[ozmidwifery] ARM

[JoFromOz]

Hi all... only 4 more shifts to go in birth suite... then I am in Post natal ward before moving to Perth!   Just a quick question... is there ever any indication for ARM aside from induction of labour?   Why would my primip in labour over night have needed one at 9cm dilated, 4 hours after being 5-6cm dilated?  She was clearly progressing well... all by herself!  And why didn't I ask for further explanation as to why it was done without consulting me or the woman?  All I got was, "oh, she neeeeded one!"    Of course FHR dropped after the ARM, and then a FSE had to be applied, then a consultant was called, and a 3rd VE was performed within 5 minutes!  The baby was posterior, and the woman, after the ARM was pronounced 8cm dilated.  She was given 2 hours 'to deliver'.  If not, a forceps would be used and why the hell hasn't she got an epidural in?  (why WOULD she have an epidural in if all she had required was gas for pain management, even then, not all the time).  Of course then the woman started to get scared, and feel much more pain, and began doubting whether she could do it!  I was really angry.     It all worked out in the end though.  She was fully dilated when the anaesthetist arrived and pushing amazingly well, so he just hung around outside until the birth... the baby turned and came out anterior after I had to cut an episiotomy (ACK!) because it looked to me like she would button hole at any minute, and FHR wasn't the best.  Of course the epis extended, but still only 2nd degree.    The would have to have been a textbook example for 'cascade of interventions', especially if she had an epidural - IDC - forceps, etc.   Thanks for listening! :)   Jo   -- Babies are Born... Pizzas are Delivered.