COTW SMNET Catch of the week 12/12/11

For anyone who's not sure - these are real situations designed to help you get an idea of what other people would do in this situation, to help you evaluate the care you'd provide, to get other ideas if you are in the situation in the future - and to make you realise just how much there is to learn in midwifery and just when you think you have it sussed something will happen to make you realise that nature has ways of taking us all by surprise, no matter how experienced you are. The women and their families have very kindly agreed for their experiences to be shared online and in accordance with the NMC all are completely anonymous.

Some of these situations will be lovely normal births, others will end up in theatre or have a nice birth with complications afterwards, as in real life not all pregnancies will have a happy ending. There are various settings so don’t forget where you are (can’t transfer to theatre from a homebirth without ringing an ambulance etc). Intermixed with the intrapartum cases there will be antenatal or postnatal scenarios thrown in as midwifery is not all about the birth.

Each event will last for 1 week, with me setting the scenario on the Monday and unfolding a bit more each day until Sunday when I conclude it, ready for the next. However if I am around and basic questions are asked (such as why I did something or what something means) then I’ll answer them earlier.

Join in, make comments - be they practical suggestions of what could have been done, a 'OMG I'd never have done that', a 'why did that happen?', 'similar thing happened to me', or a 'I haven't got a clue - hope mum and baby were ok'. The more people and comments who are part of this the more fun and interactive

Cher is a gravid 4 para 0 who is booked to have her baby at the standalone birthcentre. She is 40 weeks pregnant exactly when she rings you at 10am to say she is contracting every 3 minutes and wants to come in.










She tells you she’s had a bit of a show but no other loss and the baby is still moving.

No Ashlee shouldn't mean stillbirth as They are registrable births so should be counted in parity.

As always just guessing but I would ask her to come in with notes and bag to see her xx

Agree with asking her to come in. Ask if she's had any liquor draining and if so colour e.t.c. tell her to bring her notes with her and all her other bits and bobs she wants including birth plan if she has one.

edit.. sorry just saw you wrote 'no other loss'

I'd ask her how long the contractions are lasting and keep her on the phone long enough to hear her through one. I'd ask her how she's feeling otherwise, maybe make sure she gets something to eat before she comes in (unless she's desperate to come in) and take it from there.

Regarding the gravid 4 para 0 - at what gestation would the loss of a pregnancy be considered a stillbirth rather than a miscarriage? Is it 26wks? From what Penguin said I am thinking that any baby born after that point (whatever it is!) would be counted as "para" but can someone clarify for me please?