Logfile from Nerak

[OOC:] Nerak says "Ok, Rules for getting credit for taking my classes.  You have to be active - 1 pose for each of mine.  No idling, No posing pets.  Stay IC, ask OOC questions by paging me.  I will be logging, uless you have an objection."
[Healer] Nerak: use this for class questions, but not for spam

Nerak looks at the students in her first Midwifery class, and hopes she doesnt look nervous.  "Good afternoon.  This is Midwifery I.  If you have questions, please ask them.  I may be covering the information later, but I want you to make sure you understand all of the material.  You dont need to raise your hand, and you may call me Nerak." she pauses here and looks at them "Unless a ranker walks in, then please use my title, Journeywoman."
Aramat grins. She hasn't had a clas with Nerak yet, but she's liking her more with everything she says. :D

Nerak takes a sip of her klah.  "Alright.  We are here to discuss Midwifery, so what is it?" She looks at her students, waiting for their descriptions.
Musuko smiles, and nods.  She knows all this stuff, but will give her support anyway.  She takes out some Klah, and a sweetstick.
Aramat bobs her head. "Midwifery is when you help a woman give birth. Youhave to know the whole prosedure and what to do when things go wrong." Haha! 
Willow arrives from ::between:: and drops a note in your hand.
Sudanna pages, "Jump all over musuko for that pose..:>"

Nerak nods, and looks at Musuko. "Just because you have taken this class before, doesn't mean you won't learn anything new!" then looks at Aramat.  "Right.  Though it is the care of a pregnant woman from the time you discover they are pregnant until the mother and the baby leave the infirmary together."

Nerak smiles.  "Ok, we have determined what Midwifery is.  Now, what symptoms/complaints would you expect to see in a pregnant woman who comes into the infirmary?"
Musuko sighs.  "Morning sickness." she states only one, because the other girl hasn't taken the class.
Aramat umms. "Morning sickness for sure. And if she's about to go into labour, she'll start to have contractions right?"

Willow arrives from ::between:: and drops a note in your hand.
Sudanna pages, "We woudn't /know/ it was morning sickness.."

Nerak nods, "Well, we wouldn't know it was morning sickness until we are sure she was pregnant, but nausea, frequent urination, missing her menstral cycle, sore or tender breasts, fatigue, cravings for unusual foods, and sensitivity to unusual smells/tastes are some common signs.  Keep in mind that women may have all, some or none of these symptoms."
Aramat nods and scribbles this down in her book. She remembers some of these things happned to her mother when she had her little sister. 
Musuko nods.  Right... almost forgot that bit, about some people not having simptoms to diseases....  Oops.

Nerak "Ok, now that we know the symptoms, we would start the exam.  This exam starts like any other exam.  Start with vital symptoms - we need to make sure she is healthy!  Then we have some important questions we need to ask the woman during the exam.  What questions do you thin we should ask?
Musuko blinks...  She's never done an exam on a pregnant woman... but.. "When was the last time she had her menstral cycle?"
Aramat calls out. "If she's had any sicknesses that could harm the child?" She doesan't know if shes answering the right questions!

Nerak "Good.  We ask about her history - it's important to know about family history.  When her last cycle was, right.  Whether or not she is more fatigued than usual, if her breasts are swollen or tender, the food/ smell aversions - keep in mind that patients usually tell you all of the symptoms.  Also, whether or not she has been taking her contraceptive draughts on a regular basis.  You MUST ask if there is a chance that she may be pregnant and if she has had recently had relations with a man." she stops here for a breath.  "There have been cases of symptoms lilke these just being a virus!" and she laughs, "What a misdiagnosis that would be!"
Musuko giggles.  "Yeah.." she laughs for a bit, then just smiles, watching and waiting.  And listening of course.
Aramat grins and scribbles more down in her book and tuns her head back up to the woman at the front.

Nerak smiles.  "Ok, just a quick tidbit of info here... did you know that dolphins can tell if someone is pregnant or not?  It's their sonar.  Alright, next is the physical exam.  After you do the normal physical exam, you make sure you do an internal exam on the woman. There is a definate thing you will find if a woman is pregnant.   Do you know what it is?"
Aramat shrugs, "A swollen belly?"
You paged Aramat with: Nerak pages, "well, you'll get the idea as you take more classes, but yes, just what can be seen or felt. they didnt' do much surgery, so they didn't know much abuot the insides of the body"
[Healer] Sudanna: We don't really use the dolphins however, just as a dragon /can/ tell it's mate, but usually doesn't.
Musuko thinks, but doesn't remember, she must have been daydreaming during this part.

Nerak nods, "Well, the swollen belly usually comes later in the pregnancy.  After redwarting your hands, you would gently probe with one finger for a mucus 'plug' at the top of a long, thin cervix. That is the proof you need of a pregnancy. So, hands are redworted and the plug is found.. Yup, a pregnant lady .. Now your job is to see Mom-to-be once a month initially, help her stay healthy.. No klah, No alcohol.. as the time gets closer, so do her appointments.. til finally she is in your care for delivery... Do you have any questions so far?"
Musuko shakes her head, remembering that gross part now... she never wants to be a midwife....
Aramat shakes her head as she scribbles stuff down. Easy enough now.

Nerak "Great.  Now that we know she is pregnant, we need to figure out when the baby is due.  There is a method for determining the approx. due date. As we know, all babies set their own schedule. But essentially we add 40 sevendays to the date of the last cycle the woman can remember. But babies also tend to make their own time, so we allow for two sevendays either way. Any earlier or later and there may be complications."As the pregnancy progresses, measuring the growing abdomen can help us to adjust the date accordingly."
Musuko nods, and remembers what her mother looked like when she had been pregnant with her younger siblings...
Aramat nods. "What do you do if the baby is premature?"

Nerak looks at Aramat, "Good question, you call for a Journeywoman or a Master who specializes in Pediatrics and early births for one.  But you would keep the baby warm and to check to make sure it has no health problems.  Any other questions?
Musuko shakes her head adn waits for Nerak to continue.
Aramat shakes her head as she jots some other stuff down. "Nope!"

Nerak takes another sip of klah.  This is going well!  "Alright.  So, the pregnancy is devided up into 3 trimesters. Each trimester is approximately 3 months.   The symptoms that usually bring a woman to the infirmary are the symptoms of the first trimester.  Also a precaution, do not let a woman in hte first or last trimester go ::between::.  It may make her loose her baby. Do you know what the symptoms are for the second trimester?"
Musuko thinks.  "Swollen belly." she states, almost certian.  "and more morning sickness."
Aramat nods and agrees with Musuko

Nerak nods.  "Usually by now the morning sickness has gone away.  The second trimester is when the woman's belly starts to get bigger.  This is also when her tiredness fades for a while, but it will return in the last trimester.  She begins to have mood swings and more frequent urination since the baby is putting pressure on her bladder.  This is also the time where the heartbeat can be heard and the first movements of the baby are felt - somewhere around the 22nd sevenday. " she takes another sip of her klah.  "Ok now, what are the symptoms of hte 3rd trimester?"
Willow arrives from ::between:: and drops a note in your hand.
Sudanna pages, "maybe you can work in the proper name for the swollen belly? Expanding uterus works nicely..:>"
Aramat shakes her head. She doens't really know too much at this point about the symptoms.
Musuko shakes her head. "Fatigue, eating more, and more urination."

Nerak looks around, "No thought, eh?  Ok, the last trimester is when the woman again starts to feel tired.  It takes alot of her energy for the baby to grow!  Her legs get swollen as she spends more time upright.  She will also notice a pattern to the baby's sleep and awake cycles.  She may develop heartburn more frequently as the baby grows.  The baby will turn in the uterus, in preparation for birth.  She should know hat she should not do any heavy lifting, even as she goes through her Nesting stage - where she wants to clean everything." she takes a breath.  "Alright now.  This is where labor starts.  There are also 3 stages of labor."

You say, "Labor is divided into three distinct stages. The first stage consists of contractions of the womb. This is when the mother needs to be made as comfortable as possible, and the healer needs to be sure they have all supplies - the birthing room should be clean, with clean towels or sheets spread over the floor and bed... very often the woman looses control of her bowels during labor" Nerak takes a deep breath and pushes on.. "The second stage, is when the waters break, "amniotic fluid"is it's real name, which is when the birth sac is broken open. Let me add, that most often the waters do /not/ break naturally. Most often we will do that for the mother, using a special tool sterilised and prepared just for that purpose." She displays a long thin rod of undetermined material, stained a permanent red from all the redwort, "See this tiny hook at the end? That's all it takes." The inner opening to the womb is fully dilated. You need to swab the pubic area with redwort, and wash your own hands. Make sure to have numbweed and clean towels around, and hot water... Thread and needle in case there are any tears."  She takes another sip... talking makes you thirsty. "The Third Stage is when the contractions will get closer together and more painful - you must ask the mother to push downwards with her abdominal muscles, with each pain. And when you can see the scalp at the outer opening to the womb, birth is imminent. Ask the mother to stop pushing and pant like a canine. "
Musuko blinks, then shakes her head, giggling at the vision of some woman panting like a canine.
Aramat grins and scribbles

You say, "Then for the Birth - Support baby's head and check that the umbilical cord is not wrapped around the neck. If it is, loop it off carefully without pulling. help baby's shoulders out by easing head & rotating shoulders.  Be careful not to drop baby or to pull on cord. Once baby is delivered, tie off cord near baby's body, clamp cord 4 fingerswidths from child and cut it. Then swab the eyes and nose, wash the child, wrap it in a blanket, and give it to the mother. Encourage her to suckle. It will help the milk to come...  About an hour later,  the afterbirth will be expelled  and can be wrapped in a towel for disposal later. You'll need to wash the mother's groin area, and is some cases stitch up any tears. The mother and her child are free to leave the Hall two days after a normal birth, but they should see a healer regularly for a while." She pauses. "Some mothers may have sudden bouts of depression or feelings of inferiority when it comes to dealing with their new baby. Reassure them this is normal, help them with care instructions. Most mothers get over that quickly." She smiles at the image of mother and child. "And remember, that the most important thing after the birth is peace and quiet. Strongly suggest the new mother and baby stay in the infirmary at least 2 days to make sure all continues to heal well.""
Musuko shakes her head, and likes babies.  "Babies are sooo cute!!!!!"
Aramat grins and agrees. 

Nerak "any questions??"
Aramat shakers her head. "Nopes!"
Musuko shakes her head.  "Nope."

You say, "If no questions, we are done...  Thank you for coming to my class, and I hope you learned alot!  You can ask me questions at any time, dont' be afraid of cathing me in the hallways.  Thank you.""
Aramat grins and gathers up her books and is almost out the door before she hugs Nerak and runs away!