Thursday, February 4, 2010

I arrived to the ward this morning to sounds of many women wailing. Someone was sobbing and crying out. At first I thought someone was having a difficult labor and was in a lot of pain but as I walked up to the desk the midwives informed me that the baby that was born a few days ago with meconium aspiration and just died a few minutes before I arrived. They lost two babies in the ward last night, another one had died a few minutes after birth due to meconium aspiration also. In my grief and loss class my teacher Beth Coyote had told us about the wailing in St. Lucia when there was a death there and I kept thinking of that as I walked the halls. Eventually the grandmother carried the baby out of the nursery with family and the midwife following to bring the baby to the morgue. They had to hold the mother up as she walked sobbing. A few tears dripped down my face and the midwives giggled at me. I am definitely not used to accepting that kind of loss like they are. It is a good learning experience. In happier news there were triplets born there yesterday. The women came in expecting twins while I was there on the evening shift. I waited well into the next day and finally exhausted they convinced me to go home and rest, when I woke from my nap I was trying to decide between getting some dinner and going to the hospital and I decided to eat and missed it. So bummed, I will probably see another set of twins but not likely triplets. There are all healthy and doing well and weigh about 2kg. Everyday since I have been here the ward has been "full up." Every bed full with mothers in labor wandering the hall waiting to deliver. They have had 41 babies as of 3 o'clock this afternoon already in feb. Thats almost 10 per day. I have done 5 deliveries in 3 days. One of them today hemorrhaged. They actively manage here, which means they give meds to stop bleeding before the placenta comes to prevent women from bleeding. Most women dont lose much blood at all and I had already gotten used to it. When this mom kept bleeding and bleeding, filling up one bowl after another, my heart was pounding I gave her all the meds I had available to me while one of the nurses put in an IV. I kept massaging her uterus trying to express clots and get it to clamp down and this mom was screaming at me and pushing my hand away. We sent for the doctor and just as he arrived they put some syntocin (anti-hemorrhage meds) in the IV and the bleeding slowed. I stayed with her for about an hour keeping an eye on her blood pressure and then when the nurses decided she was stable enough to move to postpartum I was helping her to the wheelchair and she collapsed in my arms, I set her on stool and she came to, she kept trying to shake her head to "get clear" The midwife brought her some warm water with sugar and after a few sips we got her into the wheelchair and back into bed. I went out to the store by the hospital and bought her a box of juice and some crackers hoping some food would help her energy and improve her blood pressure. They were so grateful, it made me want to buy crates of juice so that we could give them to every mom postpartum.

2 comments:

Bernie Roland said...

What an emotional roller coaster! The Vanuatu experience provides lots of hands on dealings with the physical and physiological challenges of the birthing process. Equally as important is dealing with the emotions and psychological well being of the mothers. Most important is the young physician's opportunity to experience decision making under stress... with life and death happening, not just threatening. Learning to Keep a "clear" head to make good decisions while under such stressful conditions is what makes the "Sully Sullenbergers" of Naturopathic medicine. (http://en.wikipedia.org/wiki/Chesley_Sullenberger)

Unknown said...

40 babies in 4 days- holy cow- they are keeping you busy!