Just wondering: Does anybody mind when midwife/medical students are present? - Mothering Forums

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Old 02-18-2005, 04:58 PM - Thread Starter
 
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Before my last appointment I got a phone call from the secretary at the Birth Center asking me if I would mind having a student present at my consultation. I said she was welcome to be there and I came they were all so thankful I did not mind I figure: they have to learn the trait somehow, don't they?

She tried to feel the position of the baby too, and it was kind of cool because I learnt a lot about it while my midwife was teaching her how to do it

So, do many people refuse the presence of students during their appointments? I am just wondering why they were all so thankful the other day - as if they rarely have the chance to do it.

I personally don't even mind a student present at the birth - as long as everybody is VERY VERY quiet :LOL
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Old 02-18-2005, 05:03 PM
 
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Nope, I don't mind at all. I think that they need to learn somehow and the most practical training is the hands on kind.
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Old 02-18-2005, 05:17 PM
 
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My midwife has an apprentice - we met her at the initial consultation and then she's been at probably half (or a bit more) of our prenatals. I don't mind at all - double the attention! :LOL

OTOH, we were briefly with a ped. group that had medical students come in, and I hated that... I think a lot of it depends on the attitude of the students and where you are.

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and Brigid Eleanor (11/20/08)
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Old 02-18-2005, 05:28 PM
 
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I wouldn't mind them being at my appointments. I probably wouldn't mind a midwife student at my birth either. I do get annoyed when I see residents and medical students at deliveries and think I would never want them there but my experience is skewed, I only seem to be at the deliveries wher I think we are doing so much unnecessary stuff in the first place and I hate watching the residents all oogle over the EFM printouts and clumsily attemt their first forceps attempt when the woman has never been encouraged up off her back into a different position to push, I just see the bad stuff. If I were at the hospital I would not want residents or med students at my delivery. They always want to learn and try something new and I don't want to be pushed into allowing something when the person persuading me has "so so-and-so can try it" in the back of their mind. I work at a teaching hospital, I see how most things are seen as "cool, mark has never done a circ with a gomco, lets let him do this one" or "jenny has never tried the forceps, it looks like this lady might need forceps, cool!"

puke puke puke
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Old 02-18-2005, 05:39 PM - Thread Starter
 
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Quote:
Originally Posted by mara
If I were at the hospital I would not want residents or med students at my delivery. They always want to learn and try something new and I don't want to be pushed into allowing something when the person persuading me has "so so-and-so can try it" in the back of their mind. I work at a teaching hospital, I see how most things are seen as "cool, mark has never done a circ with a gomco, lets let him do this one" or "jenny has never tried the forceps, it looks like this lady might need forceps, cool!"

puke puke puke
Good point!! Hospitals are a whole different story...
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Old 02-18-2005, 07:26 PM
 
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Originally Posted by mara
They always want to learn and try something new and I don't want to be pushed into allowing something when the person persuading me has "so so-and-so can try it" in the back of their mind. I work at a teaching hospital, I see how most things are seen as "cool, mark has never done a circ with a gomco, lets let him do this one" or "jenny has never tried the forceps, it looks like this lady might need forceps, cool!"

puke puke puke
That truly is how they talk about it, huh? I used to work at a medical school before I had children, and I think that that experience is what really made me start researching midwives and birth without medical intervention. I remember hearing two med students talking about a laboring woman and thinking, "They are talking about her as though she were a piece of meat!" Sickening. And you are so right about the supervising physicians/residents talking women into unnecessary procedures just so med students have the chance to see them. The teaching hospital here does almost all of the Medicaid-covered births, and so those who are poor or without medical insurance automatically end up with an increased chance of c-section, due to the "quota" of surgical deliveries that each med student has to see on his/her rotation through the OB/Gyn department. Anyway, suffice it to say, if you are at a hospital, insist that no med students are present, or at least that a senior doc performs any necessary medical procedures.

OTOH, having recently been a midwifery student myself, I felt very blessed by all of the mothers that let me be a part of their birth experience. For the great majority of mw students, midwifery is a calling, and therefore they have great respect for pregnant and laboring women.

Um, I'm obviously a bit biased here, but that's just my two cents!
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Old 02-18-2005, 07:40 PM
 
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I think it's terrific that they took the time to call you about it ahead of time!

The first time such a thing came up for me is when I was 16 and having very painful ovarian cysts. I was in pain, and nervous with each consultation, each time with a new practitioner, and hadn't found my voice yet in general. I got undressed, put on the little gown, and when the dr. came in, he casually said something like, "you-don't-mind-the-student-observing-do-you." and sat on the little stool and got to work probing me. I was obviously very uncomfortable on many levels, but wasn't prepared to have to stand up for myself just then.
Since that day, I've been adamant about having NO STUDENTS if I'm in a hospital setting. This is a well-respected hospital, but if I was going to choose to birth in one, I would never go to this one for this reason. The wide range of skills OBs are supposed to practice... ugh. I'm not gonna be that kind of guinea pig.

But now I'm seeing a midwife I love, her apprentice is a very mild, wise, unassuming person who I am happy to welcome into prenatals and the birth. The whole attitude is so different with them, so I don't mind a bit if she feels my belly for a little longer, or takes my BP verrrry slowly.

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Old 02-18-2005, 08:22 PM
 
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My mid-wife has an apprentice who is actually almost done with her training. She is mostly assisting her with everything. She has started doing most of the prenatals on her own because the mid-wife is supposed to give her more responsiblility at this point.

I don't mind because she is at every appointment just like the mid-wife is. She is just part of the deal not an extra really. I kinda like having two women there to chat with and check on the baby.

I don't know how I would feel about an extra person hanging around. I already told them I don't want their third "assistant mid-wife" at the birth. She is an extra really. I said she can come if they end up really really needing her but I don't feel comfortable with someone I will have only met once if even that much while in labor.

Stay at home wife to Jason for 7 years Mama to Larissa Mae 2 years old :, Gavin Clay 7 months :, and Neveah Ann April 24, 2005 to July 13, 2007 ED for my food allergic babe. :::
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Old 02-18-2005, 09:32 PM
 
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I've been fine with it, but I agree the apprentice system is a lot different than the medical training system. for one thing, I think they're quicker to admit when they don't know or have a question. I can see some women being more shy or having a better comfort level with one provider that's built over time. Many, many women forgo routine gyn care, and even prenatal care over issues about dealing with medical staff and strangers. I'll talk to anyone, but if I disagree, I have no problem saying so. For people who can't manage conflict as well, I can see being very careful about who treats you.

I've had some complex things in the past - and in some respects it is flattering to be the center of attention, but it can also be very stressful, especially when the medical issues are serious. In an extremely complicated prior pregnancy that ended in loss, I was hospitalized a long time. And I was grateful every day not to be in a teaching hospital and woken up by flashlight every morning with a pack of students suggesting ways to "fix me". I do allow residents to treat my daughter at a local pediatric ER - however, they and I both consult the senior doctor when we have questions. In general, being in the hands of someone you don't know, who may not have slept recently, or seen a live person with you condition does not build confidence! Some teaching and research hospitals have experience and expertise you won't find anywhere, so it can be worth it. But I certainly prefer to have my providers of choice, and to decide whether I'm up to having a cast of thousands present for my procedures.

One oops I had, my midwife had an apprentice at my first exam visit, and we were discussing my prior pregnancies. She asked a fairly technical question, and I answered before I realized she was asking the apprentice!
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Old 02-18-2005, 09:33 PM
 
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Quote:
Originally Posted by TXmidwife
That truly is how they talk about it, huh? I used to work at a medical school before I had children, and I think that that experience is what really made me start researching midwives and birth without medical intervention. I remember hearing two med students talking about a laboring woman and thinking, "They are talking about her as though she were a piece of meat!" Sickening.
Yup I have a cousin in med school and I no longer talk to her because of the way she speakes about her patients. She's gone from a caring loving person to someone who (sorry OT) has recomended that I circ baby #2 because circ'd men are easier for them to catheterize.

That being said, I would be OK with a training LD nurse or definately with a training midwife.
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Old 02-18-2005, 10:55 PM
 
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I delivered at a hospital at a medical univeristy. There were lots of medical students and this next time, I will have a midwife at a hospital birth center. No students. Of any kind. Really, I already made my contribution to education and I don't want to do it again.

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Old 02-18-2005, 11:00 PM
 
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My OB practice frequently has students from Dartmouth Med School and the nurses will always ask ahead of time if you mind if a student accompanies the doctor for the exam. I have no problem with it...they've always been very polite, and respectful, and truly interested in the exams. As some of the PPs said..they have to learn somewhere!

Mama to DS (8) and DD (7) Aristotle was not Belgian. The central message of Buddhism is not "Every man for himself." And the London Underground is not a political movement.

 

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Old 02-19-2005, 12:09 AM
 
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I have to add that I really don't like all the med school/hospital bashing that goes on. I know that the system isn't perfect, but wouldn't you rather the students learn on someone like you, who is well informed and has a voice and is willing to say no to unnecessary procedures? I had my first two children at a teaching hospital. I was also on medicaid. I was also 15 and 18 years old. Not once did they try to talk me into doing something unnecessary or harmful. I had very easy and natural births and pregnancies and I often had med students in during my appointments and they were there for my births as well. They were always respectful of me, my body, and my wishes. Every experience is different and there are things that they need to learn. Ignorance lies in everyone, in every profession, and to point fingers at the evil doctors is just silly. I, for one, am thankful that the doctors that I've had to see in my life have been well trained in whatever I was being seen for.
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Old 02-19-2005, 12:11 AM
 
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I didn't mind the student midwives. I was actually impressed with the ones I saw. I had one at one of my appts around 24 weeks. I had my son with me. She was there when I went in for some labwork months later. I didn't have my son with me, and she asked me about him by name.
Med students though do bother me, and I always refused them.
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Old 02-19-2005, 12:16 AM
 
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I didn't mind the student midwives. I was actually impressed with the ones I saw. I had one at one of my appts around 24 weeks. I had my son with me. She was there when I went in for some labwork months later. I didn't have my son with me, and she asked me about him by name.
Med students though do bother me, and I always refused them.
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Old 02-19-2005, 12:35 AM
 
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I don't mind them in theory, like the idea of having them there for prenatal stuff. But at the actual birth, I don't want anyone I haven't met unless I really like them right away.

Midwife (CPM, LDM) and homeschooling mama to:
14yo ds   11yo dd  9yo ds and 7yo ds and 2yo ds  
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Old 02-19-2005, 03:24 AM
 
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I don't mind the students. I remember after having ds in the hospital, a student nurse came in to examine me and she was clueless. I talked her through the exam!

I wouldn't let an OB touch me, so maybe that is why I don't mind students.

DS1 2004 ~ DS2 2005 ~ DD1 2008 ~ DS3 2010 ~ DD2 born at 31 weeks Oct. 2014
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Old 02-19-2005, 09:00 PM
 
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I had my two oldest boys in a teaching hospital, and it never bothered me to have a few extra eyes. With Jake they asked if they could test for dilation, and well this new dr was totally nervous, but man was he GEORGOUS!!! I was in the middle of a contraction and giving him the evil eye, and he couldn't even look at me, he was looking at the ceiling! I still laugh about it!
With my second he was in distress, and there were about 20 people in the room, That was a little unnerving. A year later I had an IUD put in and they again asked if others could watch, and I said sure, and 4 extra people came in to check it out.
However, the hopsital I had my kids in were known for putting out excellent dr.'s
Donna
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Old 02-19-2005, 10:10 PM
 
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I would have imagined that I would always enjoy having a student/apprentice MW, however I had quite a negative experience when I learned I was pregnant with DD #2 and I went to the first appointment with the MW I had with my first daughter. I was introduced to the student who would be present for my prenatals & the birth (at my consent, of course)... well, I was all gung ho, until she opened her mouth.... she was AWFUL! She was *very* medical model and lectured me on one topic or another the entire appointment ~ DD (then 20 months) should no longer nurse in her opinion & here is why.... concerns about me being vegan & here is why... on and on it went! Yuck.

I had decided that I would have to take the less than comfortable stance of NOT consenting, however it turned out that we moved for my DH's new job and the whole issue became moot.

Ordinarily though, I would have no problems at all with a student. This one just happened to be MW student from hell!
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Old 02-20-2005, 03:18 PM
 
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In a way you are right Wendy, BUT, if they were teaching evidence based medicine to the residents and were justified in most of the interventions they did, as in did interventions only when they were necessary, then I would totally agree with you. But they are teaching a poor quality of care to these residents and I can't stand by that. I work with them, although admittedly at only one hospital, and they are being taught to try to intervene first. They don't teach the resident to have mom squat or get off her back, they go right to the cheerleader pushing in lithomy position and when that fails they go right to forceps or c-section. I have never seen it suggested by someone teaching a resident that they tell mom to get up, only when it is certain doctors or midwives in private practice and a woman who has a strong opinion about the matter does this get done. Same with other things. The resident team is all about learning skills fast and I totally notice a trend of their patients needing that kind of intervention much more often. Myybe it's just a coincidence but it hardly seems possible it is only a coincidence.
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Old 02-20-2005, 10:39 PM
 
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I have had a midwife student at appointments adn I didn't mind that at all, I'm not sure if I would mind a medical student - it would depend a bit on the vibe. With the midwife, it was just like having two midwives, the student would pipe in sometimes, depending on her experience, perform the exam under the eye of the midwife, If anything I felt like I had twice the attention.

However, if (more likely in the case of a med student) the student being there made me feel more like a 'case' than a person and it distracted the doctor from me, I would be pretty annoyed.

Also, I Think I would be annoyed on principle if the concept was not discussed with me and my consent given.

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Old 02-20-2005, 10:48 PM
 
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I don't usually mind at all. At the birth is a different issue for me altogether though, but I'm trying to keep almost all people out right now. At appointments, I have often had students present. When I got my IUD, a student at my mom's office inserted it and I had so much pain, she thought she had screwed up and was killing the boss' daughter. I thought that was pretty funny. (if you wanna know why all the pain - be sure your bowels are empty before getting an IUD inserted).

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Old 02-20-2005, 10:49 PM
 
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I haven't had a bad experience with med students. But I keep my right to say "no" to anyone very close. That includes students or doctors or nurses or anyone.

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Old 02-20-2005, 11:37 PM
 
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I had students present at my first two births. One was so sweet, she held the barf bucket in front of my face and helped clean up my puke. She wasn't grossed out and was very gentle towards me. Which I really appreciated.
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Old 02-21-2005, 03:43 PM
 
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I had a student midwife present at the birth of my daughter and she was wonderful. Gentle and supportive and unobtrusive. Afterwords she told me she was honored to have been present and that my daughter's was the most beautiful and gentle birth she had ever seen. Made me feel terrific!
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Old 02-21-2005, 06:07 PM
 
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interesting question...Overall, I very much appreciate the importance of on the job training for medical professionals. BUT I also very much appreciate each consumer/client’s individual choice as to who will work with them and how they will be treated. (an aside: my sister had leukemia at 17, happily is fine now, but was already suffering so much that I know my mom only stood for competent student intervention—if they weren’t helpful, they were told to leave, and ITA with this approach).

That said, I recently had an experience where our mw who is also a dear friend, had a student who I just didn’t like. She offered lots of unsolicited & inappropriate opinions about diet & weight (that differed from my mw’s approach) and was much more judgemental than my mw. I spoke to my mw about my discomfort with her & she did tone down, but boy was I relieved that she was gone in Dec. and won’t be there for our birth. I did just meet my backup mw recently and her student, a lovely, quiet, gentle soul who I didn’t mind at all and won’t mind having at our birth if that’s how it works out (the backup mw asked permission). Just a question of personality, I guess.

My two cents: yes students need to learn, yes they can even enhance the experience, but the choice should be up to you and if they are not helping, you can & should say NO!
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Old 02-22-2005, 05:22 AM
 
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Odd this topic would come up at this time. I just agreed to allow one of my midwive's daughters-in-law to attend my twin homebirth in a month or so. She is in training and they'd like to have an extra person to take care of all the running around if both midwives need to attend babies or me.

I don't mind at all. I don't notice anyone until it's time to push anyway. I'll be surrounded by familiar faces in my own home, so I doubt I'll care if one is a new face.

We welcomed our 3rd , 7th September 23, 2010!
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