DearAllison
It's all about evolving as a midwife and you will reflect on your practice
accept it and move on.
Thats how it goes I would have acted the same as you 5 yrs into practise its
ok
The couple had established a working relationship with their midwife
nutured over many months it would be impossible at their most vunerable time
to turn to u for guidence it just isn't on . Obviously u are kind and
experienced at building that wonderful instant relatonship with families in
your care and in this instance they hung on to their midwife and ignored u .
You sound hurt and misunderstood .
prom -so what clear liquor and a febrile
prolonged 2nd stage with dwindling contractions so what would be hardly any
active pushing
dwindling uterine contractions so what
your role as devils avocate i don't understand
the what ifs have to be positives if and when a problem occurs then
strategies around that problem could include possible outcomes if the
strategies suggested were refused.
The fact that the family transfered to hospital implys that the what ifs had
been addressed and actions were expected ie syntocinon
what's this baby nurse? is that a hospital policy surely three professionals
and 2 parents are enough in the room unless there is a problem .PERHAPS U
COULD HAVE BEEN THE BABY NURSE AND INVITED THE INDEPENDANT MIDWIFE TO CATCH
THE BABY .
a syntocinon drip in ,no bleeding and I assume a well woman in a hospital
Idon't understand your concerns re third stage I guess its years of tired
uterus can bleed etc its not wrong to worry but ask why your worried woman
ie bleeding dizzy looks dreadful history of problems etc your recent
experience of your belief in active management of 3rd stage
armed with contact nos and info re poss scenarios ---thats the answer to the
whole thing fear of the process I understand that completly. It takes ages
to accept that parents are in charge and capable and that we are not the
experts.
Don't bag yourself or them, move on and grow and I hope if I have to
transfer anyone to your del suite your there because you care alot and will
have moved on lotsof love AND KEEP HOLDING THE SPACE FOR WOMEN. jan
----- Original Message -----
From: allison buck <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, August 22, 2001 2:52 AM
Subject: Understanding?
> 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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