Monday, March 30, 2009

Never look too bored around a doctor

Especially one that loooooves to chat about horrible things.

You might get chatted at and invited to a c-section "we anticipate to be really difficult, you'll see us sweat, that will be good eh?" This woman had a previous stillbirth after undiagnosed partial previa --> full abruption --> distressed baby --> c-section --> dead baby --> couvelaire's + massive hemorrhage. She'd elected a vbac attempt, and after hanging out at 4-5 for 12 hours, with good strong contractions for 6 of those, she was talked into (offered, whatever) a c-section. After quite a lot of difficulty placing the spinal, the operation went off without issue. Mom lost a fairly small amount of blood, her uterus and intestines cooperated and returned to her abdomen (ick), baby was happy and healthy and vigorous.

I got back to the maternity ward after the time I'd decided to leave.

Rewind a bit.

When I got in yesterday, a couple of mothers had delivered and pregnant bellies were all over the ward. I helped move people around, settle people in, and then the boring bits start. All those pregnant bellies were in various states of not-really-labor, including one that just needed to listen to her baby and go home and a few that thought they had ruptured membranes, but probably didn't.

The family from the stillbirth the day before came to pick up their baby. Another hour of wailing and mourning and sadness.

Cycled women through their "CTG" (amounts to an NST), checked early-laboring cervixes for non-ruptured moms, and settled into the boredom.

About an hour before I was intending to leave, the above-mentioned doctor caught me rolling cotton balls and dunking them in alcohol with a rather resigned and bored posture about me.

When we got back from the c-section, there were several suddenly active-labor-looking moms on the ward. One I'd checked and found at a 4 just before tackling the alcohol swabs, and she wanted to know if she could go in and lie down. She didn't have to push, she said, she just wanted to lie down. She looked like she was going to push, so I told her to go ahead, ran to eat something, and was fetched by her husband not 45 seconds later. I found her 9cm, broke her water, her cervix almost-dissappeared (could feel the tiniest edge of it) and told her she could push. She had a lovely girl of substantial-for-here size just a few minutes later, intact perineum, happy mom-baby.

As I was getting the instruments cleaned up, another mom I'd checked earlier and found at a 2 walked into the labor ward (usually if they do this themselves, they're pushing already). She was 6-7cm and in hard labor, and her relatives briskly escaped the room (why?!). I ran about looking for them so that I wasn't stuck doing labor support, and found her husband instead, who gamely entered the room and rubbed his wife's back, looking only mildly horrified. Just half an hour later, a spontaneous push, and when I checked she was complete. 20 minutes later, another substantial-sized baby, her second girl, this time with dad as a witness for the first time since I've come here. Sure, he was plastered to the wall beside his wife's head looking apprehensive for most of the pushing, but his face lit up when his daughter cried. Mom, alas, had a substantial second degree tear that took a good long time to repair, and no matter how much lidocaine I injected (nor how little she seemed to notice the needle while I was injecting the lidocaine), she was in pain during the repair. I'm rather sure she detests me now, but I'm also rather sure that I did a good job putting her vagina and perineum back together, and I did as well as I could to get her pain relief in the process. "Don't worry," said the midwife to the dad (who appeared not at all worried), "next time you have a boy, it will be easier too..."

I cleaned, rearranged, prepared spaces, and left. As I left, the midwives predicted a line into the admissions room and through the labor ward all night. I predicted a solid sleep after over 12 hours at the hospital (preceded by 3+ hours of doing school work). It turned out I had to battle a monster cockroach before settling in, but I did sleep.

1 comment:

Morag said...

Toldja it would start raining babies sooner or later. :)
Xx L