I know it has been a while since my last post, and since I have now been over a month working at my new job as a Nurse Midwife, I figure it is well past time to update my devoted blog readers on my life these past couple months.
To start with, I think I have gathered a new philosophy for life. Avoid doing hair and make up before work for at least the first couple weeks when starting a new job. People will get used to you looking good and put together. Then when you happen to take a shower at work and don’t redo your hair and make up, people ask if you are feeling alright. And since lately I feel my day is generally filled with scrubbing in to assist on C-sections every day, I really question why I bother doing my hair at all before work, since I usually spend the entire day wearing my scrub cap.
A surprising aspect of my new job that I have found being in my new job is that my tolerance to submit to possibly unnecessary c-sections has become a lot lower. While still I’m a midwife very fond of promoting normal birth, I have started to find that so many of the women I care for are so high-risk for complications, that opting to side with doing a cesarean almost feels like the safer thing to do for this population. So many of my patients already that have seemed to be perfect candidates for normal birth seem to end up with difficult deliveries, dystocias, hemorrhages, strangely shaped placentas that won’t come out, and seriously their vaginas seem to basically explode pushing the baby, resulting so many large, painful lacerations requiring long and difficult repairs. While I have heard many times that this is a tough job to start with as a new midwife, I have found it keeps me up with my critical thinking and practical skills that may not be used very much in a very “normal birth” kind of setting. While I don’t particularly enjoy those teeth grinding, sweating bullets situations, it definitely keeps me more aware and up on my little midwife toes.
While I was a little traumatized by many of the birthing practices I saw in Argentina, I do frequently find myself thinking “what would the Argentineans do?” when I am in a grind. For example, one practice we learn here in the States that I really loathe doing is clamping and cutting a tight umbilical cord around the neck. I have had a couple experiences in training and at work where after cutting the cord around the neck after the head is born, it is only to find the shoulders to be tight and difficult to deliver. Cutting the cord before the baby is born leaves the baby without a life line that is crucial during a tight shoulder scenario. These babies usually need more help than usual getting started breathing and reacting after birth, and it is terrifying. What I found in Argentina is that they rarely even check for a cord around the neck after the baby is born, and even when there is one, there is no worry, because there is never any unlooping or cutting the cord before the body is born. Rather, they deliver every baby by what is referred to as the “somersault maneuver.” This technique is accomplished by simply tilting the baby’s face downward to the mother’s thigh after the head is out, then the rest of the body is then delivered in something like a flip, or somersault fashion, keeping the neck (and cord) close to the vagina to prevent pulling. When I first had this explained to me, and even after seeing it and being taught to do it hands on, I never ever thought I would have the coordination to pull this stunt off. Not when I’m in the middle of a delivery and nervous enough as it is! Strangely enough, the first few vaginal births I had after coming back from Argentina, I found my hands automatically flipping the baby out every time without trying; it just seemed like the natural thing to do, especially with a cord around the neck.
Another interesting fact is that I rarely have patients that speak English. And translators are not always readily available. While I am able to speak easily to my Spanish speaking patients, trying to communicate in Creole is a challenge I am not yet ready to face. I spent a day or so seriously studying the language, trying to memorize words and phrases, feeling ready to start learning Creole as my third language. “No gen pwoblem” right? Yeah, the next day I forgot everything, but felt a little more in touch with the broken French and clicking that I feel I will never able to reproduce.
Nonetheless, I am getting by. After a full 60-hour work week, I feel I can do [almost] anything. I can say I continue learning new thing every single day, and while I do miss my job as a nurse at times, I am glad to be in the profession I have come so far to do. I say my prayers daily, before and after work, and often during the day, because I know that “You Lord give perfect peace to those who keep their purpose firm and put their trust in You.” It was a verse that I kept with me all through midwifery school, and I will continue to live by it now as a professional.
If you have ever watched the show “Call the Midwife,” you will notice in the very beginning of the show, where the opening credits start, there is a visual of someone’s diary, and it says “Chapter 1: Why did I start this?” I highly recommend watching that show, its British but its phenomenal. And if you do watch Call the Midwife, this is an EXCELLENT parody to the show and a couple other, and it is absolutely hysterical. I know my fellow midwives will enjoy this one…