Midwifery is catching

I’m on placement at the moment, after exams. That’s the reason I’ve not posted in too long - did you miss me? I have some things queued up to post about and have things to say so should get back into it.

In the past few weeks, I’ve attended a birth with a woman whom I worked hard with the get out from under obstetrician care and into midwifery care. She had been triaged into the high risk but hated the fact that the obs run an hour late for apppointments, don’t know her from a bar of soap, don’t do anything more exciting or high tech than the same palpation, blood pressure and fetal heart that a midwife does and generally had little empathy for her or interest in her specifically. The midwives at least have that. The last appointment with the consultant was about as personal as using an ATM and she looked at me afterwards and said "do I have to see him again?" and I said "no" so she stuck her head back in the room and asked for a note so she could book back into the midwives clinic and the ob agreed! He was a little shocked but signed off before thinking it through.

And yes, even as I type this, I’m wondering why women let themselves be triaged like that. This woman has one factor that put her in the high risk category and that one issue was never discussed with her or raised as an issue for her pregnancy and just never factored in her care… and yet it meant she was denied women-centred care.

Anyway, where was I. Right. A birth. I attended a birth and it was the first one in months that I’d attended and it felt good. It wasn’t a brilliant, change my-life-kind of birth - it was in fact quite average. But I was a good midwife and even in the context of a hospital birth it was great for the woman. She became a mother, just as I’m becoming a midwife.

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I recently asked the universe to help me with my follow throughs because I’ve been in a funk recently with seeking them out. I have to work up the nerve to talk to strangers and ask them to be a part of their pregnancy and births. It’s a really hard slog to do it and when you’re in a bit of a blue it’s even harder to do. So I asked the universe to help me out and I also asked my friends to help me out and I was, in quick succession, called by a midwife whose list I’d made it to the top of, called by a community midwifery service whose list I’d also made it to the top of, and then by a coordinating midwife who gave me two other leads. And all four of them said yes! And another follow-through whom I’d not heard from in a while got back in contact with me, so my heart rested a little easier. Chasing numbers is an awful part of my degree, you know?

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In other news, I’ve unenrolled from university internally and have gone externally for a couple of reasons. The first is that I need to work to support myself and my lovely fiancee and kitty, and working around uni is far too hard. The other is I get very little out of studying internally so I may as well put my time to good use, right? Uni this past semester has been pointless in a lot of ways. The classes haven’t added to my knowledge other than to frustrate me about the state of education in this country and to remind me that I don’t learn well in a classroom. 

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Osk and I have decided to make a formal thing with our relationship. You know, because a joint lease, joint car, joint $$ and living together wasn’t official enough. So a few weeks ago (date tba but that’d require me to look it up) I asked him to do me the honour of my calling him my husband. We have rings and will make it legal and official sometime next year but you may be picking up a vibe here of understatement. Neither of us is making a big deal of it and there won’t be a huge party for the engagement. Zaria (kitty) will accept any gifts on our behalf if you’d like to send us something - please give her a call to arrange delivery. There will be a party after our planned elopement to somewhere like Lake Ohau and details will come early enough for peeps to travel to Adelaide. Every question about wedding dates sets it back by a week by the way . 

I get asked by women I am following through a pregnancy - should I make a birth plan? What kind of birth plan? Long or short? How? What to put in it? So some dot points from experience:

• If you want a birth plan, then consider a homebirth because otherwise you are having to negotiate on someone else’s playing field. You don’t know where the towels are = you aren’t in control
• Make it short and sweet. One page. Dot points. No ifs, buts or maybes. If it is important enough to write down, it’s important enough to state plainly.
• Don’t put "unless medically indicated" because this is a great out for anyone. If you don’t give them that out, you will have to be negotiated with.  

Areas that you will want to consider:

• Support people
• Vaginal examinations
• IV canula - say no to these routinely, and if it needs to be inserted, tell them where they can stick it
• Wearing your own clothes (singlet and sarong, undies, pink wig, scarf and thongs, whatever…)
• Catheterisation
• Monitoring
• Pain relief (do not offer me pain relief, or offer me massage, heat packs, pressure points, reiki, reflexology, aromatherapy, shower, water etc only)
• Food and drink (because you are after all an adult and can work these things out for yourself!)
• First stage - say plainly that the bed needs to be moved, or room made for ball, beanbag or whatever. Do not ask for permission but make a statement.
• Second stage - declare that you will not need guided pushing, that either you or your partner will catch the baby, that you want a lotus birth, that the first words your child will here will be a prayer to the goddess or the Sun, or whatever you want.
• Third stage - how do you want your placenta dealt with? Do you want to keep it, or make prints,
• Fourth stage - BONDING!! So important! You will have to be clear about bathing, weighing, immunisation, and vitamin K (these last two will be asked of you a couple of times during labour which is really irritating!), feeding, rooming in. 
• Afterwards - if you plan on being in hospital for a few days, think about heel prick tests, bathing, circumcision, immunisation etc.

You will have to do research into these things, and I encourage you to do so before giving birth. It is going to be hard to get your hands on information about these things with a newborn and away from your usual resources (read: the internet and your own phone).

And people ask me - do I need a c-section plan? I’m of two minds about this, because if you plan for it are you headed for it, and yet on the other hand our c-section rate here in Australia is more than 1 in 3, so chances are relatively high if you birth in a hospital and higher in some than others. Investigate this before birthing somewhere. And in the end yes, I do suggest you write a plan because it’s in a c-section situation that you will want to have what aspects of the birth you are wanting especially respected. Again, look at skin to skin contact, immediate baby care, partners staying with your baby if they need to be taken somewhere.

Look on the interwebs to find some examples and think about it before talking to your care provider or a friendly midwife.