Hearing the call

Did I ever tell you how it was that I became a midwife?

photo from National Geographic August 1999

I had always been interested in birth. I watched my cats give birth to their kittens. I noticed pregnant bellies. I avidly watched nature films with birthing. As a high school student I saw a birth film in year 10 and clearly recall the crowning, and seeing a small tear occur, but knowing that I was seeing something sacred, and mysterious, and rarely seen.



When I had my first child I didn't understand what a midwife was. I have recently reconnected with the midwife who attended that birth, and my son turned 24 last week and we reminisced together. With my second child I had a friend who was a midwife and I read some of her books and came to better understand the role of the midwife.

As you know, that second child led me to a whole new world of discovery. I began to attend women's weekends for mothers of children with disabilities and special needs, where I was introduced to journal processing. This has been a tool to having a life, an inner life, all of my own. It is where I learned to love the questions in my life, rather than feeling I had to have all the answers.


On November 3rd 2001 I did a session where we looked at the personas we held within. The idea was to have a dialogue with one of these inner selves and uncover truths.


Now, a caveat here. Journalling is a very private experience. I have always been taught that it is never to be shared except with ones own voice. It is a private thing that can be shared with others, or done in a group, and the opportunity exists to share through reading. Listening deepens the experience, we often find resonance in other's words. Hearing oneself saying the words that have come out the end of your own pen is confronting, and affirming, and scary sometimes. It deepens the understanding, beyond just having written the words. It is a message from your soul. It is often moving beyond all measure. I have had some of the most profound experiences in my life in a journal room. Journal is secret and respected and a safe place.


So ... This is my blog. This is my erstwhile voice. And I choose to share with you some of this session, and I trust you with this sharing.

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My Secret Selves


My list: the dancer, the midwife, the counsellor, the clear thinker, the love force of the Universe


Come out, come out, whomever you are


Here I am, coming as you have called, inside you, waiting for my time to begin, talk with me, come to know me, name me, put me up as a goal in your life, DO something to reach me.


Who are you? What is your calling? Will I like you? Will the path to reach you be long and hard? Will I have to make the journey alone?


I cannot answer that question. Any path is hard. Nothing will fall in your lap. But if you want to hold the shape of a ripe belly beneath your hands you will have to give up some things. To be a midwife will be 4 years of dedication. Set a date. start towards me, you know you want to. The coursework is not beyond you.


You were born to use your hands in this way. The power of birth, the hovering of life yet unbreathed is calling you. You talk of wanting a job which encompasses all your unique set of skills...this could be the thing. It is the sensuousness of the dance, the skills and knowledge of midwifery, the feminism, the ear and shoulder and warmth of counselling, the celebrator of life and the deliverer of fully formed perfection wrapped in death. The midwife births not only joy, but sometimes sorrow and you are well equipped to accept that challenge with grace and wisdom. Be an empowerer of women, deliver them to joy and peace, treasure their bodies and their new life, nurture the family, comfort and share with them.
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Does that sound like the universe giving a wake-up call? Yeah. I thought so.


A few weeks later I told Don, and his first words were "you'd make a bloody good midwife". And the rest is history.


I love being a midwife.

Be prepared

I will return soon, with a flashback.

waving in my sleep....

Remember me?

I barely do.

I've been on nights for 3 weeks, finishing with a run of four nights, which were all BIG nights.

Now I have 27 hrs til I start 4 day shifts .... no time for blogging ..... so apologies for the unexpected blogbreak. I'm off to bed now.

I promise I'll be back, OK?

A few baubles for you

So.... its nearly Xmas. Had you noticed?
I'm getting in the mood now. The tree is decorated.
The pressies are chosen, wrapped and under the tree

The MRI is all clear. The dizzies are mostly gone. The medication is working.

I am wearing Xmas earrings and a tinsel halo to work most days. Its fun. Work has been lovely. Interesting and brave Mums. Sweet babies. I've even had two thankyou cards and chocolates this week! That never happens! One was from the family I met before my holidays. The other twin is doing well.

Why do funeral companies have cookie cutter services with patronising overstated sentiment? Am I a bitch for asking? I attended the funeral of our colleague who died. It was about as wretched as expected, there were so many people there. Naturally there was a very notable turnout from work, nearly all the ward were there, and half the rest of the hospital. Her Dad spoke, heartbreakingly, followed by her sister, stoic and loving. They were a markedly smaller group as a family of 3, compared to the family of 5 they had been only 13 months ago. There is no easy or un-trite way to say goodbye in these circumstances. It all just sucks.

Is there such a thing as turning up to heaven uninvited? I'm sure she would be welcomed anyway, she was a kind girl who earned her wings in many ways. Her death, and the circumstances of her death have been very confronting. Once again we are starkly reminded, depression is a serious illness. How desperately 'not-thinking-straight' must she have been to make that choice. Such a waste.

I haven't been so active around this blog of late, but it doesn't mean I'm not thinking of you. Swings and roundabouts. Most bloggers I read report slow patches, and I am fascinated to realise that I have been blogging, and blog-reading, for more than 2 years now.

In case I don't get to post again pre-Big Day may I wish you all a very happy Christmas season.

A toast: To old friends who have weathered the years, and to new friends who were strangers but yesterday. Merry Christmas.

I just know that 2010 will bring good things.

Holiday activities

Spend four nights with favourite husband in a cosy and private beach-side getaway. Tick.

Spend a day of getaway baking beloved Christmas cakes. Best. Batch. Ever. Tick.

Play Bingo with hubby. Tick. I still don't win.

Tackle Xmas pressie shopping with a relaxed hubby by my side. Tick.

Get bathroom door and dining room wall painted 6 months after bathroom renovation. Tick.

Attend Xmas parties in blistering heat. Tick.

Host Xmas party in blistering heat, wondering why people say they are coming but don't. Tick.

Eat leftovers. Tick.

Read on FB that a young depressed work colleague has died tragically. At work, with colleagues finding her. Reel in shock. Make many phonecalls to distraught colleagues. Grieve the loss of a lovely young midwife. Sadly, tick.

Value life even more preciously and vows to love and support even more. You betcha.

What do I know?

How many times does a human heart beat in a lifetime?

Today I found myself in the position to count them. Almost literally.

One little sweetheart lived his brief life in my care today.

I know Miracles exist. I thought he had slipped away, after twenty incredible minutes. But his little heart beat on feebly and slowly, for another hour or so of bonus life. Cradled by his brave Mum and Dad, skin to skin with his mother in life, with his father later, in death.

It was one of the most beautiful, incredible days of my life as a midwife. From taking the phonecall, to receiving the couple. From listening in and finding two heartbeats, to seeing one falter. From phonecall to the ward they were in my care, as well as the care of superb specialists . Together, the work we did today was a work of art. An oasis of beauty in a forecast that was never going to be good.

Today, for one day only, I was their midwife.

What a privilege.

Once again, I know, I love being a midwife.

Not drowning, waving (again)

Did I say not drowning? Well.... its probably accurate.

I have been watching too much TV, playing way too much Bejewelled on FB, attending work back on the postnatal/antenatal ward and had a random night shift thrown in to the middle of a dayshift fortnight (I know) which has completely thrown my body clock for a loop and I lost close to 2 days in sleep disturbance. Sigh. I'm back on days this weekend for 4 days but then I have a week of rostered days off, before working for 4 days then having 15 days on hols before Xmas. Woot! I love to be back on the ward with all the darling staff members I was mentored by when I was a student. I am also working with my own mentee, which is a lovely change as our rotations have not coincided frequently at all and it is good to see her functioning clinically, even though our relationship flourishes mostly outside the workplace. She is so bright and buzzy, a real individual.

The workload is as full-on as usual, challenging physically and emotionally as well as an organisational challenge. To top it off the ward has been renovated since I was last there, so nothing is where I expect it to be. I am being a big girl and sucking it up. I'm just very lucky, I repeat to myself. But it does make me think of how different things might be in a year's time, in a different style of care. I am scared. But I am determined. Why does it matter to me what people think? I have good reasons for taking the path less travelled, and everyone I have mentioned it to seems to think it is an excellent move, but I suppose I must suck it and see. It may not be for me. I will be quite happy being a plain midwife out there, but how big will my envelope be? How far will I push it? There will be stuff I can only learn out there. I am not fearless, but nor am I fearful. I have a very healthy respect for the process, and the risks. I must keep my clinical judgement about me and distinguish between space for evolution and recklessness. There's a lot going on in my brain. But in the end - Megan says it well here.

I also saw New Moon on Thursday morning bright and early - its not bad, I found it very absorbing and the performances were much better this time, with less of the trembly, changing half-formed mouth movements from Kirsten Stewart that gave me the pip the first time around. She really is much better this time around, more natural. Its certainly one for the fans, but it ends a bit suddenly! There is almost the case for editing books two and three together to shift the action along, but it was still satisfying and beautifully done. The three leads were less wooden +/- overacting. The Jacob character was good and well performed. There were funny bits. The Edward character was much better made up although for a perpetual 17 y.o. someone carved from marble-like perfection he somehow looks haggard and older and a lot more manly, which was very appealing. Am I an Edward or a Jacob girl? Hmm, I think I prefer manly, but a bit of exuberant animal buff is good. The rest of the Cullen clan could have done their shots in less than a week, apart from Alice. Thinking back, they are mostly only shown in asembled set shots, with little dialogue. All in all 8/10.

Today I have a lunch with fellow midwives before the long awaited head MRI to see if there is any sinister reason for the dizzies - we suspect not, but lets rule it out. The medication is really helping and they are 90-95% gone. Edited to add - I'd forgotten how LOUD those MRIs are! Even with earphones it was like having my head trapped inside the DJ desk at a really bad alien robot techno rave, with error messages going off. Geez! 20 minutes of it!

The Big Picture tour by a Canberra ACM staff member, Abby, is going really well. She is such a dynamic presenter, and has been really flexible and super-organised and great fun as well. It is half over now, and this time next week will be all over, but it was well worth the effort. We had lunch yesterday, and she is tired but happy so far, and on days off now down south with her family. I look forward to next week.

So, I wish I had some new craft to show you, but I don't. I c.b.a. (can't be arsed) getting the camera from the other room to even show you a pic of the gorgeous Abby from Canberra. I have no excuses, I just know that if I left the computer now something bright and shiny and completely unecessarily random would catch my eye and it would be 3 o'clock before I remembered the unpublished post on the computer....so, really, we'd better play it safe and hit publish now. Yes, really.

Bag lady

Well, the Stuff continues to loom, but I had a rare weekend+ off so it felt right to do some craft.

On Friday I took myself over to Lesley's place and sat companionably with her as she pottered and planned another papercut, and I got stuck in to assembling a bag I had cut out last week. It is from a pattern by Kathy at Pink Chalk Studio, called the Mail Sack.

The base is a wool/silk mix that I got in an op shop somewhere for about $1, and the top part is a vibrant purple linen from a recycled skirt. It is designed to sit scross the body. Whaddya think? I tried to get photos of it on me, but sigh, no. Trust me, I'm sparing you. I haven't decided yet where it will go. It may go in 'the shop'. Or it may be a pressie. I had so many buttons to choose from for the flower, but Steff liked this quirky cow button, so we went with that.

On Saturday hubby and I headed to the city for an impromptu grown-up getaway. I feel like I haven't seen him for a month! It was lovely, away from the phones and the emails and the Stuff.

We went out for dinner (Globe, at the Hilton, mostly wonderful, and the good bits were Incredibly Good) and breakfast (King St Cafe, really good) and had a wander around this developing part of the city and just enjoyed ourselves in general. Comfy room, soft sheets. Exactly what we needed.

On Sunday when we returned I felt like tackling a smallish craft project, that I asked Les about on Friday. She had re-lined a bag that was shabby, or yukky, and I had a lovely bag that had frayed lining. See? It is as an Olga Berg that I bought about 3 years ago, but the original lining was shabby. So I gutted it. The pink bit here is the external zipped pocketliner that was not frayed.

Then, using the old lining as a guide I cut a new liner with a pocket, and reused the zipper for a new pocket, and reused the darted pocket opposite.

Then I hand stitched the new lining in place.
Et voila! One refurbished bag!
I have one more day off now, which is filling up quick, so I'd better fly!

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?

Night shift news

Hello world. Phew. Night shift and labrynthitis are a bad combination.

It was getting better until sleep disturbance and nausea kicked in, or they kicked each other in....or, oh heck who knows? Anyway I'm on the second of 3 days off, before I lose 5 days of my life with 4 nightshifts over the weekend. Sigh.

I did three shifts with two nights early this week. Good shifts, if slightly mad. Really busy on Monday night. Dementedly so, poor coordinator was tearing her hair out. I happened to be in the rooms in her eyeline so every time I walked past I would get another little job to do. "quick - 29 weeker coming in, wants to push, you're it!" The woman arrives, screeches to a halt in a room with a big resus unit hastily assembled in a just cleaned room, not very distressed or labouring particularly, a little pain arrives, doesn't palp too strongly, yes waters have broken...or have they? The story is convincing with a witness. Ooh, baby's coming! she wails. Can I check? May I begin? Cervix long and closed and tucked away behind baby's head, just where it belongs. Excellent. Good news! You're not going to have your baby in the next hour. Lets take you back around to the assessment unit, where you can get sorted and admitted. Its too late for a fetal fibronectin test (which will indicate if she's likely to labour in the next week) as I have examined her, but it turns out she is known to staff as a 'frequent flyer' with every little thing and vague twinge. Ambulance guys have to take things on face value and bring em in, and if things were as presented we were ready to deal with it. As it was the floor of that room could now continue to dry undisturbed.

I had been sent to theatre on arrival for a breech CS. Lovely couple, sweet baby, wet and steaming to her chest, alert and responsive. Great photos, happy relatives. I was happily present when the grandparents learned the sex of their newborn first grandchild and saw him, travelling with us to the ward. Joy all around. Told her about a clinic at our hospital for women experiencing second birth after CS, so she could start planning her next birth. Back to LBS and had a cuppa.

Technically had 2 women at this point, being induced. Gave antibiotics to one of them. The other one was snoring. Got given another woman, a multip in early labour at 4cm, contracting irregularly...but who knows, sometimes multiparous women only need half an hour of good contractions before they produce the goods. Settled her into a room on my corridor (yeah, I had a whole one to myself by this time) and went in search of a listening lead for my CTG. Bloody hell, none to be found. Grabbed a handheld Doptone and made use of that instead. Major language barrier, my Mandarin is not that hot, but we established a pleasant simple rapport as I listened in and then made tea for her and her mother. I left her to it and popped in each half hour. She went off the boil, well....was never really simmering in my time with her anyway. She went on to birth at 11-ish in the morning.

In the meantime I was still dogsbodying my way through the night, attending an imminent birth of a 7th child, there was thick meconium so I called a paed for the birth and prepared the cot in case he didn't make it in time. The fetal heartrate dropped dramatically, and the baby was not coming despite vigorous pushing from the experienced mum. Sunny-side up, we all said, but the heartrate was getting really low. We'd called a few docs when the FH dropped and they quickly attached a simple suction device and helped baby out, covered in mec. He was floppy and flat as a tack, but we didn't stimulate him immediately, as the paed needed to suck out his airway so he didn't breathe mec into his lungs. HR was 40 while we poised ourselves ready to commence chest compressions, right, GO! A minute of compressions and oxygen saw his heartrate improve but he was still completely non-responsive and floppy, I ducked out to grab an oximeter from the room next door (where the 29 weeker didn't deliver) and when I came back baby was squawking and starfishing and protesting at his awakening. Poor little mite, it was all a bit sudden, but he was down and on the way out, and as much as I promote gentle birth, I was quite glad to see him yelling. I stayed there for another half hour, to get him settled and cuddled up and fed, and documenting the resus, then returned to my odd jobs. I was most grateful to get a dinner break, then I received another semi-labouring second-timer who had a quick birth last time. She too was not quite ready to labour, but I made her comfortable, hubby re-parked the car (during which time she didn't have a single contraction) and she went on to birth at 5.30 later that day. I handed over 3 women to 3 different midwives and staggered home, literally walking home half asleep.

The next night I was allocated to first-timer who had been stuck at 2 cm, on stacks of synto. Everyone assumed she was for the chop, but my student and I breezed in with positive attitudes and explained about cervical effacement and assured her that the cervix was ready to get on with it now and start dilating. And it came true! Her epidural had been working really well, and continued to do so. The trace had been really good, and was mostly good still, it just had a pattern of decelerations one sees with head compression, followed by a period of sleep where the trace looks quiet. We worked our butts off in that room, keeping the trace well monitored, adjusting the receivers, keeping the epidural well topped up, fending off doctors who kept showing up and scaring the woman, talking about 'heart rate dips, can only do it for so long, then they get tired' wanting to do fetal scalp samples, but every time that dear little baby showed a fabulous acceleration when it was needed and warded off intervention. In the end she was born easily and quite beautifully, despite the doctors inviting themselves into the room and standing at the end of the bed and itching to get their hands in there, and asking if we had episiotomy scissors. We held them off, almost literally, and the little one emerged via the student and I to her stunned and thrilled Mum and grandma, after a mammoth effort. The doctors disappeared like magic, and the student and I dealt with a snapped cord and got the placenta out without them, whole and intact, although we did invite the doctors back to do some straightforward suturing and assist with management of a slow PPH, which had been anticipated after that much synto. There was no CS. There was no transfer to theatre for placenta removal, there was a beautiful healthy 3.7kg baby and her Mum staying in the same room, where they had stoically borne their labour together. It was a great result really.

I was sad that the docs felt they had a right to come in uninvited and stand at the end of the bed, scolding her at her to 'push into your bottom' (as if any of them had ever done it themselves). If we hadn't been there they would have held her vagina open so they could see the descent and crowning better! I feel sad that they so rarely see the way a midwife conducts a birth, with gentle encouragement and positive language. We see their way of work frequently, and frankly it can be pretty brutal sometimes. It is noteworthy when its not. Sometimes it seems that they know no other way but fear and mistrust of birth, and litigation, and invading the privacy of the moment in their relentless quest for accountability. We will call them in if we need them. We do, honestly. Just like we did for the little one with thick mec and the really declining heart rate. I like having docs there to expand the skill level if need be. They are our back-up. We work together. I don't mean to doctor-bash. This is more a doctor-whinge maybe. But when they come in uninvited I can sometimes hear myself sounding a bit terse as I respond to their appearance, at which time I politely and pointedly introduce them to the woman and her family as if they had entered the woman's home, which in effect, the birthing space is, or should be. I try to believe that they KNOW this is the case, but somehow they don't behave that way. I'm sure they think I'm a grumpy cow towards them some days. Thats to the ones that aren't arrogant. When they are being mentored by the insufferably arrogant, they are just asking for terseness.

But I can guarantee them this. If, and when, any of them are in my care when they are labouring and birthing I will protect their rights to privacy and advocate just as strongly on their behalf as I do for any woman I care for. And I will use my clinical judgement to call for back-up when the situation warrants it.

Because I love being a midwife.