Another shoulder dystocia yesterday; this time I was not alone, but the midwives (two of them!) who were there apparently didn't understand "hip flexion" "legs up" "need more room here, bring her knees up" and about 5 other ways I was attempting to communicate what I wanted them to do (ARGHARGHARGHARGHARGH!!!!!!!!!) until I finally repositioned the woman myself. And a floppy baby. The midwife refused to pass me the bag and mask, told me I had to cut the cord and take the baby to the station. Goodbye good heart rate. Baby came around after a few more minutes, but had no muscle tone even after she was breathing on her own, for a good 20 minutes. The ped's opinion was that she'd suffered hypoxia - the midwife that was with me uselessly stared and didn't inform her of the dystocia or the rescus, so I jumped in with some information. I am not sure what was going on with the midwife, but her mind was not there and I may avoid working with this particular midwife for the rest of my stay here; the others have been varying degrees of acceptable to great at working together at births. Baby looked healthy and active an hour after birth.
Two more births, without issues.
At the end of the day, I checked a primip that had been in the hospital all day and working really hard. I couldn't figure out what language she spoke, and she was off in labor-land. Not Bislama, but English, it turned out. She was only 3cm. I was not prepared to stay and do a lot of labor support, but did take time to provide her and her partner some information and some coping techniques, kind of an impromptu 30 minutes of childbirth ed. She was very tired. "There is only one muscle in your body that needs to do the work right now," she finally woke up and understood, "think about letting all the rest of your muscles sink down into the bed and rest."
I hope that she delivered without incident last night. If she is still there when I go in (in a few minutes), I'll be glad to provide support and receive information back with full fluency, but unhappy that she hasn't delivered.