Brief summary of my week

Lots of midwife lingo in this post. Here is a key:

IUD= intra uterine device.
TOLAC = trial of labor after cesarean section
R/O= rule out, meaning that's what we're worried about, so testing/observing to determine
SVE=sterile vaginal exam
misoprostol - a medication used to ripen a cervix, or get it ready for labor.
IOL = induction of labor, usually with pitocin.
PPROM= pre-term premature rupture of membranes (water breaking before a baby is ready, and before labor has begun)
CST= contraction stress test
NOB= new ob visit (prenatal)
PP = postpartum visit, usually at 6 weeks


Put in another IUD.

•Did complete informed consent with a patient for vaginal birth & blood transfusion.

•Learned to do SVE with my left hand – think it might be easier, somehow feels better.
•Managed 2 multiparous inductions, but no births before my shift was done.
*One was a 40+6 induction for postdates, given the option to come back next week. Fun lady. 100 mcg of misoprostol got her contracting, so I’m hoping it just kicked her into labor without further induction. When I left, she was 3 cm.
*IOL at 37+4 for G6P3002 (6 pregnancies, 3 deliveries, 2 live children) for previous fetal demise at 38 weeks. Had a great time working with her – she had LOTS of anxiety over losing this baby, guilt over inducing early, etc. Spent a lot of time with her talking about what her options were and why, and just helping her understand the whole process. Her induction was with pitocin, despite the fact that her SVE was 2 cm/50 %/-3 station because her baby had some strange variables, so it didn’t seem prudent to use misoprostol, and it doubled as a CST.

R/o PPROM at 21+1 weeks. Thankfully, did rule it out! History of PPROM at 27 weeks, and her story sounded pretty convincing, but her cervix was long and closed, and with ultrasound we could see lots of fluid on the other side.

NOB visit with a client in a drug treatment program. History of food addiction, gastric bypass (Roux-en-Y) then bowel obstruction surgery, then chronic pain, then narcotic addiction. Unplanned pregnancy. We had a long visit, then confirmed a 10 week pregnancy with ultrasound.

6 week PP visit with a woman who had PP blues/depression. Talked about self care, getting help from others, eating better! Referral for counseling.

Transfer OB visit at 24 weeks with an interesting client who wants a TOLAC. Good candidate overall.