I write to explore the events that have occured in my practice as a Hospital
Based Midwife in the past week.
I am on night shift at present, and we all know the challenges that sunset
seem to bring. Never do these things seem to occur during day light hours,
or if they do, seem quite trivial, with a Hospital full of Medical
resources.
After receiving handover on this cold, wintery night, I freely volunteered
to care for 'the homebirth' woman.
The instances that had seen this lady admitted to our Birth Unit, included a
prolonging of her second stage (over 5 hours prior to admission), prolonged
rupture of membranes (45 hours) and incoordinate and dwindling uterine
contractions.
My background is of course as a Hospital Based midwife for the past 5 years.
I am strongly involved in supporting women, and their families in the
choices that they make, whilst at the same time, being governed by the
Hospital in which I work, and which, in turn provides the safety and support
that I need. I have at some times thought of the possibility of entering
private practice, but for me I feel that the right time for that may be many
years away.
Following handover I was introduced to the couple I was then going to care
for and support during their birth experience. I was not greeted by a smile
or hello, and yes I can fully understand that Hospital was not where they
wanted to be. How great it was to be with a couple who were making choices
and deciding for themselves. Alternatively, I work within policies. You
can plainly see the dilemma beginning to arise for myself. I needed to be
supportive, but also the devil's advocate for all the 'what ifs'. Is this
my role? Yes, absolutely, but is it also the role of the Independent Midwife
to do this before leaving the comforts of home? That's Ok, I understand.
The lady's GP was a wonderful support to both the couple and myself.
Agreeing to be 'baby nurse' as the couple refused to have another Midwife
present for the Birth. That's OK, I understand.
A healthy baby boy was born at 10.30 that evening with the help of a
Syntocinin Infusion, and a lot of 2nd stage coaching by Her Independent
Midwife and Myself. A wonderful outcome achieved. A few smiles and nods of
thankyou were circulated throughout the room, but none unfortunately in my
direction, as I waited for pulsations to cease of the cord. That's OK, I
understand.
A long 8 1/2 hour second stage, and after 45 minutes no signs of a placents,
was I worried about a PPH or a manual removal? Absolutely, and is that so
wrong? My concerns were unfounded when after an hour, She had Her placenta,
complete with a scant amount of vaginal blood loss. "Can I pop this arm band
on your baby?" I asked, and was met with a firm "no, we will not be
separated". That's OK, I understand.
After a beautiful 2 hour breastfeed, and well deserved shower, the couple
went home four hours after the Birth. Armed full of contact numbers,
answers to possible scenarios that could happen before their Midwife sees
them in the morning, and my best wishes and congratulations, the couple
entered the coldness of the night. There was no acknowledgement or
thankyous offered.
That, I do not understand.
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