Sunday

[whitewriter]

I promised the acting MUM (highly respected boss) at SSH that I'd do a double shift for her on Sunday.

That they were so short that they could just double book me for a 16 hour shift on a Sunday should have rang alarm bells that she knew it would likely be a massive (potential nightmare) of a shift.

The phones rang hot. No sooner than I'd put it down or was halfway through documenting the previous call, another midwives call would come through and I'd be entrenched in another woman's concerns.

We had everything from broken waters (come in for assessment) to I have this cramping pain that comes approx 3 times an hour and lasts 10-40 seconds at 36 weeks.

The waters broken came in - and I had to say it was a very convincing SROM. I spent multiple minutes interspaced within the next 2 hrs tracking down the result of her GBS swab. The ward clerk was kind and helped me figure it out. Apparently we are no longer doing the swabs in house and she got it done at the GP (which meant instead of just opening her results on our system I had to chase some random receptionist at a random medical center to find the result for me, and fax it over - whilst they're doing whatever their priorities are down in their job).

I wanted to send this woman home. Everything hit the boxes (except the GBS result was missing). Then the doctor goes to do an ultrasound to confirm cephalic (so she can go home) and decides her fundal height is 34 cm (I'm sorry but bullshit it was 38cm) and that the woman was concerned about fetal movements (um. --- culturally she's Indian and they all are concerned about fetal movements... how did you ask the question Dr Let's just admit every woman and IOL them) We didn't have capabilties for an IOL until perhaps the nightshift so she ended up going home. I remember counciling her on checking her temperature whilst she was home. She said she didn't have a thermometer.

We used to give them out, until they became $26 and a scarse resource thanks to covid. So I told her to buy one from the pharmacy - they're only $20 (if they have the one I bought myself) and you'll need it for the baby anyway when it comes (true story. Every parent should have a thermometer.)

She called back at 17:00 in pain and the senior junior I was on with took the phone call - it was the husband actually - speaking on behalf of his wife, and the senior junior basically talked him into staying at home until the allotted time of 20:00 when she was due to come back for a nighttime IOL. That pain was good, that everything was normal, and there's no point coming in now if everything was normal.

I tried to keep a woman who sounded horrible on the phone describing her 5 days of vomiting out of the birth unit. I told her to rock up to ED. Then she gets to ED and says she has stomach pain (yeah from the 5 days of vomiting?) only to be shafted to Birthing because stomach pain and pregnancy might be baby related. Senior Junior thought PET. I will be looking that one up when I get back. Initial BP was normal.

1938 - broken waters turns up and I haven't had afternoon tea, or dinner - and I'm hungry. She's screaming. But that doesn't mean she's in established labour, especially if shes a P0.

I debate over wheather to do a VE or not. Junior Senior suggests doing a spec (aka. doctors review). However she looks like she probably wants pain reilef of some sort which means, I would need to do a VE to determine precisiely whats going on down there.

I want to ask Di but she's busy in a room.

So legit, whilst the woman is screaming the house down in assessment 1 with her contraband husband hiding in the same room (husbands aren't allowed in unless she's going to be defined as "in established labour" - which I can't determine without a VE - which, if I do, commits her to being admitted anyways because once you put you hand in a SROM'ed lady's vagina she needs to be delivered ASAP - via IOL or otherwise, due to risks of chorio. (Kid you not, thats the rule).

--- I go have dinner.

It's not an enjoyable dinner. I'm standing at the door to the tea room keeping it open with my foot whilst I listen out for Di being finished in room 3 whilst I practically inhale the rice/beans/cucumber salad thing I made and promptly forgot to add the tin of tuna that was meant to go with it.

I finish eating.

Di's still stuck but I know the answer: do the VE.

So i lumber on down to assessment 1, explain the process, put on the gloves. Tell Dad I can't see him so he can stay. and the VE result?

Best one out of all of them: fully dialated. Bloody hell lady, and here we were all suspecting you'd be a disapointing 1cm.

She's admitted and in a birthing room by 20:30 and I'm allowed to keep her as my woman. Which means Senior Junior is now working in MAC alone.

There's no one else to care for this lady.

There's also no one else to help me.

The doc wants a CTG. I want to do obs and check my room.

The woman is fully and starting to involuntarily push. She's doing an amazing job.

Pushing somewhat cautiously. I didn't need to encourage her apparently because the kid after going back and forth for what seemed like ages but really was only 20 mins, literally burst through in one huge gush its entire body slid through to the arms of weaping parents who are like "WHY IS THE HEAD LIKE THAT" and "HOW COME ITS NOT CRYING" (the head is perfectly normal and the baby is having fun looking around and crying intermittently its fine.

I'm trying to do controlled cord traction between the legs and Di is micromanaging my placental delivery - much in the same way Aggi was the week before. Only her thoughts were completely oposite to Aggi. Aggi said, CCT and keep the pressure to deliver the placenta ASAP or you'll have a bleed. Di is like, just bloody wait for it to separate first, and then you put CCT.

Can't catch a break. The placenta comes out with another massive clot inside it. Di does the fundal rub in the same domineering manner Aggi did it (not letting me do it) and I'm like whatever makes you peeps happy I caught a baby after 16 hours. Di reckons its a PPH of 850+ and I was like..... really.... but due to lack of assistance legit did not have time to weigh the items. Di wanted it weighed but then whisked it into the bin and I just threw my hands up and gave up. Estimated it will have to be.


By the the time I finished the paperwork it was 23:00 (a whole hour later than booked) and I walked down to the carpark with Di. She said, uncontrolled pushing at the time when the baby turns the corner and hits the peri causes labial tears.

I think, I need more experience as an accoucher.

I got home around 23:40 and was in bed just past midnight.



That's two births I need to add to my list.
(The one I did with the student, and this one)