Maternal Mental Health

Today marks the first day, of four long work days in a row, afte four days away from work.  

I’m suprised at how my unhappiness at work manifests itself.  After five weeks here it’s more of a chonic pain than an acute injury.  Just as with physical pain, the chronic can be worse than the acute.  Chronic pain is insidious; one becomes used to the constant ache and forgets that there is a better way to live at all.  The general vibe from my fellow lactation conultants here could be summed up as “tired and beaten down”.  I haven’t had more than two days off in a row since I started working here and I don’t think I fully appreciated how toxic the enviornment is until I had a significant amount of time away from it.  

On Monday I had the pleasure of going to a seminar day on breastfeeding and maternal mental health.  I am a total lactation nerd and I was happy to take one of my off days and devote it to learning about such things as postpartum OCD and breastfeeding compatible medications.  One of the talks was given by a woman who consults for neonatal intensive care units (NICUs) on the issue of infant mental health, and by extenstion, parental mental health.  One of the themes of her talk was that the NICU staff needed to be mentally healthy in order to facilitate the mental health of their pateints and their parents.  She went so far as to say that the two mental states, of caregiver and patient, were inexorably linked. She made compelling, reserach based arguements that healthcare systems need to treat their empplyees well and make sure they were satisfied on the job and that doing so had a direct impact in the metal health of their patients.  

I felt like she was speaking to me.  I see nurses not picking up crying babies in the nursery; not because those nurses are terrible unfeeling monsters, but because they are completely desenstized to the crying.  I work with several lactation consultants (my manager included) who consider a “good” consult one where they didn’t observe a breastfeeding session because “that just takes too much time”.  I see my manager focusing on how many patients per hour we see rather than on the quality and effectiveness of the care that we provide.  Now, I am a “get it done”, “don’t take no for an answer”, “fight the patriarchy” kind of girl.  I thrive on a challenge.  But at 38 years old I know what a brick wall looks like and I am up against one.  I am going to give myself a concussion, or worse, beating my head against this one.  I’m already feeling the effects.  I’m having trouble sleeping on the nights before work.  I hold in my emotions all day at work and themn I snappish and on the verge of tears all evening.  I feel like my brain is rotting away doint he same thing over and over again

Something else happened on Monday too.  The seminar finished early enough that I was able to catch the last half of Middle’s three hour gymnastics practice.  While I was watching she leanded a perfect roundoff back handspring on the floor (without mats) on her first try.  The first thing she did after throwing her hands up in the air in a gymnast’s salute was to look up and search the faces above for one of her parents.  I was there to smile back and her and give her two thumbs up.  She was even more delighted when later that evening I showed her that I had caught a video of her new skills.  “I’m so glad you were there Mama!”  It felt amazing to see her reach a goal she had worked for months to attain.  And then later that night I felt the crushing weight of the knowledge that I normally wouldn’t have been there to see it but for a quirk of my schedule that week.  

I want to work.  I love what I do and I am damn good at it.   But I can’t go and take care of other mothers and babies and then not be around to mother my own.   It feels terribly selfish to say “I’m not happy at work”  when I really have a safe job with good pay and great benefits.  And yet…I’m really not happy at work.  Just because I’m prividlged to have this job, doesn’t make it a good one.  Maternal mental health doesn’t just refere to my patients; it needs to refer to me too.

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Lows and Highs

The Lows

The nursery is probably my least favorite place in the hopsital.  At any given moment when I walk in there is usually a baby boy crying from the shock and trauma of a circumcision while another infant or two cries out of hunger or simply to be held.  Of course there are nurses present, but sometimes they are simply too busy or seemingly immune to the crying to stop it.  This morning there were perhaps ten babies in the nursey and three of them needed attention.  I saw a harried nurse walk up to one crying SGA (small for gestational age) infant and tell her in a harsh tone “You need to stop now.  Stop.  Now”.  The other nursery nurse was comforting an infant who was on the “circ board”.  She attemped to soothe him with the incredibly offensive “Today is a good day!  Today is the day you get more good looking!” (Because apparently the uncircumcised penis of an infant is ugly in her mind?)  I do what I can; today that meant taking two crying babies in my arms and walking with them until my shift started but then I had to leave the little SGA girl behind.  If we left an adult to cry in their hosptial bed it would be considered abuse.  If we cut off a functional part of someone’s body without their consent it would be criminal.  Yet, both happen every single day in the nursery.  

The Highs

I saw that one of the crying infants was due to be taken to his mother at 8:00 am for feeding.  It was 7:45 and some of the nurses tend to keep to a strict schedule.  The overworked nurse certainly wasn’t going to do anything about the obviously hungry (rooting, putting hands in his mouth, crying) baby so I offered to take the baby to his mother.  It was agreed upon and I was able to reunite the baby with his mother who was happy I had brought him back to her a bit earlier when I noticed his hunger.

It’s the beginning of my fourth week here and I was finally “allowed” to do a consult from start to finish on my own today (under direct observation).  The patient was so pleased with my work that she turned to my preceptor (who was observering) and asked if there was a form she could fill out so that my manager would know how “awesome” I was.  

The Conclusion

I am fairly certain that this job is a bad fit for me.  I’ve already started looking for a new position.  I’m angry.  I am good at what a do and I love it (see above) but I’m pretty miserable for the most part here.  That said, we need the money and I want to make progress in my career.  So unless things completely go to hell (which seems distinctly possible) I am resovoking to stay until January.  Just keep swimming.  Just keep swimming.  

Floppy Reasoning

A couple of nights ago Husband and I were having a conversation which involved mentioning a VCR.  Older was listening in and chuckled at the mention of a VCR.  I turned to him and asked, “Do you even know what a VCR is?”  “Yes, “he replied with the tone of a tween who is insulted that I dared question his knowledge.  I continued, “What does a VCR do?” In a self-satisfied tone Older answered, “Plays movies.” “And what do you put into a VCR?” I continued to probe.  Older smiled, “A floppy disk!”  

Not quite my young one.  Not quite.  

Contact High

Yesterday was yet another boring day spent shadowing one of the lactation consultant at the hospital. Besides the long hours and the long commute, the absolute worst part of my job right now is that I have to go through three months of orientation before I am able to practice independently. This is a requirement of the particular hospital I am at and isn’t typical of the profession. I did not know about it prior to accepting the position and for a type A, independent person, such as myself, it is a special form of torment.  There is something utterly miserable and defeating about being 38 years old and feeling like you’re back at square one.

But…the last consult of the day was a set of preterm (born before 37 weeks) twins. They were doing fine given their size and age but will need a great deal of help with feeding. The consultant that I was shadowing was working with the mom and Baby A when Baby B began to spit up and cry. The other parent wasn’t available to hold the crying babe so I volunteered for the “job” of holding and calming Baby B. The only way the tiny infant would settle was to hold her upright near my shoulder and snuggle her under my chin while I swayed. The previous ten hours at work had crawled by but the twenty minutes I held that baby were over in a blink. People often think that, as a lactation consultant, I get to hold babies all day long. In truth, if I am doing my job right I shouldn’t be holding babies much at all. They should be being taken care of by their parents.  Although I am quite fond of babies, I didn’t choose this career so that I could hold newborns all day long. My greatest passion is in empowering parents with information and skills and helping to ensure that tiny humans get the best possible start in life. That said, those 20 minutes spent calming that perfect baby girl were a rare respite of bliss. I’ve been smiling on and off about them for the past 24 hours.