I keep putting off writing the material I need because I want time to ensure the detail and depth for assignment purposes. Because of this concern I haven't yet written about D*'s birth. Now putting procrastination aside I am focusing on the necessity and practicality of writing in my journal regularly and remind myself of its contribution to my learning.
Looking back at J*'s visit I recall how large and tight and reactive her uterus was. I felt concern about her ability to birth her baby without intervention as she is a small woman.
I can see the J* will have a good family support network, but possibly little contact with other new mothers. With her partner's unsocial work hours this could restrict her social interaction and leave her vulnerable for postnatal depression. My reason for concern is because I was considering how I felt with my situation after Amy was born with Adrian doing shift work.
I was interested in J*'s attitude towards her health and her pregnancy. It seemed that pregnancy and the discomforts were a source of qattention focus and she was not particularly interested in improving her situation with exercise and aids. N* mentioned that J* was complaining of pelvic pain and N* went to great lengths to have a support belt available. N* had been phoned by J* at 10 pm at night complaining of the pain and then J* chose not to pick up and use the belt. Exercise could help alleviate the leg pain J* gets but she found it all beyond her capabilities.
It was a great experience seeing K* who was at home with her premature baby and N* was working with K* will after usual hand over to Plunket. The focus of the visit was to get K* to move away from the regimented and very careful handling of her baby in the neonatal environment to a more relaxed and flexible, normalised home environment. K* had wonderful support from her mother who was very helpful in moving K* to see her baby as normal and healthy, just small due to being born prematurely.
It was funny. She was a gorgeous baby and my hands were itching to hold her. I was a little bit disappointed that K*'s mother was there because when an extra pair of hands were needed, it was me who held baby. Maybe because she was so tiny I wanted to hold and protect her.
I'll leave writing about D*'s birth of C* until I get home and can refer to the notes.
The week following the birth I was very vague and a bit off-track. I'm not quite sure what to attribute this to and will have to be aware of it after the next birth. Was it that I lost touch with the purpose of the classes? gained a sense of invincibility? was just tired? Only a pattern or needing to break one will tell.
On Monday 14 August I was scheduled to spend the day with N* but as we had previously joked a woman went into labour. We did one antenatal visit and I did the BP, palpation and FHR. N* asked me to leave the room for the high vaginal swab which she had to do to assess her for Group B strep infection. I respected N*'s decision and after discussing the situation in the car realised that it was to do with the husband's anxiety and concerns about the actions in the previous birth and simply her understanding of the woman's privacy needs.
This came up once again because the woman in labour was a midwife and she didn't want a student. I felt a bit miffed and personally was annoyed about a midwife not wanting to contribute to the learning of a student. Since then i think it was not the choice of the woman, but that N* had taken that stance from her understanding of her client. Another factor in my annoyance was that I believed it was my last Monday working with N*.
This makes me realise that I am willing to respect women's wishes, but have to be careful not to let my annoyance to show.
Compounding this foolishness was the incident of the following week. I went up to Te Horo to see my brother and sister-in-law's place. I didn't check my answering machine when I got home. The next morning I was enjoying a sleep in and N* phoned saying that I was to meet her at the hospital as she wasn't able to wait any longer. I felt so inadequate, humiliated and extremely unprofessional. The biggest and first lesson in checking my answering machine.
I dropped Maia off with Adrian and met N* at the hospital at 10am. The reliability and contactability of first year students and the attitude of midwives towards us was further demonstrated by another midwife who expressed disgust at not being able to reach her student by phone or pager. There were justifiable reasons why the other midwife was having difficulty contacting the student and faults on both sides and outside their control. This just gave me insight into why presenting a professional manner is important and how a student's actions reflects on her whole class and can also impact on student in following years.
On Monday 21 August we saw R* antenatally at 16 weeks. She is Gravida 3, Para 2 and is suffering from toxoplasmosis. N* cared for her with her two previous pregnancies. R* has a very supportive and possibly over-protective husband because of R*'s illness. I was surprised to learn that toxoplasmosis can have ongoing effects throughout the infected person's life. I had thought that it was treated initially and didn't have recurrences. I will have to read more about it.
We did N*'s final postnatal visit. She was looking a little bit anxious about feeding and settling her baby. During the labout her lawyer husband took notes and N* had felt the need to be thorough in her education and documentation with this couple. N* went through a demonstration of using the breast pump and I held the baby to settle him. This may have helped Nina by giving her some different ways other people use to settle and comfort a baby.
As it was the last visit N* was a little bit emotional at saying goodbye. N* gave N* a Peace Lily. I discussed the feelings of women at ending the midwifery partnership. My thoughts on this are that the woman is losing a special contact and support that is focused initially primarily on her as the locus of attention and the special bond with another woman who has attended her birth and can connect to her through the birth experience. The midwife has had experience and knowing and the woman has felt reinforced and supported and has had some of the pressure of responsibility shared. On ending the midwifery partnership the woman must take full responsibility and shift to independence. The midwife needs to reassure the woman of her abilities and how much she has already achieved, as well as future avenues for support.
Visiting C* revealed some aspects of what it is like to support midwifery colleagues. The midwife-mother is able to make assessments but because she is so close to the situation her midwife colleague is able to provide a partial objectivity and support. The midwife-mother still needs all of the things a non-midwife does as well as reassurance if things are not going as planned as she is well aware of implications. Identify the level of assessment she wants from you and provide care accordingly.
I am having difficulty at the moment making study time. Taking this time now is helping me to focus. I have varying levels of organisation depending on my general wellbeing, and will aim to improve these in all circumstances. Assignment planning would be a good start.
