The last blog that I posted for MIDIRS was reflecting on finishing my first year. I’m now well into my second year and have finished nearly two theory blocks and 6 weeks on placement, the time is flying by.
I will start with our first block at university. We went back on the 23rd of January and had a large 8-week block of theory, which was very full on as we were provided with our workbooks and online e-learning packages that we have to work on throughout the year. For our second year, we have to complete work books on pharmacology, further medicine management, domestic violence, and a new breastfeeding workbook that we get for each of the 3 years. We then had 2 e-learning for health packages to work through on blood transfusions and cardiotocograph (CTG) monitoring. We were also taught many skills to prepare us all for our first placement on the delivery suite. This included skills such as episiotomies, fetal scalp electrodes, artificial rupture of membranes and speculum examinations.
Our first placements as a cohort were split, so half of us started on delivery suite, and the other half on postnatal wards. I know that both I and a lot of the girls from my cohort were really nervous about starting on a central delivery suite (CDS). It just seemed like such a massive step up, and it was really daunting to know that we are going to start providing care within complex obstetric cases.
Well, I had the best 6 weeks ever! My mentor was absolutely amazing, and encouraged me to do everything. For myself personally, I learn by doing – so this is exactly what I needed. My first day back, I caught a baby and then my mentor asked if I would like to suture the woman as she had a small second degree tear. Although I was really apprehensive, we had the theory at university a few weeks before so I decided to go for it. My mentor was behind me every step of the way, and she had a pair of gloves on to help me when I needed it.
As well as suturing, I have gained experience in epidural care – so when women choose to have an epidural there are certain observations that need to be monitored and recorded. I have performed artificial rupture of membranes (ARMs), fetal scalp electrodes (FSEs), infiltrating the perineum in preparation for an episiotomy (although thankfully, we didn’t have to do an episiotomy in the end), and gained more experience in theatre.
When we have to go to a theatre for a ‘trial of forceps’, it’s really important that the midwife abdominally palpates the contractions so that the obstetric registrar/consultant knows when to assist instrumentally with the fetal head whilst the woman pushes. Whilst doing this, we still have to ensure that the fetal heart is being monitored, as well as trying to complete the documentation required. Basically, we need to have about 10 pairs of hands!
One subject that I wanted to bring up, and that I found really reassuring was being part of the multi-disciplinary team. I have honestly found the obstetric registrars so encouraging and educational. There have been many times where they have really got me involved in what they are doing, for example – unfortunately a woman sustained a fourth degree tear during an instrumental delivery, and whilst she was suturing her in theatre she was showing me and explaining all the different muscles within the perineum, the layers within the anal sphincters – as well going through suturing with me again. Another allowed me to help with the delivery of a placenta when the cord had snapped, although I did try to step back and let her do what she needed to do, she told me to go and grab some gloves to help her. So, to any other student midwives reading this, don’t be afraid to ask questions. The majority of maternity staff are more than happy to answer our questions, and understand the educational journey we are on.
This year we also had the opportunity to attend a study day with other professional healthcare providers. We worked with junior doctors and focused on obstetric emergencies, so we had a consultant obstetrician teaching us about shoulder dystocia, cord prolapse, postpartum haemorrhages, etc. it was a fantastic day and we all learnt so much. I also attended a water birth study day which I found really helpful when it came to explanation of the inclusion/exclusion criteria of who would be suitable for a water birth – although we have to abide to our trust policies, it was important to learn the reasoning behind it all.
Before I went to CDS, I was worried that I wouldn’t have any ‘normal’ labour and births, however this is simply not the case. I have gained such valuable experience when looking after a wide variety of women, and it really highlighted to me the significance of holism and personalised care – no two women’s experiences are the same. That is also one of the things I love about becoming a midwife, no day is the same and I can honestly say I looked forward to each shift.
One of my special highlights from the past 6 weeks is delivering twins. They were both normal vaginal deliveries, and there were many members of staff in the room – including: myself, my mentor, another midwife and student midwife, the obstetric registrar, 2 paediatricians for the babies, and the delivery suite coordinator popping in and out. However, it was so special to see all members of staff empowering and willing her on throughout the first and second stage of her labour, and I know I will never forget it. Not only do you have the power to make someone’s experience so much more special, but they have the ability to do the same for you.
I now have 1 more week left of university, before having a much needed 10 days off. We then return to university for 1 week, and then commence our 10-week placement block. Mine consists of 5 weeks on the day assessment unit (DAU) and triage, followed by another 5 weeks on delivery suite.
These first 4 months as a second year have absolutely flown by, and they have been very full on. Whilst all the above has been going on, we’ve also had a 4000-word essay to start, preparation for a maths test next month, and I need to start thinking about a case-based presentation for July.
Keep up to date with the latest research and news from MIDIRS by subscribing to our quarterly academic journal. Subscribe to MIDIRS Midwifery Digest