Soldiering On
Well, I am blummin exhausted. Does anyone else get that thing where you are laying there idly thinking about something, and then you suddenly realise it's 4am and you've been lying awake thinking about said thing (which is usually something rubbish and nonsensical - this morning it was whether Tiffany lamps are good or crap) for hours? Well, I do. But then it makes me think - was I really lying there awake for two hours thinking about Tiffany lamps? Or was it only a few minutes and because I was half asleep and time does weird bendy things when you're asleep and I just think it was hours? How does one find out for sure?
Anywaaaaaaay, was lying there minding my own business thinking weird stuff when my alarm. Went. Off. What the fuck? It was dark. I was tired. I am a student - student's alarms do NOT go off at 5.45am, do they? I thought I read they'd amended the Human Rights Act to include this, or something.
So I struggled out of bed, fumbled around in the pitch black, knackered because I'd spent the night perusing Tiffany lamps that exist only in the mind, managed to get out of the house and arrived on Labour Ward.
Was assigned to a primip (first time Mum) contracting well, had had some pethidine a couple of hours before and had been found to be 3cm on VE (vaginal examination) four hours earlier. in the hospital it's "protocol" to VE every four hours to assess progress, and if the woman has not progressed at a rate of 1cm of cervical dilatation per hour, she has deviated from The Line (really, we draw a graph of dilatation and if she strays from the "ideal" line, we take action. What's that at the back? Women are individuals, you say? How can we expect every woman's cervix to do exactly the same thing in labour, you say? Shut up! Heresy! Take her to the stake, she must be a WITCH!!!!)
Ahem, sorry. So yes, if she deviates from the Line, action is taken. Action that involves painful and invasivie procedures, usually. So examination time is always a time when your stomach goes a bit lurchy and horrible, because if it's slow progress (whatever that is), what has been up to then a lovely empowering labour can degenerate preeeeeety quickly into something sucky. And this particular girl had been laying flat on her back for ages - not the best position to labour in, and certainly the one that's most likely to get you off The Line in terms of progress, but she just felt too woozy from the pethidine to do much else, despite my encouragement. Just before the examination she puked a lot, and had a little cry, so I thought the signs were good that she was progressing well (women often become sick and emotional during transition, a stage of labour that occurs when they are getting to full (10cm) dilatation).
Perfomed the VE, a "routine" procedure that can be extremely painful and degrading for the woman involved, but since when did that stop us? Found a tiny lip of cervix left at the front, and could clearly feel all the sutures and fontanelles (soft spots on the babes head) which let me know which way round the baby was facing. Discussed rupturing her membranes with her (again, a more or less routine intervention with no real proven benefit and lots of proven drawbacks), but she declined (may be something to do with the fact I talked up the drawbacks!). So she was basically almost completely dilated - hooray! She had progressed brilliantly despite not moving around at all.
About an hour later she started telling us she needed a poo, which basically means she can feel the head. A short while later she was having an uncontrollable urge to push. Had a little peek and voila! Her bag of membranes was just visible when I parted her labia. Told her to push as and when she felt like she wanted to and soon her bag of waters (which looks like a grey balloon) was completely bulging out of the vagina. Could see the baby's hair floating inside! Tried to break them with an amnihook (the usual tool for breaking waters) but the bloody membranes were made out of rubber! They were so tough! Explains why they didn't go on their own at the beginning of second stage. Eventually did it with a pair of artery forceps, and five minutes later a 7lb baby boy was born. It was weird acutally - his head came and then very quickly his arm, looked like he was clambering his way out of a hole - which I suppose he was. Reminded me of a soldier crawling through a combat zone on his belly.
A trainee paramedic was observing, and after the placenta was delivered I went to the sluice with him and went through the placenta (what it is, what we look for etc). The poor guy was as green as his uniform. HAAAAAA!
Lovely delivery, lovely shift - she needed some stitches but there you go. Now, Tiffany Lamps - vile or divine?
Anywaaaaaaay, was lying there minding my own business thinking weird stuff when my alarm. Went. Off. What the fuck? It was dark. I was tired. I am a student - student's alarms do NOT go off at 5.45am, do they? I thought I read they'd amended the Human Rights Act to include this, or something.
So I struggled out of bed, fumbled around in the pitch black, knackered because I'd spent the night perusing Tiffany lamps that exist only in the mind, managed to get out of the house and arrived on Labour Ward.
Was assigned to a primip (first time Mum) contracting well, had had some pethidine a couple of hours before and had been found to be 3cm on VE (vaginal examination) four hours earlier. in the hospital it's "protocol" to VE every four hours to assess progress, and if the woman has not progressed at a rate of 1cm of cervical dilatation per hour, she has deviated from The Line (really, we draw a graph of dilatation and if she strays from the "ideal" line, we take action. What's that at the back? Women are individuals, you say? How can we expect every woman's cervix to do exactly the same thing in labour, you say? Shut up! Heresy! Take her to the stake, she must be a WITCH!!!!)
Ahem, sorry. So yes, if she deviates from the Line, action is taken. Action that involves painful and invasivie procedures, usually. So examination time is always a time when your stomach goes a bit lurchy and horrible, because if it's slow progress (whatever that is), what has been up to then a lovely empowering labour can degenerate preeeeeety quickly into something sucky. And this particular girl had been laying flat on her back for ages - not the best position to labour in, and certainly the one that's most likely to get you off The Line in terms of progress, but she just felt too woozy from the pethidine to do much else, despite my encouragement. Just before the examination she puked a lot, and had a little cry, so I thought the signs were good that she was progressing well (women often become sick and emotional during transition, a stage of labour that occurs when they are getting to full (10cm) dilatation).
Perfomed the VE, a "routine" procedure that can be extremely painful and degrading for the woman involved, but since when did that stop us? Found a tiny lip of cervix left at the front, and could clearly feel all the sutures and fontanelles (soft spots on the babes head) which let me know which way round the baby was facing. Discussed rupturing her membranes with her (again, a more or less routine intervention with no real proven benefit and lots of proven drawbacks), but she declined (may be something to do with the fact I talked up the drawbacks!). So she was basically almost completely dilated - hooray! She had progressed brilliantly despite not moving around at all.
About an hour later she started telling us she needed a poo, which basically means she can feel the head. A short while later she was having an uncontrollable urge to push. Had a little peek and voila! Her bag of membranes was just visible when I parted her labia. Told her to push as and when she felt like she wanted to and soon her bag of waters (which looks like a grey balloon) was completely bulging out of the vagina. Could see the baby's hair floating inside! Tried to break them with an amnihook (the usual tool for breaking waters) but the bloody membranes were made out of rubber! They were so tough! Explains why they didn't go on their own at the beginning of second stage. Eventually did it with a pair of artery forceps, and five minutes later a 7lb baby boy was born. It was weird acutally - his head came and then very quickly his arm, looked like he was clambering his way out of a hole - which I suppose he was. Reminded me of a soldier crawling through a combat zone on his belly.
A trainee paramedic was observing, and after the placenta was delivered I went to the sluice with him and went through the placenta (what it is, what we look for etc). The poor guy was as green as his uniform. HAAAAAA!
Lovely delivery, lovely shift - she needed some stitches but there you go. Now, Tiffany Lamps - vile or divine?
posted by Midwifette | 10:51 AM
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