Help from my OB/GYN friends?

Specialties Ob/Gyn

Published

First - let me thank you all in advance for allowing me to jump on your board.

Need some advice. I had an interesting day today! I'm a School Nurse and my

day went from strep to lice (always fun) to various psych meds to "I just started

my period"" to possible wrist fx from skating in gym to "I think my water broke!!" Yikes!!

This is the first time this has happened to me in my 12 yrs. Young teacher G2 P1 (See -

I did pay attention in that OB rotation years ago) toddles into my office. I saw that

she was "leaking." I am trying to wrack my brain for what scant OB knowledge I have.

So this is what I did: Contractions? "No - just some general tightening across belly."

How many weeks? - "37.5 (whew) VS stable. No - don't finish your lunch.

Called her OB (come to the office) and her hubby (Guess you won't finishing those

errands today) and basically just kept her calm and kept the "Looky-loos" out of the area.

It did get me thinking though - Is ther anything else I should have done?

I have two more teachers due within a few weeks. The only interaction I usually have

with the pregnant staff is to let them know what's going around that could harm them and baby,

occasional BP checks, and answer "normal" pregnancy questions. This obviously wasn't

"boil the water - I'm gonna birth a baby" but what if it was or if she wasn't so close to term?

At what point or under which circumstances should I activate EMS?

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You did fine....water breaks all the time......

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Specializes in Maternal - Child Health.

There are very few OB "emergencies" that can't safely await transportation to the office or hospital.

Instantaneous deliveries are the stuff of TV dramas, not real life. Unless you have a teacher (hopefully not a student) who is a grandmultip, a precipitous delivery is highly unlikely. Even a mom who goes into labor extremely prematurely will not likely deliver without warning. Since s/s of preterm labor differ from term labor, it might be a good idea to brush up on this information, so you'll recognize it if/when a staff member complains of vague symptoms such as low back pain, irregular mild cramping, pain or pressure in the pelvic area or thighs.

The only 2 scenarios I can think of that warrant a call to 911 are a suspected abruption and severe pre-eclampia. Anyone in severe pre-eclampsia will be too sick to be at school, so you shouldn't have to worry about that. A mom with a suspected abruption will c/o abdominal pain, may have a rigid abdomen and may or may not be bleeding heavily from the lady parts. (With a partial abruption, the blood is sometimes "trapped" within the portion of the placenta that remains intact. In any case, the priority is emergency care so that an IV and O2 can be started en route to the hospital.

You did just fine. Did she have her baby that day?

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Thanks for the info. My post does probably sound silly to you you guys and gals

that see this every day but I'm used to dealing with the "little people" so this

situation is out of my comfort zone. I will definitely brush up on the suggested

topics.

Last I heard - Mom is progressing quite nicely and will probably deliver tonight.

When she comes back to work she can bring on all the baby questions - I've got

that down pat ;)

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Specializes in Community, OB, Nursery.

The only thing I'd like to add to Jolie's post:

If somebody truly is delivering precipitously, that baby is going to come regardless of what you do or don't do. Pretty much all you do is stand there and catch. You really don't even have to cut the cord, and EMS ought to get there well before Lady Placenta needs to be out.

You did the right thing in calling the OB & hubby in this scenario, though. :)

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