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midwife2b's Latest Activity

  1. midwife2b

    My 2 cents on natural birth/birth plans

    Having been in such situations, I agree with Deb 100%. Families need to feel that they've been treated well, their choices respectfully addressed, and their needs have been met. The AMA documentation did not save us from several lawsuits and investigations over the last few years when I worked as a L&D nurse. As our attorney so aptly stated, "Policies are for the institution. Guidelines are for the people, and you cannot dictate behavior in a free country". FWIW my ladies are "forbidden" to have more than one page on their birth plan :) Their plans actually addresses more newborn and postpartum issues than labor ones, because we talk about the unpredictability of the birth process. Less is more, and a lot of times less is better. That's how our midwifery service "meets in the middle".
  2. midwife2b

    CNMs in NC??

    To my knowledge, there are 2 CNM's who have backup to perform homebirths in NC. One is near the Triangle area and one is in the mountains. you can get more info from the nchomebirth.org website.
  3. midwife2b

    Questionable delivery--mom with cardiac history

    Just wondering where your anesthesia folks were during this???
  4. midwife2b

    My patient was complete for 7 hours :(

    Gee... sounds like you were the nurse I worked with at the beginning of the week :) Short of tying a rope around the baby's head we did everything I could think of for my patient before we called a C Section. She was actually complete for about 8 hrs. After 2.5 hrs of pushing she got a bolus of epidural medicine so she could rest... we started pushing again a few hours later. Baby never had a decel. Parents are happy that they were allowed to try as long as they did. It is exhausting...
  5. midwife2b

    Distance MSN CNM Schools

    Happy to chat with you about ECU...
  6. midwife2b

    U.K Midwife and nurse needs help

    I currently work with an Australian and a UK RN, both trained as midwives. They both are in school working on their masters degrees. They were told that was their only option.
  7. midwife2b

    Postpartum depression

    About 80% of all new mothers experience some "baby blues"; feelings of sadness, emotional outbursts, teary times. These blues are considered normal for the first 10-14 days postpartum. If they continue past 2 weeks, or are so severe as to cause difficulties with bonding or family relations, our patients are asked to come in for an evaluation. I've seen quite a few who benefitted from this early intervention and had great outcomes. This is one of the reasons why our midwifery service has a 2 week appointment for postpartum: to distinguish blues from depression, and to work on any breastfeeding problems.
  8. midwife2b

    Time outs for C sections

    If our patient is awake, the anesthesiologist says, "and what is your name, please?" and the patient responds. Next: "And what are we going to do now?" "I am having a C-section". "And who is your doctor?" "Doctor so-and-so...(and midwife(!) If they are asleep or otherwise unable to speak, we do the usual "ladies and gentlemen" type time out. JCAHO LOVED this! We do tell our patients about the time out so they know our safety measures.
  9. midwife2b

    Cervical Checks

    Quote from Smiling Blue Eyes: Personally I dont' get hung up and play w/any numbers other than those. Really, there is not much diff between say, 70-80% ----I mostly chart 0, 50, 80, 90 or 100%. I am amazed at folks who can call a "30% effacement" but hey, we are all different. I agree with Deb. I chart just like she does. In the "old days" we charted thick, thin or complete. No percent. Have a few older docs who still will chart "67.2312" or "not nearly as thin as it needs to be".
  10. midwife2b

    opinions about epidurals

    I really appreciate all the responses so far! Each of us has a different idea of what labor entails and means. I tell my clients that there are risks involved in crossing the street. One learns all the possible ways it can be done and then picks the best way for them. The same can be said for labor. For some it is "work", for some it is a joyful day with or without pain medication, for some it is a dreaded event no matter how prepared or how much medication is available. Risks and benefits of each intervention are carefully discussed. The patient then can make fully informed decisions about her labor and birth. I think it is a cultural (or sub-cultural) thing depending on how and where we were brought up and how we discussed things like our first period, labor, menopause, aging, and all those other transitions in our lives. I had a wonderful birth this week with a lady whose mom was delivered by the famous Dr. Bradley. She thought of labor as work, with a wonderfully positive outcome. She was also insightful enough to realize that not all life changing events turn out as planned. She has a beautiful baby daughter and her C-Section could not have been more pleasant. Her choices were supported all the way. Her epidural was not a measure for "pain relief" but for therapeutic relaxation of her pelvis so her baby would descend. Unfortunately (or fortunately depending on how one views it) it just wasn't meant to be. Epidurals can be wonderful or can be horrible depending on how the patient sees it. And it is really all about the patient, isn't it?
  11. midwife2b

    Can you be called "Doctor" with a PhD in Nursing?

  12. midwife2b

    Sterile Speculum exams for ?ROM

    I've seen warm sterile water used. I remember hearing or reading that saline may interfere with the sodium crystal pattern you are attempting to see on your slide. Personally I have never had a problem getting a speculum in a term pregnant woman b/c of their natural KY jelly!
  13. midwife2b

    Lay Midwives?

    I've been reading a bit about "unassisted birth" and "unassisted VBAC". Now that is kind of scary to me! Does anyone know of a family who has been that route?
  14. midwife2b

    Frontier in May??

    How old is too old to start? I am 41 nowand doing my Master's as Perinatal CNS/Educator. I like education, but I really do like clinical situations. I never mind helping on the unit, etc.It will probably take me about 4 years to finish my program. Right now, I think I may go into academia, like a community college when I am done w/ my MSN and moonlight as staff. I just started in staff development as a unit educator, so I am getting my feet wet. Are there any 45 or 50 year olds going to Frontier? Would someone want to hire me if I did decide to get my CNM at that age? FYI, I finished my CNM program when I was 47. Worked as an L&D RN, WHNP, BSN instructor, etc. trying to find my niche in life. You are never too old!
  15. midwife2b

    How many pregnancies are too many?

    Too many is when your health suffers. When mama's health suffers, the entire family suffers; financially, emotionally, socially. I have always admired women with large families. They are so organized! Where I grew up it was mostly Catholic blue collar folks. Large families were considered the norm. I have 4 sibs and we were "small" in comparison to the families I grew up with!
  16. midwife2b

    I have been asked to be a Doula!

    If they use a birthplan, take a CONDENSED version to the hospital. I tell my clients: the nurses would like to know what you'd like, but they really don't have time to read a 10 page detailed plan, introducing in great detail who will be there (for example: my second cousin on my mother's side, Rachel will be there. However, we are just coming off a big fight after her surprise birthday party did not go well so I don't know if she'll be there blah blah blah), or any other nonpertinent information. :balloons: I second this!!! And don't call it a birth "plan", keep it like a "wish list" or "birth desires". Anything more than one page is not read, I've experienced. Some facilities still whisk the baby away to the nursery. You might emphasize certain desires if you know they are not common practice at the hospital she is birthing at. At Christmas time I saw a family who had one very complicated 7 page birth plan that described exactly how, and where, the infant was to be resucitated if the need arose. No lie! The mom wanted the baby placed on the overbed table over her abdomen and the nurses were to do bag and mask/CPR/ meds/ etc. where she could see... and the cord COULD NOT be clamped under any circumstances until it stopped pulsating. Fortunately (for me) this was a patient who was going to be delivered by the doctors. I directed her to the Neonatology Dept. She had an uneventful birth thank goodness!