Student Midwife Life: week 1.2

Time management has really gotten away from me these last few weeks. It feels a lot like there’s so much more to do than I can fit in. Sleeping and eating aren’t things I could put a hold on, so the weekly reflections were temporarily sacrificed. But I’m back! I’ll be posting the catchup pieces over the next week so keep those eyes peeled.

 

This week was even more intense than the last. We started off with our first midwifery skill session, baby bathing, which was a nice relaxing one to start with. We talked about why we would bathe babies on units, and why we might leave it until they go home. Vernix sounds slightly magical, I’ll definitely be doing a bit of research on it in the next few weeks.

Screenshot 2017-10-13 at 20.37.34

We also started on our midwifery theory with one of the most important parts: the pelvis. The first time round, sitting in the classroom, I have to admit that it was fairly mind melting. The language of anatomy is very technical and I’ve always struggled with memorising it, but there’s always a way through! After reviewing the notes when I went home (and ordering a pelvis to study with) I felt a lot more confident.

 

Our clinical skills this week were First Aid, and an introduction to Medication Management. Having been in the college before and completed various levels of First Aid training, a lot of it was familiar to me, but it always help to go over these things.

 

22104711_1996386737315553_8944569346518145973_oI had my first real class rep duty this week as well. I attended the programme board with reps from the other years of midwifery, our lecturers, and our heads of section. It was only slightly intimidating, but everyone is so friendly that it was easy to get comfortable in the short meeting time. We discussed the assessment schedule for the first semester and clarified what components can be repeated or not. It was a brief fifteen minute chat but I found it really nice to be able to put faces to names at last.

 

I finished the week with a teeny tiny bit of protesting: it was the annual March for Choice in Dublin (with solidarity marches around the world). You can read about why I marched here.

 

So that’s it! Another week over and done with, another set of skills studied. Time really is flying away from me. Six weeks from the end of this week, I’ll be finishing up the theory of semester one and getting ready to head out on placement, wherever that may be! Don’t forget to let me know how you’re getting on, wherever you are on your midwifery journey.

 

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Student Midwife Life: week 1.1

I know, it’s a Saturday evening and I planned posts for Friday lunchtimes. But the wordpress post schedule button isn’t working right for me and neither has my planning! This week has just been so busy. I don’t know whether it’s because I haven’t settled into a plan yet or because I was just really unorganised, but here I am on Saturday with so much left to do!

 

This week we mainly had introductions to the modules that we have to complete in the first semester, which thankfully included the provisional assessment dates. My inner planner is delighted that we can make a plan now for the coming semester, right up to winter break. I had a bit of excitement as well: our class group had to choose reps to the student union and to the programme board, and my class have trusted me with half of the job (there are two reps in our class). I’m delighted to be trusted and I’m brimming with ideas to help the class.

 

21768311_1992097634411130_7205036964345981067_nWe had our first clinical skills labs during the week. We covered vital signs: temperature, pulse, respiration, and blood pressure, as well as nutrition support (helping people to eat and drink). For me it was a bit of a refresher, as I’ve done vital obs before. But I recognised that some of my classmates had never held a sphyg or a stethoscope before, and because of our timetable we hadn’t yet covered the theory so there was a bit of confusion. But the tutors were great, so patient, helpful and concise, and everyone seems to have left quite happy.

 

We also had a class on digital citizenship and how we as student midwives, professionals within the HSE, should conduct ourselves. I’ve read the NMBI Social Media Guidelines at least ten times but it’s always helpful to have things explained differently, and discussed in a specific context. You might see a few changes on the blog, on my facebook page, and on my instagram as I talk to some of the midwifery department staff and redefine the lines of what I’m willing to share.

 

28-praying_skeletonWe had our first classes in the Natural Sciences module this week: Microbiology, Biochemistry, and Anatomy and Physiology. Because I did a year of nursing in the college before, I was expecting it. But that didn’t make it much easier. If you’re like me and you haven’t really got a head for hard sciences, it can feel impossible. Just remember, you will get through it. Picture on the left is a very realistic depiction of me, first time round, hoping I wouldn’t fail. And I didn’t! I didn’t hear of anyone failing. It’s all doable one way or another. As midwives we’ll be taught to adapt to any situation, react quickly to whatever we find. No better time to start practising that than in first year sciences!

 

So, how is your course going? What are you enjoying? What subjects are going a bit over your head? Let me know in the comments!

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