Having made mistakes in the past with VE's I am now not happy to say I have felt the cervix until I have been able to really feel that edge and if possible and not painful, to be able to slip the finger tip right under it.
Judy
From: "Robin Moon" <[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
Subject: Re: [ozmidwifery] Vaginal Examination
Date: Sun, 3 Aug 2003 08:54:55 +1000
we've all done this in our life times I'm sure! I can remember calling the
obstetrician for delivery, thinking all while that whilst I had felt her to
be fully, she wasnt behaving fully. I should have listened to my inner
voice. She was only 3cms. aaaargh.
nowadays, I have learnt that the head or membranes or very thin cervix wall
all feel different. Next time you've got a really posterior thin cervix,
take time to 'feel' how that feels different from the latter two.
The other trick i use is getting the women to sit on their hands if you're
not immediately sure of what you're feeling. It has the effect of swinging
the pelvis forward and allows you a different 'view' of the VE.
Dont waste too much time stressing. We've all done it.
Robin
----- Original Message -----
From: "Neretlis, Bethany" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, August 02, 2003 6:50 PM
Subject: RE: [ozmidwifery] Vaginal Examination
> ive not made this mistake but have had another midwife chech ve's as i
was very unsure of a similar situation. as other have said try not to beat
yourself up over it, we have all done something similar at one time or
another. it is an excellent goad to try not to repeat the mistake though. i
have come up with a few little tricks to ensure i don't make mistakes i have
made in the past again.
>
> love Bethany
>
>
> -----Original Message-----
> From: Andrea Quanchi [mailto:[EMAIL PROTECTED]
> Sent: Thursday, 31 July 2003 19:10
> To: [EMAIL PROTECTED]
> Subject: Re: [ozmidwifery] Vaginal Examination
>
>
> Jean
> You are certainly not alone in this as sometimes it can be really hard
> to tell what you are feeling. Sometimes you put your fingers into the
> anterior fornix and can feel the head through the vaginal wall which is
> stretched so thin that you can hardly feel it. You feel the baby so well
> that the natural assumption is that you are in the cervix. In this case
> the cervix is often so posterior that you cant find it without making
> the woman really uncomfortable. I'd like to meet the midwife who can
> claim never to have made this mistake. Practice wil help and I would
> suggest starting with women who are likely to be more dilated and
> therfore easier to ascertain. then work backwards. Even better have
> someone who is confident do the VE first and then have them talk you
> through what they could feel as you are doing it. This is a really good
> way to realise what you are actually feeling. The trouble with all this
> is that none of it is good for the woman as it often interrupts the flow
> of the labour.
> If you can discuss it with the women before they are in labour it might
> be easier for everyone. Women understand the need for us to learn and
> are usually more than willing to co operate if it is approached in the
> right way.
>
> Andrea Q
> On Tuesday, July 29, 2003, at 07:17 PM, Steve Docherty wrote:
>
> >
> > 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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