Thursday, February 25, 2010

A pretty easy week

School has been relatively mellow compared to last semester. All of my classes (except for midwifery) have take-home exams and finals. Makes my life a little bit easier. The pharm class still isn't as useful as I'd like for it to be, but I'm making it work. I've got today off and clinical tomorrow. March will be a lot busier...with me in clinic at least 2-3x/week. I should probably continue that trend throughout the rest of my program. Currently, my practice doesn't want me to do 24hr on-call days so I'm stuck going twice a week for 12hr days. Ah well. I was hoping I could be in the hospital overnight without the docs-on-call to see how the midwives manage their patients on their own. Even though the midwives in my practice do most vaginal deliveries, the docs really have a say in how the labor management goes when they're there. So far, I've only seen one hands-off-let-the-midwives-do-it doc who really only provided guidance when we wanted to consult him.

Delivery-wise, I've caught 3 babies so far. I'm pretty much even with the other midwives in my class although one of my classmates has done 5. The sweet number is 40 to graduate, but I'm sure I'll have more than that by December when I finish. So far, my deliveries have been relatively straightforward, healthy and normal. My last catch was Thursday as soon as I got to the hospital. The off-going midwives (my manwife & the practice's new midwife-on-orientation) had saved her for me. :) She was C/C/+1 when me and Midwife A got into the room. Shortly thereafter, I caught baby #3. My first OP (aka sunny side up.) She was a teeny thing -- just under 6lbs but very cute. Mom was intact so no suturing. After that delivery, we had absolutely nothing else to do for the rest of the day save a couple (not in labor) triage pts. I have yet to see a pt in the hospital (laboring or triage) that I've seen in the office as well. I'm sure that will change soon, but I'm still having fun with it. Life is good.

As an aside...there has been a F*cebook explosion of pregnancies among my friends' list. Offhand I can think of at least 7 people who are pregnant. Two people announced pregnancies yesterday and one was announced the day before. It's insane! While I'm super happy for everyone, there is a tinge of jealousy. I wonder what is in the water these days :)

Me & B are doing well and still going strong. I'll get to see her in about a week as she breezes through here on her way out West. Spring Break is also fast-approaching and I'm planning on flying up to see her that weekend after being in clinical three days in a row. Things with the live-in ex gf are also okay. She was kind of mad at me about Vday weekend but soon got over it. I even suspect she's seeing someone (possibly a guy?) We really don't talk about who we're dating and I'd like to keep it that way. I think that could open a Pandora's box of drama that my quiet living situation doesn't need. Our biggest disagreement is about post-breakup-sock-ownership. Lol.

Wednesday, February 17, 2010

Perks of being a (student) midwife

You get to be the first one to know when someone is pregnant. I just found out a family friend who's been trying is about 8 weeks.

Tuesday, February 16, 2010

Finally getting somewhere on Friday, I caught my first baby -- a boy weighing in at a healthy 8 lbs. It was a first-time mom who was an induction for "post-dates." I was working with Midwife A who I worked with in the office. We came on in the middle of her induction around 4cm. She was complete around 1130a, but baby was still high so we labored her down. She pushed for maybe 15 minutes and we had a baby. I didn't drop him (thank goodness.) He had a nuchal cord x 2 that was easily reduced. She was intact and had just a couple little skid marks...nothing to suture. Placenta came out without difficulty and she had minimal bleeding. Overall...a great first delivery. Somewhere in my deer-in-headlights face, the family asked if this was my first delivery...I said no because -technically- I've been at other deliveries. Just not as the midwife.

This was the day when we had some freak snow storm outta nowhere. Check out what it looked like after just a couple hours (Is it just me or do I need to pay more attention to the weather..?) I left the hospital earlier than expected so I didn't get caught in it and have to spend the night there. We didn't have much going on -- only 3 pts: two who were C/S & the one we delivered.

Onto my fabulous weekend with B. She had to drive through the crappy freak snow storm on Friday while I was at the hospital. It took her a long time to finally get here, most of which was spent trucking through crazy snow and even crazier southern drivers who have no idea how to drive in snow. After a minor freak out moment, she made it here in one piece. We had dinner at a yummy sushi place with my friends from school, W & H who are dating. We stayed with H over the weekend per the breakup agreement of no overnight guests. Saturday we went to brunch with them, then to the aquarium (which was awesome), and Valentine's Day dinner. Sunday I made her my yummy french toast and then we went to see V*lentine's Day which was super cute. We spent the rest of the time just hanging out and she left yesterday.

I spent yesterday in the hospital with a different midwife who I hadn't met before. Midwife C (MC) as she shall be dubbed was interesting to say the least. She felt comfortable with me being hands-on and really seemed to like teaching. Her confidence was not the best ---- it's hard to make a student feel comfortable when you're not. When we came on shift there was no one laboring but that soon changed. We had a few pts in triage...a couple not in labor who were sent home. Then came a multip induction (4+ cm & labile BPs) and 35wk twins w/SROM. The twin momma wanted to go vag so we went for it. Doc on call with us was super freakin impatient the whole day. Very hands on...interventive and pushy. I did not like him hovering over my pts at all. 35wker went vag with both babies...delivered in the OR. I didn't catch them...waaaaayyyy too much pressure. MC was really nervous about that birth. I was glad when it was over. Our induction was chugging along -- wanted to go natural. By 1845, she was complete and wanted to push. So we did --- baby girl (delivery #2) came down nicely. Born around 1900...another 8+ pounder and intact with just a few skid marks. Minimal bleeding. Pushy doc came by while we were pushing and got all up in my space. Gr. He did leave soon thereafter.

Friday, February 12, 2010

It's about time!

So officially today at 1240p....I caught my first baby. It was a beautiful birth.

Monday, February 8, 2010


So today was supposed to be my first official day in clinical. I got back into town last night, got all ready...woke up super early (circa Traffic sucked royally this morning so it took like an hour-plus to get to the hospital. But I managed to get there on time. 4 accidents later. I walk onto the unit where my midwife-preceptor was getting report from the off-going midwife. I say good morning. That's when she says there's a problem. Apparently, the new midwife who is still orienting to the practice, made a last minute schedule change and would be working today. They didn't want us working at the same time. So all three of them (new midwife, off-going midwife and my preceptor) were like, "Sorry. You have to leave. We can't have you here today." I guess my disappointment was obvious and they tried to smooth it over with, "Don't be upset. You can come another day." But cue my tearful (not-so-graceful) exit.

I am prone to tearfulness when I am super frustrated and angry. And such was the situation this morning. I really was excited and prepared for my first day. I drove 20+ miles in shitty rush hour morning traffic to get there. And they (all of them) didn't care at all. There was no professional courtesy of a phone call at least. I'm certain they knew prior to my arrival of said scheduling conflict. But no one called. Didn't even apologize really. Because they really don't care how much it inconvenienced me. So...I had to get back into my car and drive another 1+ hour through even crappier traffic to get home. What a great freakin way to start my week.

On a happier note, my weekend away with B was awesome. We spent some quality time together...just hanging out. Saw Dear J*hn. It was a cute movie --- two people who have to spend most of their time apart -- a theme with which we can relate. But I didn't really like the ending. We had a fabulous brunch and meandered around an art museum. I have also come to some final decisions about Valentine's Day and I think she'll like what I've got planned. She'll be here on Friday night. We're having dinner with some of my good friends. Then I've got us dinner reservations for Saturday night. There will probably be some brunch somewhere in the mix, but she leaves Monday. I'm so happy to see her two weekends in a row.

Thursday, February 4, 2010

A new hospital...

I just returned from orienting at my new hospital with my manwife preceptor. I got my hospital ID badge, login info, and a general tour of my unit. There are several key differences from my old hospital (where I was in L&D as a nursing student and worked in postpartum for almost 2 yrs.) First of all, this hospital is a lot smaller which I like. All of their LDRs have jacuzzi tubs. My very first interaction with the nurses was a shoulder dystocia drill with Noelle.

Side note: Noelle is a computer simulator woman who can give birth, hemorrhage, etc. The baby can be manipulated in all sorts of ways too -- breech, etc. We have two at my university -- one in the med school and one in the nursing school. So I am pretty familiar with how Noelle works. She can one of our simulations she said "I don't feel very good" then she vomits (and there are sound effects for that too!) I mainly just observed.

Back to the story. So right from the beginning the nurses are talking to the patient about open-glottis pushing...telling her she can push whenever she feels ready. I literally had my jaw to the floor. Open glottis pushing? Evidence-based nursing care? Did I just enter the twilight zone? Well...since it was a shoulder dystocia drill, there was a shoulder dystocia. And my jaw hit the floor again when they flipped Noelle in hands-knees to deliver the baby. Nurses had no problem with it cos they see deliveries in hands-knees all the time (just in general, not necessarily shoulder dystocias all the time.) Also in this hospital, there are no "nurseries" like my old hospital. All healthy babies room in with their mothers. OBGYNs do circumcisions there. None of the midwives do it either. Wow...I'm impressed. I think I may like it. We also have an on-call room with a bed, computer for charting & W*tchChild, locker rooms with fairly decent accommodations and everyone was super friendly. My first 12hr day is on Monday with a midwife I've been working with frequently in the office. I'm looking forward to it.

In unrelated news, I'm going out of town for the weekend to spend it with Blondie (aka B.) We picked a destination halfway between us. It should be a lot of fun. A weird thing happened last night. So (as I think I've mentioned before) I dream a lot about being pg -- it's not unusual for me to be going about an everyday dream but 6 or 8 mos pg. Usually, I'm not giving birth and it's just a belly that I notice. I also rarely dream I'm pg with a partner. However last night, I had a very detailed and specific dream about giving birth. I'll try to describe it.

I was laboring on the couch. B was there with me. I went to the bathroom because I thought my bladder was a little full. I peed then got up, but felt the baby come down. I reached my hand down between my legs and felt the baby's hair. I called out to B who came into the bathroom. Just a couple of pushes and B catches this very cute baby girl. She was small -- 6 pounds or so. And I just held her...studying her. She had brown hair, big eyes, ten fingers, ten toes, my nose and was just bright-eyed and calm. B cut the cord. We were all still in the bathroom. Then came the placenta. I was looking at it...trying to make sure it was all there. But it wasn't a normal placenta --- it was shaped like an angel. It didn't bother me. I got cleaned up. And we moved from the bathroom to the bedroom and everyone got into bed for snuggling and breastfeeding. Everything still really calm. Then I woke up.

So when I woke up, I wanted to tell B about this dream. I called her and said I had had the strangest dream. I told her all about it and she was just kind of quiet. When I finished, she said "That is so weird because I had a dream about you giving birth last night too." In her dream, I was also at home, laboring in a pool -- she was with me, supporting me and climbed into the pool to sit behind me while I was giving birth. Her dream ended there. Isn't that so strange? We had very similar dreams at the same time. And we hadn't really spoken about being pg or birth or anything recently. So it's odd that we dreamt the same thing at the same time. I wonder what it all means...

School-wise we have our first midwifery exam of the semester on Tuesday. It covers first and second stage, and lab stuff (local & pudendal blocks, ISE/IUPCs, EBL, placental exam, etc.) We learned our hand maneuvers and the baby's rotation -- so that will be on there as well. I'm not super worried about the test, but I'm studying with one of the other CNM students tomorrow morning before I head out to my weekend with B. Anyway...I've got to get going on packing and homework.

Pictured above: Me snuggling the baby we caught about 30+ times on Tuesday. The midwives decided to name him Oscar.