Wednesday, May 14, 2008

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

Tuesday, May 13, 2008

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

Friday, May 9, 2008

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

Monday, May 5, 2008

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

Sunday, May 4, 2008

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

Friday, May 2, 2008

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