labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Friday, March 27, 2009

Men In a Women's Field

You know, I've heard so many women say they wouldn't go to a male ob/gyn or midwife because they "don't get it" or for the sheer fact of being male. I don't necessarily agree with this, but I certainly don't think people should go with someone they aren't comfortable with regardless of the reason.

The reason I don't necessarily agree is because just being female does not make the provider a better ob/gyn physician or a midwife. Some of the most horrible things I've heard come out of providers mouths were from women. Some of the worst manipulation of a perineum has been done by women providers in my presence. So as you can see, I just can't agree that men providers in the obstetrics and gynecology fields is backwards.

I do, however, often wonder what drives men into women's health. I wish I had asked some of the great men providers I've worked with why they chose the field. Many of these male providers are the same age as my parents, so they entered at a time more men were entering the field in general. None of the residents I work with now are men, so I don't have the opportunity to ask any entering the field now.

But, I do want to share something I witnessed that expressed such caring and compassion that I was struck speechless (not something that happens often) that may have answered my questions about men entering women's health. After an arduous labor and second stage pushing that seemed to last my entire 12 hour shift that ultimately led to a cesarean for failure to progress, the doc followed us into the recovery room. This particular doc is a man of few words, and awkwardly tried to express his well wishes despite the situation. As he did so, he gently took a warm blanket and spread it over the bed. Before he left the women's bedside, he pulled the blankets up as if tucking her in. I am sure some will read this as a patronly act, but I know this was not the intention. This very simple act of trying to provide comfort and warmth for this mom and baby was very touching.

Friday, March 20, 2009

The Interview, Part 2 & 3

So last week's interview led to another one earlier this week, followed by a third at the hospital the following day. All interviews went very well, I felt very comfortable with all of the providers I met, and was impressed with their very low c-section rate. I was given some very nice compliments by those I met with, and told on several occasions by several different people that I would hear from them soon- right after they check my references.

I see a job in my near future! Woo hoo!!!

Monday, March 16, 2009

Getting Rid of the Fear

The editorial in the most recent Journal of Midwifery and Women's Health got me thinking: what can I do as your nurse midwife to make labor and birth as fearless event?

So many women fear childbirth. And with good reason. We are told it is the worst pain ever, that it will feel like you are being ripped in half, that you can't do it unless you get boat loads of drugs or a dense epidural, that it causes women to lose total control of themselves and scream bloody murder, or it is better to just schedule your c-section because you can avoid labor altogether. At least, this is what our culture makes it out to be.

And I am not saying that having fear is wrong. I think its only natural. I mean, this is what I do- this birthing business- and even I have my fears. Specifically, I fear two things: perineal lacerations and lack of options requiring me to give birth in an environment riddled with needless interventions and an attitude that birth is a pathological process that needs to be "cured".

Now, I understand there are women who have a history of sexual trauma can have major anxiety and fear about childbirth- I am not referring to this root cause of the fear in this post. That is a whole other can of worms that deserves special attention outside of this.

I am just talking about your everyday woman who fears birth.

One of the things I stress when I teach childbirth classes is how fear plays a big role in perception of labor and birth, and for many will actually heighten the pain experience. I truly believe this, and have cared for many women who are so frightful that active braxton-hicks contractions has them tearing up the walls and pleading for death.

I try to help alleviate fears when I get the sense that a woman I am caring for is anxious or fearful. I do this by being calm (you'd be surprised how much difference it makes when a nurse or other provider comes into a room very high strung, loud, or abrupt, among other ways, can make a woman in labor more fearful or anxious). I listen to what she is saying. I validate what she is saying. I try to reground her when she spirals into her fears. I give encouraging, positive words when needed.

Prenatally, outside of listening, educating, encouraging the woman to further educate herself, I don't know what else to do. So, as I asked earlier, what can I do to help alleviate these fears?

(And a congrats to Rixa for the publication of her article Staying Home To Give Birth in the same issue of JMWH)

Sunday, March 8, 2009

The Interview

I have another interview coming up this week; I am hoping it goes well but I'd be lying if I said that I had high hopes. I have gone into every interview with a positive attitude, did my best to portray the CNM I would be and what I would add to their practice. I've walked out of each one thinking I had it in the bag. And then.... nothing.

I've reviewed everything about these interviews to see what could I have done that turned them off. And I honestly can't find anything. Seriously. And I can find fault with lots of things; this is not one of them. Actually, the one thing I could say is a negative is something out of my control: I'm a "new grad". I've got that stigma. I would require extra work on part of the providers in the practice because of the extra nurturing and mentoring I would require. And I've requested that I get adequate mentoring.

There has got to be something out there for me! My plan, however, is to pursue the NP route if this job doesn't come through. I am more than 6 months out from graduation and even if all the experience I can get right now is outpatient office care, then so be it.

But I really want to catch some babies!!!