Midwifes comment of O.T.T

[Pinkerbells]

This has a bit of a back story so bare with me. 14 years ago, when I gave birth I really struggled. I was 24 at the time. My labour was 36 hours long, started in a midwife led unit was eventually taken to a larger hospital for an epidural, (even though I ended up not having one) as I was struggling with the pain. I was in hospital for 5 days after, and had severe PND.
Once discharged, I made the fatal mistake of reading my midwife notes. After 24 hours in labour, a midwife had written clearly in the notes I was being O.T.T! this really really shocked and upset me, but I was young and didn't think it was my place to challenge the entry
7 years ago I was diagnosed with fibromyalgia, which they think began when I was 19 after a severe case of glandular fever. Unknowingly, this meant that I had fibro when I was pregnant. (Fibro doesn't just cause chronic pain, it alters the way an individual manages pain)
Fast forward, and I am pregnant again. My midwife is very understanding about my fibromyalgia, and I have been referred to an obstetrician. However, and this is where my AIBU enters, am I BU to be terrified that my next labour will be like my last and midwives will judge me for how I cope in labour.

Just to add that for legal/ethical reasons no nurse/doctor would write OTT meaning “over the top “in a patient’s notes

Patient has B.O is another one that causes confusion

It means out to toilet.
When I was pregnant with my first over 30 years ago, the consultant who was known to be abrupt, but great at his job, was examining me. He gave my nipple a quick twist and announced to the midwife ' hmm good feeders ' followed by a ' hmm a good broad beam, she won't have any problems birthing '
I was
Imagine that these days?

Thankyou everyone. It has really put my mind at ease that it might well have been medical abbreviations. I looked through as many as I could and couldn't find it

I doubt HCP would write something like that in medical notes. Now, I have no idea if they would quietly tell oncoming staff that a patient was a drama queen etc (still unprofessional in my mind). but to write that in a legal record would be breathtakingly stupid. Far more likely to be a medical abbreviation. I can see how something like "patient is OTT" would sound, but could just mean, as said above "patient is out to toilet" (eg mobilising to bathroom).

My first birth was similar to yours, looking back I think the midwifes thought I was making a fuss, I didn’t have any pain relief as I stupidly wrote on my birthing plan that I didn’t want any, I had no idea how painful birth would be, I was only 21, I then asked for pain relief and they refused it. I was so upset at how I was treated that I discharged myself after a few hours and eventually I ended up with a bad infection.

My 2nd was very different, I knew how painful it would be so I planned to have a epidural and as much pain relief as I could, the birth was much much easier and a less stressful. Recovery was harder but I kind of knew what to expect after the 2nd.

Your 2nd birth is likely to be a lot different than the first. Make sure you take what ever pain relief is on offer, epidural was amazing .

Yes, sounds like it's just an abbreviation. HCPs know that patient notes are kept forever and any snide comment they might write in them could be read by others and be embarrassing or get them in trouble professionally. Guidelines are to use patients own words (patient says pain "feels like x") and to keep things neutral (eg, patient declined procedure instead of patient refused).

I had a similar experience my ex partner overheard a midwife say something not unkind, about me to her colleague 22yrs later I find out I have a double cervix which is likely to be the cause of the long (36hr) slow, excruciating labour. How I would love to find out who she was and put her straight! (and him!).

@DonDrapersOldFashioned *"‘Nursing training now teaches that pain is what the patient says it is’

Not exactly true. "*

The correct quote about pain is “whatever the experiencing person says it is, existing whenever the experiencing person says it does” McCaffery, M. (1968). Nursing practice theories related to cognition, bodily pain, and man- environment interactions

It is a obviously not as simple as that, however, the health professional may have bias due to the patient behaviour and previous experience without considering the subjectivity of pain. Just because they don't act like 8/10 pain or how others perceive their 8/10 pain, doesn't mean it isn't 8/10 pain.

I covered it in CPD, sadly after my mum's experience where no-one believed how much severe pain she was in because she was a quiet unassuming woman who never sat down to her pain. When she was diagnosed with primary cancer with bone metastasis - everyone believed her then although her behaviour didn't change. Shame she suffered 2 years without a diagnosis and no adequate interventions for her pain.

In maternity speak this is defo "out to toilet" A midwife is a trained professional and as such should write only professional, factual and certainly non judgemental notes. We are there as the womans advocate and support. I wish you all the best with your current pregnancy and labour. Your consultant will hopefully in conjunction with yourself have a plan of care in place for when you go into labour so any midwives caring for you will be fully aware of your requirement for sufficient analgesia in labour.

You poor thing. If it does mean what you think, that's awful. Unfortunately, I think every hospital has a bad midwife. When I had my first DD, I had immense pain in my back three weeks before my due date. Went in to get it checked (after talking to my own midwife and she wanted me to check) and the midwife in the hospital refused to listen to me because the pain had subsided by the time she could see me. It turned out my DD's head was in a bad position now and then. It was spotted while I tried to give birth naturally and had to have an emergency c section because of it (glad I did because of a bleed that almost killed me). The doctor at the time looked over my notes and saw the mention of the back pain and actually asked me about it and told me that I should have had some sort of exam.

My second DD I had no problems at all. No back pain or anything. All midwives I saw were awesome throughout.

I think that it would be very unusual for a midwife to write that in any official notes. They might wander into the break room and say 'Room 21 is a bit of a drama queen', but they're not going to write it down anywhere.

Bit like teachers and what they may say to each other about a child (or their parent!), but would never write it anywhere.

OP my first birth was horrific, terribly painful, didn't cope well with pain at all but my second was blissfully easy, although still painful my labour only lasted 2 hours from my water breaking compared to 16 hours with my 1st, no pain relief at all and I managed very well. There is 7 years between my children. Lots of luck OP with your pregnancy and labour.

Can't believe you are still saying it "might" be an abbreviation. It 100% means out to toilet.

Don't make something out of it that isn't there, you'll only serve to stress yourself out more.

Poshjock, you are right. Pain is a complex and subjective topic, one person’s 8/10 is another’s 5/10 and so on, some people will be more reserved than others, some will have cognitive or communication issues that complicate things. It isn’t a straightforward area.