Friday, December 18, 2009

Reflections on the exam of doom

I only sat one exam this year as the other one I "took ill" in - I ran out of the exam to throw up and spent 3 days feeling very ill afterwards. This was for the subject that I've had to repeat because of my motor vehicle accident in 2007, and so it's effectively taken me 3 tries to sit.

Anyway, there were 13 questions. Of those, I barely had time to write (and certainly not neatly) everything that I wanted to, so chased the marks that were there and moved on.

But there were several questions that reminded me of why care providers are often lambasted as "scare providers". There were a couple of questions about:

- breech presentation
- being "over due"
- induction
- posterior babies

and usually the question was structured around "what is the definition of this / types of this" and then "what are the care options".

Now these questions are really important to ask and discuss and to know your stuff. But - they also put the frame around looking at these problems from a really frightened, defensive point of view.

Let's take breech for eg. The options for care and birth in my opinion are:
- do what you want/can to turn babe (moxibustion, acupuncture, rebozo, visualisation, chiropractic work, external cephalic version)
- find an attendant who is confident with attending you and embrace your breech babe

and if you can't:
- book a c-section for when you go into labour (contradiction in terms of course)

But if you're anywhere near a hospital for care for your pregnancy, the options would be:
- see an obstetrician
- have multiple scans
- have your otherwise lovely normal pregnancy pathologised
- book a c-section for immediate action before you go into labour
- panic, stress and worry

So you can see what my choice was for answering this question in the exam - chase the marks or being a hippy wingnut who isn't afraid of something not strictly in the "norm". And also you can see that student midwives are indoctrinated from such an early stage to be afraid of breech birth. And OP babies. And "post dates" which is so irritating as on one hand we're told that pregnancy goes to 42 complete weeks before being "overdue" and yet we as midwives are taught to get hysterical and Take Action at 40 weeks.

Go read The Lie of the EDD: Why Your Due Date Isn't when You Think to see more.


anastasia_wolf said...

How frustrating. Would you get marked down for providing the first answer?

zang2424 said...

I hate exams/assignments where you just know they're expecting a particular answer but you have your own alternative answers which are equally appropriate but you might get marked down for putting an answer they're not necessarily expecting!! My Japanese exams at uni were like that- they wanted one word, I knew an equally good one and they'd only give half a mark because it wasn't the word that was used in the text book!

Elizabeth said...

Wow. There's not a whole lot of opinion in my least first year.....although maybe it's that I'm being indoctrinated or just like the opinion that's being put forth! Our tests (second term, first year) were 28 pages this term. We had questions on back labor, amniotomy (mostly why NOT to do one, and the things that should absolutely be in place if you do do one), hypovolemic shock, position/lie/presentation, CPD, and the two different kinds of shoulder dystocia.

I enjoyed reading this post about your classes! I originally found your (other) blog through a search of midwifery and scooters. :-) I don't think I ever introduced myself....but I'm a student in Portland, Oregon, USA. And we certainly are not taught to freak out at 40 weeks--we're taught that that is what the *medical* community does.