[ozmidwifery] Vaginal Examination

[Steve Docherty]

I would like to ask any midwives if they have ever completly stuffed up a 
vaginal examination as I would dearly love some reassurance that I'm not 
going completly mad. I have been a partime Midwife for 4 years, have not 
had a lot of labour ward experience but enough to not make stupid mistakes.
I was looking after a primip who had SROM at term the day before and was 
having niggly contractions 2-3-in10. I was looking after her overnight, she 
was a private patient . She had had some pethidine overnight to get some 
sleep and the idea was to start syntocinon in the am if she hadn't got into 
active labour. Four hours after the pethidine wore off this was about 
0500am  she was wanting some more pain relief and  was considering an 
epidural before the syntocinon started. I suggested doing a vaginal 
examination as she looked as though things were picking up slightly. I did 
a v.e. and thought I felt 5cm dilated. fully effaced -1. I handed this over 
to the day shift and anther vaginal examination wasnt done until 6 hours 
later, at this exam she was 2cm posterior 0.5 cm thick -2 .
I keep asking myself what was I feeling to get my result?. It did cross my 
mind that she was too comfortable looking  but this can be deceiving at 
times. I probably didnt go posteriorly enough , but I thought I felt  the 
rim of the cervix in the mid position???. I'm now not on labour ward as I 
rotate so cannot do more vaginal exams to help myself feel more confident. 
I will just have to wait until I work on labour ward again and do some much 
needed practise. The woman went on to have syntocinon and an epidural and 
had a ventouse delivery early the following morning. I have apologised to 
the woman and she was very forgiving but I still feel very angry with 
myself for extending her time of induction.

Thanks for reading

Jean