I thought it would be cool to write a little bit about what I do really in my Praktikum instead of just write, "yeah, I'm there when babies are delivered...nbd"
So first of all, let me just start of by saying I feel much more comfortable (at the moment) just watching babies be born. It's a comfortable place. I can observe without having to say much, I am sometimes needed (to hold this leg or that wash cloth or hold the baby's head or cut the umbilical cord) and am always happy at the end of the birth because there's a new little baby! I've learned some new vocabulary to help me, "ruhig und tief atmen...durch die Nase ein und durch den Mund aus" or "Sie können das schaffen! Das Baby ist gleich da! Ich kann das Köpfchen schon sehen!" [Breathe deeply and peacefully...in through the nose and out through the mouth" or "You can do this! The baby is going to be here very soon. I can already see the little head!] And I think gently touching the woman or offering something cold for her forehead is always appreciated. I try. I did see one really horrifying birth though...the hebamme was also mortified because the doctor just came in and kind of imposed his ideas on how the birth should run. I felt helpless. It turned out good in the end though, the baby girl was beautiful and healthy and very cuddly :)
What is really scary for me still is meeting people at the door when they ring the bell. I always have to ask how I can help them, and when they reply, chances are that I will 90% understand them, but not be able to repeat a word back to the Hebammen. And no one really explained much to me all at once, I've kind of had a slow learning curve so far (or at least to me it seems that way). Most often, women seem to come either for a "Termin zur Kontrolle" like...just to make sure everything is okay when they reach their errechneter Termin [due date], or an "Einleitung" which is an induction. Being induced in Germany is really much different than in the US: the women receive a "cocktail" made up of two tablespoons Rizinusöl (castor oil), two tablespoons Mandelmus (almond butter) and a bottle of carrot juice. If this doesn't work on the first day, they receive two cocktails on the second day. On the third day, I think they get three cocktails. On the fourth day after beginning induction if they haven't had any contractions, they finally receive one 500 mg (?) Cytotec tablet (usually the first line in the US, correct me if I'm wrong). If that doesn't work, they continue with cytotec...I haven't seen any invasive measures used quite yet, excluding breaking the bag of waters but they only do that when a birth is imminent as far as I can tell. Svenja, one of the hebammen, told me today that although they start inducing the births as early as 7 days after their due date, it really isn't an issue until later because at +7 days the baby may still not even be ready to be born. Giving birth past a due date only becomes a real issue when the placenta starts to break down and stops providing the baby with nutrients. Then is an induction really necessary.
Anyway, I usually lead these women, whether they are there for an Einleitung or a Kontrolle Termin, into a CTG Zimmer (EFM=electronic fetal monitor in English! I finally figured out the proper translation, more info can be found here) and I put the CTG on them. This involves placing two round discs on the woman's belly, one at the top of the fundus (where the top uterus is) to measure the force of the contraction, and one where the fetal heartbeat can be monitored (done through ultrasonic waves, so usually placed somewhere on the back of the child or near the child's head). I learned how to feel a pregnant woman's stomach to tell where the baby is laying (in welcher Stelle=in which position). It's so crazy because you can feel EVERYTHING. It's just a matter of being able to distinguish which lumps are which. I must admit I feel kind of boss when I ask (in German) if I can touch their belly and magically find a heartbeat in one try with the CTG Knopf. It's a good feeling.
One thing I find extraordinarily difficult in Germany is measuring blood pressure. I have done it a thousand times in America manually and with a machine. Here, first off, everything is manual. So, not only do I have to properly hear the two blood pressure measurements (systolic and diastolic), but I also have to remember the numbers in German. I'm not good at remembering them in English. it's really, really difficult. So like, if I think to myself..."ok, one hundred and twenty two over seventy eight" it's not so difficult. But THEN, I have to remember those numbers long enough to translate them, repeat them to the patient, "ein hundred zwei und zwanzig zu acht und siebzig" and write them down on a piece of paper. It's really difficult for me, I must say. In my opinion, made only worse by the fact that in German the number order is reversed, so rather than saying "seventy eight" I effectively have to say "eight and seventy."
Another one of my menial tasks is to "urine tasten" or test urine. The women all pee in a cup (really unscientific, it's not collected by a lab or anything, they just simply leave the urine cups in one of the two bathrooms and I come on by) and then I stick a stick into it which tests for leukocytes, erythrocytes, pH (pay-hah in German :D ) glucose, protein and a host of other possibilities which I can't pronounce in German. I then report this back to the Hebammen too, usually also written on the paper that the CTG machines spit out with the results. Yep. The vocab for all the stuff I am learning. No biggie.
Other things I do: clean the Kreißsaale after births, help the hebammen do random stuff, hang IV bags/prime tubing, change pillow cases, fold towels, run blood down to the lab (no, there is no tube system, I run it down wearing a white lab coat...usually because it's raining and I have to actually leave the building to get to the lab), pick up Steri from the autoclave people (that's also on a different floor), weigh, measure, dress and give vitamin k to newborns, make Bändchen for the babies (little bracelets for their wrists), set the table for breakfast, make Wehencocktails (for the inductions). It's so much, it's so different every day, and I am absolutely beside myself because I love it so much.
In other news...things have been good. I had a sore throat yesterday but slept forever and it went away. today it's back a little, but it's alright. Hopefully I'll survive. I'm still trying to figure out the insurance thing...working on it. Over the weekend I didn't do much in the way of social things...had to work both days. Marco and I had a lovely Sunday afternoon today though, wandering around Bonn, eating ice cream, pizza and drinking beer. He has some free time now, which is awesome because every second I'm not working I'm basically free. Maja is reading some paper or making some bizarre youtube video about cats, god only knows, and everyone else is working on some presentation or another. Excited for the upcoming week :D :D
Goodness I love it here! Words can't even describe. Apart from having to wake up at 6 this morning, the day was perfect. Absolutely perfect.
Bis nachher...
Becca
{geburtszahl: 7}
So first of all, let me just start of by saying I feel much more comfortable (at the moment) just watching babies be born. It's a comfortable place. I can observe without having to say much, I am sometimes needed (to hold this leg or that wash cloth or hold the baby's head or cut the umbilical cord) and am always happy at the end of the birth because there's a new little baby! I've learned some new vocabulary to help me, "ruhig und tief atmen...durch die Nase ein und durch den Mund aus" or "Sie können das schaffen! Das Baby ist gleich da! Ich kann das Köpfchen schon sehen!" [Breathe deeply and peacefully...in through the nose and out through the mouth" or "You can do this! The baby is going to be here very soon. I can already see the little head!] And I think gently touching the woman or offering something cold for her forehead is always appreciated. I try. I did see one really horrifying birth though...the hebamme was also mortified because the doctor just came in and kind of imposed his ideas on how the birth should run. I felt helpless. It turned out good in the end though, the baby girl was beautiful and healthy and very cuddly :)
What is really scary for me still is meeting people at the door when they ring the bell. I always have to ask how I can help them, and when they reply, chances are that I will 90% understand them, but not be able to repeat a word back to the Hebammen. And no one really explained much to me all at once, I've kind of had a slow learning curve so far (or at least to me it seems that way). Most often, women seem to come either for a "Termin zur Kontrolle" like...just to make sure everything is okay when they reach their errechneter Termin [due date], or an "Einleitung" which is an induction. Being induced in Germany is really much different than in the US: the women receive a "cocktail" made up of two tablespoons Rizinusöl (castor oil), two tablespoons Mandelmus (almond butter) and a bottle of carrot juice. If this doesn't work on the first day, they receive two cocktails on the second day. On the third day, I think they get three cocktails. On the fourth day after beginning induction if they haven't had any contractions, they finally receive one 500 mg (?) Cytotec tablet (usually the first line in the US, correct me if I'm wrong). If that doesn't work, they continue with cytotec...I haven't seen any invasive measures used quite yet, excluding breaking the bag of waters but they only do that when a birth is imminent as far as I can tell. Svenja, one of the hebammen, told me today that although they start inducing the births as early as 7 days after their due date, it really isn't an issue until later because at +7 days the baby may still not even be ready to be born. Giving birth past a due date only becomes a real issue when the placenta starts to break down and stops providing the baby with nutrients. Then is an induction really necessary.
Anyway, I usually lead these women, whether they are there for an Einleitung or a Kontrolle Termin, into a CTG Zimmer (EFM=electronic fetal monitor in English! I finally figured out the proper translation, more info can be found here) and I put the CTG on them. This involves placing two round discs on the woman's belly, one at the top of the fundus (where the top uterus is) to measure the force of the contraction, and one where the fetal heartbeat can be monitored (done through ultrasonic waves, so usually placed somewhere on the back of the child or near the child's head). I learned how to feel a pregnant woman's stomach to tell where the baby is laying (in welcher Stelle=in which position). It's so crazy because you can feel EVERYTHING. It's just a matter of being able to distinguish which lumps are which. I must admit I feel kind of boss when I ask (in German) if I can touch their belly and magically find a heartbeat in one try with the CTG Knopf. It's a good feeling.
One thing I find extraordinarily difficult in Germany is measuring blood pressure. I have done it a thousand times in America manually and with a machine. Here, first off, everything is manual. So, not only do I have to properly hear the two blood pressure measurements (systolic and diastolic), but I also have to remember the numbers in German. I'm not good at remembering them in English. it's really, really difficult. So like, if I think to myself..."ok, one hundred and twenty two over seventy eight" it's not so difficult. But THEN, I have to remember those numbers long enough to translate them, repeat them to the patient, "ein hundred zwei und zwanzig zu acht und siebzig" and write them down on a piece of paper. It's really difficult for me, I must say. In my opinion, made only worse by the fact that in German the number order is reversed, so rather than saying "seventy eight" I effectively have to say "eight and seventy."
Another one of my menial tasks is to "urine tasten" or test urine. The women all pee in a cup (really unscientific, it's not collected by a lab or anything, they just simply leave the urine cups in one of the two bathrooms and I come on by) and then I stick a stick into it which tests for leukocytes, erythrocytes, pH (pay-hah in German :D ) glucose, protein and a host of other possibilities which I can't pronounce in German. I then report this back to the Hebammen too, usually also written on the paper that the CTG machines spit out with the results. Yep. The vocab for all the stuff I am learning. No biggie.
Other things I do: clean the Kreißsaale after births, help the hebammen do random stuff, hang IV bags/prime tubing, change pillow cases, fold towels, run blood down to the lab (no, there is no tube system, I run it down wearing a white lab coat...usually because it's raining and I have to actually leave the building to get to the lab), pick up Steri from the autoclave people (that's also on a different floor), weigh, measure, dress and give vitamin k to newborns, make Bändchen for the babies (little bracelets for their wrists), set the table for breakfast, make Wehencocktails (for the inductions). It's so much, it's so different every day, and I am absolutely beside myself because I love it so much.
In other news...things have been good. I had a sore throat yesterday but slept forever and it went away. today it's back a little, but it's alright. Hopefully I'll survive. I'm still trying to figure out the insurance thing...working on it. Over the weekend I didn't do much in the way of social things...had to work both days. Marco and I had a lovely Sunday afternoon today though, wandering around Bonn, eating ice cream, pizza and drinking beer. He has some free time now, which is awesome because every second I'm not working I'm basically free. Maja is reading some paper or making some bizarre youtube video about cats, god only knows, and everyone else is working on some presentation or another. Excited for the upcoming week :D :D
Goodness I love it here! Words can't even describe. Apart from having to wake up at 6 this morning, the day was perfect. Absolutely perfect.
Bis nachher...
Becca
{geburtszahl: 7}
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