel like I can function as a midwife now. I've seen 7 births since my return to LBS, 5 x CS (! - although 4 of those were when I was working on the section list) and 2 normal vaginal births with no analgesia. Plus my friend's homebirth. I know which births I prefer.
I really am keen to work in the community, or at least in a model of care that offers continuity of carer/midwife. I was chuffed that morning to have the coordinator ask me if I could see myself working as a community midwife. When I readily answered yes, she said I would be good at it, and that it had been a lovely birth. I couldn't help but feel all warm inside. A beautiful labour and birth, and a compliment. I have been qualified a year, and working for 9 months now, and I really feel like I am finding my feet as a midwife. There are now 2 groups of midwives who are less experienced than me. I am sucking it up and getting on with it more, but still very ready to ask for guidance.
Of course as a rotational midwife I don't stay in one area for too long, but move around every 2 months or so. The next shift I was sent unexpectedly to the postnatal ward, where I had the care of 6 women including 3 women less than 24hrs postpartum, 5 babies including a 36 weeker twin, a withdrawing 37 weeker under phototherapy and a 3 week old baby whose Mum was very ill and was unable to care for it safely. The other staff were very kind and helpful, and cuddled and fed and answered my bells when I had my hands full, but it was a bit of a rude shock after the idyllic previous shift!!
They were both good shifts (in the end) and made me realise how much I have learned as a midwife in a short space of time. Two more night shifts to go in this stretch.
I still love it.
Monday, June 23, 2008
Which leaves more time for sewing!!!! I have been going a bit mad lately and loving it!
I was her bridesmaid at her first wedding. The first quilts I owned were made by her for each of my children - I still have them and treasure them. She is such an inspiration to me. She went back to uni to complete her high school, and became an environmental scientist. She is a grandmother now, and still her own self. I just love her. It was so good to see her.
Here is a very bad shot of the Michael Buble concert, which is badly out of focus but conveys something of the atmosphere. Jeez it was a great concert.
Friday, June 20, 2008
Its hard to maintain a blog on night shift, my bed is sooooo appealing.
I've had a busy week on re-entry.
I've caught ONE baby (very cute).
I've made ONE super bag (pics to follow)
I've seen ONE movie (Sex and the City - I liked it immensely)
I've been op-shopping (pics to follow)
I've got people coming for dinner in 4 minutes.
I haven't packed for journal, belly dancing and doll-making camp - and I leave at 6.30 tomorrow morning! YIKES!!
Sunday, June 15, 2008
The Michael Buble concert was BRILLIANT!!!
I was a fan before, but now I am completely smitten. What a voice.
Truth be told, he was singing just for me. I don't know who the rest of the people were at the venue tonight, but their intrusion did add a concert atmosphere. Nice of them to turn up really.
And the support act, Naturally 7? Also very, very good. Not a hardship to listen to at all. Here's a clip of them with an impromptu (?) performance on a Paris subway train.
Three hours of pure entertainment. Just a great night.
The hotel on Saturday night was a great idea. We haven't been so relaxed for months. The room was really comfortable. We had a 2-person spa, and a walk through the evening streets and a browse in a bookshop before a delicious dinner for two in a swish restaurant up the road. Slept like logs. Plans for another wander in search of breakfast was somewhat curtailed by pouring rain and wind, so we breakfasted at the hotel instead, which was pretty average.
And then back to the real world. It was such a lovely oasis. I think we'll make it a regular date. Sigh, contented sigh.
I start night shift tonight. It should be OK. I haven't done any for a few months. I might get to see a baby born (well, duh).
I'll catch you when I can.
Friday, June 13, 2008
Monday, June 2, 2008
Laura's game mosaic
Originally uploaded by Laura 61
1. Laura y el aire, 2. Meyer Lemon Tarts, 3. Mirrabooka, 4. Purple Euphoria, 5. George Clooney in Dolce e Cabbana, 6. Lighthouse (and a little help), 7. Last day in Paris, 8. My wifes todays artwork: Schwarzwälder Kirschtorte (Black Forest gateau), 9. The Sahel Good Giant (Le grand baobab - The African Tree of Life), 10. Soft purple, 11. Cat Conspiracy, 12. havenCreated with fd's Flickr Toys.
Here is my contribution to the game.
Seen over at Craftapalooza, Pea soup, and Chapter III ; (oh and at Life in General and Muppinstuff too - its really catching on!!!)
a. Type your answer to each of the questions below into Flickr Search.
b. Using only the first page, pick an image.
c. Copy and paste each of the URLs for the images into fd's mosaic maker.
1. What is your first name?
2. What is your favorite food?
3. What high school did you go to?
4. What is your favorite color?
5. Who is your celebrity crush?
6. Favorite drink?
7. Dream vacation?
8. Favorite dessert?
9. What you want to be when you grow up?
10. What do you love most in life?
11. One Word to describe you.
12. Your flickr name
You can play too.
Its not too hard, you just need to have two windows open and switch between the two.
Its sometimes surprising to see the photos that come up in response to a keyword. That makes it a little difficult to discern the answers to the questions, but I think that preserves a bit of mystery.
Enjoy! The photos on Flickr are amazing!!!!
P.S. I'm so stoked to find the mosaic photo maker tool! I've seen these amazing mosaics on other sites (esp. My Happy Little Life) and thought I had to pay to have a Flickr Pro account or something...I'm not cool enough, or so organised to upload all my photos on Flickr. My account is so understocked, but it is useful to be able to send a photo to my blog from there.