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procrastinating hence the post
12:24 am
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only get inspiration to update my blog when i'm meant to do something else. (pssst... i have a 2500 word report due by next monday. current word count: 300)

yeah, you'll be in this position for at least an hour. say babai to your dignity!

ok, so i HELPED deliver a baby. the midwife's hand was over mine so I won't classify it as handling the delivery on my own.
After a week in the labor ward, i've seen a grand total of 4 c-sections, 2 instrumental deliveries (using the vacuum cup/forceps) and 2 natural deliveries. Natural deliveries are really hard to come by for some odd reason. Even my batchmates concur with me on this. Maybe it's the pandemic use of epidurals. Although scientific studies showed that the use of epidurals should not change the outcome of the labour, from my (albeit limited) experience, the women with epidurals always end up with some sort of intervention at the end.
nvm la... look at the cute baby you get in the end. and yup... this is how a newborn looks like. not like those giant toddlers depicted in movies. lol.

haha... this should be a great educational post for my non medical female friends whom 90% will find themselves carrying (in Dr. House's words) "a parasite" in their uterus at some point in the future. ;)

ok, the deal with epidurals. This is in the UK context though. Not too sure how is it like in M'sia. In UK, antenatal care is top notch. High risk women (those with diabetes, high blood pressure, etc) get to see the consultant every 4 weeks or something like that. So they get to talk to the consultant exactly what they want for their labour. With low risk women, they discuss their birth plans with their midwives (who see them every 4 weeks as well). How it goes it usually... all women will say they want it au naturale (cause all these pain relieving drugs usually make the babies go a bit sleepy. so they can take a while to take their first breath once they are born). But once the contraction starts becoming regular.... they start demanding for epidurals. hahahaha. (when the contraction starts, it actually takes quite a while for it to become very regular. so it's not really like the movies where everybody basically runs around like headless chickens when the mother is in labour. but normally mothers requesting for epidurals leaves it till the last minute when they cannot tahan)

With all the pain of contractions, etc, they have to listen to the anaesthetist ramble about the risk of epidurals etc then when that is done with, they have to bend their backs and be MOTIONLESS  for the epidural to be inserted. Basically a small tube is inserted between the bones of the spine to reach the spinal cord. so you can imagine what a delicate procedure it is (not to mention uncomfortable) and if the patient moves one bit, the epidural can't be inserted properly.
so epidural will basically numb the contraction PAIN. a lot of women wrongly mistaken that the epidural will take away all sensation. but they actually can still feel pressure (imagine tooth extraction. pain is gone but u can still feel the dentist tugging away and the tooth) and the pressure on the back is pretty intense i think.
then most of them also can't really feel their legs. We actually have to move some mom's legs around cause they can't feel them (they can move their legs... it's like their legs kena chopped off cause they don't have the "sense of where their legs are").
The problem is when there is too much epidural. some women mistake the pressure as pain and keep requesting their epidurals be topped up until they can't really feel their contractions anymore. Then when it's time to push, they are seriously clueless. The midwife can feel for contractions and instruct the mom when to push but some women are so bad... they don't even know how to push. (the midwife gives plenty of support and encouragement and instructions but i guess with all the chaos, the women just becomes damn blur)
I don't really blame them... I still remember this girl, who was younger than me, and it was her first baby. When she realize she didn't know how to push, she looked so frightened and desperate. She ended up with an emergency c-section in the end.

so how on earth do you push?

imagine like you're having the worst constipation in the world.
yup... that's all it is to it. (okla, maybe a bit more complicated cause without any pain relieve, each push cause more pain due to stretching of the tissues. not to mention u already have a horrific tummy pain when the contractions occur. so a more accurate description would be "having the worst constipation in the world with a horrible hemorrhoid and the most earth shattering tummy ache")
all the movies depicting women screaming their heads off while pushing is wronggggg.
Have you ever seen a person scream when trying to shit? NO

The only time when the women might shout a bit is at the start of their contractions (before they have their epidural, etc) and near the end when the head is coming out (cause the bloody big baby head is basically tearing a bit of the vagina). And also, the women doesn't start pushing once the contraction comes. They actually have to wait quite a while until the cervix is fully dilated (that's why some women can be in labour for up to 24 hrs. they are basically just waiting in their beds until they are fully dilated. then active pushing only last for a maximum of 2 hours. If baby is not out by then, the doctors will fly in to the rescue)

Ok, so after seeing the after effects of a vaginal delivery, should one opt for a c-section instead? Not really.
Most obstetricians will try their best to convince the women not to do an optional c-section. I think the media wrongly depicts c-section as the easier way out. Women with c-sections stay in hospital longer and the pain after surgery is more intense then the trauma of a vaginal tear. Plus I've seen wound infections and they are not pretty. And a lot lose quite a bit of blood during the surgery. Then when you have another baby after your c-section, you are at risk of uterine rupture (albeit quite small.. 1-2%) but you hv a 10% chance the next pregnancy will be more complicated (in terms of delivery. higher chance of having a forceps/vacuum delivery).

Best way: do not get pregnant. hahahaha. adoption is the way to go! (fyi, women who don't get pregnant are at a higher risk of developing breast and ovarian cancer i think. but everything causes cancer anyway....)

go thank your moms for giving birth to you guys now. especially to moms who did it without any pain relief (salutes my mummy)
Last week of O&G!
7:57 am
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It's the last week of placements and i'm ending with crying babies, swearing mothers, umbillical cords, placenta, sweat, blood, excrement, etc

But i guess this is as sweet as medicine gets. Obstetrics is said to be one of the most rewarding careers since we sort of get an instant reward at the end of labour. Everyone is happy (except when things go wrong, it is also pretty grim).

Hopefully, i'll get to deliver a healthy baby on my own this week :)
11:38 pm
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i just found a whole stash of PBL notes in my gmail account.
i feel so nostalgic and stupid at the same time.

looking back at my notes, it appears that i was smarter when I was a 2/3rd yr med student in IMU. ahhh... how times has passed. now i can't even answer simple questions about basic anatomy and physiology.