Midwife-ette - almost a midwife!

Midwife in training. Or student midwife, if you will. Although I prefer midwife in training, as student midwife conjurs up the beer-guzzling, tequila-snorting, casual-sex-having lifestyle I should be leading, but am just too damn busy for.

Name:
Location: London, United Kingdom

Sunday, October 29, 2006

Home birth

I'm on community at the moment. Had a call from my mentor at 8am this morning - she was on call the night before and had just been called out to a homebirth. She had VEd and the woman, Sam (not real name) was 6cm dilated. Set off on my way.

Arrived about 100 years later having missed the turning and not realising I'd missed the turning until I hit the coast and having to turn back and wander about desperately trying to find this house! Got there at 10 and assumed as I was pulling in that I would have missed the birth, as I had assumed the woman was a multip (had already had a baby).

Arrived and could hear Sam as I was coming up the drive - definitely hadn't missed the birth! She actually turned out to be a primip and had only started having pains at 5am. She was working really hard with contractions which were coming every three minutes and lasting a good forty five seconds, puffing and panting her way through the and the way she was moving was amazing! It really was absolutely textbook stuff - she was on hands and knees rocking back and forth, standing up, kneeling on the bed hanging on to her very valiant mum, who was supporting her!

She was being supported by her mum and her auntie - her partner and brother were around but not in the room. Also there was the second midwife and her student, my lovely friend. So there were plenty of us in the teeny bedroom and the other student, second midwife and I were feeling a bit spectatory, as the only place for us all to stand was at the end of the bed in a line! So we trooped out and kind of spied on all the happenings from outside the door - had a great view but were not being intrusive.

Really I was completely superfluous as any kind of support, emotionally or otherwise for Sam and clinically wasn't allowed to do much, as my mentor had not had a birth for a while and wanted this one. No problem for me, as it meant I could completely immerse myself in watching and observing and just drinking the whole thing in without doing stuff. I LOVE doing stuff, but this was a good experience too. Watching her was just brilliant - I really saw and understood the term birth dance. She was moving so fluidly, off the bed, around the bed, hands and knees, standing, kneeling, rocking, keening and moaning. She was totally in her world but kept her hands tightly clasped with her mum the whole time. What struck me was the way she just did stuff - just got off the bed, just got on hands and knees, just grabbed a glass and drank some water- without asking permission for everything like they do in hospital. It was so wonderful!

About an hour after I got there things went a bit horrible for a while - my mentor decided to re-examine, even though it had only been 3 hours since last exam, because she wanted to know what was happening, and possibly break her waters. The door was shut and she was examined, and it sounded pretty traumatic for Sam, who was shouting "Get off! It hurts!" etc etc. SRMed on VE, waters clear. Cx 9cm dilated. But it seemed to change the atmosphere - Sam had lost control. She stopped moving (which she may have done anyway, I know) and just hung on to her Mum for dear life and screamed. And screamed. Then we got her back moving again, put her knickers back on (again, wouldn't happen in hospital), my mentor started giving her a massage and things chilled out again for a bit.

Then she said she needed to push. This happened a few contractions in a row, and then contractions stopped, textbook latent phase of second stage. About twenty mins later, she was sort of pushing and not pushing, on all fours. My mentor kept putting her fingers in and could feel babies head right there and then unfortunately the second midwife started coaching the pushing - "deep breath, chin on your chest" bollocks. Why? It's like it's ingrained. This went on for a bit and they got her on left lateral, then on her back doing classic Valsalva, then my mentor seemed to come to her senses and realise that this was denormalising things. "Right!" she said "get back on all fours". Sam did. She then out her fingers in and pulled down on perineum (! - she kept doing this!), focussed very squintily on the perineum and barked "Get me some jam!" I did and asked her "why are you going to put jam on her perineum?” Cue hilarious laughter and me realising I was a twat!! It was funny though. Sam had a few spoonfuls of jam and then my mentor said "right, let's walk" This was noon.

So we trailed around the (very small) house, from bedroom to living room and back, all of us in a line! Very silly. She kept sinking to her knees with contractions and then getting up and carrying on. Eventually she came to a rest in a supported kneel over the sofa, the other student and her mum supporting. I grabbed everything from the bedroom and bought it to where we were, then sat down on floor near business end. Everything felt very "female" - does that make sense? We were eight women, together in this - when she rocked, we did, when she held her breath, we did. We spontaneously formed a kind of circle with her labouring at the centre. It was pretty cool and powerful actually (if my mentor was reading this she would laugh at me! But it was!). Then, after an hour of saying she couldn't or wouldn't push this baby out, she looked up and said quietly, but so clearly "OK. I'm going to push him out now". That moment was electrifying - made the hair on my neck stand up. The air was filled with solidarity and anticipation but there was no stress or anxiety.

And she did. So so slowly the head crowned and looked at us. My mentor didn’t guard the perineum but did keep the head really well flexed. It extended across the perineum verrrrry slowly. Didn't really restitute. Shoulders slipped out and we had a screaming baby boy, over 7lb, at 13.00. Intact perineum. Placenta was a battledore insertion and there was a bloody great vessel in the membranes - good job she wasn't ARMed!

Babe was cleaned and wrapped and given to mum, mess cleared up (by me! i do have some uses). Left mum snuggled on sofa with tea and toast whilst grandmum bottlefed the baby. Brilliant experience.

1 Comments:

Blogger chimera said...

wow - amazing.

glad you've updated your blog, very interesting stuff!

12:24 PM  

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