21 days to go...EEEEKKKKKKK!!!!!

So I finished my last post commenting how interesting the comparison between care for poorly babies would be, well after completing my placement on a small special care baby unit (SCBU) I must admit my perspective on care here has changed already...well actually I suppose that's not quite an accurate way to put. Really it's more a case of I had views about care before starting this course, then as I've learnt things and worked with different people I've kind of adopted some of their views and thinking - as happens. Now after my time on SCBU, I've been exposed to another view which really has reminding me of what my opinion originally was. I'm sorry, that's a bit of a spaghetti junction on an explanation there! Hope you're still with me lol

As student midwives, and registered midwives too, the message about woman centred care is at the core of everything we do and learn; organisations such as the RCM, White Ribbon Alliance and WHO tell us woman centred care should be pivotal in all that we do while providing safe care...but I'm actually starting to think that's too narrow! 

One SCBU nurse told me about a situation many moons ago, where she was trying to facilitate a premature (but stable) neonate to have some time with his mother who was recovering a traumatic labour followed by a crash section and PPH. However her endeavours were in vain as this nurse was told by a midwife that she is too busy caring for the mother and doesn't have the time to think about cuddles. As the nurse was not given permission to bring the infant onto the postnatal ward, it was over 12 hours before this mother and infant got the opportunity to bond. Now it can't be denied that high risk postnatal care is demanding for any midwife but surely the priority of any woman after giving birth is to see and spent time with her child. So while I accept there may be much more complex elements to this situation than I know, in my opinion, facilitating time for mother and child to bond in those significant early hours, addressing what is the woman's priority (seeing her child) is more woman centred than just focusing on her physical well-being, and the duration of separation may also affect her physical well-being (stress causing raised BP, resulting in a higher EWS score perhaps).

Now that is one very rare occurrence, but just an example of how this placement has got me thinking about the perspectives from both sides perspectives and it has made me consider experiences I've had where perhaps care should have been family-centred on a holistic level rather than woman-centred on a medical level.

I've found this experience on SCBU eye opening and invaluable, it has really made me think about the importance of infant development and environmental factors. Consider more flexibility with care, can jobs be consolidated to reduce interfering with bonding time, things that can be done to encourage bonding, being family centred in postnatal care-not just woman centred and think about what I can do in the future to make transitional care smoother for the two teams involved. It's also made me think about how I can support women when their babies are taken straight to SCBU - I now believe I'll be able to support women better, be able to explain what the neonatal team will be doing, preparing women for what to expect when they see their child on SCBU and

So after those thoughts/impressions being consolidated, I'm wondering what care of the new family will look like in Tanzania? More-so where there is a premature or ill infant. How much of what I've learnt in the last 2 weeks will I be able to share with the midwives there, and similarly, how much more will I learn from them?

In other news - I had my birthday, I got spoilt, I smashed my money jar and banked the pennies.

 I gave blood for the first time, something I've wanted to do for a long time and decided I had to do before the big 3-0 next year so figured I best do it a) before my yellow fever jab and anti-malaria drugs and b) while I'm feeling brave!

I've paid for my placement, paid for my R&R trip to Zanzibar, got a selection of donations together for both the hospital and the orphanage which I'll be visiting. I still need to sort my travel insurance (job for later today) and have my yellow fever jab tomorrow...not looking forward to that :/ I'm currently putting together an info pack for my parents with my whole itinerary and important details that may be of use to them. My to-do list is looking interesting - as soon as I cross something off, there's usually 2 or 3 more things to add lol typical! I've got all the important things bought, and completed my toiletries shopping today...so think I'm almost ready!!! 

3 weeks today I depart...beginning to wonder whatever possessed me to fly alone?!?!