Prenatal check-up

Posted on Sun Feb 21st, 2021 @ 6:51pm by Lieutenant Commander Alicia Kelea-Salik & Lieutenant Tate Sullivan Ph.D.

Mission: MISSION 0 - History Speaks
Location: Sickbay
2244 words - 4.5 OF Standard Post Measure

Tate smiled in thanks as she was directed to an exam room within the maternity section of Elysium's large medical complex. Relatively few members of the medical staff knew Sullivan had been quietly studying to increase her medical competence, but today was a coming out of sorts, because she was moving beyond the care and treatment of holographic patients to the treatment and care of members of the crew. She had not yet completed a nursing degree, and in fact, she wasn't sure that would be her path, but officially, she had completed credentials to expand her medical education beyond what was required of all Starfleet officers, and she was grateful that she now New and could accomplish more than what was required in emergencies when Starfleet crews required anyone with any degree of medical training to provide assistance.

What mattered to Tate at this moment was not formal degrees or titles, but the opportunity to focus on life, something positive, and something that represented the second side of the nurturer in her. Taking a breath, she New the nurse that had escorted her to the exam room would be back any moment with her first mother to be. Her smile widened at the prospect.

Alicia was waiting to see the maternity nurse for her latest check up, she was in her eighth month now. As the nurse walked into the waiting area to collect her Alicia was surprised to be told she’d be seen by someone else not that she minded. Walking into the room Alicia smiled as she saw Tate waiting for her. “Tate! Now this is a nice surprise.”

Sullivan's smile widened. "I appreciate you saying that. I wasn't sure if you'd be comfortable with this, and if you think there's a professional conflict in this, I'd be happy to ask someone else to do this. It occurs to be in my eagerness to get experience, I may be putting you on the spot." Of course, the patient couldn't always choose who treated them, but in this case there was no state of emergency and state wanted to give Alicia as much control over her care as possible.

“I don’t mind at all Tate, in-fact this puts you in an ideal spot.” Alicia smiled. “As a counsellor you’re in the prime position to spot any signs of emotional problems amongst the expectant mothers onboard. Postnatal depression is a serious condition, catching it early is key to helping any mothers who might experience it. That and other emotional conditions.” She took a seat ready. “As for me I’m more than happy to have you deal with my care. I believe I’m practicing ready for the birth today, my usual nurse had a video she wanted to show me, which to be honest, is the part I’ve not been looking forward to.”

Tate couldn't argue with Alicia's words. It was part of the reason she found herself drawn to obstetrics in particular, because while wonderful, pregnancy presented its own challenges for not just women emotionally, but also families. Part of the stigma of talking about postpartum depression and other mental health concerns during and following pregnancy was that most people expected women to feel happy during such a momentous time in their lives, which made it harder for people struggling to reach out for help. Even today, Tate knew it wasn't easy for people to talk about, and Sullivan had always been drawn to helping people who could be overlooked.

Tate gestured for Alicia to take a seat next to the bed. She would gather her vitals in time, but for now, she just wanted to talk. It occurred to Sullivan that this would be a familiar dynamic for both of them as therapists. "Is there something in particular about seeing the video you're anxious about?"

“I’m scared to death of going into labour!” Alicia sighed. “I know it’s the inevitable outcome of being pregnant but I’ve seen a woman give birth before. It terrifies me thinking that’s what I’ve got to go through!”

"It's understandable you'd be nervous about it," Tate replied. Even with our modern medicine, I think fears about birth can still be passed down. It's also something you've never done before, which can add to anxiety. Will you tell me more about the birth you witnessed? Perhaps we can identify the aspects that you're most concerned about."

“It wasn’t under the best of circumstances.” Alicia paused. “It was after my miscarriage, while I was in the hospital. One poor woman didn’t make it to the delivery suite, she was just arriving as I was waiting to leave. She had her baby right there in the waiting room, they put screens around but from her screams ...” she shook her head. “I know it’s silly to be afraid of what you think might happen. I’m afraid of being in that amount of pain, even though I know Savar and my father will be there to look after me!”

"It's not silly at all," Tate reassured. "In a short period of time, you experienced two events in which you were confronted with the ways your body can rob you of a sense of control. At this point, deep down, the only association that you have personally with that kind of pain involves memories of loss. I wonder, though, if in addition to the birth itself, you remember the mother's reaction once the baby was born?"

“Actually I ...” Alicia paused to think back, trying to picture it in her mind. “She was ...” her expression changed to a smile. “Amazed, she cried with joy!” She offered Tate a warmer smile. “I hadn’t thought about that, all I remembered was the pain of the birth not the mother’s reaction afterwards. Thank you Tate!”

Sullivan smiled. "You're welcome. There will always be some discomfort associated with birth, but like with other things, I have found what you say to yourself mentally has a lot to do with how you feel physically. What do you suppose you've been telling yourself about this birth experience? What is your worst case scenario when you think about being in pain?"

“I guess ... I’ve been telling myself that this will be a painful experience. That it’s something to be feared.” Alicia paused. “My worst case scenario ... I think, it’s not being able to stop the pain. That something will go wrong.”

The fears Alicia described were common and not unexpected given that this would be her first full-term birth. "It sounds like you've focused on two fears, that you won't be able to handle the pain and that experiencing pain could mean something will go wrong. How about this? Close your eyes for me. I just want you to take a couple of moments to take some slow deep breaths to start. Inhale through your nose and hold your breath for a count of 3 and when you exhale, exhale for a count of 4. Think you can try that? Just trust me for a sec. There will be more to it, but let's just start with some simple breaths first."

Alicia nodded and closed her eyes, inhaling and exhaling as Tate had instructed. She started to relax finding the breathing exercises useful to calm herself.

"You're doing great," Tate assured. "Keep breathing just like that, but now I want you to picture you're on the edge of a beach watching the ocean waves ebb and flow back and forth to the shore. With each breath, I want you to remind yourself to relax a little deeper even as you remain alert to the sights and sounds around you. Notice that even as the water comes toward you lapping at your feet, it just as quickly retreats in a very predictable pattern. When you notice the water coming toward you, use that time to inhale slowly and hold your breath just as you have been. As you watch the water retreat, exhale slowly and let your whole body relax."

Alicia could see and practically feel the sand between her toes as she listened to Tate. She could smell the sea air and practically feel the breeze on her face. She felt like she was there for real. If she hadn’t already been lying down she would have fallen down as her body fully relaxed at the sight in her mind’s eye.

Tate watched as Alicia visibly relaxed. She couldn't determine what the counselor was thinking, but Sullivan could see signs of progress. "Your labor is just like the ocean waves you see. Sensations will ebb and flow, and you can control your breath to ease those sensations. Continue to imagine you are observing those waves roll in and out, inhaling as you watch the waves come toward you and exhaling as it moves away from you."

Alicia pictured waves ebbing back and forth, the sound of the ocean was always something that made her relax. She timed her breathing with the ebb and flow just as Tate wanted her to.

Tate watched Alicia breathe as directed for several minutes before offering, "When you're ready, slowly open your eyes. The goal is to remain alert, but relaxed."

Alicia slowly opened her eyes, she felt wonderfully relaxed thanks to Tate. “I swear I’m coming to you every time from now on!” She smiled warmly. “Thank you Tate, I feel much more relaxed.”

Sullivan smiled. "I'm glad I could help. Truly, it's really just applying many of the same skills we already use to help people cope with anxiety just in a new context. even just the word contraction can create tension, so if you can think of another word or image, like the ocean wave, to replace it, it can help to change things. Now, shall we get the rest of your vitals?"

Alicia nodded, “By all means.” She smiled warmly. “Last time I was in for a check up my blood pressure was up so my father had me wear a monitor. You should have all the latest readings. There’ll be a gap where I took it off when I had a fall in my quarters, it was the only way to get help at the time! My arm was well broken but it’s been fine since it was repaired.”

Tate looked stricken for a moment. Had she missed the broken arm in Alicia's records? She looked again and confirmed the notation. Of course, Alicia was under no obligation to tell Tate of her illnesses and injuries as her college, but as someone who genuinely cared about Alicia, Tate was alarmed. "I'm so sorry that happened to you. You must've been so frightened." Of course, Alicia had shared her previous loss with Tate, and so the mention of a fall had significant emotion attached. "Your blood pressure is still a little higher than i'd like, but it has improved since last time. It's normal for a blood pressure to be slightly elevated in the second and third trimesters due to the increased blood volume you have, so I don't see anything to worry too much about. We will continue to keep an ion it, and in the meantime, perhaps you can continue to practice that visualization exercise when you get anxious?"

Alicia nodded. “I will, that’s a promise. I’ll admit I was in complete panic when I had that fall. What worried me more though is the fact that I think I terrified Sthilg more than he was letting on. He’s lost so much already, that’s why I agreed to be adopted by him. So he could be part of a family again.”

Tate recalled the CMO recounting his losses to her sometime ago. She could imagine for both Alicia and the doctor, such an accident added an extra layer of anxiety. "I'm glad you have each other for support," Sullivan replied with a smile. "I hope you know you can always count on me as well. I'm sure you already have plenty of offers for babysitting, but please feel free to add my name to the list."

“That’s a definite!” Alicia nodded. “You’re welcome to visit anytime Tate, I’m sure both Savar and I will need a break every now and then.”

"I suppose that's one advantage raising a family on a starship, you have no shortage of babysitters," Tate replied with a grin. " your vitals look great, and I can see the baby is quite active. Do you have any questions for me?"

“Err ... I don’t think so right now” Alicia shrugged her shoulders. “If I think of anything I’ll let you know.”

"Feel free to reach out to me anytime. In the meantime," she began, before turning around and reaching for a PADD, "Here is some information about common changes at this point in your pregnancy and things to look out for. Some of this I'm sure you were previously told in your earlier prenatal appointments, but I thought it might be helpful to have additional information on what's common. Having that kind of knowledge can sometimes help to ease the anxiety." For Tate, it was not dissimilar to providing information about coping strategies or common misunderstandings concerning anxiety and depression

“I’ll read this, Thank you Tate” Alicia smiled warmly before heading on her way.

{OFF}