Maternity ward survival guide

How to charm a midwife and “catch” babies, when you have no idea how to put a nappy on; nor if the “magic” part of birth ever kicks in.

If you approach the Women’s Health rotation and the inevitable maternity ward with a mixture of apprehension and terror then you are not alone. While many midwifes frequently extol the wonder that is the “magic” of childbirth, I reflected on the first birth I witnessed with equal measure of horror and disbelief. I had been attending for over 16 hours and it finished with, maternal exhaustion, vacuum extraction, and an episiotomy. After a number of subsequent births, I realised that this first experience was not a representation of most births and was much like watching Jaws and thinking that this was a regular day at the office for fisherman. While I still think that if there was truly “magic” involved, there would be less; screaming, blood, Category 1 C-sections, and suturing of perineal tears. However, I have come to truly appreciate the midwives and the medicine involved, and to grasp that there is something wonderful about the process, as well as being exciting and challenging.

This is a bit of a ‘House of God’ survival guide to Women’s Health, which requires equal measures of late nights, good resources, humor and charming the guardians of pregnant women; Midwives. Firstly, be prepared to do some long days or nights; while there are some units that will call you in if things get interesting, you first have to prove yourself. No one is going to bother to call, if you are disinterested or rude, as it is just one more thing they need to remember to do in the middle of the night. The junior doctor creed being: Availability, Affability, and Ability rings true in the Maternity Ward. Women do not give birth on 8am-5pm schedules so ward attendance should not be restricted to these times. Also this is a highly personal, stressful, often painful and intimate event, so behave with this in mind and also consider this when negotiating with staff and the patient regarding your presence in the birth suit.

Humor at 1am is necessary, as is charm, and I mean this in a manners, courtesy, humility and being helpful sense; rather than trying to be the Tom Jones, George Clooney, or Rebel Wilson of the maternity ward. Be polite to the staff, and given a chance, pick their brains as even the youngest midwife and midwifery student has probably seen more births than we, as medical staff will see in a lifetime unless we become obstetricians. Also remember that ability, or in this case knowledge is important, do some reading and have a good understanding of some of the basic conditions so you do not feel completely lost on the wards, in clinic, and in theatre. For study, I have a few recommendations: Obstetrics and Gynaecology an Evidence Based Guide (Abbott, Bowyer & Finn), the RCOG Green-top Guidelines, the RANZCOG Guidelines, and Practice OSCE’s in Obstetrics and Gynaecology (G Weston).

Ultimately, while I cannot guarantee you will discover the “abracadabra” required to make birth truly magic, I hope that if you approach Women’s health with an open mind, a pinch of humility, a good dollop of enthusiasm, and a solid mix of study and availability it will be enjoyable and rewarding rather than traumatic.

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