Hula hoop in a hay stack...

You know the term looking for a needle in a haystack? That sounds difficult doesn’t it? Well for a student midwife this is not dissimilar to finding a cervix, checking how dilated it is, how long, it’s position and what station (as in relation to the ischial spines, not what train station it might have scarpered off too when I try to find it during a vaginal examination). Weirdly, when I started on placement one of by biggest fears was not understanding what I am feeling when conducting a vaginal examination (VE) and worrying that I will never learn this skill, or worse might get it wrong.

As a student midwife we have to get a considerable amount of paperwork signed off to pass each placement and to pass the overall course. We have to deliver 40 babies, witness 10 babies being delivered, conduct 100 antenatal checks, 100 postnatal checks and there is space to discuss 15 VE’s. This is a skill we have to learn as it is fundamental that we don’t assist women in actively pushing against a cervix which isn’t fully dilated, that we can recognise the difference when a woman is feeling ‘pressure’ or ‘pushy’.

I feel as a student it is a massive ask to our women to let us conduct a VE, as it then is repeated by our mentors, so it isn’t just one examination, it is two but equally there is no other way to learn. I must say a massive thank you to all the women who have let a student conduct a VE. You have helped us in furthering our education.

This week I had my ‘light bulb moment’, which I have been waiting for since my first placement in May 2017. I am finally starting to understand all the elements of a VE and have been able to report the same findings as my mentor. Yesterday I was presented with the opportunity to artificially rupture a woman’s membranes with consent from her, I was terrified, what if i hurt her? What if I hurt the baby? But at the same time I have to learn this skill, as although it isn’t common practise it does have its place in augmenting labour. I pushed my fear to one side and believed in myself and I did it… I swear the mentors I work with must think I am bonkers, especially when I leave the room and punch the air in excitement at being able to do it (to them the most simplest of tasks). For me it was another tick off my list, another element of midwifery I finally understand.

On a different shift this week I was reminded why active birth is important and this blew my mind. A woman myself and my mentor looked after was 5 cm dilated, for 10 minutes she moved into a left lateral position and then moved back again. To my absolute amazement just doing this changed her cervix. Within these 10 minutes of moving around she was now fully dilated and five minutes later delivered her baby. The body is a fascinating thing! This reminded me why we encourage women to be active in labour and why it is not beneficial to lie on your back for hours on end. Amazing!!!

I am hoping my ‘light bulb moment’ carries on but in true student style one day you can completely understand something and the next day be completely baffled, so we shall see how the next week goes. This placement has been incredible so far and I will be sad when it ends. 2 weeks to go…

I have been out for a lovely walk in the snow today but now warm inside with a cuppa brew! I hope you are all having a lovely weekend :)

JP

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