Saturday, September 7, 2013

Just getting started - Day 1

I fell asleep to reggae last night, which was being played live downstairs at our hotel. It felt like they were playing at the end of my bed, but I was too tired to care. That's just a side note really. I had my first day at the hospital today. I arrived at 6:45 am because I was told to arrive at 7 to do rounds with the midwives and doctors. I should have known that that meant rounds would be at about 9. I enjoyed meeting everyone while we waited though, because they are just so incredibly kind. They all say hello to everyone at home and appreciate the flavored coffee that was recommended as a gift. They also say I should speak Bislama with those of you back home who now speak it. You know who you are. I was given another tour this morning and then there was a lot of waiting. We waited for the doctors. We waited for women that were slow to dilate. We waited for things I didn't even know we were waiting for. The nurses were watching a downloaded movie on the television, while women paced the hallways, families cooked in the kitchen, and the shifts continued to change over. Finally, two doctors came to do rounds and I was told about all the things, surgeries, deliveries, and strange and peculiars that had occurred during the past week. A couple of huge fibroids that surprised them during a cesarean that caused them to do a strange-looking T-shaped incision and will likely lead to a hysterectomy; a couple sets of twins, one term, one preterm, but all healthy; and several tubal ligations, which seems to be encouraged and quite common. I was surprised by this - 21 year old girls getting tubal ligations. The access to and/or education about contraceptives is very limited, but tubal ligations are just so permanent. I won't harp on this. I'll move on.
Today was simple and easy. This really means uncomplicated, because we all know no sane laboring woman will say "that was easy" afterward. And that's not to say being there wasn't tiring, because I always find myself pretty worn out after any birth. The adrenaline just gets you. Three babies were born during my 9 hour shift, all within a couple hours of one another. The first I was helping with, when the midwife said she was going to step out for a moment. I continued to be with this young woman as she was finding her "push." She appreciated some manual pressure to guide her, and soon enough the head was crowning.  Eventually, two midwives came into the room and said "your assistants are here." They were going to let ME be primary. I was surprised, even though I'd heard stories of this. I was happy to do it, though. I felt ready, because birth is birth, no matter which country you're in. One of the midwives got into the young woman's face and strapped her feet down on the foot pads. A few minutes later, that midwife left the room, and her feet were unstrapped so as to pull her legs back and open up her hips. Seconds later, the head delivered - LOA it appeared, however strangely enough, that head that was facing mom's left thigh turned ALL the way around to face the right thigh while letting his shoulder free. Very owl-like. Happy, healthy little baby boy. Next, in the room across the hall, a woman was pushing so I popped my head in to see what was going on. The midwife in that room asked if I wanted to do the delivery. Of course, I said yes! Less than 10 minutes later, a tiny little baby girl was born. The mom was supposedly 35 weeks, but this baby was just over 3.5 lbs. She had a decent suck, nevertheless, and was "labeled" SGA rather than pre-term. Again, across the room, another woman was pushing.  Then, all of a sudden you could hear a huge gush and a good-sized baby girl was born with a lake-sized amount of water behind her. She was vigorous and healthy. The midwives were more than happy to allow me to suture, but today I wanted to learn their styles before I jumped right in. I've always found suturing to the be the thing I'm a little hesitant about. I've always found, all the same, that after I start, I actually enjoy the art of doing it. I'm sure I will get plenty of suturing experience here.
        After leaving the hospital, I took a little walk into town, which was mostly closed down. I grabbed some snacks from the only open mini-market, some peanut butter and crackers, and headed back to the hotel to read and relax.
Things I took away from today: 1) Despite being located in the middle of the South Pacific, the midwives in Vanuatu practice much like the midwives in Argentina, but with more patience. I found that to be very interesting.  2) While I think active management plays an important role in some births, I wonder about the role it plays in those placentas that are really hard to get out (something I experienced today). 3) The people of Vanuatu are so lovely and I look forward to the rest of my days here.

1 comment:

Sally said...

Really enjoyed reading your blog! Sounds amazing!