Day 4: 6:00 Alarm

Today was a very early morning, as I was on my way to the office by 6:45. It was my first day with Irma, and she had an even earlier morning since she was at the hospital by 2:00 a.m. to deliver a baby!

I got to see a wide variety of things today, including everything from pregnancy comfirmations to postpartum visits. I also heard and saw several of the things I read about in Ina May Gaskin's books; it was fun to be able to connect my knowledge to my experience.

The first appointment was a comfirmation of pregnancy, so she was only eight weeks in. She was complaining that she was having a lot of cramps, which I learned was because of the placenta burrowing in to the wall of the uterus, and the placenta starts functioning at about ten to twelve weeks. The mom wanted to know if she could listen to a heartbeat yet, but at eight weeks, the uterus is still behind the pubic bone, so we wouldn't be able to hear it if we tried.

Another patient came in who was about 33 weeks along, and she said that previously her baby was in breech position (the head up instead of down), but now it was transverse (sideways). This connected to the chapter I read on determining the relation of the baby to the mother's pelvis. If the baby doesn't turn into a longitudinal position before 37 weeks, the attendant tries what is called an external version where he or she manually turns the baby from the outside. Here is a picture from Ina May's book on external version:

Irma explained this to the patient today, and I knew exactly what she was talking about because I read about it earlier this week! Irma also asked the patient if she was planning on taking flu and whooping cough vaccines, which are recommended for pregnant women because their immune systems are compromised. When Irma was checking the heartbeat, the baby was very active, but the mom was saying that she could barely feel it, and it worried her that she doesn't feel the baby moving much, but apparently when the placenta is in the front, the mother can't feel as much movement from the baby. I also learned that the minimum movement for the baby is ten movements in two hours, and anything less than that causes some concerns.

The next patient was 40 weeks, and her due date is today! We did a non-stress test for her, and the baby seemed to be very active with a good heartbeat. One of Irma's questions for the mom was if she wanted to get stripped. I didn't know what this meant and neither did the mom, so Irma explained that it is when they separate the amniotic sac from the cervix, which releases prostaglandins and sometimes helps initiate and encourage labor. The mom decided she did not want that done at this point.

Irma let me use the gel and monitor to check the baby's heartbeat for the second to last patient we saw! She also let me measure her belly, and I didn't realize before that the measurement should be the same as the number of weeks along the pregnancy is. How convenient! This mom was a little small because she measured 29 centimeters and is 33 weeks in.

I learned a lot today in each of the appointments, and I am excited to see what the next two and a half weeks bring!