This mom’s s/s were: lower/mid back pain, noticeable but non-painful uc, cramps, pelvic pressure, diarrhea, and mucous plug like discharge. FHT were good. No amniotic fluid was present. HMMMM. So, an internal exam was done, she was high, long, fingertip, but soft. No bloody show was evident on glove. I noticed that this mom has not had to go to the bathroom when we arrive. This is peculiar to me. Another midwife was seeing this mom for her prenatals up to this point, and for this mom not to anticipate the urine dip at every visit by now, was weird. Since we had just been here last week and she took forever to have to go to the bathroom—what mom at 35 weeks takes forever to go potty? The one who isn’t drinking enough! And what is a treatment for PTL? Adequate hydration! Her urine was cloudy, with high ketones and blood in urine. Now, I have issues with this dipstick. It has too many tests on one strip that it seems to bleed onto the other nearby tests, like the ketones, if high, will seep onto the urine square. I try not to get too much urine onto the dipstick, but it inevitably seems to bleed. I think when I get into my own practice; I will get a test strip with fewer indicators so that this doesn’t happen. It drives me crazy because at the other PTL visit, I tested the urine and saw a similar reading, but I didn’t think it was conclusive since it was obvious the ketones were spilling—all over the dipstick. Plus, it is hard enough to read those dipsticks with 12 indicators in electric lights, but when you only have a pen light or kerosene lamp—well, I guess I better learn fast.
So, this mom seems really anxious to me. She is full of energy and seems not confident of herself, which saddens me, but I have to remember that she came from a hospital birth. I think she needs more coddling and reassurance than I am seeing her get from her midwife, but what do I know? I feel like being a doula to her, where I haven’t felt that before with the other moms. I think this is weird. Is it just because she is English? She just seems to be all over the place and not focused on enjoying these last few weeks. Stressing over them and waiting for labor to begin is not helping. Hopefully, she’ll become centered and at peace soon. Apparently the mom was having a UTI, which was aiding in the PTL. She said she felt as if one was coming on and she was urinating more and very thirsty. Her husband went out and got her some cranberry juice, but the midwife was going to call in a prescription in the morning. We didn’t have the black haw with us—gotta replenish those bags! The mom didn’t have any wine (our second suggestion), so we offered Benadryl, which she accepted. It worked like a charm on the 2nd dose and we waited a good 1.5 hours before letting ourselves out and going home. Her uc must have subsided once she relaxed and fell asleep.
Her plan was to do another internal exam and go from there. If needed, she would escort mom to the hospital, but hopefully, she needed some reassurance and a hug. Since it was my day off, I use that term loosely, because I would have normally went, if I didn’t have a quiz that I was studying for tomorrow. Plus, my kids were not expecting me to be gone today. I told the midwife that I would check and see if the neighbor would pick them up and go from there. Unfortunately, my neighbor’s mother had committed suicide today and I was not going to impose any babysitting favors upon her. That must have been God’s sign that I didn’t need to go. Normally, I tell my girls that I may not be home and give instructions on what to do, but today they both had activities after school in different locations at different times and I didn’t feel comfortable trying to get a bunch of other mothers involved. After today I will tell my girls just to walk home after their activities, but since it was such an unusual day, well, I had to say no to work as hard as that was.
My Journey as a Licensed Midwife in Louisiana 