The semester that was...

I can't believe that the mid year break is halfway through! Assessments are over and results are coming in. So far A for Midwifery and A- for constructions of knowledge - Yay! All that hard work and stress has paid off. Only the lovely research paper result to go and frankly, it could go either way!

I spent a week going out with Matty - no births but attended antenatal clinic and postnatal visits. Did lots of palpation and baby checks. I feel quite confident on conducting a postnatal baby check now and supporting a mum to breastfeed. Antenatal clinic is similar although the palpating and fundal measurement is going to take a while to get to grips with, however I've heard that can take the full three years to get down pat.

I feel like I've learnt heaps and Matty has been a great teacher and she is always happy to answer my questions (of which there are many).

We had an antenatal visit with a couple who had an increased risk of downs syndrome from a nuchal scan, Matty set me homework to find out about the absence of nasal bone formation and downs syndrome on ultrasound. It was an interesting exercise and I learnt heaps compiling it. The nuchal thickness risk was 1:200 for a downs baby, but the nasal bone was present, which (from my research) decreases the risk factor further, though this is not taken into account in the risk percentages given on the nuchal scan, other than noted whether the nasal bone is present or not. Very interesting.

The couple decided to proceed with a triple serum test and then decide what to do after that. It showed me that to support a woman fully as a midwife you have to be totally there for her and put your own feelings about things aside in order to counsel, educate, advise and reassure.

Another situation that arose was with a VBAC who is supposed to be trying for a normal birth this time, but when we bumped into the obstetrician at the hospital who had reviewed her we found out the woman had said she wanted to have an elective caesarean. The OB said that no it was more risky and she was a good candidate for VBAC. The woman then proceeded to book a c-section in for one day after her due date. M is not going to go to the caesarean as a matter of principal - the woman ignored her advice and that of the OB but his happy to put her baby at risk with unnecessary surgery. I must say I admired her for her stand on this.

One thing that I have noticed is that sometimes the woman gets lost. We had one situation where a mum had signs of preeclampsia and to cut a long story short was induced, and ended up in hospital for three days before anything happened. She was a bit "precious" as the staff called her, but I said to M that it was understandable given that she had been having this normal pregnancy and all of a sudden it was risky and she had to be induced NOW. The induction then failed to work and she is stuck in hospital for three days with not much but minor contractions.

It is enough to do anyone's head in. I felt that the staff were a little blase about her and wrote her off because she was a hassle, but in fact she was a tired, frightened woman. I have found it a little disturbing the way that some of the midwives talk about the women when they are out of the room (Lordy, it makes me wonder what my midwife said about me!!). It is very disrespectful.

Everyone (including myself) had pretty much expected that she would end up with a caesarean and in the end, she went from 2cm to fully in an hour and had a normal birth - which I ended up missing because I had left the hospital with the expectation that nothing would happen until the next day, so I had a few wines and when the call came a couple of hours later that she was fully I didn't think I should go. I wouldn't have made it in time anyway as she had the baby within the hour!! I felt really pleased for her though, because she ended up doing really well and having a healthy little baby.

I received a lovely box of chocolates and a card from one of the women whose birth I attended. It said some lovely things. I have also had another evaluation back from a woman and it was very good, with some fantastic comments, so I was really pleased. It really is an honour to be present at these births and I can't wait to be a fully fledged midwife.

Following a midwife around...

I haven't been very good at writing my journal as I go. I find that the paper/study/clinical experience are so intense that it takes me a while to process everything before I can write it down.

I went to the Michel Odent conference last week, which was so inspiring and so needed after the hospital births that I've attended. It is good to know that there is a movement alive and well that not only promotes but practices birth without epidural or caesarean unless clinically indicated. Did lots of good networking at the conference - heaps of people I knew there and met heaps of people also. Learnt lots and got to meet the amazing Michel Odent (I think everyone there is just a little bit in love with him - don't worry though he's 78 so Steve is not about to be replaced). Also James McKenna was amazing and probably for me the most beneficial session on cosleeping and SIDS. Alison Barrett, as always was an interesting, funny and thought provoking speaker on breastfeeding. So that was a nice little break from study.

My practical skills assessment and exam are now over over. Did well on the assessment, although it was nerve wracking, I managed to get through it and not cock it up. Exam was ok and I should (fingers crossed) pass. If I don't I will crawl under a rock and hide for a long, long time!

After the exam (last Tuesday) I went straight to the campus bar with a couple of pals and had a wine and then met one of my darling friends for lunch. Handed in two assignments last Friday for my other paper and have got one hideous research assignment due on Monday. Have I started it yet? No. Will I pass. Probably not. Do I care...No...well yes actually because I hate the paper so much that I really really don't want to do it again. I would be happy with a c-...any pass, I don't care. The intermediate research paper has put me off research for life!! After my breastfeeding research for my CBE Diploma (which I was told was a very good piece of research - an A+ I might add) I thought it might be a field I could enter, but now I don't want to go near researching with a barge pole. I feckin hate that paper with a vengeance!!

Anyhoo, I refuse to waste energy on that. Onto better things. This week we are on clinical which means following around my darling midwife (dear friend, and future business partner) like a little lap dog. It is really interesting and I am completely knackered - pathetic really. Just not used to working a full day...I need to toughen up.

We have spent the past two days doing antenatal clinics and postnatal visits. One of our women has preeclampsia and has been induced tonight - so will head off to bed shortly and see if we get a call in the middle of the night.

Today I had one ah-huh moment when I actually felt the fundus very easily in two women..I was very excited about that.

Things are starting to fall into place slowly. I managed to get the blood pressures done pretty accurately and am getting a little faster. Have done three baby checks this week (all bar the hips) and can fairly confidently pick up the heart sounds now. Ok on reflex checks but hate measuring the head - the buba's hate it and scream! Overall really enjoying the vistis and clinics.
It is incredible that every woman is so different and her needs, fears and excitement is so individual. Some bring their partners, some have screeds of worries, others have no questions and some have zillions of questions - it never ceases to amaze me what a huge proportion of the job is listening, counselling, reassuring and supporting. Such a small (yet very intense) portion of the job is the actual birthing.

Had one couple in clinic today with a Nuchal scan that came back with a slightly increased risk of Downs, so sat in on a farily heavy visit with them. Midwife gave me homework to research the nuchal translucency and nasal bone assessments in relation to downs risk (which I have done). It was very interesting and illustrated to me how you have to put your own feelings aside in regard to terminations, ultrasound testing etc, and counsel and support the couple.

All in all a very interesting day. Exciting that another baby is about to be born as we didn't think we would have any babies during my clinical week - so I'm looking forward to it but at the same time it is completely terrifying! So on that note I had better have my cup of tea and away to bed, just in case I get the call. I definitely need my beauty sleep (and my brain does too!).