Browsed by
Category: Clinicals

Notes to Self

Notes to Self

We’re beginning the clinical portion of our midwifery education now, after a very intense, action-packed 8 weeks of theory and classroom work. For the next 8 weeks, we’ll be in the clinical setting, on our placements, learning by doing, helping and shaping the antenatal, birth and postnatal experiences of the women we meet.  I’m SO EXCITED to begin actual midwifery work again! But on the eve of my clinical placement, it seemed like a good time to write a few notes to myself (and my fellow students on the eve of this exciting milestone):

Clinicals are going to challenge you in ways we can’t even imagine yet–even though you’ve done parts of this before, it’s still going to be challenging, and new. You’ll need your mind, your ability to think, your ability to feel, your ability to see clearly, to watch and wait, to put 2+2 together, to use all of this knowledge we’ve been working so hard to acquire.

But remember that birth isn’t in the textbook. It’s in the mother, sweating with exertion, it’s in the partner, whispering words to encourage her, it’s in the baby, liminal and waiting.

Remember that wherever you stand in that labour room, no matter how chaotic, you stand in a holy place. Your heart has called you to this profession, this path, this work. Let your heart shine–your wisdom, your strength, your love.

 

 

Day One and Two: Full on!

Day One and Two: Full on!

Hello lovely readers: guess what? I’m in midwifery school again! And trust me, I never thought re-qualifying was going to be a walk in the park, but these last two days have been a pretty brusque reminder to just how intense this is going to be. And I know I’m capable (and thankfully, a lot of it will be familiar, at least), but man–here we go!

Yesterday was a general orientation to the program: the course requirements, the timetable, our first assignments. Thursday is a day-long orientation to the library, where I suspect we’ll be spending *a lot* of our time. We’ve received an independent study guide, a workbook on medications and abbreviations and prescribing in labour, and an inch-thick workbook on reproductive physiology, plus some fervent warnings to keep up with the work and not let it pile up. Right! We also spent yesterday and today working in small groups, getting to know each other, and discussing the role of the midwife and the principles of midwifery care, which is always nourishing and enriching work.

The class itself is fabulous–there are 28 of us in total, ranging in ages from 18 and fresh out of sixth form (sort of the UK high school equivalent) through late 40s with teenager children, all from very diverse cultural and social backgrounds, and with a myriad of reasons for wanting to be midwives. I was very relieved to discover that I’m not the only mature student, by a long shot, and not the only mother going back to university with children at home. In fact, most of the other mothers in my class have three children rather than just two, and a few of them even have four children (and one with a set of twins), so if they can do it (superwomen!), I can too. I made a comment along the lines of “wow, how do you do it?” to a mum of four in my class, and her response was “You just have to get super organised.” Right! Wise words; that is definitely the plan! We’re still just getting to know each other, but everyone seems very friendly and welcoming so far, and I suspect that the wonderfully stressful bonding experience we’re all about to go through will ensure some lifelong friendships. I still think of my midwifery school friends from my US qualification with such love and warmth, and even though most of us don’t talk or hang out much any more, I still feel like many of them are my sisters as much as friends and colleagues, and the feeling hasn’t faded through the years, despite the distance and limited contact (mostly through facebook these days). So there is definitely something to be said for midwifery school friends!

Tomorrow is our orientation to our clinical site. My first rotation will be community midwifery, which is an area I’m very excited to learn more about, as it doesn’t exist in the United States. At all. In fact, the UK’s commitment to community midwifery is a bit of a rarity even among European countries, and is very exciting. My limited understanding of it so far (I’m sure I’ll have a much better grasp of it in the weeks and months to come) is that community midwives are responsible for delivering midwifery care in womens’ homes. This includes providing home births, of course (which is my particular love, and where I want to be practicing when I finally graduate again), but the more remarkable feat of community midwifery is that here in the UK, ALL women (even those who delivered in hospitals) are given follow-up postnatal care by a midwife in the comfort of their home, usually 1-2 days after returning from the hospital, then again around Day 5-6 postnatally, and finally one more time around Day 10 when the woman and baby will finally be discharged from midwifery care. Let me say that again, because it still sounds so incredible to me: a midwife will come to your *house* in the first few days and weeks after you give birth, check your bleeding, help with breastfeeding, weigh the baby, perform the newborn screen etc. etc., and this is not some extra, luxury service for wealthy clients with private insurance, but ROUTINE POSTNATAL CARE.  In the US, postnatal care generally looks like this: you give birth, you’re seen in the hospital by a midwife or OB on postnatal Day 1- Day 2 (which is usually when you’re discharged if you’ve had a vaginal delivery; usually Day 3-4 if you’ve given birth by cesarean), and then…that’s it. Your next postnatal visit is booked for 6 weeks later. And to a new mom with a newborn baby, the chasm between Day 2 and 6 weeks might as well be the Grand Canyon. SO much happens during those first 6 weeks–so many questions, such a steep learning curve–and you’re basically on your own for most of it (unless there’s a rare complication that would necessitate an earlier visit). Add to this the fact that many women in the US are also expected to return to work around 6 weeks, and maybe it begins to sink in just a little bit how cruel and inadequate the US maternity leave/ postnatal care system is.

Which isn’t to say that UK postnatal care is perfect.  In fact, most of the complaints I’ve heard since I’ve been working as a lactation consultant here for the past 3 years is that postnatal care isn’t nearly supportive enough, and that the advice about breastfeeding in particular can be very inconsistent. Also, one of the reasons community midwifery follow-up happens so quickly here is because many women are being released from the hospital within 6-24 hours after giving birth, which can also be very disorientating and stressful, for first-time moms in particular, I think.

In any case, I am very excited about working in the community initially–and I’m even hopeful that I might be able to attend a home birth, if I’m lucky. Fingers crossed! But our clinical rotation is still 8 weeks from now, and first…there’s a whole lot of reproductive physiology to review.