A Cold Front and A Challenging Week

A major cold front came through the Houston area last week and brought many babies with it. Five women in my practice had their babies. All of them had some kind of problem or challenge that gave me a few more gray hairs. However, they and all their babies are doing fine.
The first one to deliver was one of the sweetest women I've ever met having her third baby. She had developed a condition called cholestasis- a liver dysfunction. It was a month before her due date, but she had been admitted to the hospital the day before and induced. We had spent a lot of time in the early part of the week consulting with a GI specialist and then finding an Ob/Gyn to take over her care. The encounter we had with the GI doctor had been very unpleasant. Dr. J at NW Memorial had taken over her care and he took good care of her. She had a vaginal birth and went home the next day. Unfortunately, the baby had to stay in the hospital, but is doing well.
My next client was having her first baby and was a few days overdue. She went into labor after a few starts and stops. I really believe the cold front is what did the trick to get her into labor. She had a relatively quick labor and a normal size baby, but a severe tear. I knew when I saw it, that I could not repair it at the Birth Center. I called Dr. M and made arrangements for him to meet us at the ER of the closest hospital to the Birth Center. He met us there a few hours after the birth. He did a great job. I have to say that he is something of a saint to help me the way he does when I have problems. Good natured and so competent. I can never say enough good words about him. Things are going well with her now.
That same morning, one of my other clients not due until April 2nd called to tell me her water broke (three weeks early). A definite casualty of the cold front. No labor at all. So we waited. I won't go into all we did to get her labor going, but just let me say we did everything (and worried). We had given up and decided to go to the hospital when the sun came up. I laid down for a little while and woke up and she was in labor and three hours later we had a baby!!! Joy to the world. When her baby was born, it did not breathe right away. I had to resuscitate it and we called 911. By the time they got there when she was 12 minutes old, she was fine- pink and breathing normally in her mama's arms. Just a few minutes of high drama.
My next client actually had her baby before the one I just wrote about. She had two due dates and I think because of the cold front, went with the first one. Went into labor and everything went well until she started pushing. It seemed like she was having a much more difficult time pushing than she did with her first baby. She only had to push for about 30 minutes with the first baby, but this one took an hour and a half. We knew this one was bigger, but she had to really work to push this baby out. She tried many different positions and we helped her every way we could think of. Finally the baby came out- face up! No wonder it had been such a challenge. And on top of that, he weighed 10 pounds. Thank goodness she was so young and strong and able to do it.
The next challenge came the next day, and was relatively minor. My client who I had been expecting for quite awhile went into labor. She was 11 days overdue. Had a wonderful, normal labor at her home. Everything went well. She was in a birth tub at her home, and pushing strongly. Her water had not broke and I was wondering if the baby would be born in the bag. Suddenly, her water broke and bright green meconium fanned out into the clear water of the tub. The baby was born about two minutes later. We suctioned him well to get all the meconium out. He was fine and had APGARS of 9 and 10. All well.
On top of all these interesting experiences, we were having a big family reunion for my husband's family at our home this past weekend ( the first one in 25 years). About 70 people showed up. I got to come home and see everyone for a few hours on Saturday afternoon. Thank goodness my three sweet sisters-in-laws and husband did all the cooking and cleaning and organizing. Since the weather was so cool, we all stayed inside (we had planned to be outside).
Another week in the life of a midwife. Jackie

End of February

Well, February, 2009, is over. I'm getting ready to go to bed and thinking about what I did this month. Helped with 5 sweet babies, and all with no major problems! One of the best things I did was go to see my mom in Amarillo. She is so old and frail-it's hard to see her like that, but I'm so glad I could go and be with her for a few days. She is in a nursing home in a little town called Canyon near Amarillo. I flew up there and drove back. I went through Austin on the way home and went to Lobby Day at the Capitol. That was a good experience- I'll write another post about that.
I started exercising again after a long break. I am starting to feel stronger. I can't always exercise every day, but I try to do something most days. The 3 things I like to do most are an exercise video I do at home, go to the YMCA, or just walk for 30-45 minutes.
I got a new room set up at the Birth Center. That is a big accomplishment! It's good in case we had two babies at the same time there. We got some new carpet in Bonham's room at home. That was one of the casualties of the hurricane. Moved a bunch of furniture around at home.
At the office, I got all the charts from 2008 audited and put away. That is MAJOR! Wrote a letter in response to my inspection from the Department of Health.
Anson is doing well and getting completely over the surgery he had in December. He gained about 5 more pounds this month. I'm happy about that.
I didn't think I did much this month, but now that I write it all down, I got more done than I thought.
One sad thing is that I had to cancel the Annual Reunion I had planned for February 15th. Just have to try again for that.

Life as a Waiting Game

Lately, my life has been about waiting. I have three women who are due most anytime. They are all three expecting their 4th babies. I love each one of these women and am looking forward to their births. I am actually at one of their homes right now. She is in labor, but it is going a little slowly. Sometime today for sure.
This past weekend, I was in waiting mode, but still did a lot of things. On Friday evening, my son and husband and I went to Galveston to a dinner for boys who have earned their Eagle Scout award. Governor Rick Perry was the main speaker. We are very proud of Bonham and I think he is proud of himself. I wish all boys could be in Scouts. It has been a great experience for our boys. On Saturday, I went to three different places looking for carpet for Bonham's room. During Hurricane Ike, his room got flooded and the carpet got ruined. We are just now getting new carpet. We've been trying to get our insurance to pay, but finally gave up on that and are fixing stuff on our own. We are anxious to get his room cleaned up again. On Saturday evening, my husband and I went back to Galveston for a play at the Grand 1894 Opera House. It was Hal Holbrook as Mark Twain. It was good. Yesterday, I went to church and then came home and took a long nap. Last night, I got my kitchen very clean. Now I am ready for these babies to be born.

Inspection at the Birth Center

I'm sitting in my quiet home getting ready to go out for the day. It's cold out there. I see ice on the cars. I'm listening to the radio and disheartened to hear that the bickering between politicians goes on and on.
January has been a slow month for me as far as delivering babies. Only three sweet babies born that I helped with, and they were all early in the month. The past week, I've been consumed with having an inspection by the Department of Health at the birth center. They come once a year to see what goes on there. The woman that comes looks at my charts, looks at my policy books, and asks a lot of questions. Her general attitude toward me is critical and it is stressful. I know she has the power of life and death over my practice of midwifery.
Luckily, I had some warning that she was coming. She showed up last week and I was not there. She called me on my cell phone and asked where I was. I was at a class renewing my Neonatal Resuscitation certification. When she found out where I was, it seemed like she was aggravated, but said she would come back another day. That was a blessing to have some time to get things clean and organized. I felt prepared when she got there on Monday morning. She stayed all day Monday and Tuesday. I don't blame her- I know she is doing what she is hired to do. It just seems like the State is not supportive of something like my birth center where we have generally good outcomes and happy moms and babies.
It is a good thing to get my paperwork cleaned up and organized here at the beginning of the year. Anyone who knows me, knows I tend to be a bit of a pack rat. I have so many things in my life I want to do. It's hard to fit it all in. I went to a seminar recently about giving presentations. I would like to talk to more people about midwifery. I got a lot of good ideas about how to do it. The guy giving the presentation, Edward Tufte, hates power point. I never thought about it much, but he showed how to make something much better.
I am making a quilt. Last year, I saw a beautiful quilt at a shop and took a class to make it. All I did was buy some material and make the first square. So I am taking the class again this year to actually get it made. I have always loved to sew, but sometimes I've gone for years without sewing at all. I am going to try to keep a quilt going from now on. There are so many beautiful patterns to make.

Summary of 2008 Births

We helped with 66 babies at Bay Area Birth Center in 2008!

Home births 33
Birth Center 33
Girls-31
Boys-35
Biggest Baby 10 pounds, 10 ounces
Smallest Baby 5 pounds, 13 ounces
Busiest months- January and October
Busiest day- October 27th- 3 babies born in one day!

Transferred to Hospital Moms-8, Babies-1
C-Sections- 3
Premature- 1 (at 34 weeks)

Oldest Mom- 44
Youngest Mom- 20
Attempted VBAC's-7, Successful VBAC's-7
Breech Births-1
Deaths-0
Long term morbidity-0
Miscarraiges-8 (not counted in total)

8 Resolutions for 2009

- Get my little office cleaned up and usable.
- Get paperwork organized into piles of priority and handled.
- Get active for awhile every single day.
- Get to the office earlier and leave earlier (8-5) unless someone is in labor.
- Eat 7 fruits and vegetables every day.
- Go to the library once a month.
- Take more pictures.
- Get my pictures organized.
- Do something about global warming.

A New Year!

It's the first week of 2009. I am slowly getting back to the rhythm of my life before the recent holidays. Everything was slowed down for the month of December because of Anson's sickness (see previous post). I took my midwife hat off for awhile and just left my mama hat on. It was good to slow down and take care of him and our family. He is doing much better. He went back to school for the first time today, and seemed to do fine. He is terribly skinny, but eating well and looking better.
I went back to work at the Birth Center- not that I haven't been there, but I haven't had my focus there. I have a lot of paperwork to get organized. I guess I will always struggle with paperwork, but I will keep on trying to tame it. It's a requirement for being a good midwife.
I am disappointed in myself when I look back at the previous posts. I only wrote one post on this blog in 2008. When I originally started it, I thought I would write a minimum of once a week. I often lie in bed and think of things to write, but I rarely actually log on and write. I've been reading several midwife books this past year. When I read books like those, I think there is nothing left to write. Many midwives have already written about their lives. On the other hand, no one sees things from my point of view, at this time and place. I witness amazing things in my life as a midwife. I will keep writing because it is comforting to me whether anyone else reads it or not.