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.
