Birth in the Squatting Position [WARNING: DEADLY AMOUNTS OF EARNESTNESS INSIDE]

[abilouise]

... a ten minute video that is unusually well-titled. Ten minutes of babies emerging from women's stretching vulvas. I was like COOL! I watched this video in my Labor Assistant/Birth Doula training today, day two of my drinking-from-a-firehose-style 3-day training that starts my odyssey of becoming a certified birth doula. After this part comes the part where I need to find pregnant women to volunteer for the births of. I am overwhelmed, and feel like I can't possibly be REALLY getting trained to do this -- this is way too important for lil' ol' me to do. Supporting women in labor and their partners, being a resource with information, helping them navigate the strange world of hospital birth requires TACT and DIPLOMACY and DECISION MAKING SKILLS and often KEEPING MY MOUTH SHUT and not letting my feelings and prejudices get in their way, whose idea was this for me to do again? Oh right, mine. I am really excited about this and it feels like a brave quest, where I do my part to make this world that I live in more resemble the world that I want to live in.
Today we had volunteer third-trimester women come in and we did fetal palpation and listening to fetal heart tones with a fetascope which was all cool. I've massaged enough pregnant women who were not sick of people touching their bellies that I've sort of done it before, I can usually feel the head and the butt even if I couldn't tell them apart until today when I learned the cool trick for differentiating (too bad nobody has taught this trick to certain US voting-age citizens), basically that if you wiggle the head the body doesn't move but if you wiggle the butt then the torso moves too. So if you meet someone and can't tell their face from their ass, try wiggling it.
Tomorrow we do vaginal exams on each other (it's not a required part of the class, we will learn sterile technique, there will be no speculum, and this will not be part of my scope of practice, it's just a learning experience, to answer all my own questions).
Here's my homework question for tonight and it's hard. it caused good conversation at dinner tonight, and I'm not happy with my answer, so you tell me what you think:

You have just assisted at the most difficult birth you've ever been to. The baby is in the NICU and may not survive. You stop at the grocery store on the way home and run into your client's friend. She asks if your client had had the baby yet and how it all went.

Comments

[boojum.livejournal.com]

It might depend on what sort of person the client is, whether she'd prefer you to protect her privacy or to take the burden of telling people so she doesn't have to. Especially casual acquaintance sorts of people -- I think if I were in your client's position, I'd completely stop leaving the house after the third or fourth "Oh, so was it a boy or a girl?" conversation with a non-inner-circle person. I don't know that hushed and gentle silence with whispers ("Oh, don't you know? You have to be nice to her.") would be any better, but at least I wouldn't have to talk about it as much.

It seems like it'd be weird to not at least answer whether the client had the baby yet, but I'm not sure whether it'd be possible to only answer that part of the question without strongly implying that there were issues. Maybe "Hey, look, you know I can't talk about that"?

I can't think of a good way to ask the client in advance -- either it's before the problem and it's too abstract for her to really predict, or it's after the problem and it's going to hurt like hell and she's not going to be able to answer anyway because it's too hard and too painful to think about.

I can definitely see both the hardness and the good-conversation-inducingness of this question.

[lerta.livejournal.com]

Oh, wow. How'd you get into being trained for that? Sounds really neat. Good luck with it.

Anyway, Aletta here. I just recently found your lj. hi.

[abilouise.livejournal.com]

Hi Aletta!
I got into the training by signing up for it, it was pretty simple. The organization that runs the trainings is ALACE, which is all groovy and the people are all nice and stuff. I've been wanting to do it for a while, because I'm geeky about stuff like this.

[abilouise.livejournal.com]

so for anyone who was interested in the "right answer" to my ethical question, going with the confidentiality is the way to go. Saying something like "I'm sorry but I keep all client information confidential" is the right way to go, unless one discusses with the client in advance whether she wants me to talk about it and she says yes, in which case I would talk about it in vague terms from my own experience like "it was a moving/challenging/whatever experience for me".

[estheruth.livejournal.com]

I always try to say "I can't talk about that," it in a way that makes the askee feel like a tool. Cause they are, goddamn it, if they're asking a health care worker about a patient in that kinda situation.
*ahem*
I just worked a 12.5 hour shift.

[abilouise.livejournal.com]

Yeah. I'm not quite such a big fan of making people feel like tools tho. I think it's because I'm not very good at it so the only one who ends up feeling like a tool is me.

[estheruth.livejournal.com]

I'm pretty good at it. I'm not sure that's good, tho.

[abilouise.livejournal.com]

Yeah, you are pretty good at this, which I think is sometimes good, but then again, you don't really ever make ME feel like a tool, so mostly I get to watch you do it to other people which depending on how I feel about them can be entertaining (I can think of some parties that were made bearable by your abilities).