tag:blogger.com,1999:blog-56164527393790094202024-03-13T05:21:01.815-07:00Catch and ReleaseJournal of A Burgeoning MidwifeL.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.comBlogger24125tag:blogger.com,1999:blog-5616452739379009420.post-70182646128926494292012-08-02T07:45:00.001-07:002012-08-02T07:46:23.905-07:00First Day On the New Job<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;"><i>Today is the first day of me officially being a stay-at-home mum. I resigned a nursing position in labor and delivery yesterday. </i></span><br />
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;"><i>I've worked since I was 15 years old.</i></span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;"><i>I am thrilled and scared to death. </i></span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;">So yes, we did get pregnant again, which was at first a nerve wracking experience as it came right on the heels (3 months) of the ectopic. Our little daughter "V" was born February 16, 2012. We delivered naturally in the hospital where I worked (!), surrounded by my sweet colleagues who were both intrigued and adamant that I have the "granola" delivery I was so set on. We used "Hypnobabies," (at least I think we did...I fell asleep after every contraction. I also fell asleep while I was pregnant, listening to the hypnosis tracks.), my husband caught and we used LeBoyer's "Birth Without Violence." It was an amazing experience, and little V came into the world quietly, staring around her like the little old soul that she is.</span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;">And she's six months old today.</span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;">My bright, sweet, blue-eyed girl with the lightning quick smile and the curiosity of ten babies...</span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: x-small;">I've never been in love like this before.</span></div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-44597480446130123942012-08-02T07:22:00.000-07:002012-08-02T07:22:16.256-07:00So this is me, attempting to catch up. I haven't written in what we call in the South, "a month a Sundays."<br />
<br />
Our first pregnancy (Dec. 2010) turned out to be an ectopic. I made it to 10 weeks "pregnant," marveling at how great I felt, reveling in the excitement of "carrying life." While I was at work, helping a sweet couple labor with their first child, I began, very quietly, to bleed.<br />
The smooth even of my world shattered in an instant. My husband collected me from work, and the midwife's voice on the phone confirmed it after the emergency blood work: no baby for us. The next morning in her office, as I sat weeping, she patted my shoulder and informed me that, "this, too, is a side of being a midwife."<br />
<br />
From there, it's a fog of endless glasses of water, repeated violations with the vaginal ultrasound probe, empathetic faces averting their eyes from mine, and explaining it a million times over to everyone: "Yes, Gran. My body<i> thought it was</i> pregnant. No, there never was any baby. Yes, I'm fine." Whatever that meant.<br />
<br />
A shot of methotrexate and a few weeks later and I was back to work, ready to get about the human business of moving on.<br />
<br />
Not long after that, I woke around five a.m., cramping. Thinking I was having gas pains, I decided to get up and walk around a bit. 10 minutes after getting out of bed, I was dry-heaving on the floor, sweat dripping into my eyes and down my neck. In between heaves, I screamed for my husband. My appendix was apparently rupturing. My dumb luck.<br />
<br />
About half an hour later, the E.R. doctor was asking me about my ectopic a few weeks previous. Through a haze of pain, I snappishly asked what the ectopic had to do with the price of tea in China. He calmly responded that my severe pain was likely due to a complication from that, not the appendix as I'd thought.<br />
We found out a day later that my ovary (presumably the site of implantation for the ectopic) had been very kindly leaking blood into my pelvis, which eventually caused my sudden and severe pain. Excellent. My utter dumb luck.<br />
<br />
But, like all tragedies, it's begun to fade. Somewhere in there I withdrew from grad school. Angry at the process of childbearing (and sometimes, as in my case, losing) I took my revenge by vowing to have no part in it.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-52288033649071074692012-07-31T06:52:00.002-07:002012-07-31T06:52:44.303-07:00<br />
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<span style="color: #999999; font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif; font-size: small;">Some of the language is objectionable, but I give you:</span></h2>
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<a href="http://www.blossombelly.com/2011/04/21/tina-feys-prayer-for-her-daughter/" rel="bookmark" style="color: #336699; margin: 0px; outline: none; padding: 0px; text-decoration: none;" title="Permalink to Tina Fey’s Prayer For Her Daughter">Tina Fey’s Prayer For Her Daughter</a></h2>
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<em style="margin: 0px; padding: 0px;"><b>First, Lord: No tattoos. May neither Chinese symbol for truth nor Winnie-the-Pooh holding the FSU logo stain her tender haunches.</b></em></div>
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<em style="margin: 0px; padding: 0px;"><b>May she be Beautiful but not Damaged, for it’s the Damage that draws the creepy soccer coach’s eye, not the Beauty.</b></em></div>
<em style="margin: 0px; padding: 0px;"><b><div style="margin-top: 10px; padding: 0px;">
When the Crystal Meth is offered, May she remember the parents who cut her grapes in half And stick with Beer.</div>
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Guide her, protect her<br style="margin: 0px; padding: 0px;" />When crossing the street, stepping onto boats, swimming in the ocean, swimming in pools, walking near pools, standing on the subway platform, crossing 86th Street, stepping off of boats, using mall restrooms, getting on and off escalators, driving on country roads while arguing, leaning on large windows, walking in parking lots, riding Ferris wheels, roller-coasters, log flumes, or anything called “Hell Drop,” “Tower of Torture,” or “The Death Spiral Rock ‘N Zero G Roll featuring Aerosmith,” and standing on any kind of balcony ever, anywhere, at any age.</div>
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Lead her away from Acting but not all the way to Finance. Something where she can make her own hours but still feel intellectually fulfilled and get outside sometimes And not have to wear high heels.</div>
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What would that be, Lord? Architecture? Midwifery? Golf course design? I’m asking You, because if I knew, I’d be doing it, Youdammit.</div>
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May she play the Drums to the fiery rhythm of her Own Heart with the sinewy strength of her Own Arms, so she need Not Lie With Drummers.</div>
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Grant her a Rough Patch from twelve to seventeen. Let her draw horses and be interested in Barbies for much too long, For childhood is short – a Tiger Flower blooming Magenta for one day – And adulthood is long and dry-humping in cars will wait.</div>
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O Lord, break the Internet forever, That she may be spared the misspelled invective of her peers And the online marketing campaign for Rape Hostel V: Girls Just Wanna Get Stabbed.</div>
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And when she one day turns on me and calls me a Bitch in front of Hollister, Give me the strength, Lord, to yank her directly into a cab in front of her friends, For I will not have that Shit. I will not have it.</div>
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And should she choose to be a Mother one day, be my eyes, Lord, that I may see her, lying on a blanket on the floor at 4:50 A.M., all-at-once exhausted, bored, and in love with the little creature whose poop is leaking up its back.</div>
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“My mother did this for me once,” she will realize as she cleans feces off her baby’s neck. “My mother did this for me.” And the delayed gratitude will wash over her as it does each generation and she will make a Mental Note to call me. And she will forget. But I’ll know, because I peeped it with Your God eyes.</div>
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<b><em style="margin: 0px; padding: 0px;"></em></b></div>
<div style="margin-top: 10px; padding: 0px;">
<em style="margin: 0px; padding: 0px;"><b>Amen.</b></em></div>
</div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-89881799682772297982011-03-30T13:46:00.000-07:002011-03-30T13:46:10.226-07:00After AllBonjour, mes amis.<br />
<br />
Still here.<br />
Kicked while I was down, (multiple times),<br />
but still here.<br />
<br />
i have meandered the full spectrum of grief:<br />
i have been wild and angry,<br />
despondent,<br />
and have begged on my knees.<br />
<br />
i have cried out,<br />
stamped my foot,<br />
shaken my fist at the Heavens.<br />
i have rationalized,<br />
withdrawn,<br />
and turned myself inside out.<br />
<br />
but i am still here.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-88546101799737717722011-01-09T17:15:00.000-08:002011-01-09T17:15:23.230-08:00le Grand SecretThis is impossibly fun.<br />
To be amidst a group of people that are not yet privy to a secret that will make them ever so happy...<br />
my husband and I keep winking at each other over everyone else's heads.<br />
<br />
It's gloriously excruciating.<br />
<br />
And I still cannot seem to stop grinning.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-69785253951966372942011-01-03T09:19:00.000-08:002011-01-03T09:22:56.293-08:00New<span class="Apple-style-span" style="color: #ead1dc;">We have just discovered that we are five weeks pregnant with our first child.</span><br />
<span class="Apple-style-span" style="color: #ead1dc;">I am overjoyed, and overwhelmed. So much to do, to read, to prepare!!!</span><br />
<span class="Apple-style-span" style="color: #ead1dc;">And in the midst of it all, a nervousness, holding hands with a very calm feeling of completeness.</span><br />
<span class="Apple-style-span" style="color: #ead1dc;"><br />
</span><br />
<span class="Apple-style-span" style="color: #ead1dc;">I just can't quit grinning to myself.</span><br />
<span class="Apple-style-span" style="color: #ead1dc;"><br />
</span><br />
<span class="Apple-style-span" style="color: #ead1dc;">It's like an amazing, exciting secret that only I know.</span><br />
<span class="Apple-style-span" style="color: #ead1dc;"><br />
</span><br />
<span class="Apple-style-span" style="color: #ead1dc;">This will be the year of New.</span><br />
<span class="Apple-style-span" style="color: lime;"><br />
</span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLZkJ97MLkoIdlrcrSK4SCIDfzlseeIj0B8wzyqT52zka730QBdSe68-lBwHo8sZq-pkEoiUvlAxp_quOIInftBfMyU5hylBsCzubnLTcH8aKkBJZSypdzOAh6wbjomJmM305SoOL4p0c/s1600/MoonRise.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLZkJ97MLkoIdlrcrSK4SCIDfzlseeIj0B8wzyqT52zka730QBdSe68-lBwHo8sZq-pkEoiUvlAxp_quOIInftBfMyU5hylBsCzubnLTcH8aKkBJZSypdzOAh6wbjomJmM305SoOL4p0c/s320/MoonRise.jpg" width="236" /></a></div><span class="Apple-style-span" style="color: lime;"><br />
</span>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com2tag:blogger.com,1999:blog-5616452739379009420.post-51625442889444504172010-12-15T14:03:00.000-08:002010-12-15T14:03:05.747-08:00<span style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: x-large;"><b>GAHHHHHHHHHHH!</b></span></span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: x-large;">Finals this week.</span></span><br />
<span style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: x-large;"><b><span style="font-size: small;">Grad school is a nasty, nasty homewrecker.</span></b></span></span>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-84705345196884850632010-12-15T13:59:00.000-08:002010-12-15T13:59:25.870-08:00Nitrous Oxide For Childbirth<a href="http://www.scienceandsensibility.org/?p=1129">http://www.scienceandsensibility.org/?p=1129</a><br />
<br />
Fascinating interview with one of the "Giants" of Midwifery, Judith Rooks.<br />
<br />
I hate to go all "feminist patriarchy-basher" but as I read the portion about the male OB/GYN that was uncomfortable watching the woman in labor, it definitely occurred to me that if you are uncomfortable with the process, you probably shouldn't be involved.<br />
<br />
Watching someone hurt is not a pleasant experience (or not for the psychologically sound, at least), but it is a part of laboring to give birth. It is, for better or worse, a natural part of the process.<br />
<br />
As soon as finals are over, I'm considering writing to the director's boards of the hospitals in my hometown to let them know about this.<br />
I may even reactivate my Facebook to get the word out for others to do the same.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com2tag:blogger.com,1999:blog-5616452739379009420.post-48636446972163113982010-07-14T14:39:00.000-07:002010-08-09T12:31:54.846-07:00Principles Of PharmacodynamicsFound in my <i>Pharmacology for Nursing Care </i>text, "...it is neither appropriate nor desirable to hunt squirrels with a cannon."<br />
<br />
Quite so, you may respond, but what on earth have either squirrels or cannon to do with pharmacology?<br />
<br />
In short, nothing and everything, grasshopper.<br />
This is very typical of my particular journey on the path to becoming a midwife.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-1145960554716435062010-07-10T20:28:00.000-07:002010-07-14T11:40:21.814-07:00Some Like It Hot<div style="text-align: right;">I Love Natural labor. </div><div style="text-align: right;">I love how unpredicably predictable it is. </div><div style="text-align: right;">I love that women go through (almost!) the same pattern for labor and birth.</div><div style="text-align: right;">I love the cheerleading.</div><div style="text-align: right;">I love the nervousness of a first-time Dad. </div><div style="text-align: right;">I love showing them what to do to help the laboring Mum.</div><div style="text-align: right;">I love the adrenaline of catching.</div><div style="text-align: right;">I love that it's normal.</div><div style="text-align: right;">I love that it's a connection to all the women who've gone before me,<br />
and all the ones to follow.</div><div style="text-align: right;">I LOVE Natural labor. </div><div style="text-align: right;"><br />
</div><div style="text-align: right;"> </div><div style="text-align: right;"><br />
</div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com2tag:blogger.com,1999:blog-5616452739379009420.post-76791783500202135382010-07-01T08:16:00.000-07:002010-07-01T08:16:14.443-07:00Hands To ThyselfThe mamas that don't need mothering disconcert me.<br />
I'm unsure of my footing with them.<br />
<br />
They are quiet, and hard to draw out.<br />
And not in the "laboring quietly" sort of strong way; it's more of a disdainful sort of laboring. <br />
I can almost always forge a connection with the women I labor.<br />
Almost.<br />
The times that I cannot, though, are the awkward times.<br />
I slip into the old feelings of being too young for midwifery. Too naive.<br />
<br />
Even though, I know myself well enough to know that I will be one of those mothers.<br />
The ones that don't really want your coddling.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-28461289803867741972010-05-25T16:27:00.000-07:002010-05-25T16:27:45.101-07:00Birth Center WorkshoppinWent to the "How To Start A Birth Center" workshop in Charleston this past weekend, and it was entirely overwhelming with waaaaay too much information.<br />
I went with these rosy expectations of what a birth center was - mostly a cute victorian house with an herb garden - and left utterly schooled.<br />
I realized that attempting to open a birth center by myself was not only implausible, but rash and irresponsible. Doomed to failure, really.<br />
(And since I am twenty-six years old with three shock-white hairs already...well, I'd prefer not to be completely white-haired by the time I'm thirty-five.)<br />
<br />
But that's not the end. My busy little brain is reformulating and regrouping. Reconsidering battle strategy to save the women of my hometown from the Dreaded UnNecessarean.<br />
<br />
To be continued....<br />
<br />
Oh! And also, my undercover research is coming up on the six month mark, so the results to be posted in the next few weeks. Prepare to be shocked and amazed!L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-85879102200527012412010-03-26T19:25:00.001-07:002010-03-26T19:25:59.953-07:00One Down...Nine (?) To Go.First term of school officially over.<br />
GPA intact and improved.<br />
How the hell it happened? I have no clue.<br />
<br />
Onwards and upwards.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-32438931466160199212010-03-23T12:10:00.001-07:002010-03-23T12:10:53.771-07:00midwife's hands<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4fjyzkag6uP1vgNxQBbTzQY4xeTaEzuZQXR2DOmkhFdlYjE9WyLNgo4kcZg6-3gn6XfZuOYsagffAk-W0RrZ8LB0tUpJSXRBGLt1xlmN4A1RGXuZ2jz_s3XdOe-0JoZr5t87sGNlVa6w/s1600-h/midwife.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4fjyzkag6uP1vgNxQBbTzQY4xeTaEzuZQXR2DOmkhFdlYjE9WyLNgo4kcZg6-3gn6XfZuOYsagffAk-W0RrZ8LB0tUpJSXRBGLt1xlmN4A1RGXuZ2jz_s3XdOe-0JoZr5t87sGNlVa6w/s320/midwife.jpg" width="256" /></a></div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-18129447480081324482010-03-21T08:37:00.000-07:002010-03-21T10:33:16.230-07:00The RockStar Delivery of Tiberius Achaemenes<div style="text-align: right;">Yesterday, I pushed with a Mum going natural from 0715am until delivery at 1134am.</div><div style="text-align: right;"><br />
</div><div style="text-align: right;">Let me repeat, Mum was au naturale without so much as a Tylenol from the time her labor started (1730pm on the 19th) until she got a pudendal block for the forceps at 1130 on the 20th.</div><div style="text-align: right;"><br />
</div><div style="text-align: right;">And she didn't even want the pudendal! We had to coerce/strongly encourage her to take it. </div><div style="text-align: right;">And once the forceps were on, I'm pretty sure she was glad she got whatever little relief from the pudendal that she did. (A pudendal block is an intra-vaginal injection of anesthetic that supposedly numbs the perineum, vulva and vagina.)</div><div style="text-align: right;"><br />
</div><div style="text-align: right;">She had a doula, who was (thankfully) awesome. </div><div style="text-align: right;">But have mercy. </div><div style="text-align: right;">I needed a doula, too. Someone to tell me to "keep breathing" and offering me water. </div><div style="text-align: right;">And maybe the Doula needed a Doula.</div><div style="text-align: right;">Over four hours of pushing, and we were all exhausted.</div><div style="text-align: right;"><br />
</div><div style="text-align: right;">GooberDoc, who is not her primary but is just on call for the group wants the patient to have pitocin to increase the frequency of her contractions. The patient (literally) growled at him. </div><div style="text-align: right;">Granted, in GooberDoc's defense, she did need at least a sniff of pit. Her contractions were 2-7 minutes apart, and this was after two hours of pushing already. </div><div style="text-align: right;"><br />
</div><div style="text-align: right;">Outside the room, GooberDoc says to me, "If she is so fucking crazy that she wants to do this her way, I'll let her keep going... It doesn't hurt <i>me</i> at all." (Side note: this is how he earned the title of "GooberDoc.")</div><div style="text-align: right;">Really? </div><div style="text-align: right;">Perhaps you should've been a dentist, </div><div style="text-align: right;">or a dermatologist.</div><div style="text-align: right;">Bastard.</div><div style="text-align: right;"><br />
</div><div style="text-align: right;">Nothing perturbs me quite like a male doctor making some borderline (or even over borderline) comment about my gender, and expecting me to agree, or laugh along with their asinine comments.</div><div style="text-align: right;">It's the equivalent of telling a "black joke" to a black girl, and expecting her to giggle, just because you're <i>sharing</i>. </div><div style="text-align: right;">Bastard.<br />
<br />
Anyway, RockStar Mum had a tiny first degree (so GooberDoc is good with the forceps) and a gorgeous, gorgeous, baby boy.<br />
Tiberius Achaemenes isn't his real name, by the way.<br />
But I am thoroughly convinced that it should've been. <br />
<br />
</div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com1tag:blogger.com,1999:blog-5616452739379009420.post-46370437087333061092010-03-13T22:22:00.000-08:002010-03-21T08:22:14.876-07:00Catch!Today was a triumph.<br />
I fought for my patient and we won.<br />
<br />
She was dead set against an epidural, and had gone natural with her first baby, over 17 years prior.<br />
When I got report, I was told she was a medical induction for pregnancy-induced hypertension (high blood pressure). She had come in the night before, at only a centimeter or two, and the Doc had broken her water. Since then, she had progressed slowly to four centimeters, and at the last exam (@0630), she was finally seven centimeters.<br />
Great.<br />
So I went down to meet her, and it was just her and baby-daddy in the room, and she was side-lying in the bed. (Let me say now, that this is one of my pet peeves. Women in labor should be UP! Using gravity to its fullest advantages.)<br />
I asked her how she was feeling, she said not so great, since they wouldn't let her out of the bed, and her hips were "killing her" from lying down so long. She said the night nurse had made her use the bedpan because her blood pressures were "so high" that she was afraid getting up and down to the bathroom would only increase them. Her blood pressures were running 140s-150s systolic, with diastolic within normal limits. (Normal BP is considered 120/80. The newest guidelines actually state 120/70. Fluctuation is normal, though, and this is only a guideline.)<br />
*Sigh*<br />
So this is were I got a little pissed. Well, yeah, she's putzed along all night, because we stalled out her effing labor by making her lay in one of two positions and not letting her MOVE!<br />
Grrrrrrrrr.<br />
Ignorance gets my Irish up. <br />
So we got her up to a rocking chair at bedside and she was much happier after that.<br />
This was all at around 7:00am.<br />
Doc shows up at 7:30, and checks her cervix. She's only 4 centimeters. He recommends an epidural so we can go ballistic with her pitocin (a med used to induce or augment labor). He didn't say "ballistic" but that's exactly what he meant. He also told her to start thinking of a cesarean section. He then proceeded to blindside me by announcing to the patient and baby-daddy that their nurse (moi) is an "anti-epiduralist."<br />
Hmmmmph.<br />
He sarcastically asked if I had any suggestions, to which I stammered something about moving around more...I know, I know. I dropped the ball.<br />
He and I left the room. As soon as the door was closed, I mimed kicking his shins. He feigned shock.<br />
I told him that it wasn't fair of him to put me on the spot like that, in front of a patient that needs to trust me. He said that he had given me an opportunity, and I hadn't taken it. I got irritated, (i.e. grew a set) and told him that it wasn't like he would've actually taken my suggestions as he obviously just wanted his patient epiduralized anyway.<br />
He again, feigned shock.<br />
He asked me why I am so "anti-epidural."<br />
I told him that it's because: we give the epidural, then the catheter into her bladder because she can no longer safely get out of the bed to urinate. This is a risk for infection. Then her labor will slow, so we have to intervene, to augment her labor even more. Then we stress her baby, or her uterus, so we have to give a med for that. Or we just take the big leap, call her a "Failure to progress" or a "Fetal Distress" and back she goes for a cesarean section. In a nutshell, epidural = more interventions = cesarean section likelihood increases drastically.<br />
He rolled his eyes. But! I tell him, the literature supports these findings!!! And I have personally given this very doctor the printed research articles that show this. Because I am a Grade A Dork.<br />
(But you can't argue with college kids that have access to online article databases. I can find the article to support my claim that the sky is in fact green, if I want to.) <br />
Okay, he says. You've got an hour. If there is at least one centimeter of change in one hour, you can keep doing it your way. No cervical change in an hour, she gets the epidural.<br />
Fine, I say, shall we synchronize watches? He rolls his eyes.<br />
We go back into the room where the patient is sobbing and saying, "But <i>why</i> do I have to get an epidural? I know I can do it naturally. I've done it before." He tells her to stop crying, that her nurse "went to bat for her." I grin at her. He wants me to check her cervix, so we can both agree on what 4 centimeters is for this patient (This is because cervical exams are rather subjective. What I call 5cms, someone else may call 4cms, or even 6cms. The only two checks we all agree on are "Closed," or 0cms, and "Complete," or 10cms.).<br />
I check her, we agree, he leaves.<br />
We get to work.<br />
The baby, of course, starts with the variables as soon as I get ready to put her on telemetry monitors so she can walk around the unit. (Variables mean the baby's heartbeat is having small decelerations with the contractions.)<br />
I switch to plan B, the birth ball. I put her on that, and for the next hour, she huffs and puffs her way to a true 6cms. This was at 0850. The variables came back, so I left her in the bed, on her side with some O2, while I went to call Doc to let him know she was progressing. She was hurting, but still pretty well in control.<br />
At the desk, she starts having deeper, more often variables (as most people involved with labor/birth can tell you, for a mum going naturally, this usually means the baby is moving down F-A-S-T). I ran back to check her. She is now 7cms. I tell a nurse standing by to tell the unit secretary to call the Doc. She does. I don't leave the room because I know I'm about to need to catch a baby...<br />
Doc gets transferred to my phone (we carry unit cell phones), and I can hear that he is driving. He says he is about 13 minutes away. I tell him he is clearly not going to make it. Mum shouts that the baby is coming, and she is trying not to push.<br />
The head comes out anyway. I drop my phone (with Doc still on it), sit down on the bed, and deliver Mum's baby. Mum's first words as she delivers:<br />
"Oh my God! My Baby!!! Laura, we DID it!!! Camera! Camera! Is somebody taking pictures!?"<br />
<br />
I felt so validated in the profession that I have chosen.<br />
Doc congratulated me, and told me that I should be proud for a job well done.<br />
I didn't gloat.<br />
But I'm pretty sure I was glowing.<br />
And maybe next time, he'll read one of those articles I gave him.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com1tag:blogger.com,1999:blog-5616452739379009420.post-10050661477491162602010-02-20T19:08:00.000-08:002010-02-20T19:08:40.454-08:00And Miles To Go Before I SleepToday's lesson was that no woman is an island...<br />
As Lone Hero Nurse, I drowned miserably, while the tiny hospital-world kept spinning, in spite of my martyrdom. <br />
It was a hard lesson for me.<br />
<br />
And here I sit at ten p.m., awake since 5:30 this morning, having worked all day, and still have my portion of a paper to write that's due tomorrow.<br />
<br />
Waaaah.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-60710954653948745672010-02-19T19:04:00.000-08:002010-02-19T19:04:07.092-08:00The Ugly TruthToday was rough.<br />
I stood in on a delivery with a first time mum that really had to work for it. She got the epidural, and it crapped out before the end. She could feel pretty much everything, but she did great, and stayed very in control. She pushed for around an hour and a half, and then Hero Doc breezes in, gowns up and delivers the baby.<br />
Mum sustained one second degree laceration midway from vagina to rectum. She had another second degree laceration from clitoris to urethra. Double ouch.<br />
As Hero Doc starts to repair, it becomes painfully clear that Mum can feel every, single thing he's doing to her.<br />
Hero Doc continues to sew.<br />
I offer local anesthetic.<br />
Hero Doc ignores me.<br />
I offer local anesthetic again, louder.<br />
Hero Doc ignores me and continues to sew.<br />
I address the tech behind Hero Doc and tell her to bring the man some local, STAT. While she's out getting it, he continues to sew on Mum. I'm wondering what in the world is so pressing that he needs to hurry and finish with this patient before he moves on... <br />
The tech gets the local anesthetic and preps it on Hero Doc's table.<br />
He continues to sew without it.<br />
It was at this point, that it dawns on me, that Hero Doc is an apparent sadist, and quite possibly a He-Man Woman Hater.<br />
The poor mother is sobbing, and trying to writhe in agony in a way that she hopes will not annoy her doctor...it was really pitiful to watch.<br />
I enlisted the help of her labor nurse (i.e. dug my elbows into her ribs) to prevail upon Hero Doc the prudence of using the lidocaine.<br />
Hero Doc gave up and used the local, but he was really digging and gouging at her, a touch more than was really necessary.<br />
It was then that I was wondering how he would like someone suturing his scrotum without local. <br />
I knew if I said anything to him, it would get ugly fast. So I squeezed Mum's hand, and encouraged her breathing.<br />
But you better believe I a) glared two laser holes into the back of Hero Doc's head, b) ripped him a new one to the charge nurse, and c) wrote his ass up.<br />
What a disgusting, miserable person, that can suture his patient, knowing she can feel every stitch...!<br />
It was all I could do to stop from grabbing his hand. Good thing Mum had a death grip on mine.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com1tag:blogger.com,1999:blog-5616452739379009420.post-70770114104930821352010-02-18T07:43:00.000-08:002010-02-18T07:43:46.528-08:00HeavyI'm learning a lot about myself.<br />
I hate...abhor...and <b>Loathe</b> the overwhelming fact, that I am a procrastinator of the worst sort.<br />
I just want to get to the meat of being a midwife, already.<br />
<br />
Or do I?<br />
Is this dragging of feet a subconscious plea to wait, and listen? That maybe midwifery isn't really for me?L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-67838039897115290152010-02-17T17:55:00.000-08:002010-02-17T17:56:45.264-08:00BlueprintThe plan was always five steps:<br />
a) become a Doula<br />
b) get the associate nursing degree<br />
c) finish the bachelor nursing degree<br />
d) tackle the master's midwifery degree<br />
e) open the birth center<br />
<br />
And so, here I am. On the eve of step four. I'm amazed that I've made it this far. Not because I doubted myself, I just didn't realize it would happen so fast. Or maybe I've been so intent on the journey, that I forgot all about the destination. That there actually <i>is </i>a destination.<br />
<br />
But here I am. I have reached the peak of the mountain, and the view is...<br />
daunting.<br />
More peaks ahead. Rough climbing. Solo-work. Social excommunication. And the nagging feeling of being tethered down, of staying in one place.<br />
The rest of my life written.<br />
I've always enjoyed the luxury of thinking, "One day, I will live in a gigantic, drafty, crumbly Italian villa, or cozy English cottage...I will travel frequently, and study flamenco in Spain. I will probably live in France for awhile and have a brief romance with a nerdy-but-charming French bookseller...I will do all of that and so much more."<br />
<br />
But in the shower this morning, it occurred to me, that the odds are I will never do any of that. Especially if I stay here, devote myself to a midwifery practice and potentially open a birth center. There would be no room for any of those other things.<br />
And it sort of saddens me, that the luxury of my youthful dreaming is so quickly running out.<br />
I feel this loss keenly.<br />
And it makes me doubt myself, and the foundations I have laid.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-86797255661494168192010-02-17T13:25:00.000-08:002010-02-17T13:25:30.156-08:00<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVMqotmStXjMNm5AkrzTub1Y6xBHBynVfEnAf7HQFszTGBVfalGDjBM_qjsfV7HFBidFj0L-GEPtXoYr9ub1uvtissid8yKfPtlag4a7AfxqBqvOJBhCG98WswvZs9qOhVD2Nvcnbv9mo/s1600-h/mia_71822e.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVMqotmStXjMNm5AkrzTub1Y6xBHBynVfEnAf7HQFszTGBVfalGDjBM_qjsfV7HFBidFj0L-GEPtXoYr9ub1uvtissid8yKfPtlag4a7AfxqBqvOJBhCG98WswvZs9qOhVD2Nvcnbv9mo/s320/mia_71822e.jpg" /></a></div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-10946988367491939832010-02-17T13:05:00.001-08:002010-02-17T13:06:06.469-08:00The Importance of Waiting<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdDIrmqUFXiEZlVjF7RjXRu0b3MB5f6k16eF7zoGBJ7Acq35UM2c6r4fQD1GnsmRnyxtTPRK_-1jNf3QVKID98w95E5VCpuLk7nZV5ng_GyW1TNdEGugT8ShCgNKoN3UdyPXvBoWOhthc/s1600-h/c-5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdDIrmqUFXiEZlVjF7RjXRu0b3MB5f6k16eF7zoGBJ7Acq35UM2c6r4fQD1GnsmRnyxtTPRK_-1jNf3QVKID98w95E5VCpuLk7nZV5ng_GyW1TNdEGugT8ShCgNKoN3UdyPXvBoWOhthc/s320/c-5.jpg" /></a></div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com1tag:blogger.com,1999:blog-5616452739379009420.post-14428671501230776102010-02-17T12:46:00.000-08:002010-02-17T12:46:44.600-08:00To A Delivery<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg70LQwE5eVeWnGwPSyey2w47HtuHf-FP0-BfhRtDd9DXpdDO1zX4Y2LsAThOc82LrCxwadnvhOI8xQjT0j_2WJOAfUMINSbB6MQhK3wbBmw3_AOD4GCKzZgp07XHSe58kohcRfO1Mm0qg/s1600-h/c.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg70LQwE5eVeWnGwPSyey2w47HtuHf-FP0-BfhRtDd9DXpdDO1zX4Y2LsAThOc82LrCxwadnvhOI8xQjT0j_2WJOAfUMINSbB6MQhK3wbBmw3_AOD4GCKzZgp07XHSe58kohcRfO1Mm0qg/s320/c.jpg" /></a></div>L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0tag:blogger.com,1999:blog-5616452739379009420.post-68616530905200771562010-02-09T20:12:00.000-08:002010-02-18T07:51:07.537-08:00L'HistoireI am in my first term of midwifery school, and it's been a long journey to get to this point, so I am determined to savor every single drop of this experience. <br />
I feel like this is the first profound thing I have done with my soul purpose in mind. Not "sole" purpose, but S.O.U.L. purpose. What I am meant to do. The work that my soul demands that I do.<br />
Feminism, female-ness, birth, feminist theory, the relation of women to women fascinates me.<br />
It captivates me and resonates in me. <br />
<br />
As I am writing a paper on the history of midwifery in America, I am struck, finally, by a sense of innate belonging.<br />
Something I have heretofore glimpsed, only.<br />
<br />
I'm a mixed woman, from a poor family. Growing up, it was mostly my mum and I alone, in my formative years. My mum's family know very little of where they came from, and our ties to one another are, sadly, not very strong at all.<br />
The older I get, the more I have come to regret and resent my lack of heritage.<br />
I grieve for the lack of strong women and strong female ties in my upbringing. <br />
<br />
It is this grieving, regret, and resentment that have caused me to "mother" myself.<br />
<br />
I have found my history in the history of American midwives. I have found it in the thousands of women-healers burned during the fifteenth and sixteenth centuries in Europe during the Inquisition.<br />
Those were my ancestors.<br />
I'm not sure of the exact linear relations, but I know the blood of these women flows through my veins.<br />
<br />
I speak with their voices, and see through their eyes.<br />
<br />
I look at my hands, and realize that, these hands, in new skin, have been around for centuries.<br />
They've caught babies for thousands of years.<br />
<br />
This is my history.L.K. Moorehttp://www.blogger.com/profile/13173968692715188594noreply@blogger.com0