Oh it is so sad to leave. Today was our last day at Vila Central Hospital in the maternity ward. The midwives were sad to see us leave and so grateful for our help. They presented Susanne and I with little gifts. We brought a big chocolate cake, biscuits, soda and chips. Not the healthiest of snacks, but they loved it.
Susanne and I each delivered a couple babies today. No suturing though. My first baby was very tachycardic (190-200 beats per minute). We started an IV with normal saline, but it did not help. As soon as she was fully, she pushed so strong she got a nose bleed. I have never seen that before. But baby came out (in moderately thick meconium stained water) and was fine. No problems. Later, she could not pee so we put in a urinary catheter. Out came 750ml of urine! So much. Then I pushed 3 large clots out of her uterus.
Tonight we have gathered a bunch of locals and non-locals to go out dancing. Yay. Then at 7am tomorrow we leave for NZ. Hopefully tonight we won't be out too late :)
Now off to town to pick up a bag of powdered kava to bring a friend in NZ, a quick swim in the pool, kava, dinner and dancing.
Peace and love (and kava!),
Samantha*
**Elias, I never got the CDs but I do have a note for you from MW Sam.
Thursday, November 11, 2010
Wednesday, November 10, 2010
Over 100 births total...
Hiya! Again, sorry about not writing in so long. Total births my whole midwifery career: 107!! Tomorrow is our last day in Vanuatu, I am a bit sad to leave but also looking forward to our next adventure in New Zealand.
I forget where I left off last time, so sorry if anything is repeated. A baby was born was a huge tumor on its lip, which it kept trying to suck. The peds docs did surgery and it looks amazing. That baby will not even have an outside visible scar.
Last Friday there was a 5.1 scale earthquake here. Susanne and I were reading by the pool, and the ground was shaking. She thought I was pushing her chair, haha, but no. I did not hear of any casualties or damage done by it. The funniest part was the reception lady was in the toilet when it was happening and she thought the plumbing was acting up. On a totally separate note, the brand of toilet paper at our hotel is "ABM." I find that quite funny.
Today a baby was born acynclitic (head was a bit crooked coming out). The momma pushed for a very long time, eventually the midwife in charge cut an episiotomy, and baby came out with the longest/most crooked head ever. Both momma and baby were fine. I helped suture the episiotomy.
Lots of other NSVDs (normal spontaneous vaginal deliveries) at the hospital.
Outside of the hospital, we have been having lots of fun! We went to Blue Lagoon, a lovely little lagoon where the water is a mixture of sea water and fresh spring water. There are several rope swings, where first you climb up on a tree and swing into the water. It was great fun, but I have some sweet bruises on my inner thighs from gripping. Ouch. I took a picture :)
We also went to White Sands Beach and swam in the ocean...the proper ocean, not a harbour or lagoon. The water was so warm and nice, and the sand was white and soft. We got a lot of sun that day. Still working on our killer tans :)
Yesterday we went on an island tour to Lelepa island. We caught a small ferry boat there, did a mini medicinal herb walk with a local guide, snorkeled in the sea, had a yummy BBQ lunch, saw a big cave (where they used to take lepers to live out their final days). Then we fed some fish chicken bones (from our BBQ) and bread, while in the water snorkeling. They were right up in our faces, I even touched some. The snorkeling was unbelievable, saw some huge and brightly colored fish and lots of cool coral. Then a boat ride in the choppy ocean where we all got soaking wet, finishing at a little village where I bought my mum a gift :) Overall, a great day.
Tonight we are going out with the lovely NZ midwife Christine for a Korean dinner. Should be good. Tomorrow we are bringing cake and biscuits to the maternity ward for a final goodbye party. And we brought the midwives each a shirt "Support Your Local Midwife". They will love them. Then tomorrow night BIG partying, lots of dancing, maybe a few cocktails.
Our time here has been amazing, life changing and so rewarding. I learned LOADS, had so much fun and feel like a more confident and competent midwife.
Not sure if I will blog again, maybe a quickie from NZ. Thanks for reading and following and leaving comments (if you did).
Be well! Peace and love,
Samantha*
I forget where I left off last time, so sorry if anything is repeated. A baby was born was a huge tumor on its lip, which it kept trying to suck. The peds docs did surgery and it looks amazing. That baby will not even have an outside visible scar.
Last Friday there was a 5.1 scale earthquake here. Susanne and I were reading by the pool, and the ground was shaking. She thought I was pushing her chair, haha, but no. I did not hear of any casualties or damage done by it. The funniest part was the reception lady was in the toilet when it was happening and she thought the plumbing was acting up. On a totally separate note, the brand of toilet paper at our hotel is "ABM." I find that quite funny.
Today a baby was born acynclitic (head was a bit crooked coming out). The momma pushed for a very long time, eventually the midwife in charge cut an episiotomy, and baby came out with the longest/most crooked head ever. Both momma and baby were fine. I helped suture the episiotomy.
Lots of other NSVDs (normal spontaneous vaginal deliveries) at the hospital.
Outside of the hospital, we have been having lots of fun! We went to Blue Lagoon, a lovely little lagoon where the water is a mixture of sea water and fresh spring water. There are several rope swings, where first you climb up on a tree and swing into the water. It was great fun, but I have some sweet bruises on my inner thighs from gripping. Ouch. I took a picture :)
We also went to White Sands Beach and swam in the ocean...the proper ocean, not a harbour or lagoon. The water was so warm and nice, and the sand was white and soft. We got a lot of sun that day. Still working on our killer tans :)
Yesterday we went on an island tour to Lelepa island. We caught a small ferry boat there, did a mini medicinal herb walk with a local guide, snorkeled in the sea, had a yummy BBQ lunch, saw a big cave (where they used to take lepers to live out their final days). Then we fed some fish chicken bones (from our BBQ) and bread, while in the water snorkeling. They were right up in our faces, I even touched some. The snorkeling was unbelievable, saw some huge and brightly colored fish and lots of cool coral. Then a boat ride in the choppy ocean where we all got soaking wet, finishing at a little village where I bought my mum a gift :) Overall, a great day.
Tonight we are going out with the lovely NZ midwife Christine for a Korean dinner. Should be good. Tomorrow we are bringing cake and biscuits to the maternity ward for a final goodbye party. And we brought the midwives each a shirt "Support Your Local Midwife". They will love them. Then tomorrow night BIG partying, lots of dancing, maybe a few cocktails.
Our time here has been amazing, life changing and so rewarding. I learned LOADS, had so much fun and feel like a more confident and competent midwife.
Not sure if I will blog again, maybe a quickie from NZ. Thanks for reading and following and leaving comments (if you did).
Be well! Peace and love,
Samantha*
Wednesday, November 3, 2010
Ups and Downs
Hi again, been so busy lately have not had much time to write...and no access to internet either. Today my friend Jeremi let me borrow his computer, cheers mate!
It has been a whorlwind of emotions for me, both in and out of the hospital. Last Saturday (30th of October), I helped deliver a VBAC (vaginal birth after cesearean, she had previously had a prolapsed cord). The woman was making noises like a hose whinnying (it made me smile, but not in a sadistic way). As she was pushing and I could start seeing the head, a steady trickle of blood started to escape. It was more than I wanted to see, and I could not see any tears. At first I thought, "Shit, maybe the placenta abrupted a bit." I listened to the fetal heart tones and they were fine. As the head crowned and came out, more blood came. The baby came out, and with it more blood. She was given an injection of Syntocin and the placenta quickly delivered. Still more blood. I rubbed her uterus which was very firm, so the blood was not uterine. I checked for tears, using gauze to try and wipe away the blood, but it could not be wiped away fast enough. So, I inserted a finger and felt for tears. On the left side of the vaginal floor my finger sunk DEEP into a tear, and I could feel the blood pulse out with her heart beat. Shit. I had the midwife in charge call the OB (who thankfully was in the hospital) and I packed the vagina with gauze to try and put pressure on the bleeding vessel. The blood was soaking through the gauze and pooling on the sheets,. It clotted and was an inch thick. I was worried, though I remained calm and spoke clearly to the woman and told her what was going on. She was a sweetie. The OB finally came in, had a look, and decided to wheel her off to the surgical theatre to deal with it. Over an hour later she was wheeled back in, with a third degree tear and a lot of blood loss. In just the time I was with her, I estimate at least 800ml blood loss, which is a lot for Vanuatu. I can't even imagine how much more she lost in the theatre. This was the first time I was VERY grateful to be delivering babies in a hospital setting.
I was a little shaken from this, but the next birth totally redeemed my love for midwifery. A G2P2 momma pushed for only a couple minutes, out came a lovely baby, no tears and no blood loss. Such a contrast to the previous birth.
The next day Susanne delivered a baby with gastroschistisis (spelling??), its insides were born on the outside. I wasn't there, but apparently everyone but her stood there in shock and didn't know what to do. The intestines were covered with saline covered gauze. The baby is still alive, and if it makes it until Sunday some doctors are coming from Figi to do surgery. But, it is looking very pale and vomiting meconium and probably will not make it.
Follow up: the baby who was brought in dead from the mum who killled it...the mum was taken to jail. THe sad thing is, what she really needs is some mental health help, which she will not get here. She probably came from an abusive family or was a rape victim, but she will not get the help she needs.
The baby who was born breech and needed resuscitation died. It was seizing and had brain damage. Sad.
Two days ago I delivered two babies. The first one was a lovely birth, and I sutured a first degree tear. The second baby was born with club feet. It will likely be given some sort of therapy, but perhaps not for over a year when a volunteer medical team comes from NZ. Maybe they will do boots or braces.
It has pretty much turned into the tropical rainy season here. Sunshine in the mornings (which we are avidly soaking up) followed by torrential rains in the afternoons. And, I freakin lost the umbrella, darn.
Only one and a half weeks left here in Vanuatu. I am up to 34 births now, and only need 4 more to reach 100 total.
Be well,
Samantha*
It has been a whorlwind of emotions for me, both in and out of the hospital. Last Saturday (30th of October), I helped deliver a VBAC (vaginal birth after cesearean, she had previously had a prolapsed cord). The woman was making noises like a hose whinnying (it made me smile, but not in a sadistic way). As she was pushing and I could start seeing the head, a steady trickle of blood started to escape. It was more than I wanted to see, and I could not see any tears. At first I thought, "Shit, maybe the placenta abrupted a bit." I listened to the fetal heart tones and they were fine. As the head crowned and came out, more blood came. The baby came out, and with it more blood. She was given an injection of Syntocin and the placenta quickly delivered. Still more blood. I rubbed her uterus which was very firm, so the blood was not uterine. I checked for tears, using gauze to try and wipe away the blood, but it could not be wiped away fast enough. So, I inserted a finger and felt for tears. On the left side of the vaginal floor my finger sunk DEEP into a tear, and I could feel the blood pulse out with her heart beat. Shit. I had the midwife in charge call the OB (who thankfully was in the hospital) and I packed the vagina with gauze to try and put pressure on the bleeding vessel. The blood was soaking through the gauze and pooling on the sheets,. It clotted and was an inch thick. I was worried, though I remained calm and spoke clearly to the woman and told her what was going on. She was a sweetie. The OB finally came in, had a look, and decided to wheel her off to the surgical theatre to deal with it. Over an hour later she was wheeled back in, with a third degree tear and a lot of blood loss. In just the time I was with her, I estimate at least 800ml blood loss, which is a lot for Vanuatu. I can't even imagine how much more she lost in the theatre. This was the first time I was VERY grateful to be delivering babies in a hospital setting.
I was a little shaken from this, but the next birth totally redeemed my love for midwifery. A G2P2 momma pushed for only a couple minutes, out came a lovely baby, no tears and no blood loss. Such a contrast to the previous birth.
The next day Susanne delivered a baby with gastroschistisis (spelling??), its insides were born on the outside. I wasn't there, but apparently everyone but her stood there in shock and didn't know what to do. The intestines were covered with saline covered gauze. The baby is still alive, and if it makes it until Sunday some doctors are coming from Figi to do surgery. But, it is looking very pale and vomiting meconium and probably will not make it.
Follow up: the baby who was brought in dead from the mum who killled it...the mum was taken to jail. THe sad thing is, what she really needs is some mental health help, which she will not get here. She probably came from an abusive family or was a rape victim, but she will not get the help she needs.
The baby who was born breech and needed resuscitation died. It was seizing and had brain damage. Sad.
Two days ago I delivered two babies. The first one was a lovely birth, and I sutured a first degree tear. The second baby was born with club feet. It will likely be given some sort of therapy, but perhaps not for over a year when a volunteer medical team comes from NZ. Maybe they will do boots or braces.
It has pretty much turned into the tropical rainy season here. Sunshine in the mornings (which we are avidly soaking up) followed by torrential rains in the afternoons. And, I freakin lost the umbrella, darn.
Only one and a half weeks left here in Vanuatu. I am up to 34 births now, and only need 4 more to reach 100 total.
Be well,
Samantha*
Wednesday, October 27, 2010
30 babies and counting...
Hi, sorry it has been a while since I have written. I have been super busy and have had no time for internet. And thanks for all the kind words from my last post.
So much has happened. I have know helped 30 babies come into the world. I only need 8 more births here to reach a total of 100 ever. So good. We still have two more weeks here, so this is totally possible.
Last week I saw my first breech. I was horrified at the management of it. The midwives called in the OB (who is a resident and simply sucks) and the main OB in charge. I was always told for breeches that hands off is the best way to deliver. The resident was ALL HANDS ON, and was fussing all over with the baby and vagina. It was a frank breech (butt came out first). The OB in charge told her to deliver the legs and bend the knees. She couldn't figure out which way to bend the knees, so she hyperextended them! I was grimacing the whole time. Then she delivered the arms, and let the baby hang from the vagina (which is fine). When the momma went to finally deliver the head, the head popped out and a HUGE gush of amniotic fluid came out and went all over. With the fluid, the placenta was delivered and the umbilical cord broke. We have no idea how long the placenta had been detached. Baby was immediately taken away for ventilation (with bag and mask), chest compressions and epinephrine was injected into the umbilical vein. Baby's apgar scores at 1 minute, 5 minutes and 10 minutes were all zero. So bad. Baby did eventually breathe a little, but has been in the nursery ("NICU" kinda). It was seizing the next couple days and had an oxygen saturation of only 60%! It will not make it.
A couple days ago, the first baby Samantha was born. The grandpa insisted the baby be named after me, he was so cute. He alse MADE ME wash the baby ("swim the baby") and dress it. Baby Samantha loved the bath, she was so cute. Glad my namesake wasn't an ungly one :) Allison has had like 15 little babies named after her, but just the one for me. They can't even say my name 100% correct, haha.
Today saw another kind of brutal birth. A first time momma, with a long pushing stage. After an hour of pushing (which is already forever long here!), I decided to put an IV in and give her some normal saline. I thought a little hydration would do her good and maybe perk her up a bit. It did help. She pushed for another 45 minutes. As baby was just about to crown, a Chinese doctor came in (the Chinese doctors here are not well liked by the Vanuatu people, and she speaks almost no English or Bislama). She stood on a step stool and put all of her weight on the woman's belly to push the baby out. It did work to help get the head out, but it was brutal. Then, the head was out and I checked for a cord, there was one, but it was loose so I left it. I was applying some downward pressure to get the anterior should out and the Chinese doctor said I needed to push harder. I was doing it fine. When I didn't do what she demanded, she pushed me out of the way and ripped down on the baby's head. Honestly, I am surprised the baby does not have a brachial plexus injury, ohhh so bad. She was manhandling the baby and the woman ended up with the biggest, messiest tear ever. It was only a second degree tear (goes into the muscle layer), but it extended from the top of her left labia minora, into the vagina (where the deep part of the tear was) and down the perineum. I have never sutured something that big, but honestly I did a good job. Love the subcuticular stitch!
Other than that, life is good. I finished my scuba certification and plan to do an advanced course. Been swimming almost daily in the ocean, so freaking great. In fact, I am going to go swim right now. Peace and love,
Samantha*
So much has happened. I have know helped 30 babies come into the world. I only need 8 more births here to reach a total of 100 ever. So good. We still have two more weeks here, so this is totally possible.
Last week I saw my first breech. I was horrified at the management of it. The midwives called in the OB (who is a resident and simply sucks) and the main OB in charge. I was always told for breeches that hands off is the best way to deliver. The resident was ALL HANDS ON, and was fussing all over with the baby and vagina. It was a frank breech (butt came out first). The OB in charge told her to deliver the legs and bend the knees. She couldn't figure out which way to bend the knees, so she hyperextended them! I was grimacing the whole time. Then she delivered the arms, and let the baby hang from the vagina (which is fine). When the momma went to finally deliver the head, the head popped out and a HUGE gush of amniotic fluid came out and went all over. With the fluid, the placenta was delivered and the umbilical cord broke. We have no idea how long the placenta had been detached. Baby was immediately taken away for ventilation (with bag and mask), chest compressions and epinephrine was injected into the umbilical vein. Baby's apgar scores at 1 minute, 5 minutes and 10 minutes were all zero. So bad. Baby did eventually breathe a little, but has been in the nursery ("NICU" kinda). It was seizing the next couple days and had an oxygen saturation of only 60%! It will not make it.
A couple days ago, the first baby Samantha was born. The grandpa insisted the baby be named after me, he was so cute. He alse MADE ME wash the baby ("swim the baby") and dress it. Baby Samantha loved the bath, she was so cute. Glad my namesake wasn't an ungly one :) Allison has had like 15 little babies named after her, but just the one for me. They can't even say my name 100% correct, haha.
Today saw another kind of brutal birth. A first time momma, with a long pushing stage. After an hour of pushing (which is already forever long here!), I decided to put an IV in and give her some normal saline. I thought a little hydration would do her good and maybe perk her up a bit. It did help. She pushed for another 45 minutes. As baby was just about to crown, a Chinese doctor came in (the Chinese doctors here are not well liked by the Vanuatu people, and she speaks almost no English or Bislama). She stood on a step stool and put all of her weight on the woman's belly to push the baby out. It did work to help get the head out, but it was brutal. Then, the head was out and I checked for a cord, there was one, but it was loose so I left it. I was applying some downward pressure to get the anterior should out and the Chinese doctor said I needed to push harder. I was doing it fine. When I didn't do what she demanded, she pushed me out of the way and ripped down on the baby's head. Honestly, I am surprised the baby does not have a brachial plexus injury, ohhh so bad. She was manhandling the baby and the woman ended up with the biggest, messiest tear ever. It was only a second degree tear (goes into the muscle layer), but it extended from the top of her left labia minora, into the vagina (where the deep part of the tear was) and down the perineum. I have never sutured something that big, but honestly I did a good job. Love the subcuticular stitch!
Other than that, life is good. I finished my scuba certification and plan to do an advanced course. Been swimming almost daily in the ocean, so freaking great. In fact, I am going to go swim right now. Peace and love,
Samantha*
Sunday, October 24, 2010
Horrible and scary story, read at own discretion...
Hi again. So, lots has happened. Hmm, where to start.
Yesterday at the hospital was a crazy night. First, we had a woman who was 5cm dilated and was having huge late decels (the baby's heart rate decelerated after the peak of contractions=bad). It got as low as 50 beats per minute and was lasting over a minute, regularly. She was dilating quickly, and ended up having a vaginal birth and baby was fine (though small at 1.9 kg). The baby's eyes did do a weird shaking thing, which I have never seen.
Second mum I helped deliver, G3P3 (3 pregnancies, 3 births), no tears, no problem.
Then, a mom and her family came into the hospital. The baby had been born "in the bush"and was wrapped up in a blanket and was handed to the midwife. I was busy making cotton balls, but I wanted to know what was going on, so I went into the labor ward. The mum needed suturing, so I helped Susanne draw up Lignocaine (like Lidocaine) and she sutured the second degree tear. Susanne said this may be a police case, the baby was dead. After helping suture, I watched the OB (who was specially called in) examine the baby. The baby's face was covered in blood, and the body was covered in dirt and leaves. Blood was coming out of its mouth. There were small bruises and lacerations on the baby's nostrils and on the neck (where the carotid arteries are). This is what the mum told the midwife: she said her baby was only 6 months along (which it was not, it was definitely full term and a good sized baby) and she was out in the bush collecting oranges. She said she jumped up with a stick to get an orange, and when she landed back on the ground her baby "fell out" and hit its head on a rock. She said it died there (there were no marks on the skull and no broken bones, though the x-ray report has not come back yet). She delivered the placenta, left it and the baby there, took a bath in the ocean, and then went home to take a nap (leaving the baby alone, dead, in the bush). Later, her mum asked her what happened and she said her baby fell out and she left it in the bush. Her mum made her come into the hospital. So, a police report was filed. I could not get the picture of the dead baby out of my mind for the rest of the night. It was sad. The mum was kept at the maternity ward over night, and lots of security guards were around. I don't know what is happening now, but I will keep you posted when I find out.
Susanne (who says HI!), caught the next baby, a G2P2, no problem. The next woman, I helped deliver (G2P2). I got to suture her two second degree tears (they were deep, between the vaginal floor and labia minora, a tricky spot to suture, but good experience).
Other than that, not much else new. Oh, we have been swimming out in the harbor (Molly, we go past the helicopter pads to the rock in the ocean). It is super sweet, and a good swim. Sorry if this blog is choppy, I am a little intoxicated :)
Peace and love (and Southern Comfort with Coca Cola),
Samantha*
Yesterday at the hospital was a crazy night. First, we had a woman who was 5cm dilated and was having huge late decels (the baby's heart rate decelerated after the peak of contractions=bad). It got as low as 50 beats per minute and was lasting over a minute, regularly. She was dilating quickly, and ended up having a vaginal birth and baby was fine (though small at 1.9 kg). The baby's eyes did do a weird shaking thing, which I have never seen.
Second mum I helped deliver, G3P3 (3 pregnancies, 3 births), no tears, no problem.
Then, a mom and her family came into the hospital. The baby had been born "in the bush"and was wrapped up in a blanket and was handed to the midwife. I was busy making cotton balls, but I wanted to know what was going on, so I went into the labor ward. The mum needed suturing, so I helped Susanne draw up Lignocaine (like Lidocaine) and she sutured the second degree tear. Susanne said this may be a police case, the baby was dead. After helping suture, I watched the OB (who was specially called in) examine the baby. The baby's face was covered in blood, and the body was covered in dirt and leaves. Blood was coming out of its mouth. There were small bruises and lacerations on the baby's nostrils and on the neck (where the carotid arteries are). This is what the mum told the midwife: she said her baby was only 6 months along (which it was not, it was definitely full term and a good sized baby) and she was out in the bush collecting oranges. She said she jumped up with a stick to get an orange, and when she landed back on the ground her baby "fell out" and hit its head on a rock. She said it died there (there were no marks on the skull and no broken bones, though the x-ray report has not come back yet). She delivered the placenta, left it and the baby there, took a bath in the ocean, and then went home to take a nap (leaving the baby alone, dead, in the bush). Later, her mum asked her what happened and she said her baby fell out and she left it in the bush. Her mum made her come into the hospital. So, a police report was filed. I could not get the picture of the dead baby out of my mind for the rest of the night. It was sad. The mum was kept at the maternity ward over night, and lots of security guards were around. I don't know what is happening now, but I will keep you posted when I find out.
Susanne (who says HI!), caught the next baby, a G2P2, no problem. The next woman, I helped deliver (G2P2). I got to suture her two second degree tears (they were deep, between the vaginal floor and labia minora, a tricky spot to suture, but good experience).
Other than that, not much else new. Oh, we have been swimming out in the harbor (Molly, we go past the helicopter pads to the rock in the ocean). It is super sweet, and a good swim. Sorry if this blog is choppy, I am a little intoxicated :)
Peace and love (and Southern Comfort with Coca Cola),
Samantha*
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...)
Samantha*
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...)
Samantha*
Tuesday, October 19, 2010
Anterior lips..
Hiya,
still loving life in Vanuatu. Two of the last three babies I have helped deliver, the mommas had huge anterior lips (a bit of swollen cervix in the front under the pubic bone), like nothing I have felt before in the states. I just had to keep rubbing it down and holding pressure on it. I'm sure it hurts like hell, to have me in there messing and pressing, but I need to when it gets swollen. Each of these mommas were trying to push before they were fully dilated. So with a lot of pressure, I shoved the last of the cervix up under the pubic bone and the babies descended instantly and came out with 3 minutes. They are amazing pushers here.
The second baby I helped with last night was born with a nuchal arm (her arm was up by her face) and a nuchal cord (cord wrapped around the neck). Both proved to be no problem at all, and she did not even tear! Quite a feat.
Yesterday Susanne and I did two scuba dives. We saw the remains of a crashed plane, which was cool, though I asked the scuba pro and he said it had been placed there for divers to look at. There was even a fake skeleton in a baseball hat in the pilots seat with a beer can in his hand. Monday we will do our last dive for our certification, I'm excited. I am such a water baby, and diving is awesome. Looks like I will be doing the advanced course by myself though.
Today we are off again to sun and swim on Erakor island, yay. Hopefully we will stop at a little local bakery on the way and pick up something sweet :) By the way, we have mastered sweet potato hashbrowns. So good!
Ok one more random thing. Yesterday I cut a few really hot chili peppers, and washed my fingers so many times, but my finger tips were still burning. It just so happened to by my right hand which I use for checking the cervix. So, last night when I was feeling dilation and my hand was inside the womans cervix it burned like hell. No fun at all.
Talk later.
Samantha*
still loving life in Vanuatu. Two of the last three babies I have helped deliver, the mommas had huge anterior lips (a bit of swollen cervix in the front under the pubic bone), like nothing I have felt before in the states. I just had to keep rubbing it down and holding pressure on it. I'm sure it hurts like hell, to have me in there messing and pressing, but I need to when it gets swollen. Each of these mommas were trying to push before they were fully dilated. So with a lot of pressure, I shoved the last of the cervix up under the pubic bone and the babies descended instantly and came out with 3 minutes. They are amazing pushers here.
The second baby I helped with last night was born with a nuchal arm (her arm was up by her face) and a nuchal cord (cord wrapped around the neck). Both proved to be no problem at all, and she did not even tear! Quite a feat.
Yesterday Susanne and I did two scuba dives. We saw the remains of a crashed plane, which was cool, though I asked the scuba pro and he said it had been placed there for divers to look at. There was even a fake skeleton in a baseball hat in the pilots seat with a beer can in his hand. Monday we will do our last dive for our certification, I'm excited. I am such a water baby, and diving is awesome. Looks like I will be doing the advanced course by myself though.
Today we are off again to sun and swim on Erakor island, yay. Hopefully we will stop at a little local bakery on the way and pick up something sweet :) By the way, we have mastered sweet potato hashbrowns. So good!
Ok one more random thing. Yesterday I cut a few really hot chili peppers, and washed my fingers so many times, but my finger tips were still burning. It just so happened to by my right hand which I use for checking the cervix. So, last night when I was feeling dilation and my hand was inside the womans cervix it burned like hell. No fun at all.
Talk later.
Samantha*
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