Last days

Snapshots from my 'place of birth'

A final week of madness on the ward. The hospital is in crisis mode, with a serious bed shortage and a staffing shortage to boot (I have not offered to work an extra shift this weekend).

I was lucky enough to work the same 4 rooms for 4 days, and saw 9 different women through those rooms, and 5 different babies. Some babies were in the nursery, some hadn't come out to play yet. All but one of the babies were great feeders, with sensible practical mums. It really makes a difference.

I can't tell you how many bells I answered, but it was a LOT. I have a sore foot currently and am limping alot of the time, which makes my other hip and my back sore. I was not pleased with frivolous ringing of bells, but I did take a certain pleasure in seeing that I would not be answering bells next week. Just mobile phonecalls.

I had my last late-early split. Bliss. I am well aware that I will be on call and I may long for the life of a rostered day off, but just let me enjoy this tiny fantasy, will you?

I worked a late, early, early, early, and was in a meeting from 9.30-1.40 today. Hubby was away on business and I had to walk/limp to and from work all week as I have no parking permit at work, and I live pretty close anyway so its not worth taking a car for an 8 minute walk. Unless you're limping. This part of the week DID suck.

Word was still spreading about my departure, so I have broken the news and said goodbye to many people all week. I have enjoyed much goodnatured ribbing about people making me hand-embroidered placenta bags if they'd known (my reply? Frankly my dear I'm bloody insulted you hadn't already wrapped it ready for me, what's the holdup? You've had 4 weeks notice!).

I have had 2 avo teas, with cake, wherein I received a lovely gift from my home ward, and many many good wishes, acknowledging my long-held desire to work in this field. Students and former students professed to have enjoyed birthing and working with me, saving lives with me, and laughing with me. I cried. I laughed. We hugged. I assured them I would not be far away, and would not be a stranger to them.

This morning I handed in my uniforms to the cheerful Julia in the hospital laundry/uniform section. She asked where I was heading and was delighted to hear that I was going to be a homebirth midwife. She regaled me with tales of her mother giving birth to 12 babies at home, including one caught by Julia herself when she was 13 years old. Her brother had come really fast and her dad was still away fetching the midwife!

This afternoon I had a final engagement with labour ward. Over two hours staff staggered in and out and asked for information about my next job. Some of them almost seemed to be giving grudging permission for this career move, but were greatly outweighed by those assuring me I would love it, and that it would be a great fit for me. There was much discussion about knowing me, and my capabilities, and knowing that I would understand their expectations if transfer occured. There was more ribbing about me phoning in to transfer primips who had been pushing for 7 hours (c'mon girls, you KNOW my minimum time limit before transferring is 8 hours) and much curiosity about details, which I was largely unable to furnish, as I have yet to be oriented. I caught up on the gossip, who was pregnant (3 of them), who was planning to be and who had got new roles. It was great to touch base with these fantastic bunch of hardworking and talented midwives again. I have missed them over the last 6 weeks and was a little sad not to finish up with them on Labour ward. But I am sure I will see them from time to time, and I know it will be a warm welcome.

Lastly I handed in my security pass. I cried again, suddenly, and couldn't speak as the man took it from my hand, and I left the building with tears rolling down my face for the umpteenth time that day.

The tears are ones of recognition of the importance of that place in my life. Of gratitude to my colleagues who have taught me and shared so much. Of grief to be leaving their daily lives. I have been delighted to work there, to become the midwife that I am. My tears are also of pride in my accomplishments so far. The tears of transition.

Most of all, over the last 4 weeks, I have been humbled by the warm support of mentors. They have been open in their joy for me. I am certainly standing on the shoulders of giants. I mentioned before that I felt like I was at Everest base camp, still with one heck of a climb ahead of me, but Oh! The view!

Who knows what sort of midwife I am yet to become?

In safe, strong hands

Today my husband's hands have opened presents.

They have eaten chocolate. And spooned porridge.

Fetched hot chocolate at swimming. Pressed timekeeper buttons at the competition.

Massaged the back of a swimmer.

Recorded a personal best time for our daughter.

Driven us safely home.

Eaten a picnic by the beach, and drank wine.

Done the fruit and veg shopping at the market.

Unloaded the dishwasher. Hugged our son.

Packed a suitcase to take him away for a brief business trip.

Opened the door for the cat (umpteen times).

Later, they might get lucky ;)

But wherever those hands travel, I feel safe when I see them. They are strong. They are dependable. I love to hold them, and be held by them.

They held our babies many years ago, and continue to do so. Safely.

We are very lucky to have them.

Happy Father's Day my love.

Everest Base Camp

I have had one hell of a week. In a good way.

I had a job interview on Monday with a publicly funded homebirth program, one that has led the way for their model of care, one that has been replicated across the country. It has always been my goal to work for them, when I had enough experience. I was encouraged to apply. I applied with my fingers crossed. I thought 'well, if I get an interview I'll be pleased, and I might be a chance, but I will be hysterical if I truly get it'.

I got the job.

Yep. You read it right.

I got the job, my dream job.

And now the climb, the steep learning curve really begins.

I am skipping with happiness.

I wrote my resignation letter, and handed it in person to all my managers. Then I howled on and off about leaving all my lovely workmates that I have shared so much with. Each day since, I have broken the news to a new set of people. Its very exciting.

And then, yesterday to top it off, and just when I was lamenting that I would not catch another baby at my hospital, one of my women on the ward went into precipitate labour while I was at tea. I returned to hear her distressed behind her curtain in the shared 4-bed room. She nearly clawed my arm off and it was clear she was nearly ready to push. Which was a bit of a shame ... because only 2 hours before she had signed for a repeat CS, especially if she laboured. I notified the coordinator that we needed to move, like NOW, and returned to her with a pair of gloves, just in case. She was in the throes of another contraction. She clung to the coordinator, who talked her through it, then she allowed me to examine her - wa-hey! Fully dilated and a breech close to the world. Seemed a shame to waste a perfectly good CS on a baby who had plans for exit via an alternate route.

We ran with her on the bed to LBS and shanghaied a passing consultant as we skidded around a corner. I found the first empty room and we pushed the bed through the curtain, pulled a warm baby blanket bundle out and threw it on the heater. Then I changed gloves and returned to the woman still on her ward bed and peeked under the sheet - and there was a breech on view. She crawled across onto the birthing bed. I waved my ward coordinator goodbye, and volunteered to stay as the only other midwife around was having her first day at work. The LBS coordinator assembled a team of paediatricians and spare hands, and I urged her to ignore everyone else and focus on me, which she managed really well, and I spoke quietly and encouraged her to go for it, and praised her to the eyeballs. The consultant stood next to me, and talked me through the birth, giving a small hand here and there. And so . . . . I caught my second VBAC breech baby! All pretty textbook. This one was close to term so the maneuvres were harder than last time, but it all went smoothly. I would have preferred a hands off approach, but in that setting it was never gonna happen, and honestly it was an excellent result.

I was utterly thrilled! The woman was shocked but delighted. I handed over to the afternoon staff and tottered back to the ward to pick up the threads of my day, after a very adventurous 90 minutes away! The staff were all agog, it was the talk of the hospital that a midwife had done this birth! The young doctors were high-fiving me, and were delighted to have seen a vaginal breech birth. My manager came back from lunch and told the tale, only to find out it had happened to one of her ward patients with one of her midwives! She then got the full story straight from the horse's mouth.

I saw the woman again today and she is glowing, just radiant that her body worked and that she could give birth vaginally, and that she could be up and about and so well, rather than recovering from surgery. Baby was in nursery for a day or so, but he is nearly ready to come up to the ward! 2.35kg nearly 36 weeker. We congratulated each other on our cleverness, and had a big hug. She is such a darling, and was so brave during her 'amazing experience'. My sixty-ninth baby. Her second. Unforgettable.

I'll miss this place, but I'm looking forward to exploring the big world outside and I know that whatever the setting....I love being a midwife.

And the winner is Syd-dnee! (now with added dugong)

Uh-oh. How did it get to be August already?

Somehow I have not posted since June. Oopsie. Its not that nothing has been happening. Shall I recap? June 23 - we all headed to Sydney. We bagged a superb apartment that we all wanted to move in to permanently, right near the town hall. It was drizzly but we didn't care.

We wandered out to Darling Harbour in the dusky gloom along a street that somehow contained all the hiking shops, every chain, every supply you could want, holding our umbrellas against every pissing awning - and there were plenty of 'em!

We walked across the Pyrmont bridge and into the Aquarium which we essentially had to ourselves. It was wonderful. Much bigger than when I had last been there in 1988. The displays were enchanting, and really easy to photograph too if you had a steady hand.

There was a special dugong exhibit, with a pair of dugongs lolling about quite mournfully at one end of the pen and slowly crossing the tunnel above our heads and returning to the wooden pier where they would try to hide in a corner. There was nowhere to hide. Yet it was still entrancing to watch these creatures, even though I had a clear impression that I was intruding on their privacy. Excuse me, maam.

Another tunnel contained a shark pool where the toothy crowd were a bit more lively and numerous. Nothing scary, just ...Establishing Respect.

The upstairs exhibits were fantastic, but the big tanks really were stunning! When I say big I mean BIG! HUGE! probably about 5m deep and at least 15m in diameter, all landscaped and populated with reef fish, or deep sea fish, or sharks or rays, Nemos and Dories, just fantastic and surprisingly entertaining. Great big fish looking mournful. It was wonderful, I'm so glad we went.

We then walked past the damp World Cup Soccer Village all the way to the other end of Darling Harbour and into China Town where we had dinner in a very chaotic restaurant. I have no idea what we had but it was delicious, and there seemed to be a LOT of Taiwanese people in there, enjoying a ridiculous gameshow on a big screen. Fascinating place. Couldn't for the life of me tell you what it was called, sorry, but it was popular.

Slept like logs in our sumptuous rooms. The apartment had 2 bedrooms and 2 bathrooms, a laundry, a full kitchen and a huge living and dining room, big TV, all brand new and modern, with 2 balconies overlooking the rooves of churches and in eyeline with skyscrapers. We were on the 27th floor! It was brilliant.

The next morning my cousin arrived. Katharine is my youngest cousin (of 23 first cousins), I was 17 when she was born. She is living in Sydney now after being brought up between England and Perth. She is just lovely, and I wish I could see more of her. We stayed with her Mum in 2007 in London. K is very arty and has recently directed her first short film. She works heaps in the arts scene and we were delighted to catch up with her and be shown around the Sydney Opera House backstage - we even had coffee in the Green Room, and saw the Sydney Biennale on Cockatoo Island. The art was thought provoking and really evocative, and often really out of left field. There was a plywood model of the Hubble Space telescope, that seems like a steampunk had had a hand in it! I also enjoyed the piece with a car flying overhead in a shower of sparks. Cockatoo Island is the site of old naval shipyards and the buildings and spaces made me feel the presence of my Dad, who was a mechanic. The smells of oil on a dirt floor, and the industrial spaces and the rust. Being with his sister's only child. I'm sure he was with us as we wandered about that fascinating site, or maybe, just remembering him makes it seem that way. It was a gorgeous day and the free ferry ride was an added treat. Stephanie saw where Dance Academy was filmed, we went under the bridge, it was all good.

I've never spent long in the Circular Quay area before so it was such a treat to really see it, and wow what a place. It deserves the reputation as one of those locations where if you sit there long enough, the whole world will walk by. It is not only physically beautiful, in the sense of water and coves and clean air, and buzzing atmosphere but the man-made environment (i.e. the Bridge and the Opera House) is also gob-smacking. I hadn't expected to enjoy it so much but it truly was superb.

K also works at the Museum of Modern Art, right on the harbour, so we had spent the day in her environment. It was so enjoyable. She joined us for dinner back at our place, where we waited for the slowest Indian food delivery I have ever experienced. It was a bit average, but we talked and talked, and it was nice to just hang out with a family member I hardly ever get to see.

The next day - Taronga Park Zoo! 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.

See that thing on the right?

How do these things get handed out?

I ignored it for a bit, thinking it was a viral phishing code, but as I have barely posted anything this year I thought it would make for another post! Desperate huh?

Anyway, I have really mixed feelings about any such thing. You've probably noticed that I don't write so much recently about work and individual births. This is because I was heavily warned off by a series of events, including a lecture on cyber-presence and how one is vulnerable to 'flaming' if radical groups find you and take you on. Examples were given and my blog was used (among others) to illustrate the talk. This blog IS in the public domain, so it IS fair game to such things. No permission was necessary. But it made me feel vulnerable.

I also received a few comments accusing me of breaching confidentiality. Just a few, scattered over one or two posts, mixed with many times more comments appreciating the posts. But coupled with the warning lecture it put me off. I didn't enjoy writing it anymore, even though I still felt the same way, and reflected just as much as I always had, it was just in my head, instead of on the page and shared with readers.

I wondered if I could leave stories to 'cool off' for a while before telling them. Then days became months, and so many stories fell away from my memory. And I got out of the habit of sharing them with you. I felt silenced, but safe from criticism.

There have been many, many stories I wish I could share.

I haven't actually seen a baby pushed from a vagina in months. Truly. I did have a woman pushing with me two weeks ago, a first timer, but after an hour it became clear she was going to need a hand to get her baby out. But the doctors were busy. So even though I stayed late after a nightshift, I still didn't see the baby emerge.

I had another woman, another first timer last week. She was being induced for post-dates at 11 days after her due date. The balloon catheter hadn't budged after 18 hours. We deflated it and applied hormone gel high in her vagina near the cervix to help ripen it. My shift ended and I handed over to another midwife and student, who were between 2 rooms. I could see she was contracting a bit, but I went home. I thought I would have her again the next day (our third day allocated together for continuity). But she was left alone for a long time on that shift as they got busy in the other room. She called the bell later that evening and was attended by a different midwife who, finding a woman in some distress and contracting a fair bit, examined her. She was 8cm and proceeded to push her baby out two hours later!

So, a good result in the end, and a relatively uninterfered with 'natural' birth after a second induction attempt. I saw her the next day and they were a bit stunned but delighted with their daughter. They were pretty lucky that the docs were busy elsewhere, and that she was able to be undisturbed, even if they felt abandoned. I was sad they felt under-supported in the building labour, but thrilled for her that she achieved a vaginal birth, against the suspicion that her induction would be deemed a failure.

After a summer in the homebirth arena, well...at the shallow end of it....it is still chafing to find myself in a high-risk environment. Yet I am largely proud of the work we do in that world. We see a lot of stuff. A LOT of stuff. Big Stuff. Confronting and complex stuff. Life threatening stuff. And we do it, and deal with it, and do it well a lot of the time.

There are some who don't cope or thrive in that environment. There are some who have forgotten it can ever be any different. And there are some who have a bare minimum of exposure to complexity and emergency, and pooh-pooh those who work in those environments. I've met them all. Birth can turn in an instant. Recognising the instant is the art.

As a midwife I want to experience it all. I don't want to become so indoctrinated to swimming with sharks that I forget to take off my chainmail when dealing with goldfish. Yet I don't want to forget that birth (and life) is bigger than the goldfish bowl of homebirth. Most of the world sits somewhere in between. Its a tricky balancing act.

Yet despite the tightrope act....I love being a midwife.

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.