The first thing to do is remind yourself that the perfect midwife has yet to be created!! We all learn from our mistakes.
The thing that I always try to remind myself is that if I am going to put my client through the indignity and discomfort of a VE then I should ensure that I learn what I need to know. So that means you dont take your fingers out until you are sure of what you are feeling. And even if you are fairly sure always reach down and back as far as you can to ensure there isnt a posterior cervix. I remember once when I was newly graduated midwife I mistook the feel of a foetal head felt through a thin lower segment for full dilation. That was some mistake!!
You may also have been feeling foetal head/face through a thin lower segment - it's hard to say. Try not to be too hard on yourself.
Leanne.
From: Steve Docherty <[EMAIL PROTECTED]> Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Subject: [ozmidwifery] Vaginal Examination Date: Tue, 29 Jul 2003 18:47:18 +0930
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
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