So after a crazy few hours on labour ward one night, suddenly all became calm. A chance for us midwives to recharge our batteries before the pregnant women of Bristol began contracting again. We all headed to the staff room to grab a cup of tea, eat cake and catch up on the gossip. The team that night consisted of a few fresh faced student midwives and a few ‘golden oldies’- those midwives counting down the shifts to their retirement. And so the conversation began….
Oh remember when…..? My ears pricked up. I love the remember when conversations, listening to the golden oldies telling us how things used to be in the world of midwifery, like watching an episode of call the midwife.
‘Oh remember when we used to give all women a pubic shave and an enema in labour. Yes without fail even if the head was visable and baby was on its way, she still had to have a pubic shave or sister would go mad if she didn’t!!’
‘Oh remember when it was unusual for the woman to have her husband with her in labour, and there was no such thing as a birth plan in those days’.
And so the conversation continued….
Now I’ve only been in the game for 13 years, I am by no means a golden oldie (yet!) but even I can join in these conversations now with my own remember when moments and this got me thinking how routine practice and procedures can change or disappear almost overnight, just like fashion, an end of an era. So here are my top 3 remember when midwifery moments…..
Number 1. Remember when we used to suction out the baby’s nose and mouth before it was even born!
The baby’s head would be out, but the baby still not yet fully born. Everyone in the room would be waiting in suspense for the baby to arrive with the next contraction. Now at this moment, if the amniotic fluid was green because the baby had opened its bowels in the womb, we would poke a thin plastic tube up the baby’s nose and in its mouth to hoover out the green stuff. We did this to try and avoid the baby inhaling it once born which could cause breathing difficulties. However this hoovering method wasn’t very effective and achieved very little. It may even have done more harm than good as it stimulated the baby, encouraged him to breathe too soon, so he could potentially inhale the green stuff anyway, thereby defeating the whole object. So this no longer happens. Now we assess the baby once it’s born and decide then whether suction would benefit the baby or not.
Number 2. Remember the payphone on wheels?
This was before everyman and his dog owned a mobile phone. If a woman on bed rest asked to make a call we would drag in the heavy payphone on wheels and plug it into the wall for her to make the call. The payphone on wheels has long gone, nowadays the women are tweeting, texting and updating facebook on their smart phones whilst in the throes of labour! I kid you not! Modern technology in the birth room, a good thing or not?? Lets save that question for another post!
Number 3. Remember when we used to ‘feel for the cord’!
I remember this from my days as a student midwife. The baby’s head would be out, and again that ‘weird moment’ – everyone waiting for the next contraction for the baby to be born. My midwife mentor would bellow at me ‘feel for cord! Is there cord around that baby’s neck, does it need to be cut?’ With direction from my mentor I would fiddle around the woman’s rather sensitive nether regions searching for cord. The woman and partner would both look at me with terror in their eyes waiting to hear if their baby had been strangled by its own cord. Then came the dreaded moment of me telling my mentor that ‘yes I can feel cord around the neck’. Back then some midwives would have told me to clamp and cut the cord to ‘free the baby’ before the next contraction. Thankfully I’ve never had to do it, I’ve seen other midwives do it, but it happens very rarely these days because we know so many babies are born with cord around their necks and it doesn’t usually cause a problem. I looked after a woman who birthed her first baby naturally without any drama and was suprised as I unravelled 4 loops of cord from around its neck! That baby didn’t seem at all bothered during labour that it was wearing its cord like a scarf.
So now we avoid ‘feeling for the cord’ and there is a move towards delayed cord clamping which is becoming more common practice. Rather than cutting the cord as soon as the baby is born, we are more likely to wait a while, until the cord stops pulsating before we cut it because research suggests there are health benefits for the baby.
All this got me thinking about the future of midwifery. What’s the ‘in thing’ at the moment? What might change? Maybe in years to come I’ll be sat in the staff room, older and wiser with a few more grey hairs and I’ll be saying….
‘Oh remember when we used to cut the baby’s cord as soon as it was born?’
Maybe in the future we won’t cut the cord at all? Maybe the postnatal wards will be full of baby’s in their cots snuggled up to their placentas waiting for their cords and placentas to detach naturally (AKA a lotus birth)?? Only joking!! The golden oldies would be shuddering at the thought I’m sure!
I’ll sign off with this fab quote by Maya Angelou ‘Do the best you can until you know better. Then when you know better, do better’.