The definition of bliss...

Getting 15 hours of sleep.

Peachiness

I was paged last night around 11:30 by a first time mum, a planned home birth. She wasn't quite ready for me to come yet, so I managed to get a couple hours of sleep before going out at 2am. I got a speeding ticket on my way there, but managed to make it there in plenty of time to deliver a baby girl, at around 6am. This girl was also 8#4oz! It was a beautiful home birth. The parents were so connected, and the mom was so responsive to do whatever I told her to, and things sailed along and were just peachy.

Postpartum went long but well, then I after I finished with her, I had to rush to the clinic to see the morning appointments, and though the administrators cancelled my afternoon clinic, I had another mum call that wasn't feeling her baby move much, so off to University hospital to do some tests, which all turned out fine. Consequently, I was exhausted (but still happy about the great birth) by the end of the day!

Expectations vastly exceeded

Neighbour midwife was on her weekend off, when I was paged by one of her clients about 3 hours before she was to go back on call.

The client was having her second baby, but her first labour went so long that she ended up having a cesearean section. I went to her home, and at 16:15 she was 7cm, right at the point where she had failed to progress beyond last time. The cervix didn't feel very well applied to the head, and I thought - "another section, here we come". We headed in through a snowstorm (deva vu!), and got her admitted at 17:00. She sat on the toilet for about 20 minutes, then it was to the bed where I put on the monitors (which we don't do for a normal birth, but because she was higher risk having a scar on her uterus, we monitor more vigilantly), and attempted to draw her blood when she started pushing! Checked her, and sure enough - completely dilated, with the baby's head at +1 station! I called for Neighbour midwife to come (as she was going back on call within the half hour anyway), but she didn't make it! A baby girl, 8#4oz just minutes before Neighbour midwife got there!

Clinic day #21

Clinic after returning from a weekend off is often busy. You have to return calls from the weekend, get report from the midwives who covered you, and answer all the questions about the date you had on the weekend on top of doing your regular clinic!

Turns out that one of my clients delivered while I was off call, so I had to run to the hospital on my lunch break to discharge her, then do a home visit for my Valentine's Day baby in the evening.

I felt quite rushed all day!

Finding joy in the little things

When I called the paging company (which is a call centre, and you get a different person each time) to put myself back on call, a woman answered who sounded like she just loved her job. She joked around with me, "are you sure you want to go back on call?!" and made a comment about the recent storm producing lots of babies in 9 months. Her attitude was infectious - I went away with a little bit more bounce in my step, grateful for someone putting their heart into what must be a sometimes boring job.

The pull of midwifery

I love my job. VERY much. But sometimes a break is what is needed. I normally hate going off call, for fear I will miss a birth. But today I am going off call for an entire weekend (we take one per month), and I feel happy to be going off. I have great plans, and I will be able to sleep every night. I am grateful for this weekend sans-pager.

Of course, when I am rested, I will be dismayed if I return to discover that a baby of my client's was not born into my hands. Maybe I'm addicted to my job.

Clinic day #20

My clinic day went very long. By the time I was done, I was a whole hour behind. It seems that everybody had questions or concerns, and when every visit takes 40 minutes, after 6 visits, you are an hour behind! I also got the dreaded "so how long have you done this" question, but at least this woman was satisfied when I added the number of births that I've attended!

Long wait, short push

Yesterday I delivered a first time mom - 7#5oz girl after 14 minutes of pushing! It took her long enough to get to that point, though. She called at 11pm... at 1am I checked her, she was 1cm. 1.5 hours later, 2cm. We moved to the hospital at that point because she didn't want a home birth and it was going to take us at least an hour to get there - we were in the middle of a HUGE snowstorm. It ended up that the highway was closed and we had to take a detour. I was so glad that we ended up traveling in a caravan, because there were a few touch and go moments. When we got to the hospital, she was 4 cm! After 5 hours of active labour she was 7 cm (very good progress!), but then her baby rotated to be facing up and her contractions just quit. The cervix also hung loosely from the baby's head, not well applied at all. Grr. Despite all the position changes, hands/knees, walking, squatting, swaying, lunges, I could think of, the babe wouldn't rotate and she would have a contraction only every 7-8 minutes. With the added back pain she finally got an epidural and then we ran IV oxytocin. I was a bit mad - it was going along so beautifully! I was relieved by my neighbour midwife and took a 2 hour nap, and about an hour after I came back we were seeing early decels on the monitor, and I was hoping against all hope that she was complete... I went to do a vag exam and ran straight into baby's head! +2 station!!! YAY! I went to the desk to get my backup midwife, did a little dance, then went back to the room and 14 minutes later we had a baby! Woohoo!! 1 primip down, 2 still term to go (and one a homebirth!)!

Clinic day #19

We currently have a student in our practice. She is a Midwifery I student, which means she is basically absorbing information by watching and doing very basic skills (blood pressures, etc), but not providing any care. I am technically not allowed to teach her, but she is following her preceptor's clients, so she ends up sitting in on some of the appointments that I do for her preceptor (who is on vacation). I find myself really enjoying explaining things to her, and the clients for the most part have been very helpful by letting her do blood pressures, and blood draws, etc. I am looking forward to the time when I can have my own student. Teaching gives me energy!

Epidural certification

In my first few months here I have not had the capability to run my own epidurals. I would have to call in another midwife to oversee the epidural. It was really a pain, no pun intended. So I got the epidural booklet, studied up, took the test, got my skills signed off, and contacted the chief of OB anaesthesia to have a chat.

It took a couple weeks to finally contact him and set up the appointment, and yesterday I was finally able to meet with him. He is the nicest guy you will ever meet, and we just sat and chatted about my experience and then he very hesitatingly asked me if I knew about indications and contraindications for epidurals, so I listed some. Then he very shyly and quietly said "well, you must know the complications of epidurals..." at which point I said yes, paused, and then launched into the most common complications and how I would manage them.

He said, "Well, you know your stuff, I'm happy for you to go ahead" and after a bit more small talk, we shook hands, and parted ways.

Now I don't have to call my co-workers in the middle of the night to run the silly epidural pump!

Clinic day #18

This week's clinic was very short, just the ladies that are due this month and a couple others.

No complications, just the way I like it!