After a long two-week midsemester break, we’re trying to get back into the swing of classes. Attendance was substantially better this week, but assignments are drawing near and everybody is panicking a little bit. There is a lack of direction in that sense – our assignment guidelines are vague, and it’s difficult to get clarity on what is expected of us. They are also worth a LOT, and so everyone’s a bit anxious. We only have one chance to complete the assignments, and if we fail because we misunderstood the instructions, we could potentially fail the course.

Biology:

Right before we went on that break, we had a very dense lecture about the physiology of ECG -Electrocardiograms. I’ve only ever seen these in cheesy medical dramas, and it is complicated. The theory behind them is VERY complicated. I was nervous about it heading into the practical lab this week, and had gone over the lectures a couple of times already. As it turns out, it was not too complex! It made a lot more sense when we were able to do it in person. This was also our first opportunity to practice semi-invasive procedures on our colleagues. My group ran our ECG on two different (brave) women, who ripped their tops off in class for us to place the stickers. It was interesting to see how different body types make the job challenging. The first had large breasts and a tight bra, which meant that it was difficult to find the right ribs to place the stickers on, and that we had to effectively feel around her nipple. The second had smaller breasts and a looser bra, but more muscle mass (she’s an Olympic weightlifter), which meant that the space between her ribs was difficult to feel, and we actually misplaced one sticker.

CBL:

We spent a lot of time discussing the third stage of labour this week – delivery of the placenta. Luckily, because I had inspected a placenta on my first day of placement, I felt fairly confident about it. We also got to clamp fake cords (just a bit of rope, but those clamps are finicky!) and tried to measure “blood” loss on a pad or bed.

IBL:

My last class before placement this week was IBL. I left IBL feeling like the idea of midwifery that I had in my head was going strong: woman-centered care, personalized care plans, using language like “woman” or “mother” rather than “patient” because they’re not sick! Herstories, individualized approaches to birth, PTSD and birth trauma. This was the beautiful, holistic view of midwifery as the art of being “with woman” that I had before starting this degree.

Placement:

The next day, I entered the hospital, where I watched the messiest handover I’ve seen yet, and tried to make sense of a chart that was 10cm thick. I saw midwives handling a woman whose two older children were in state custody, and who would probably be losing her baby to the state as well. I saw mothers being referred to by their room number rather than their name, heard midwives discussing mandatory rectal examinations for every birth, and heard of a woman who gave birth right as she was entering theater for an emergency c-section. The issues seem to be directly related to overmedicalisation, understaffing, hospital beaurocracy, and an intense legalization of the medical system.

For example, a nearby hospital has recently instated mandatory rectal exams; There was one case of a hospital in the UK being sued because although she did not have an externally or internally visible tear in her vaginal canal, her rectum tore during birth. The chances of this happening are very low, but now every woman must undergo an uncomfortable and invasive examination following their birth.

I appreciate the fact that women used to die during childbirth, and perinatal death rates have dropped drastically due to the medicalization of birth. However, it does not feel like the right path. Midwives are too busy to offer anything close to woman-centered care. As my close-to-retirement preceptor said yesterday “I’m glad that I’m at the end of my career, and not the beginning. We’re not midwives anymore, we’re obstetric nurses.”