The 'Let Down' and the Beauty of Birth!
My intentions were good... I really wanted to debrief here everyday after work but it seems that baby bundles had other plans for me!! I had made the decision before I started this placement to throw myself into every possible opportunity and that I have. Monday and Tuesday were back-to-back days of 14 hours followed by an awesome encounter with Michel Odent on Wednesday at the BBB Conference backed up with two more days of 'my' midwifery! Below is a little of what happened...
Monday unfolded in a way that had me believing in myself as a midwife. Without really being aware of it at the time, I reflected on the day as awakening me to how much I knew and how far I have come. I had initially started on the ward and had completed my first round and then sat to await the influx of antenatal assessments from clinic. Fortunately for me, with this influx came the opportunity share one woman's experience of nature of birth to creep up at the most unlikely of times.
Whilst she leaned over the desk holding her belly and pointing to her appointment on her handheld record, the adrenaline started pumping. I wasn't quite sure whether to trust what I was suspecting and yet I seemed to go with it sub-consciously. Palpation further confirmed suspicions - LOA, head engaged, uterine tone, concentrated breathing. Baby??
As a formality I continued with the CTG and even with the understanding that their story of the situation isn't always a true indication, I soon had a trace in front of me that flashed 'labour', 'LABOUR', 'LABOUR'!!
Of the many opportunities I have had, it was the first I had been able to step up and take the reins in the sense that I did what I had to do as far as the politics were concerned but also in bring the elements of birth how I know it to assist and optimise this woman's experience. Despite our medicalised surroundings, I kept it simple. We utilised the floor for massage, optimised the calm with minimal light and between contractions, engaged in chit chat. As contractions intensified and second stage neared I followed to the shower that soothed the pain and empowered her with a sense of owning the moment and listening to her body. Close by but far enough away so as not to intrude in 'her' space, I directed the stream of water. When her legs became tired we moved back to the the birthing stool and she found comfort in sitting leaning against her partner whilst I took the weight of her legs on mine to assist in the squat. Position changes flowed to the beginning of second stage and the calm remained.
This mood remained for so long as second stage continued to the point where progress seem to stall despite the numerous position changes and reassurance and a completely happy baby. Given the 'time' restraints and the lingering registrar, it was found we had a case of Deep Transverse Arrest and ventouse birth soon followed.
Tuesday began with another birth and entering the room was so different to the day before. Light, people, urgency. The stage was set and a baby was had. It was beautiful in its own right.
The urgency soon dissipated and I was soon blessed with the opportunity to be with another woman. Although it was an induction, the mood was similar to the day before and I observed as she went about labour as just another part of the day. Ignoring the the syntocinon infusion and the continuous CTG monitoring (which is sometimes hard to do!) she birthed her baby like a goddess. I was fortunate to work with a midwife that was happy to hold the active third stage (query as to whether I can call it a physiological third stage or not due to the synt infusion) and I was supported in my choice to allow the cord to pulsate and the baby's need for the blood more than the blood bottles. Skin-to-skin and left to indulge in each other. Beautiful.
Wednesday - BBB Conference! I need a separate post for this. See here!
Thursday - Continuity! Postnatal care of two of these women to discharge! And showered with thankyous and gifts... I swear they are trying to make me fat - I have enough roses chocolates to feed an army!!
Friday... An absolutely fulfilling end to an amazing week! Again blessed with another birth, not just ANOTHER birth but a very special, unique and empowering experience for all involved. This woman was amazing, her husband was amazing and I was priviledged to be given the joy of being there with them. Circumstances for this woman warranted an epidural but the atmosphere was beautiful.
It was this finish to an unforgettable week that awoke me to my evergrowing intuition and my obvious distrust in it! Silly me... All signs pointed to second stage - palpation, fetal heart heard OA and early decelerations with contractions = head compression. Registrar appears. Outcome of palpation - head felt high! Response - huh? and a quick check. A show and head on view! Two pushes, no gloves, baby born, to chest, finds boob, sucks... no fuss, no rush.
SO I have explained the latter part of the title of this post and have in the best way expressed how I brought my understanding of birth and midwifery to the forefront and advocated and empowered the woman despite what was outside the bubble...
Definitely no 'let down', but plenty of 'let downs'!!! (what birth does to a breastfeeding midwife!) HOW I LOVE OXYTOCIN!!
Monday unfolded in a way that had me believing in myself as a midwife. Without really being aware of it at the time, I reflected on the day as awakening me to how much I knew and how far I have come. I had initially started on the ward and had completed my first round and then sat to await the influx of antenatal assessments from clinic. Fortunately for me, with this influx came the opportunity share one woman's experience of nature of birth to creep up at the most unlikely of times.
Whilst she leaned over the desk holding her belly and pointing to her appointment on her handheld record, the adrenaline started pumping. I wasn't quite sure whether to trust what I was suspecting and yet I seemed to go with it sub-consciously. Palpation further confirmed suspicions - LOA, head engaged, uterine tone, concentrated breathing. Baby??
As a formality I continued with the CTG and even with the understanding that their story of the situation isn't always a true indication, I soon had a trace in front of me that flashed 'labour', 'LABOUR', 'LABOUR'!!
Of the many opportunities I have had, it was the first I had been able to step up and take the reins in the sense that I did what I had to do as far as the politics were concerned but also in bring the elements of birth how I know it to assist and optimise this woman's experience. Despite our medicalised surroundings, I kept it simple. We utilised the floor for massage, optimised the calm with minimal light and between contractions, engaged in chit chat. As contractions intensified and second stage neared I followed to the shower that soothed the pain and empowered her with a sense of owning the moment and listening to her body. Close by but far enough away so as not to intrude in 'her' space, I directed the stream of water. When her legs became tired we moved back to the the birthing stool and she found comfort in sitting leaning against her partner whilst I took the weight of her legs on mine to assist in the squat. Position changes flowed to the beginning of second stage and the calm remained.
This mood remained for so long as second stage continued to the point where progress seem to stall despite the numerous position changes and reassurance and a completely happy baby. Given the 'time' restraints and the lingering registrar, it was found we had a case of Deep Transverse Arrest and ventouse birth soon followed.
Tuesday began with another birth and entering the room was so different to the day before. Light, people, urgency. The stage was set and a baby was had. It was beautiful in its own right.
The urgency soon dissipated and I was soon blessed with the opportunity to be with another woman. Although it was an induction, the mood was similar to the day before and I observed as she went about labour as just another part of the day. Ignoring the the syntocinon infusion and the continuous CTG monitoring (which is sometimes hard to do!) she birthed her baby like a goddess. I was fortunate to work with a midwife that was happy to hold the active third stage (query as to whether I can call it a physiological third stage or not due to the synt infusion) and I was supported in my choice to allow the cord to pulsate and the baby's need for the blood more than the blood bottles. Skin-to-skin and left to indulge in each other. Beautiful.
Wednesday - BBB Conference! I need a separate post for this. See here!
Thursday - Continuity! Postnatal care of two of these women to discharge! And showered with thankyous and gifts... I swear they are trying to make me fat - I have enough roses chocolates to feed an army!!
Friday... An absolutely fulfilling end to an amazing week! Again blessed with another birth, not just ANOTHER birth but a very special, unique and empowering experience for all involved. This woman was amazing, her husband was amazing and I was priviledged to be given the joy of being there with them. Circumstances for this woman warranted an epidural but the atmosphere was beautiful.
It was this finish to an unforgettable week that awoke me to my evergrowing intuition and my obvious distrust in it! Silly me... All signs pointed to second stage - palpation, fetal heart heard OA and early decelerations with contractions = head compression. Registrar appears. Outcome of palpation - head felt high! Response - huh? and a quick check. A show and head on view! Two pushes, no gloves, baby born, to chest, finds boob, sucks... no fuss, no rush.
SO I have explained the latter part of the title of this post and have in the best way expressed how I brought my understanding of birth and midwifery to the forefront and advocated and empowered the woman despite what was outside the bubble...
Definitely no 'let down', but plenty of 'let downs'!!! (what birth does to a breastfeeding midwife!) HOW I LOVE OXYTOCIN!!
posted by lovebubs at
1:26 PM
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