Wednesday, June 13, 2012

I am a Midwife... Part I from Mothering.com


I spent some time last week with a dear friend in my community who is a homebirth midwife. Then I saw her facebook page a link to this video on Mothering.com and guess what? She is in the video. I teared up a little at the end when they all proclaim that they are midwives. But I guess that is what happens when you are a midwife yourself. 




I am a Midwife Because…Part I

Why do women (and yes, some men) become midwives? In the latest video from the new series, I am a Midwife, seven midwives with diverse backgrounds and practicing in different settings in the US and Canada–home, hospital and birth centers–share their stories of what led them to midwifery. For some, it started with their own birth; for others it was a deeply felt “calling,” a way to be part of the “solution” of improving birth outcomes and experiences for women and their babies.  Inspiring, moving and at times hilarious, I am a Midwife Because…provides an inside look at what moves women to do the important work of being a midwife. Part 1 of 2. Part 2 coming next week!

Monday, June 11, 2012

My facebook post answers... C-Sections

I thought I would take a second to answer the questions that I posted on our facebook page over the past couple of days related to c-sections.

Click "like" on this status if you had a c-section... was it planned? emergency? We will have some c-section posts over the next few days and would love any moms with experience to comment/post.
I had a c-section in July 2009 with my daughter... It was unplanned for fetal intolerance to labor.

Okay moms that have had c-sections, how long after delivery was it before your baby was skin-to-skin or snuggled up to you?! I feel very fortunate. It was probably 5-10 minutes after delivery that she was being held by my husband and snuggled up to my shoulder and face. As soon as I was moved from the table to my recovery bed (still in the operating room) she was placed skin to skin and I held her as they wheeled me into recovery. I was nauseated, exhausted and don't remember these moments very well but I can remember how beautiful she was and how happy I was that she was okay. I don't remember exactly when but I know there was someone helping me breastfeed her while I was still in the first hour of recovery. I think she latched well... I can't remember. I do remember my family kept calling her a little lizard because her tongue was going in and out of her mouth so much... I'm lucky that even after a stressful labor and c-section she was ready to latch from the moment she was born.

Was your c-section recovery easier or harder than you expected? What surprised you most about the recovery? Was your pain well controlled? It was SO much harder than I expected. I am amazed as I watch women moving around on only motrin day one post surgery!! I still can't believe the burning feeling that I felt for the first couple of days at the incision site. I staggered motrin and percocet for pain control. It worked okay but I was on pain meds for a couple of weeks. I had a very hard time walking up stairs and/or leaning over to pick up my baby for at least a couple weeks after I got home. I thought it was strange that one side of my incision always hurt more (I think the left side) than the other. I remember being surprised at the numbness at the incision site. I had never thought about the nerve endings being cut during surgery. I don't have a vaginal delivery to compare my experience with but it was about 6 months before I really felt like my body had recovered.

We will be continuing with c-section posts and discussions... the reality is that many women deliver via c-section (32.8% in 2010, CDC National Center for Health Statistics). Many of these are unexpected, unplanned. What can we do to better support and prepare our c-section moms? The World Health Organization suggests that best outcomes for mom and baby occur with a c-section rate of 10-15%. What are we doing and what can we do to lower our c-section rates? So, so many things to explore... thanks for participating and sharing!!

Sunday, June 10, 2012

Sorry

So sorry for the lack of posts lately. I am trying to recover.

My back up doctor is out of town. He has been gone since Thursday night.

Friday I caught 1 baby.
Saturday I caught 2 babies.
Sunday I caught 3 babies.

Need I say more?


Sunday, June 3, 2012

The WRAP -UP from South Africa

(This post was already on my Facebook page, but I realize not everyone has access to that) So...now that we are all done with our South African journey, it will take awhile to process the trip, and all I have seen and done. I managed to do five surgeries with no mishaps, no needle sticks, and, thank goodness, no bad outcomes. It is amazing how much they do with so little...Yet, their operating room was equipped with all of the same instruments that we use, including cautery--and they are very aware of the high risk of blood contamination, because EVERYONE wears a protective "apron" under their surgical gowns, and EVERY package of gloves comes with two pairs. On the last day, when we were supposed to be packed up and gone by 4:30, I could not say no to doing a stat CSection at 4:00 when there was no other doctor around. I feel good for having done "good", but at the same time, I was always SO much more vigilant than usual, thinking of my family and myself, and what would happen to me if there was a surgical mishap when most of these patients are HIV positive. It was exhausting. Would I do it again? Definitely. Would I do some things differently? Definitely. Working for a short time in two different places, although interesting in terms of variety, is not as effective, I believe, as working for longer in just one place. I had JUST gotten to know the layout of the hospital, who to ask for the key to a locked office, and who is the nurse in charge of booking a C Section; then we were leaving. They told me they learned so much from me, but it was truly both ways. I now (unfortunately, because of their patient population) know when to put a patient on anti-retroviral medications, how to treat TB, and how common cervical cancer is in a place where no one gets a Pap smear. One thing I can definitely say is that I would like to make a plea: the places we visited and worked are in serious need of money for supplies, equipment and education. Everyone who has been following and enjoying this blog (and your friends and family)---it would be so great if you could make a donation to either the Network of Caring, or the RSAA, the Rebuild South Africa Association. These are the two organizations that sponsored this trip, and both have websites where you can go to see their work and to donate. In closing, there is one declaration that comes to mind which sums up how I feel about all the doctors, dentists, nurses, contact people and everyone else who made this trip possible. To quote from one of my favorite musicals, (Wicked)------"because I knew you....I have been changed for good".

Saturday, June 2, 2012

Isn't it ironic?

I am pretty much done blogging about my trip for now, unless anyone has other things they would like to ask or know about from my journey. I just thought I would mention one last thing---the irony of the fact that I have been blogging on a website devoted to beautiful gowns that moms can wear in labor------yet EVERYONE who was laboring in the hospital that I was volunteering at went through their entire labor, AND their delivery---completely naked!!

Friday, June 1, 2012

Surgery in South Africa

Dr. Levy's Blog Post from May 30, 2012.

Where on earth do I begin to talk about the last 4 days of our trip? We got on a van, with an attached trailer with all of our belongings, and after a mishap with a speed bump disengaged the trailer, we were finally on our way-(after it was fixed of course)- to Tegula Ferry, a town in the mountains of South Africa 7 hours from Johannesburg and about as poor as they come. It's the home of a large orphanage where forty % of the population have HIV or AIDS, and we came here to open a temporary dental clinic and for me to do whatever I could. The dental clinic was a resounding success-- seeing and taking care of many children (and adults) who had never seen a dentist. They filled cavities, did check ups, extractions, root canals and gave away about a thousand toothbrushes.

As for me, it turns out that the list of "whatever I could do to help" was long indeed. The one (ONE!!) main doctor here, who is responsible for almost all of what goes on at this 300+bed hospital is a wonderful, sweet, overworked general practitioner who told me he is a "jack of all trades and master of none"....more like he is a Superhero and something close to a Saint, all rolled into one. I went on rounds with him, advised him on at least fifty different patients' treatments ( for example, for those of you in the L&D world, they had a 10+weeker on Mag Sulfate, and wanted to Section a primip who had slight fetal tachycardia but no IV!!) I did many sonograms, saw patients at their high risk antenatal clinic, and did three surgeries. The surgeries were a D&C ( they don't have suction), a postpartum tubal ligation that I convinced him could be done with a sub umbilical incision instead of a Pfanensteil, and believe it or not I repaired a female circumcision on a woman from Somalia who had been almost completely sewn up. I hadn't seen this in real life before but had read about it in preparation for this trip. All three surgeries were successful, and the learning opportunities here are amazing....and not just what they can learn from ME!!! It is what I can learn from them--- like how to run a maternity ward with only one working fetal monitor....how to judge how pregnant someone is without really knowing when their last period was or having an early sonogram...how to diagnose and treat multiple conditions without the methods or technology we take for granted every day, that truly stand out in my mind. I am in awe of what they do and truly did not come here to tell them how to do it "our way". They have taught me that our way is certainly not the only way, or even necessarily the BEST way; but that it takes a certain kind of person to be able to manage all that they do here using only the most basic of tools; skilled hands, a sharp mind, and a kind heart.

This is the midwife in charge of L&D in the hospital in South Africa. Note the name on the t-shirt-- they're going to put it on the model doll that they use to teach breast feeding to the moms.


Thank you Dr. Levy for sharing some of your experiences with us. We are so excited to see you back at work this weekend. We are very excited to hear more about your adventures!