Friday, February 12, 2010

With Woman - Rachel's Experience

Rachel is a Labor & Delivery Nurse who also blogs about pregnancy and motherhood. Visit her blog.

"Midwife is defined as "with woman", and that definition has played a role in how midwifes view themselves nowadays. I thought I'd just respond to this by relaying a few experiences I've had.

"The one thing I've noticed when working with hospital based midwifes, is that they show a lot of concern for the women's emotional health, regardless of the choices they make. If they have a woman that is going natural, they are there in the room most of the time. They are not just sitting, watching, and waiting. They are actively working with the women in their care. If a woman is using an epidural, they are still usually in the room or close by. They check on them quite often, rather than just relying on the nurse to do so. Very often, the midwifes stays at the nurses desk along with the nurse. And they also very often leave the bed together (no stirrups or leg rests) whether or not the woman has an epidural. They work with ob's, so that there is a sense of continuity of care if something should happen that needs more intervention. All in all I would in general recommend midwifery care for a low risk patient no matter what you are choosing to do with pain control.

"From my own experience using midwifes, I don't remember a lot of how they operated. I do remember feeling much more at peace and calm with my midwifes than I did with a physician. I felt like they were there for me from the onset and through labor. If I had questions, I could talk directly to them. I didn't have to wait for the nurses to decide it was important enough to call them. I also loved having them put my baby up with me after they were born from the get go. I was never made to feel like a medical case at any point.

"One of the hospital midwifes I worked with asked dad if he wanted to catch (the baby). He did and it was a neat experience. The mom had an epidural, but the midwife was still working to keep that connection together. I had just never done that before and I know the family really appreciated it.

"I think one of the neatest experiences I've had in being "with woman", was when I was working with a hospital based midwife. She stayed with the mother the whole time. As the mother was having a natural birth, both of our attention was undeniably on the mother. We watched her movements, tried to understand her needs, and spoke with her where she was at emotionally and physically at that time. I have never before experienced such an intense feeling of teamwork. Not only did we focus on the moms emotional needs, but there was a keen awareness of the need to focus on how the baby was doing also. There was no tension over whether there were too many interventions or not, because we were all on the same page. There was a sense of trust. And while there were some issues that were worrisome, there was no feeling of fear or adrenaline rush. We simply did what we needed to do. I think a lot of this was due to the fact that the focus was on the woman.

"The other time I think of, was when I was laboring with a woman who had intended on going natural. She had become exhausted by the time she got to eight centimeters. A decision was made at that time to get an epidural. She wanted to just have a light one so that she could feel a little bit more when she was pushing. Well, it came down to pushing time, and she pushed and pushed but that little baby just did not want to make his way down. So, me being the natural minded nurse I am, decided that having her push on her back the way I was taught she should, was ridiculous. I knew she was able to move a little bit more and we had lots of help, so we had her role over on her hands and knees and with support she pushed more.

"She eventually was able to push her baby out, but the thing that was most memorable for me, was how I loved working with her to decide how she might be able to push better. I loved supporting her in her desire to push the baby out, and in her desire to try different positions (we even had her squatting on the bed with some support). I loved being able to make sure that her new baby was still ok by holding on the monitor while she pushed instead of having it strapped to her. To me, supporting her in this way was one of the things I love the most about my job."

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