As a second year student...

It is so overwhelming becoming a second year midwifery student, all of a sudden you are sent back out into practise with the same knowledge you had as a first year. I felt like I should all of a sudden know so much more, I should know all of the medications we use from the midwives exemptions list, I should know what to do in the event of a postpartum haemorrhage or how to care for a woman with any number of complications in labour but the truth is, I don’t yet have this knowledge. It is a strange thing going to bed a first year and waking up a second year, I try not to get to caught up in thinking about how quick the course is going and how I can’t imagine becoming a registered midwife yet, instead learning to take one day at a time with this course.

As a second year I went straight back out into practice on the delivery suite, where I am attempting to fill the gaps in my knowledge by choosing during handover which women I would like to look after with my mentor. I have spent two days in the past week looking after women on the delivery suite for induction of labour (IOL), as there are a variety of reasons why women are induced, I needed to look after these women to understand this process and why IOL is advised. During the two days I worked with women in for IOL, I found one of the most common reasons is IOL for reduced fetal movements, which is a reduction in your baby’s regular pattern of movement in a day. With a correlation between reduced fetal movements and stillbirth it seems to be the best form of intervention to induce women early but in doing so in my opinion it can start a cascade of intervention. Intervention such as; days of going through IOL, even up to 2 cycles if necessary with a rest day in between. Leading on to artificial rupture of membranes and if contractions don’t come in a regular frequent pattern then a hormone drip being recommended to augment labour. Women can find the hormone drip quite intense due to it working quickly (going from no contractions to ⅘:10). It is not uncommon for women to decide to have an epidural at this stage if the contractions are too painful, which leads to reduced mobility. Epidurals have there place as the induction process can be extremely exhausting and an epidural provides women with the ability to rest and feel comfortable. However, once an epidural is sited this can lead to increased risk of an instrumental delivery, episiotomy or a cesarean section. IOL is unavoidable as reduced fetal movements is linked to the increased incidence of stillbirth but equally this whole process sparks the question ‘was the woman’s body ready to go into labour if all of this intervention was required?’......

As a second year who understands the definition of ‘normal labour’, I find myself questioning the reasons why we intervene in labour so much. I understand it is to prevent poor outcomes but equally I have found it hard when women expect a certain type of labour and state so on their birth plans but leave the hospital feeling downhearted when they have not had the labour they expected. I find women often stating ''well that didn’t go according to plan, why did I bother doing hypnobirthing?''. This weighs heavy on my mind and although I don’t have the answer to my worries I am glad that next week I have the opportunity to assist a midwife in birth reflections. This gives women (and family members) the opportunity to discuss their labour with a midwife so they understand why certain aspects of their care was advised and why their birth plans did not go how they thought it would. I will follow up on this next week….

Thank you so much everyone who read my first post, I feel very humbled and blessed to have so many wonderful, inspiring and encouraging people around me supporting my journey.

Enjoy the snow everyone and go careful out there!

Much Love

JP

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