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Discussion Starter · #1 ·
hi i have this weird question perhaps its more concerning clinical students rather than step 1 takers. but here goes:

ive just recently started my clerkship and observed this during my obgyn lab rotation:

the lady was in labor and she had on her gown (but it didnt cover her chest) and her legs werent covered either so she was all out there in the common ward with 3 obgyn specialists around her, 2 other nurses and 3 other residents (me and 3 other friends were far in the background because we didnt wanna crowd the area even more). now as it was shocking to us that the lady wasnt covered efficiently, the culture shock didnt end there for us. here (where i am studying currently), they stimulate the production of oxytocin release by massaging the lady's breast so she would milk whilst asking her to push. bearing in mind that she was already given an ergotamine jap, we dont understand the need for the extra oxytocin stimulation? also, if she starts milking before the baby is delivered, wont that be her colostrum and then when she starts feeding, the baby wont have it because colostrum only lasts 20 mins rite? did i get this rite?

now my question:
is this the same procedure for child birth in the US? cos in malaysia (where i come from), this is a law suit at hand. disrespecting the lady for one, but milking her?? she aint got udders. :confused:
 

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Discussion Starter · #3 ·
Now if this happens in your country but all the doctors and residents were all females, would it still qualify for a law suit?
of course. no double standards there.
child birth is usually really touching. i actually love watching it especially when the child makes its first cough and cry. i just couldnt get over this though. unless i havent seen enough child birth and this is quite normal. is it?
 

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Discussion Starter · #4 ·
so we asked around and it turns out that there is a reason for what we think is inappropriate but is actually in fact quite normal here.

this patient in question had a CPD so it was a 2-hr late neglected pregnancy + PROM. the whole time she wasnt on pain killers and an episiotomy was done using lidocain about 2 hrs post PROM. the sad part: lidocain was believe it or not, diluted. yes, it was diluted with saline so the dose she got was lesser than the needed but enough for a short while. all this because she couldnt afford it. she couldnt even afford a cesarean section which would have immediately saved her baby, but there was no choice and she was forced to push the fetus. the vacuum spoiled half way through the procedure so forceps were used and well, i darent asked what happened cos everyone seemed to be shouting especially the residents, but the baby's head was detached. so i guess an unsuccessful delivery? well the lady was in so much pain afterward that she had no reaction to the death of her new born (who had a beautiful heart rate of 140, 20 minutes prior to birth as heard on the USG). it was a beautiful baby boy with no deformities. sadly, this is the procedure here. with no money they do what they can. the teaching hospital here caters for low SES patients. and if they have no money, they are left unattended or attended with manual care without any pain killers. the doctors do their best i guess.
the part which is of benefit to us students: after all episiotomies, we get to stitch the patient up. and well, we get to learn from a lot of mistakes (not quite so ethical i know, but not all parts of the world have proper medic care).

ps: i was wrong earlier, the patient was not given a uterotonic med because she couldnt afford it, hence the stimulation of breast so milking will cause release of oxytocin to help uterus tonicity.

i guess its just about getting used to the way things are done here and appreciating life as it is. I do sincerely hope that someday people ALL around the world get proper and EQUAL medic care.:) AMEN.
 
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