Monthly Chai: April 2017


Hello dear readers. And hello, April. I’ve officially been working as a midwife for three months. I’ve survived the first trimester. And just as I reassure my pregnant patients that most of the time, the worst of the nausea wears off by second trimester, I’m reassured by the fact that I feel more settled and (ever slightly) more at ease as a new baby midwife. I won’t ever have to experience those first three months of being a brand new midwife again…and you know, I’m so ok with that.

Signs of spring are everywhere here in Portland: the daffodils are in full glory, the cherry blossoms are stunning, and there’s even been glimpses of glorious sunshine in recent days. After a long winter of illness (oh, those little toddlers in full-time daycare–they bring home all the germs!), I feel like a new person, ready to take on the world…or at least, to take on some new projects at work.

I’m discovering that one of the best ways to make myself known among my collaborating OB’s is to volunteer to draft clinical practice workflows/guidelines. In my practice, a lot of what we do is evidence-based, but not all of it…and much of it is not currently documented in an easy to access manner with up to date references. So, after three months of observing and learning my clinic culture, I’m diving in and providing my research and midwife perspective on such things as misoprostol management of miscarriage, substance use screening in pregnancy, and early screening for gestational diabetes.

Some topics are more work than others, but I’m finding it’s a great way to get to know my OB colleagues and share the latest research with them. They’re excited to have someone eager to do that work and make it efficient for them. It’s also been super helpful in making sure our triage RN team (we adore them!!!) is on the same page with us about triaging various situations, making communication about key urgent situations more streamlined. It’s a win win for everyone.

Other new developments: I’ve been recruited to be the “marketing committee.” There are still other channels I have to work through, as my practice is physician-owned, but I get to help develop marketing strategies and priorities for the midwifery practice, which I find to be both exciting and a challenge. It’s something we don’t talk about much (or at all?) in our training as midwives, but the business of running a midwifery practice requires just as much care and attention to detail as the clinical aspects of running a practice…and it’s a steep learning curve. I’m grateful for the ACNM Administrative Handbook to help bring me up to speed on some basics. I’m soaking up as much of the wisdom and experience of our clinical lead midwife as I can.

Oh…and then there’s benchmarking. Apparently my love affair of spreadsheets has won me the coveted role of benchmarking guru in our practice. I’ve been slowly working on refining our data collection system, which has been really fun (yes, really!). I’m looking forward to being able create a system that’s user-friendly for those middle of the night births while also allowing us to actually use the data to improve clinical practice.

So what am I doing on my off days you ask? Basically, trying to relearn how to live a normal life again. It’s been so long since I haven’t been in school, I’ve forgotten a bit what it’s like to have time off. Like, real weekends, sometimes even three day weekends, depending on my call schedule. It’s been lovely to be able to spend more time at home, just relaxing, reading for fun (I’ve been devouring John Lewis’s March trilogy, an amazing comic series on the civil rights movement).

I’m recommitting myself to a more regular schedule of movement and outdoor activity now that the rain is easing up a bit, including regularly biking or walking to work (it’s only an 8 minute bike ride or 25 minute walk, I really have NO excuse). Last fall I had made a goal of biking Mackenzie Pass this spring. I don’t know if I’ll make it this year (June is fast approaching!)…but I am relishing every opportunity to get my heart rate up. Of course, it’s also a great de-stressor, since reading the news these days brings on regular fits of fury and rage. I’m sure I don’t even need to link to any recent examples of how the current presidential administration is f*ing everything up. You know.

What are your spring passion projects? What are the things you’re wishing and dreaming about for your midwifery practices? What seeds are you planting for the coming year in your personal and professional life? How are you pacing yourself to keep up stamina for the long haul? I’d love to hear from you! Comment below, or find me over on Facebook. I have a new Full Spectrum Midwife Instagram account, now too!



2 Replies to “Monthly Chai: April 2017”

  1. My upcoming passion is miscarriage management. My current (and new since January) practice only does D&Cs in the OR for folks that want active management of their miscarriages (besides miso), and I was shocked! We’re a major practice associated with the flagship university of our state! There’s no reason that we shouldn’t be offering suction procedures in the office with MVAs.


    1. Oooof, I hear you. We have many providers in our office who would totally do MVA’s, myself included…but our clinic rents space from a Catholic hospital, so unfortunately, it’s a no-go. I struggle with it, but for now, it’s how things are. Someday o know I will get trained and will work in a setting where I can provide full-spectrum care. Good luck to you in your efforts!


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