In my Department Head role: the challenges were related to wanting to keep members feeling informed and supported given the amount of information, which was changing so fast, and new committees and even more meetings. Agendas were all about planning and preparedness, but without being able to predict what was coming next. Sounds a lot like maternity and birth work - and what Midwives already do. In my communications it felt important to remind Midwives, how good they already are, at re-assessing maternal and fetal / neonatal well-being with each encounter, in the presence of conflicting protocols and guidelines. It's not new to Midwives to have to apply of blend of evidence informed practice, individualized care, and good clinical judgement.
We assess levels of risk intrapartum in real time all the time. We are already accustom to actively involving our clients in their plan of care. I've have been impressed by how creative and innovative Midwives have been in their response to Covid-19, and have enjoyed seeing this be recognized and appreciated in our Health Authority.
This crisis has forced teams to come together and do our work in new ways. At first, I was so concerned about the loss of the 'in person' impact, in clinic appointments and meetings I attend. Turns out it's harder to chair a meeting when you can't see facial expression and body language. I've learned that by simply acknowledging our discomfort with the new ways - opens up a different way of relating to and understanding each other, whether its a emotional topic for a client or a difficult topic as a committee. It's been exciting and heartening to see our Island-wide perinatal leadership team (including 7 Midwives!) come together to share ideas and local hospital guidelines. Suddenly there are zoom meetings with Nursing, Midwifery, Family Practice, Obstetrics, Pediatrics, Maternal Fetal Medicine, Neonatology, Anesthesia - where topics like Doula support, Home and Water birth are being talked about. It's like this common goal of reducing Covid-19 transmission has brought us closer in our shared goal of care for pregnant and birthing people and their babies together.
Whether it's in my family, my clinical practice or my work for Midwifery in Island Health, I feel like Covid-19 has brought us back to the basics. What groceries do I really need? (other than coffee!) What clinical assessments are actually the ones guiding our management? What is it like to respond to a newborn babies cues when you don't have too many visitors in the early days? What's it like to attend a high level meeting in your pajamas? What steps do we really need to ensure credentialing and privileging processes are diligent but also efficient? It's been interesting, to shed away some of the other layers and focus on what's right in front of us for a change.
"Are you ready? Don't be anxious!" This reminds me of the pep talk I often give my clients when they are understandably unsettled while they await the birth of their babies. We talk about how rare it is in today's world, to have such little control over such an important time in our lives. And the importance of respecting forces of nature - a wave breaking, a tree falling, an avalanche happening - not unlike birth. No matter how hard we try to plan, manipulate, manage or control - it's not possible. It's having been a Midwife for so long, having spent so much time, having to be in the present and not knowing what would happen next - that has helped me during this time. And also that I love being at home. I realize that while we're all in the same storm at sea - we're all in different boats. I am grateful that I have work and to work alongside such inspiring colleagues. The Island Midwives have stepped up for each other, and for their clients, across communities. I have been humbled and reassured by the energy and expertise of Island Health leaders in infectious disease, medical microbiology, emergency and critical care. This has given me a new opportunity to learn from other Midwives and leaders, as I am exposed to and grow from, their creativity, kindness and resilience.
Just as the amazing Ilana knows, we are not just Midwives. We are mothers, sisters, and daughters, and...What a strong reminder of the impact of our profession on our families and personal lives. We are united on this too. How lonely it can be self-isolating at home. How hard it can be to to participate in telephone meetings, while your kid is singing in the background instead of doing her homework. How strange it feels not to hug a friend who is suffering. Beyond the clinical guidelines for PPE, we are all in this together.
Each day, I remind myself of what a privilege it is for me to be connected to all the Midwives on Vancouver Island, and what a joy it is to get to watch us get one step closer to building our strong Island-wide Midwifery community of practice across 8 different hospital sites. At the end of each work day, I try to be gentle on myself re what I was able to accomplish (especially if the dishes are also done!). Then I get into my real work (garden) clothes and get to work till the light become dark. And just as my day's challenges or frustrations are disappearing with each shovel full of manure, me and the birds, jump in response to the sudden onset of the super loud harmony of bells, drums, banging pots and pans in my neighborhood in celebration and appreciation of the front line workers. I stop and take it in - and think - well done Midwives!