Meconium and Feet First

Well today is my half Birthday!! I am 22 ½ now. I know it is kind of funny but my family always like to have fun with it. You should figure out when you half birthday is too and have a ½ birthday celebration!

Today started out with cleaning a store room that has a whole bunch of medical supplies and I mean a lot lot of supplies. The problem is that they are all in bags and boxes and nothing is organized. Some if the stuff came back in the 90’s so you can imagine how much and long the stuff has been there. Our job is to organize all of it and separate it into useable things and unusable things. There are things like ventilator tubing, tracs, expired meds and other things that will never be used here but there is a lot of things that can be used such as IV’s and tubing, needles, caths dressings just to name a few. This room is such a mess that after working for a couple hrs you are exhausted and can’t stand the mess and dust any more. So we have been working a few hrs every morning on this big project.

After lunch and a short rest we were off to the hospital for our pm shift. When we arrived there was only one first time mom in L&D and she had just been started on pit because she had SROM’ed about 10hrs before and was not having any contractions. So the pit was started and we were to up it every 20 min until contractions started. So we had to sit and feel her tummy to feel if any contraction came and how long they were (there are no monitors here). It was very interesting to say the least to start a pit drip with no IV pump, we had to count out the drops, and with no electronic monitoring. So after upping it only once her contraction started J . A few hrs later another laboring woman came in she was on her 2nd baby and came in a 5cm. We got her all settled in the laboring bed and then let her labor down. About 1hr after that another woman, on her 4th baby came in in labor (when it rains it does poor). We only have 2 labor beds so she had to labor on the delivery table. After doing an assessment we discovered that the baby is breech with a foot presenting and bag intact. We had called the OB Dr. to consult and he came to evaluate the situation. He too confirmed that it was breech and one foot was slightly down. He decided that it the foot would go back up then we would attempt a breech delivery but if the foot continued to present then he would do a c/s. The woman was progressing very quickly she came in at 5 cm and about 1hr later she was 7-8 and then her water broke spontaneously. We quickly checked her and got heart tones and everything sounded and looked great. Things went very fast from here and with in minutes a foot was appearing. There was not time for a c/s so the Dr. would do the footling breech. It was very neat to watch and the Dr. did a good job except when it came time to deliver the head he starting pulling and pulling, I was horrified that he was pulling so hard I really though he might decapitate the baby. But my a miracle he didn’t and he had that baby out in less than one minute. (to bad there are not chiropractors here I think that baby might need one) The baby did well with apgars of 7/9 and the mom did not tear at all.

After we had that mom all cleaned up and out to the ward we went to evaluate the next laboring woman. She is the G2 P1 and was 5cm last check with a bulging bag. It had been several hrs since her last check so we decided to move her into the delivery room. Upon examination she was now a 7 with a very bulging bag. I broke her water to find thick +3 mec. We got everything ready to do suction if needed and resuscitation. It did not take her long to become complete and then the pushing started. She really did not push long at all and the head was out. I did some bulb suction at the perineum and then the body came out. With a little more bulb and some stimulation the baby had an 8/9 apgar. The mom had no lacerations so she was cleaned up and moved out to the ward.

It was now the G1 P0 woman’s time! Poor thing she was the first one to start laboring and she had to watch two other women labor beside her and deliver before her. I think she was very excited to be able to move to the delivery bed! I checked her again and she was now 8cm. It only took her around an hour to reach complete and then the pushing began. Because she was a first time mom it took her longer but she did very well. The baby came and had a cord around the neck but loose enough I was able to take it off at the perineum. Also when the baby was born we realized it also had thick mec. But a little suction with the bulb did the trick and the baby did great. This mom did have a laceration so I learned again how to stitch. It was much easier this time and everything made much more since. Linda is a great teacher! I will have to say the stitching job looked very pretty especially compared to the way the locals stitch!

Well I had prayed that we would get some births soon because it had been 3 days with no births, and well God answered out prayer and gave us 3 in 2 hrs! I am really enjoying helping the women here and learning so much. This experience is priceless.