I am a student midwife. I would like reassurance/advice on the subject of being a midwife and being left-handed. I do VEs (vaginal examinations) and deliveries left-handed. Most of the midwives I work with are fine about this; some even prefer me to be like this as it allows them to stand where they normally would (I am training in a large teaching hospital where most births are on the bed).
However, some midwives have told me that they find it very hard to work with me and the question always comes down to ‘how do I do my episiotomies?’ I have never yet had to do an episiotomy, so I don’t know exactly what I would do. One midwife said that nobody else would be able to suture for me if I did left-handed episitomies. I’ll have to learn to suture! But surely we should be to give care from any side of bed/floor/bath etc, and if a woman tears she might have to be sutured whatever direction the tear is in. I have never been made to felt as bad about being left-handed as recently. Help!
I am a third year student midwife currently working on a ‘challenging practice’ module. The practice I hope to challenge is that of left-handed students and midwives being made to practise right-handed. For instance, why palpate/deliver from the right hand side of the bed? (why deliver on a bed at all?) Why perform a vaginal examination with the right hand? Why suture right-handed? My questions have so far led only to answers such as, ‘We’ve always done it like this’ and ‘That’s the way I was taught’. Not exactly evidence based practice! I would love to hear from anyone who can shed some light on this midwifery ‘tradition’ or from other students/midwives who have been taught to practise right-handed.
I am also left-handed and not found it too much of a problem (although, as you say, I do waver to the opposite side, or find myself that way until others point it out to me!). As a matter of fact, I think most lefties are probably quite ambidextrous as many everyday things are designed for the right-handed person (e.g. kettles, tin openers, scissors etc). I am glad to be left-handed and while I do adopt ‘right sidedness’ quite a bit (because this is often the way couches are aligned in clinics) I find in the woman’s own home, I will palpate whichever way she chooses to be, whereas midwives I work with sometimes have to ask her to move. It can also be advantageous if women choose different birthing and labouring positions (you can listen in etc. sometimes with left more easily).
I think you will be great as you are, and probably find your own leftness ‘specialities’ that your collegues may even seek out in the future!
What difference does it make? I have always thought that the way we ‘right handers’ do episiotomies (if ever) is very awkward – I was taught to point the scissors towards me. Odd.
I agree, repair could be any direction with a tear, so midwives should be able to suture any direction. I trained with a left-handed student, who always requested a left-handed mentor. I don’t believe that she ever had any particular problems.
I have worked with a left-handed midwife. As we are independent, we own our instruments. You may need to purchase a left-handed needle driver, scissors etc. Certainly, anyone competent to suture should be able to repair a tear or episiotomy. However, working in partnership we often offer to suture if the primary midwife is tired or does not feel confident with a particular tear.
I have done births in just about every position and dominance has not been a problem.
HOORAH! How nice to meet another south paw! The answers I have had range from, ‘You have to change the scissors to your right hand,’ to, ‘It won’t make any difference’.
One consultant I asked (thinking they might be able to shed some light on the problem!) said that if I cut left-handed I would sever the woman’s Bartholins Gland. Now, forgive me for being a student, but I always thought that we had Bartholins on BOTH sides!
As I see it, as with everything else, the midwifery world is mainly right-handed and hasn’t had to think of opposites before!
When I trained, which was in the mid 1980s, as a left-hander I found it extraordinarily difficult to do some things. Palpation wasn’t easy, but this was because all (and I mean all) beds and examination couches were against the wall, which meant that things had to be done from the right side. So I learnt to do this right-handed. Assisting at the birth was different, but only in that I wasn’t allowed to move round to the other side; excuses for this were, ‘there isn’t room for the trolley on that side’, the emergency bell is on the other side’, ‘you’ll be in the way if we need the resuscitaire’ (!) and so forth. So I gritted my teeth, practised ambidexterity, and vowed that when I qualified I would stand, sit or kneel where I damn well liked, as long as I didn’t get in my client’s way. This I have done. I can now palpate with insouciance from either side, I learnt to suture from a fellow left hander and remember that in the old days left handers had their left hand tied behind their backs to discourage its use. We have made progress!
We no longer insist that left-handed students practise in a right-handed way. They can palpate and assist births from the side of the bed that is most comfortable to them, and also undertake manoeuvers in the most comfortable way.
Students may also assist mothers in giving birth in the position of their choice, on or off the bed. Although students find guidelines helpful, we are doing students a disservice if we insist that they assist women in a way that is contrary to their desires or instincts. It restricts autonomy of the mother and the student.
The only practice that I have questioned is that of episiotomy. I was once asked by a doctor (before the days of midwives suturing) to undertake a left sided episiotomy, because the doctor found it easier to suture. I had no problem with this, but I feel that it is unfair to do a left-sided episiotomy if a woman has previously had a right-sided one. Having a scar on both sides of the perineum can increase discomfort and the amount of scarred tissue. So I believe that this should be discussed with the woman and it should be her choice.
I think the practice of doing everything in a right-handed way is rooted in the same attitude that insisted that children write and eat with their right hand. It is discriminatory and discrimination is unethical.
As a child I was made to write with my right hand at school. I have been lucky and reaped the benefits now (although I don’t advocate it and my left-handed daughter will not be prejudiced against if I can help it) but I now consider myself to be ambidextrous. My hands work in co-dominance. I find it great at the moment (1st year student) I can take blood either handed and blood pressure using either hand and it makes no difference to me what side I palpate from and hopefully it will mean that it won’t matter if my mentors are left- or right-handed!
As a righthander, I can only do things from the women’s right side. Even when the bed/couch is against a wall, I have to push it forward to examine the women. I’ve never tried to do anything left-handed. I suppose it’s a bit like the challenge of vaginal examination in an all-fours position – you just have to think harder.
AH updated 22 April 2002