Secrets of your trade.

Moo thanks. I was 1cm dilated ambit my contractions went wonky when I got to the hospital, I refused to go home for a few hours it gave in. In hindsight I should have been checked again before leaving but they said they wouldn't do that for 6 hours and I'd need to be having regular close contractions for at least 3 hours then comeback, I'd had the baby by then not bitter... thinking I had hours and hours of agony left was awful at least next time I can be a bit more prepared, Sod's law says it'll be the complete opposite though

Olddentist A question or two if you don't mind?

I had chicken pox when I was a few weeks old and when my milk teeth came through they all had a horrible brown line across. The dentist told my DM it was due to the CP. My teeth lasted until I was about 4 and then started to decay from the brown line and I had to have most of them removed when I was about 5. It was horrible. I still remember the smell and taste of the gas and coming round feeling like shite and spitting blood. It was probably 1972. My DM was anal about tooth brushing and we didn't have sweets, juice or anything sugary.

Can CP really do that to teeth that have yet to erupt or was I just unlucky?

My adult teeth though were absolutely great - up to a point. I didn't need a filling until I was 25. Now I'm in my 50s and bone loss has become a problem along with freaky tooth roots.

I've lost most of my upper molars due to bone recession in my upper jaw - thank you menopause - and freaky pointed tooth roots. Mine don't have that claw appearance. They are sort of welded together into a point so don't anchor into my jaw. Am I very weird? My dentist says it's quite common in women.

theyvallgonethat made me well up, I'm sure it brings lots of comfort to people that have gone through that awful experience.

@olderthanyouthink

An incident form would (should!) have been completed, which means it would have been looked into. Unless seriously unwise advice was given (eg sending home a woman pregnant with her 7th baby at 5cm dilated) then it’s just considered ‘one of those things’ - there are always going to be people, like yourself, who don’t fit the (pretty inflexible) model we work with.

ihate true they aren't secret

Midwifes, what if any is the consequence of a BBA where the mother was sent home (i didn't fit the model of contraction timings)?
I slightly want to print and laminate my contraction timings and stick them on the front of my next birth plan (hypothetical, not pregnant atm I hope)

Theyvallgone - that brought a tear to my eye **

MadGreyCatLady
Outside of a hospital setting, if you wish to have a DNACPR order, the best way is probably speaking to your GP. They can record this in your clinical notes and complete a community DNACPR form. You should have a copy to keep at home in case emergency services are called out. Most hospital trusts in my area now have access to GP records but not all will. Usually a new form is completed if you are admitted to hospital to ensure uniform documentation in the trust. They will not necessarily re-discuss with you if you already have / can show a community DNACPR form.

GPs can also create an online record for you on something called Coordinate My Care, which documents your medical history, allergies, resuscitation status etc and is available to healthcare services and the emergency services to view.

Never ever ask your midwife if they’ve got kids of their own.

Does this apply to every profession?

@Shimy

I’m sorry, I phrased that very poorly - I mean scenarios where the baby is known to have died in utero. I get no satisfaction at all from unexpected deaths. In fact I get no satisfaction at all from any fetal death, but I do feel that it’s a more rewarding part of the job.

Why? think it’s because there’s an opportunity to make more of a difference to the couple. They tend to cling on to any act of kindness, and there’s a sense that, as a professional, you can only improve their situation - nothing can make it worse. Also the care can be truly ‘woman centred’, because the worst has already happened to the baby.

theyvallgone

Your post about caring for angel babies is very moving

Delivering dead babies is far more satisfying than delivering live ones, and I don’t know why that is

Can you elaborate further please?

I once had a patient tell me he was going to murder someone.
He went on to murder someone else and is now serving life in prison.

Did you report it, olddentist?

Midwife here.

I’d never let it show, but I judge your baby name choices! If I can’t bring myself to compliment it then I’ll say something like “oooh, you won’t get many of them in a class!” 😳

If your epidural works - you’re very lucky!

We have code phrases: if I press the call bell to get another midwife in then I might say “the back is on maternal right” (I.e. I think this’ll be a shoulder dystopia) or “can I have 40 units please?” (She’s gonna bleed!)

Delivering dead babies is far more satisfying than delivering live ones, and I don’t know why that is

Never ever ask your midwife if they’ve got kids of their own. I know you might mean well, but fertility issues don’t disappear just because of your job title.

All newborns look the same.

If I’m suturing a woman after she’s given birth and her partner asks me to “put an extra one in there” I’ll give him a hard stare and ask how small he’s talking.

We do have a chuckle at laminated birth plans.

@Mysterian totally agree. Ofsted is a stupid waste of energy.

Midwife here!

Two things come to mind, maybe not tricks of the trade, but hopefully interesting:

• As delivery suite midwives we do not simply catch a baby and get it to feed. We are actually highly skilled in critical care - managing patients who are suffering dangerously high blood pressure, massive post partum haemorrhages and those who are septic or otherwise unwell. We are trained to scrub in theatre as well as manage epidural and strong opiate pain relief. We are experts in resuscitating your baby if they need it, and ensuring they recover well afterwards. We suture your vagina, perineum and labia after delivery and much more - it’s so diverse (which is why I love it!).

When we care for women who have lost or are losing their babies we genuinely feel every ounce of distress with you. We think about you on our days off and will check in with you every once in a while.
If I’m looking after you and your angel baby I will treat your baby as if they are my own. If they are ever separated from you I will cuddle them, chat to them, tell them how much their mummy and daddy love them. No matter if they are 16 weeks or 40 weeks. I make sure they are cosily dressed and snuggled, have all their toys and won’t be alone. And I’ll never ever forget you or them.
If you come back to have your rainbow baby we will cry tears of joy and sadness with you and make sure your angel is remembered.

olderthanyouthink
Yes they have other places. But they are not secret places. The studio they used when broadcasting house couldn’t be used was on the South bank.
It’s a bbc building but well known.

joyfullittlehippo is it ever going to be possible to put links on an area of MN for charity or redistribution?

Thank you for all that info enigma

Yes, I can see that HCPs find it difficult as do the replies, very upsetting and not wanting to face, I can see that. Very tough.

snugglesnuggleblanket
i think the netflix documentary is Root Cause
It has been widely condemned by the dental, medical, and scientific community as being complete tosh!

ihate BBC news can and has recently used a studio they have away from broadcasting house because they couldn't broadcast properly from there. And some people work between BH and White city so presumably a certain amount of work could be done from there.

Enigmasaurus thank you very much for taking the time to explain that so well ... I absolutely accept it isn't easy for families (and must be very hard for staff themselves) but without doubt these things need to be brought to the public's attention much more

Obviously a time of imminent loss isn't ideal for learning about such things for the first time, but hopefully with more knowledge some of the distress might be avoided?

vets have the highest suicide rate of any profession

I'll be amazed if this is true. All the statistics I have seen show that the construction industry has the highest rates by a significant margin.

@Enigmasaurus can you tell us please how to go about having a DNR ? Do I write a letter and carry it with me? Do I tell my GP? I am in my early 60's and seeing my parents in an awful state has convinced me that I do not want to be left living half a life.

Smother sadly I think things within the profession are unlikely to improve for the foreseeable future. I have actively discouraged young people from entering medicine and will continue to do so until there is improvement. The junior doctors contract, changes to pension allowances and pay freezes that mean real time loss of upwards of 20% of salary in the last few years combined with the toxic media narrative and unrealistic patient and relative expectations has created the lowest morale I’ve ever seen. I regularly think about leaving. In terms of things you can do - believe that the vast majority of medical professionals are trying to help and want to work with you to achieve the best outcome. And believe that the best outcome isn’t always prolonging life. Be honest and open about what you can offer by way of help for your relative and what you cannot. Engage with us / the therapists / social services to help us support your loved one in the best way we can. Don’t ‘granny dump’ at Christmas or when you go on holiday (yes, this sadly also happens).

puzzled if you are admitted to hospital in the UK you are automatically for resusciatation if you have a cardiac arrest. It requires someone to instigate a conversation about death / dying / CPR for this to be changed. Sometimes (but not often enough IMO), the patient starts the conversation. In some cases (such as that of your ex’s father), the doctor will discuss it and recommend a DNACPR - usually because the predicted outcomes are so poor. IME this tends to be where a patient is predictably unwell or likely to imminently deteriorate. Both highly sensitive and upsetting times. We are not (unfortunately) routinely discussing this with all admitted patients. A lot of people are in denial too and many will not engage in discussions around this.

Not all treatable conditions should be treated, particularly if someone is at / near the end of life. Treating the 6th chest infection in as many weeks does nothing but prolong the inevitable. These decisions are not easy to make however and are very much on a case by case basis. It does require an engaged and realistic family to accept this viewpoint. Just because we can do something, it does not mean we should. Patients and relatives also cannot demand specific treatments or interventions (including CPR) - there is clear legal guidance on this - but HCPs are reluctant (rightly so) to go against strongly held views. It takes time, multiple conversations and discussion of the facts / statistics to reach a mutually acceptable outcome in some cases. The current situation in the UK is that a discussion must be had / attempted with either the patient or nominated NOK before a DNACPR order can be completed. As before, this is not always an easy conversation to have and sadly many HCPs simply avoid it.