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The women of the day
Apr. 28th, 2025 08:04 pmNot sure if I did enough of the load today but it felt like smooth sailing in MAC today.
Perhaps, I missed something. And thats why I had extra time on my hands.
I apologised to the poor med student that I was not a shit magnet.
And at dinner to help my toddler not get bored by the adult conversation I turned the story of my women today into a story about a princess who was ... I want to say stupid but the more PC way to describe them might be confused or vague.
Princess no 1.
Woman who had her first baby in Pakistan 4 years ago, had an IOL for "post dates"? and got to 4cm and was said to be failure to progress and sent for emergency c-section now came in spont labour, membranes intact, contracting on and off 1:10 or less. on the CTG, off the CTG. Not wanting pain relief. Saying her pain tolerence was high (I don't deny that may be so). She could have gone home at some points but she just wanted to hang around. Like hanging around would make her cervix open faster (it doesn't, midwives believe that early presentation and longer presentation at hospital decreases the likelihood of VBAC success-- I am absolutely not sure this is supported by evidence but the way this goes is, the more interference, the more things they find wrong with you, the lack of progress etc. they can use these against you and some how you find yourself on the slippery slope of signing a consent form for a c-section you didn't want or are not sure you need.
So she sat in the corner all day, in bed 8, taking up space. Waiting.
Princess no 2.
"Hi. I want to tell you about my underwear. It's been wet, like you know, damp. Since yesterday. But like, I'm not sure how much comes out. and I haven't been wearing a pad because I haven't got any, so I can't see the colour of the liquid, so I don't know if its like. Abnormally coloured.
Oh here I am in birth unit. Did I put a pad on? No I couldn't find it/forgot." But here am I and my .. soggy undies from like, yesterday...
Princess no3.
Hi. I'm 21. This is my second baby, the first one is 2 years old and a total screaming terror. I'm 34 weeks pregnant and also Aboriginal. My other risk factors include being 37 kg at approximately 155cm tall. This makes my fundal height inaccurate, but actually my dumb midwife forgot to measure my fundal height, which is bad. This should be a part of every basic assessment (BP, HR, CTG, FUNDAL HEIGHT, PV LOSS, BABYS movements, ?dysuria -- all this in 5 mins is your traditional midwives assessment supposed to be done in normal conversation).
Now I wonder super hard what was her FH because she looked teeny tiny despite being 34 weeks.
Anyway so. The notes said, CTG for SGA but - what it didn't say was (and now i'll go back into her voice) I had a bleed last week and on ultrasound there was a "mushroom like appearance in my uterus" and the doctors scared me about an abruption but i didn't want to stay in the hospital anymore so i DAMA'd and went home agreeing to daily CTGs. Which I came and did as I pleased over the weekend, but now I'm getting that crampy feeling I had last week again, and I've got this dark brown discharge in my pad that's pretty thick. The midwives think its old blood but I'm scared and sad that I'm about to loose my baby so I've packed my bags and I'm ready to be admitted to hospital.
Princess no. 4
I'm itchy and the clinic doctor sent me upstairs to ...
I'm not sure why but the midwife said she'd figure it out - and then started reading my notes but found other aspects of it more interesting than it should have been. I had gastric banding a few years ago but I still eat whatever I like. The dietician says i have irregular CHO amounts and eat high fat diet. So I've now gone all fish and salad to try and be healthier. I'm 45 this pregnancy so that probably also doens't help.
I'm itchy. I don't know what it means. The midwife was surprised I'm not of Indian or South East Asian (but caucasian) descent.
As I arrived the midwife said : so you haven't had a CTG yet? (no I have) and oh so you need bloods done? (and no I had that too) and I thought oh. You haven't had a review yet? But .. wait. Didn't you just SEE the doctor? who sent you here? Like .
This is where a more senior midwife would have said "look doc, so is the clinic going to do the CTG and bloods? cool so can you like. just gimme the MRN, and I can put her in the MAC book. and we can recheck the bloods when the results come and then call the lady if she needs a script? There's no need for her to come and sit in MAC to wait for results...
Instead of me who is like :yes send her up and I'll figure it out later when she gets here since you said she needs to be here, like even though she doesn't.
Princess on the phone
Hi, when i walk I have pain. But when I rest i don't and it's better. The baby moves well, or it did this morning. Not sure now. I haven't taken paracetamol - because (no reason why) but I'm worried about this pain. I know you said it sounds like round ligament pain but it hurts bad. And my PAPP-A was high which I know is a risk factor for miscarriage /non continuing pregnancy so I'm extra worried. I can't come in until 4pm is that ok?
Sure. Whenever you'd like since you really want an assessment - so whats your medical record number and name. Cause I can't find you in the system. You know what. So We've had the discussion, and we've talked about causes and normal things to experience in pregnancy. You said you want an assessment - and that's your right - to come in, as we are open 24/7 how about, you go on your merry way, and come in when you can and i'll go talk personally to the reciptionist to figure out what your file is so I can write a note and hand you over to the PM staff because I'm outta here by 15:30.
Perhaps, I missed something. And thats why I had extra time on my hands.
I apologised to the poor med student that I was not a shit magnet.
And at dinner to help my toddler not get bored by the adult conversation I turned the story of my women today into a story about a princess who was ... I want to say stupid but the more PC way to describe them might be confused or vague.
Princess no 1.
Woman who had her first baby in Pakistan 4 years ago, had an IOL for "post dates"? and got to 4cm and was said to be failure to progress and sent for emergency c-section now came in spont labour, membranes intact, contracting on and off 1:10 or less. on the CTG, off the CTG. Not wanting pain relief. Saying her pain tolerence was high (I don't deny that may be so). She could have gone home at some points but she just wanted to hang around. Like hanging around would make her cervix open faster (it doesn't, midwives believe that early presentation and longer presentation at hospital decreases the likelihood of VBAC success-- I am absolutely not sure this is supported by evidence but the way this goes is, the more interference, the more things they find wrong with you, the lack of progress etc. they can use these against you and some how you find yourself on the slippery slope of signing a consent form for a c-section you didn't want or are not sure you need.
So she sat in the corner all day, in bed 8, taking up space. Waiting.
Princess no 2.
"Hi. I want to tell you about my underwear. It's been wet, like you know, damp. Since yesterday. But like, I'm not sure how much comes out. and I haven't been wearing a pad because I haven't got any, so I can't see the colour of the liquid, so I don't know if its like. Abnormally coloured.
Oh here I am in birth unit. Did I put a pad on? No I couldn't find it/forgot." But here am I and my .. soggy undies from like, yesterday...
Princess no3.
Hi. I'm 21. This is my second baby, the first one is 2 years old and a total screaming terror. I'm 34 weeks pregnant and also Aboriginal. My other risk factors include being 37 kg at approximately 155cm tall. This makes my fundal height inaccurate, but actually my dumb midwife forgot to measure my fundal height, which is bad. This should be a part of every basic assessment (BP, HR, CTG, FUNDAL HEIGHT, PV LOSS, BABYS movements, ?dysuria -- all this in 5 mins is your traditional midwives assessment supposed to be done in normal conversation).
Now I wonder super hard what was her FH because she looked teeny tiny despite being 34 weeks.
Anyway so. The notes said, CTG for SGA but - what it didn't say was (and now i'll go back into her voice) I had a bleed last week and on ultrasound there was a "mushroom like appearance in my uterus" and the doctors scared me about an abruption but i didn't want to stay in the hospital anymore so i DAMA'd and went home agreeing to daily CTGs. Which I came and did as I pleased over the weekend, but now I'm getting that crampy feeling I had last week again, and I've got this dark brown discharge in my pad that's pretty thick. The midwives think its old blood but I'm scared and sad that I'm about to loose my baby so I've packed my bags and I'm ready to be admitted to hospital.
Princess no. 4
I'm itchy and the clinic doctor sent me upstairs to ...
I'm not sure why but the midwife said she'd figure it out - and then started reading my notes but found other aspects of it more interesting than it should have been. I had gastric banding a few years ago but I still eat whatever I like. The dietician says i have irregular CHO amounts and eat high fat diet. So I've now gone all fish and salad to try and be healthier. I'm 45 this pregnancy so that probably also doens't help.
I'm itchy. I don't know what it means. The midwife was surprised I'm not of Indian or South East Asian (but caucasian) descent.
As I arrived the midwife said : so you haven't had a CTG yet? (no I have) and oh so you need bloods done? (and no I had that too) and I thought oh. You haven't had a review yet? But .. wait. Didn't you just SEE the doctor? who sent you here? Like .
This is where a more senior midwife would have said "look doc, so is the clinic going to do the CTG and bloods? cool so can you like. just gimme the MRN, and I can put her in the MAC book. and we can recheck the bloods when the results come and then call the lady if she needs a script? There's no need for her to come and sit in MAC to wait for results...
Instead of me who is like :yes send her up and I'll figure it out later when she gets here since you said she needs to be here, like even though she doesn't.
Princess on the phone
Hi, when i walk I have pain. But when I rest i don't and it's better. The baby moves well, or it did this morning. Not sure now. I haven't taken paracetamol - because (no reason why) but I'm worried about this pain. I know you said it sounds like round ligament pain but it hurts bad. And my PAPP-A was high which I know is a risk factor for miscarriage /non continuing pregnancy so I'm extra worried. I can't come in until 4pm is that ok?
Sure. Whenever you'd like since you really want an assessment - so whats your medical record number and name. Cause I can't find you in the system. You know what. So We've had the discussion, and we've talked about causes and normal things to experience in pregnancy. You said you want an assessment - and that's your right - to come in, as we are open 24/7 how about, you go on your merry way, and come in when you can and i'll go talk personally to the reciptionist to figure out what your file is so I can write a note and hand you over to the PM staff because I'm outta here by 15:30.
