Sunday, November 30, 2008

On call part 2

My mexican lady came in and was dilated to 6-7 cms! Woohoo! She took her sweet time but eventually progressed to complete, pushed badly (so we did some towel tug of war which really did the trick), but then had a cute little boy.

In the meantime, the same patient from Thanksgiving night that Medwife had scheduled for induction today showed up for a labor check. She was 6cms! So I kept her and she labored au naturale - and did a beautiful job even when I had to give her a little pitocin. She walked a lot, used the tub a couple times, and did a fabulous job.

Today we put the trees up but haven't done any decoration yet..will probably do throughout the week.

Holy Family Birth Center

The Holy Family Birth Center is in danger of closing its doors...check out this article and then see how you can help.

Saturday, November 29, 2008

On call today

Not much going on yet for today. A spanish speaking patient should be going to the hospital soon as she thinks her water is broke. With what little spanish I know and her very limited english we still managed to talk on the phone :)

Which one of us... not like the others?

There's one of us midwives who is very different from the others....Medwife.

Her annoyingness seems to come in waves. And we in the midst of a huge wave!

Last week, Medwife takes it upon herself to induce my personal patient on her call shift. Ok, I could get over this. But she never calls me to see if I want to come in for the patient! The patient and her spouse asked Medwife 4 times if she was going to call me. Medwife informed them that it would be unethical and inappropriate to call me because it was my night off. WTF????? She's had no problem calling me on my day off in the past for my personal patients. And I know it's not about the money. So, WTF? The nurse tried to page me...unfortunately not knowing that when I am off my pager is off, and I have to be called on my cell or at home. Oh well, was disappointed that I had missed it.

While on call for Thanksgiving, a patient came in that evening - the patient sees Medwife in the office and was scheduled for induction on Sunday. She was contracting a little and hoping maybe we would move the induction up. I didn't do it but maybe I should have :P

Medwife is scheduled on call Sunday she has two inductions scheduled for Sunday. One comes in at 6am and the other at 2pm. So she'll make the midwife on call manage her labors all day (on a Sunday no less - we aren't supposed to schedule inductions on the weekend) then she'll come in to catch. That's messed up and I would certainly be raising hell about it. We are gonna have to have a long talk with her at out next meeting.

Thanksgiving call was pretty laid back. I got to stay home during the day then went in about 9pm for a labor patient. Had a nice birth about 2am, then off to home and in the bed :) The food was delicious and I was thrilled to have spent the entire day at home with my family!

Wednesday, November 26, 2008

Thanksgiving Menu

I want to wish everyone a Happy Thanksgiving!

What's on your menu?

What are your traditions for Thanksgiving?

Our menu...

Green bean casserole
Squash casserole
Garlic mashed potatos
Baked sweet potatos
Dinner rolls
Shrimp cocktail (for my semi-vegetarian mother)
Cherry pie
Brownie Chocolate Chip Cheesecake
We don't really have any traditions for Thanksgiving. I'm on call so hoping for a quiet 24 hours. We'll sit around and watch movies and just chill. And eat, of course.
We will do a little shopping on Black Friday. Then I am on call again Saturday. Then Sunday, we'll start decorating for Christmas :)

Monday, November 24, 2008

Dental work

I had dental work done today...a 'deep cleaning' to be exact. Because I have had dental and oral surgery in the past, I tend to get very nervous about all things dental. I am pretty tough when it comes to pain...except in my mouth. I opted to fork out the extra $25 for nitrous oxide (laughing gas) since my heart rate was almost 110 bpm and I was rather tense (I think I left my butt cheeks indentation on their chair :p).

That is some good sh*t! Sign me up for weekly dental work!

Sunday, November 23, 2008

A funny birth story

I was on call again for 36 hours - this one was much quieter. I got to stay home both nights, only at the hospital during the day.

Two stories of interest...

I thought I was going to have my first run-in with Dr Attitude (he's got a very quick temper, been known to make nurses cry, hates one of the other midwives and let's her know it, has been a complete ass to every midwife, except me, at least once). I have always gotten along fine with him. He's a great doctor and has a nice following of patients who love him. So anyway...

I had a pretermer come in who had been seeing a mix of midwives and doctors for her prenatal care thus far. She requested a midwife when she came in. She's totally not a midwife patient at this point with a combination of recently diagnosed GDM and PTL. She's 2/70/-2...and contracting. She can't have the terb due to the GDM. Her UA is negative except for sugar and ketones. The RN in triage (who really friggin scares me and shouldn't be in nursing due to general lack of common sense and intelligence) doesn't collect a fetal fibronectin prior to the exam so that's out the window. I'm now really limited in a situation where this is true PTL. So I ask the nurse to go and give Dr Attitude the run-down since he is in the OR and can't come to the phone...I mainly just want to know if he agrees with me that we need to mag this patient. He basically gives her a hard time, won't let her finish reporting the situation and tells her to tell me that I need to come in and evaluate my patient.

I was absolutely livid and cussing! It's a teamwork thing for's also really a patient who is out of my scope and he should be handling anyway. It's 8am, I had a rough night due to allergies and my pager going off every 20-30 minutes for the past two hours, and the induction left over from the previous day was just getting going. I have gone and discharged c/s patients for him, when he forgot, or just couldn't get by there, I have handled his induction because he didn't a certain doctor caring for his patient, I have caught babies for him when he couldn't get there or just didn't want. The least he could do was not act like an ass.

So I go tearin' up there, ready to get into it with him. However, I have a quick temper, but also quick to cool off. So by the time I get there I am chillin' again. I decide to just see how he behaves towards me. And he behaved very friendly and helpful! Go I just let it go.

Story #2 - I had a patient that came in 5-6 cms and requesting an epidural. This is her 2nd baby. She gets very comfortable with her epidural. She has a very active baby, at times the nurses are struggling to keep the little one on the monitor. They requested a scalp electrode at one point to which I said no (she's GBS positive). I catch another baby then come out to chart. While charting I notice that they are not tracing the baby again and haveven't been for several minutes. Since I was wanting them to have her start pushing (she had been 10/100/-1 a little over an hour previously) I decided to go ahead and place the scalp electrode. I get a glove on when the patient has a funny look on her face.

I ask "What's wrong?"

She thinks for a few seconds and says "Nuttin', I'm just trippin'."

I pull the sheet back one else is looking...There's the baby born to its armpits already.

I say "no, you aren't trippin'. Hey everyone, take a look"

So with one glove on, I guide the baby out the rest of the way, the nurse lifts him to momma's belly and we were all laughing. The nurse kept swearing up and down that she had just looked down there when she went to turn her again.

No wonder she couldn't trace the heart rate...*giggles*

Thursday, November 20, 2008

36 hours is a long time

I did my first 36 hours of call earlier this week. It's kinda intimidating to think about that many hours in which anything or nothing can happen, stretching out ahead of you. This only preps me for when I do my first entire weekend next month - from Friday night to Monday morning. It wasn't too bad, but I was definitely wore out by the end. Here's a recap...

8:00pm - I get a call from a patient who has a history of fast labor with her first baby. She thinks she's in labor and plans to head to the hospital in about 30 minutes. Calls me back 20 minutes later to let me know her water has broke and she is contracting one on top of each other. So I strip off my pajamas and throw on scrubs and start the mad dash to the hospital to meet her. She lives much closer so I call ahead to the hospital to let them know she's coming and that she will likely be pretty active. Now, because of those stupid photo zones, I can't fly too much but there's no traffic so I still make pretty good time. I'm 10 miles down the road when the hospital calls and says "she's complete and +2, when will you be here?" Twenty minutes. Never gonna make it. I tell them to have a resident stand by. The resident doesn't make it. I miss it by 6 minutes. The nurse and FOB caught the baby :) I was very disappointed especially since she birth standing up (which freaked the poor newbie nurse out) and I haven't caught a baby like that. I would have loved to have done that!!!! Anyway, everything ended well.

So I go back home as there's nothing else going on.

2am - a young primip comes in because she's worried about some spotting/bleeding after intercourse. No pain, just wanted to make sure everything was ok. She's 5cm with a bulging bag of water. But contracting irregularly, and not feeling them. I give orders to let her walk a couple hours and I go back to sleep (I had been asleep maybe an hour up to this point).

4am - she's still 5cm but now feeling crampy with contractions....ok, keep her and I will come in a little later to break her water. I go back to sleep.

6:45am - crap, I need to get out of bed and get in gear. Hit rush hour traffic, arrive at the hospital about 8:15am. The lady is still just mildly crampy, 5-6cms, narrow pubic arch makes me nervous. I break her water and send her walking. She gets going and progresses to complete after walking, showering, and dancing with her boyfriend.

11am - she's pushing

1pm - The caput is +2, head is still at 0. I call the doctor for a c/s for failure to descend :( My first c/s in 4 months :(

I first assist for the first time and it went well! I was nervous and clumsy but the patient was happy that I would be staying with her and helping the doctor. The doc was very nice and helpful as was the scrub tech.

While this is happening, another patient comes in. She is also a young primip. She also walks for awhile and then changes her cervix. I keep her for labor.

I break her water around 6pm - she's 5-6cm now and requesting an epidural.

Shortly before 10pm - we have a really nice delivery, no lacs, after 30 minutes of pushing. She did a fab job.

I go home.

11:45pm - I fall asleep.

12:15am - The hospital calls to inform me that the young lady has a large hematoma. After discussing with the doc, he will go in to drain it. I feel obligated to go back as it is my patient.

1am - they are already in the OR and taking care of it. Patient is out cold. I hang around and watch him finish up. I wonder how often the nurse was looking at the patients' bottom, for a grapefruit size hematoma to have formed. The bleeder was small.

2am - Back home - I go straight to bed to rest my bloodshot eyes. Not a peep from my pager the remainder of the night!!!

And I get to do this again this weekend :p

Sunday, November 16, 2008

Sign on the dotted line

Please go check out this statment and sign it! Help support a woman's choice for childbirth!

NY Times talks about home birth

Check out this article from the NY Times about home birth...

Saturday, November 15, 2008

Another one of those

I had another one of those ladies the other day. You of those who no longer wants to be pregnant at a ridiculously (sp) early time in her pregnancy. She fell in that gray area of 34-37 weeks, where outcomes are sometimes fine, and sometimes not. No matter what I said to her, she just wasn't interested. She 'knew' her baby would be fine. I really tried to explain to her why it was so important that babies gestate for the full amount of time but she just wasn't having it. She had told the nurse, prior to my arrival, that she would break her own water if she knew how to. I finally told her that there wasn't a midwife or doctor in our practice, or anywhere for that matter, that would do anything to help her have her baby. I felt the need to tell her that in case she got it in her head that I was the only one who wouldn't help her cuz she just wasn't liking what I had to say. I really was very patient with her!!!! When I finished (finally gave up), I walked out to the nurse's station and asked the nurse if it was wrong of me to want to smack the patient upside the head?

BTW, before any woman flames me because some women have a lot of problems with pregnancy (such as severe hyperemesis, etc) - this woman had no problems...just didn't want to be pregnant anymore.

Wednesday, November 12, 2008

Call yesterday/last night

Lots of pretty normal and straightforward labors and births yesterday/last night. I caught four babies total :) It was my first call this month, due to being on vacation most of last week.

I was aggravated though on the way home from the first round. They have placed these stupid photo enforcement zones all over the interstates I use to get to the hospital and I got 'flashed' on the way home last night. One of the nurses suggested sending them a copy of my badge and explaining I was on call for births...I'm thinking "yeah that would be great but I traveling away from the hospital". Might be hard to get that to fly. The whole photo thing really is a pain in the butt for me. In the middle of the night, if I need to get to the hospital fast I really put the pedal to the medal :p Now I can't do that. Hope women can just cross their legs and hold it in.

Sunday, November 9, 2008


Vegas was great! We had a fabulous but exhausting time. It was me, my mother, and one of our old midwifery students (who had greatcause to celebrate since she just had passed boards). She taught me how to play craps which is wonderful fun!

While we had a great time, there were some things that drove me nuts...

1. People from other countries that seem to have a smaller bubble (thx Lisa) than we do...stay out of my personal space!

2. A man asked me, after touching my tattooed back and arms, "if it was sexy getting tattooed?" Umm, no, duh. It f*ckin' hurts so I guess it would be sexy if you were into S&M.

3. When walking through the casino, do not stop dead center in the aisle and force everyone behind you to squeeze around you. You are not that f*ckin' special princess.

4. When walking through the hotel/casino/wherever watch were you are going. It's kinda hard to avoid running into people when you are walking and looking at the ceiling.

5. When playing Blackjack, do not regal us with your amazing prowness at the game by splitting tens against the dealer's 5. You are breaking up an almost sure winnning hand. And regardless that you think it's your money and you can play how you want - you are f*cking up the whole table.

But other than that, had a fab time!!!!!

Monday, November 3, 2008


I'm on vaca starting this morning - woohoo! It's just another short one but still much appreciated. I was on call last night - very quiet - as I had hoped it would be. I got the typical 5am phone call from a lady who thought she might be in labor. As I have mentioned before - night call will always involve a phone call at midnight, 3am, and/or 5am. I told the lady (a primip) to stay home as long as possible - and baby moving well of course. She rushed right into the hospital - she was surprised I was telling her to stay home. Naturally she was 2cms...

So tomorrow I leave for Vegas. We are having a girls trip this time. It will be me, my mommy, a nurse who used to work at the hospital and a old student nurse midwife (who's taking her boards today and hopefully passing as we 'speak'). I'll be back Thursday so will plan to blog on the trip this weekend :)

See you guys in a few days!

Saturday, November 1, 2008

Halloween fun

We had a nice time last night for Halloween. It's one of my fav holidays....well any holiday that gets me candy is a fav! In fact, it's one of the reasons I had children - great way to get free candy :)

I was a zombie midwife carrying my raggedy zombie baby. Both of us had blood all over us. My scrubs said Ded Midwifery Service - snicker...get it?

My husband was a cereal killer. My mother was a cross between Cyndi Lauper and Tina Turner - she was punk rocker wearing this purple wig that i thought we would have to kill.

The kids were a vampire, red devil witch, and a princess.

I hope everyone who celebrates this heathen holiday had a wonderful time!

Part 2

Lady #2 did an amazing job with her labor. This was her first baby and she did it like a pro. I had seen a lot of her in the office so was thrilled that it had worked out that I would catch her baby (it usually does). She labored all day long and into the night doing various positions, the tub, the ball, etc. Unfortunately the baby was so low in her pelvis that from 5cms on she wanted to push. The ball helped the most but I felt so bad for her. Now, the delivery, I'd love to tell you how wonderful it was but I missed it! I got tied up with lady #3 and was not happy about it. So, a midwife from another practice happened to be there babysitting her two ladies with crappy labors. She stepped in for me and caught. She said lady #2 rocked. It was a big baby boy and no lacs - woohoo! But I was very sad to have missed it.

So while my personal patient lady #2 was delivering, I was stuck with a naughty baby belonging to a very whiny lady #3. Essentially, she and her significant other were very nice people but I had only met them the day before. She spent much of the time when I would visit with her talking about how she went into labor and what she did and didn't want for this induction. For someone who spent so much time begging to be induced she was being awfully picky and high maintenance. After pitting, broken up with some walking and a shower, she finally started moving along. We had started before I even came on call with pitocin and I couldn't break her water until around 8pm that evening. She continued to make progress but then we started getting some really ugly strip...big deep variables with contractions...guesses on what the problem was??? Yes, she had a nuchal cord. So anyway, she had an anterior lip which I was able to reduce. She was about a -1 station at this point but I figured she could push it out in 10 minutes or less. Her biggest baby was 8-4 and she had had three vag deliveries already. So I tell her I want to go for a quick delivery due to the variables. She then tells me she is a bad pusher, had to push a minimum of one hour with all her babies. Greeeaattttt...and she wasn't kidding! For every good push she had, there were about 8 crappy ones. I was starting to think I would need to call the doc in for a vacuum delivery. She finally did it about 12 minutes after lady #2 delivered. Grrr...and she whined the whole way through. I felt a little bad because she was starting to cry but I knew she could do it...we just had to figure out what worked for her. It was just frustrating for her and for us...towards the end we were getting variables down into the 40's but still fairly rapid return to baseline after contraction. I hate hearing that slow thud....thud...thud....and naturally my doc didn't want to come in. I had told him I would work with her for 10 more minutes, and if she didn't make some progress then he was questions asked.

Oh well, lots of healthy, happy parents and babies so all's well that end's well :) Can't ask for much more than that!