Thursday, November 12, 2009

Sex and lots of it!

I saw an adorable couple in the office and have seen them several times actually. She's a couple days past her due date and we were dicussing various options and plans for the next week or so if she didn't go into labor. She said both her husband and herself were 42 weekers. I told her that it was likely she would carry that long then. But her cervix is changing - 1-2/80/-1 - so I told her for now to just focus on lots of sex and lovin' :) I kinda hope she goes into labor when I am on call...they are lots of fun!

I only caught one baby on my last call. And it was in the evening so I ain't complaining considering how crappy I have gone back to feeling since Tuesday afternoon. This particular patient, I had seen a couple times with this pregnancy and also with her pregnancy last year. She came in to L&D and was 4cms and requesting an epidural. I was at the office seeing patients so gave orders for that and said I was almost done and would be over shortly. I expected that she would have an epidural by the time I got there. Uh, no. Apparently there was a section going on and they were just finishing up. I checked her and found her to be 7/90/-1 with a BBOW. I asked her if she was sure she wanted an epidural and she was very sure! She finally got her epidural, we put her on her side to rest, and anticipated a baby soon. I was kinda hoping to make it to her second dose of antibiotics but didn't really think we would. But alas, we got close to the time so decided to break her water as her contractions were spacing out . Although, sometimes when putting a women on her side, the contractions may space out but they become stronger. However, she also wanted to get the labor over with.

I checked and she was 9/100/-1 with a very BBOW. I broke her water and figured we would have a baby very soon....and we did. She felt pushy about 20 minutes later and was complete. So she started pushing. It took her about ten minutes to get the hang of pushing again, then she moved that baby right on out. She was kinda in a squatting position....she was holding the nurse and her husband's hand to pull herself almost upright. This was very effective for her. I kinda wish we had had time to get the birth bar out for her but she was gonna deliver without it anyway. She delivered over just a small perineal ding and it was her smallest baby yet! I had told her that the baby looked small earlier in the night, maybe 7 pounds. She said "that's what you said last time and he was 7-11!" This baby was 7-2. I rock.

I admitted someone about 2:30am but no need to go in as she was a primip and wanting an epidural at 3cms (SROM). That's unusal that that happens to me! Typically if patients come in around that time, they are going natural or are a primip and 6cms who might deliver prior to 7am or etc. All of these scenarios would require me to go in. When I checked back this morning she was 4cms with spacey contractions (probably because of the epidural) so I started a little pit, then handed off to the next midwife.

Speaking of the next midwife...While I was hanging out waiting on my lady to deliver, this midwife had a personal patient of hers come in. So you would think "cool, I don't have to manage this patient and potentially be here all night - yah!" But this midwife has health issues so if she doesn't get enough rest, she ends up needing to go home to bed. Twice before she has asked me to take over in the middle of labor. Both times, they were personal patients of hers, and both were having natural childbirth so needed labor support. This left me in the awkward position of having to step in during very active, almost transitional, labor for both. Not cool. It's not fair to the patient or to me. I had never met thses women before even. Fortunately her patient this time was 9cms when she arrived and it was her 5th baby I think. So it didn't take long. But imo, either commit or don't....just plan to follow through. What I mean is...if you know you are tired or that the patient is earlier in labor and it's night time then maybe don't come at all. If you agree to come, then stay. And if you can't do that, then maybe you shouldn't be committing to patients like that. If someone comes in that is a personal patient of mine....if I agree to come in for her at that time then I consider that a committment that I will foloow her until she delivers, no matter how long that might take.


There's a doc who drives a tag says 'empuje'. He's a funny guy. Until he parked in the CNM parking spot instead of one of the many open OB spots. There are only two CNM spots....and they are compact spots. My car is not huge but nor is it a compact car. But because he didn't want to park ten feet further away, he parked in the CNM spot. Seriously. The neos have done this as well, on occasion. But it's worse because one of them drives a SUV. Geez. I have parked in the OB spot before because of either someone's big a$$ SUV or crappy parking job in the CNM spots. I ain't shy.


Joy said...

I agree that that midwife shouldn't be committing. As a patient of a midwife I'd be TICKED OFF if my midwife left in the middle of my labor and just passed me off to someone I didn't even know. I understand emergent situations but if she knows about her health issues and knows what she can and cannot handle she needs to find some other career path.

Beetus said...

All your post titles have sexual innuendos in them. Time for some nooki!