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Last few shifts at SSH
Mar. 8th, 2023 07:59 pmLately I've been on the swing shift.
What this means is that I just end up hanging around and helping various people. Which really means, get sent to MAC to cover breaks, which means - help out with 1 or 2 women - while other staff members declare they are too busy to go for a break.
Nothing too interesting has occured and my brain hurts with the amount of things they want done for each lady.
Obs, proper palp, CTG, link the eletronic CTG, sign off the CTG sticker, document it all in powerchart and in ASSA, the yellow card, talk to the woman, council them properly.
A few memories that stuck with me.
Some women you just wonder how they got pregnant in the first place
28 yr old Indian? lady.
Had trouble conceiving for no reason.
34 yrs old.
Ended up having IVF
Now pregnant, 38 weeks, complicated by Cholestasis and rising bile acids
Therefore they've decided she needs to have the baby now.
That means induction
So they reccomended usual route - fokeys first (mechanical ripening of the cervix) followed by usual oxytocin drip. They tried to put the foleys in 3x and failed.
so then they're going to do chemical ripening (what I experienced).
The Doctor is like, okay so we are going to put this hormonal gel into your cervix and it will open your cervix. You will need to be admitted to the hospital.
The negative effect of this gel is that if it over stimulates your uterus, and your baby cannot cope with this over stimulation (which we will see on the CTG aka. baby ECG or EKG) then we will take you for a c-section, okay?
I remember back to when I had the chemical ripening of my cervix and I can tell you now. No one said the C word to me (c-section). So I was a little shocked with how blunt the Doc was about it.
But at SSH they have a lot of bad experiences with families and the doctors down that way are ultra scarred. I feel like they're definaly doing defensive practicing (which is what some midwives call it). essentially what that means is they're practicing with the assumption they're going to get sued and they're doing what they can to avoid it.
So the doctor is there, saying that if this goes bad we are going to get a c-section sorted for her.
The woman looks super unsure.
I'm standing there as a chaperone/assistant, thinking. Lady. How did you think women had babies?
Like your 38 weeks and you have cholestasis. The baby needs to come out. Your liver is not doing well, your body is suffering. The kid can't stay in there. Like eventually it comes out either through the vagina or through a surgical opening. The end?. Like. Hello. ... whats the hesitation?
Maybe her english wasn't good enough.
Then the doctor puts the gel up and she squrims so bad, and cries its like she's getting raped.
Like. Okay bad analogy perhaps but honestly, perhaps she never had sex properly and that's why she could never get pregnant. Like seriously, that's a possibility (an expensive one). But if she has vaginismus, perhaps, its not in her history.
which, btw is a totally legitimate reason for IVF.
Women who have vagininismus who want to get pregnant anyway are pretty brave.
Although, like, who wants pain. Every woman feels it - vaginismus or not - Unless your that weird 1-5% that has some sort of orgasmic/painless experience.
Anyhow. I just had no idea why she was so unsure. I'd only met her 2 minutes before this conversation went down. Which is not really how gold standard midwifery is supposed to work.
But here we are In the imperfect hospital system. Me trying to keep my registration 2.5 years after graduation
Can you believe it's been 2.5 years?
some women can predict their labour
One lady, from ?Africa. 4th baby. The first 3 were pretty quick.
4th baby so she knows how this goes.
Each other time she's had a baby - stretch and sweep is all it takes to get her going and 4 hours later the baby will be born.
So she can literally predict when the kid will be born. delay the S+S until the date she wants (within a reasonable timeframe, of course). Poor thing had diabetes with insulin so the doctors were keen for her to hurry it along.
These women get booked for a foleys and induction - its like, why bother with this whole bullshit.
She's going to go into labour the moment the midwife touches her cervix on the foleys day. But here we are booking her for an induction anyway the day after. Just because thats the protocol.
I wonder if she does end up having her baby right after the S+S. If I remember I'll follow it up but I'm fairly certain this time next week I'd have forgotten about her.
What this means is that I just end up hanging around and helping various people. Which really means, get sent to MAC to cover breaks, which means - help out with 1 or 2 women - while other staff members declare they are too busy to go for a break.
Nothing too interesting has occured and my brain hurts with the amount of things they want done for each lady.
Obs, proper palp, CTG, link the eletronic CTG, sign off the CTG sticker, document it all in powerchart and in ASSA, the yellow card, talk to the woman, council them properly.
A few memories that stuck with me.
Some women you just wonder how they got pregnant in the first place
28 yr old Indian? lady.
Had trouble conceiving for no reason.
34 yrs old.
Ended up having IVF
Now pregnant, 38 weeks, complicated by Cholestasis and rising bile acids
Therefore they've decided she needs to have the baby now.
That means induction
So they reccomended usual route - fokeys first (mechanical ripening of the cervix) followed by usual oxytocin drip. They tried to put the foleys in 3x and failed.
so then they're going to do chemical ripening (what I experienced).
The Doctor is like, okay so we are going to put this hormonal gel into your cervix and it will open your cervix. You will need to be admitted to the hospital.
The negative effect of this gel is that if it over stimulates your uterus, and your baby cannot cope with this over stimulation (which we will see on the CTG aka. baby ECG or EKG) then we will take you for a c-section, okay?
I remember back to when I had the chemical ripening of my cervix and I can tell you now. No one said the C word to me (c-section). So I was a little shocked with how blunt the Doc was about it.
But at SSH they have a lot of bad experiences with families and the doctors down that way are ultra scarred. I feel like they're definaly doing defensive practicing (which is what some midwives call it). essentially what that means is they're practicing with the assumption they're going to get sued and they're doing what they can to avoid it.
So the doctor is there, saying that if this goes bad we are going to get a c-section sorted for her.
The woman looks super unsure.
I'm standing there as a chaperone/assistant, thinking. Lady. How did you think women had babies?
Like your 38 weeks and you have cholestasis. The baby needs to come out. Your liver is not doing well, your body is suffering. The kid can't stay in there. Like eventually it comes out either through the vagina or through a surgical opening. The end?. Like. Hello. ... whats the hesitation?
Maybe her english wasn't good enough.
Then the doctor puts the gel up and she squrims so bad, and cries its like she's getting raped.
Like. Okay bad analogy perhaps but honestly, perhaps she never had sex properly and that's why she could never get pregnant. Like seriously, that's a possibility (an expensive one). But if she has vaginismus, perhaps, its not in her history.
which, btw is a totally legitimate reason for IVF.
Women who have vagininismus who want to get pregnant anyway are pretty brave.
Although, like, who wants pain. Every woman feels it - vaginismus or not - Unless your that weird 1-5% that has some sort of orgasmic/painless experience.
Anyhow. I just had no idea why she was so unsure. I'd only met her 2 minutes before this conversation went down. Which is not really how gold standard midwifery is supposed to work.
But here we are In the imperfect hospital system. Me trying to keep my registration 2.5 years after graduation
Can you believe it's been 2.5 years?
some women can predict their labour
One lady, from ?Africa. 4th baby. The first 3 were pretty quick.
4th baby so she knows how this goes.
Each other time she's had a baby - stretch and sweep is all it takes to get her going and 4 hours later the baby will be born.
So she can literally predict when the kid will be born. delay the S+S until the date she wants (within a reasonable timeframe, of course). Poor thing had diabetes with insulin so the doctors were keen for her to hurry it along.
These women get booked for a foleys and induction - its like, why bother with this whole bullshit.
She's going to go into labour the moment the midwife touches her cervix on the foleys day. But here we are booking her for an induction anyway the day after. Just because thats the protocol.
I wonder if she does end up having her baby right after the S+S. If I remember I'll follow it up but I'm fairly certain this time next week I'd have forgotten about her.
