Hi new here, but have introduced myself on the newby bit.
I was with a woman the other night, multip, came in cont strongly 1:3 on ve 6/7 cms. Baby loa. No concerns preg normal, using tens. Used pool for labour and fh good throughout.
After 2 hours asked to get out of pool and onto mattress and beanbag, as cont had spaced out now more like 1:5 and lasting over a minute. I helped her out. Once onto mat on all fours over b/bag she had strong "pushy" cont. Fh good. On one cont, thought I may have seen vertex, so got m/w in with me. New shift new m/w and other student.
Listened to fh whole minute, lovely. Still pushy.
New m/w asks what is she on ve, said hadn't done one for 2 hours thought that okay?? Says needs ve and ARM if membranes still intact?? So under pressure did ve (with consent) and duly ARM as bulging Waters, a little very soft thin anterior lip, could easily pass over head. No caput, sutures felt, still oa. Clear Liquor. FH still good.
New m/w " we need a bed and CTG" me " huh??"
Woman still pushy good strong contractions and involuntarily pushing. She keeps quietly saying she needs a bed and monitor....we eventually have to strong arm this poor woman through d/s in front of handover, to a room onto her back onto a CTG...FH still fine?? After talking to the woman, she gave me permission to leave her as she understood I had a home to go to...
Women birthed her baby half an hour later and went home 6 hr discharge, no problems either mum or baby.
What was all that about? Now if that woman wasn't "normal" low risk please tell me what is?
I have an essay to write a reflection and am thinking of using this, anyone see where I can go with it.
Funny I can't discuss it with her, I just don't feel able to. Had I missed something? Apparently she had read my notes when in the room and passed on that they were excellent, and at no point were there any concerns, just really wondered what was she thinking?
Thanks to anyone who can make sense of this for me. xx

I really don't understand the need for her to be on a bed or put onto a CGT, everything had been and still was normal.

Sorry I am no help, but I am as confused as you about this, and will be interested to see if anyone can suggest a possible reason why.

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Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

Please help us raise funds for a bereavement room in Honey's memory by taking part in the SMNET Auction & Raffle here thanks x

From what you've written, there is absolutely no reason why she should have been ve'd, had an ARM and put on the monitor. She was low risk and the midwife should have been able to tell from her behaviour and the pattern of contractions that she was nearing full dilatation. If there was nothing visible by the time your next ve was due then you would examine her again and providing progress had been made and both mum and baby were well then you just carry on and wait! I'm sure she would have delivered by then anyway. Did the midwife examine her too? Sometimes if there is a rim of the cervix left and the Waters are still there, midwives will break the Waters to speed things up but you're not supposed to. But we know these things happen....

Would be a good one to reflect on. There is absolutely loads of articles on ARMs and why they shouldn't be done on normal, low risk women so you will have plenty to discuss/argue in your essay.

Thankyou guys. No she didn't check my VE I had worked with her before and she knew me I guess so trusted my findings. However, i just didn't get the whole VE and Arm thing, let alone the need for bed, back and CTG. I need to reflect in 3000 words on normal m/w and I should choose one aspect and investigate it. And the ARM is a good one, and I have got issues with it anyway...
She does practice defensively as has been to court before and that may be behind the CTG?? But not sure about the other interventions.
Thank you for thinking about it with me.

Maybe the whole court issue makes her a little too defensive then, still not right, but it could explain why she reacted that way?

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Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

Please help us raise funds for a bereavement room in Honey's memory by taking part in the SMNET Auction & Raffle here thanks x

I agree, there is absolutely no need to VE, ARM or monitor. What were her previous deliveries like? Not that I can see it making much difference as to whether she would need a VE/ARM doing.

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3rd year Student Midwife

Poor practice, she can equally be accountable in litigatious circumstances for negligent care by intervening, so I cannot understand at all, if she was trying to make an impression on the other student then its a poor way to go about it. I simply do not understand her actions, great reflection though.

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