Tuesday, February 17, 2009

Private Practice: "Acceptance"

I don't watch much television - for the most part, I'd much rather read. Especially because it seems like so much on tv is crime drama, and watching shows that feature violence against women & children just doesn't feel like entertainment for me - more like fodder for anxiety & nightmares. So! There are a few things I watch, like American Idol... The Office... 24... And Private Practice: I like the characters, the drama, and school or medical dramas have always been my favorites (I still miss Boston Public and Everwood). Does anyone else watch it?

I'm wondering because the show two weeks ago, "Acceptance", just about made me do my crazy-shriek and wake up the kids when I watched it. We had it on tape, and I thought: now this, THIS *#$&($#, would be perfect to show in my classes when I talk about informed consent looks like - or doesn't look like. And I planned to blog about it. But then we taped over it. And I didn't want to blog it without a transcript because I started thinking, well, maybe it wasn't as bad as I thought.

Then I taught an early pregnancy class through our local continuing education department (if you're local, look for this class in the Monmouth/Winthrop continuing ed course offerings) and both of the families who attended had seen this show, and brought up the vacuum extractor. And that got me thinking again about how this show might seem to someone who was watching it as strictly entertainment, without the critical-thinking part of their brain on high alert. I know I don't watch most tv ready to jump up & down with the crazy-shriek of "how could they do that??" primed.

Then I thought of looking on the ABC page to see if they have free past episodes, and they do! So I could type out a transcript of this tiny scene, just to make sure it was as bad as I thought: it's four minutes into the episode, which can be viewed here.

The characters are:
Dell (the office manager/midwife-in-training),
Addison (neonatal surgeon/OB)
Laboring mom
Worried dad

The scene is in the Private Practice birthing room.
Dell & Addison are in scrubs.
Mom & Dad are in scrubs with hair coverings.
Mom is covered in blue drapes so she & Dad can’t see anything.
Mom is flat on her back, hooked up to fetal monitor.


Dad: “Why is it taking so long?”

Dell (hushed voice to Addison): “She’s still at +2”

Dad: “What does that mean?”

Addison: “It means that labor is not progressing and the baby has variable decels. We’re going to need to perform an assisted delivery to help guide the baby out. It’s VEEEERRRY safe. Dell would you prep the vacuum extractor please.”

Mom: “The vacuum WHAT?”

Dad: “It’s going to be fine honey.”

Dell (whispered aside to Addison: “I’ve never done one of these!”

Addison (aside to Dell): “It’s okay. I’ll guide you through it. ‘Kay. Place the cuff directly on the vertex. Good.”

Addison (to parents): “Now Maggie, when I tell you, I need you to push as hard as you can and while you push we will take the baby out. Okay?”

Mom gives a nod with scared look on her face.

Addison: “Okay.”

Addison: “Ready… and push!”

Mom: “AARRRRGGH!!!!”

Addison: “That’s great, Maggie. The baby’s crowning.”

Mom: “Take it out take it out take it out.”

Mom: “AAGH.”


Dell: “It’s a girl. A baby girl.”

Addison: “Congratulations!”

Dell (aside to Addison): “Discoloration on her head?”

Addison (aside to Dell): “Hematoma. Happens sometimes with vacuum delivery.”

Dell (aside to Addison): “Her apgar is low.”

Addison (aside to Dell): “Dell. Don’t worry. It’s fine. You did great.”
Anybody else see huge red flags?

In case you want to read a summary of the whole show, here's a link to a Yahoo summary. Here are the most relevant parts of the summary, for my purposes:
Dell and Addison are continuing the delivery. The father wants to know what's taking so long, and Addison tells him the labor's not progressing (still at "plus-2") and that the baby has "variable D cells," [sic - decels, or declerations in fetal heart rate] so they are going to have to help guide the baby out through assisted delivery. She instructs Dell to get the vacuum extractor, a term that freaks the mom out -- as it would any sane woman. Dell has never used one of these, but Addison has him do it anyway. It basically looks like Dell is holding onto a hose and pulling it out of the woman, which I guess is what's happening, but the other end of the hose is attached to the baby's head. The baby's out before we know it, and Dell's freaking out about the shape of the baby's head. Um, seriously? Has he never seen a newborn baby, because I am no expert, but I have seen several of them with crazy head shapes. That's because heads are too big to fit through a hole that size [!!!!] so they get misshapen. Addison tells him it's normal to have a head like that with a vacuum delivery, but he's still worried. She tells him not to. He worries some more.

. . .

Dell comes in to Violet's office and sits next to her on the couch . . . He tells her he thinks he might be a pretty good midwife, and she says she thinks he is. It's a really sweet moment, and I'm glad Dell got it, even if his story seemed sort of insignificant otherwise.
I'll post more tonight or tomorrow. We're off to the children's museum to watch a presentation on "scales and tales" and then to a friend's house for some sledding.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
New Mothers Support Circle

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Anonymous Anonymous said...

I echo the mom -- ARRRRGHHHHH!!!!

Yeah, love the "informed consent" they gave her! And the fact that they tried other measures, like getting the mom upright -- NOT!

Ok, gonna stop now before I ***really*** start to rant! :-)


February 17, 2009 at 9:37 AM  

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