Friday, September 13, 2013

Women Inspire

It's Friday the 13th. But don't worry - no freaky stories to be told. I woke up at 4:30 this morning to dogs barking and roosters crowing. Since I went to bed at about 9:30 the night before, I guess I'd gotten enough sleep. The sunrise was incredible, though. I can see it right from my hotel window. I can't wait to take a day off to explore all this island has to offer.
I woke up with enough time for blow-dry my white scrub pants again. It's so humid that nothing really dries here. So I spend about 30 minutes with my hair dryer blasting my clothes for the day dry each morning. I'm sure my neighbors love me. I have to wash them. It wouldn't be okay to wear them otherwise. Birth can be messy.
I look forward to breakfast each morning - since it will likely be my lunch as well. It is included with the cost of my room. And it's actually quite good - eggs, a rice pilaf-type dish, some sort of sausage, fruit, toast, muffins, etc. I eat a little and take the rest with me to the hospital to have for lunch. Even better - after several days of not knowing - I found out I get a free coffee with that breakfast. Espresso even. I feel spoiled.
Everyone at the hospital wears sandals. Even the foreign students, midwives, and doctors. I don't understand this. We go through the charts and see all the infections some have...and even worse, don't see much of what some others have. I've been blasted a few times with a popping bag of waters all over my feet or on my clothes. Needles have been dropped, medication vials crushed on the floor, AND there are a few resident mice and rats crawling around the hallways...Why even take the risk? I don't think "when in Rome" applies in this situation.
Friday was a great day in the maternity ward. These women of Vanuatu are just incredible. They are so strong. Some are so quiet that you barely know they are in labor.  Just a little sound here and there, and then they're all of a sudden pushing - quietly of course. Yeah, there are others that will squirm around on the bed. I've actually seen a few women putting their legs nearly back to their ears - straight, not bent like you'd think). I've almost been booted across the room a couple times. But hey - whatever it takes to get that baby out! Most women's pushing stages are quite short here - we were talking about how it might be due to the fact that they spend a lot of time in the squatting position. This might help form the hips in such a way that the head can get through a bit easier.
Three babies today during my shift. All three were boys. Two of the women required suturing. The first one had her cervix come down to where you could see it, so we used gauze again to put it back in place. This seems to be happening too often, they start pushing before they are completely dilated and just can't stop pushing. The second mom's waters had been broken for nearly 40 hours. The baby's heart rate was hanging around the 180s. She was contracting about every 3 minutes with good strong contractions, was 8 cm dilated, and they put her on Syntocin to augment her labor. I don't really understand why. She would have done just as well without it. We were concerned for this baby, thinking that this mom might have a bit of a longer pushing stage because it was her first baby - would this babe be able to handle it? Well very shortly after they started to augment her, she said she felt like pushing so we went over into the labor ward. She pushed like a champion, and as that head came out, so did the thickest meconium I have ever seen. Meconium streaming out of the nose, the mouth. Covering the face, the ears. When that baby, a large baby at that, came out, we had to do a bit of suction and a little free oxygen - but he started screaming just fine. He pinked up really well. His heart rate stayed up at about 180 for quite a while, with a respiratory rate of 70 (high) and a bit of a temp. Mom also had a temperature, her respirations were 30, and her pulse was staying around 120. It was apparent that the mom had an infection and we were concerned about the baby too. The baby doc came in, though, and said that the baby was fine. Antibiotics were given to the mom. We were really hoping they'd give the baby antibiotics too, but none were given before I left.

Yep. I'm working the weekends. But it's so worth it. A shorter shift today. Two lovely, very strong women had their babies. The first one was a first time mom. She had had several CTGs throughout two days that showed regular early (and occasionally late) decels. They continued to monitor her every 3-4 hours and gave her IV fluids. When I arrived this morning, she was about 6 cm dilated. Not too long after, she was feeling pushy. Babies heart rate continued to go down...into the 60, 50s, 40s. Thank goodness these women have short pushing stages. Just a minute later she pushed out a beautiful baby boy with great APGARs. That's the 7th baby boy in a row. She had a few bad 2 degree tears that took an hour to repair. Partly because I go slowly, but partly because it wasn't straight forward. Unfortunately is was about 100 degrees in that room, with a bright light shining down on me, and 95% humidity. I sweat easily, so you can only imagine what I looked like when I finished. Then finally a girl! A sweet young woman arrived at the hospital having had no prenatal care and unsure of her dates. She was measuring 34 cm. Baby didn't feel too small though. That baby was also having several decels. We brought her into delivery. She was nearly complete and ready to push. After a very short pushing stage, she delivered a sweet little baby girl - probably about 37 weeks gestation. They named it after the student midwife from New Zealand who's birthday it was today as well. I also have a little baby girl named after me. They like to do that here - name their babies after you. One of the midwives from New Zealand that's been here for 3.5 years has dozens of babies named after her. She started requesting that they start using her kids names instead.
We got done early, got showered up, and are relaxing by the pool and listening to live reggae music. Tonight we'll go down to a local pub and watch rugby and celebrate the student midwife's birthday with a bunch of other locals.
I am so appreciative for the experiences I'm having here. It has been so wonderful and the women have been inspiring. I look forward to starting my second week. I can't believe how fast the first week has gone by!

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