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Using narratives to inform practice
Published in Alison Brodrick, Emma Williamson, Listening to Women After Childbirth, 2020
Alison Brodrick, Emma Williamson
As discussed earlier, memory is not a camera snapshot of an event. Time and spatial awareness can be blurred, as too the dialogue and intonation of the speech used by healthcare professionals. This can often be corrected or given context as part of the reflect and reappraise stage discussed in Chapter 4. There have been times when women have repeated a phrase used by a member of staff that is well known and seems innocuous; it is about understanding and accepting that even with the best intentions at that point for that woman, it was not helpful. Often it is not the actual phrase or words but the meaning that is subsequently attached to it by the woman. If a woman with symphysis pubis dysfunction, who has found lying down very uncomfortable since thirty-five weeks and has been awake and in pain with contractions for the last thirty-six hours is met by a busy midwife who says briskly ‘just hop up here then’ whilst patting the bed, the woman may attach the meaning ‘she is being unkind’. The meaning attached to this comment then becomes a lens through which she views the episode of care and further interactions with staff. Given another context the phrase may not even be remembered. This example also leads back to the debate around caring for women within a continuity model: had she been met by a midwife who she knew and trusted, and already held in positive regard, would the scenario play out the same?
Operative delivery
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
OVDs are traditionally performed with the patient in the lithotomy position. The angle of traction needed requires that the bottom part of the bed be removed. In patients with limited abduction (such as those with symphysis pubis dysfunction), it may be necessary to limit abduction of the thighs to a minimum. It is the operator’s duty to ensure that the bladder is emptied.
Pubic Bone Pain in Pregnancy
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Anushka Thalayasingam, Sharmistha Williams
Diseases involving the pubic rami and/or the symphysis pubis may be mechanical (symphysis pubis dysfunction), idiopathic (osteitis pubis), inflammatory (osteomyelitis), or metabolic (osteomalacia). The commonest condition in pregnancy is symphysis pubis dysfunction.
Minimal-contact physical interventions for pregnant women with musculoskeletal disorders: a systematic review of randomised and non-randomised clinical trials
Published in Journal of Obstetrics and Gynaecology, 2022
Chukwuebuka P. Onyekere, Grace N. Emmanuel, Benjamin C. Ozumba, Chinonso N. Igwesi-Chidobe
For pubic symphysis pain, Flack et al. (2015) reported that flexible neoprene belt reduced pain intensity more than rigid nylon belt. However, pain preceding 24 hours decreased in the flexible belt group compared to the rigid belt group while combining the two groups, pain intensity preceding week also decreased overall. Depledge et al. (2005) reported that verbal and written education about the anatomy and pathology of symphysis pubis dysfunction and self-help management, multimodal home-based exercise plus rigid/non-rigid belt reduced pain intensity. However, on group comparison, there was significant reduction in pain intensity for the exercise-only group and the group receiving exercise plus a rigid belt but not for the group receiving exercise plus a non-rigid belt (evidence: high).