Leah Hazard has been a midwife for nearly 10 years, supporting thousands of families in labour suites, ante- and postnatal wards, triage departments and community clinics. She continues to work at a large maternity hospital in Scotland 🖊️ By hazard_leah
– The shift has got off to a relatively gentle start: we’ve seen a few women whose waters have broken overnight, as well as some with bleeding and reduced movements. Sometimes, though, I’ve already caught a baby by breakfast; although most women make it to the labour ward , some babies are in much more of a hurry and are born in our department, or in the car park. I’m lucky that today has been fairly calm so far.
Another ward has asked for one of us to help with their drug round; I speak to the hospital coordinator to update her on our workload. Many days in maternity feel like one long game of robbing Peter to pay Paul: midwives are often moved to fill gaps in ward staff, but that always leaves somebody else short.– Finally, it’s safe to stop for lunch. Our tea room is a windowless box, so I often like to go for a walk and eat outside if weather permits.
My heart leaps with anger; many women attend our hospital for essential abortion care after learning that their pregnancy has a life-threatening complication. These women are in a state of deep grief, and they are treated with the utmost compassion and skill. In Scotland, legislation is under way to enforce buffer zones around premises like ours where terminations are carried out , but the process is frustratingly slow.
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Efficacy of first dose of covid-19 vaccine versus no vaccination on symptoms of patients with long covid: target trial emulation based on ComPaRe e-cohortObjective To evaluate the effect of covid-19 vaccination on the severity of symptoms in patients with long covid. Design Target trial emulation based on ComPaRe e-cohort. Data source ComPaRe long covid cohort, a nationwide e-cohort (ie, a cohort where recruitment and follow-up are performed online) of patients with long covid, in France. Methods Adult patients (aged ≥18 years) enrolled in the ComPaRe cohort before 1 May 2021 were included in the study if they reported a confirmed or suspected SARS-CoV-2 infection, symptoms persistent for |3 weeks after onset, and at least one symptom attributable to long covid at baseline. Patients who received a first covid-19 vaccine injection were matched with an unvaccinated control group in a 1:1 ratio according to their propensity scores. Number of long covid symptoms, rate of complete remission of long covid, and proportion of patients reporting an unacceptable symptom state at 120 days were recorded. Results 910 patients were included in the analyses (455 in the vaccinated group and 455 in the control group). By 120 days, vaccination had reduced the number of long covid symptoms (mean 13.0 (standard deviation 9.4) in the vaccinated group v 14.8 (9.8) in the control group; mean difference −1.8, 95% confidence interval −3.0 to −0.5) and doubled the rate of patients in remission (16.6% v 7.5%, hazard ratio 1.93, 95% confidence interval 1.18 to 3.14). Vaccination reduced the effect of long covid on patients' lives (mean score on the impact tool 24.3 (standard deviation 16.7) v 27.6 (16.7); mean difference −3.3, 95% confidence interval −5.7 to −1.0) and the proportion of patients with an unacceptable symptom state (38.9% v 46.4%, risk difference −7.4%, 95% confidence interval −14.5% to −0.3%). In the vaccinated group, two (0.4%) patients reported serious adverse events requiring admission to hospital. Conclusion In this study, covid-19 vaccination reduced the severity of symptoms and the effect of long covid on patients' social,
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