I just wanted to say that this entry is awe-inspiring. It brought tears to my eyes. It was beautiful.

You tell such great stories!

-Elizabeth

I assure you that I am not trying to be sarcastic or caustic in asking this question….just curious as to what your answer is.

I actually have seen that before with preeclamptics, during a few deliveries I attended as a nurse (prior to qualifying as a midwife). Sometimes (and espeically if they’re not on magnesium yet) if the woman is in early stages of preeclampsia and her muscles are hyper-reflexive (as in, gearing-up for siezures, but not quite there yet), her uterus contracts extremely powerfully, and the baby comes very quickly. Once you start the Magnesium, though, this tends to disappear.

I’m guessing you’re in the UK? Do you use Magnesium routinely over there, or only for severe pre-eclamptics?

And yes, I do feel supported. I feel nervous and anxious most of the time, but I’ve still got a preceptor which I’m always working consistently with, and this makes a huge difference.

As for not being able to imagine doing this….10 months prior to qualifying, I couldn’t have imagined it either. You do get there, little by little. Guess I have to keep reminding myself of that too. A year from now, I’m sure I’ll feel so much more confident and secure in my skills and management ability, but from where I’m standing now, that still seems pretty far away.

Thanks for reading!  I’m glad you like the site.

The other day I cared for a pre-eclamptic woman who was being induced - we came on in the morning at 7.30 and the midwife had examined her an hour before and said she was 3-4cm and contracting well. At 8am, just before the epidural, she suddenly said ‘the baby was coming and she wanted to push’ (1st baby) and sure enough by 8.30 a little boy had arrived. After the birth, my mentor said pre-eclamptics can suddenly ‘just go’ and dilate very quickly - have you noticed this before?

Anyways, thanks again. Love the site!
s.x

I too wonder what would have happened if alternative methods had been used. Unfortunately, I don’t know much about homeopathy or altnerative therapies yet (I say yet because I really want to learn about all of this, but so far my education has been western medicine, and I haven’t had a chance to start to explore the alternative stuff yet), but I have heard from friends who work with homebirth midwives about how amazing and effective homeopathy can be, especially in stopping hemorrhage. I’m not sure what it can do for preeclampsia, but it certainly bears exploring.

And yes, you’re right: what have people been doing for centuries (eons) to treat preeclampsia prior to magnesium therapy? There must be other methods for symptom relief, and yet, I do think that untreated preeclampsia is one of the reasons the maternal mortality rate is so high in undeveloped countries, or why childbirth was so dangerous in previous centuries. It’s no joke when it’s severe, as it was in this case. It’s certainly not uncommon, but thankfully, preeclampsia is the exception and not the rule. I think that it was all of those other healthy, totally normal, uncomplicated pregnancies and births which have populated our planet with 6 billion inhabitants. Prior to this century, I think many people died from preeclampsia (otherwise known as toxemia), and I think that many women still do in the poorest countries around the world. I’m all for alternative medicine, but I do think that in some cases (like preeclampsia) the hard science makes a lot of sense, and there is strong evidence backing up the use of magnesium to prevent seizures.

Still, it’s good to have it pointed out: is it automatically a given that all of these interventions were unavoidable? You do have to think about it, every single time.
As for the doctor having the ultimate say: it’s always a balancing act in a hospital, like I was describing in my post on Hospital Midwifery. Midwives are the experts in normal pregnancy and birth, but this woman had many complications which made her situation much more high risk, and as a new practitioner and a new midwife, I was more than happy to defer to the doctor’s knowledge and expertise. If this woman had been a totally normal, uncomplicated labor and birth, the doctor wouldn’t have been co-managing. But yes, they do always have the final say. There are certainly days when I feel more like a resident than like a midwife. But still, I think that midwifery care makes a big difference in a hospital setting.

I was sweating and walking the corridors with you. I chaffed at the constrictions and at the presence of the doctor.

But fuck! What a potential mess that turned around so wonderfully. And I’m saying this from the stand point of not at all being a hospital, doctor or medication kind of person.

I shrunk away from the parts of your tale that seemed to say that the interventions were unavoidable. I really do wonder what sorts of thing homeopaths or naturopaths would offer in this sort of situation.

I really don’t think that the doctor’s approach is the only way. It’s just that their medicine has behaved like a predator eating up recognition of all else. I mean, if pre eclampsia was such a scourge and not at all rare for pregnant wimmin, how did we end up filling the planet with 6 billion people, many of whom don’t have access to hospital care?

But, I digress!
You were so amazing! That part where you were stalling, waiting, watching, hoping that nothing would change in any of her data that would set off the doctor and allow for the scheduling of a cesarean? That was intense.

I can’t help but understand midwives working in hospital environments as dealing with major domination. The doctors function as managerial staff, higher ups who can veto anything. This isn’t a relationship of equals they’ve set up that midwives have agreed to.

They have final say. That upset me.

But I saw how you attempted to slow the process even as their model was inexorably dragging that woman towards a horror.

And to my way of thinking, this really didn’t suck at all. It could have been *so* much worse. I’m still amazed and overjoyed that everything turned out as well and as normal as it did.

Have you ever read some of the new research speculating that iron supplementation, esp with synthetic iron, can increase the risk of pre-e? I think it has to do with the physiological blood volume expansion and the response of the synthetic iron to that process. I’ll see if I can find that info for you, if you’re interested.

xoxo