A Saturday Afternoon Bike Ride

It is August 21st today, and we finally had a birth yesterday. I was on second call, so the “baby midwife” as the second midwife is called here. The woman was an young primip, who had developed slightly elevated blood pressure about five weeks ago. She also had proteinurea (for you non-medical types protein in her urine) at 28weeks. Nobody had thought it was significant. A student was taking care of her, which is the norm here, and a senior midwife did each visit with them. The senior midwives are largely southern,and do not speak Inutittut, which is the language that is used for maternity appointments.



Two weeks ago I was asked to help with a visit, which I did, but seeing the blood pressures, insisted on a consult. Blood tests were ordered before the consult, and the student figured out which tubes were needed, and took the blood. (Yes we do our own blood taking here.) So we began checking blood pressure twice a week. This last week however, the blood pressure was high enough to need another consult. We started a more normal, for me course of care...twice weekly blood pressure, once weekly blood tests, and twice weekly NST’s (non stress tests).

There is no fetal monitor here. Non Stress tests are done by using a Doppler and two people, one to count and one to write. The fetal heart is taken for six seconds and then announced, then there is a four second rest. This is repeated for twenty minutes. The writer takes down all the numbers and plots them. When the twenty minutes is up they are joined, and you can get a line that shows if there are accelerations or not.

We did this Thursday, but as her pressures were very labile, we consulted again. The docs said to take her blood pressure again at the end of the day, and if it was high to let them know. It was, so consultation again. The MD’s decided that she should be induced with cervadil that night, and hopefully would go into labour. She was to remain in hospital, but under the care of the nurses, not the midwives, although she was staying in maternity.

This always causes a bit of stress for the nurses. They are not OB nurses, and the hospital is largely chronic care. There are twenty beds, and really is largely extended care. The building provides care for the whole community, but where in some communities there are group homes for seniors, there is not here. The seniors that need help are in the hospital, and so are the handicapped, who cannot be cared for at home. There are also a few beds for the babies and children with lung problems, and others who need to be observed. There is usually no surgery, and when there is, as there was last week, it is very specific. Last week a dentist was here taking out children’s teeth. Apparently they do orthodontics under an anaesthetic as well. (I do not know this for sure but was told that by the Inuit Midwives.)

Anyway, the woman went into labour, and had an extremely precipitous PIH birth. Mainly she went from three centimetres to birth in less than two and a half hours. Of course there were decels, a shoulder dystocia and a PPH. Typical PIH birth and only a little fast for an Inuit primip. But all this was done with no heart monitor, or additional monitoring. (It worries me slightly because I am the senior midwife here in September, and it is not something that I will do. So, there may be some battles with the director or the physicians. Am hoping there is just no more PIH. This is the second case since I have been here, although the other lady was from another community).

When the client was not having so many contractions, first thing in the morning, the student who was working with her said...”maybe we need a little synto” to get her going. Quite cavalier really. Luckily she delivered without oxytocin.

After delivery and overnight a postpartum worker took care of her. Post partum workers are women who take care of the women and baby dyad. They work eight hour shifts, so probably three postpartum workers and one or two trainees took care of this couple.. And there are always numerous family and friends at the maternity as well.

At two this afternoon I went to the maternity to discharge the baby. The first call midwife was already there, having dealt with a miscarriage, and had said she would do the baby as well. She had a different student with her, who really did need more experience, so I decided to leave. Told the other midwife I was going out on the road to the Hudson’s Bay so she gave me the walkie talkie. Apparently the phones do not work out there. Mind you, no cell phones work here. There is talk of getting a company to get them working for the Bay and Ungava coast, but who knows if the rumors are true or not.

She also suggested that I take the bike and go out. What bike?? Turns out there is a bike in the apartment building (six apartments only) that does not belong to anyone, and everyone uses. It seemed like a good idea.
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Went to the co-op, and got an avocado then back to the apartment. Forgot my camera, but did pick up water and took the walkie talkie, which is large, and headed out. The bike is purple. It matched my hair. The sky was overcast, but it was warm, and thank goodness I only wore my bug shirt. It also saved my arms and back.

As I rode off the realization quickly came as to why this bike was “free”. The gears did not work. Instead of ten or twenty, there are perhaps two gears. Not great for going up and down hills on gravel roads, but better than nothing, and it could take me further than my feet.


I rode through town and out the other side, following the road to the Bay. Before the houses ended, the gravel started, and it is heavy gravel, so the going was a little rough. There were a few bugs, but on the bike they were not noticeable.

I went over the first hill, and then I started to see things. There were mushrooms everywhere. Now fresh picked mushrooms are lovely, usually, but there are some poisonous ones here, and they are red. So, finally I got off the bike, took my water out of the bag I was carrying and started to collect mushrooms. Like all wild mushrooms it is advisable not to take the really big ones, because they have worms and maggots in them. Worms is what are in them here, and in the south you can often find the maggots after the worms.



So I was carefully checking out the mushrooms, and suddenly noticed that the blueberries and blackberries were ripe, so also picked some of them. Now the blueberries and blackberries are the size of small huckleberries, but they grow very close to the ground. I got enough for some youghert, so was happy with that, and about five mushrooms, and four puffballs.

Back on the bike, and riding along, and I suddenly saw little orange aupicks. These are Arctic raspberries, and they are orange in colour when they are ripe. They grow one on a stalk, so at first I thought they were flowers. Each little one is about two inches high and the berry sticks up from the stalk. They are delicious.


Of course while I was picking the berries, the bugs picked me. I realized I was being bitten on the face, but afterwards realized I was bitten inside my ear. It is quite odd to feel yourself being bitten inside your ear canal, and scratching with your finger to find a fly under your nail. Then you know that you are in trouble. Hearing becomes different, and you get a little vertigo as your ear canal closes from swelling.


As I had been riding a number of quads had passed me. They rode down the road and then off on little trails, and the riders were also collecting berries. You could see the quad drive off, slow down and the riders looking for what looked liked good areas. Picking berries here requires only a small container. The size means you are unlikely to get anything close to a bucket, and a small jar of jam can take a whole afternoon of picking. Of course if it is the aupicks, a number go into your mouth as well.

I felt very lucky and turned around to go home. I had not made it as far as the Bay, but had mushrooms, puff balls, aupicks, blueberries and black berries. Then I also noticed the little red mushrooms that were everywhere. I am going to go back and take my camera. There were so many little things to make the camera useful.
Rode home, having a good ride, although not that far really, maybe two or three miles, and got the filthy bike into the building.


Got upstairs and opened my bag. One of the puffballs was past its best and the ride had opened it, and its slimy contents. It went in the garbage. The other two will be my breakfast, with a mushroom as well, sautéed, put on toast with a little cheese grilled on them. And if nobody takes the bike tomorrow, the walkie talkie and camera and I will be repeating this little trip. If the bike is busy, then will have to decide if we are busy enough for me not to go out, as I am still on call. Either way it will be a fun day.