Monday, 20 October 2008

Diary of a working midwife

Monday 20th October – Diary of a working midwife.

Any names or reference to events the details are changed to protect client confidentiality.

Its 5.30 am and only another three hours until the day staff come on duty. It has been a long night shift – 12 hours to be precise with only 30 minutes for a quick cup of tea and catch up on note writing before the next women needs attention in labour. A quick glance out of the frosted windows of the labour ward tell me that it is still dark and I can hear the wind and rain rattling the windows but all is warm and cosy and for the moment, quiet on the delivery suite.

Suddenly, the much longed for peace and quiet is shattered. There is an ear piercing cry like someone being attacked as a woman arrives in a wheel-chair at the door. She is obviously in advanced labour so she is wheeled straight into a delivery room. Her partner is asked to help myself and a colleague move her onto a bed so we can quickly assess the situation and the health of the baby and as we do so quickly gather a history about the woman, whether she has had any previous pregnancies, if so, how many, and any medical or obstetric problems. Whilst this is taking place, the woman is screaming and throwing herself about in pain and great distress. Her observations need to be taken and the baby’s heartbeat needs to be listened to. It also has to be ascertained that the baby is a term baby and that the woman is not about to birth a pre-term baby. In this first two to three minutes or so a great rapport and relationship has to be built up between not only midwife and woman but midwife and partner. They both have to be able to feel absolute trust and security with your skills and way of interacting with them. This is vital to ensure that a safe, happy outcome ensues and that what ever happens they are made to feel involved and part of the process.

Anyway, it is very quickly evident that the baby is term but it is breech (bottom first). This is classed as an obstetric emergency in out unit so the obstetric team has to be called for the birth. The woman is very frightened but she is quickly calmed and reassured by the skilful counselling of my colleague. Meanwhile, I put out a ‘crash call’ for the obstetric team who are in the room within seconds. All the equipment is assembled. The doctor makes a decision. This is the woman’s second baby, the baby’s birth is imminent. No time for c.section or theatre (thank goodness) but the team is outside the door in case. My colleague wants to deliver the baby with the doctor’s guidance (midwives in this unit do not have much experience of breech delivery so feel safer and happier with the doctor present). Nb this will be a topic of discussion over the next few weeks. Three minutes later baby is safely delivered, so is the placenta and all is well.

It’s amazing – after only being on the delivery suite fifteen minutes, the woman and her partner have become parents again and all is well. Baby is alert and crying, he is the one making the noise now, not the woman!! However, after another five minutes piece reigns again, baby Sam is on the breast and feeding contentedly.

6.30 am – still another 2 hours to go – plenty of time for a cuppa. Oh no there goes the bell again and the phone and the door. All in a days/nights work.

48 comments:

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I look forward to reading you desciption of a midwife's life. I'm a botanist, but I dream every day of going back to school and becoming a midwife.

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