Another (Suprise) Breech!!!!

Okay, so I was out for lunch today as I had the whole morning and afternoon off. I strolled around El Paso for awhile and decided to come back to the birth center at around 3:30pm. Talk about perfect timing...Right as I was walking in I saw Alison drive up and make a mad dash into the birth center, I thought it was a bit bizarre that she was running in like that and knew there had to be something interesting that either happened or was about to happened. I hurried in to find out what was happening and as I walked in I was immediately handed a lab coat and told that there was a surprise breech about to be born and they needed me to help out with appointments. The waiting room was filled with so may families that were waiting to be seen - everyone was tending to the Mama that was about to birth her breech baby. I tried to delay as best as I could and watch the birth on the monitor they have in the office - I was really bummed that I was about to miss this breech birth. I figured I would just get on with the appointments and do what I needed to do :-(

Five minutes into a prenatal visit the birth was coded!! It was music to my ears "Code one to the bear room, Code one to the bear room" That's the code we use hear at Casa when birth is imminent and the interns can observe. "Uno momento ,por favor" I said to the woman I was seeing and high tailed it out of the room as fast as I could. As I entered the birth room I could barely see that little purple bum making it's way out. With each push the baby came down more and more and within a few minutes the baby's entire butt was out. Alison, assisted with the delivery of the head. It was another beautiful & straightforward breech birth!! The baby had apgars of 7 & 9 and transitioned beautifully into the world.

Theres even more to this incredible story!! Shortly following the birth the placenta delivers. We have an amazing (and scary) Velamentous cord insertion. Check out the pics of this placenta!! For those of you that don't know what a velementous cord insertion is, these types of placentas/cord insertions can be fatal to the baby. The cord typically inserts itself into the fetal side of the Placental bed. This particular placenta the cord actually inserted and attached itself into the membranes (aka waterbag). As you can see in the pics the two arteries and one vein are both stemming off into separate directions at least a good six inches from the placental bed. Needless to say this birth was filled with surprises!!

Mom and baby and doing wonderfully and off to a great start! What an awesome experience that was!!

Well, I hope you all enjoy the pics. I said I wouldn't post again unless something exciting happened and it did :-) I need to get going as I'm 1st on tonight...Hopefully there will be more babies on my shift!

Hugs and love to you all,

Kim

99 hours left!!

Yes, I'm counting the hours I have left till I'm home :-) I've even already begun packing my bags today as well...Yippy! I'm so happy I remained patient and stuck it out here. I really learned some valuable skills along the way. Tomorrow I'll be doing a skills exam and will be getting checked off of on many of the skills that are required by Narm!! I'm pretty excited about that. Each step is bringing me closer to my goal.

Lately I've really been putting alot of thought into exactly what type of midwife I want to be and in which capacity I feel drawn to serve in. My dream has been to open up a birth center in the next few years serving woman both at the center and at home. However, I'm finding that I have an intense desire to do more humanitarian work in areas like Africa or possibly the Middle East. I've also been thinking alot about becoming a Naturopathic physician in addition to my CPM...It's actually something I've contemplated for years. I decided to volunteer working at the Brannick Clinic in Berwyn 1-2 a week, beginning next week. It's an incredible clinic ran by one of the most wonderful Naturipathic physicians I know (she's actually my doc). They provide care for both children and adults, including well woman care, massage, colonics, etc. Dr. Brannick was thrilled that I was interested in volunteering and has welcomed me with open arms!!

Anyhow, I miss all of you a bunch and cant wait to see you all when I get back home!! Thanks again for staying updated on my little blog while I was here. I may post again if something exciting happens but if not then this will be it. Much love to all of you...Mmmmwwaaaaa!

C-ya back in Chi-town!!

Hugs,
Kim

A quick update

Okay, I'm seriously wiped out! I was 1st on last night and was blessed to have five babies born on my shift...Including one frank breech!!!! Talk about exciting :-) It was the coolest thing I've seen in awhile. Vaginal Breeches are a rarity here at Casa - Well, really their a rarity everywhere except the OR room these days. It's been over a year since Casa has done a breech birth. I feel so lucky to have witnessed it (a staff midwife stepped in to deliver that baby - Not me). It saddens me to think that this Mom would have been subjected to major abdominal surgery otherwise - The birth was so straight forward and seemed so normal. The baby came out with apgars of 6 & 9 and eagerly began nursing shortly thereafter...Not bad huh! I have to say he had the purplest little butt and toted a matching purple scrotum as well...He didn't seem to mind though :-)

I've been witness to the incredible phenomenon of what I like to call "labor synchronicity" -A few moms will come in shortly after each other in labor, all at different stages, effacement, dilation & station. Within an hour of each other they're laboring almost in sync with each other and deliver minutes apart - Such was the case last night. The breech was the last one - Indeed it was the icing on the cake for us birth junkies!

I will update gain soon when I can. Right now I'm only on three hours of sleep in two days...I cant wait to go home! Seven more days now (and for sure this time :-)

Hugs & Love,
Kim

Sing it from he rooftops!! A public love note :-)

Steve, I want the world to know how much I love and appreciate you! Your strength and support through this is what has allowed me to be here right now realizing my dreams. I couldn't ask for a more tender and loving husband. Thank you for sharing in my vision and helping me reach my dream in life, I couldn't do the work that I do if it wasn't for you. There have been countless times that I've come home from a birth tired, weepy, hungry and of course, irritable and you have always been there for me. Weather it was preparing a meal for me, watching the kids so I could sleep undisturbed or just listening as I debriefed the experience from the night prior...you were there. I am eternally grateful for you & love you from the deepest part of my soul. You are what pushes me and keeps me going, chasing my dreams, never questioning my intuition. You are my best friend in the whole wide world and I'm so happy to be your wife. We are truly blessed to have each other.

Thank you for everything - Thank you for believing in me!

Your wife,
Kim

I think i can, I think I can, choo-choo...

Okay, there's been a slight change in plans. I've decided to extend my stay at Casa for just a few extra days. I paid for an entire month so I figured I should take advantage of the time I paid for. When I initialy made my arrangments I realized that Mothers day was on the 11th, being the sap that I am I thought there was no way I could be away from my kids over Mothers day so I decided to cut my stay a few days short here. After going over the schedule with one of the midwives here she made me realize what a not so wise idea it would be to leave 6 days early...She pointed out to me that i'd be missing out on almost an entire week of shifts - Which is alot more hands on experience (again, that I already paid for). I'm here so I'm just going to suck it up and do it. I was already begining to pack my bags :-( I cant believe I'm staying longer, wow! I remember when I first arrived here I called my husband and asked him to find me the next flight out of this hell hole. I then phoned Tracey (my prior preceptor & friend) and cried my heart out...ha-ha-ha! I never said I was rational or sane! I'll now be getting home on the 17th.

Sending my love to you all. Keep me if your thoughts and prayers and send lots of good baby catching energy my way!

BTW - Did I mention to you all that I ruptured my very first bag of waters...I never thought I'd say this but it was sssoooo cool! Of course I dont plan on making a habit out of it but I can so see why docs love this stuff. I can now "offically" sign off on that skill for NARM. Corny,I know but it's the name of the game.

Hugs,

~Kim

babies, babies, babies

Last night I worked the night shift as 1st on. We had two more babies born on my shift. Their births were so wonderful!! We have a visiting midwife here that's filling in for the next few days for the staff midwives that are typically on schedule...She's WONDERFUL! What a blessing in my last week here :-) She's totally hands off and completely allowed me to work with the clients in a way that allowed me to utilize my own practice style and incorporate the needs and desires of the families I was serving. A few of the other interns here that have never seen anything else but "Casa birth" were completely blown away by the hands off approach...As an observer though all you can do is sit there and watch, and so that's exactly what they did (and technically so did I)as these Mama's pushed out their babies without a skid mark on their perineum's! When the time came to cut the cord I was able to voice that I didn't want it cut yet and the staff midwife completely accepted my request. So we had delayed cord clamping for both babies...at least until the Placenta was delivered!! I think I personally needed to see birth untouched again as it so renewed my spirit!

I have seven days left here...I cant wait to be back home and see my kids! I miss them so much. I hope the weather is warm back home, it was snowing a bit the morning that I left. Hugs to you all and I'll post again soon!

Much Love,
Kim

I officially have only eight days left here at Casa. It amazes me how quickly the time has passed. As horrible as it felt when I first arrived I'm already able to look back on the time spent here with much gratitude for all that I've experienced and learned thus far. There are friendships that I've made here that I'm certain will last a lifetime. I have a friend from Hungry that's here, she currently lives in Indiana but will be relocating back with her family to Hungry in June of next year. She has incredible plans for the families she will serve back home. Another woman is here from California that works with families in Africa's Sierra Leone. She trains traditional birth attendants on how to provide safe maternity care for the families in their village. She's invited me to come down for a trip with their organization...Perhaps I'll be in Africa twice next year...we'll see :-)

I've learned that there truly is no such thing as a "language barrier" I'm confident that the women I've served have walked away with all their questions answered and with nothing less then optimal care. When i first got here I was so worried that I wouldn't be able to adequately provide care to these families due to my lack of Spanish. I'll tell you what did it for me...It was the first day I was on my own and i had to do a speculum exam on a woman that didn't speak a smidgen of English. It was a MUST that i explain to her what I was about to do, I couldn't just walk up to her and shove this spec in her gyna!! I was seriously so nervous that I went through two sets of gloves because my hands were so clammy I couldn't get them on :-) In the best Spanish I could muster up, including my own made up words (that sounded like Spanish to me) I explained to her what I was about to do. She thought it was hilarious, which totally broke the ice for me. I showed her the speculum - How it opens and closes and explained what I was looking for. I managed to somehow find out that this woman had never seen her cervix before so I happily showed it to her with a mirror once the spec was in place. I hope I'm not grossing any of you out...If so, I'm sure you'll get over it.

Anyhow, I've since learned the importance of getting creative and doing whatcha gotta do to get your message across - weather that be demonstrating it, drawing it out, speaking spanglish, whatever, ther're so many ways to communicate. So that was my big epiphany while I've been here :-) My spanish is really coming along - I can make an appointment completely in Spanish now...he-he!

I should get to bed. I'll update again when I can. Much love to you all and I'll see you soon!

~Kim

last of the pics...

and more pics...

More pictures of Mex...

My second trip to Mexico!

I spent the day in Mexico again...It's hard not to when your so darn close! I must admit, I havent walked this much in a looonngg time, It feels so great. Anyhow, I really explored much more of Juarez this last trip. I ventured into their main market area...It's so wonderful! There was live music, clowns, people flooded the streets, the churches were wide open throughout the day with people wandering in and out of them...it was like a festival...but it's every weekend in Juarez!

I took lots of pics this time so I'd like to let them tell you more of the story of what my day was like yesterday...Enjoy!

Love,
Kim

My first Casa catch

Last night at 6:51pm I caught my first baby here at Casa...a beautiful baby girl! The staff midwife that attended was the one I mentioned in my last post that's extremely interventive. I did manage to squeak away with a whopping six minutes of delayed cord clamping!! That's pretty rare here at Casa :-) Another intern and I tried to coax the midwife into allowing the mom to birth in a different position since the mom was complaining of back discomfort and the intensity of the pain (from being flat on her back). We failed miserably but at least we tried. She literally looked at us like our heads were on backwards!

We had two more mamas come in for labor checks throughout the night...One was sent back home and the other is still in labor with an OP baby (and of course flat on her back). I really hope to be with that Mom when she births as i was with her all night - Still adjusting to the idea of shift changes but quite honestly there so needed here.

I love and miss you all so much...only 16 more days to go...I cant wait to be back home!!!!

Love,
Kim

1st on tomorrow

The gig is up...As you've noticed in the picture the reality is that midwives really are witches. We have green faces and consult with our trusty magic 8 ball for insight.This is what Casa is all about folks...

So tomorrow evening I'll be first on...That means that I'm the head intern in charge for any births that come through that evening. Unfortunately the staff midwife that will oversee what I'm doing is known to be the most interventive midwife here at Casa. In all honesty I get along with her incredibly well and was picking her brain tonight and very passive aggressively pulling out how she feels about "gentle birth". I unfortunately didn't get very far with that conversation but at least I tried! Cord blood collection is mandatory immediately following all births here at Casa. Which means that the cord is immediately clamped and cut following birth. I suggested the idea of possibly delaying cord clamping and pulling the blood from a nice juicy vein in the Placenta and she said "it was of course possible" but didn't seem at all enthused by the idea. I'll see if I can get away with maybe five minutes of allowing the cord to pulsate before she notices. I must entertain myself somehow....sneaky little me :-)

Today I was off and sat out in the dry desert sun. Ya know, you can literally feel the moisture being sucked out of your skin here. I miss home ssssoooo much, I miss my kids, my Steve, my dog, my bed and my hula hoop...oh, how I miss hoop dancing(it's my new obsession) google it if you don't know what it is.

I love and miss you all and will update more tomorrow...

Love,
Kim

Hi everyone,

I needed some time to decompress from all the activity here before I could post again. I definitely feel I'm in a much better place today then I was the day prior. I woke up this morning with a sense of peace and clarity about being here at Casa. I'm going to try my best to stick it out because the reality of it all is that I will more then likely learn alot here if I just keep my mouth shut. I don't have to agree with the way they do things here (cause I don't)and that's OKAY! I've already learned so much about myself in the week I've been here and that in itself has been worth the money I paid. I still wouldn't personally recommend Casa to anybody though...It really does suck ass here. They treat the interns like crap and can be very confrontational & demeaning. Not very conducive to a learning environment to say the least. It's bootcamp birth though and of course bootcamp is hard but I will hopefully walk away from all of this with stronger skills that I can choose to use when appropriate. Were going to be doing an IV skills workshop soon as well as an incredible full day suturing class. Obviously both good skills to have in case you ever really need them. I'm also getting really good at my cervical checks...Yippy!

You know, I was thinking about it and I've probably had my fingers in more vagina's lately then all the men I've known have had combined! Just a thought that crossed my mind as I was typing...Anyway...

So today I went to Juarez, Mexico. I had a great time! We walked into Mexico...about a 45 minute walk from Casa. I had some traditional Mexican flautas & frijoles and of course the Coke a Cola in Mexico is the bomb! I also enjoyed a Frutas Fresca - Which is a tall glass of fresh fruit juice...mmmmmm! I love the colors, sights and sounds of Mexico. The people are so friendly and greet you with a big huge smile. My pasty self should have brought some sunscreen with me but didn't, needles to say I got a little burned :-)It was really a neat experience to walk into Mexico, I've never done that before.

Well enjoy the pics...I will update again soon!

Love,
Kim

That wonderful full moon energy

I've literally been attending births since 5am this morning. We had four mama's deliver today at Casa...and it hasn't even been a full 24hrs!! I'm wiped beyond belief. Promise to update more tomorrow.


Buenos Noches,
Kim

Tearing me apart

Okay, I was warned. I'm so not pulling the victim card but in all honesty I'm kicking myself in the ass right now for NOT heeding the advice of those that have been to Casa before me. I'm seriously traumatized. "Birth is different here" I'm told. Woman are ONLY allowed to birth in the McRoberts position...so sad. I was told that this is the optimal position for Mexican woman cause their pelvis' are shaped differently then all other woman...??!!???!! All I can say is WTF!!!!!! I know of practitioners in Mexico that are providing waterbirth & Moms can deliver in any position they desire. I wonder if maybe when they cross the border into El Paso if maybe some big brother type shit happens and their pelvis' contort into a different shape...? Hmmmmm? Could be, ya just never know.

Right now as I sit here and type I'm deeply saddened by the birth I witnessed earlier. Perhaps I sound naive but I had no idea that CPM's would ever dare be this interventive. I witnessed this babies head being yanked on like a tug of war rope...mind you he was descending beautifully with NO signs of shoulder distocia. After birth the cord was immediately clamped & cut and baby was whisked away and given a bottle of formula to make sure he had a strong sucking reflex!! I feel like either I'm on Mars or this is a REALLY bad joke. I failed to mention the routine deelee suctioning that they did on this little guy, which the American Academy of Pediatrics NO LONGER recommends. Mostly I'm sad - Sad for those precious moments lost between mother & child, Sad that this baby was treated with little regard to the conscious and aware being that he is. It will inevitably be my turn to be first on and catch a baby in the next week or so. I refuse to needlessly tug and pull on a baby's neck, I simply wont do it. Yes, I need my numbers for my NARM paperwork but not at the cost of potentially damaging a baby's nerves.

I want to cry, I'm so far away from my family and I feel I'm learning nothing I would EVER apply in my own practice...It doesn't feel worth the sacrifice or cost. I only hope that things get better from here on out. Morally I'm not sure how long I can take witnessing this type of abuse. There are some clinical skills I want to learn but I'm not quite sure if it's worth sticking it out. I also realize that weather I'm here or not births here at Casa will still be happening. One week has passed here already I hope the other three fly by just as quickly. Who knows though - I might be on the next plane back to Chi-Town tomorrow.

I should get going as we just got two mamas that came in in labor. I need some good energy sent my way friends...I'll update soon!

Love,
Kim

pack of hungry wolves

Casa has been sssllooooowwww. Me and the other interns here have literally been sitting around like a pack of hungry wolves waiting for a birth! I caught myself even going as far as stepping out in front to look over the bridge and see if there were any pregnant mamas in labor walking over to the center...Yep, it's pretty pathetic, I know. We had a long & somewhat grueling class today on vaginal exams and cervical assessment. Vaginal exams are done ROUTINELY here on ALL pregnant woman from 36wks on until delivery...I'm disturbed beyond belief. I need to remind myself daily that it's not homebirth though and these woman are not coming here for homebirth type care. I'm trying to remain open as much as possible. All I can say is that I'm so glad that I came here with a firm foundation in prenatal care prior to coming here and even more grateful for my training and experience in homebirth. I cant imagine only having this type of clinical experience and then going off and serving woman at home...OMG!

I trust in women and their ability to give birth with as little intervention as possible. We are not disasters waiting to happen. Babies need and deserve to be born into a loving & safe space where their consciousness is recognized and respected. These are core beliefs of mine. I'm choosing to stay open to what Im learing here and store it away in my brain...some info further back then others!

~Kim

The Zombie Shift

Okay, so today I'm on for a full 24 hr shift! I've been taking "citas" all day (remember that means appointment). I'm on a two hour break right now. Things have been going pretty good - No birth yet!!! Can you believe it?! We have alot of mamas due right now though...I think there all holding out to bombard us together. I'm already getting signed off on alot of my NARM skills, that feels really good. I cant wait to be done with all of this and get my CPM. When I do pass my NARM test people Im having a HUGE celebration partay and everyone's invited!!

I've been much better with taking care of myself - Yes, I'm eating and drinking water Jen! Sleep is difficult though here. I miss home sssooo much, staying busy helps the time pass. My Spanish is getting much better. When your submersed in it and doing prenatals by yourself you learn rather quickly. My conscious will not allow a woman to go with less then optimal care due to my own language barrier so I'm learning as I go. Today I told a woman that "lo siento, Mi espanol muy Sangre" Which means "I'm sorry my spanish is very BLOOD" she laughed...I meant to say Malo (bad). The woman are sweet and so paitent with me as I read verbatum out of my spanish/english dictionary and spanish for midwives book.

I guess I should get going now before my entire lunch passes me by...Till next time!

Love,
Kim

What a day!

Oh my good god this is one of the most exhausting days I've had in a looonnnggg time!!! I spent all day - literally from 8am-7pm doing prenatal visits (aka "citas" here...means appointment), initial registrations, well woman care & newborn exams. After my shift was over I had the opportunity to do my first blood draw on a fellow intern. It was pretty exciting and I surprisingly wasn't nervous about doing it at all...of course my fellow intern didn't feel that way :-) It was easy as pie though. I also got a few other skills checked off today - Finger sticks, drawing up meds, Oxygen tank set up and a few others.

The mama's here are sssooo wonderful! I cant help but to wonder about how many Hispanic woman would be giving birth at home in IL if we had more bilingual midwives...It's an entire community of woman and families that have no resource for homebirth. I just may have to change that :-) Seriously, I highly doubt that only "well of white woman" are the only ones that desire peaceful, gentle and safe homebirth for their babies. The woman and families of the Pilson area had a homebirth resource once upon a time...the name of the program however is completely evading my mind at the moment (Lo Siento - Means I'm sorry). Perhaps by the end of this blog It'll come to me.

On another note I can pretty much guarantee I'll be a much slimmer me by the time I get back home. Food doesn't seem to make it very high on the list of necessities...sleep seems far more important. Screw weight watchers, dieting, whatever - Come to Casa and you can catch babies and lose weight all at the same time - What more can you ask for!

I should go and get some sleep while I can. If anyone goes into labor tonight I need to be there for the birth. I miss you all and will update again soon.

Buenos Noches,
Kim

I'm here!

Hola everyone! I've made it to El Paso. I arrived at the birth center at around 1:30pm, unpacked my belongings and got acquainted with most of the interns here. I'm choosing to get some decent rest tonight as I'm running on only an hour & a half of sleep...Yes, I waited till 9:30pm the night before my 6am flight to BEGIN packing. Ahhh, well...old habits die hard I guess. I start my first shift tomorrow morning at 8am...Yikes! All new interns are instructed to be a fly on the wall and ONLY observe the first few births that they attend here. I've already been forewarned that birth is different here...It will be NOTHING like homebirth, woman will push their babies out flat on their backs in the oh so famous famous McRoberts position and I need to pretty much keep my mouth shut and not say a GD thing about it...So I wont. I'm choosing to stay positive and not expect a horrible experience here...otherwise I'm sure that's what I'll get. So far everyone has been super friendly. It is so like being in Mexico, of course Juarez Mexico is only right over the bridge. I brought by passport and plan to take a bike ride into Mexico on my day off. I hear they have a fabulous little market there. I promised my boys that I'd bring them home a gift - Keenan has requested coyboy boots and Jacob wants a bow & arrow...I think I'll get them some Maracas and call it a day :-)

Okay - I need to get some rest. Thanks for all your support and love. I promise to update as I can.

Love,
Kim

I do want to say that for client confidentiality reasons I will not be disclosing names or details of anyones birth experience

It's a pretty strange fee

And so I begin...

I promised I would make a gallent effort to blog my journey and experience while down in Texas during my midwifery internship. Although I cannot promise a daily blog I will attempt to write and check in as often as I can. I suppose all the people that really love me will check in frequently and comment on my blogspot often! Those of you that dont, I will have to reconsider our friendship once I return from Texas :-)My flight is set to leave early Sunday morning at 6am (4/13/08) and I should arrive in El Paso Texas at around 12:15pm. I'm ssooo nervous!! I've never been away from my kids for such an extended period of time, I hope things go smoothly for Steve & the kids while I'm away. My control freak side of me has emerged and reared it's ugly head as it always does right before I leave for a trip or plan a big event...I become a super duper drama queen during this time. I plan to combat that though tomorrow with lots of rescue remedy and maybe a mid afternoon margarita.Till tomorrow my friends!Buenas Noches,Kim