Third placement: Antenatal Clinic

This placement is where my reflective journal habit went out the window a little so I apologise if this is a little more vague than my previous placement posts!

 

I had two weeks on antenatal clinic and I adored it. Every woman is different but because of the amount of people I saw on ANC it seemed like it was an incredibly varied experience.

I observed booking appointments, tests for gestational diabetes, the diabetic clinic, ultrasounds, and the local clinics for checkups. I sat in with the doctors for the local clinics and saw women at a variety of gestations with a huge range of different needs.

I also got the chance to go to the gynae clinics and see other aspects of reproductive health that midwives probably don’t regularly deal with. But everything – from painful periods as a young adult, PCOS investigations at age thirty, and searching for the right way to manage incontinence in later life – it either impacts or is a result of pregnancy. So it was really great to sit in on those appointments and get more of a holistic view of reproductive health outside of pregnancy.

 

My favourite aspect was probably the local clinics. I loved that the hospital made care more accessible to families by sending us out to their areas. It was also a great way to practice my clinical skills – I had the vital signs and urinalysis learned down fairly well by the end of the two weeks! It was interesting to see all these families come in, all with different stories and different sized bumps, and I really enjoyed looking after them even just for a few minutes.

Image result for antenatal clinic

So that’s my antenatal clinic experience as a first year. I really enjoyed it, I loved the variety of care, and the lovely atmosphere that the staff made for each other and for the families we looked after. Keep an eye put for my post on what was in my pocket for this placement coming soon.

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I’m going on an adventure!

If you follow my facebook page or my instagram you’ll know that after years and years of dreaming, I have booked to go on an elective midwifery placement in Cambodia for six weeks in the summer of 2019.

 

I’ve been dreaming about this for as long as I’ve been dreaming about midwifery. I’ve looked at multiple companies and locations. Ultimately I decided to go with Work the World. They have no age limits, a good ethical history, and were so helpful with all my questions (of which there were many) before I actually dived in and booked.

So in March, just before my second placement block, I went ahead and booked my dream. I don’t think the reality of booking it really hit me until a few days later, then I started crying and literally hopping around the place with excitement! I think my parents still don’t really believe that I’m going but there is absolutely no stopping me now! Especially as one of my loveliest classmates has booked to come along with me on this amazing journey.

 

I feel incredibly lucky to be in a position to start this adventure off. Booking alone cost €350 and with extra costs like vaccinations and flights I can easily see this tipping into €4000 by the time it’s all added up. So I’ll be doing a lot of fundraisers over the next year to earn as much as I can. I’ve already done the 2018 Women’s Mini Marathon, splitting what I raised between my fund for this trip and the Rape Crisis North East centre. I’ve set up a GoFundMe (link here) where anyone and everyone can vote on whether I should shave my flame hair or save it. And I’m hoping to make use of my self care hobby – cross stitch!

Cross stitch was something I detested in Junior Cert Home Ec, but I’ve learned to love it. It’s methodical, it’s routine, it’s hard to make a mistake. And it’s not an expensive or messy hobby, which is a bonus. A few girls in my class have asked me to make similar pieces for them so the little bit of extra money I make from them goes straight into my adventure savings!

 

I’ll keep updating as things develop but for the short and sweet versions make sure to follow our facebook page here

Talk about it: Primodos

You may have seen the documentary on Sky News last week on Primodos, a drug given in the 1960s and 1970s as a pregnancy test and the cover up of its adverse affects (you can read the full Sky article here or watch it here). I thought it would be an appropriate topic for Talk About It.

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image via Sky News

The doc was presented by Jason Farrell, and from the start you could tell that this case has stuck to him. He’s invested. He and his team have been working for six years investigating Primodos, and have met with the affected families. It would be hard to not be invested.

So what is Primodos? It’s two tablets, containing the synthetic hormones norethisterone acetate and ethinyloestradiol. It was given as a pregnancy test in the UK between 1953 and 1975 – you took one tablet the first day, and another the second day. If a vaginal bleed occurred, you were not pregnant. If there was no bleed, it was considered to confirm the pregnancy.

Norethisterone  is used in lower doses to treat abnormal bleeding from the uterus, endometriosis, and amenorrhea. It is also used in the contraceptive pill and the emergency contraceptive. There is speculation that it was also used as an abortive in other parts of the world – the documentary cites it being used in South Korea by prostitutes.

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image via the Daily Mail

Primodos is reported to be 40 times the strength of the contraceptive pill. Families have been campaigning since the late 1970s, claiming that Primodos caused birth defects such as limb loss, heart defects, miscarriage, still birth and infant death. It was heart wrenching to hear the parents speak of the guilt they felt. One mother said that she blamed herself until she was given another answer, when other parents started reaching out. Campaigning seems to have begun with Dr Isabel Gal, a London paediatrician who raised alarm bells in 1967 with a study suggesting a link between the Primodos test and birth defects. There were corroborating studies, and there were also opposing studies. IFLScience states in an article that the “effect of synthetic hormones on embryonic development is not well studied and their effects can depend on timing and exposure.”

So there’s conflicting scientific information (as there pretty much always is). But after Dr Gal’s claim, a lot started to happen with the drug. In 1970, its licence as a pregnancy test was removed. In 1975, a warning was placed on the packet (above). And in 1978 it was voluntarily removed from the market, given the advent of the pregnancy test we all know and love – the pee stick. At about the same time that this was going on, an internal review was being carried out. Dr William Inman, who at the time was the principal medical officer for the UK government, conducted a study over five years. He reportedly made a finding  that women who took a hormone pregnancy test like Primodos “had a five-to-one risk of giving birth to a child with malformations”.

Farrell’s documentary reveals that, bizarrely, Inman tipped off Schering (manufacturer of Primodos) and seemed to want to avoid them facing any medico-legal challenges from families. This is a part that I can’t get my head around at all. Inman is in a position where it is his function to review medications, appraise their safety and effectiveness, and recommend action to UK regulators or the government. He had pt i place earl warning systems to detect drugs exactly like Primodos, that had adverse effects. But he doesn’t do that. He destroys evidence of his study “to prevent claims.” It’s just not weird, it’s totally unethical. He went on to write to Schering, discussing Dr Gal and her study. According to Sky News, he states that “we’re defenceless” against legal action because of the delay in possible associations being reported, and the drug being withdrawn. A Schering lawyer wrote that the company was like to be found guilty in a court case due to a “breach of duty.”

Image result for primodos warning label

 

But don’t they test drugs before they give them to people? Companies are absolutely supposed to, legally and ethically it falls under their duty of care (and of conscience, I would imagine). But it appears that Schering failed to carry out any kind of toxicology testing before Primodos was released in the UK and Germany. So Primodos seems to be have released to the market, and prescribed by doctors to pregnant women, with no evidence of it’s safety. After the thalidomide scandal (1961), teratogenic testing was common. So what was the reason for it not being carried out with Primodos?

 

To me, it’s just unbelievable. I know I’m speculating based only on what I’ve seen on the Sky documentary, and the articles I’ve since read trying to understand the situation. But there is just so much wrong with this. It’s in a way worse than the thalidomide scandal. Before thalidomide, there was no inkling that anything like this could happen. Babies were safe in wombs, regardless of the medication given by your trusted GP (who in turn trusted the charming pharmaceutical reps). But after thalidomide, there was new awareness. There was testing. There should be accountability. Let me know what you think about Primodos and about Inman’s disappearing report. I’ll leave links to the articles I used for this post below. You can read stories from the families here, on their website. ❀

 

SOURCES: IFLScience, the GuardianMedicines in Pregnancy

PINKOUT: I stand with Planned Parenthood

Today, March 29, is a Planned Parenthood day of action called #PinkOut. I actually only realised slightly late in the day (I’m researching and writing in a bit of a panic!) but it’s a great opportunity to talk about some of the reasons that Planned Parenthood is so important for women and men alike.

So let’s start with that. I think there’s an idea out there that Planned Parenthood serves women (primarily women accessing abortion services). Wrong! While 1 in 5 women visit during their lifetime (there was no similar statistic on men), PP offers a huge variety of health services to women and men – 2.5 million per year across the US according to their website.

But what are the services? It’s mainly prevention of unintended pregnancies – hormonal control like the pill or IUDs, condoms, and vasectomies. PP services prevent about 579,000 pregnancies per year. Not to mention all the STI testing and treatment they provide – 4.2 million per year. HIV tests alone account for 650,000 of that number.

And then there’s the health screenings. Planned Parenthood carries out 270,000 Pap tests a year, and 360,000 breast exams. Planned Parenthood does a lot of the work in catching cancer early. As well as this, PP carries out a lot of general health work including cholesterol tests, diabetes screening, administering flu vaccines, helping people to quit smoking, and basic physical exams.

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But what about the abortions?

Abortions come to about 3% of Planned Parenthood’s work. That little 3% might be because they do so much for education in sexual and reproductive health, reaching 1.5 million kids and adults every year. That number in particular makes me giddy with happiness. Sexual and reproductive education is SO important, and it’s something I’m passionate about. Once the eighth has been repealed here in Ireland, my activist mode does not turn off. It switches straight to clear, factual, and broad (as in not hetero-normative) education.

So what is this whole #PinkOut craic? Basically, they want the internet pinked out to show the US government that people stand with Planned Parenthood, people need Planned Parenthood, and people are better for Planned Parenthood being in the world (they actually do a lot of global good by being a member of the International Planned Parenthood Foundation, like our own lovely IFPA).

There has been a lot of talk about “defunding” PP over the years, and it’s been a real fear since Trump was elected. However an attempt to do so was blocked quite recently. But the threat to Planned Parenthood remains. Planned Parenthood want Congress to realise that defunding will never happen (75% of Americans oppose defunding), and to hear the big pink message “do not block access to care at Planned Parenthood. Not now. Not ever.” ❀