The thing I lost in the fire.

I'm in the last few weeks of my first year of midwifery school. Only two years more before I graduate and become eligible to become a Florida licensed midwife! Time has flown by.

A lot has changed since I started midwifery school in August. One of the biggest changes came when Mike and I broke up during my first semester. I've been wanting to write about this for a while but how do you sum up two years in one blog post?

There is no blame for how our relationship ended. When I got the calling to become a midwife it was as if a fire consumed me. I was being pulled toward midwifery on an almost cellular level. It takes a lot of compromise and patience to date someone who is in midwifery school (or who is a midwife!). Not only was I spending two days a week in Gainesville, I could get called to a birth at anytime and not know when I'd be home. How would you feel if you had to share your partner with laboring families for hours, or even days, at a time? It's asking a lot.

I don't know if I was just extremely busy with school and clinic this past semester but I've been thinking about us more now than when we first broke up. I miss us. When I look back at the good times it brings a smile to my face because we had a lot of fun together. I miss our dog family, going to his moms to hang out and just spending time together. I don't regret going to midwifery school at all. I know that I'm in the right place. I just wish that we could have figured something out. I suppose everything is exactly how it should be.

I've been carrying around this ache for a couple of weeks. I am grateful for everything that has happened and I can't wait for all the changes that will happen next. When some people break up they see their relationship as a waste of time. I look back at our relationship and see it for all the ways it changed me in a positive way. Moving to Saint Pete, meeting my midwife preceptor, becoming a doula and applying to midwifery school all happened because of my relationship with Mike.

I haven't seen him since February but I wish him love and happiness in whatever he does. He truly helped change my life.

"Love hurts sometimes when you do it right." - John Legend

Pelvis Project

This semester is Reproductive Anatomy and Dr. Scott has gone crazy with the art projects! I'm no artist but here is my Pelvis Project. The female pelvic floor muscles and the female bony pelvis in 2 views. Thanks to my friends suggestion I used tracing paper and the project was 100 times easier than I thought! 

 

 My poster board

I traced those!

100,000

 

Well, it's official. My 2007 Toyota Corolla has over 100,000 miles on it!!! When I got to the hospital last night it registered at 99,999. Too bad I forgot to take a picture of it at exactly 100,000.

Each mile gets me closer to my goal of becoming a midwife.

(I sleep well at night knowing that I'm balancing my carbon emissions by being beef, pork and seafood free for the last ten year.)

"Best Doula Ever"

Today was the day of one of my happiest and most beautiful births (thus far).

The couple hired me late in their pregnancy after they took a childbirth education class at St. Joseph's (43% cesarean rate as of 2008)  and the teacher recommended that they hire a doula if they were wanting an unmedicated birth. I had met the couple a few times and was super excited to work with them. They were incredibly nice and the mom had such a beautiful pregnancy I just knew her birth was going to be amazing! Plus I had never doula'd at St. Josephs and was up for the challenge of preserving a vaginal birth at the hospital tied with Brandon Regional for the highest cesarean rate in the county.

I met the couple at their house around 2:30 pm yesterday after the mom's water started leaking at work around 10:30. After hanging out for a couple of hours (watching a child care video, walking on the elliptical, eating the best grilled cheese sandwich and with nipple stimulation for 20 seconds every 5 minutes) the contractions picked up a regular pattern. Around 8 pm the mom took a shower and the contractions were getting stronger, longer and closer together as time moved on. The dad did an AMAZING job at timing the contractions and keeping a log!

Dad's contraction log

Around 10:30 pm we decided to go to the hospital because I suspected the mom was in transition (good moaning sounds during the contractions, hot flashes, shaking). At 11:10 pm we were in our cars and on our way to the hospital (honorable mention: we made it to the hospital in 30 minutes when it usually takes 45)

Hospital art in the lobby

When the nurse checked her in triage she was 9.5 centimeters dilated! Family soon arrived and the baby was born gently, completely unmedicated and natural around 2:30 am. 

Beautiful baby boy

Today when I went to the bank to deposit the check that the dad had written for the birth in the 'for' line it read: "best doula ever." That just made me smile. While I am honored at the title, that birth would not have happened the way it did without the incredible way they worked together and their faith in her ability to birth their baby. It was an amazing experience to be a part of. I am so proud of them, it was beautiful.

Lunch with the ladies.

I just got home from a really nice get-together with the other student midwives in Pinellas county. It was so fun! One of the girls couldn't make it but me and the other two sat around and talked about birth for over 2 hours! It's so awesome to share the experience with wonderful people like my sister-midwives!

Hopefully we can keep it up and meet more often. It's always nice to share time with like minded people with similar interests!

Your placenta IS an organ

SO, I was at this (typical) hospital birth ALL day yesterday. After the birth the mom wanted nothing more than to be "unplugged" from all of the machines that were tying her to the bed. Joking with the mom I said, "you're already down one organ what more do you want?" The nurse, rudely snapped, "the placenta is not an organ it's the inside of an organ."

Ok, I'm not one to argue or bet but this woman is out of her mind. The placenta IS an endocrine organ. The first sentence of Wikipedia (which the entire world can access) begins, "The placenta is an organ..." The placenta is the only temporary organ. It's the baby's little apartment. It keeps the baby warm, safe and fed along with other magical things.

I really shouldn't be in shock. This woman was the nurse at my first birth that ended in a cesarean last January. She was rude to me then and was no better this time around, she wouldn't even sign my silent birth observe form!

Sometimes I wonder how and why some people became nurses! I don't even mean that in a bad way because I love nurses. My best friend is a nurse. My favorite teacher is a nurse. I respect and admire nurses. I wouldn't even mind being a nurse. They are typically full of amazing information, however, last night the nurse was way off base because: The placenta IS an ORGAN! (I promise)

I just don't understand how someone could complete something as difficult as nursing school, work in labor and delivery (for at least a year) and not know that the placenta is an organ. People with the "I don't know I just work here"- attitude really shouldn't be nurses and the nurse last night was one of those people!

ROM

ROM- rupture of (amniotic) membranes
SROM- spontaneous rupture of membranes, happens naturally during labor, pushing or at birth
PROM- premature rupture of membranes, happens at least an hour before the onset of labor
PPROM- preterm premature rupture of membranes, happens before the onset of labor before 37 weeks gestation
AROM- artificial rupture of membranes, happens when a physician or midwife purposefully rupture the amniotic sac releasing amniotic fluid

Before you arrive at your due date it is important that you research the rationale, benefits, risks and alternatives (including doing nothing) of AROM. It is one of the most commonly performed procedures in hospital birth. It has pros and cons and proponents on both sides of the coin.

Pro's
-May speed up labor by an hour
-Allows for the placement of internal fetal and contraction monitors
-Allows for the examination of amniotic fluid for the presence of meconium
-Used for labor induction (ALSO, understand the rationale, benefits risks and alternatives of induction before consenting to an induction)

Con's
-Opens the mother and baby to infection
-Places the laboring mother on a "time-clock" for delivery which may lead to other interventions (ie, Pitocin)
-Lack of mobility (must now stay on monitors)
-Umbilical cord prolapse
-May make contractions more painful

If you are declining AROM be sure that your provider is aware of your refusal of AROM before they perform each vaginal exam. If you are consenting to AROM it may behoove you to delay AROM until you have established a consistent contraction pattern in active labor, this way allowing for shorter time between rupture and birth. A shorter time frame between ROM and birth may help lower your risk of infection because of fewer vaginal exams.

Please, research your options. It is your right as a health care consumer!