Sunday, September 7, 2008

Ode to L&D Nurses

I've been asked by friends and family alike if babies come out the same way in the antipodes as they do back home in the states. The answer: they do indeed. And while the healthcare system is wildly different here, midwifery is midwifery, and I'm happy to be catching babies again.

I miss my sister-midwives (I'm from Utah, after all), and I love hearing their stories as we move away from Utah and on with our lives catching babies and working with women all over the planet. I also miss my sister L&D nurses. I miss you personally (nights at work aren't as fun here without you!) but I'm also missing you professionally, because you see there are no L&B (labour and birthing) nurses here. This has been, far and away, the hardest transition for me to make.

Midwives here perform the role of nurses in the US in addition to being the midwife. (We're also the MAs, and sometimes the cleaners, but we never have to be the ward clerk.) They do not teach OB in nursing school here, so all antepartum and postpartum patients are cared for by midwives. So, nurses, you can just consider yourself midwives because you are!

At a typical birth in the states there would be a woman and her baby, a nurse, and a midwife (or MD). Usually there is a support person. Rarely, a pediatrician. Each person plays a part but the woman does most of the really important stuff, and the rest of us are just there to support her. Usually the midwife (or MD) catches the baby, but sometimes the woman reaches down and catches her own baby, and that is one of my most favorite things in the whole world! And sometimes the nurse catches it because the midwife (or MD) is in the loo or whatever. Once the baby is out the nurse has a million things to do, and has to do them quickly, but the most important job is watching over the baby and making sure it breathes for the first time just like it should, and if the baby seems a bit stunned the nurse starts resuscitation (CPR for babies). So nurses are invaluable. I should state that the role of nurse is sometimes filled by a second midwife at birth centers, so you don't technically have to have a nurse. The point is there are at two people at the birth - one focusing on the woman, one for the baby.

OK. So here, like I said, we don't have nurses. And, like the States, we have a staff shortage, so finding a free midwife to assist you as second midwife at a birth is difficult. I have yet to find one when I want one (but they do respond to the emergency light, and unlike the States only one or two people enter the room instead of 57, and the rest wait in the hall to act as runners if needed - I LOVE this). I haven't had enough births here to experience a typical one yet, but it generally goes like this: woman, baby, midwife. Maybe support person. Woman pushes baby out, I catch, and then I have a million things to do, including all baby care! The trickiest part is maintaining sterility, and I have yet to use less than 8 pairs of sterile gloves at a birth.

So far it is all working out and each birth seems a little less chaotic, but going it alone as a new midwife within a foreign health system in a foreign country, is certainly challenging and out of my comfort zone. I miss having nurses to formulate a plan with and get feedback from. I miss having another pair of eyes and a different perspective. So, L&D nurses, when you visit me in NZ plan to spend a day at my hospital so I can enjoy your company again (and so I can catch up on all the gossip!) because I miss you like crazy!


The Pond's Lily Pad said...

I wasn't planning on crying today, but you got me!! We miss you, too, like crazy! I think that the reason we all do what we do is because we want to take care of women and babies, nothing less. What rewards there are doing that, across the world or in good 'ole Utah!!

Adrianne said...

I miss you too! I was laughing at work the other night telling the story of you reading a glamour mag how to please your man- and acting so shocked at the suggestions (ie nibble on his ear)ha!like we had never heard of these amazing ideas before. Love you and miss you. Take care!!