Stewart Island and Ulva Island

My sister Kelley is here visiting us and we took a trip to Stewart Island which is South of the South Island. We crossed the sea by ferry (one miserable hour for some of us landlubbers).  We stayed on Stewart Island for two nights.  It was rainy, then sunny periodically--seems to be typical NZ weather. It was a tad bit cold and was interesting in learning how to heat our cottage with a coal-burning stove.  One day we took a water taxi across to Ulva Island. It is a birders paradise since they eradicated all pests like rodents and cats. We did not see an elusive Kiwi bird... but we had a nice time enjoying the sights.  We walked a lot--and saw some well-prepared trampers heading out to the national park for overnight trips. We met a Swiss tramper who mentioned that mud was 2 feet deep in places. Not for the fainthearted to do some of those rugged trips!

"So sorry...", being sick, breastfeeding, kamikaze bird

(these babies don't match the stories)

What a week! Two more lovely births...One was a primip who had days of prodromal labor, premature rupture of membranes...had to transfer to the District Hospital for IV antibiotics, but great, fast birth once she got going. Immediately after her birth (as in 12 minutes after the baby was out)--was called to another one--an hour a way--back at the Centre. Someone was contracting every three minutes, with a history of precipitous delivery. After racing back to Tuatapere, after being with her almost the entire night, no cervical change past 4 cm, contractions were frequent, but not long lasting. Doomed I say, Doomed...because when she was reading a magazine, while in the tub---I KNEW she was not in labor. Finally sent her home at 0330--this was not active labor. Contractions stopped shortly after she got home.  They then started back up several hours later--and when she came back about 24 hours after being sent home--she proceeded to birth within the hour.

We had a wonderful four hour breastfeeding workshop taught by the esteemed Mary Grant, Midwife, Nurse and Lactation Expert. It was spectacular!!!  I am so happy we were able to host this event.


By the end of the workshop, my stomach just did not feel right. The kids walked over to the Centre from school, I took them home to feed the "sweeties" (lambs), raced back to the office to do a antenatal visit, by the end of that visit I knew something was not quite right.

Went home planning to collapse in bed...when three very somber girls met me at the door. Quickly the story started, "I am sorry, I did not mean to..." (Oh heavens, not the computer I thought) "I don't know how it happened..." WHAT???!!!!  Somehow Mia broke of the front door key inside the lock.  Gracious.  Clearly they had tried with no success: gum, my now tattered tweezers and some other metal devices.  Oh woe, I IMAGINED how much it would cost to get the locksmith out from the city.

(movie night)

Stymied, I laid on the couch as the chills and the pain finally took over. As my own internal army was mounting an immune response to the culprit, which I suspected was food poisoning, I just wished for merciful evacuation whichever end, ASAP.  I moaned and groaned on the sofa as my Florence Nightingales brought me sprite and toast.  I half-heartedly oversaw homework, supper preparations and bedtime routine. I rallied at some point and took the whole lock off the door, and got the barrel out. I even figured out how to lock the door with a screwdriver.  At least I could sleep in relative peace without worry of some imagined intruder.  [Yes, I admit to watching too many scary movies over the course of my lifetime.]  I was sick through the night.   In the wee hours of the morning I heard a great thud--half asleep it sounded like a Moa birth trying to enter through the window.  I then forgot about it until...

Right as rain in the AM, and good thing too--as I ended up driving more than 300 kms to see all my postnatal and antenatal homevisit patients. I also took the lock barrel into the locksmith who could fix it for a fraction of what he would have charged for a home visit repair!  When I got back home I even figured out how to put the lock back together...and then I saw it, my kamikaze friend who had been laying on the hot pavement all day long--slowly cooking into the driveway. EEEEEEWWWWWWW!
I had to peel him off the cement. Bleech.  Bagged him up and he was a normal-sized bird by the way--off he went into the wheelie bin (garbage can).

We are now joyfully anticipating the arrival of my sister Kelley tomorrow. Meili has been at a friend's farm learning how to de-tail, as in some process of removing with lots of bloody, ooey-gooey, the tails of baby lambs.

Trying to end this post on a happier note--with some photos that do not do our beautiful Spring Flowering shrubs any justice. Shown is part of our front yard.   Of course sharing the sweeties too--so you can see how much they have grown.

Critters in the road and Change of plans

(photo taken from Maternity Centre parking lot)

Unusual things you see when you live rurally:  It is common to come across a sign by the road with a sheep or cow on it.  If it is orange you slow down--as it means they are moving stock to another paddock at that time. The farmers most often ride on these 4-wheelers or walk along with a few dogs, shepherding them to where they want them to go.  One day--as the girls were with me--someone was moving cattle--and we were pleased to see that the real-live cow dogs were doing their cow doggy-thing.  Some of the smart cows went on the road, but three took another route and the dog chased them over the hill.  The hill was made of limestone with a picturesque, rolling green carpet if you went up and over it politely.  If you chose to go the "short-cut," it was a high cliff that was cut through for the road.  Two cattle made it down the hill but one panicked and jumped over the cliff.  It was as if in slow-motion, as the large steer somersaulted through the air landing with a loud thud on the cement road.  It all took place about 30 feet from the front of our car.  That poor animal was still alive--impossibly struggling to stand, but quieted down quickly.  I hope it was shot soon--because it was awful to see.  The girls were very, very quiet and whenever we go by that cliff--we have to talk about the cow that jumped over the wrong side.  I thought about making some parenting analogy about friends, jumping over a cliff...but frankly the moral of the story is that if you take the path less traveled--you might end up dead. Not very comforting.  Plus I had just read the book about the expedition of finding Mallory from the Everest expedition--it made me think of Mallory and Irvine's last lonely hours, injured--well, we know that about Mallory. Anyway--I am feeling pretty glum right now.

So this stock on the road story--is quite common--I love an excuse to slow down and watch.  I have also seen beautiful hawks enjoying a bit of roadkill.  Lost sheep, sometimes lost lambs trying to get back in their paddock--the momma baaaaaing hysterically trying to give some lessons on how to get back to the inside of the fence.  My strangest observation was the random peacock I found strutting his stuff like some rapper dude with all  his bling on.  He was just sauntering down the road, refusing to move...hey, just like Selby Avenue in St. Paul!  My investigations since then have uncovered a farm in that vicinity with a whole bunch of peacocks, peahens AND turkeys.  Since turkeys are not farmed here--I was warned it would be nearly impossible to get one for Thanksgiving--and expensive too.  Maybe I will stop by and see if they sell theirs? But when I really think about it they look so pretty--I may not have the heart.  I like my meat shrink-wrapped and found in the frozen food aisle, as far removed from the original beast or fowl state it once lived in.  Maybe I should just become a vegetarian--since I am such a hypocrite and want my formerly-breathing protein source to be packaged?

The great news: My sister Kelley comes next week and will be with us for three weeks. We plan to explore Stewart Island and the Catlins Coast. We will also go to Dunedin (again) for a longer visit.  I will attend a breastfeeding workshop for midwives one day--while they go off to a museum.

Azule and 33 are growing by leaps and bounds.  The still bleat to be fed whenever they hear us, or see us in the kitchen window, but we are cutting back on their formula so that they start eating more grass.  They are absolutely the cutest things and we will miss them when we give them back to their owners.

Tuatapere Maternity continues to have steady growth, and we are actually seeing patients who will birth after I leave.  We are moving forward, slowly with the makeover plans.  Recruiting has gone well and we have a few applicants for my midwife replacement--all USA midwives.   The Board seems determined to get another American because they believe that our training is more in-depth and that it has been the hiring of Americans these past four years that have helped grow the practice due to trust in the community for safe maternity care.

Bad news: The girls are going back home early.  I have tried to find an au pair to live-in, especially for December and January, with no such luck.  Young women who want to live in a foreign country do not necessarily want to live remote, rural--far from the amenities of a town, let alone a city.  NZ immigration does not make this job category specific as the US does.  Many interested applicants would not meet the criteria established by NZ immigration.  My work visa for here was a big deal to complete with a chest x-ray to confirm that I did not have TB, etc.  Just one of the many of the PIA steps I had to take to get permission to enter the country.  I found that I bit ironic, since I was filling one of the most desired critical occupational shortages they listed.

As a midwife who is on-call 24/7 all but 8 days a month, it would be too much time away from my girls and a assortment of babysitters nights and days.   Last week when the girls were off for term break, and I had not one, but two births--and lots of appointments, I could only get a sitter for two days! That meant hauling the kids to the maternity centre where they were bored or leaving them home alone.  Part of this overseas job opportunity was because I wanted to share it with my darlin' daughters.  Once they go back home, no matter how wonderful the people here--I will be counting down the days until I get back to my family. 

Oh woe is me, and I would love to drown my sorrows with an ice-cold coca cola---but I gave them up when I got to NZ.  So now I don't have anything to make me feel better. I am homesick.

Two birth stories

My very nice, very complicated, Polycystic Ovary Syndrome, infertility, history of placental abruption leading to intrauterine fetal death, gestational diabetic on insulin, morbidly obese--BMI 57.5 patient had her baby by elective c/section due to suspected fetal macrosomia this past week.  It was my first NZ section.  Unless it is an emergency--they are all called elective. They do support TOL or trial of labor for many women. However, I was so appreciative of this decision to do a section or  "caesar" [yea, I know-I picture a salad too] as it is called here. It was virtually impossible to monitor the baby's heartbeat due to the mom's body habitus. She has classical truncal obesity--and antenatally it sometimes took as long as 15 minutes to find the heartbeat for momentary glimmer of audible heartbeat with an external monitor.

Of course, the surgery was delayed a couple of hours--hospital time which = "hurry up and wait."  I was quite extraneous to the whole thing, but my patient was very pleased that I took the time to come, as she did not have her midwife at the last section--or her partner.  I spent time in the room with her and her partner waiting for the blessed event. It was nice getting to know more about her and her family in which just about everybody has had a fetal death and several have diabetes and have died quite young. ;-(

In the surgical suite or "theatre" as it is referred to here--it was packed full of staff. Most who I had no idea what they do or who they were.  Many male staff--three of whom wore no socks with the Croc knock-offs. I can't imagine that being acceptable in the USA?  Even the anesthesiologist was sockless.

There were two OB-GYNs in attendance, one from the Philipines and one from the US--South Dakota in fact---she sounds right out of a Coen movie.  US doctor did the surgery--both docs were really short, standing on stools to reach over the operating table. They had this bar that went over part of the patient's abdomen, and using very wide surgical tape--they literally taped her tummy to the bar.  A whole new meaning for "Belly Up to the Bar!"

The challenge of getting a big baby out of the masses of tissue were apparent--it was the longest incision-to-baby that I have witnessed. Baby did fine--all 10# 3 oz of him.  Everyone was commenting on his size--and granted it was a gestational diabetic-caused macrosomic infant...but I have seen plenty of goodly infants--especially in the homebirth days.  I think I witness smaller babies here in this country due the high amount of cigarette smokers.

After the baby had been extracted by vacuum, through the incision--it was handed to the slighly quaking hands of the medical student and carried over to the warmer.  The pediatrician talked the student through the nuances of a newborn exam.  GUESS WHAT???? Even c/section babies don't get bulb syringed!!!! Finally a country that has figured this out--and guess what---they do not have a high rate of neonatal death due to "mucous."  

Two days later--the partner of one of my first time mommas, called to let me know she was in "pain."  She had taken castor oil the previous day--as she was pretty desperate to NOT have to be transferred to the big hospital--although she was only 40 + 4/7 days when she drank the wicked potion. After I talked with him-- describe the pain--like are they contractions? Yes, how far apart? How long? Some teaching on how to time contractions and a plan to contact me when they were five minutes apart.  I kept busy going to check on a five week old baby and mother. When the next call came in--the report was good-and she sounded seriously uncomfortable in the background, so I went over to the maternity centre and prepped for their arrival.

On admission she was 8 cm and I quickly put her in the bathtub. She loved being in the water.  I called my nurse and ob-aide to let them know things were hopping.  About an hour later--spontaneous rupture of membranes while in the tub--clear fluid and soon the unmistakable sounds of bearing down began.  She ended up getting out of the tub--it is a long, skinny bathtub and she could not manuever around at all.  She eventually got on the bed, kneeling for a long time, and then turned over and was semi-sitting for the final pushes.  Out came a beautiful baby girl, over an intact perineum, quick somersault to unravel the nuchal cord and onto mom's belly. Some drying to get the baby crying, viola! she pinked up right away.  Slight peri tear that didn't require sutures--oh happy day.

What a great loving couple they were too. So tuned into each other. I appreciated the dad telling her how good she was doing.  Later on he told me--I just love how my soft my baby's skin is.  Of interest to this secret anthropologist, they say "f**ckin' A" like some people say "um" or "like."  Let me tell you--from them it did not even sound like swearing. So like, um... f**ckin' A what a beautiful birth!

Azul and Thirty-three now have guardians to care for them