Midwifery is catching

Wah wah wah about me. I’m frustrated with the whole process. If I got a decent amount of Austudy, I’d not have at least one of these problems. If the College of Midwives wanted to make a difference for students, it would lobby for more Austudy, or a stipend for the cost of studying each year. Or the universities would open scholarships to people who have studied before - we often make better students and are here for our own edification rather than because we had to find something to do post-school (which is not why all straight.out.of.school students are there of course).

This style of learning is EXHAUSTING. I don’t think people who aren’t doing this course can understand this. Even those that are studying other courses perhaps don’t get what it’s like to be all things to all people - student, midwife, support for women in a broken and fragmented system, on call 24/7 at times, juggling work and a social life and my health while also trying not to go insane or bankrupt, and be a good partner to my lovely boy.

I was recently asked to participate in an online learning process and while I would LOVE to do it, I can’t find the hours to dedicate to this. I can’t find time to learn a new system, log in at a specific time, or try to give any more of my time and formidible brane to this calling. I am sad about that and honoured to have been asked but cannot keep saying yes to things at this stage. And I’ve not even gone back to uni yet!

I can entirely understand why midwives work shiftwork because it is set and defined a month in advance and a known quantity, and it annoys me when other midwives in other models of care attempt to tell me that I have it really good to only have to have a week like I did last week on rare occassions. No, actually - you get rostered days off, you have back-ups and YOU GET PAID for this. I don’t. I lose work hours because I can commit only to the minimum of hours at work. I miss social events which makes me frustrated and sad and feel isolated. I struggle to buy textbooks because I am filling my car up every week at the moment.

*le sigh*

And yet I wouldn’t trade it for the world. Perhaps a small slice for a haircut and a cheque for some textbooks though .  

Last week was a big week. I feel like I’ve spent every day in the hospital which is about the truth as I have. Three births, one wedding, two missed nights of work, a dinner party, a bbq with friends as well as lots of kms in my car and I’m exhausted. Because I don’t want to overshare on my blog, I won’t go into lots of detail here but the three births:

- One birth was, in hindsight, a malpresentation that was perhaps destined for intervention from the first moments of labour. I don’t mean any disrespect by that - women birth bigger babes and in less well-supported situations than this but the stop-start nature of the birth, the horrednous agonising pain she was in (her words not mine), and the lack of progress in pushing perhaps indicated something was up. Perhaps a better midwife would have manipulated the babe, perhaps a better midwife would not have thought the less than charitable thoughts I had about the staff and the whole procedure.

I am still debriefing about this and the parents are both traumatised by the whole process and the whole hospital birth nightmare replays in my head. Would it have been different had she not been on her back? Would it have been different if she’d laboured at home and/or in water instead? Perhaps if she’d had "her" midwife as well as me, rather than a revolving door of hospital staff and another dedicated but not overly familiar midwife, things might have been different. I cried in the delivery room, I cried in the lift, and I cried on the way home. I also cried with my partner, and another midwife.

- One birth was an interesting example of two things - support partners who don’t deal well with the blood and goo of birth, and a nuchal hand that held up stage 2 until a few flips and rearrangements and then fantastic pushing had a gorgeous flock of blonde hair slipping into my hands. Nuchal hand gave a simple tear as we breathed a babe into the world, as support partner looked shaky on her feet.  

- One birth was so inspirational. The woman was a rare and precious beacon of strength in the face of a fairly long and obviously painful labour. She only had a shot of pethidine in a moment of panic (not my suggestion but she wasn’t coping so I understand perhaps a little why the hospital.midwife offered her it rather than a change of position or a bath or a shower or SOMETHING OTHER THAN DRUGS) and after a few more hours, birthed a 4kg babe into my lap.

One of these happened early on a weekend morning and there may have been a few words sworn when my phone rang, because I was due at a wedding a few hours later. Babe slipped into this world at 0907 and I was shoo’ed out the door by the midwife *and* the mother to get to the chapel on time! I did make it with a few minutes to spare, though I was not dressed up for the occassion. Photos to follow when I get them off my camera.

Agatha wrote a comment which I felt I should respond to.

• Gestational diabetes is a "diagnosis waiting for a disease" so it’s lovely to hear someone else agree! I love reading Michel Odent’s views on this subject.
• GBS screening is a 36wk screen for group B step and it is POINTLESS - I’ve blogged on this before, but you can hunt around for some more information on the interwebs too. 
• I commented that many women attend lots (10+) of appointments during pregnancy, and I should probably explain that I’d rather quantity over quality. If the midwife knows the woman and the woman knows the midwife and doesn’t just feel that she is presenting to be ticked off as attending her appointment, and that the care was personalised and one-to-one and continuous, it’d be a different story. I dislike attending appointments, as a student, where the woman walks in, is kind of talked at rather than listened to, has her blood pressure checked and fundus measured then patted on the head and sent on her way. What is the point of this? If there’s no dialogue about *why* these things are done, is the full potential of these appointments realised? I think not, but I may be wrong having never been pregnant myself.
• Ultrasounds bother me because I’m not entirely convinced that they’re harmless. Women do love them but when you see the fetus curl up and away from the probe, and react to it, you have to wonder how much harm is being done by this and how much benefit there is. It also goes back into the "we’re just reassuring women that Nothing is Wrong, rather than being able to prove that Everything is Ok". Those two things are actually quite separate and different.
• CTG monitoring in general annoys me - not evidence based and not always monitored closely, and usually means the woman is in bed.
• Delivery rubs me the wrong way because it is such a clinical term when used in the context of c-sections and you deliver pizzas, not babies. It’s the whole connotation of someone else giving a baby unto the mother, rather than the woman doing the work. I had to think long and hard about why that bothers me so much Agatha and I appreciate the poke to do so! I use the word "birth" myself, because that’s what it is, and given the name of my blog you can probably guess that "catch" is a term that I use and I have used around me quite a lot. Tastes in words change, and "catch" is more in vogue these days with the people I learn from, but this may vary around the world. It also does describe more of what I do - I coach and support and guide and in the end have a babe slip into my hands, safely, before being handed on to the parents (not always - I’m a fan of encouraging mums and dads to catch their own babes!!). 
• Clocks in the room mean people watch them slavishly. Delivery rooms here have windows and natural light - I can’t imagine working in a room without some kind of outside light during the day!
• The 38wk due date thing annoys me because I see a lot of women spend 3-4 weeks upset that their babe is "late" and scared because of that!! 
• The baby size guessing game - if you are experienced in palpating babies and guessing their size based on that (I’ve seen a midwife who can do this and be within 50g of the birthweight!) then yay. But when women get an ultrasound that has a 15% margin of error either way, this annoys me because they obsess with the upper limit and are then unable to hear anything I might say about pelvises and breathing babes out.
• I find it interesting that you think birth is unnatural as soon as a woman enters hospital. I will have to ponder more on that. 
• The woman being at the correct height is really important OH&S-wise - I damaged my pelvis/back last year and need to be very careful with it even now, so I use the bed to my advantage (yay also for being 5′5" tall!!). But there are ways of doing it that are degrading still and these are what I’m talking about.

I’ve got a heap more comments and emails to respond to, but thought I’d reply to this one first. I am on holidays at the moment but will post more!