I don't mean to be derogatory to the profession, but it's almost as if some doctors aka obstetricians missed that part of their education...learning how to relate appropriately to the women in their care.
It seems to be a fundemental part of our learning as midwives and I dare say because the majority of us are women as well, that we learn to communicate in many ways, not only with talking, but with more innate senses such as touch, and compassion. Why is there such a vast difference in the communication between we midwives and those in the medical profession?
Jenny ;)
>From: "elizabeth mcalpine" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: Re: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!)
>Date: Fri, 4 Oct 2002 11:19:24 +1000
>
>Yes, absolutely.
> ----- Original Message -----
> From: Lynne Staff
> To: [EMAIL PROTECTED]
> Sent: Friday, October 04, 2002 8:58 AM
> Subject: Re: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!)
>
>
> I agree, BUT there are ways and ways of discussing......
> ----- Original Message -----
> From: elizabeth mcalpine
> To: [EMAIL PROTECTED]
> Sent: Thursday, October 03, 2002 7:29 PM
> Subject: Re: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!)
>
>
> Jo, you did great - as did the couple!!!
> early decelerations due to head compression are of less concern than late, as you know, and in a multi who will dilate quickly the stress put on all of you is just about typical of hospital and medicalised birth.
> I just hate the panic sometimes too - after nearly 30 years - the same story. And sometimes the pressure is just enormous. Frightening women is part of medicalisation but, to understand it from their (the medicos) point of view, the pressure on them is also enormous, and the fear of litigation real.
> You did well. Sometimes things do get out of control and there's little you can do about it.
>
> Liz
>
>
> ----- Original Message -----
> From: JoFromOz
> To: [EMAIL PROTECTED]
> Sent: Thursday, October 03, 2002 10:35 AM
> Subject: [ozmidwifery] Almost c/s - horrid shift (VERY LONG!)
>
>
> I worked in birth suite last night, and had a not-so-nice shift...
>
> This woman was due to be induced on saturday, and came in for routine CTG monitoring (as she was post dates by about 5 or so days), and the CTG was very flat... variability 1-5, but a reactive trace. Eventually the decision was made to induce there and then. She had an ARM around 3pm, and was 2cm dilated. Clear liquor. Since this was her second baby, they decided to leave her for an hour to see if she went into labour 'spontaneously'. She felt some niggles, that's all. So after SEVEN attempts to get an IV into her (and 2 hours after the ARM) syntocinon was commenced.
>
> For most of that time after the ARM I was told to leave the CTG on because they (the doctors) were not happy with it. And, of course when the syntocinon went up, the CTG was there to stay. Because the woman was mobilising well, on the ball, on the loo, walking, sitting, etc, the trace wasn't very clear. So, I sat with her the whole time, listening to the baby's heart, often getting the maternal pulse showing up on the monitor (low-lying placenta), but always hearing the baby's heart rate in the backround, assuring me of the baby's well-being. After about an hour of sketchy tracing, I told the woman and her husband that the doctor might want to put a FSE on because they wouldn't be sure of how the baby was from the printout. I showed them the device, and explained to them everything that would happen. They asked whether it would hurt the baby. I can't lie... a wire being screwed into a baby's head would hurt anyone. I said it would probably hurt the baby, but ch!
ances are it won't harm the baby. They were not happy with that, really, and the husband said that he has been sitting with me the whole time, listening to the baby's heart with me, and he was happy that the baby was fine if I was. Just then, I heard the first decelleration. I watched and heard it go down to about 80 at the onset of the contraction, then return to the baseline of about 135 as the contraction was letting up. An early decelleration. I listened in carefully during the next contraction, and the same thing happened.
>
> I went out to tell the doctor, and she came in, all stressed out, saying she had to put a FSE on. The father explained their concerns, and the woman was getting all stressed out too. I tried calming her, just whispering, 'just ignore the talking, you've been doing really well concentrating on your breathing, just keep doing that', etc... Eventually they agreed to see how dilated the cervix was before deciding on the FSE. If she was almost fully, they didn't want it.
>
> Unfortunately, it was time for doctor's change of shift. The new doctor to come on is one I've had altercations with before: he's rude, unwoman friendly and spiteful. He came in loudly proclaiming her need for and FSE, so they had to explain all over again to him why they didn't want one. The woman was contracting, and wanted silence, and even said, "shut up!" and he just kept talking, explaining why they needed it. So he did a VE. 4cm. After 3 hours of good contractions on a multi, who was feeling bowel pressure... 4cm. I had my doubts, but what can you do? Then she needed to void, before the FSE was applied. So we got her up to the toilet, and while she was sitting, the midwife in charge barged in, saying we need her back in bed, on her left side with oxygen. She's in the toilet... yes, well she needs to get back in bed as quickly as possible, the baby's in distress. The woman, in desperation, in the middle of a contraction, said, "don't tell me that!!" She t!
urned to me, and said, "why are they scaring me like that??" I didn't know what to say :(
>
> We got her back to bed, on her left side, and applied oxygen. The FSE was attached, and showed the same early decellerations with most contractions down to about 80 or so. All the woman wanted to do was sit up on the ball... oh no, that wasn't allowed. The baby is distressed, you have to stay there.
>
> Just as a theatre was being prepared for a c/s, she had an urge to push, and there was head on view. Baby was born within 10 min, with the heart rate at some points only 50bpm. That was scary. When the baby came out, she had the cord tightly around her neck 4 times, and around her body once. She came out screaming, with apgars of 9 and 10.
>
> I just felt like suddenly my evening was out of control. Sorry it was so long... any comments?
>
> Jo (new midwife)
>
> Babies are Born... Pizzas are Delivered.
>
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