La sexta semana/The sixth week Part III

I spent the rest of the afternoon doing rounds (checking fetal heart tones) with the student who was to be primary (this would be our second birth together in which I had been shadow primary) and checking fetal heart tones with the doppler. I also spent an hour with the Assistant Academic Director learning how to do PP citas. It was crazy to see all of the students sitting out in the sala together chatting and the office assistants joked that we had citas waiting. I had some chocolate pudding and carrot cake leftover from one of the staff midwives' birthdays and felt like I had done more eating than citas today! The young woman in the peach room labored mostly alone (her parents had left to get her some food - her parents were a fantastic couple and provided a lot of support in their presence) and when the primary inquired as to whether she was okay with this, she said she was fine. She tried to relax in the bed with calming music playing in the background. The student and I began staying in the room full time after she had eaten and began feeling much stronger urges to push. She was at 9cm and moved to the tub to prepare for the birth of her son. The student and I had been hearing screams from the purple room and were worried she was going to give birth at the same time as our client! Our client gave birth at 5:14pm to her son and I played the role of assist, providing towels, hats, and calling Apgar scores (the documenter did this because I am still learning how to call those) and really seeing how a water birth works. The midwife was literally back and forth between the rooms since the other woman was so close to giving birth, too; good thing there's a door connecting the peach and purple rooms!

Soon after this birth, birth team was called and I was asked to be documenter since one of the other students had gone to the hospital with a woman in pre-term labor. The woman gave birth at 6:17pm and was so gracious to all of us, thanking us over and over again for our being there during her birth. I was with her a very short time before having to leave to do a PP cita since there were citas waiting by this point. This would be my first PP cita alone and luckily I had had my lesson earlier in the day! The woman was here for her 12 day PP cita and seemed tired to me. She had a fifteen year old and five year old and said it was difficult having a baby again. The cita went very well and I was able to do everything, except check her fundus (checking her uterus to make sure it has contracted), the 12 day PP newborn screening (poor babies have to have their foot pricked again since they have it done on the day of their birth), and respirations for the baby (which is really difficult to learn). It was great to do a PP cita and spend time talking with the woman about her birth, breastfeeding, how everything was going, and any concerns or questions she had. It made me feel like I had gone through the entire cycle and spectrum of citas and care at MLL and I look forward to doing more. The client also had a calm, relaxed personality and it was nice to be with her energy after an hour of back to back births!

The night was young, though! I spent the next few hours checking in on the woman who had had the water birth, sitting down to some chicken and field greens with blue cheese dressing, cleaning more dishes (it really feels like they're never clean for very long), finding out the midwife's 2 month old baby had the same birthday as me!, and helping during the physical exam and newborn screening. During this span of time, a woman who had been in for a labor check, gone to eat, and returned settled into the rose room and another woman in labor (she was at 2cm, but progressing quickly and yelling a lot) had to settle into the divided sala since we had no rooms left. The student with whom I had been shadow primary and I worked hard to go through all of the paperwork and exams/screenings and I again interpreted as she explained how social security works. It was fun to weigh the baby and get guesses from everyone as to how much he weighed. The daughter spoke English (she was 18 and still had markings of pimples on her face, which reminded me how young she was) and her parents spoke mostly Spanish. She had been worried about whether she would be a good mom (the student had told her she would when she was laboring in the tub) and now when the student asked if she could believe she loved someone so much, she happily smiled and said no. She and her family left around 11:30 pm and it was special to have seen them through the labor, birth, PP, and out to the car to get the portabebe (carseat, which we had to loan to them because they had brought one that was too small and not safe for the car) strapped in and give lots of hugs.

There was no rest in sight as we returned to the clinic. We had to clean the peach room, treat laundry, clean the heaping piles of birth bowls at the lab sink, get the peach room ready for another potential birth (another woman came in for a labor check who had been coming a lot the past few days but remaining at the same dilation and we all rejoiced that she was someone's on-call who was not on shift so we could have extra support!), and be available to provide support in case the birth team in the sala needed it. The student and I out doing laundry together said I should be inside in case someone was needed and it was a good thing I was because I had to take the midwife's baby when it seemed like the woman was going to faint and all students were needed to make sure she didn't hemorrhage. Everything was alright and I was disconnected from the birth, holding her 2-month old daughter and letting all that needed to get done fade away for 20-30 minutes. I then had to get back to my date bleaching the peach room, cleaning the lab sink (that took an hour to an hour and a half) and then my best friends, the dishes, piling up in the sink. I took at break at some point to eat some cereal (a mix of Honey Nut Cheerios, vanilla almond, and Kashi Crunch) and my back was extremely sore. Luckily, laughs were abundant as the student who with whom I had just spent all day with during the peach room labor sit, birth, and postpartum laughed about things that seemed extremely hilarious at 2 in the morning (the purple room husband couldn't figure out how to get the faucet to turn to cold and we just lost it, along with the student's Mexican accent that was accentuated as she spoke in English). At about 3am, I always think I can do no more, but I realized you have to just make tea. I did birth art for the woman who had the water birth (you draw the baby's name, time and date of birth, and weight in pounds and grams) and checked on laundry when I could. I helped the student who had been working in the purple room clean up there (there was a terrible blood/rust stain on the plastic sheet and we had to use 100% to get even close to getting it out) and even though I wanted to lie down, I felt I needed to remain downstairs a little longer for the impending birth in the rose room.

I had been hearing groans from the rose room and at about 5 or 5:15am, birth team was called. I was to document at this birth and didn't see very much of it, which was unfortunate because the baby was born face up in the cull (amniotic sac) and the student said it was just beautiful. Because the PP period is so busy for primaries, the documenters usually start tying to do paperwork for that primary, so I returned to the midwives' table, happy to sit down and drink my now cold tea, and began writing her name on everything and looking through her initial interview to write down information for the creation of the birth certificate. I was in and out of this room for the next two hours, clarifying the baby's name, last name of the father, what time she wanted her postpartum appointments, doing birth art, and anything else the primary could think of, and she told me afterwards I had been like an angel to her. I was grateful to feel so much love from the students today and they all told me I should just stay at MLL because I fit in so naturally. I had never worked with the staff midwife on between 8pm and 8am and she said I had just come out of nowhere, but really seemed to fit right in.

I can't say I was too sad to leave the clinic when our shift was over after the craziest night ever - I have never been on shift during a day with four births - but I felt a great sense of peace and satisfaction having been present and worked so hard on different personal, interpersonal, and manual levels. I look forward to my upcoming shifts, classes on Posterior Presentation and Water Birth this week, a pancake date with a student to finish her interview (there's a restaurant called Crave where a short stack costs only $2), and potentially two more interviews this week. My dad and I will also be planning our northern route home through Abilene, Dallas, Shreveport, Birmingham, and Atlanta and I just can't believe how quickly July is going by. Thanks for continuing to read about this special, life-altering experience and I continue to be grateful for the phone calls, cards, text messages, and love!