COTW SMNET Catch of the week 9/1/12

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, or the experiences are already detailed and shared with the public, 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


Megan is a gravida 2 para 0 who contacted the birth centre where she is due to have her baby at 41 weeks and 0 days gestation saying she is contracting every 10 minutes and has had a show.

I would find out what gestation did her other pregnancies reach and why were they unsuccessful?
Also can she describe the show in more detail, was it bloody?
Some people contracting every 10 mins could be fine to stay at home for a while longer but i'm not sure about her previous 2 pregnancies and what her anxiety levels are like about this labour if she's experienced two other pregnancies that for whatever reason didn't result in a live baby.
If she wants to come in let her and tell her to bring her notes. Also ask her if the baby has been moving around as much as usual. Oh and how long as she been contracting every 10 mins and roughly how long do they last? Are they painful/crampy?

oh yeah it does doesn't it lol i thought it meant she'd had 2 previous pregnancies but you're right.

Megan lives about 10-15minutes away

She's carrying her handheld notes, all the hospital notes show are booking details, scan reports, test results and any obstetrician appointments

She had a TOP a few years ago in the first trimester

Everything has been straightforward in the pregnancy, at 38 weeks she was refered for a growth scan as her midwife felt the baby may be small but the EFW was 3kg and she was referred back to MLC. She has felt the baby move, reassure her that things sound normal but it's early on and she doesn't need to come in yet, advised paracetamol and a bath. Last Hb 12.4 at 28 weeks, placenta anterior and clear of os. Blood group A+ve
3hours later she rings back saying the contractions are now every 4 minutes, she sounds a bit tearful on the phone and stops talking when she has a contraction. Waters haven't gone yet



Show described as 'red and slimy'

Ask her if she wants to come in and is she crying because she is anxious? Remind her to bring her notes and maybe put on a pad incase her waters go.