Wednesday, October 20, 2010

20 babies and counting...

Hi again. Still love it here.
Last night was kind of a blood bath at the hospital. Both Susanne and I left covered in blood, amniotic fluid and sweat. But it was a good night, between the two of us we helped 4 babies be born. The first baby was the woman's fourth, easy easy.

The second and third (Susanne and I each had one) had similar labors. Both had an induction of labor with a 1/4 tablet of cytotec inserted into the cervix. Hours later both had labor augmentation with a drip of syntocin (same at pitocin or oxytocin). Then both took forever to fully dilate and ended up delivering the babies the same minute (8:10pm). During the whole labor we thought my woman's baby was OP (occiput posterior) due to the funny shape of her belly. There was a lump high up near her fundus and then a dip and another lump low down. The midwife in charge said that was classic for OP, but I had never seen a belly like that before. Eventually, I put in a urinary catheter hoping to speed things up a bit, nearly 400ml of urine came out (a lot!!) and the lump at the bottom was noticably smaller. So I wonder if it was just a distended bladder we were seeing for a long time. Poor momma. Baby was born with a nuchal hand and a nuchal cord, but she only had a very minor perineal tear. I sutured it up, perhaps my best work yet. I really and getting better at suturing. It is amazing what a little practice can do! Ha.

Susanne's momma had a retained placenta. 35 minutes postpartum the placenta was still inside, and this was with active management (giving 10 units syntocin with delivery of the baby). The midwife in charge called the OB to come and he did a manual removal. I don't know the whole story, as I was busy with my woman, but I saw him deliver it in chunks. She lost a lot of blood, and that was a mess to clean up. Blood everywhere.

The fourth baby was the quickest ever. I admitted the woman, checked her cervix (6 cm, BBOW, -1 station, 80% effaced) and listened to baby. Took some vitals and AROMed her (artificial rupture of membranes). She was told to go on a "walkabout" and when I saw her next she was lying on the bed with the baby crowning. I barely had time to put gloves on to support hte perineum and the head was out. Head and shoulder came out no prob, but when I had to PULL the baby out once it got to the umbilicus. That baby was huge! 4.3 kg (umm...over 9 pounds). A fat, happy baby. And a small small tear which I let Susanne suture.

Hmm...what else is new. Soaked up the sun some more yesterday on Erakor island. Ohh! Today we leave for an overnight trip to the island of Tanna where there is a live volcano. I am so excited! My whole life seeing a live volcano has been on my to-do list. Yay. I hope it doesn't rain, which could affect visibility. I even had a slight nightmare last night that we couldn't make it there (they wanted to see our birth certificates and we didn't have one and then my mum's car broke down and we never saw it). But, hopefully that will not be an issue.

So that is all for now. Elias, yes please post the comments I don't know how. Hope all is well!!
Peace and love (and delicious sweet potato hashbrowns...)

No comments: