Lottery results and international placement

Where was I again? Yes, just waiting for the results of the lottery for my senior placement. That waiting period after we sent in our choices was one of the hardest things I have ever experienced. I had multiple migraines and several panic attacks in the days coming to the result. It has been particularly hard because even though I felt my world was falling apart, I still had to continue with my obstetric placement that I was doing during that time. This placement on itself is already quite challenging with the long 24-hour shifts and the many issues obstetricians deal with that we have not been exposed to yet, so the added stress was not well tolerated.

The day we were supposed to receive the email with the placement allocation I could feel the adrenaline rising. I had multiple palpitations that day, and when the email finally came, I couldn’t open it. I was in the clinic, and I felt if the placement location was not what I was hoping for I was going to lose it in front of everyone. But as I left the clinic I still couldn’t open it. Opening the email meant having to deal with the results and potentially a bad one. I then drove to a friend’s house who calmed me down with some tea and food since I had not been able to eat anything all day. She then opened the email for me. When she put her hands on her heart and smiled, I knew there was good news. The email said Community Midwives of Halton. I started sobbing. I couldn’t stop crying, all the stress that was accumulated during the last two weeks exploded. For the longest time I couldn’t even get excited, I just felt relief.

Soon after my obstetric placement finished, I had to get ready for my international placement. In third-year, we have the option of doing our elective placement internationally. I had been planning on doing this placement in Brazil since I joined the program. I was going to spend a month in Brazil at a public hospital in Florianópolis, a small island near the south coast. My dad lives there, and I also have an uncle and cousins there. This is the place where I used to spend my summer vacations as a teenager. Lots of good memories from that place! I was a little nervous to leave my family for one month, but we were planning for them to come and join me during March break for a week. I organized my hours at the hospital so that I did double hours prior and after their stay so that I could have time off when they were there. It was the best family vacation we ever had. The weather was perfect, and we stayed at a house right on the beach. Beautiful sunsets, amazing food and lots of fun.

My experience at the hospital was also amazing. I saw more vaginal normal births during the 120 hours I did there than the 4 1/2 months of my normal childbearing placement in second-year. You are probably asking: but doesn't Brazil have something like 80% c-section rates? Not in the public system. Their c-section rate is the same as Joseph Brant Hospital in Burlington. They had zero assisted deliveries and zero epidurals while I was there. They do breech vaginal delivery, twins, VBACs regularly. It was a great learning experience. Also, they don’t have EFM (electronic fetal monitoring), so I got lots of practice with IA (intermittent auscultation). Keeping the woman off the bed seems to be their primary focus, so it was very refreshing to me since every single birth I participated during my second-year placement was with the woman on the bed and her back. I know… this is quite disappointing.

Midwifery is not regulated in Brazil, but it is also not illegal, so there are some midwives there. I got in touch with two home birth midwifery clinics while there and was even invited to do a talk about the integration of midwives in Canada at one the clinics. I do think about someday going back, so it was important for me to assess the midwifery situation there. Though Midwifery in Brazil does not come anywhere near what we have achieved in Canada regarding the scope of practice, consultations, and hospital privileges there is a seed planted there. It also gives midwives more freedom from the medical profession as they are not controlled by them. Just some food for thought.

Now I’m back in Canada and getting ready to start my senior placement. Lately,  I have often stopped and acknowledged that I am in my last year of this program. How did I get here? When I look back, I realize how far I have come, and I feel very confident about this upcoming placement. I had some opportunities to talk to my preceptor so far, and I believe that this placement is going to be more human than the previous one. I’m expected to follow only one midwife (4 clients a mother instead of 8) and only be on call when my preceptor is one call (not every single day except four days off we get a month). This represents a huge improvement in my ability to cope with the demands of the midwifery profession. I’ll try to keep writing during the placement, but if the time is short and the work is massive I’ll have the month of August off and will catch up then.

Following are some pictures of the hospital I worked while there:

Nurses Station

Triage

Squatting bed

Regular bed with squatting bar 

Birthing stool

Rocking horse

Flip-flops everywhere - even at the nurses station

One of the babies I caught

And now some picture of us having fun:

Beautiful flight with beautiful view of the mountains

View from out bedroom

View from living room

Bonding with my daughter

Family time

A waterfall we visited

Off course some fishing

Time with hubby

Market time

Healthy food every day

Senior Lottery – This is so hard!

The time has come to enter the senior lottery, the scariest part of this program. Of course, when the list of our options came out, it was not what I had expected. In the last year, the University has made some changes in an attempt to improve the support they give to students during placements. In the past, we were able to choose any midwifery practice in Ontario that was taking students for the particular placement. Many students were experiencing problems with their preceptors and due to some clinics' distance and the University lack of familiarity with some of the areas; the program was not able to provide better support to those students. With this in mind, they divided the clinics concerning its proximity to the university you are associated with. Though I can understand this reasoning, it has also created a limited amount of choices for students. Another change that was made is that many clinics are clumped into one choice. For example, Burlington and Oakville are considered one choice, the two clinics in Waterloo and the two clinics in Kitchener are regarded as another choice, the two clinics in Cambridge and the two clinics in Guelph are considered yet another choice. If you are interested in Cambridge and put down this as a choice, you may end up with Guelph. This is horrible, especially for people where moving is a major problem. In all, we only have eight choices of areas, and we have to identify our first top four. Then, it is up to the lottery and your luck to find out where you are going.

Have I said how terrified I am of this lottery? Way more terrified than the one in the second year. First, in second year, all of my four top choices did not involve moving. I would only have to move if I fell out of the lottery by not being chosen for any of my top four choices. For the senior lottery I’m about to participate now, there are only two choices that I would not involve moving. So, I have to choose two places I don’t want to move to as part of my top four picks. It is horrible to have to think about moving when the fact hasn’t happened yet. Second, the last placement was only for four months. The senior placement is three sets of three months with a month off in between, which means I would have to have other living arrangements for basically one year. Also, what is making me nervous is that in the second year lottery, my designated placement ended up being my fourth choice. So I know there is a real chance of me not getting my first two choices, meaning there is a real chance I would have to move and leave my five children and husband for almost a year. I don’t have any family in Canada, so I can’t count on any help. Imagine that.

There is also another factor aggravating the situation, and that is, the closest midwifery clinic to me, which is Burlington and Area Midwives, will declare a conflict of interest with me being a student there. This is because I had my last baby with one of their midwives and also had a business relationship with the clinic when I used to teach prenatal classes. The university says that if the clinic or the midwife feels that they cannot adequately assess a student for whatever reason, they should declare a conflict of interest. So there you go! No Burlington clinic for me. What makes it even harder is that the Burlington and Oakville clinics are clumped together into one choice; Halton. So I’m not entirely sure how this is going to be affected if I put Halton as my first choice. Can I just say it? This sucks! Big time. I’m still not sure what I’m going to put down as my first four choices. Then, the wait. Yes! Three weeks until we find out where we are going. Is this torture or what?

Did I mention how much this sucks?