A midwife's hands do so much more than hold and support. Indeed, it is not cheesy when people talk about their power. Much of what they do is to feel the invisible - and 'see' what is under the skin, just out of reach, and up and back behind what we can image. A good (and practiced) midwife can tell the estimated weight of a fetus in utero, it's position, if it's head is flexed or extended, if it is facing a bit to the left or right inside the mother's uterus, if the head is down or up or (lord forbid) sideways.
Hands become measuring tools as well - how much is she dilated? how big is her pelvis? how far down has the baby dropped? there is no scientific measurement - just very educated guesses - placing one or two fingers in the cervix and thinking - if two tips of my fingers are 3cm - she must be just under three cm dilated. Yes, sobering how un-exact it is - but excited how precise it can become. We have all measured every length and width of our hands, fingers, and fingertips. I have really never paid so much attention to any part of my body. The length from my pointer finger to the base of the thumb is 13cm.
To practice estimating dilation - we have been instructed to measure every round thing with our fingers - then check the diameter with a tape to get a sense of truth. For example, the middle and pointer fingers of my left hand stretched to their maximum is about 10cm from edge to edge. And so, voila - if I can fully stretch them - she's ready to have that baby.
So, there goes distancing my self from just about anything - a water glass, a water bottle (mine is about 3cm in diameter at the opening, a door knob, a shampoo bottle.
It's all a cervix. And my hands are my tape measure.
Hmmm.... I think I deserve a manicure.
Thursday, January 24, 2008
Wednesday, January 23, 2008
boot camp
I fondly call the last two weeks "midwifery boot camp." Each day from 9-5 (or beyond), our class of 16 has sat through lectures, demonstrations, skits, pretend-you're friend-is-birthing-a-plastic-baby-in-the-squat-position sessions, chicken-thigh suturing lesions, and other creative means to determinate the how-tos of being a midwife. Today we ended with a two hour tour of the labor and birth unit where we will be taking call starting next Tuesday.
Honestly, how fun, and what a whirl wind. Two weeks ago I really didn't know much about being a midwife, and wasn't really sure that this whole labor and birth thing is what I really wanted to do - and now I am undeniably excited about the years to come - and could probably even bumble and fumble my way through explanations about latent, active, second and third stage labor, and a myriad of genetic tests that we offer during prenatal care, and why.
There is certainly a HUGE amount still to cover, and lots of practice to obtain, but what a way to start the new year.
Perhaps one day I'll sneak my camera into the lab while my friend Amber is butt up in the air, grasping a plastic head while the rest of the class coaches her and rubs her back, and one of us take the seat as the catcher...and she huffs and puffs and pushes out that plastic head and soft little body right through her legs to the applause of 15 other midwifery students.
Honestly, how fun, and what a whirl wind. Two weeks ago I really didn't know much about being a midwife, and wasn't really sure that this whole labor and birth thing is what I really wanted to do - and now I am undeniably excited about the years to come - and could probably even bumble and fumble my way through explanations about latent, active, second and third stage labor, and a myriad of genetic tests that we offer during prenatal care, and why.
There is certainly a HUGE amount still to cover, and lots of practice to obtain, but what a way to start the new year.
Perhaps one day I'll sneak my camera into the lab while my friend Amber is butt up in the air, grasping a plastic head while the rest of the class coaches her and rubs her back, and one of us take the seat as the catcher...and she huffs and puffs and pushes out that plastic head and soft little body right through her legs to the applause of 15 other midwifery students.
Sunday, January 13, 2008
the goings and comings
While in Kentucky, visiting Jo, I quit my job. What a relieving, freeing, scary, odd, sentimental feeling. I did it in the respectful way, with lots of notice and an explaination.
I worked my last shift on Saturday - complete with a 28 year old drug addicted man who fell while jumping down some stairs and broke his ankle in 2 places - and nothing could 'touch' his pain - a 25 year old law student who was scared and brave, admitted with a small bowel obstruction, young, blond, shivering in the bed, wishing she was anywhere but here - a 51 year old guy who looked 72 with no teeth, grey hair and recovering from a hip replacement with a crit that, even with 3 units of blood - wouldn't creep above 28 - and a handful of others, in and out, in pain and out of it- admitted and discharged.
It was such a strange feeling to walk out at 7:30, running to meet caleb for a delicious dinner and movie. Everything seemed so normal - but also so disorienting, knowing that I would never work there again. I finished a chapter after I had started the next book, reminding me of the multiple stories that weave throughout a life, and how new doors open and close continuously, and nothing is ever done really, but just is added into the ever expanding record - our own sort of chart.
So too do I go and come. I just drove back from Cambridge to New Haven after a wonderful three weeks away. A new chapter is starting tomorrow. Second semester. Monday starts at 9 and goes 'till 7:30. A brutal amount of sitting and listening, in my opinion. And while last semester was in a midwifery program, tomorrow is the start of learning to be a midwife. We will be focusing on IP (intrapartum - labor and delivery) and AP (antepartum - pre-natal care) throught out the next 4 months. Clinical will start in a few weeks, and I will finally catch babies, assist with breastfeeding, hold hands, wipe sweat, and memorize, memorize, memorize. This is a chapter, that while seemingly is beginning tomorrow, actually began years ago - perhaps even 28.
A funny moment from today, below. A flat. As if I needed another excuse not to leave Cambridge.
I worked my last shift on Saturday - complete with a 28 year old drug addicted man who fell while jumping down some stairs and broke his ankle in 2 places - and nothing could 'touch' his pain - a 25 year old law student who was scared and brave, admitted with a small bowel obstruction, young, blond, shivering in the bed, wishing she was anywhere but here - a 51 year old guy who looked 72 with no teeth, grey hair and recovering from a hip replacement with a crit that, even with 3 units of blood - wouldn't creep above 28 - and a handful of others, in and out, in pain and out of it- admitted and discharged.
It was such a strange feeling to walk out at 7:30, running to meet caleb for a delicious dinner and movie. Everything seemed so normal - but also so disorienting, knowing that I would never work there again. I finished a chapter after I had started the next book, reminding me of the multiple stories that weave throughout a life, and how new doors open and close continuously, and nothing is ever done really, but just is added into the ever expanding record - our own sort of chart.
So too do I go and come. I just drove back from Cambridge to New Haven after a wonderful three weeks away. A new chapter is starting tomorrow. Second semester. Monday starts at 9 and goes 'till 7:30. A brutal amount of sitting and listening, in my opinion. And while last semester was in a midwifery program, tomorrow is the start of learning to be a midwife. We will be focusing on IP (intrapartum - labor and delivery) and AP (antepartum - pre-natal care) throught out the next 4 months. Clinical will start in a few weeks, and I will finally catch babies, assist with breastfeeding, hold hands, wipe sweat, and memorize, memorize, memorize. This is a chapter, that while seemingly is beginning tomorrow, actually began years ago - perhaps even 28.
A funny moment from today, below. A flat. As if I needed another excuse not to leave Cambridge.
Monday, January 07, 2008
Not in order of importance
Ok - an update since my last post (no promises regarding order and significance)
1. I am currently eating ice cream for lunch in Charlotte Airport on my way to Lexington to visit a dear friend
2. 3 out of 16 women in my midwifery class got engaged over break. odd. amazing
3. Obama won the Iowa caucus and is well on his way in New Hampshire tomorrow - a fact that is hard not to get excited about... regardless of how undecided I was before
4. I had a very relaxing and computer free vacation - a lovely Christmas at home with Caleb and my family complete with a plastic talking Jesus - a quick trip to Virginia to see my whole entire quasi-Mennonite crew and some historical houses and (out) houses - a visit to Frank Loyd Wright's Falling Water - and a snow filled fabulous few days for new years in New Hampshire.
5. I haven't worked a day at the hospital while on vacation - but did send a huge check to my union, as I'm still technically a member of my bargaining unit. Argh. Union dues. Good in theory. Making me broke in practice at the moment. I think I may have forgotten how to be a nurse.
6. Luckily for me, I'm working on other things - and am knee deep in information on maternal mortality and post partum hemorrhage for a research proposal I'm writing for the summer (fingers crossed).
7. My ice cream (it had fresh blueberries and raspberries - the best thing I could find in this airport - snobby me) is all gone now.
here are some pics to share from my vacation.
Don's John, Virginia, 2007
Frisbee on the frozen lake, New Hampshire, 2007
UNO! New Hampshire, 2007
Bob's famous Christmas Stolen, Hastings, 2007
My cousin Hillman and his mock apple, VA, 2007
1. I am currently eating ice cream for lunch in Charlotte Airport on my way to Lexington to visit a dear friend
2. 3 out of 16 women in my midwifery class got engaged over break. odd. amazing
3. Obama won the Iowa caucus and is well on his way in New Hampshire tomorrow - a fact that is hard not to get excited about... regardless of how undecided I was before
4. I had a very relaxing and computer free vacation - a lovely Christmas at home with Caleb and my family complete with a plastic talking Jesus - a quick trip to Virginia to see my whole entire quasi-Mennonite crew and some historical houses and (out) houses - a visit to Frank Loyd Wright's Falling Water - and a snow filled fabulous few days for new years in New Hampshire.
5. I haven't worked a day at the hospital while on vacation - but did send a huge check to my union, as I'm still technically a member of my bargaining unit. Argh. Union dues. Good in theory. Making me broke in practice at the moment. I think I may have forgotten how to be a nurse.
6. Luckily for me, I'm working on other things - and am knee deep in information on maternal mortality and post partum hemorrhage for a research proposal I'm writing for the summer (fingers crossed).
7. My ice cream (it had fresh blueberries and raspberries - the best thing I could find in this airport - snobby me) is all gone now.
here are some pics to share from my vacation.
Don's John, Virginia, 2007
Frisbee on the frozen lake, New Hampshire, 2007
UNO! New Hampshire, 2007
Bob's famous Christmas Stolen, Hastings, 2007
My cousin Hillman and his mock apple, VA, 2007
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