Getting My Name Out There

So I've reached a point in my apprenticeship where my preceptor has given me permission to reach out and start bringing clients to us. Which is great and good. I feel so stoked that she believes in me. Trust me, if she didn't, I wouldn't have this green light! But what no one tells you is that it is hard to start. Finding clients, creating your "brand", encouraging mamas and being able to keep up your home life (and jobs if you have them!) is work. Work that will pay off, but will never get easier. So I've been setting here for the last 7 hours working hard at getting envelopes stuffed with a letter telling locals about me and midwifery, brochures and business cards. The taste of glue is so thick on my tongue that I cannot even use the Starbucks to cover it up anymore.

I know that each one of these letters brings me that much closer to clients, to getting my paperwork signed off and to having my CPM, which is the goal after all. Among other ideas, I'm basically talking to every. single. mother. I meet in any store, fast-food restaurant or bathroom-even the zoo (seriously, on my family vacation this past week I probably stopped 4 moms to make sure they know they have options in childbirth!). Having business cards and flyers on hand at all times and dressing where I'm cleaned up but do not look like I'm not an average mom who just happens to be a birth worker.

It will pay off. It will pay off. It will pay off.....

Practice Guidelines: Urinary Tract Infections

***Please know that I'm a student midwife and my education is every growing. This is my current Practice Guidelines for Urinary Tract Guidelines. I cannot say it is definite or complete. Please seek care from your provider of choice.***

Urinary Tract Infections (UTI)

 

Urinary Tract Infections (UTI) are the most common bacterial infection in adult women. They are 14 times more common in women than they are men. By age 24 approximately 1/3 of women have been diagnosed with a UTI and prescribed antibiotics by a doctor. UTI’s are more common in pregnancy. 5-10% of UTI’s are asymptomatic. They are caused by bacteria entering your system. The most common ways bacteria enter your system is improper wiping, sexual intercourse and holding your urine.

Signs and Symptoms:

      *        Sub- or suprapubic aching pain

      *        Burning upon urination

      *        Cramps

      *        Fever or low grade fever

      *        General fatigue (common if the infection is well established)

      *        Lower backache (may indicate kidney involvement)

      *        Frequent urination

      *        Small amount of urine output

      *        Incontinence

      *        Cloudy and/or unusual smelling urine

 If it spreads to your kidneys:

      *        Chills/shaking/night sweats

      *        Fatigue/general ill feeling

      *        Fever of 101°F or more

      *        Flushed, warm or reddened

      *        Mental changes (confusion in elderly is common

      *        Nausea and vomiting

 

Complications of a UTI:

      *        Miscarriage

      *        Kidney infections

      *        Preterm labor

      *        Preterm ROM

      *        Preterm birth

      *        Uterine infections

Conditions That May Mimic a UTI:

       *        Early sign of an ectopic pregnancy

       *        Premature labor

       *        Torsion of the pregnant uterus (rare)

       *        Incarceration or sacculation of the uterus (rare)

 

Diagnosis and Treatment:

 

Diagnosis: When you do all prenatal care you should test a woman’s urine at every visit. You can observe it for clarity, color and smell. When you read the urine test analysis strip, make sure you have first let it set for the specific time it needs to rest before being read.

When reading the test strip you will find that the leukocytes and nitrites will be elevated. The best urine for getting an accurate reading is after not having urinated for several hours. The reason these are elevated is because leukocytes (or White Blood Cells) are produced in relation to an infection. Certain bacteria (like the one that causes the UTI) change nitrates to nitrites. If the test is positive for both it means there is bacteria present in your urine likely causing an infection.

 More than 500mg of Vitamin C in the past 24 hours may give a false positive for nitrites. And tetracycline may cause a false positive for leukocytes.

 

Prevention and Treatment: The best treatment for any type of illness is prevention. To help prevent a UTI make sure to wipe properly (front to back), urinate before and after any sexual contact, watch your diet and lifestyle, wear cotton undergarments and urinate when you feel the urge to, never hold it.

 Traditional Treatment Methods:

*        Antibiotics- Common ones are: trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline and fluoroquinolones.

*        Increase water intake

Alternative/Holistic Methods:

*        ¼ tsp baking soda in water 3x daily for 3 days.

*        Cranberry pills

*        Hydration and frequently empty the bladder

*        Uva-ursi- 2 capsules 4x a day for 3-5 days then recheck urine

*        Rinse with a vinegar and water mix

 

Reasons Why Women Have More UTIs:

Common reasons that women have more UTI’s in general are:

*        Relatively short urethra

*        External 3^rd of the urethra is close to the rectum

*        Friction during sex allows bacteria into the urethra easier

*        Pregnancy hormones cause the urethra to be a bit more open than normal, which also alters the tone    and movement of it

*        Sugar in the urine and bladder compression because of the growing fundus