![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriterCulture plays a big part in how people feel, think and act. How they perceive situations, how they deal with situations, how they rationalise them and even their outcomes.
You don't see this any more strongly than in the clinical setting.
It's racist to classify someone pre- event into the category of the "Indian princess" but when you see it right in front of you I find it hard to judge them any other way.
So an Indian princess is someone who wants something but doesn't want to do the hard yards for it.
They want everything to be easy, and light and they want you to do the work for them.
I come into the room on handover, and I'm introduced by the morning staff as "an amazing midwife" (I want to barf right there, I know she's just trying to pep me up but please... spare me, I don't know what I'm doing half the time). It's literally the worst time to be introduced to a woman and take care of them: she's fully and pushing.
Cept with each push you don't see any progression.
So. In a nutshell: second baby, nil complications this pregnancy, all normal. No epidural, apparently, they had prepared for one, but the VE just prior to the anesthetist coming was 8-9cm and they thought that she was "too far" for them to put it in.
It's been about 40 mins. I decide to get in there and try some guided pushing.
We change positions. I can't seem to get her into a good one.
The senior walks in. "Thats not a good position for pushing, you need to change."
I'm like okay. So we get more lateral. Doesn't seem to help.
We try the mini sturrups.
What gets me, is that ever since I walked in shes begging us for a vaccume.
She's like just suck it out.
Can we use the vaccume?
I can't do it...
And we tell her, you are doing it, your doing it.
And she shakes her head and is like ... too tired.
The doctors come in, threaten the vacuum (lol thats what she wants dudes...)
They want to augment her labour, the contractions have died down from 4:10 to 3:10-- we start the synto at 15mls/hr ... btw. This stuff takes at least 30 mins from when we start it, to have an effect.
They tell her the risk factors briefly.
Then leave saying "they'll come back in 15 mins if there isn't progress".
I try more guided pushing.
I swear the heads not moving.
The CTG is fine.
I had previously explained how she needs to take in a deep breath, focus all that breath on her bottom and bear down. She's not doing it. Her breaths are small, and the energy doesn't seem to be going down, it seems to just go any other way but down.
The doctor already explained that the vacuum isn't without the woman pushing, she has to do it too.
So I'm there, palpating contractions, because this woman, doesn't seem to reliably push with them.
The doctors do more guided pushing, and they get a little forceful with her, which I agree was necessary. They tell her her pushing isn't strong enough and she has to push harder, and it's not moving enough for a vacuum and she will need a forceps then to help out, which has increased risk. The head comes down a little.
Anyhow I won't bore you with more details. So she end up with a Vacuum. Paed is there, the baby is fine. Its born 26 mins after the synto was commenced, did it even do anything for this lady?
O&G didn't need to do any episiotomy (somehow, which I still find confusing) the perineum and the vagina are intact.
So post birth, literally the woman asks me when she can have a shower...
Usually the women are too tired and half dead to think about walking to the toilet. So I explain that, well, if you can walk, you can have a shower, do you think you can walk to the toilet?
She looks at me like "why wouldn't I be able to walk"? Anyhow I focus on how she should feed the baby first, as it clearly looks hungry. -- And usually we get the woman to eat first.
They ask me about the baby's weight ... I explained we haven't weighed it yet.
(Did no one talk about skin to skin and benefits of breastfeeding within the first hour with this woman in clinic? I suppose not.... Are these topics beneficial? I have to meditate on this one).
So she's attempting to feed but i can see her position isn't good. She's like he isn't sucking. Something tells me it's not the baby isn't sucking but its just in the wrong position. I decide to do the baby check whilst she fixes her position in the bed.
She's asking if she can have the drip out of her hand and the IDC out. I explain their purposes... and how they are related to the vacuum (increased risk of bleeding, so we put up the drip to reduce that chance. The IDC assists the uterus to contract and reduce potential for bleeding post instrumental.
I return the baby, it latches on when she gets it in a good spot.
I check the food order for dinner with them, I ask are you vegetarian cause that was what was previously ordered. And they're like no, I'm not vegetarian. So then I'm like -- which is probably the question I should have asked initially "Is there anything you don't eat" which turns out to be beef/pork/lamb... and I'm like but you eat chicken. And she's like yes. So I modify the diet (which takes longer than I'd like to admit --- you wonder if the processes that should take 2 mins but end up taking 15 mins was corrected that we wouldn't have staffing shortages).
She walks just fine to the bathroom with a little assistance, because I'm adamant the IVC meds and the IDC need to keep running.
Her husband turns to me and says "so she can go home?" And I explain again that with a vacuum delivery, they need to stay for extra monitoring of the baby, and with the IDC in and the meds running probably tomorrow sometime, I say 24 hours but I'm not entirely sure if it's a different length of time.
In the paperwork I list maternal exhaustion as reason for using the vacuum but I'm gonna go out on a limb here and be extremely judgy and say that she gave up. She literally gave up, and didn't want to push.
She pushed in that way like all they're doing is blowing a raspberry.
Lady, the doctor yelled at you and told you to get angry at your baby not coming out, and instead you just looked at us and told us to "suck it out".... If you had just pushed properly, it would have been out. Here you are, able to walk, have a shower, looking normal and cute after labour. Did you really need the vacuum? What if your baby has consequences or issues as a result of the vacuum delivery? Will you think that it was you that chose that result? Cause from where I sit in my chair of judgement yes, I do believe it was your choice. I guess I'll never know what was going on inside her head, in that moment. And I wouldn't ever ask her or make such demands, because that would be unprofessional, right?
Let me take you to a birth I did with an Islander lady 26/9/20
1st timer.
Antenatally nil complications.
In a lot of pain, utilising the gas intermittently.
Not wanting an epidural at all.
However even the midwives were getting concerned for her because she was starting to look acopic, but really, she was probably fully.
Doc did the internal and classified her as fully. (and in hindsight, I wish I had done that internal. And this is becoming my new goal - along side learning to put in IVCs.... midwives should be able to detect and follow through with deciding someone is fully).
So we get into position and start pushing. She does a few for 15 mins, and I'm not really seeing anything.
I glove up and try some guided pushing.
Holy shit, with just a bit of guidance boy can this woman push.
I get the trolley ready asap and before you know it I'm telling her to slow down and just do small ones.
I end my morning shift with a baby delivered (very cute) and a happy looking mum, and I congratulate them, and tell her with a smile she was an A+ pusher, very strong.
You don't see this any more strongly than in the clinical setting.
It's racist to classify someone pre- event into the category of the "Indian princess" but when you see it right in front of you I find it hard to judge them any other way.
So an Indian princess is someone who wants something but doesn't want to do the hard yards for it.
They want everything to be easy, and light and they want you to do the work for them.
I come into the room on handover, and I'm introduced by the morning staff as "an amazing midwife" (I want to barf right there, I know she's just trying to pep me up but please... spare me, I don't know what I'm doing half the time). It's literally the worst time to be introduced to a woman and take care of them: she's fully and pushing.
Cept with each push you don't see any progression.
So. In a nutshell: second baby, nil complications this pregnancy, all normal. No epidural, apparently, they had prepared for one, but the VE just prior to the anesthetist coming was 8-9cm and they thought that she was "too far" for them to put it in.
It's been about 40 mins. I decide to get in there and try some guided pushing.
We change positions. I can't seem to get her into a good one.
The senior walks in. "Thats not a good position for pushing, you need to change."
I'm like okay. So we get more lateral. Doesn't seem to help.
We try the mini sturrups.
What gets me, is that ever since I walked in shes begging us for a vaccume.
She's like just suck it out.
Can we use the vaccume?
I can't do it...
And we tell her, you are doing it, your doing it.
And she shakes her head and is like ... too tired.
The doctors come in, threaten the vacuum (lol thats what she wants dudes...)
They want to augment her labour, the contractions have died down from 4:10 to 3:10-- we start the synto at 15mls/hr ... btw. This stuff takes at least 30 mins from when we start it, to have an effect.
They tell her the risk factors briefly.
Then leave saying "they'll come back in 15 mins if there isn't progress".
I try more guided pushing.
I swear the heads not moving.
The CTG is fine.
I had previously explained how she needs to take in a deep breath, focus all that breath on her bottom and bear down. She's not doing it. Her breaths are small, and the energy doesn't seem to be going down, it seems to just go any other way but down.
The doctor already explained that the vacuum isn't without the woman pushing, she has to do it too.
So I'm there, palpating contractions, because this woman, doesn't seem to reliably push with them.
The doctors do more guided pushing, and they get a little forceful with her, which I agree was necessary. They tell her her pushing isn't strong enough and she has to push harder, and it's not moving enough for a vacuum and she will need a forceps then to help out, which has increased risk. The head comes down a little.
Anyhow I won't bore you with more details. So she end up with a Vacuum. Paed is there, the baby is fine. Its born 26 mins after the synto was commenced, did it even do anything for this lady?
O&G didn't need to do any episiotomy (somehow, which I still find confusing) the perineum and the vagina are intact.
So post birth, literally the woman asks me when she can have a shower...
Usually the women are too tired and half dead to think about walking to the toilet. So I explain that, well, if you can walk, you can have a shower, do you think you can walk to the toilet?
She looks at me like "why wouldn't I be able to walk"? Anyhow I focus on how she should feed the baby first, as it clearly looks hungry. -- And usually we get the woman to eat first.
They ask me about the baby's weight ... I explained we haven't weighed it yet.
(Did no one talk about skin to skin and benefits of breastfeeding within the first hour with this woman in clinic? I suppose not.... Are these topics beneficial? I have to meditate on this one).
So she's attempting to feed but i can see her position isn't good. She's like he isn't sucking. Something tells me it's not the baby isn't sucking but its just in the wrong position. I decide to do the baby check whilst she fixes her position in the bed.
She's asking if she can have the drip out of her hand and the IDC out. I explain their purposes... and how they are related to the vacuum (increased risk of bleeding, so we put up the drip to reduce that chance. The IDC assists the uterus to contract and reduce potential for bleeding post instrumental.
I return the baby, it latches on when she gets it in a good spot.
I check the food order for dinner with them, I ask are you vegetarian cause that was what was previously ordered. And they're like no, I'm not vegetarian. So then I'm like -- which is probably the question I should have asked initially "Is there anything you don't eat" which turns out to be beef/pork/lamb... and I'm like but you eat chicken. And she's like yes. So I modify the diet (which takes longer than I'd like to admit --- you wonder if the processes that should take 2 mins but end up taking 15 mins was corrected that we wouldn't have staffing shortages).
She walks just fine to the bathroom with a little assistance, because I'm adamant the IVC meds and the IDC need to keep running.
Her husband turns to me and says "so she can go home?" And I explain again that with a vacuum delivery, they need to stay for extra monitoring of the baby, and with the IDC in and the meds running probably tomorrow sometime, I say 24 hours but I'm not entirely sure if it's a different length of time.
In the paperwork I list maternal exhaustion as reason for using the vacuum but I'm gonna go out on a limb here and be extremely judgy and say that she gave up. She literally gave up, and didn't want to push.
She pushed in that way like all they're doing is blowing a raspberry.
Lady, the doctor yelled at you and told you to get angry at your baby not coming out, and instead you just looked at us and told us to "suck it out".... If you had just pushed properly, it would have been out. Here you are, able to walk, have a shower, looking normal and cute after labour. Did you really need the vacuum? What if your baby has consequences or issues as a result of the vacuum delivery? Will you think that it was you that chose that result? Cause from where I sit in my chair of judgement yes, I do believe it was your choice. I guess I'll never know what was going on inside her head, in that moment. And I wouldn't ever ask her or make such demands, because that would be unprofessional, right?
Let me take you to a birth I did with an Islander lady 26/9/20
1st timer.
Antenatally nil complications.
In a lot of pain, utilising the gas intermittently.
Not wanting an epidural at all.
However even the midwives were getting concerned for her because she was starting to look acopic, but really, she was probably fully.
Doc did the internal and classified her as fully. (and in hindsight, I wish I had done that internal. And this is becoming my new goal - along side learning to put in IVCs.... midwives should be able to detect and follow through with deciding someone is fully).
So we get into position and start pushing. She does a few for 15 mins, and I'm not really seeing anything.
I glove up and try some guided pushing.
Holy shit, with just a bit of guidance boy can this woman push.
I get the trolley ready asap and before you know it I'm telling her to slow down and just do small ones.
I end my morning shift with a baby delivered (very cute) and a happy looking mum, and I congratulate them, and tell her with a smile she was an A+ pusher, very strong.
