Countdown

Why the blog silence?

Long story.

Short version : this is a very different arena with so much more I would love to share with you, but these things and events must essentially remain unbloggable.

Long version: It seemed a good place to leave things, with me heading off into the sunset (or maybe it was a sunrise) over the horizon.

My life as a midwife has broadened immensely. And so therefore I have so much more to lose should this small world be revealed. Plus I've signed all manner of contracts to that effect.

I am not so vain to assume my meagre life outside my (challenging but rewarding) new job would hold much interest for many. Besides: life outside work? What life outside work?

At this point I am 8 days away from a month long holiday. And I am, shall we say, most keen for this to commence.

This post is to say I have neither forgotten how to blog, nor forgotten any of you. I am reading your blogs, if not quite as voraciously as I once had the time to do, then at least regularly. And I am (oh, slings and arrows) Facebooking much more than is required. Its hard work 'keeping up' with 400+ friends. I have spoken to all but about 10 of them in real life, or online, even so it is a little amusing to think I have so many acquaintances ;) Lets just say that it is both a good and a bad thing.

Lastly, I am about to turn 50. In 16 days time.

I think I feel ok about that.

But I thought I would work out any potential issues I had with the big 5-0 by talking to the Universe. And that's where you come in.

Stay tuned.

A quiet life

Well, we've had 'the talk'.

I made it quite clear that it was unacceptable to know so much about their intimate life. And for our visitors to hear so much about it even at the other end of the house.

Would she make that much and that kind of noise at her mother's house? I was boldly told 'Yes, I do actually'. So I encouraged her to do it there instead, because I never, ever wanted to hear these sounds from her again. All luck to her for her talents, good for her, I had no objection to them engaging in sex, per se, at all. I just didn't need to hear it. Nor did his sister on the other side of the wall. Nor did his dad, his aunty, or I need to hear it. I was NOT kidding. I was approaching her directly about it because seven discussions with our son had been ineffectual.

There was no apology, from either of them.

They couldn't skedaddle back to his room quick enough and stayed in his room all evening, only emerging after my husband had gone to bed to have a 30 minute shower and talk loudly in the echo-y bathroom right next door to where hubby was sleeping. (insert grinding of teeth here)

They stayed in his room all day until 5pm, undoubtedly trying out silencing methods which must have worked because I didn't hear a peep out of them apart from talking and laughing occasionally. She left late in the day.

He wandered into my bedroom and asked if I was happier with the course of the day. I reiterated the level of distress that had built up over the last four months, and how I was quite clear about this being non-negotiable, about how it had been widely discussed with all and sundry in the suburbs and how I was by no means an island in feeling so alienated by their behaviour.

I described the advice about suitcases, buckets of water, ultimatums and unpleasantness on upcoming trips and the remainder of the year, and the undesirability of such courses of actions when compared to the relatively small price of cohabiting as adults while remembering our manners. I told him how much their voices carried. Especially in bathrooms late at night. How inconsiderate they had been. I described how my holiday period had begun with the frustration of being constantly hemmed in the house with a caterwauling young woman invading my personal and mental space being not at all what I had planned and now my final day of potential alone-ness was gone and I was pretty annoyed.

I wanted him to truly understand not only which side of his bread was buttered but how thick that butter was for a relatively small price of civility. The time was coming when he would be buttering it for himself, and it was important that he not take our butter for granted, and that would require some consideration for this final period of time we would be living together.

I think we have reached a new level of understanding. He said he was glad we had had it out. We had a few chuckles. We remain friends, but with a new, non-negotiable boundary.

Phew.

My life in dot points

Its all I can manage... But here are some questions Life has thrown at me lately.

• Is it wrong to expect 24 year olds to silence their girlfriends during sex? Its been going on for 4 months now. When I was a girl I would have been mortified to think anyone would hear my activities....let alone be able to determine exactly how many orgasms constitutes a multiple event. Don't want to repress anyone's sensual life. Teensy bit of pride in son's ... um ... talents. Don't want to engender shame. It wouldn't be my shame anyhow. Just DON'T. Want. To. Hear. It. Any. More. Someone I was lamenting the situation to told me, "Laura, some women will come in a stiff breeze". Yes. So I hear. (sigh). Terse SMS war already on the issue. Repeated approaches to son to keep it down. Will I still be seeing this young woman at family meals with my grandchildren in 40 years time? Son's final university exam tomorrow. Am I a Bad, Disloyal, Enabling Mother? Or am I just being 'dissed'? Discuss.

• Just how much stuff does one really need? Is it in inverse proportion to the amount of floorspace available for the purposes of walking around? (phew, moved out 4 crates of Stuff today, it helps already).

• How long does one wait for midwifery models of care to shift? How does one bite one's tongue at the backroom discussions undermining women's desire for non-interventionist birth? Will I be happier in the long run just going independent and taking the blood pressure pills, being my own boss, and paying through the nose for PI insurance. Should I just move to New Zealand? How long is a piece of string? You get the idea. I'm doing a major review next week to take a snapshot of my career/practice so far. Why does one always feel ready to be shot down in flames. Am I trying to run before I can walk?

• How will we face another major surgery for our daughter? This will be a biggie with the potential to really improve her life, but it won't be easy. It has come as a surprise, sort of. She's had similar surgery twice before, but doesn't remember it. I do. Gulp.

• How good is it to have friends who love and support you? And listen to your whining. And write loving things about you. And share bookclub with you. And paint with you. And go to Vegas with you. I truly am blessed.

• On a lighter note.....How good is this? Now these girls really know how to shop. And I thought I had good op-shops near me.

• Will we all be fit and well enough for our trip? All four of us are limping or crippled in some aspect. This is lame (literally). We are all ready to feel well again. I am certainly sick of keeping the doctors in business, nice people though they are. I will keep taking (all) the tablets. Calm blue ocean. Calm blue ocean.

• How will I pack? For 4 people, heading in 3 different directions at the end, for Sydney, Melbourne and Central Australia.

Bearing in mind that one must be alive to complain, and that we live in a well resourced country, with no war, and plentifully stocked supermarkets, and that our children have survived childhood, and that we have careers and sufficient income to service our whining whitebread world, and that I may just delete this whole post because I am so sick of the sound of my whining......answers on a postcard please.

Waving

HI!! Can you see me waving? I am.

Hello November! Where did you come from? I blinked and you arrived, while I was working and organising and conferencing and feeling crappy and stressed and finishing night shift. And getting bad feelings about anonymous comments. Sigh.

Sometimes a blog just feels like another thing to feel guilty about. So I put the blog in the too hard basket. Just for a couple of weeks.

To make myself feel better I am crafting (or half-assed-crafting). I am cutting out. I have sewn some stuff. Half-finished things. Frogdancer and Victoria your pressies are nearly ready to go. I have a pretty fab red giant tote half assembled.

Blogs are being read. Otherwise they would Pile Up and add to my load of Stuff Un-done.

I have folded an enormous pile of clean washing. Six baskets full.

I have cleaned off my desk. Gasp. Its true, Lesley has seen it!

I have Made Plans. Midwifery plans. Hah! I am both inspired and a bit terrified by this. Therefore it must be good.

I am working (what seems like) a lot. Probably seems like it because I have so much to do on the days 'off'. Like conferences. Like organising a two week statewide tour for a lovely and important guest, although I am getting lots more help with that now, phew.

I have favourite people coming to WA (ooh, they've just landed), and a favourite niece having a party tonight for her birthday and I am working :( but I will have the next two weekends off and see them all then.

On the upside- a friend has started an unexpected new romance that is thrilling and wonderful and that she thoroughly deserves. And my daughter has found a JOB! It is 95% fabulous, with small forecasts of glass-half-empty, depending on your point of view. We're pretty delighted, but it also involves the doing of Stuff. Which I add to my Do In My Spare Time list. You know the one.

I am feeling about 50% better in the swoon department, although I have to go back on a medication I hoped to not take. It seems this is a new manifestation of migraine. Cos two sorts are barely enough. Bummer. On the upside it means I am sleeping better / heavily. Take THAT night shift diurnal rythm messer uperer.

I'll stop whining now. I'm sick of myself.

Back with REAL blogging soon, I promise. But that was a small catchup of why I've been offline.

You'll never get those minutes of your life back, so no asking for a refund, alright?

Correspondent's report

Hi Laura,

Time is flying past. Tom-Tom now 2.5yo. Still cute, fun and full of energy. He's talking very well now.

I hope these don't take too long to download for you.
cheers

love Jo

***********************************************************************************

OOOHHHHHH JO!

Thankyou so much, I actually ACHED with longing when I saw that child in the photos and now I'm in tears cos I miss him (and you, my darling) so much.

I want to get on a plane right now and bring you all HERE!!!!!

Why don't you live next door? Why has my sister moved back to Perth so I don't go through Melbourne or nearby lately!!!!!! Dammit!
I am heading to Adelaide on Sept 21st for the conference, and wish you were coming too. Rats.

We truly need to live closer together so I can smooch your lovely children. (throbs with longing for those gorgeous kids....) Tom is unbearably beautiful, I bet he is such fun chattering away and dragging cats around. The photos of him with Darwin are gorgeous, and Georgie is looking like a mini-you. I'm sure Andy was just moving too fast to be captured on film! I just can barely believe how much I love that Tom-Tom, and am especially thrilled to be the first to have seen his sweet face. This midwifery deal is a pretty special gig.

I have just surfaced today after a stint of night shift so will rejoin the land of the living...the work on LBS at night is very absorbing but can be torrid at times, last night was one of those, just pulled from room to room with IOL left right and centre, and the previous night's ones still lingering and only just producing the goods 24 hrs later, or failing and having CS. I had a nice baby at 5.53am by vacuum, compound presentation which meant the Mum's epidural wasn't as effective while she was pushing - you know how they really hurt that extra bit with a hand as well. OUCH. The Mum was so loving and gorgeous to her baby as soon as she was out, it was beautiful to see. Three minutes later, at 0600 was a birth (with another midwife) to a multip who I had cared for initially that night before being moved, and as I left at 7.40am I stopped by theatre to see another primip who had not gone into labour after a tough 24 hours of trying, and was about to meet her babe by CS. I had been caring for her as well last night, and she headed off to OT just as I was in the thick of things for the vacuum, so another midwife took her up. Its all go I tell ya!

Has it really been 9 months since you moved in? Time flies! Any further midwifery work for you? What else you been up to?- as if those gorgeous monkeys aren't enough to keep you fully occupied.

Anyway...I will call you soon,

Thanks again so much for sending those pics (get Georgie to take one of you too!)

Much love, dear friend, I really miss you

Laura x x x x x

Laying low

I am here, alive, just on night shift, and quite absorbed in the other doings of life.

Thankyou all so much for your kind words about my memories of my Dad. He was quite a man. I have enjoyed seeing that photo on my blog.

I am reading everyone else's blogs, dropping comments here and there, I just haven't had much chance to post as I am sharing the computer with the boy wonder currently as well. There's fierce competition.

What else have I been up to?

I have had a sister turn 40.

We have lost a dear cousin to lung cancer after a brief illness. As this branch of the family are Tassie there have been many phonecalls, and flowers sent, and notices lodged. It is not fair to lose such a lively witty man, who had such depths that he hid so readily. He follows his late son, his only child who died in a car crash about 15 years ago. He was loved by many.

Stephanie has finished work for now, as her site closed unexpectedly with short notice. She is now going to pursue open employment (gulp) as the alternative supported placements are probably not for her, sadly. We're all putting a brave face on it but it is disappointing after she was settling in so well and experiencing some success. The new phase involves MANY appointments, not always easy to fit in with shift work, or her Dad's work commitments.

I have worked 20 hours, and been flat tack with some very messy and tricky cases. Had a birth just in the nick of time 7 minutes before knock off yesterday morning, that kept me busy for a further hour or more. This was after a pretty torrid night, but we were grateful to see this baby and end his Mum's suffering ... she really suffered, quite unusually given the numbers of measures in place for her comfort, but it happens sometimes. Her little one really needed to be out for complicated reasons and finally he emerged in a fragile state, into the arms of paeds who resuscitated him very well and he is doing OK in the nursery where he can finish growing without relying on an abrupting placenta!

And today a new baby was born into the Tassie family, another grandchild to dear cousin Susan and her husband Richard, after the loss of her elder brother last week. They will welcome two more grandchildren by Xmas, one from each of their surviving 3 children. They too lost an adult daughter in a separate motorbike accident over a decade ago. They are stoic and brave, but I know they all miss seeing her become a parent along with her siblings.

Welcome to the world Abel Craig, named after your Mum's cousin. Babies are such a treasure.

And finally in the midst of it all I have been quite obsessed with playing Bejewelled Blitz on Facebook. It is VERY BAD. And VERY ADDICTIVE. The chink-chinking sound of the jewels clicking into place sends me into a trance and I spend waaaaay too much time developing RSI in my tapping-the-mousepad finger..... I am fairly disciplined with it, and set myself a time limit but I have been known to exceed it. I'm doing fairly well though....

Today I have been a housefrau staying in to see the refrigerator repair man...who informs me that I need a new fridge. When I think about it the old one is 21 years old! Its done very well, but I'm sure there are much more energy efficient ones available. We kind of chose one this evening, with a 5.5 star rating, but then came home to rearrange the kitchen a bit to accommodate it, so I'll go back and buy it for real tomorrow. Isn't my life scintillating?

Well, I'm off to bed, very late but I'm between night shifts and its barely worth retraining my body clock after 2 shifts on with 3 off before 4 more nights, so I've been staying up late. Sigh.

Thanks for feeding the fishies!

High and dry and still out in the cold!

I'm fuming.

I've been working every day since Tuesday. Its been a long and tricky week. I'll tell you about it when I calm down.

TODAY the door was finally installed. By pulling apart the frame that we had just painted with 4 coats of paint.

And putting crap all over the tiles that we have taken great pains to protect throughout painting.

And then the shower screen was installed unexpectedly, again with no-one home to supervise. Spreading more sealant and crap on the floor, in a shape I hadn't expected that means the shower head now seems to be pointing in the wrong direction. I can't even get any water onto the corner glass shelves to clean all the wood dust off them. I tried. Not knowing that I shouldn't be letting any water into the shower screen area due to silicon drying time until Saturday morning. Sigh.

No major damage except that there's a significant chip in one of the floor tiles right in the middle of the floor.

And there's still no glass in the door (raw green ), which still needs to be painted along with the frame - AGAIN!!!! When there is gloss enamel painting to be done or dried the bathroom cannot be used. Including the bath.

When I came home today the bathroom looked like a scummy shabby 10-year-old tiled disaster. with the door frame paint all ripped off and peeling - the carpenter has shifted the whole centre plate of the doorframe. I have told the bathroom contractor that he can stick the carpenter up his jaxie cos I'm not impressed with him at all. Tears were involved. I scrubbed and swept ( I can hear you laughing at the thought of me cleaning, stop it!) and rubbed at sealant crap and swore - a LOT.

I have few words to describe my fury at the waste of time, and the lack of sleep due to paint fumes, not to mention the fact that I am still showering outside in the cold wind (much to the cat's amusement this morning)

I am really over this.

Report card

The bathroom now has some black floor tiles. Tomorrow there will be some plain gloss white wall tiles. The feature tile of cut green marble chips was sealed today (stinky and sticky work). It looks FABULOUS!!!!!!!! The colour is divine. I'm very excited. It will be another week or so until he is all finished, then the ceiling and door must be painted. Luckily the weather is holding and the outdoor shower (hot) is not palling yet.

Mother's Day was had. I have a lovely double yellow hibiscus in a large pot. I will try not to kill it. The gardener (not me) has made a similar vow. I arranged a picnic at Matilda Bay for my family. Some of them came. Long story. Food was eaten, photos were dutifully taken (but not yet uploaded). The Bag was much admired. No comment was made, or the 'feature' even noticed by the recipient. The lining was a special hit. Contractual obligation met. Tick.

My husband chivvied one of my offspring into delivering breakfast in bed. I walked past my hibiscus and the cards 9 times before they were actually proffered towards me. Sigh. One of them had other plans for lunch that involved playing cards, with like minded men. I cooked the picnic lunch, texted everyone madly to arrange a meeting point and tried not to cry that my family will never all be together again. It was all quite pleasant in the end, if smaller than I had pictured. Everyone brought their manners, which is not always guaranteed. Long story.

I went home and had a nap. No, not just a nap, an excellent nap. Dinner of lamb chops was cooked by the guys (now home from playing cards) and I watched some TV before retiring to bed and reading the last of the 4th Twilight book, which series I have just enjoyed re-reading.
I am now reading a charming midwifery memoir set in London's East End in the 1950s.

Today I have cut out a bag for a friend's birthday next weekend. Much planning involved. I also plan to give her a lovely vintage frock that I just know will suit her beautifully. She's having a rough time lately, and needs a boost.

Its only 5 weeks until we go to Europe. EEEKKKKKKKKK! DO I have the right shoes to stomp around Amsterdam?

Ah, the perpetual question....and I'm lovin it!

Where has the midwifery content gone, I hear you ask? Well, to be honest I barely feel like I have been at work lately, but I promise there will be some soon.

I did save a baby from a sticky name last week. It was an entirely culturally appropriate name for this little girl...but I'm sure her parents wouldn't have willingly named their daughter anything that sounded remarkably like "Shitty", even if it didn't look like that when written down. I carefully broached the subject, and made the comparison for them, clarifying the implications. They were very practical about it, and quite horrified at the near disaster. Phew. Welcome baby Lakshmi, nice name!

In other news on the naming responsibilities faced in the world..... I really look forward to hearing what twin boys 'Lefty' and 'Righty' resolve into when they are named by their sweet parents.

Be good, or good at it!

Asking the question

I've had a very full few days at work. Steadily busy, but not madly so, yet the women I have seen have been so interesting.

I do like meeting women. And men. I s'pose I just like people really.

We've had students through, as is common in any area, but this time I have more actively been seeking them out and keeping them company. I am beginning to feel I could show them stuff, finally, after a few years in the field.

One of my objectives for working in clinics was to gain experience in abdominal palpation. I'm very pleased to feel I have gained confidence in this skill. I have picked up a number of breech lying babes, a few transverse, and become more confident in understanding attitude - i.e. the full position the baby is lying in, including head positions. Phew. Filling in the gaps. It feels good.

I have also wanted to better understand antenatal education given at the visits, and the tests at various stages, and I think I have got that down now. I'm not fast at it, but I understand it much better. I had visits with interpreters, both in person and via the telephone, adolescents, first timers, and grand multips, new migrants from other counties or new settlers from other states in Australia. We track down results from everywhere, even different time zones across the world. It is quite astounding how many phone calls we make and questions we ask over the course of a clinic session.

Some of questions we ask are the hard ones. Domestic violence. Depression screening. Any history of unwelcome sexual contact. This last one is often difficult to broach, and I confess we don't ask it of everyone, although we are alert to the possibility of it in any woman we see.

This week I have referred two women to our psychology services for raised depression screening scores with positive answers to questions of thoughts of self-harm in the last week. I'm so pleased we have these services so readily available. They are vital supports for vulnerable women. One teenager, in a very difficult position, was especially in need and I was hopping from foot to foot as I waited for the clin psych to be free. She was seen within 20 minutes, and will be followed up with a psychiatrist and a visiting midwife for adolescents and social workers and will hopefully be feeling much safer, more stable and supported soon. She was really brave, very private and reserved but clearly in a bad place, and feeling there was 'no happy place'. Poor kid.

Another woman I didn't refer set off all sorts of alarm bells as we had a chat. She was clear that she was going to try breastfeeding again (this was her second child) but that she would not be putting the child to the breast. No thankyou, its not my thing, my body is private and I don't like people touching it. (ding-a-ling-ding), No, I don't want to be referred to a psychologist even though I have a history of postnatal depression and I was medicated but took myself off it because my depression is not related to my baby (ding-a-ling-ding), yes I have a long-standing history of depression, no I don't discuss my depression with my family, they've got enough to be coping with (ding-a-ling-ding), I'm alright. I don't want anyone touching me (she wants a vaginal birth after CS last time) (ding-a-ling-ding). I took a deep breath.

Hmm. Many of the things you're telling me make me wonder... Have you ever experienced unwelcome sexual contact? Perhaps in the past?

She dropped her eyes and with a deep sigh made a decision to break her silence....

She had never told her mother, a former heroin user, because so many people would end up 'down there' she said, indicating a low level with a horizontal wave of her hand. It would tear my family apart. Maybe one day when some people were dead she would tell her family, but for now she chooses to keep it to herself to protect the greater whole. He is still around. She sees him frequently. She never discusses it with him. It stopped, she doesn't know why. She doesn't think it happened to her younger sisters, or is happening to anyone in her circle now. It wasn't her fault. Or his probably. He was not right in the head. But it stopped and she was content to leave it alone. Let sleeping dogs lie. She would only struggle and get all stirred up if she allowed herself to think about it. I've never told anyone else apart from my partner, and two friends, she said, through tight lips and with raised eyebrows as if unable to believe she was telling me now. But she was determined that she did not want any intervention or referral, and to leave it alone.

I was not surprised. She asked what had made me ask the question. I explained the signs I had seen in her tough, fiercely independent and private defence system. Most brick walls are not so high, or so tough. These kind of walls are built extra strong for a reason. A good reason.

We tossed around some of the connections and ramifications of her experiences. I joined a few dots, she joined a few, and we acknowledged her survival. Her choices. But it was important that she knew that she was not alone in her walled community. I reminded her that we had people who were able to support her if she wanted to knock out a few bricks in the wall.

One wonders about the ability of young women living these tightly wound and edgy lives to grow a well nourished baby to term. Last time her baby was small and growth restricted and she ended up with a CS due to concerns about the prem baby's ability to cope with labour. I'm not sure what her chances are like to achieve a VBAC this time around. Labour will not be pleasant, and she will be quite challenging to care for, as women pursuing VBAC are closely monitored, and vaginal examination will be extremely threatening for her. I hope she is able to labour well at home and stay away from the hospital for a good while, and arrives almost ready to push. And that the midwives pick up the subtext of her behaviour and are able to leave her alone as much as possible. And that her baby is better grown than the last one and able to cope well with labour. That's a lot to hope for.

The getting of wisdom

After my last stressed, sad-sack post this is a happier one.

A very wise midwife elder posted this today.

It says it all. Words to live by.

I'm surprised to note that RLS only lived to age 44. That means that by the time he reached my age he'd been dead for more than 3 years.

Not a bad life's work to leave behind. We should all be so lucky.

Lookin' through old stuff

I am here. Not hiding, just thinking.

Starting some things and not finishing them. So many competing demands.

Completing some long-unfinished tasks.

Finished the advanced fetal assessment course and passed. Yay!

Struggling a bit with fragile hope. About many things.

Listening, loving, waiting. Feeling.

Uncovering old stuff. Wishing I hadn't. Damned core beliefs (again).

Reframing painful things. Forgiving myself. Naming guilty parties.

Headaches. Just tension. Tears near the surface.

Doing for others. Should I be?

Learning to do for me. First, for a change.

Letting others help me. Its been a long time.

Hearing old voices and emotions. Do they belong here, now? Fighting and reframing their influence.

Feeling judged. Need I anymore?

What can I let go of? Do I need all this clutter? This baggage. Literally. Its weighing me down.

Freedom in the moonlight. A new way forward?

Much to think about...

Don't you hate it when...(warning contains whining)

Second warning - contains no midwifery content either! Just whining. And a snapshot of my day.

Don't you hate it when you wake up early to see the kid off to work. After a late night baking sticky date cake for her work, waiting for it to cool and packing it carefully. In bed after midnight. A hot night, not good for sleeping.

When you head out to the dentist, arrive after arranging the appointment weeks ago for while you were on holiday and being told your appt has been shifted and no-one told you?

And that your notes had NOT arrived from the previous dentist after sending a fax weeks ago requesting that very thing.

And when she keeps offering you an new appointment at a very inconvenient time because I'm a shift worker and that's why these things are arranged weeks in advance honey! No, I have paid A LOT of money to attend on conference on THAT day. (Oh, beam me up.)

And you get home to spend the last day home alone with your sweetie, but he's gone into work to kill some time because you were at the dentist.

And its your first day home alone together for literally months, and you know what that means.....

And when he gets home you go to hang out the just finished washing before leaping into the sack for some well-deserved adult time...and he has put a new tea-towel in the wash - a RED one- with your three favourite (previously) white tops, fave nightie, knickers, socks, and assorted other things that you really wanted to be WHITE (and now they're not).

So you grind your teeth and reach for the bleach while the washing is still wet, and you run out.

And while you are trying to remain cheerful and maintain the idea of libido the phone rings and its the workplace and someone has to come home because her back hurts from standing.

And she works a 40 minute drive away. And they can't possibly let her come home on the train (literally doorstop to doorstop) because she is distressed.

And don't you hate trying not to punch a wall with frustration (of all kinds) that the day's plans have gone awry? On the ONLY day alone together on our holidays.

And then you have a meltdown where you pour out your heart to explain why this is so fucking shitty. On so many levels.

And you both drive clenching and sniffing through snot to the workplace (thereby dripping shiny snot onto your fave clean pants) to pick up the also sniffing and red-faced worker, and deliver her floor workmat for standing (so there is no further excuse for repeat performances). She then catches the train home with her Dad because there would just be way too much emotion in one car. The workplace support workers support me as I blub.

There's no way to ever get this day back again. Life's like that. It could be worse.

Casual lunch out with hubby was quite nice in a 'desperate escape from the house with zero privacy' kinda way. But not what we had planned.

Then, with back miraculously repaired, and offers of pain relief declined she sat at her computer and read Fan Fiction with a smile on her face. He had a nap in our room, I fell asleep with a book in the lounge room.

Then he went out. Then I went out, walking, in the 36C heat to a long meeting where I scribbled very hard for two hours.

When I got home we looked up the only remaining hotel room in Perth for Saturday night, Valentine's Day, in a 5-star hotel for a luckily very good price.

We're going.

What do you do when you need privacy?

Baby talk.

One of the downfalls of night duty is inconsolable babies.

They are inconsolable because their mothers are shattered by hours or days of labour. Their mothers are sucked out husks, facing their second or third night without sleep, with tender inexperienced nipples. They are stroppy babies who haven't read the books on normal physiological lacation processes and therefore are really keen for some stomach filling, like, NOW. They suck and suck, and don't feel right unless they are sucking, but until the milk comes in they are not getting full bellies and therefore are driven to keep sucking. They are dry, pass almost no urine, and run a bit warm as is normal in slight dehydration - all normal for babies of around 48 hours of age. And their mothers are so tired they keep falling asleep and are worried they will drop the baby. And their nipples are tender. And they are often a bit sore, or have mobile phones going at all hours of the day and night!

The woman who has a CS is marooned in bed for those first 12 hours or so, unable to lift the baby in or out by herself, with catheters, drips and epidurals to contend with. The CS may have been planned or an emergency, so the woman is often utterly exhausted after an induction of labour, which has not been successful i.e. the door (cervix) did not open so the baby couldn't be born. It is a lot to take in.

The night midwife is a big part of the adjustment process to new parenting, especially for the woman who has had a caesarean. There is an enormous amount of physical care, including monitoring blood loss and fluid balance, full assistance with breastfeeding, teaching as you go, as well as the emotional care of a woman who is adjusting to the first hours of mothering in a (mostly) unexpected way.

These last 3 shifts I have cared for a number of primips (first timers) some with unexpected CS. One had had many miscarriages and was very unsure of every sound the baby made, every whimper in his sleep, how many sucks it took to constitute a breastfeed - she was a bit incredulous that it needed at least 10-15 mins of a consistent sucking pattern to be called a good feed on day 1 of life. She had read all the books, imagined how her first breastfed would be, and planned every aspect of her skin to skin contact with this baby...following a vaginal birth... but had not made a contingency plan for any other outcome. Luckily her baby seemed to have a pretty good idea that the principles were the same - get a good position, line it up, shape the breast/areola and get a good deep mouthful with the tongue under the breast. And suck away! Bliss! He'd read the books too! Mum had so many questions, needed so much reassurance of normality, and rang the bell every 20 minutes! For her water jug to be filled up (it still had 1/3rd left). Give me strength.

I had had similar nights for the last 2 nights, with the woman in the next room sitting on the bell for every mortal thing. Wrap my baby, burp my baby, pour me a drink. Sure sweetie, I'll be right back. (staggers off, gnashing teeth, wondering how the other 6 women in my care are doing as I wear a path to her door). Some nights are just like that.

Last night I had 6 women and 4 babies, three of whom were inconsolable at regular intervals for long periods. They were all really sucky babes, waiting for their Mums' milk to come in.

The other midwives are as helpful as they can be. Any spare pair of hands is cuddling a fractious baby to give Mum a break for an hour's sleep if we can hold baby off for that long. Last night I had a scrawny little chap who could suck for Australia, miserable without a boobie in his mouth, who nearly sucked the meat off the bones of each of my (clean) little fingers in turn. I only managed to get 70 minutes sleep for his young mum, who was knackered, but her breasts were filling well and I think he'll be very satisfied with the offering today!!!

One baby was really loud. I mean REALLY LOUD. I had seen another midwife with her the previous night, squawking the place down as she was bathed to try and calm her. She wanted a burger, with fries and a milkshake and she wanted it NOW NOW NOW. No chance. I tried to talk soothingly to her, I tried joking with her - she was NOT amused, and I was glad i didn't have her in my tribe that night. Oops - guess who I got last night? Her Mum was really patient with her, and fed her well and readily, but was dropping off the perch with exhaustion. There was a small volume of formula in the room when I started the shift, warming, ready to be finger fed (a method of sucking the formula through a straw like device that feeds in next to the pad of a finger in the baby's mouth). We really try hard not to offer formula, and NEVER mention the possibility of using it to mums. However it seemed mum had asked for a top-up in desperation as nothing would console this child other than a continuous boobie fest. The nipples were a bit tender and grazed despite good attachment. We had the talk about breast comes first, second and third. We agreed to try for another hour or so before offering the formula. In the end we offered it just after midnight. Baby scoffed it down, sucking hard. And finally conked out. I tucked the two of them into their beds and turned out the light. In the morning Mum looked like a new woman after a four hour sleep. Baby was just stirring, still no urine but she had pooped, and pooped again as Mum changed her nappy - she was delighted to see it and laughed and laughed! Nothing like a bit of sleep to restore the sense of humour.

Women need the right information to promote and initiate and sustain breastfeeding. Its a difficult phase, those first few days, waiting for the breasts to kick in. I am a passionate breastfeeder, I know alot about it and I am, I believe, a strong advocate for breastfeeding. But I do also believe there is sometimes a place for the use of something else temporarily, especially in the baby who can suck for the national team. Sometimes you see half-assed, can't be bothered semi breastfeeding, where the breast sort of gets the stimulus it needs to kick into gear, but the baby is not encouraged to stay for long feeds, and growth spurts are not factored in. Building of supply is not factored in and 10 minutes a side each 4 hours just won't cut it after three days or so. Some cultures seem to mix and match, offering bottles freely until the milk comes in, and they then establish a long feeding relationship purely breastfed. Some people genuinely don't care if they feed or not, or have always felt it was not likely to be their thing, and that is honestly fine by me. The sky will not fall in. As long as they are sure. But if they want good information on how to do it, just ask me.

In the meantime, my little fingers will be well used!

PS Our friend A has still not been seen the incident, much instability, occasional phonecalls and cancelled plans. Daughter very anxious and worried, send good vibes.

PPS Sister back - Yay! No job offers for her daughter yet, sadly a No from the locals. (Bloody Sydney Dance Company shuffling staff and catapulting others into job queues ahead of talented newly qualified dancer, grumble, grumble)

What do I know?

What do I know now that I didn't know this time last week? (Will I love this question?)


Well, I know that keeping labour normal is not always a job for which one will receive thanks. Not that I expect any in particular. But in the case I'm thinking of, should I have done so?


The unit was crazy, like....Crazy! There had been 10 inductions started the night before and they were all coming home to roost, so to speak.



I had already seen the couple I had been caring for the previous evening (one of the inductions), who had just had their baby at lunchtime, an hour or so before I started. He was a whopper! 9lbs 14oz (4.485kg - the same as my son!) it was a pretty yukky birth in the end (he had a REALLY big head!) and she was being stitched up pretty extensively. I spent an hour or so in their room, cleaning up the chaos post-birth, and organising some solid pain relief for her immediately and planning the next few days worth of it too! There was pressure to get her up to the ward quickly as labouring women were piling up in the corridors and there was a room crisis.


So I was removed from the first couple (their morning midwife took them up to the ward) while I was allocated to another room - their third midwife of the day in all the shuffling around. There was a young woman of 25, labouring spontaneously, hot and heavy. Just holding it together with the use of gas. Oh, and she'd had a shot of morphine too. The husband was in and out of the room, and was clearly quite anxious and unsure of his role. She was attended by her Mum and sister, who were in a great rythm with her, and she sought them as each wave came. She was really focused, eyes open and intense with each contraction, membranes intact. Just how we midwives would expect it to be. Woo-hoo I thought, another spontaneously labouring primip! I know normal birth! I can keep birth normal! I can do this!


I introduced myself softly between contractions, watching quietly as the labour continued thick and fast. Checked the room quietly, gathered a few things ready to meet a baby in the next hour or so. She was so in the zone, sitting cross-legged on the bed. I was just in awe, in fact at one point I was moved to tears by her beauty and strength, she was that amazing. I almost never cry at births, and this is certainly the first time I had cried watching someone labour! Her mother and sister were a little surprised, but I decided to be unashamed about my damp face and silently pointed to her and gave a pat of my heart, acknowledging her effect upon me. They whispered to me "are you always like this?" to which I shook my head- but she is that good.


Every now and then she would rouse and speak, I took her BP every 2 hours, someone came and took the CTG machine (we weren't using it, I could use the Doppler). At one point she asked for an epidural, and her Mum asked her to wait another half-hour, which she agreed to. She sailed through that and on and didn't ask too hard again. Her husband was worried, will she be strong enough to push the baby out after all this pain now? I can't stand seeing her in pain like this. I told him that women were so much tougher than they looked, that's the way God made 'em and that his wife was an absolute Goddess and doing it all superbly.


The madness outside was not getting much better. I was asked to 'prang her' (i.e. rupture the membranes) and get her going and out of there! Well, no! I decided. She was in spontaneous labour, the cervix was dilating steadily (I was watching the line), the waters were intact and she was only just coping with the pattern of contractions now, without bringing them harder and faster, not to mention the effects on the baby - who may need those waters to help him turn to a good position for birth. There was no indication that an ARM was necessary. I regretted performing a belated ARM on staff request on a 34 weeker a few weeks ago who shot into a less than favourable position and ended up being born abdominally via CS. I was not keen to go back there again. I felt I would make the decision for the preservation of normal. So I ignored the request.


The woman refused to reposition, or get up for a wee. When she asked again for an epidural I offered to examine her and see if she was near the finishing line and that may help her decide if she wanted one or not, if the birth was going to be soon. After a wait of a few really intense contractions, she was 7cm dilated. There was a brief discussion of pros and cons of epidural, and I stated that of course she could have one if she wanted one, but that it would be a shame to turn a normal labour into an abnormal one - with a monitor and bells and whistles etc. She was doing so well. The contractions were so powerful, she was so focused .... she lost herself in the next one and kinda never brought the subject up again for a while.



I went for a meal break, ex-HB midwife relieved me and persuaded her up for a wee. Hooray! I was expecting her to report feeling pushy any time. She did report rectal pressure with the peak, but not overwhelming. There was a bunch of mucous - a good sign. It was all really intense, but 7pm came and no baby.



Back to sitting on the loo, listening in to the fetal heart regularly, noticing that the rate is always in a similar range - definitely fetal, but not widely varying, during or after a contraction. I encouraged her to drink fluids, which she did. She was getting really exhausted and desperate and whiny (its typical transitional behaviour) and I was pretty sure she was fully or close to. She agreed to be examined - I thought it was 8-9cm dilated, but there was a pulsating bit off to one side that i was sure was a front fontanelle, and a gap at the left back - bugger! She nearly hit the roof during the exam, which I apologised for, but it was important that I rule out the pulsation as NOT being due to a cord presentation. She stayed on her back, gasping as the next contraction hit, and just lay there. It was horrible to watch. I did that to her. She was coping before and now, for this one, she wasn't. When it passed I helped her immediately to a sitting position and reminded her that she was comfortable in this spot and she would be again, lets regain that working formula.


At this point I had some decisions to make. I felt that with a deflexed or neutral positioned head, even with membranes still intact, it may be a bit longer yet until she was ready to push this baby out. As I had tried to tuck the baby's head down to chin on chest, it had almost risen away from me - yet on abdo palp it felt well down, although in the pelvis it was barely at spines. Her blood pressure had also crept up, not startling, but a sign of prolonged pain/stress. The fetal heart rate variability told me that the baby was either asleep or starting to get stressed. I was getting concerned about her and felt that with all these factors I should have her reviewed. I had kept her normal, but I also recognised that this was deviating from the norm and starting to add up to needing a second opinion. The first step before any further assessment would be possible was to get her out of pain, so as not to cause her trauma.


I apologised again for the stressful VE. Then I suggested she have an epidural, as although she was progressing well, I felt it may be a while yet due to the baby's position and she may need break from pain before the effort of pushing (funny how we can couch the same words as the husband in our favour when we have to, eh?). She readily agreed. Gratefully agreed. Almost kissed my feet agreed!


So then we waited for an anaesthetist. And waited. Finally after 45 minutes (the longest 45 mins in her life I bet) a consultant comes in from home. He is fast and good, considering we don't even have IV access yet. I had everything assembled, the machine, the epidural stuff, the IV stuff. It is in quite quickly, just in time for the night shift staff member to come on. I was attaching the trace as she entered, doing BPs, the woman was smiling, hubby smiling, the intensity was all altered. We were saying that we had waited for a while to meet this baby and the night midwife was going to catch him instead of me - yet I would have bet good money that I would see this baby before the end of my shift! Oh well.


And then we saw the trace. Gulp. It was pretty awful. Late dips all over, pretty crappy variability. Still contracting frequently but oh my, that baby was not coping well. It was the first time we had put a trace on him - there was no reason to - this woman was normal, low risk, and now look at it! The night shift midwife scooted me out the door as I had a morning shift the next day. She is a very capable new midwife with ICU experience, and loves a challenge. So I went home.


I slept really badly. I woke up at midnight and couldn't get back to sleep until 2-ish, and then only fitfully. My alarm was going off at 6, and so when I woke up and started tossing again at 5.30 I gave up and got up.


I dragged my yawning butt into work, where I found out that the baby was born by vacuum extraction at 1.26am, and needed a bit of resus with Apgars of 4 and 9. They had ruptured membranes not long after I left (when she was comfy and in no pain) and there was thickish meconium. Followed by fetal blood samples every hour or so, which weren't too dire, so she was allowed to push for a while before they dragged that 4kg baby out of her when the trace got too terrible to watch any more. Baby was sent to nursery for a while due to respiratory distress. I saw them briefly the next day, still with the whole entourage in tow, and trying to breast feed the baby with 6 people in the room. Sigh - what are their chances of establishing that?


So, in terms of normal childbirth, what did I preserve? Was I all misty eyed about my ideals for her birth? Everything I did was on her birth plan. Should I have said YES, Certainly! when she first asked for an epidural? Which wasn't on her birth plan, and of course she can change her mind, although could she have known that she would cope so beautifully that her midwife would see such beauty and cry, for fuck's sake? Was I so busy singing Kumbayah and reassuring the husband that 'this is all normal' that I ignored danger signs? Was it that dangerous? If I had blindly followed orders and 'pranged her' at 3.45pm and given her an epidural at that time would the mec have been picked up earlier? Was it there then? Did she actually care about having a normal birth? Or does her idea of a normal birth include an epidural? Cos it technically isn't...and introduces all sorts of interventions that can start the cascade of interventions that lead to CS ...oh for God sakes...you KNOW all this!


I'm a bit frustrated and bewildered. Is this a win some/lose some situation? Cos if it is, I could have just saved her all the trouble and pain and got her an epidural 5 hours earlier - even though it would have meant finding a spare CTG machine in a full LBS with all the women on all the monitors already...sigh. Has anyone been done a favour here? Answers on a postcard please.


In other news - something else I know now, that I didn't know last week, is how to suture perineums. I did a workshop yesterday. It was fun! Yes, really. I can now be Really Useful. I took to those knots like a duck to water. It was fun having a trial run on a piece of mutton. It took a while, but I think I am willing to do it under supervision this weekend when I am working 5 shifts in a stretch. (We then had to undo all the stitches so the demonstrator could take it home for her dog! )


Be good.

Introducing...

Introducing Bluebell.

She is the latest in the stable of Wild Women (WW). She is destined to be a birthday gift for a friend.

I have used different sizes and shapes of beads for her to create texture and to hint at hidden depths. There are many layers and facets to Bluebell that are not immediately obvious. She is going to a rather special friend. With hidden depths. And layers.

Here she is with her sisters Polly and Woman. They need more sisters. I know someone red, and someone green are just lurking somewhere. Maybe someone bluesy. Someone even more wild (did you see the comment that their original designer/creator left on the first post I did about them?). I spent a bit of time online choosing accessories for more WW -I'm trying to challenge myself to make someone genuinely wild, instead of pretty or elegant (I never thought my work being described as elegant would make me feel I'd been safe).

Anyway, when I'm not creating elegant Wild(ish) Women I have been to work, where I had a day as section queen, and then a lovely shift with a primip who seemed to warm to me instantly and declared herself very keen to push her baby out into my hands.

Her story had me feeling slightly reserved about the possibility of this happening, as she had had an epidural at 1cm dilation (!), was a fairly large lady and had collapsed and spent a while on the floor until she got feeling back in her legs. The trace looked pretty dodgy as soon as I saw it, and I was quite sure that the docs would be hovering and keen to use any excuse to chop her.

However we bonded nicely, and she was quite unaware of the concerns we were feeling in the background. The synto was on at a reasonable level, and the baby was moving heaps - always a good sign. The docs were busy with a string of other emergencies, so they had enough to keep them busy while I just kept her calm and distracted, and we chatted and laughed, and talked and I answered her questions and it was all sweet. When it was time to examine her I felt she was very well dilated. almost fully, but the head kept moving and swinging from side to side as if baby was jockeying for position for descent. Its a strange feeling, but you know baby has a bit of room and energy to move well, so its usually good.

We positioned her on the side to await the last little bit of dilation and to allow the baby to descend as completely as possible before she started pushing. The woman had a medical condition where it was preferable to avoid prolonged pushing effort. There was a lot of rectal pressure pain, but a bit of epidural tweaking helped with that. In the end, she only pushed about 4-5 contractions worth and pushed out a very sweet little girl, creamy and pink with fair hair. The medical student (the one who had got such an eyeful on her first birth [forceps, very ugly] with me in early July) got a lovely catch and we couldn't praise little Aimee's Mum enough. So clever. What a complete genius she was to labour so beautifully, and push out such a splendid baby with so little fuss. Her mother and husband were thrilled to bits, as was she herself. It was such a love-in. Baby Aimee went skin to skin with Mum while she had a few stitches put in and was calm and alert and cooing and communicative. It was gorgeous.

So I skipped home, glowing with delight at having helped to create such a positive birth experience for this young woman. Those kinds of births really help sustain one's energy. Even though there was an epidural, and augmentation of labour, and a continuous trace, and fluids and catheters and blood in the urine, there was a pretty normal birth behind it all. In the end her cervix dilated really smoothly and she birthed beautifully. I just know her next birth will be even better, with the confidence that she now has in her body and her abilities.

I love being a midwife.

The battle for VBAC

I've been thinking alot this week about vaginal birth after caesarean (VBAC).

I had the care of a woman early this week who was keen for a VBAC after her first labour ended in a CS for non-dilation in first stage. Her cervix had not dilated past 4cm 6 hours after reaching that stage. She wanted a VBAC because she had found recovery from the CS to be very difficult, understandably, and was keen to avoid the same again.

She had presented to the assessment area of LBS, a day or so past her due date, contracting strongly but irregularly and was keen for an epidural. Her cervix was dilated about 1.5cm, but was fully effaced- a bit early for an epidural. She was given a shot of opiate - which knocked off the contractions and had a sleep. When she woke up she started contracting strongly again, and was very anxious to get an epidural. This was not a method of pain relief she had used with her previous labour. She was transferred around to the labour room where she tried to settle in and get the contractions started again, as they had died away. I was assigned her care and after an initial chat it was clear she felt under the pump to labour that day as there was a CS scheduled for her the following day. She was also quite cross that she had been given the opiate earlieras she felt it had dampened down a happening thing. I spoke quietly to her, encouraging her to set aside everything else that was going through her head, and to give herself time and space to just be in the room, in this moment. We worked together quietly to create a space where she could feel safe, dark and quiet.

After a while, and a rupture of membranes by a doctor(2cm), she recommenced contracting. They were strong and lasted for 45 secs or so, but were irregular in their pattern. 2-3:10, then a gap, then 5-6:20. The baby was lying in a posterior position, which does cause an irregular pattern, but something just wasn't convincing as the pattern was too easily disturbed.

When planning a labour after CS the accepted wisdom is to avoid the use of artificial hormone stimulation i.e. syntocinon/pitocin, as this is technically contraindicated as a use of the drug when there is a uterine scar. The big scary bugaboo is uterine rupture along the previous scar. The incidence in natural labour is quoted at 1:80 - 1:200. That's 79:80 and 199:200 where it doesn't occur (if you're thinking positively). Under syntocinon augmentation/induction the incidence rises significantly. This woman had done some reading and consulted some people in the lead-up to this labour and her understanding was quite clear. Avoid use of synto.

Four hours after the ARM I examined her again, very little change (2.5-3cm). There was a different doctor hovering outside the door, who demanded the information and ordered an epidural and another examination in an hour. Then synto was to be started if there was no change. AN HOUR! She hadn't even met the woman, felt the contractions, heard her fears. The next shift came on as this occured and we collectively decided that this was not in her interests and she could decline this plan if she wanted. She declined, I documented it.

I was torn in many directions. I felt psychologically that this woman needed to do something different in this current labour to change the script from her previous labour. Her first labour had been induced from scratch, building up to maximum synto use, with a stalled dilation under a theoretically adequate pattern of contractions. She herself had little faith in the ability of synto to cause cervical change in her. We had been keeping upright or on all fours to encourage rotation of the baby to a more favourable position. She had been off for walks. She was trying nipple stimulation to encourage contractions.

We're taught that there are often mental blocks to cervical dilation related to fear of pain, anxiety of other nature, insecurities of all sorts. One of the challenges for the midwife is to identify and work with the woman to push through, allay or dissolve these factors, making the conditions right for relaxation and cervical dilation will follow. It so happened that the next shift midwife was one who had cared for this same woman in her first labour! I was unsure whether this was a positive or negative factor for the woman. Was this to be a re-living of the script?

The next midwife was having a quiet and assertive advocacy argument with the doctor in the corridor outside. I was very grateful to see it, as I don't have a lot of experience in caring for VBAC candidates and felt a little shocked and out of my depth at this challenge. There are practical factors to be faced either way.

I can see the doctor's point of view - no amount of standing around watching and creating a nurturing environment is going to establish a truly effective trial of contractions. Except that I felt we had been getting somewhere psychologically up until the point of that examination at the time of shift change. If the cervix had been dilated 5cm at that point I felt we would have been home and hosed. But honestly, there had been very little change in nearly 4 hours of strong but not always regular contractions. Her body clearly wasn't quite ready to do this.

There was the question of pain relief. This was a back labour, and was pretty painful. The afternoon midwife felt an epidural was not the way to go, as it often knocks off contractions a bit if used too early - which this was on the borderline of being. Her recommendation was for a shot of opiate - which the woman herself didn't want because it had diminished the labour 12 hours earlier. The doctor didn't care which method was used as long as the synto went up, sooner rather than later so the woman and the baby were less tired than they would be if we held off for a further two hours, which was the general preference in the room. Tick tock tick tock. Bloody hell, we felt we were getting nowhere.

The doctor entered the room for the first time (uninvited). It felt like an ambush. There was a lot of 'baby getting tired' language (the trace was excellent), contractions have to be effective (she hadn't palpated a single one), the pattern isn't established yet (well, I'd pay that one). She asked who had done the last assessment and insisted that I repeat it now (2 hours later) and a plan would become clear if there had been any change with the spontaneous (under pressure, very disturbed, doubt creeping in) contractions.

The woman agreed. The doctor left the room, her views and orders were clear. I did the deed. There was very little change.

What I know is that to achieve any vaginal birth, whether the first or the seventeenth, for VBAC or not, the cervix must dilate. The baby cannot be born through a closed or semi-opened door. End of story. No matter what one believes, or what the environment one creates. Babies are born with their mothers clinging in trees to avoid being swept away in floodwaters. Does that desperately unfavourable and exposed environment inhibit cervical dilatation? Clearly not.

My emotions were swirling. I would not lie to this woman. I felt her crumbling hopes acutely, her self-belief, her visualisations for cervical opening evaporating by degrees. I felt she had spent the last two hours being undermined by a series of factors, but was that really true? What if her cervix was one of those that just didn't dilate? Sure she was anxious and a bit nervy, but I would be in her place too. Was it my belief in her that was wavering? Or was it a growing acceptance of reality?

I saw the logic of the doc's plan. Let's have this labour declare itself one way or another sooner rather than later. Was I being pie in the sky waiting for spontaneous labour to 'win'? As much as I wanted nature to take over if I could protect the environment and sing Kumbayah sincerely enough, was it always going to be a losing battle in this woman? I have seen VBACs achieved before, with and without the use of synto. I just wish it didn't have the reek of 'doctor getting all her ducks in a row by knock-off time' about it.

I stayed for the discussion about synto Vs pain relief. They looked to me for guidance and I felt like a traitor discussing the benefits of a compromise, with a trial of synto under controlled conditions, yes, start with an opiate for pain relief (not my first preference for this woman, an epidural may have been the psychological script change she needed), you can always move up to epidural (oh God, that trace is going to suffer with morphine and an epi, hope the baby is alright when he/she is born around 8-10pm - my estimate - probably by repeat CS). It was time for me to leave.

I phoned later that night and she ended up with a repeat CS at 8-ish pm. A little girl. They already had a boy at home. They would be really pleased to meet her, I know. I confess I had a bit of a tear about the outcome.

I have been troubled for days about this 'failure'. Was the failure mine for not creating the environment appropriately? Did I do her a disservice by holding on to her birth plan too solidly - trying to create a safe space for her with time to get into labour. I wasn't convinced she was in established labour except for maybe the last hour before the lunchtime assessment. The contractions were sneakily irrregular. Yet only days before I had seen a woman give birth to her 7th child with a similar pattern of contractions. Through a cervix that had dilated. Was this woman doomed to a repeat CS by a physiological anomaly of her own body, regardless of my supportive touch and words? Kumbayah humbug! Did this anomaly cause a script re-run?

I am trying hard to love this question. I suspect there are different answers in each woman. I was always taught that the CS to avoid is the first one. With the syrocketing CS rate in this country, state and the facility I work in I am certainly keen to work to avoid the first in all women in my care. Have I seen any soft decisions for CS? Hell yeah. I have also seen many vaginal births that may have not been achieved in other facilities. Some women have one CS for breech and then just never think about not having a VBAC with the next. In some countries it is the same, one just assumes she will have a VBAC unless there is another really good reason (placenta praevia, severely bad trace, placental abruption - which can give a subtly bad trace, cord presentations, delayed progress in first stage of labour). Breech presentation in first-timers is another common reason for a first CS- I am in two minds about this one. One school of thought says that this leads to de-skilling of midwives and obstetric staff as they never get to manage a breech birth, so never develop confidence in it. Others think that the consequences of a bad breech birth for the baby and woman can be catastrophic, e.g. with a trapped head. I know of a recent case of this, the staff still pale at the memory, the baby was not good (i.e. nearly died) but is coming good now apparently.

So,VBAC is quite a fraught issue in my profession. It is not the case that all vaginal birth is better than birth by CS. They say that recovery from a good CS is much better than from a bad vaginal birth (i.e. instrumental births with minimal analgesia and 3rd or 4th degree tears). There is definitely a place for the use of CS. The World Health Organisation accepts that CS is appropriate for births in about 10-15% of women, and women die daily for lack of skilled surgeons to support the needs of these women. Would the woman of this story be one of those who falls into this category? Whose cervix hasn't fully dilated with either an induction of labour or a spontaneous and augmented labour? Would she be the mother of two living children? Albeit recovering from a second non-elective CS? We'll never know.

Picture diary

Thanks for the comments. I read and appreciate every one. When I asked if anyone was still there it meant I hoped you hadn't stopped visiting because there was nothing new to read! I must say since I started using bloglines my blog reading has been greatly simplified. Instead of rabidly going to every site just in case I missed something new, now I can see instantly who has posted and I can relax about all the rest. I am spending less time on the computer, but am still in touch and up-to-date. Phew.

Which leaves more time for sewing!!!! I have been going a bit mad lately and loving it!

OK I promised photos. First - from my birthday. Here is the cake. Black Forest Cake. YUM.

And my oldest friend called late in the day and came by to join us for dinner. We hardly ever get to see each other any more - she lives an hour or so away and now I work shifts with less holidays its too easy to let time slip by. But we manage 1-2 visits per year and it is always such a hoot to see her.

We met when she moved to our area at the start of year 5. For the only time in my childhood or since I was picked to choose a softball team. Such a responsibility! I was always picked last so I knew the anguish of waiting to hear your name spoken. So I chose all the kids who usually waited and waited, including all the interesting kids who were new or who had accents or different coloured skins. It is a decision I have never regretted, least of all because it brought Bobbie into my life. We were inseparable from that moment on. It still feels like that. Can you tell?

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.

Here is a quick excited photo of my sister and I in the audience. Even though its crooked, I like this shot. She is not usually so pale, she's been unwell. Yep, that is the favourite pink cardigan of the moment getting another outing!

Something else exciting happened last week. I received my labels. See? Its a name that a family friend used to call me (my family call me by my middle name) I accidentally ordered iron-on ones (sigh) which don't necessarily suit every fabric I use to make a bag, but they still look very satisfying to have on my products. Even if sewn a little rustically.

Speaking of rustic, here is the bag I just had to make on Friday instead of doing housework (I don't recall making an active choice - was the housework ever a realistic option? ;P )

I had found the orange embroidered jeans in a favourite op-shop on Thursday. They fitted Steff but she felt she wouldn't wear them. Ditto the black chunky cord Diesel jeans we had found a few weeks ago. So....she requested a shopping bag. Et voila!

I was very brave and even put in an internal zipped pocket - my first time - piece of cake. Everything on this bag was chosen for recycledness (is that a word?). The outer fabric, the lining fabrics, the zip, everything had been used before. I'm really pleased with it. It wears my label outside and hers inside!

Which brings me to the weekend....sigh. It was an oasis. I took a healing doll that I had started back in February sometime, that I got stuck on. It was meant to be my inner child, but she looked so vulnerable that I just couldn't move forward with her alone. She needed longer arms to reach out to people. I was a long lanky kid (snort), and while the hair colour was about right, and she had big brown eyes I felt stuck. I knew that if I took her with me to a safe place she would be able to evolve into herself.

We chose messages from a set that spoke to us. Mine were about not believing and living old, negative messages, and how I could create new beliefs about myself, about how I am alright NOW. These tapped into some thought patterns I needed to change. Remember don't believe everything you think ..... So I set to work.

We learned about the orphan archetype and the pros and cons of examining the orphan within us all. We heard the story of "the Ugly Duckling". We journalled. The opening sentence was "I want..." A very powerful tool. We danced through a guided meditation through a four part garden with gates dividing the areas. We experienced the long hard winter that precedes transformation and growth. Rocks for grief, sticks for anger, water for despair, and sand for feeling depleted. We then went for a silent meditative walk about the bush. It was the winter solstice and people all over the world were also engaging in that exercise simultaneously. We were encouraged to see if anything called to us on our nature walk and to collect them for inclusion in our dolls or journalling. The sticks of anger had called me during the meditation. It was time to examine their purpose.

The other women had mostly not made the dolls before and we all had kits in front of us for a new doll. So did I. So I made a new one as well as working on my inner child doll. She had come with me as plain Jane. I was called that a lot as a child. This weekend I made her/myself blossom.

I used the sturdy sticks I collected to first of all give plain Jane a backbone. Next I entwined some curved sticks to her to give her longer arms to reach out for help and comfort. Next she needed to stand taller, so some very strong branches were bound to her short legs. These new limbs were bound in a tartan that reminded me of the little tartan pinafores I wore as a child - with a plain cotton top and a beautiful pleated skirt. They were worn with a pretty white blouse and a cardigan over the top. My new doll seemed more confident already. She had been mousy and brown before, and I look hideous in brown. She wasn't happy being brown. As the dove-grey and green tartan strengthened her she seemed happier. Suddenly I knew she needed more green. A scrap of sequinned green spoke to me. I bound this across her heart. There were some leaves that filled a gap or two, then she sighed contentedly. At last, you are getting to the heart of me. Returning to the treasure chest I found a small sculpted baby, painted gold. This touched a very deep chord. The little one was immediately tucked next to her heart. Scraps of green gingham, more layers of beautiful dyed green cotton with leaf prints, a few more sequins, a tie or two, more hair, a flower for blossoming happiness, a jewel or two, a few pearls, following our instincts. Then someone brought me an amazing gift. There, in a small velvet covered matchbox, was a tiny baby with a message in the box that read "I love you just the way you are". It was just the message she/we needed to hear. She held a stick to acknowledge the rage at her mistreatment, but it was softened by a growth of green, as she didn't want it to define her. It now looks like a wand to achieve transformation. A friend across the table said, you realize, don't you, that she is Mother Earth. A bell rang somewhere. Many people call me an Earth Mother midwife. Others have called me a Demeter figure. But of course. My inner child had blossomed into a manifestation of something that feels very natural to me. An earth mother. I was profoundly moved by the whole experience and can barely take my eyes off her. She is just right. I had never imagined that I would create something as beautiful as she is. As green as she is. But she is "No More Plain Jane" now. And I love her just the way she is.

The white doll I am holding is my midwife warrior I made in the first healing doll workshop I attended. She is full of symbolism and has a long story too. Her new red sister is also related to the meditation. She is a goddess of rage, who trails her anger behind her and has no problem expressing it. I think her story is one for another day....

Here is our group with their dolls at the end of the weekend. We all found it a very powerful and symbolic exercise, an oasis in our busy lives as mothers of children with special needs, some bereaved mothers. We had danced, including a belly dancing session, journalled, ate great food, talked, laughed, cried, discovered, meditated, slept and relaxed and shared an incredibly intimate weekend.

I am very lucky to have access to this type of workshop. It is a lifeline for me, a tool to have an inner life that allows my inside to match my outside. This doll making is a stunning exercise when taken as a whole 30 hour journey in a supported psychotherapeutic environment with trusted friends. And now I entrust the sharing of it with you, dear reader.

Peace and love.

Poor me (not)

Feeling time-poor lately. I wish there were two of me to accomplish all the things I want to get done!

I have so many projects and interests running through my head. Am I mad? Or just constantly creatively stimulated?

Work is absorbing. I work 7 shifts in a 14 day cycle. Currently I am working all day shifts, so that means I have no time at home during the day. Days in which to daydream ... not enough.

I see that in print and it looks wussy and whiny. I don't have 5 children to bring up, I have a comfortable home and resources to spare. I don't live in a famine or war torn country. I have a supportive husband who loves me, and whom I value more each day.

I like being absorbed by work. I love practising and thinking about midwifery, and plan to do a LOT more of it, for the next 20 years! Midwifery is a meeting of my heart, intellect, experience and soul. It enriches me immensely and I feel like my inside matches my outside. Its all good.

Yet what I put on hold to study and become this fulfilled midwife was my stay-at-home, free to create-while-kids-were-at-school self. What I mean is that my artistic, creative life is feeling cramped.

Since I finished studying and started working I feel like I never have any time to 'myself' any more. I suppose it has coincided with my children finishing high school and not being out of the house at regular times daily. If I think about it, it is probably the kind of stress that working people, especially Dads, have felt forever. Sigh. Welcome to the real world Laura.

I have kidded myself that the good thing about fabric is that it is non-perishable. I can build my stash and pick it (craft/sewing) up again at any time. But I never seem to have a time when I can get a good run at it without feeling like a. someone else needing my attention, b. someone else needing the room I am using, c. selfish for ignoring all other demands and just doing what I want, d. guilty for having all that stuff and not using it thoroughly enough, e. overwhelmed about which project to start / finish first! So I don't do as much as I would like to do in the time available, which leaves me feeling guilty and frustrated, and almost panicky for some reason.

Do I feel like this because of some inner sense of impending mortality? I know some people who have died young lately, and I just have a sense that I may not make old bones (for lots of reasons). Sounds morbid and/or strange I suppose, but I feel that I have so many things left to finish. Remember that old joke "My to-do list is so long that I can never die!"

I am also daunted/getting hassled (and wouldn't know where to begin to sort it) about the clutter caused by my stash. I am a pack rat. I hate people moving my stuff. HATE IT. Feel very threatened by it. But if I died tomorrow - boy would it be a pain in the ass to clear up my stuff! And as much as my husband would cheer if I (meaning me, myself and I) were to clear it up tomorrow, it would be a dreadfully painful task for him to do it without me, plus he wouldn't know what it was, where, or to whom, I wanted half the stuff to be distributed.

However I am quite capable of ignoring the mess and creating within it. Quite lovely things really. That bring me joy to plan, select materials for, cut out, make and finish to a high standard.


I feel time-poor because I want time to play, create and just DO some craft stuff. When I'm not tired, so I can see well. When I'm not tempted to just snuggle up with my favourite squeeze. Without having to set the task aside. Without eating if I don't feel like stopping for it. Without stopping to answer the phone, or even pee! Without being obliged to anyone. I like it to work out. I hate leaving a project abandoned in the middle cos I get stuck. I will adapt and think my way through a project wherever possible. But I need the time.

I am working for the next few weekends, including Mother's Day. Then I somehow have a week where I am rostered off. Just all my shifts smooshed up at the beginning and end of the cycle, including a 6-day straight stretch. I may be a blithering idiot by the end of it! But at least I will have time to recuperate. Hmmm......

What will I make first? A drop-dead list with instructions for my stash distribution? Or another bag.....?

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 !