Last night I worked on night shift, and for the first time ever, I was taught how to check the fundus after birth, and I checked it myself once, too. I was thrilled that it’s actually there and palpable. I’ve always thought it’s crazy to try and feel for an organ inside the abdomen, and I didn’t believe I’d actually be able to feel anything. But I did!
I also learned in my reading that the #1 way to prevent tears during birth is a slow pushing stage. (And it’s actually better when the head emerges between contractions.) Last night I saw a physiologically “slow” (ie, absolutely normal) second stage. And no tearing 🙂 Which also helps there to be decreased blood loss.
I’ve been in school for 5 weeks–today is Saturday; it’s the completion of the 5th week. Week one was Orientation Week.
I’ve worked 5 shifts in the birth room (one shift I worked in August, because I arrived early). I’ve observed 5 births here. While working birth room shifts, I also observe immediate postpartum care, the newborn exams, 24-hour postpartum observation, newborn screening and discharge. I also observe return mother-baby checks (each client is under the clinic care through 6 weeks postpartum).
I’ve worked 4 days in the regular prenatal care room, taking vitals and observing a midwife doing prenatal visits. One of those days was a day of initial prenatals (the mother’s first visit to the clinic during her current pregnancy).
I’ve stared learning to measure fundal height, palpation of the fetus and finding and timing heart tones using a doppler.
This Monday was my first day to work clinical prenatal shifts (I’ve already worked several birth shifts); our job was to take initial vital signs on the moms coming into their initial prenatal visit.
I do confess, I was very clumsy! The first woman who sat down, I needed to count her pulse, and my own heart was pounding so LOUDLY it was all I could hear!
I also was trying to take her blood pressure with my stethoscope head turned to the infant side, so no wonder I heard nothing, and a teacher pointed out that this was why.
I have so many emoticon faces going through my brain while writing this post!!!
To get through it, I learned to go slowly, and fortunately, there was no hurry as the initial interviews take a lot longer for each woman to complete. I calmed myself down, positioned my chair so it was easy for me to hold her hand/arm to take her pulse and count respirations. There were a few other gaffes.
But! I made steps of learning! I’m so thrilled. I asked a teaching midwife for help with one blood pressure– it takes a lot of coordination to count backwards with the dial while watching the dial and listening for her heart sounds to start. And the midwife said something that made it *click* in my head–what I was supposed to be expecting to hear.
So I have practiced again on some family members, and it’s getting easier to hear that first knock of the heart and remember the number and ignore extraneous crackles.
Also, another teaching midwife let me sit with her for the initial exams, taught me about their computer program for entering data, and let me practice measuring fundal height and palpating the baby and using a doppler to hear heart tones. I have since practiced on myself feeling my pubic bone for FH (fundal height) measurements).
Overall, it was an amazing 4-5 hours. I learned a lot in a friendly, safe environment.
I’m also working through a required reading list. I’ve finished 14 of 25 books, and I’m reading #15 and #16 currently. It’s a range of reading–biographies of midwives, different cultures of birth, various birth models, missions books, midwifery books, women’s physiology and cycles books.
I’m specifically trying to choose books I’ve not read before, and this gives me a lot of choices.
In this photo is one page of the required reading lists to choose from, and the bottom page is my own list so I can track how many I’ve read from each section, when I finished, the date I wrote then submitted the review. The purple highlighting marks what I have read; the yellow marks what I’m planning to read.