Antenatal clinic

This comes with a warning that more of our blogs are going to be about midwifery but I'll try and keep them in English so that you don't need a midwifery dictionary to read them. Yesterday we saw 52 women in clinic which made for a busy day! I have been writing down my thoughts when I get back, so here are just some short random thoughts from what I wrote to give you some glimpses into what it is like...

My first day in AN clinic, it was sort of like AN clinics I remember - urine checks, BP checks, palpations (assessing the position of the baby), giving advice, and yet somehow it was quite alien. This new world includes routinely giving worm medicine, antimalarials, tetanus vaccines and iron tablets/folic acid to every woman....the day started with the women attending clinic singing and praying and the midwife reminding the women about the danger signs in pregnancy, which included more singing and clapping and laughing as she dramatically acted out each one...
...Its a world where a large proportion of the patients have suffered loss of a newborn, some have lost one baby after another...they take it all very matter of factly, it seems a bit harsh at times but I guess it is a part of life they are more familiar with than I am...
...I learnt my first maternity Krio today: "de pikin du shake?", "fine, fine shake?" (is the baby moving? moving well?)...I managed to amuse quite a few women by my poor attempt at one sentence along with some interesting body wiggling...
...There seems to be different thresholds here for referring to a doctor, admitting patients for observation or acting on the findings of the antenatal check. It was hard to decide whether this was because there are less options here, less that can be done, or whether the midwives didn't really understand or acknowledge the warning signs at times...
...my first assessment by myself (having done a couple with another midwife there) and I think the baby is breech. It has been years since I palpated a breech and so I reluctantly asked for a second opinion - waiting for someone to tell me that I had my very first palpation wrong, but alas it was truly breech! Sort of to my relief and sort of disappointing given that the lady was near term and would have been happier with a well behaved cephalic (head down) positioned baby...
...the other lady that I'll remember was 26 weeks pregnant and the midwife seeing her couldn't find the fetal heart beat. Once I had the same trouble as did a third midwife we were trying to decide a plan. I must admit I have never had this trouble before, but knew that back home we would just scan to check if we had any doubts. I asked whether this was possible, otherwise suggested we get her to walk around for a bit to see if the baby moved position and try again. It turned out that the doctor was already at the ultrasound scanner with someone else from clinic so we took here there. That was quite a horrible moment for a minute, wondering if we would find it ok. It was like a flashback to when I was scanned at work and they didn't find the baby's heart beat, it is not a nice way to find out something is wrong. It was such a relief that the heart beat was fine, just apparantly hiding from three different midwives....

So there was another day at work, and another week ahead trying to make sense of it all and read up on some of the things that came up before more midwifery fun next week!