Yesterday I cared for a woman in labor. I supported her through contractions, encouraged her softly when she looked afraid and placed the baby gently on her chest when she pushed him out. We spoke, but did not speak the same language. We spoke through hand motions, through facial expressions, and through touch. She had an interpreter with her, but most times we did not need to say words to understand each other. It was really quite beautiful.
Her birth was the third baby that I have officially caught as a student midwife. It was an amazing unmedicated labor. The type of labor and birth that would usually be seen in a birth center or at home. She never had an IV, she never stayed in bed for more than 5 minutes, and aside from the 20 minute NST on admission, she was never hooked up to a monitor. She was checked twice, once on admission, and once 4 hours later. She was 5cm on admission, 7-8cm four hours later, and two hours after that, her bag of waters was bulging out and she was ready to push. She began pushing while standing, then sitting and then gave birth squatting. It was her first baby and she only pushed for 25 minutes. 20 of those minutes were the baby's head crowning. As I looked around the room, the two nurses, two midwifery students, and midwife were all watching this woman in awe as she squatted and swung her hips back and forth to push out her son. One of the nurses later remarked how incredible it was to see a woman so instinctively follow her body's urges. In a tertiary care center where epidural births are the norm, the nurses do not often have the opportunity to witness the amazing process of an unmedicated labor and birth.
I feel honored to have been the one to catch this baby boy. I felt full from a day of supporting a woman in labor and holding her hand when the contractions became strong. As I placed the baby boy on her chest, she shreaked with joy and pride. Even though she was speaking a language I could not understand, the look on her face told it all "did you see that everyone, I did that! I JUST DID THAT!" After I had given her a few stitches and cleaned her up, I went up to say congratulations and goodbye. She held onto my hand and called over her translator. She thanked me for being so supportive, and for being there for her when she really needed it. We held hands for a few moments and silently thanked each other for a wonderful day.
Thursday, April 28, 2011
Tuesday, December 7, 2010
Finished the First Semester of Midwifery Classes!
It's hard to believe that I've finished my first semester of midwifery classes. The semester has flown by. It's been difficult, enlightening, joyous, and tearful. I have learned how to perform pelvic exams, prescribe contraception, listen to a fetal heart with a doppler, measure a pregnant belly, perform a full physical exam, take a thorough health history, and diagnose and prescribe treatments for vaginitis and STIs. I have loved getting to know my patients at clinical even though clinical was just not what I had expected. I had a preceptor who did not enjoy her job. She found no joy from being a midwife, or really any aspect of her life. It was such a shame. I wanted to have an instructor who loved midwifery, loved working with women, and loved passing on that knowledge. But instead, I had a preceptor who grunted at me as a greeting in the morning and barely gave me any guidance as I learned how to take care of women at all stages of life.
That being said, I still love being a student midwife. At times I am frustrated and feel discouraged, but overall I am happy and grateful. I adore my midwifery classmates who have helped make this program so much richer. I eagerly anticipate next semester when I will begin catching babies. In January we have "birth boot camp" where we learn all of the basics on how to help a woman in labor. Then we are on call at the hospital for births! We will also still be in a clinic once a week to provide antepartum and GYN care.
Until then, I have 5 final exams to take in the next week and a half. Off to cram loads of information into my head and then 4 weeks off!
That being said, I still love being a student midwife. At times I am frustrated and feel discouraged, but overall I am happy and grateful. I adore my midwifery classmates who have helped make this program so much richer. I eagerly anticipate next semester when I will begin catching babies. In January we have "birth boot camp" where we learn all of the basics on how to help a woman in labor. Then we are on call at the hospital for births! We will also still be in a clinic once a week to provide antepartum and GYN care.
Until then, I have 5 final exams to take in the next week and a half. Off to cram loads of information into my head and then 4 weeks off!
Tuesday, September 22, 2009
flashback to May 2009..fabulous natural birth
I met Christina in her house in mid-March. She and her fiance, Drew, were expecting their first baby together and Drew had an 8-year old from a previous marriage. I immediately sensed the love between them and could tell they were very supportive of one another. Throughout the two prenatal visits, we discussed their hopes for the upcoming birth. They had taken the natural childbirth class and were very much hoping for a drug-free delivery. Christina warned me that her family members had a history of rapid labors and her main fear was delivering too quickly- while en route to the hospital. I assured her that this was unlikely, especially given that this was her first baby.
The day before her due date, Christina called me...squeezing out words between contractions. Her membranes had ruptured, contractions were becoming regular and she was on her way to the hospital. Soon I had gathered my doula bag together and was on my way to meet up for the main event.
I found Christina laying on the bed in the triage area, Drew beside her on a chair. The midwife had checked her about a half hour prior and she was 1-2cm. She looked up with sweat dripping down her brow and told me that she was exhausted and in pain. I quickly got to work getting her out of bed so that she could labor upright and encourage the baby down. The nurse came in and warned us that they were having an extremely busy day in Labor and Delivery and that no real labor rooms would be available anytime soon. So, we made the most of our tiny space in the triage area. Christina labored standing, leaning onto the counter and rocking back and forth. She sat on a birthing ball and rocked side to side as she held onto the foot of the bed. She sat in the bed, laid in the bed, and breathed like a champion. She was doing an excellent job, very focused, and determined. The one setback to the focus was the vomiting that occurred for about a half hour. I assured her that this was a good sign- vomiting often signals that you are rounding a corner in labor and that great progress is occurring. She handled it and moved on and although she was tired, she did not request pain medication once.
About three hours into the labor, we were still in triage, going through our routine when a medical resident walked in. She introduced herself and explained that all of the midwives were assisting deliveries at the moment and that she would take care of Christina until the midwives were available. Christina's body tensed and although she did not verbalize her anxiety, it was clear that she was upset at the thought of not being attended by a midwife for her birthing. When the doctor left the room, Christina went back to her steady breaths and position changes. We barely had anyone coming into the room to check on us throughout the 5 hours we spent in the triage area. The nurse had 5 other patients she was caring for and knew that Christina was doing well so we were pretty much left alone...which was great.
Between hours 4 and 5 Christina began to feel pressure. I called in the nurse who called in the doctor who checked Christina's cervix- 9.5cm! Christina had not been joking about the fast labors in her family. Going from 1cm to almost 10cm in 4 hours with your first baby is so quick. The nurse began to realize that she'd better move us to a labor room quickly or Christina was going to push this baby out in triage. Luckily they found a room and 15 minutes later we were being run down the hallway.
Almost immediately upon entering the labor room, the Anesthesiologist stepped in and nearly scared Christina to death. He was explaining the procedure for an epidural to Christina (even though she was still adamantly against getting an epidural) and mentioned the words "in the event of a c-section". Christina shot up out of bed and said "WHAT? I need a c-section?" Luckily I was right next to her and assured her that she did NOT need a c-section and that she was doing a fantastic job and would deliver her baby naturally very soon. I think the doctor got the hint at that point that no pain meds would be needed and he left the room.
A midwife then stepped in and began gowning up for the delivery (she had just finished catching another baby and was available to take over for the medical resident, just in time). She checked Christina again and noticed that there was still a lip of cervix. Christina went through 30 minutes of agonizing rocking on her hands and knees to get rid of that lip of cervix while resisting the urge to push. She did an amazing job.
Finally she was given the go-ahead to push. Each time she pushed she made great progress and in less than an hour the baby's head was poking out. Unfortunately the baby was having decels on the monitor (his heart rate was dropping) so an attending OB/GYN came in to assess the scene and see if she would need to intervene. The midwife told Christina she had to push with everything she had so that they would not have to use a vacuum or forceps. That next push, baby Joshua entered the world. A beautiful 8lb baby with a full head of black curls. Within the hour he was breastfeeding and the room was transformed from a stressful labor scene to a serene mother-baby bonding session. As I left the labor room, Christina said to me "thank you so much, Kat. you're going to make an amazing midwife." I welled up as I thought about Joshua's beautiful birth and the many many births to come in my midwifery career.
The day before her due date, Christina called me...squeezing out words between contractions. Her membranes had ruptured, contractions were becoming regular and she was on her way to the hospital. Soon I had gathered my doula bag together and was on my way to meet up for the main event.
I found Christina laying on the bed in the triage area, Drew beside her on a chair. The midwife had checked her about a half hour prior and she was 1-2cm. She looked up with sweat dripping down her brow and told me that she was exhausted and in pain. I quickly got to work getting her out of bed so that she could labor upright and encourage the baby down. The nurse came in and warned us that they were having an extremely busy day in Labor and Delivery and that no real labor rooms would be available anytime soon. So, we made the most of our tiny space in the triage area. Christina labored standing, leaning onto the counter and rocking back and forth. She sat on a birthing ball and rocked side to side as she held onto the foot of the bed. She sat in the bed, laid in the bed, and breathed like a champion. She was doing an excellent job, very focused, and determined. The one setback to the focus was the vomiting that occurred for about a half hour. I assured her that this was a good sign- vomiting often signals that you are rounding a corner in labor and that great progress is occurring. She handled it and moved on and although she was tired, she did not request pain medication once.
About three hours into the labor, we were still in triage, going through our routine when a medical resident walked in. She introduced herself and explained that all of the midwives were assisting deliveries at the moment and that she would take care of Christina until the midwives were available. Christina's body tensed and although she did not verbalize her anxiety, it was clear that she was upset at the thought of not being attended by a midwife for her birthing. When the doctor left the room, Christina went back to her steady breaths and position changes. We barely had anyone coming into the room to check on us throughout the 5 hours we spent in the triage area. The nurse had 5 other patients she was caring for and knew that Christina was doing well so we were pretty much left alone...which was great.
Between hours 4 and 5 Christina began to feel pressure. I called in the nurse who called in the doctor who checked Christina's cervix- 9.5cm! Christina had not been joking about the fast labors in her family. Going from 1cm to almost 10cm in 4 hours with your first baby is so quick. The nurse began to realize that she'd better move us to a labor room quickly or Christina was going to push this baby out in triage. Luckily they found a room and 15 minutes later we were being run down the hallway.
Almost immediately upon entering the labor room, the Anesthesiologist stepped in and nearly scared Christina to death. He was explaining the procedure for an epidural to Christina (even though she was still adamantly against getting an epidural) and mentioned the words "in the event of a c-section". Christina shot up out of bed and said "WHAT? I need a c-section?" Luckily I was right next to her and assured her that she did NOT need a c-section and that she was doing a fantastic job and would deliver her baby naturally very soon. I think the doctor got the hint at that point that no pain meds would be needed and he left the room.
A midwife then stepped in and began gowning up for the delivery (she had just finished catching another baby and was available to take over for the medical resident, just in time). She checked Christina again and noticed that there was still a lip of cervix. Christina went through 30 minutes of agonizing rocking on her hands and knees to get rid of that lip of cervix while resisting the urge to push. She did an amazing job.
Finally she was given the go-ahead to push. Each time she pushed she made great progress and in less than an hour the baby's head was poking out. Unfortunately the baby was having decels on the monitor (his heart rate was dropping) so an attending OB/GYN came in to assess the scene and see if she would need to intervene. The midwife told Christina she had to push with everything she had so that they would not have to use a vacuum or forceps. That next push, baby Joshua entered the world. A beautiful 8lb baby with a full head of black curls. Within the hour he was breastfeeding and the room was transformed from a stressful labor scene to a serene mother-baby bonding session. As I left the labor room, Christina said to me "thank you so much, Kat. you're going to make an amazing midwife." I welled up as I thought about Joshua's beautiful birth and the many many births to come in my midwifery career.
Thursday, September 17, 2009
Midwives Midwives Everywhere!
Today was a day full of wonderful midwives. After class today we were invited to a reception to welcome Holly Powell Kennedy, CNM, PhD to the Yale School of Nursing Faculty. Holly is one of the lead researchers in the world on normal birth and is just beginning here at Yale. She is the first Helen Varney endowed professor at YSN and it seems like she has wonderful things in store for us, including starting a birth center at Yale New Haven Hospital!
It was wonderful to be at her reception, surrounded by midwives and future midwives. Immediately following, the students were invited to a midwifery potluck hosted by the second years. There were about 45 student midwives there and it was both exciting and inspirational to meet everyone and see what brought each person into this career path.
I feel very lucky to be in this place surrounded by people who inspire me and make me feel at home in my chosen life path.
It was wonderful to be at her reception, surrounded by midwives and future midwives. Immediately following, the students were invited to a midwifery potluck hosted by the second years. There were about 45 student midwives there and it was both exciting and inspirational to meet everyone and see what brought each person into this career path.
I feel very lucky to be in this place surrounded by people who inspire me and make me feel at home in my chosen life path.
Wednesday, September 9, 2009
Becoming a Midwife, the beginning
After a whirlwind summer that went by far too fast, I find myself here, at Yale University studying to be a Nurse-Midwife. The first two weeks of my program have come and gone in a blur. A blur of activity, of meeting new people and of learning new things at an unnatural rate.
The people are wonderful, the fellow aspiring midwives are fun and kind and engaging and everyone has an interesting story to tell. We are all dying to do birth-related activities but the first year we will barely talk about catching babies. The first year we will learn to be nurses. Next week I will begin working on the adult cardiac unit at a local hospital. It will be quite the transition from working with laboring mothers. However, it is all part of the process of getting to where I want to go.
At some point, perhaps today, perhaps another day when I have less work to do, I must post my last few doula birth stories. They were wonderful and deserve to be told before I forget the details.
As my new adventure in nursing school begins, I must remember to take it all in and not get bogged down by the workload. I can easily become tense when I think too far into the future...I need to let things come as they will.
The people are wonderful, the fellow aspiring midwives are fun and kind and engaging and everyone has an interesting story to tell. We are all dying to do birth-related activities but the first year we will barely talk about catching babies. The first year we will learn to be nurses. Next week I will begin working on the adult cardiac unit at a local hospital. It will be quite the transition from working with laboring mothers. However, it is all part of the process of getting to where I want to go.
At some point, perhaps today, perhaps another day when I have less work to do, I must post my last few doula birth stories. They were wonderful and deserve to be told before I forget the details.
As my new adventure in nursing school begins, I must remember to take it all in and not get bogged down by the workload. I can easily become tense when I think too far into the future...I need to let things come as they will.
Sunday, May 31, 2009
May is Natural Childbirth Month!
The last 8 days have been filled with wonderful, natural childbirth. I just returned home from the hospital where one of my clients gave birth to an adorable 7lb 7oz baby girl. Mom and her husband were so thrilled with the new addition to their family. It was beautiful to watch both of them admire their little girl with tears in their eyes.
Just 8 days ago I witnessed another fantastic natural childbirth of a sweet baby boy. And Shana had her all-natural VBAC 2 weeks prior to that.
More to come on the birth stories of these strong moms, supportive partners and beautiful babies.
Just 8 days ago I witnessed another fantastic natural childbirth of a sweet baby boy. And Shana had her all-natural VBAC 2 weeks prior to that.
More to come on the birth stories of these strong moms, supportive partners and beautiful babies.
Tuesday, May 12, 2009
A Mother's Day VBAC
Mother's Day began slowly. A nice long sleep followed by lounging and breakfast-making. Just as I was leaving the house to go to my favorite cafe, my phone rang. It was Tom, husband of Shana, my first May client.
Shana's first birth experience had been traumatic, a c-section that she felt had been completely unnecessary. She felt as though she had no control over the decisions made during the birth of her first baby and was determined to have a different experience this time around. When I met Shana at the hospital an hour later, she was very controlled through her contractions. She was easily talking in between them and could breathe through every one. I was concerned that she was not very far along and that she would be disappointed when the midwife checked her cervix. In her ideal world she wanted to labor at home until late active labor but her husband was too worried that she would deliver the baby in the home if they waited.
When the midwife checked her, she was 1-2cm. Shana immediately got up and said--ok, I'm going home. The midwife suggested that Shana, Tom and I take a walk outside, grab food, and come back mid-afternoon. We thought that was a great plan but things quickly changed. The nurse took Shana's blood pressure and it was way too high. Darn. Back to the bed, no walking around until the BP went way down.
Although Shana changed positions on the bed, she was really much more comfortable when standing. When we were moved to the official L&D room, her BP had gone down enough so that she was allowed to stand and sway during contractions. I applied firm counterpressure during the contractions and her husband helped to keep the baby's heart rate on the monitor (she had continuous EFM because she was a VBAC and had high BP). This went on for a couple of hours until I suggested she get on the birth ball. After settling down on it, she really found relief from the way it was opening her up. Soon it was mid-afternoon and the midwife wanted to check her again. As the midwife checked Shana's cervix she smiled and said: "guess how many centimeters you are, Shana". Shana said 5-6 and to our delight the midwife informed us that she was 7cm, 100% effaced and the baby was nice and low. Phew. The VBAC was well on its way!
Shana went back and forth between the birthing ball and standing and swaying for the next hour or so. Soon the contractions began to intensify and although Shana was still very focused and breathing beautifully, she was definitely getting more uncomfortable. I suggested she get up onto the bed on her knees. We raised the head of the bed and she draped her arms and rested her head on the top of the bed. She was starting to contort her face during contractions and I tried to get her to relax her facial muscles and gently rubbed her head when she scrunched up.
Maybe an hour later she felt "pressure" for the first time. She said to wait to get the midwife, so we continued with our routine for another forty minutes. The midwife came in and re-checked Shana. Fully dilated! A new midwife was on-call and she was wonderful. She gave Shana great hints on how to breathe during pushing and how to rest between pushes. Shana's husband really got into gear at that point and was so sweet and supportive. He looked into her eyes and held her head gently in his hands. Shana pushed on her side for about thirty minutes until the cutest baby girl entered the world. Mom looked at baby and said "Hi beautiful" and the baby looked longingly up at mom. Soon they were beginning to breastfeed and getting to know each other. I felt so happy knowing that Shana had a wonderful, natural, empowering second birthing experience.
Subscribe to:
Posts (Atom)
