I don't get it...

Did anyone see the segment on GMA this morning about women who didn't know they were pregnant until they were giving birth? I didn't catch much of it, other than a clip of a woman who was explaining how she went to an emergency room with the complaint of terrible stomach cramping from what she contributed to the flu.

Let me just start by saying I don't get it at all. I really don't. Now, I can understand a woman not gaining weight or just a few pounds. That happens, particularly for larger women. And I can understand that many large women don't appear pregnant until much later stages due to their body habitus. I can even understand thinking you are having your periods still; some women do have vaginal bleeding in pregnancy that can be chalked up to subchorionic hematoma, friable cervix, or placenta previa. But how can you explain fetal movement? Perhaps you can pass it off as gas around 20 weeks or so, but what about 35 weeks when the fetus is causing the abdomen change shapes or pushes their body parts out with their movements?

I've only met one woman who didn't know she was pregnant until 34 weeks or something like that. She was a college student, who had bulemia and anorexia but was in complete denial about her disease. She weighed 92 pounds at 34 weeks, when I met her. The reason she even learned of her pregnancy was because she was being worked up for abnormal abdominal pain and severe gas that caused her abdomen to visibly roll and move. Huh.... go figure.

I am sure that I will meet more women in my career who don't know they are pregnant until later stages or even birth. But I don't know if I will ever understand it.

Ode to the Dansko

When I started my obstetrical nursing career, I found the beloved Dansko. I bought my first pair in 2000; grey nubuck clogs. The cured my lower back pain. They let my feet breathe. And they worked well with jeans and such.

I loved my Dansko clogs so much that my feet would reject any other shoe. So I had to buy more Danskos in various styles. Sandals, sport clogs, dress clogs, you name it. But the best Dansko of all was my original grey clog.

Eight years later, I still have that original pair. They are tired and worn. The leather is stretched out. The edging is worn off completely. The grey now looks hunter green, so I'm told. This must be from the various fluids that they have been exposed to. I've been finding that my feet slide too much when I walk around and have acquired another callous on my foot. As much as I didn't want to admit it, my original Danskos need to be put to sleep.

I've known this for several months now. But I couldn't bring myself to do it. I went to stores and tried on new Danskos. It just wasn't right. Maybe, just maybe, there is still some life left in them I thought. But when I wore those grey clogs to work my last shift, they just couldn't keep up.

I bought a new pair of Danskos.... well Sanita, actually. You see, Dansko contracted with Sanita for years to make their shoes. But recently, Dansko decided they were going to contract elsewhere and Sanita decided to keep making the shoes under their own name. I find that the Sanita's fit like my other Danskos; the "new" Danskos don't fit the same. So if any of you are wondering why Danskos don't fit exactly the same despite wearing your usual size, now you know why. But I digress....

My new clogs are wonderful. They fit perfectly, and feel good on my feet. They came just at the right time. And then I realized one afternoon while feeling a little poetic, the old clogs lasted my entire obstetrical nursing career. My new clogs are starting my new midwifery career. And they better last longer than eight years.

Breaking the Cycle

I've been fortunate for most of my student clinical career to have preceptors who don't subscribe to the philosophy, or at least strongly, of "I suffered and so should you". It is not unique to midwifery; I've seen it in nursing and medicine. For instance, when I was in nursing school we often heard that new grads would just have to accept night shift jobs on over-worked med-surg units because that is what those did before us. Or being the new grad on the floor meant the more senior nurses treated you like shit just because they were treated horribly as new grads. When residents were fighting to make their working hours more humane several years ago, the opposition was arguing that they worked 180 hours a week when they were residents, and so should the residents now.

In midwifery school, I knew this would likely be the case as well. Like I've said, I've been lucky to have escaped this for the most part. But it has been said to me that when my preceptors were in school, they had to do 36 and 48 hour shifts, couldn't work a job, didn't see their family for weeks at a time, well.... what exactly are you saying to me? That I should suffer like this, too? I resent this because suffering doesn't equate sound clinical education. Being sleep deprived, family deprived, life deprived does not mean I will be a better midwife. Actually, I feel quite opposite of this. When I arrive to clinical well rested, I make better clinical decisions and feel more available for the women I will care for. If I managed to have a day or two during the week that I actually got to do things just for me, or got all the housework done, I don't feel stressed about the other days being filled with school work and clinical hours. And when I get to spend time with my husband, I feel supported in what I do and all the hours I put into this. How can this not be healthy? Why should I be miserable just because those before me were?

If this attitude of requisite suffering was let go, I'd imagine we'd have more midwives. I've heard my fellow nurses say that they would consider midwifery school but don't solely because they know how horrible their experience will be. I think this is pretty counterproductive for both current midwives and future midwives. We need more midwives, so this attitude needs to change.

Senioritis

Do you remember when you were a senior and high school and you finally saw the light at the end of that long, tortuous tunnel? And you like stopped caring about school and homework, and even skipped to hang out at your friend's house to watch daytime talk shows and eat ice cream and fast food? You know, the senior slide?

Well, I am experiencing this as we speak. Type.

Except the cutting school thing. That's generally not well tolerated in midwifery school.

I mean, seriously, I am so mentally done. Cooked. Studying for boards? Ha! Doing writing assignments? Are you kidding me! Reading every single assigned page? Please!

I think part of it is that a friend of mine from school has already finished last month and has been set free. She even took her boards today- and passed! I can't wait to say that.

Surprise!

My final clinical rotation is underway, and boy is it tiring. I've had several births, all very nice. They were all first babies for the mothers and all were unknown sex. I love that. Where else in life do you get a surprise like that? I can't think of any.

I had asked a couple who had decided not to find out the sex of their baby why they chose to do this. So many people find out (and often it is the only thing they care about during their fetal anatomical survey ultrasound...) that it seems like such a rarity if the birthing couple has no idea if they are having a boy or girl.

The father said, "Ok, so what do we say when the baby comes out if we already know what it is? It's a.... baby! We already know that! We want to say.... It's a boy! or It's a girl!" Very cool.

As the midwife or nurse in the room, I love to see the surprise and excitement on the faces of the family and parents when they find out what their baby is. I know it's not about me, but there really is something special that is added to the birth when things are left a surprise.