VOL 60: JANUARY • JANVIER 2014 | Canadian Family Physician • Le Médecin de famille canadien e53 Web exclusive Marathon Maternity Oral History Project | Refections Jennifer Coleman: “I deliver babies with the docs” Narrative 2 of the Marathon Maternity Oral History Project Interview date: August 11, 2008 Aaron Orkin MD MSc MPH CCFP Sarah Newbery MD CCFP FCFP In 2008, we interviewed women about their experiences of childbirth and maternity care in Marathon, a rural community in north- western Ontario. This narrative is one of a series of stories that resulted from the Marathon Maternity Oral History Project. All of the narratives in this series were edited from the interview transcripts, then reviewed and approved for publication by the women involved. We invite readers to see the accompanying research paper for more on the Marathon Maternity Oral History Project. 1 M y name is Jennifer Coleman. I’m a registered nurse here. That’s it! I deliver babies with the docs, maybe one or two a month. Abigail was my first daughter. Oh, I was terrified of childbirth! You always remember the negative things as opposed to the positive things. I had seen a couple of really bad tears and mom screaming through the whole thing. I wanted pain control. I had a placental abruption at 24 weeks. I was working in emerg and had a patient who arrested. I went to pull him up in the stretcher and I tore my placenta! So I was high risk, had to deliver her in Timmins. I had a 5-hour drive home, and that was the worst experience. I had to stay at my mom’s, which was an hour and a half away from Timmins at the time, and then I had to have a booked induction. I had her with an epidural. “I’ll just lie here and you guys can do whatever; I’m having a great time.” I’m putting music on in the delivery room; it was nice. Great care. An hour of push- ing, babe was out, everything was wonderful. Hired and required to work in every area I came here 6 years ago. The first couple I did, I was really nervous. I hadn’t had a lot of obstetrics training before. It was all education. Learning, learning, learning. I took the neonatal resuscitation course and this and that. Here, you’re hired and required to work in every area of the hospital. If that patient comes in on your shift, you’re required to labour with them, so the nurses don’t really have a ... Well, they have a choice. They choose to work here. They’re the ones who made that decision and part of that is you do obstetrics. When I first came here I had no attachment to any- body who came in. I was more like a robot in function: boom boom boom. Now, if it’s a person that I know, I think you function better. You have more trust. You get a sense early on whether they can tolerate labour in Marathon or if they need to go to Thunder Bay. You know their weaknesses and strengths and what they’re capable of. It makes your decisions a lot easier. That’s what I found, anyway. It’s rewarding. I try to never ever think negative during a delivery. I know that there are things that are beyond what we are able to help them with and at least we can help them with certain things. I remember one delivery; it was really scary. She was bleeding and it was quite a bit, and you knew that there were 2 patients involved. She was really scared. I put it out of my head that she’s a friend of a friend. Try to do my best. This is not a large facility. I never shake, and that was the first time I ever shook putting IVs in. You always have in the back of your mind, “Okay, I really can’t mess up anything right now. I have to look like I’m a professional.” They flew her to Thunder Bay; her bleeding slowed down. She was in there a week. When it’s a friend that delivers a baby, wow, it’s so great. But it is scary when you know them because you’ve got that emotional attachment. I think sometimes it’s not fair to the patient because, really, it can be more embarrassing knowing that they know me. They’re more exposed, more vulnerable. I’m seeing a different side to them. If you’ve got a mom who comes in and doesn’t want to talk, doesn’t want to give you information, won’t help or give you suggestions, won’t be open with her birth- ing plan or care, you know that you’re not going to have a very good outcome or be able to help her out as well as you’d like to. That has only happened once to me, and that was a young girl who was just miserable pregnant and she was a very difficult labourer. She just wouldn’t do anything. To me, that would have been rea- son enough to transfer her to a larger facility to manage her, in case. I mean, you go to do a check on her and you say, “Okay, we have to check the baby every 15 min- utes.” But she doesn’t want you to touch her? This is one of the ways that we make sure that everything’s going all right, and if it’s not, then we start a transfer right away and get her out. That’s why we have one-to-one nursing, to pick up on any abnormalities and make sure that she’s comfortable and that things are going okay. To advocate for the patient. If we don’t have that early