Baby for the Midwife. Fiona McArthur
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to work.
The baby’s heart rate continued strongly and even picked up pace for most of the contraction before evening out again. Mel sighed as the contraction finished and the baby’s heart rate clopped along merrily. Satisfied, Georgia stepped back and wiped the conducting jelly off Mel’s abdomen.
‘That’s great. Baby is cruising in there. I’ll leave you for a few minutes to complete the handover with Karissa and then I’ll be back to do a few observations on you. Then we’ll talk about your preferences for the birth.’
Georgia followed Karissa out the door and closed it behind them. They could hear the murmur of the next contraction starting.
‘They’re wonderful.’
‘Yeah. Lucky you for a nice shift and you get to catch a baby. Come on, I’ll show you the rest.’ Karissa breezed into an open ward where two women sat up in bed, eating their breakfast.
‘This is Leanne and Tanya, our two postnatal ladies. And this is Georgia, who is your midwife on today.’
‘Good morning.’ Georgia waved. ‘I’ll see more of you when we’ve had our baby, but for the moment do you need anything in case I get tied up in the birthing room?’
‘I’m fine.’ Leanne waved them away with her piece of toast and Tanya smiled and shook her head.
‘I’ll see you later, then. You can buzz if you need someone, but otherwise just have a lazy morning and we’ll catch up later.’
‘Sounds good,’ Leanne said around her next bite.
‘Leanne likes her food,’ Karissa whispered with a grin as they walked back towards the desk. ‘I just wish I could put it away like she does and still stay that thin. And if you can’t find Tanya, she pops out for a cigarette. She’s trying to give up.’
She glanced at the clock and grimaced. ‘That’s about all. When Mel’s ready to birth, push the red call button and one of the girls will come down from the ward to help you.’
‘The on-call doctor…’ Karissa grinned cheekily ‘…in this case your husband, can be contacted on the pager number if you need him.’
Georgia nodded and fought down the warmth that spread through her just thinking of Max. It was happening more often when she thought of him. What was wrong with her? ‘What about pain relief orders if Mel wants something?’
‘There is a doctor’s standing order book there which spells out the options, and it is countersigned by the locums when they come the first day. I usually let the doctor know if I give any analgesia or do an internal examination so they know where the woman is in her labour in case we need them. Otherwise they will drop in before and after work.’
‘Thanks,’ said Georgia. ‘That all seems pretty standard to any of the small hospitals I’ve worked at.’
Karissa picked up her bag. ‘I have a feeling Max would like to be here but if you ring him don’t let him push you out of the way for the birth. We can’t have him begin bad habits and we catch our own babies here. But he’ll let you know when he does his morning round.’
Georgia savoured the thought of having Max there for their first professional birth together. It would be lovely to share such a moment with him and until she knew what sort of back-up the general ward nurses wanted to be, the idea seemed sensible.
Karissa went on. ‘It works for us. On paper, it’s sad our only OB GP has retired, but in fact he rarely came for deliveries and high-risk women were shipped out anyway. If we stick to low-risk labours, I can’t see why we couldn’t do what we’ve always done and keep training midwives to be autonomous and the unit open. Fifty miles away from her family to the base hospital is a long way to send a woman to have a normal delivery.’
‘I agree. It’s crazy that it all depends on some number-cruncher in a distant city.’
‘Don’t start me on that. That way is madness, girl.’ Karissa had obviously been there. ‘We’re just dots on the big picture.’ She shrugged and yawned. ‘But I’ve been up all night and what I vote for at the moment is going home to bed. Good luck and happy birthing.’
She pulled the drug keys from her pocket with a wry smile and handed them over. ‘I’m so glad I didn’t accidentally go home with the keys and have to come back.’ She yawned again. ‘Bye.’
ALONE and in charge of a labour, Georgia thought wryly. It had been a while.
She had a quick look through the two inpatient records to check there were no medications due and why the women had chosen to have Caesarean births. Both had had babies in the breech position and their doctor had suggested they not attempt vaginal deliveries.
She reminded herself to ask Max what his stance on that question was.
She picked up Mel’s chart and quickly scanned her previous labour and antenatal history, before tucking the chart under her arm and heading back to the labouring woman.
‘Hi, guys. How are you going in here?’
Tim looked a little more stressed and Mel’s smile had slipped. ‘It’s getting tough now,’ Mel said through clenched teeth, and the next contraction cut off her sentence as she began to rock and moan with the force of the pains.
When the contraction had eased, Georgia quickly checked Mel’s blood pressure, temperature and pulse, and then listened to the baby’s heart rate through the next contraction. All observations were normal and she documented the progress in the nurse’s notes.
When she’d finished she crossed to the cupboard where the large blue exercise ball was kept. Georgia rolled it across the floor to show Mel and Tim. ‘Would you like to try sitting on the ball in the shower for a change, Mel?’
‘I might fall off.’ Mel gave it a quick glance and shook her head. ‘The ball wasn’t here last time.’
Georgia rolled it around in front of herself and sat down on it to show Mel. She tried to move it with her hands while sitting on it and the ball didn’t budge. ‘It sticks to the floor and won’t roll away when you are on it, Mel. Balls are very safe.’
Mel frowned and then nodded that she understood.
Georgia went on. ‘Your legs must be tired. Sitting here will straighten your back and encourage the contractions to work straight down with gravity and onto the cervical opening to make the contractions achieve as much as they can, just like the position you are in now.’
Georgia studied Mel’s strained face and her instincts told her Mel would get some relief sitting for a while. ‘The position you’re in now has been great but you may benefit from a change of position, even if for a few minutes. It’s getting tough.’
‘Too right it’s getting tough.’ Mel glared at her husband and Georgia restrained her smile. When a woman began to express irritation towards her partner, it often meant good progress in labour.
‘You could take the ball into the shower and while you sit you could direct the heat of the water onto the area giving the most pain. You can sway from side to side too—all those things will give good relief from the pain.’
Tim grinned. ‘What a salesperson. Do you have shares in the company that sells birth balls?’
‘Absolutely. Have a go, Tim, and tell Mel if it feels safe.’
Tim lowered himself gingerly onto the ball and never looked in danger of rolling away. ‘I see what you mean about it sticking to the floor. If you don’t want the ball, Mel, I might sit here to rub your back. Mine feels better already.’
That was too much for Mel. ‘Get off. My turn.’
She sat, sighed into it as her back straightened, and smiled. ‘Ok. Let’s try