IOL for poor reasons

[whitewriter]

So inductions are fancy way for doctors to say, well I think theres a risk factor here: a risk factor for problems.
Due to this risk factor, we should mitigate it by ending the pregnancy and forcing your body to undergo labour. Like. ASAP. At a date determined by us, and this long
thin catheter baloon we are about to stick up your vagina and into your cervix.

OPEN WIDEEEEE YOUR LEGGIES (insert voice of midwife P from MSH here)

Dodgy reasons for IOL (only my professional opinion for working the last 3 months at SSH)
- LGA
- SGA
- reduced fetal movement first presentation


Not dodgy reasons:
Term SROM >24 hours
non-reassuring CTG
cholestasis

So I had a P1,
20 yr old
previous NVB
poor antenatal care in clinic because ?she was sick a lot and was told not to attend (covid fear? Pregnant women are *sick a lot* normally... and yes vomiting and stuffy can be symptoms of pregnancy .... and covid (not classic symtoms) ANYWAYS. I DONT KNOW. I DONT WORK IN CLINIC.
So I read through her scans, all done in the same place by what I think was the same guy.

And he decided the head circumference was 96% at 34 weeks, which I assume was undertaken because based on the nuchal at 12 weeks and the morph at 20 everything kept measuring on the high side for percentiles

So here we were doing an IOL at 20:00
once we got the waters properly broken (22:00) we were in buisnes.

I established her by 00:00 and at 01:15 I thought she had a little cervix in maternal left posterior. So I decided she was 9cm.
She carried on worse and worse.
So I re-did the VE at 00:40 and found her fully.
She was doubting herself. She's like this baby is big so its harder.
And we told her. DW the scan, scans are inaccurate. We won't know the real size until its born.

So i just bad mouthed a colleague there.

The doctor is making a decision based on an inaccurate scan.

I told her, plenty of women push out big babies, you'll be fine.

02:16 baby was born and when I weighed it at 03:30 it was just shy of 3.4 kg.






I will not forget the feeling of her poor perineum tearing. Luckily it was just a 2nd ....
First time I ever did a PR on a woman though, as the senior was like "its a good idea and I'll talk you through it"

also first time the senior was like if your unsure about if the placenta has detached you can feel up the top of the fundus and if its firm ( it was) it hasn't detached. 5 mins later, re-feel, soft as!

This is why I'm still in birth unit. So much you don't pick up at that place they call university ...