Belly Tales

The Diary of a New Midwife

Colicky Babes, Part Deux

Filed under: Postpartum, Babies!, Breastfeeding — The Midwife at 10:14 am on Friday, November 11, 2005

Don’t you just love it when birthing or breastfeeding or babies makes it to the front page of the New York Times? I do! Go check out today’s front page (well, the online front page, at least). There’s a very fun article there by Nina Bernstein about the diversity of colic remedies for new babies—as diverse as the population of this city. (You have to register to read the article, but it’s free). Go go go!

And speaking of postpartum, guess where I ended up working again last night? Still haven’t seen a birth for weeks (boo, hiss), but I did get to do some great breastfeeding education with four women in particular. There is so much to teach when it comes to breastfeeding, though, that sometimes it’s incredibly frustrating, because you never feel like you have enough time to cram it all in—adequate hydration, and how to know that the baby is getting enough, and how to latch and unlatch, and reassure the mother that the baby is breathing just fine, and how to care for sore nipples, and how often to feed, and for how long, and when to switch breasts, and how to position the baby. You would want to spend at least an hour just talking about breastfeeding alone, but you have eight patients at a time, and inevitably three of them need pain medication and a third is asking for another ice pack and the fifth wants to get out of bed for the first time since her cesarean, and the sixth needs another IV bag hung, and breastfeeding always seems to get short shrift. However, I do try to spend as much time as possible on it, even at the expense of my break, or my charting, because I really believe that if a woman and her baby can have positive breastfeeding experiences while they’re in the hospital, they’ll be able to go home with so much more confidence, and not abandon breastfeeding for “something easier”. And it’s true, breastfeeding does require a lot more work than bottle feeding, especially in the beginning when both the mom and baby are still learning how, but the benefits are so obvious (granted, I am quite biased, but even so…do formula-fed babies ever look even 1/4th as blissed-out and contented as the breast-fed babies?? I think not!). By the end of the night, three of the babies were latching beautifully, with exactly that look on their faces. And I must be doing something right, becuase one of the couples even asked if I was willing to moonlight on the side and give them some lactation support at home in the coming weeks, which is an offer that is actually tempting (although the next question is…how much do you charge for something like that?).

However, the fourth woman I worked with had an adoreable little guy who kept insisting on sucking on his lips and tongue, no matter what we did. In fact, his tongue actually curled up towards the roof of his mouth, so that when you opened his mouth, you couldn’t see the roof of it because his tongue was always in the way. We tried so hard to get him to open his mouth by stroking his nose and lips in a downward motion, and then trying to get the breast in his mouth, but he never opened his mouth wide enough for that because he was always busy sucking on himself instead. The few times we were able to get his mouth open, his tongue was always in the way. At best, we were able to get his outer lips around the areola, but that was it. I feel certain that if we could have just gotten him a little taste of the breast, he would have been hooked. He was obviously hungry, but was self-conforting by sucking on his lips and tongue. I spent over an hour with her trying to get him to latch. Does anyone have any suggestions for how to get a baby like that to actually open his mouth? I think I’ll post this on a breastfeeding message board as well and see if anyone else has any tips either. I’m usually pretty good at helping women get their babies to latch, but he really stumped me. Gotta learn more. First, though, gotta sleep. Good night!

Homebirth in the Capital Region

Filed under: Homebirth — The Midwife at 5:10 pm on Thursday, November 10, 2005

Homebirth is legal in New York State, but only if you are a licensed midwife, and only if you have a practice agreement worked out with a doctor or hospital that explicitly allows the midwife to deliver at home. There are homebirth midwives who practice here in New York City, and homebirth midwives in upstate New York, but if you happen to live in or around Albany, your choices are severely limited. There are NO legal homebirth midwives in the capital region, which means that women who choose to deliver at home in that area have to keep it under wraps, and end up being cared for by midwives practicing illegally. It also means that homebirth midwives in the capital region are pretty hard to find; for many women, homebirth isn’t an option simply because they don’t even know it exists, or else they can’t find a homebirth midwife in the first place. Miriam Axel-Lute, the news editor at Metroland, a weekly alternative news source for the capital region, has written an amazing article which explores the subject in more depth. Definitely worth checking out.

And now, a lament:

The year is 2005. Studies have shown that homebirth is just as safe as hospital birth. 60% of all people born in the Netherlands are born at home, and it’s not a big deal at all. This is America, presumably the land of choice. Why…WHY…do so many midwives still have to practice illegally in this country if they want to deliver babies at home?? Why does it have to be such a struggle?? Why must midwives be viewed by doctors as threats, rather than as colleagues?

Yeah, yeah, I know there aren’t any easy answers to this, and I know that if we sat down and had a five hour conversation on the subject, we could reasonably answer all of those questions, but even so, as a future homebirth midwife, I do wonder…am I going to have to practice illegally someday? Am I going to have to live in fear for my license, my livelihood, my practice…my family? Am I going to have to spend my entire life fighting?

Sadly, I think those, too, might very well be rhetorical questions.

Updates all around

Filed under: Miscellaneous, Education, Academia — The Midwife at 5:18 pm on Wednesday, November 9, 2005

I’ve been a bad blogger, lately, and haven’t been writing posts nearly as often as I should. Which is not to say that nothing has been happening lately (in fact, I’ve been quite busy, and have been having a hard time finding a moment to write), but none of it has seemed particularly news-worthy. School continues at its steady pace. We’ve gotten through our first round of mid-semester exams, which was stressful and is thankfully over, our check-out exams are done, and clinicals start next week for me. We had a spectucular 4 hour lecture on urinary tract infections in Primary Care last week, which was very cool, but didn’t seem to merit an entire post. Although I will mention this cute little factoid: did you know that a woman’s urethra is approximately 2.5-3.5 cm long, while the male urethra is approximately 16.5-18.5 cm?? I mean, obviously the male urethra is longer, but I had no idea it was that much longer. No wonder women get so many more UTIs than men! It seems a bit unfair.

On the work front, I’ve been doing nothing but postpartum lately, which has been a bit depressing. Not that there’s anything wrong with postpartum—it’s fabulous to see all the women and their babies, and to take care of them during a time when they so desperately need nurturing, and you can make such a difference in a woman’s life by helping her with the breastfeeding—but even so, postpartum is a bit more routine and repetitive than Labor and Delivery, and you end up taking care of 8 patients at a time, which can be stressful and frustrating, since you never feel like you get nearly enough time with any of them! Sadly, as a per diem nurse, I don’t have much say in where I end up working. If L&D is well staffed, but they need nurses on postpartum, I am always the first person to get floated. It’s been weeks now since I saw a birth, and that makes for one very very grouchy student midwife. I’m working tonight, tomorrow night and the next night, though, so hopefully I’ll get to see a birth again fairly soon.

In other news, I’ve found yet another really cool website which is well worth checking-out (there are so many of them out there!): Spinning Babies. I’m going to post it as a link under the Labor and Birth –> Vaginal Birth sections, since the information here is really helpful for women trying to turn their babies, or learn about the optimal positions for birth, and ways to help get their babies into these positions. Gail Tully, the homebirth midwife (CPM) and doula educator who is the driving force behind Spinning Babies, offers workshops on her techniques, and there’s a workshop in Boston next Feb., which I would really like to attend. There are so many conferences and workshops I’d like to attend next year! Guess I’d better get saving…

Anyway, more posts to come, I promise. I’ve been working on a doozy of a post on premature rupture of membranes, and I discovered some amazing birth art just a few blocks from my house, so stay tuned.

We’ve come a long way

Filed under: Feminism, Women's Health — The Midwife at 10:41 pm on Tuesday, November 8, 2005

My heart goes out to our poor grandmothers and mothers! Thank the gods for all the progress we’ve made!

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