A Midwife student
Wednesday I met with Marie (Alias). Marie is a midwife student and is already doing clinic hours which means she’s attended several births and sat in on regular consultations with pregnant women.
From Marie I learned that the vandrejournal is used as a risk assessment tool. She explained how for example the BMI early on can alert the professionals to future risks in a womans pregnancy. If a woman has a BMI of 30 or above she will have to do a glucose test to check for pregnancy diabetes — or if a woman has a BMI over 50 she can’t give birth in Esbjerg, because they don’t have the facilities.
“We need the information there, ready to read, so we can easily see if there have been complications — or if the risk of complications is high”
Later on the changes in measurements(signs) might indicate a risk and so the vandrejournal is continually used to screen for current or future risks to the pregnancy.
Marie also explained how many midwives will multitask to make the most of the time given during consultations. A regular consultation is 20 minutes — so to get through all the relevant information AND find out how the woman is doing, feeling and behaving the midwife might take a woman’s measurements while asking about something else; like how her mood has been or if she’s had any water retention.
“We don’t have time during a 20 minute consultation to go over everything. So we look for the most common problems or things that might have been a risk earlier. It’s very common for the midwife to be measuring the SF while asking the patient if her feet has been swollen”
I’ve experienced that things weren’t written in the vandrejournal and asked Marie specifically about this — to which she answered:
“In principle everything should be written in the vandrejournal. But nobody has time for that. So your doctor might be writing stuff down in his own electronic system and only putting some things in the vandrejournal — or maybe nothing, if it’s not important”
“A lot of family doctors don’t write things in the vandrejournal — we just assume that no news is good news”
In my initial survey (aimed at pregnant women) I learned that the women felt it was important to be comfortable with their midwife. I prodded Marie about this and she explained an important thing about trust:
If you’re about to give birth you’ll trust any person that wears a white medical coat — provided you trust your midwife.
What I gathered from this is that if you trust your regular midwife you are much more likely to trust the midwife that might be the one to help deliver your child — because it is very uncertain that your regular midwife will be on duty when you have to give birth. Marie continued to explain about a new sort of arrangement some regions are providing as an alternative to regular midwife consultations. It’s called “Kendt Jordmoder Ordning” which loosely translated means “Known Midwife Arrangement” in which you will get to know 3 different midwives instead of just one — and once you give birth you can be certain that at least one of them will be on duty.
From my conversation with Marie I’ve come to several insights that I feel are supported by the talks I’ve had with different pregnant women and the initial survey I did:
1. Trust is important for a pregnant woman.
2. The vandrejournal is a risk assessment tool