Different Needs

On 2 October I met C* who is over the age of 40 and is a 38 weeks expecting her first baby. She was confident and self assured but very anxious about her pregnancy and her birth. I used the term "precious cargo" when N* first discussed C*, and this was reinforced by her communication during the visit.

When we visited S* it was fantastic being able to palpate her twins. As there is less room I found it quite tricky identifying the lise of the babies. N* did a palpation and guided me through. After N* showed me, everything seemed obvious.

I'm enjoying visiting M*. Her husband was home and he didn't seem to be very happy. Their son is getting really used to me visiting. I'm really hoping that I am able to attend the birth. I guess I'll just have to wait and see.

S* let me know that while she was quite happy for me to be able to be at her birth, her husband wasn't so keen and wanted it to be a private affair. When I first heard it I was quite disappointed, but now I'm quite philosophical about it. I think of it this way that I've done more births than the minimum and at the moment I have 1 definite birth to attend and 3 maybes. I'm still ahead and any little bit I do gets me ahead.

The next day I met T* and her husband at delivery suite. We soon figured out what his reluctance was in attending the birth. He was fine with the new birthing rooms and the standard delivery rooms but when we took them into one of the delivery theatres he loked very uncomfortable. It was partly the clinical apearance of the place as well as the smell.

Monday the 9th was a really busy day. We had to quickly stop in and visit N* who had a severe nosebleed on her way to work. We checked her blood pressure and did a general check and N* recommended the N* visit her GP as everything was alright in relation to her pregnancy.

N* had 3 appointments at the rooms she uses at the Karori Village Medical Centre. I didn't see one of the couples as we were short of time so I went through booking paperwork with another couple. One thing I realised about booking visits for multiparous women is that one of the most important things for discussion is the previous birth.

We visited one woman postnatally and I had an opportunity to hold her baby. On feeling his head I was amazed how moulded his skull bones were. It was easy to identify the posterior fontanelle.

N* warned me about S*'s house before we arrived and her concerns that the state of the house posed a health risk to the whole family, and especially a newborn. S* is an uncompromising woman and continues to smoke during her pregnancies and after the births of her babies.

I felt composed until I passed their dog and it decided to growl at me. I took a quick breath to reassert myself and told the dog firmly to be quiet. This worked but it certainly put me off balance.

When we entered the house I was shocked. It probably isn't the worst I'll ever see but I hadn't really expected it to be as bad as it was. This is where N*'s years of experience as a community nurse and her previous work with S* provided me with a model for interaction. N* treated the whole situation as normal.

S* is expecting her fourth baby and they currently have six people living in a three bedroom house. I know what that's like, but our home was definitely not in that state. S*'s partner arrived and I felt like he was looking down my top. I'm not necessarily worth looking at, but that made me really uncomfortable.

After we left N* said that she intentionally chose the lounge for the discussion as the kitchen was appalling. She suggested that S*'s would be a good birth to attend. I think I'm a little wary because N* has stated that S* can be really blunt. If she was directing her frustrations at me, how would I react? Tears, a joke, or just brush it off, or return the comments. I don't know, but I think I would follow the patterned response set by N*. It could be quite helpful being there if S*'s husband is away when she goes into labour.

I'd already checked with Adrian and was able to go in with N* to commence an induction for one of W*'s clients N*. They hadn't met S*, so I didn't feel as though I was stepping on her toes. They were happy for me to attend the birth and I went home excited with anticipation.

Adrian and I are both learning as we go along about the nature and timing of midwifery. I'm learning to work out estimates and Adrian's happy if I respect his needs and keep him informed.

I was up bright and early for the induction and got to the hospital in time, but it looks as though it might pay to be a little bit early as N* gets started as soon as she arrives and I might miss things.

It was a really cold day. I felt as though I had two left thumbs. One comment another midwife made is that she finds students tiring because she is directing traffic and they aren't as quick as she is. And these comments she was applying to a third year! I felt as though I fulfilled these comments. After enough births a lot of the processes become automatic. I'm looking forward to then, but right now evrything seems painfully slow.

N* provided us with a tricky induction process. Frequent monitoring was required because baby didn't like having the syntocinon rate too high. N* and her husband had a few questions which I felt I answered accurately. Possibly questions they weren't wanting to ask N*.

Once again the privacy and confidentiality issue arose. I am super aware of it after querying N* about a first year being disciplined and she stated that it was over a breach of privacy. One question I need and answer to: Can our reflective journals be used against us in relation to breach of privacy and malpractice? If we meet a family in public who we cared for during pregnancy and labour, are we able to introduce them to our family or friends, and how should that introduction be worded?

During the labour there wasn't quite the feeling of being connected with N*. She was tired and sore and was in a fast/slow time warp dealing with pain.