My First Year As A Midwife

The Credentialing Saga Continues

2008-07-06T18:23:00.000-07:00

So this is me hard at work. Walking around holding a sweetpea on my chest. Well, when you work in such a mother friendly environment, what can I say. Anywhoo, no credentialing updates. Still waiting for my lovely credentialing specialist to find all my papers... twice. But enough about that business stuff, lets talk about MIDWIFERY!

Been catching babies in both settings and I have to say both have their benefits. I love waterbirth and find that the jaccuzi tubs are excellent pain relief. But honeysugarbaby, cleaning up the birthing room after a delivery is no joke! However, the freedom and support to practice straight and uninterrupted midwifery makes this setting a winner. The only benefit at the hospital is that you don't have to clean up afterwards! Hee-hee!

As continue to shape my midwifery tools, I am finding methods that I love and some that I don't like. Let me tell you, I am all about warm compresses. I know that the mother of perineal intergrity, Leah Albers denies their efficacy, but I love them. I find them to be great for destracting momma at the beginning of second stage when she is apprehensive about pushing. I also use them to as guide for her pushing efforts and for pain relief. I say, whatever works for YOU, use it!

Speaking of perineal intergrity, let's talk about repairs. When will I be able to look at a laceration and already have a repair gameplan in 0.2 secs?? Man, I had a perineum that looked like hamburger meat (the baby's compound presentation was to blame) and I thought, WHAT THE HECK AM I GONNA DO! I called on a wiser and experienced CNM and she just looked and went to work. She explained everything she did and it all made sense, but I would have never thought to do it that way. Needless to say, 6 weeks postpartum and her hindparts look great! I guess this will be like my learning curve with IUDs. FYI, no IUD complaints yet!

Until next time folks. Hopefully the next post you read will be from a fully credentialed hospital CNM.

All my paperwork is in!

2008-05-31T00:21:00.001-07:00

Hey Ya'll!

I am officially a toddler midwife! Graduation ceremony, check. DEA number (this means I can prescribe), check. One month of a realistic call schedule, check. Better with IUD placement, check. Hospital privileges, almost check. So far so good and my partners have been awesome! They have welcomed my questions and always made me feel supported. I will say this. When choosing where to work make sure its an environment that is conducive to your learning. This includes people that are patient and willing to teach. It makes a huge difference in your development.
One thing that I am finding interesting is how many of my folks really don't understand what I am doing. I find myself constantly explaining my role and duties as a modern day midwife. I am even more encouraged to promote midwifery and write a letter to Oprah! She should do a whole show about midwives and give us all free cars!! Doubt that would happen but a girl can dream.
The best thing that did happen this month is a birth I did with my mom present. She was in town for graduation while I was on call and as fate would have it she watched me deliver a baby. No HIPPA violations, the family requested to meet her and allowed her to stay for the birth. It was a really big moment for my mom and me because I have been telling her I how I wanted to deliver babies since I was 6. Of course she cried and I played tough, but I knew this was a special blessing.
Recent news, I have been made co chair for my local ACNM chapter. Couldn't believe I won, so I gotta bust my tail to make sure I do a good job! For those who know me, you know I love to juggle 5 different things at one time anyway so an added responsibility will be fine. Stay tuned for my next entry in which I will be completely by myself with hospital privileges!

Lobby Express!!

2008-05-04T16:38:00.000-07:00

Well gang, I am entering my second month and I am still having a ball! I was granted another gift from the birth goddess and got to deliver one of my faves.....in the lobby. I was at a staff meeting when the front desk attendant announced her arrival. I jumped up with excitement only to greet her in the lobby with the classic precipitous statement,"the baby is coming!". I ran past her to a exam room and grabbed a pair of gloves. I ran back to her pants being pulled down and she simutaneously delivered the head. We laid her down on a blanket then she let the rest of the baby come out. Technichally, the baby and her body did all the work. I just made sure my piece of love muffin didn't hit the floor!

Got to place my second IUD, this time a paraguard. Had some difficulty sounding and I later found out it was because her uterus was retroverted. Question, any of my midwifery mothers out there have any tips on properly assessing this? I should have know there would be some issues when I sounded her to 5 and 1/2. Anywhoo, after my attempted placement, I felt the ball of the "T" in her cervix. Bummer! I really need to practice advancement with the demo model because I am sure I pulled it down on the way out. I am going to seek out all the placements on the schedule this month so I can get some practice.

This is a big month for me. I am starting a full schedule this month! A bit nervous, but everyone has been totally patient with me so they can't stop now!

I caught a baby!!!

2008-04-20T18:35:00.000-07:00

YEA!!!! I finally caught my first baby as a CNM and let me tell you it was amazing. His mama had a hypnobirth the first time and labored like a champ. She drank root beer and ate an apple while she was transitioning! It was wonderful and my chunky friend came right at dawn. It is moments like this that remind me why I busted my butt to get through school. I know all of my deliveries won't be this fun and with the best darn picadillo made by grandma, but for a first it was awesome!

Good times are on there way. I am starting to take more call shifts next month and man I am excited. I won't be fully alone and trust me I will take whatever guidance I can get!

Finally!!!!

2008-04-12T05:18:00.000-07:00

Hey everyone! I am so sorry about taking so long to post, but man I have been busy. I spent the first few weeks just trying to get paperwork in order. Licensure, hospital credentialing, insurance credentialing, and site orientation has put many cramps in my hands. Every state has a process and I belong to one of the most dysfunctional one! At this point I finally have my license and most of my credentialing done, but I am halted waiting to get my DEA number. It's $550 bucks! Needless to say this is still a working process.

By week three I finally got to start seeing patients. It was here that I began to remember why I have been working so hard. I am having the most wonderful complex time with some of the most interesting folks on this planet! Their struggles are very different from the population I left. For the last three years, I have been taking care of compliant Latina women who only challenge care when it conflicts with cultural considerations. Now, I am faced with constant non compliance based on overpowering social issues that supersede their current situation. I wanted a challenge and boy am I getting it! I have to create new ways to deliver my care with special considerations for the families I am taking care of. SO, far so good.

Now on to some hard core midwifery concerns! I am not going to lie. I had been having this reoccurring nightmare that I would be having a busy clinic day and not be able to visualize one cervix! I know that sounds crazy but all the way up till my first day, I keep feeling anxious and worried about my pap skills. The difference from being a student to a LICENSED midwife is that you shouldn't have to consistently call for help to visualize a cervix for a pap. I know, I know I can ask for help, but I don't wanna! I have done at least 100 spec exams, so why am I freaking myself out.

I am happy to report I only require minimal assistance with the FIRST one. Call it performance anxiety. Since then I have been able to visualize 98% of the time and placed my first IUD. Some students are lucky and get the opportunity to do this often, but I hadn't even seen one placed. Not for lack of trying, but I was working in population who relied on breastfeeding and depo as their main forms of contraception. As for IUDs, I don't like the tenculum! I feel like I am gonna rip the cervix apart. However, I have learned a cool tip on how to have the woman cough as you are closing the teneculum. Amazingly enough, she didn't even notice! One down and many to go. Our practice provides numerous IUDs every month.

As for births, I have been to 4 birth center and 2 hospital. Man, I love not admitting anyone until they are 4-5 cms! My first birth was a 20 mins after she arrived to the birth center. My big boy was 10lbs and mama had an intact perineum! Fabulous. I am officially able to catch now and boy I can't wait. I haven't delivered a baby since Dec and I miss it. So hopefully my opportunity is coming up soon. My call schedule has been awesome so far, nothing too crazy. Let's see if I feel the same by next month. Till next time and hopefully I will have caught a baby by then!

Salutations!

2008-03-09T17:50:00.000-07:00

Hey all!

I have created this blog to inspire those interested in becoming a midwife and to remind others of their past. This is a way to receive guidance and transition from a baby CNM into a.... teenage CNM??? No matter what I hope you laugh, cry, and enjoy my first year as a midwife.

Well, I am finally here. No more studying, no more test, and no more papers. Or so I thought! I had my first day at work Monday and man was I ready! I had on my cute outfit, lunch pack, and even some am exercise. How about I didn't touch not one belly:( PAPERWORK!!! Let me tell you, there is so much paperwork to fill out, you can't even imagine. Beyond that I am excited! I love the staff and I can't wait get somewhat adjusted.

I had a few labor checks, but my first weekend on call was quiet. I can't lie I am a little sad. I haven't had a delivery in months. However, I hope I am ready when I do. I am most excited about the birth center. I haven't had a lot of exposure to this type of birth setting. So many new things to learn and most importantly, protocols. No more continuous monitoring for normal pregnancies, yahhhhh!!! I think this week when I have down time, I am gonna peek around the birth rooms to familiarize myself.

The best part of this week was bellycasting. Built into their prenatal care visit, mommies get to have their bellies casted then come the following visit to paint their works of art. I love it!! Of course, the woman I casted looked at me like she was gonna fight me, but we got through it! I will post a pic after she paints it. What I enjoyed most was the fellowship and the excitement of the women. This is a beautiful experience for these women and I am proud to participate in it. Can wait to have a bun in my oven to plaster!! Hee-hee!