Busy day at the office

The clinic this morning was packed full. The first woman I saw was pregnant with her 2nd child. Her first baby was stillborn at 38 weeks. How on earth am I meant to fulfill all her needs and offer support in a 10 minute slot? She was understandably anxious and my 10 minute allocation went out of the window as we talked about her lost son and her fears for her current pregnancy. We planned that I would offer her more visits and at her home so that she would have the privacy and time to explore all her apprehensions and of course for reassurance that all was well in this pregnancy. The trust won't be happy. "Multips" are only meant to have 7 visits antenatally including all bloods and scans according to the (not so) N.I.C.E guidelines.

All my timings were then up the spout. The third woman who came in with her brood of 3 toddlers starting swearing at me and complaining about waiting for an extra 45 minutes. She stunk of cigarettes but I could tell that now was not the time to be discussing her smoking habits if I wanted to keep my teeth.

10 women later, I had to rush to my first home visit. No time for lunch, luckily I had a banana in the car (the only fruit that doesn't cause me to puke). My first visit was to a woman who had given birth 2 days earlier. She was struggling with breastfeeding and her left nipple was quite cracked and sore. I sat with her a while and watched her feed and we found a position which helped her latch on the baby more comfortably.

The second woman was someone I had concerns about as her blood pressure had been creeping up and she had one plus of protein in her urine when I saw her yesterday. She was 31 weeks pregnant. She hates hospitals and had been planning a homebirth. She sobbed as I told her that she really did need to be admitted after the third BP reading was still 140/90 and her plus of protein wasn't disappearing. We talked about the dangers of pre-eclampsia and that she was outside the realms of normal midwifery and needed obstetric input quite urgently. She eventually agreed to go in.

A couple of routine postnatal visits and then my "cause for concern" family. Wendy (not her real name) lives on the 11th floor of a high rise. The stink of urine in the lift would overpower anyone but in my current state it sent my gag reflex into overdrive. Wendy's flat would be small for a couple but for a family of 6, it is cramped and overcrowded.

Once again I am hit by the smell of stale smoke as she opens the door. Wendy's latest addition is 6 days old. The other 4 children range from 7 down to 2 years. The baby has lost weight. It is normal for babies to lose 10 % of their body weight in the first week of birth but this baby had gone down from 3.7kg to 3kg. Quite a drastic weight loss and worrying. Wendy doesn't like Doctors. She doesn't like hospitals (this baby was a BBA, born before arrival..we are seeing a lot of these in the community). Two of Wendy's children are on the at risk register. The baby needed a paeditricians' expertise. Wendy especially does not like paeditricians!

Eventually I persuaded Wendy that it would be in her best interest as far as child protection orders and the like were concerned, that she attend hospital with her baby. It would look far better from her point of view as a mother, that her concern for her child's weight loss over ruled her desire to keep away from "the system". She lit a fag, sighed a plume of smoke and reluctantly agreed with me. I felt it best not to inform her at that moment that her flat was also my place of work and therefore she was breaking the law by smoking!

On call tonite. We have 4 homebirths due. I hope none of them smoke.

© Copyright The Pregnant Midwife

Midwife bashing

When I was a nurse, I was stereotyped as an "angel" or a "naughty stocking clad nursey". There were times indeed as a young 20 something nurse that just by telling men my profession, their pupils would widen as if I had told them I was a lap dancer! If the truth be known, there is nothing less glamorous than hard graft nursing. Collecting sputum, cleaning catheter tubing of old men and passing NG tubes is hardly erection inducing (despite the fact that I used to wear stockings).

But now, same person, same values, same passion for caring and people and yet I am stereotypically viewed as a fat, man hating bully with hairy toes,an unruly bikini line and proud moustache! OK, I don`t wear stockings anymore but I am a cosmetic junkie and get regular pedicures.

See NHS blog doctor http://nhsblogdoc.blogspot.com/ and Doctors.net for views on midwives by our medical colleagues and The Telegraph for regular vitriol by Christine Odone et al just like her.

I sigh when I read the above as I know that in the main most midwives are genuinely caring, dedicated and committed to making sure that women have the best birth experience they can help give them. I have never had a bad experience with junior doctors who do their 3 month stint on DS. Quite often they are freaked out by the power of labouring women and need lots of support from us. Now the SHO`s often come out with us in the community too especially those doing their GP training. They are usually great company and learn a lot about the role of the midwife as well as getting to see a few homebirths/waterbirths too.

Either, it is only a few vocal docs that truly hate us, or the ones I have had the pleasure to work alongside and train up in the art of accurate V.E'ing are trained actors. And doctors, we don't hate you or invent silly names for you or think that you are all Shipmans or Ledwards because a couple of crazy's happened to be members of your profession. Quite a few of us are in fact married to you doctors (not me despite a few near misses in my younger days). Some of us have parents who are doctors, others have off-spring who are doctors. That means that quite a few of you have midwives as mums, wives and sisters. Some of you GPs even have us as patients treating our hairy toes!

We do need to stop the multi professional slagging off. For most of us health care professionals, we go to work, we come home and we switch off. We should not all be defined just as one role. I am not only a midwife. I am mummy, wife, friend, daughter, sister, customer, patient,MSc student,writer,lecturer. Don't get me wrong, I love my job. I chose my career and probably could have chosen a completely different path with my exam results. I have siblings who earn far more than I in the media and the legal profession. I chose midwifery because I have a passion for it and because I really care about how women experience pregnancy and birth and entering parenthood. The money is crap. My husband, a successful company director has always thought I was nuts to do a job which gives such little financial reward, but hey, we cannot all be capitalists!

I digress, must be my pregnant brain wandering. I will return to this subject but for now I need a pickled onion and jam sandwich.

11 weeks going on 12

According to my text books, Small now has fingers and toes and even a little head of hair (although the head is huge compared to it's little body). He/she is the size of a little lime and has already decided his or her gender.

How can something so little make me feel so sick! So sick and shattered! With 2 boys to look after and a caseload of pregnant women to care for, births to attend and an MSc to finish, I guess the tiredness can be excused but the sickness, not fair!

I have tried everything: ginger, sea bands, acupuncture, homeopathy, crackers on waking. Everything I suggest to my clients but does any of it work? Rhetorical question!

Being a pregnant midwife has it's challenges. Whilst women from other professions can choose to avoid the ubiquitous birth video's at NCT classes, us preggie midwives are confronted with the thoes of labour daily. I remember, 34 weeks pregnant with my last son squashed into the corner as a woman in transition relayed how f@#+ ing pleased she was that I too would be suffering the same agony in only a few weeks time whilst hanging onto my neck as the baby slowly crowned.

People also assume that you will "know what to do". Hallo! Us midwives need midwifing too, often a lot more. It is tough to put out those images of shoulder dystocia's and PPH's when you are a pregnant midwife.

My booking visit is next week. It is with a midwife I don't know as I live in a different area to where I work. Shall I tell them I am a midwife? Hmmm,we shall see.

This is my third baby but I am still apprehensive and a little scared. Will it be ok? How fat will I get this time? (I usually put on 4 to 5 stone!!) Will I cope with labour? Will I love him or her as much as I adore my boys? Will my nipples drop off (yes, midwives have feeding difficulties too!) How will I manage with two under 3's?

And before you ask..boy/girl I simply don't care! I love my boys and know where I stand with them so another boy would be cool. A girl would be lovely too.And no, I am not going to find out!