It’s my time for a blog post now!
I have a little rambling/reflection about continuity of care that I just wanted to share with you all…
As midwives it is so important that we are able to reflect on our actions (or inactions!) so that we are able to continually improve the quality of care that we provide to women and babies. Ange, Marnie and I often discuss our experiences over coffee – this is why we drink so much! It is important to debrief, to deeply reflect and to move forward and improve.
I recently cared for a woman in labour – this in its self is not unusual, it’s my job, I do it most days (I know I am very lucky!!) but this was no ordinary woman. This was a woman who I knew very well, I had provided care for her at The Nest during this pregnancy from very early on. The first time we had met was during her first labour many years ago. By the time she went in to labour, after many hours together during her pregnancy, I knew her well. But she also knew me!
I knew that this beautiful woman was anxious about birth and breastfeeding, I knew what books she read and what exercises she did during her pregnancy. I also knew that she wanted minimal birth intervention and that she was gaining in confidence with every pregnancy visit that we had! I knew that she loved a Cherry Ripe, that her husband was an amazingly supportive fellow and that her daughter had a dolly named Rachel!
As I mentioned earlier though, this was not a one sided relationship. This women knew me very well, she knew that I had every confidence in her and her body, that I would do everything in my power to advocate for her choices, that I had exceptional taste in T-shirts and an odd obsession with my rabbit! She knew that I would be there in whatever capacity she needed during her labour and in the long days and weeks after her baby was born.
So other than everyone knowing each other intimately, what is my point?? – my point can be found in my own personal reflection of her birth. This may be mostly of interest to other midwives, but I feel that it is important to share, becausewhen we are discussing pregnancy care, we can never over emphasise the importance of continuity on outcomes and wellness for both women and midwives.
This amazing woman went in to labour, she laboured gently at home for most of the day and came in to the hospital when she felt the time was right. I was at the door when she arrived, she laboured quietly, so quietly in fact that I was questioning if her labour was progressing! She was lying down and appeared to be sleeping, she made very little noise and needed nothing physical from me. In hindsight of course, she was in ‘labourland’ – that beautiful place that Michel Odent speaks about, the place where women need to get to to allow their primal instincts to take over from their thinking brains and allow their babies to be born.
Remember that I knew her… I knew what she wanted and didn’t want during labour, I knew what she was afraid of, allergic to and excited about. It was because of this knowledge that I did nothing (that sound’s terrible I know!), I did the important things of course, I ensured that both her and her baby were safe and well, but beyond that I watched and listened. Even as I watched her sleep and every cell in my body was questioning if her labour was progressing or stalling, even as I considered encouraging her to change positions or offering her an internal examination ‘just to check’ – I did nothing, I continued to watch, wait and listen because I knew that both her and her baby were well and that she didn’t want any of that.
Guess what?? After less than two hours of being in that room I could hear the instinctive sounds of a woman who was ready to meet her baby. Under the shower, without coaching, instruction or intervention, she birthed her baby girlpowerfully in to the waiting hands of her husband. She had done an amazing job, and by knowing her well, protecting and respecting her choices and birthing space I had done mine. What an absolute privilege continuity of care is.
We are live!!
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