August Community-Based Research Reflection

As I begin writing my August reflection, I am attuned to how different my surroundings are. Everything is enveloped in green. My living space is about twice the size of the casita, with boxes, books, and bags strewn everywhere. I do have Internet access as of today and it's not only in my bathroom. I have returned to the hectic pace of social, community, and academic life in Chapel Hill. I am in the process of readjusting and getting back into balance here.

I apologize for not having written in so long. I still have not written about the last two weeks of July at MLL nor my trip home across the country. Once I returned to N.C., I was busy spending time with family and friends and preparing for my move back to CH and into college life again. It has been hard to have quiet, alone time to reflect and it feels strange to try and summarize my experience when I am still processing so much and am not participating in it in the same way anymore. I will be writing about my final weeks in El Paso soon, however, so stay tuned for those posts. The pictures included in this post are of students and staff from the birth center; I hope you enjoy finally seeing some faces! Thanks again for your support of my community and self-exploration - there will be more to come, I'm sure :)

1. Has your involvement in community-based research impacted your motivation to engage in community issues, research, or service?

I have always thrived working in groups and organizations whose purpose is to serve the needs of the community and facilitate its growth. UNC and the Chapel Hill/Carrboro/Durham/Hillsborough communities have provided rich opportunities to engage in service and enhance my awareness of community issues and dynamics. I am grateful to have had this opportunity yet again in El Paso and that While community-based research has shown me how service and research complement one another to serve the needs of an organization or group of people, I would not say it has heightened my motivation to engage in research.

I strongly believe that I will remain involved in community issues and service throughout my life and hopefully through my career, but I am not certain that I will continue to participate in research. Community-based research is unique because it allows the researcher to be actively involved in the field, thus enhancing the quality of interviews, fieldnotes, and observations (hopefully :) While I believe this model should be more widely integrated into qualitative research-based fields, I am not so sure I could constantly keep up with the aspects of research - I'm talking to you, fieldnotes - that are so vital to the research process. I do love interviewing, however, and believe it is a powerful tool of representation for the voices of those who are not always heard. Just not sure how to incorporate that into a job without doing research, too...

This experience has definitely centered me and my direction in terms of my career path. It has confirmed that I would like to work either directly as a midwife or as an advocate for midwifery by continuing as a doula, lactation consultant, childbirth educator, or by working for an organization that champions women's reproductive rights and access. I am currently thinking about ways to translate my work in El Paso back to Chapel Hill and would like to do a Women's Studies internship during my Spring semester that expands upon and provides a new perspective on my time at the birth center. I have decided not to do my honor's thesis and am looking forward to spending more time doula'ing (I wish it were a verb) and discovering just what it is I would like to do next year once this phase of life is over.

2. What assistance will be most helpful to you in the fall semester wrapping up your CBR project?

I just spoke with my research adviser about this today in light of my decision not to do my honor's thesis. We came up with an alternate plan that sounds good to the both of us! I plan to transcribe the fifteen interviews that I conducted with staff and students while in El Paso and write a compilation of thoughts/findings that would be useful to the birth center's growth and expansion of its services. What would be extremely helpful in this process is guidance on formatting this document so that it is both professional and accessible and setting a timeline of tasks to be accomplished each month since there is so much information to sift through. I would also appreciate guidance as to when I would like to/should have the transcriptions and compilation finished and ready to send to the staff and students at MLL. I feel supported both by APPLES and my research adviser and will be extremely grateful for any advice they provide!

3. Please share recommendations you would have for future Fellows knowing what you know now.

The first thing that comes to mind with this question, and I know it's probably been said a thousand times before by those who have moved out of their comfort zones and followed their hearts/spirits, is to be open to the fact that one of the most beautiful aspects of a summer like this is not only what you learn about the people and place you become a part of, but what you learn about yourself. I would advise future fellows to be open to change and growth on a personal level and to not always knowing what's going to come next. I absorbed so much about pregnancy, birth, family, relationship dynamics, being a midwife, border politics, and the Southwest by being at the birth center for two months, but also found out about parts of myself that had not yet been accessed or challenged. I didn't know what kind of learner I was, didn't know if I could stand to live by myself, and didn't know that I could be successful in less academic-related work and had not allowed myself to seriously dream about other avenues as an option. Flexibility is important in terms of working with one's community partner and adapting to their schedule, pace, and staff. Having a support system, whether near or far, is crucial for expression of worries, doubts, joys, and everything in between. Accept, especially when going to a place that's new to you and far away, that you're going to feel uncomfortable for awhile, but that this will dissipate once you are a bit more integrated into your organization, community, and work. Taste and see whatever the place has to offer you; it's not only delicious, but makes you feel more a part of the place and gives you something fun to do. Overall, believe in yourself and the research/service you are doing. Know that you have support from your research adviser, APPLES, family, friends, and new friends/work associates and that people extend themselves in amazing ways when someone they love and care about is going through a major transition. My grandmother and mother's daily cards come to mind here :) Give yourself time to process when you return and realize that you will be changed and aged by your experience. You will grow up and be so glad you did!

July Community-Based Research Reflection Part I

As with most of my blog posts, I've been meaning to write my July Community-Based Research (CBR) reflection for awhile now. It's been written in my calendar ever since I received the email with the questions, but with interview times constantly changing and unreliable Internet access, unless I put my laptop on a ledge under the window in my bathroom and stand up to type, this is the first time I've really had to sit down and write thoughtfully about these questions. I really do believe it's better that I am responding now with four days left in El Paso, however, because I can really synthesize all of the rich, hard, and amazing experiences I've had here. The pictures I've included are from last weekend when I went to the Municipal Rose Garden near my casita. I'll be posting more from Chamizal National Memorial and numerous border crossing points in my week 8 post (even though I really want to right now - have to leave you something to look forward to, though!) Hope you enjoy these reflections!

1. What is the current status of your project?
It's hard to believe, but my time as a short-term student in the birth center will be ending after my last 24-hour shift on this Saturday, July 31. It's been a busy two weeks trying to fit in a lot of interviews with student and staff midwives and I still have five potential interviews to do in four days (we'll see about that...). I am a bit behind on recording fieldnotes and updating the blog because these last two weeks have been so busy with the combination of shifts, classes, interviews, and time to decompress. While my time in El Paso is coming to an end, I don't feel that my goodbye on Sunday will really be final. I sense that I'll be back here as a student, researcher, or both and have truly come to love Maternidad and El Paso. One of the students told me in her interview that you have to scratch away at the surface of El Paso to really see how beautiful and rich it is; she was absolutely right. I was also told in our April CBR workshop that we'd be left feeling that we had more, rather than less to do once the experience began drawing to a close - that's surely true!

I feel like I am straddling two worlds with my project - one being the direct, hands-on practice of being a midwife and the other being the observer, interviewer, and writer. I must say that I really love both, but am uncertain how my findings will help Maternidad. I really need some time to read through/listen to my fieldnotes and interviews to see what sorts of themes have emerged. My goal with CBR was to help Maternidad assess and expand its services to women, but I feel that because I did not interview clients my findings will really be more helpful in terms of staff-student dynamics in the clinic and in the ongoing development process of the school's curriculum. I still feel indecisive about my Honor's Thesis, as well. While I believe I want to write about this experience and the research I've conducted and have yet to do, I am not sure if it will be this year or at some point later in my life. I feel strongly that these aforementioned aspects of midwifery, the direct practice and research/advocacy, are extremely necessary so that midwifery will survive and thrive in the U.S., but don't know if it's possible to balance both and still do a good job at each. Overall, I feel that while my time in the birth center is ending (for now), my project is still evolving and will continue to do so for awhile. I look forward to processing on the way home and throughout August, as I have not really had the chance to do that deeply enough yet.

2. How does your fellowship experience compare with your initial expectations?
When I first came to El Paso, I really didn't feel that I had any specific expectations for my project. I soon realized I certainly did once I discovered some things I was not expecting, such as the two, 24-hour shifts per week (I hadn't read the brochure thoroughly enough and thought I'd be in the clinic more; the two, 24-hour shifts were certainly enough, I soon discovered!) and imagined I would be more involved in births as a doula than I have been (mostly as a documenter). In terms of the experience as a whole, however, I really desired to discover whether direct-entry midwifery and/or research was the path for me. I believe this experience has shown me how necessary each is and that I am able (and enjoy) doing both. While keeping up with fieldnotes was tedious at first, I believe this was more due to the fact that I had not yet found a groove and didn't value alone and processing time as much as I do now being around people so much of the time. It's interesting because I never thought about how midwifery is a path that involves tactile learning. I've really realized what a tactile learner I am and how important it is for me to have a practical application of what I'm learning. This is really what APPLES does and has provided for me for the past three years, but being at Maternidad has truly reinforced how much I enjoy and thrive learning through my hands and how much better skills assimilate into your body when you learn through the complementary combination of academics and direct application. I never knew what kind of learner I was and certainly didn't expect to see it so clearly here!

I also entered the experience with the hope and desire to conduct interviews with clients, which did not end up happening. Mainly because of the constraints on their time and because I thought it would be hard to explain my role as a short-term student and researcher without making them feel uncomfortable about receiving prenatal and/or postpartum care from me, I decided not to interview clients at the end of June. I already feel like I am invading on their privacy when I take a look at their chart to remember how a cita went to then discuss on my fieldnote recording and feel/felt that interviewing could have had the same effect. I feel like I have integrated into and become more confident in the center this month and that I have developed stronger, deeper relationships with clients. I would probably try to do interviews if I were here for a longer time and as a long-term student, but I believe the difficulties of both the constraints on their time and my inability to go to them in Juárez (even though I want to) would make the process tough.

I also never expected I would enjoy living alone after despising it so much the first month! I really have gotten into a routine cooking, writing, recording fieldnotes, and getting together with students and have a newfound appreciation for solitary time. This is definitely an outcropping of the experience I was not expecting, but am happy to have found because I believe we all need varying levels of alone time and that it's important to find the level that's right for you for processing and rejuvenation. I'm also happy to have become a relatively good cook (I hope so at least!) and it feels good to be able to take care of myself having integrated into a completely new place and lifestyle.

3. What has been the most rewarding and challenging aspects of working with your community partner?
When I first saw this question, I immediately thought about how often the most challenging parts of an experience can also be the most rewarding. That's definitely how I've felt in relation to my level of involvement as both a short-term student and researcher at MLL. As I mentioned above, this has been extremely difficult to balance at times, mostly in terms of keeping up with supplemental fieldnotes and having interviews go through when they're supposed to (really difficult with varying shifts and levels of tiredness), but I've found the depth I have attained in each has made the research and direct practice all the richer. Interviews feel like informal conversations amongst friends and one of the most fulfilling aspects is that I understand so much better where students are coming from or what they've been through here because I've been through a piece of it myself. I believe this sort of applied research/anthropological approach augments the quality of the research conducted because the researcher is so much more integrated into the lives of the people and place. I would like to see the development of more applied research where the researcher is not the detached, "objective" observer, but an actively involved member of the group who really understands the pulse of the people and place. This type of research can be draining, however, since you're doing so much of both and I guess the opinions you develop are a lot more subjective because you've been through the process that you're researching, but I think that makes it fuller and richer. This part of my summer, therefore, has been both rewarding and challenging, but I believe these often go hand-in-hand, especially when you've learned or grown a lot.

July Community-Based Research Reflection Part II

At my last Birth Talks on Tuesday, the midwife/Associate Clinical Director announced it was my last one and the students began sharing some of their testimonials about their time with me as I shared the highs and lows of my experience here. One of the most challenging aspects I mentioned and would like to discuss here is how my status as a short-term student has at times felt stagnant and frustrating. I believe this is partly due to the fact that I'd like to continue progressing in my learning path here, but it's tough when it seems like other students don't know what to consider or classify you as and that because your role is confined to such a short period of time, so, too, is your learning and formation of relationships with others. While I have formed special relationships with many of the women at MLL, I have felt that some students have not opened up as much (which could be due to their personalities, of course) because I am here for a set period of time and it is unknown whether we'll see one another again. In terms of my restrictions as a short-term student (which have been few because MLL has allowed me to do SO much in eight weeks - I feel like I have been here for 3 months), my role in births has been different than I imagined.

I remember a specific time in the clinic during which two of the interns went to class and the 2nd quarter student stayed in the clinic to work with me. When discussing the birth rotation, she commented to the staff midwife that she was the only other person on that day, which made me feel that my role in births was disposable and unimportant. As soon as she realized I was on, she apologized, but I still feel that students are often unsure of my role and will ask if I'm working a 24-hour shift, which I've been doing steadily twice a week for the past two months. There have been few instances during which this has happened and these glitches in communication or understanding stand out more because I have felt and been told how valuable my help, energy, and dedication have been. I would have appreciated becoming more hands-on with birth as time went on, however (I know I helped catch the baby and I will be forever grateful for that!), and feel that my skills have started to become stagnant mostly serving as documenter all the time.

The other challenging aspect that I'd like to mention is that I'm not exactly sure how my research will be helpful to MLL. I don't feel this has been extensively discussed with the Assistant Academic Director, which is a bit worrisome because community-based research is for the progression and growth of the community partner. I believe communication between MLL and me will and needs to continue to clarify MLL's needs and what would be the most helpful for them to know and utilize in their development and maturation. MLL has been around since 1987 and is extremely rooted in the community, but that doesn't mean that positive alterations cannot still be made to improve the dissemination of information or services.

I would say the rewarding parts of this experience - becoming integrated into a community of women, learning how to do prenatal and postpartum citas, witnessing 16 births (hopefully more on Saturday - July has been slower than June, which always worries me because of what's happening in Juárez), attending classes, seeing, feeling, and absorbing the border, eating some amazing Mexican food (and meat!), receiving letters from Grammy Lo and my Mom every other day (and many other friends and family members) to put on my big windowsill, hearing Spanish and English spoken in the same sentence all the time, and learning more about who I am and want to be - far outweighs these minor discomforts and frustrations, however, and are memories that I will carry with me and be grateful for always.

4. What role has your faculty mentor played in guiding your work and helping you to address
any problems that you have faced?

My faculty mentor has been extremely helpful in providing commentary and feedback on my written fieldnotes and in sending me encouraging emails, especially in June when I was having such a hard time getting through. We haven't communicated with one another as much in July, mostly in the last two weeks, because I have shaky access to the Internet (yes, I'm sitting in my bathroom writing this right now), I am often gone all day and don't have time to compose emails, and I've switched to recording most of my fieldnotes and will share them with her when I return to CH. Despite our lessened communication, I know she's available when and if I need her and she has made herself open to me all summer, meeting with me during my trip to CH in early July, sending me many a hug across the miles, and reminding me that she's there for me by phone or email. She sent me a significant email about midway through July that has influenced my overall approach as my time in El Paso has wound down. She told me not to get too bogged down in the small details of day-to-day life here and to think of the bigger picture in terms of emergent themes in my research and how this experience has and will continue to affect me in terms of my career and growth as an individual. I continue to carry this advice with me whether I am conducting interviews and thinking about direct-entry midwifery on a national scale or am doing a prenatal cita and am incorrect measuring a fundal height, trying to look at the experience as a microcosm not only of relationships in the working world, but also for midwifery on national and international scales. This has been difficult to do with so many daily details to keep up with, but I appreciate her foresight and her encouragement in noting and exploring themes and ideas that interest or excite me the most. It will be nice to see her in person again soon, as I feel like it has been harder to connect through my fieldnotes and interviews since they are all on my audio recorder, and discuss the experience as a whole. Overall, however, I am so grateful for her time, energy, advice, and dedication and have really listened to and thought about her advice during my final weeks here.

5. In what ways have you needed to be flexible?
Yesterday was a perfect example of how flexibility is an important virtue when working with midwives (well, really anyone for that matter, but especially in a bustling birth center). I was supposed to do an interview with a student at 11am and was on my way to the birth center (stopped at the RR tracks as usual) when I received a text message from her saying she was tired and wanted to take a shower and rest a bit before class. We never ended up doing our interview, but I did interview one of the staff-in-training midwives and a student when the clinic was slower during the early evening hours. Both were interested in doing the interviews, as was the student who was unable yesterday, but often the actual time when an interview takes place is not what was originally planned. I remained closeby at Kinley's Coffee House (with my piece of chocolate cake), ready to go to the birth center whenever the stream of citas calmed down. This flexibility, patience, and not having a plan (especially when you really love having a plan) has been extremely important trying to coordinate interviews because everyone is busy, tired, and stretched for time, which makes it all the more crucial to respect the women's schedules and work with them for a time that is best. Many of the students are studying for the NARM (North American Registry of Midwives) exam and have told me they would like to do phone interviews after they have taken it on August 18. I never envisioned doing phone interviews, but am willing to do them to work around the hectic pace of the students' schedules and lives. I've learned to create basic sketches for the day, but to be prepared and open to the fact that I may not be able to record fieldnotes, post on the blog, or go to Mesilla (I really am going to go tomorrow) because I need to be available for the opportunity to interview if it arises. The process has helped me cultivate patience (which I have in abundance for certain things, but not others) and become more comfortable with fluidity, rather than rigidity in my day-to-day life.

I've also had to be flexible in my role at MLL. As I mentioned in my Week 7 post, it was important for me to be available as a floater two weekends ago so that the sick student would have time to recover. I always tell staff and students I am willing to play whatever role is most helpful in the flow of the clinic and it really translated into reality that weekend. While I mentioned in the question above that not having an assigned role can be challenging, it also carries with it fluidity that is helpful in a setting in which a birth may happen, but citas are still coming and everyone has their specific place they need to be. Having someone who can float and be in-between provides a sense of security and back-up that is not always possible when students have a specific role on the birth rotation and their experience is counting towards their certification and development as a midwife. I feel that I have been flexible in this way, especially as I've gained confidence and have had more time with the students and staff in July, and believe this is a beneficial outcropping of not having a strictly assigned role.

Thank you all for reading through this long post (I know all of them are) and for the quality of these questions that were created by APPLES students and staff in provoking deep reflection. I will likely not get to more blog posting until next week when I am traveling back to NC or have returned there because time is passing quickly here and I need to write 27 thank you notes to all of the staff and students! I look forward to seeing many of you soon and thanks again for being here with me all the way through and at the end of my journey (for now :)

La séptima semana/The seventh week Part III

Friday, July 16

Friday was a busy, but productive and fun day. After taking a shower at the casita and returning to the birth center to meet up with two of the students from the previous shift, we went to Casa de Nacimiento, another birth center in El Paso just a mile from MLL. We spent about an hour at Casa getting a tour of the birth center and the house next door where all of the interns stay. Casa has a bigger space than MLL and feels more like a clinic, too. It is set up a bit differently with short-term students, as well, because they are mainly responsible for catching babies and do not do prenatal or postpartum citas. The staff was extremely welcoming and gracious to us and spent about an hour showing us all around and answering any questions we had. I was grateful to have the opportunity to see Casa and couldn’t believe so many students had never been because it’s so closeby to MLL. Just shows how busy and tired they are!

The student with whom I had done couch the night before and I then went to the Percolator (a local coffee shop with great eats, too) and spent a bit of time together just chatting and enjoying one another’s company. I was hungry (what’s new?) and had a croissant with eggs, avocado, and tomatoes before I took the student back to MLL and she was off to see another friend. Since my interview was at 3pm, I had some time to see some sights around El Paso and was trying to decide between going to the El Paso Museum of Art or the Chamizal National Memorial which straddles the Texas-Mexico border. I decided I was in the mood for the art museum and spent an hour and a half or so there taking in a variety of pieces created by Native Americans, Mexicans, and Mexican-Americans over the past two centuries. The art museum was comprehensive and included pieces ranging from Mexican retablos (painted on tin, generally of Christ, Mary, and Joseph) to expansive pieces chronicling the Southwest. The tension on the U.S.-Mexico border was palpable as I took in an exhibit called “Dreamland/Tierra de Sueños: The Way Out of Juárez/Una Salida Lejos de Juárez,” which aimed to document the violence in Juárez, but also link it to similar violent uprisings and occurrences around the world. Other pieces explored the historical and present relationship between the U.S. and Mexico. I must say (and another short-term student said this after visiting, as well) that I wish there had been more inclusion of pieces by women and about women, but this is a common historical theme and past I cannot change.

I was a bit late getting to the staff midwife’s house for an interview because I spent awhile in the gift shop buying some beautiful plates and salt shakers hecho en México (made in Mexico) and got confused on some streets trying to find her. It had rained a bit when I left the museum and I was beginning to notice how ominous the skies get in the rainy season of July. My interview with the staff midwife (she had been doing staff-in-training for six months and just became a staff midwife) was incredibly open and candid and lasted for about an hour and a half. Among many things, she discussed the challenges of balancing her role as a midwife (who has the final say-so) and teacher to students with various personalities, backgrounds, and beliefs. I was surprised when she told me that she feels pretty disconnected from the clients because she is juggling so much and as a protective mechanism. Fascinating how much perspectives can vary depending on how long you’ve worked in a place and what exactly your job is. I was grateful for her time and her delicious cole slaw and mint water – how refreshing!

Saturday, July 17

While I had set my alarm for 7:00am so that I could start the day off early getting in recordings and blog postings, I stayed in bed until about 7:30am until I heard a knock on my front door. It was the Assistant Academic Director and midwife who I live behind and she asked me if I could come in today instead of Sunday for my 24-hour shift. One of the students was sick and needed the coverage and weekends are generally pretty busy at the clinic. I took a few minutes to decide, and would have to reschedule my planned interview with one of the students, but felt good going in after having slept on my last shift. I was also excited to work with students with whom I had not worked in a long time or ever before.

The Assistant Academic Director told me to take my time getting ready and made sure I had food to bring in for the shift. Luckily, I had just been to the grocery store the night before! I arrived at the clinic at 9am and had a pretty busy morning, barely fitting in time to eat some delicious tortellinis (the housekeeper I interviewed had never tried one before and had a spinach one; she really liked it) as it neared 2pm (we are supposed to be cerrada – closed – between 12 and 2 pm, but we continue taking citas if it’s busy). How I wished I had a gordita to nibble on throughout the morning but the woman who sells them luckily takes time off on the weekends. What I noticed during this shift is how rusty I was not getting enough time in between to rest and recuperate. As I measured fundal heights, checked positions, and listened for heart tones, I found I was having a harder time today than usual and attributed it to the fact that I was doing a back-to-back shift (when you only have one day in between instead of two).

My first cita was with a young woman who was having her first child. She seemed a bit shy, but her aunt did plenty of talking for her (what seemed loving and doting to me may have felt extremely awkward to the niece, though). This was my first cita during which the woman did not seem to be eating enough. I had to ask one of the students how to encourage her to eat more without acting as if I didn’t appreciate where she might be coming from in terms of access and eating habits and the student told me to remind her that she had a baby growing inside of her and that newborns eat every 2-3 hours and need the same nourishment in the womb, as well. The client asked some questions, but it was mostly her aunt (who I embarrassingly addressed as the grandmother by asking, “¿Está emocionada sobre la llegada de su nieto?/Are you excited about the arrival of your grandson?” (Nice move) who was asking about what kind of positions were best in labor, whether her niece could tener relaciones (have sex) during pregnancy, and whether her niece needed to do anything to prepare for breastfeeding now. I asked the aunt to help me check her belly (after asking the client if this was alright) and we palpated together. The cita felt inclusive, but I also noted a sense of awkwardness with the client, as if she didn’t want to discuss all of these things as openly as her aunt. Her aunt said that her niece had verguenza (embarrassment) and that was why she was asking all of the questions. It’s so interesting to observe family dynamics, as coming to MLL is often a family event, and note the tensions and comical moments that arise among family members during citas.

The next woman I saw came with her sister and they were having a grand time together. They were smiling and giggling and seemed so happy to be in one another’s presence. The client was having her second child with us and was about 33 weeks along. I’m always amazed how much I learn about a person in a cita whom I may never see again. As the client went to do her prueba de orina, her sister and I spoke for a few minutes about her birth at a local birth center and her husband, who she said treats her badly. What sparked the conversation was the fact that all of the women in the family had had boys and I asked the sister if she ever wanted to try for a girl. She told me más adelante (later, in the future) due to how badly her husband treated her. I felt at a loss for words as she revealed something so personal to me and found myself in yet another situation where I wanted to counsel, but wasn’t sure if anything I said would be any consolation or comfort to her. She also told me about one of her birth experiences at a local birth center in which they had given her tequila (not exactly sure why); she didn’t seem to pleased about this! Both women were extremely outgoing and chipper. The sister bobbed her head back and forth (as if rocking out to some tunes) as the baby’s heartbeats clicked on the doppler; I couldn’t figure out why the client was laughing as I counted heart tones for a minute and only had to look back at the sister to realize why. The client really didn’t want her pap smear done, though. When I asked if she would like me to leave, she said that both the student and I needed to be there or else she would leave. She didn’t audibly complain during the pap smear and I saw no visual signs of discomfort; the student and I decided she was just very open telling us how she felt about the procedure, in general!

I took another cita before breaking for lunch (it was pretty busy) and realized when I put my initials next to her name on the sign-in sheet that I recognized her name from the past. It was a woman whose initial I had done in June and I was excited to see her and her mother again. I could tell I was getting tired and hungry during this cita because I was having trouble explaining what the plasma glucose test looks for (I said it was to check for pre-eclampsia, but the student in the mama cita room told me it was actually for gestational diabetes) and felt a bit disorganized. Yet again, I noticed my gaps in knowledge and that I so often have to explain tests which I knew very little about (and have had little time to learn about both in orientation and throughout the summer as I have had to keep up with the research side of my work, too). She and her mother were extremely patient with me as we went over other aspects of her cita and I appreciated how gracious they were as I felt a bit sloppy.

I quickly boiled some water for tortellinis and ate them fast before getting into another cita after lunch. I felt guilty taking a break to eat as there were many women waiting in the sala, but also realized that we needed to take breaks if we were going to do a good job. As I inhaled my lunch, I confessed to both the staff midwives that I felt I was doing a bad job getting positions and fundal heights right and they reassured me I was doing great for someone with so little training. I also told them I couldn’t believe I only had two weeks left and the Assistant Academic Director told me she sensed I would be back to MLL at some point. She said I would be an asset to the center and that I fit in so well. I appreciated her kindness and feedback, especially because I felt really rusty today.

As I got fuller, one of the students told me she’d take the initial waiting if I took the woman she was originally going to take. I had noticed this woman sitting with her husband and two children; they had been in the sala for awhile. The woman had thin, long bangs with her hair pulled back into a ponytail and a thick black headband on. She had a warm, inviting face and a calm demeanor. I noticed her belly seemed small for being 38 weeks and that her baby had only been measuring about 5 pounds over the last two citas. While I also got a small fundal height and weight, the midwife who checked got larger numbers, which again made me wonder what on earth I was doing wrong. The client told me she had been feeling colicitos (little cramps) in her lower abdomen and I told her that her body was preparing for the arrival of her daughter (she already had a daughter and son who were out in the sala with their dad, who was entertaining all of the kids at the table of Legos and blocks). We did the 40-week protocol together and I, again, felt like I was in new territory because I had not yet done one of these with a client. Even though I’ve done dozens of prenatal citas now, there is still so much learning to be done. While some things remain the same, like giving UTI prevention recommendations, other aspects are so different and I feel like I stumble each time I try a new one, but am confident that at least it will be better (hopefully) the next time.

After this cita, the clinic became a lot calmer and it was nearing 4:00pm. I sat down at the table with the two staff midwives who were trying to figure out how to schedule the student who had been and was still feeling sick. She had a throat infection and had received a shot of Penicillin that would make her non-contagious in about two days (so Monday). They asked if I’d be able to come in for another day shift Sunday and said I’d work until citas calmed down. I was perfectly fine with this plan and liked the opportunity to work just during the day and get rest at night. I was disappointed that I would not be attending births and sort of felt like my presence at births wasn’t nearly as important as in citas (which it may not be at this point), but still appreciated the shift in schedule. I left soon after around 4:30pm and spent the rest of the day catching up with family and friends on the phone and on my five birth reports and reviews so that I could prepare for the next two weeks of births. I didn’t feel like I had really had a break when I returned to the clinic at 8am the next morning, which has become a theme in my last two weeks here with so much to do and so little time to do it. I almost feel as if I am in last stretch of school at the end of the semester when you’re tired and unmotivated, yet have to push forward. I am so happy with what I’m doing, but am finding that I really need time at night to decompress and release by watching a movie. Sunday, 7/18 will be part of the week 8 update!