Today we had our class on the management of the normal labor. We talked about the cardinal movements, the natural progression and stages of labor, how to know when to do cervical checks and how to determine if a woman was actually in labor. We even talked about how to “catch” a baby.
In our case studies I noticed the only hesitation was the case that was obviously not in labor. I instantly sent the woman home, but some classmates wondered if there were reasons you might keep this hypothetical woman. There was similar concern about the woman with ruptured membranes and no contractions – could you really send her home? They still had the “but what if” that I had when I began my doula work. When you first start, you just don’t trust yourself or your assessments – this is normal.
And this is where I got excited. Because at this point the amount of information I need to learn about the normal labor is pretty slim. In fact, ten years of assisting at midwife attended labors has taught me the essence of midwifery.
We talked about this in my undergrad nursing program. You see, many people think the essence of being a nurse is about knowing how to give a shot or putting in an IV. But these tasks are pretty easy to learn, do it once or twice and you’ve got it. What is harder is managing the patient, knowing what to expect and how to best promote health. This can take years for a new nurse to learn.
Turns out midwifery is similar. After about 10 minutes of explanation and one or two practice attempts I pretty much get how to put in a scalp electrode. But to know when to use it, that takes some deep understanding of labor. That takes being able to assess the labor and anticipate what could happen. It takes being able to weigh the benefits and risks of using the internal monitor and not using the internal monitor. To do it well means you understand the recommendations / indications and why it would be indicated.
I still have much to learn. But what a fabulous feeling today to know that I am starting with a body of knowledge that will take some of my cohorts years to build. And that is why being a doula rocks.
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