Tuesday, March 17, 2009

Maybe it's the Barometric Pressure?

I came in late today, a little after 8am rather than at shift-change at 7am, only to find out I'd missed three births in that hour. I got there just in time for a birth, and had finished postpartum (got baby's shots done and latched on, everybody stable) and moved on to measuring babies by the time T arrived at the hospital. It was VERY HOT at the hopital today. Even the midwives and staff, who normally are fairly impervious, were sheltering in the delivery rooms or fanning themselves.

A twin mom arrived around 11am, was asked (it looked like the 5th or so time according to her chart) if she really wanted a c-section - they were actually game for a vaginal delivery, breech first twin and all, not that the doctor tried to sell her on the idea at all. Despite the fact that she was a multip in labor, they scheduled her c-section for 2pm.

In the meantime, T and I did a birth together; T caught, I assisted, and one of the midwives observed.

As we were finishing that up, we saw the twin mom getting wheeled off a tad bit early for her section. We ran off down the hall in pursuit, changed into scrub-dresses and crocs (the operating-room uniform, oddly enough) and arrived well before the doctors did. The first baby came out breech and pretty much fine, the second the doctor had to do an awful lot of fishing-around for. Both received PPV long after they stopped needing it (what on earth that was about, I don't know). Two decent-sized (2.7k and 3.2k) babies, a boy and a girl, looking slightly undercooked; this mom's first baby had been 4.4k. Multiply those numbers by 2.2 to get pounds, I'm too lazy...

There were three more moms in labor when we left, none of them particularly close to delivery. One of them had brought along a husband/boyfriend/something that was actually involved in labor support and excited to see all the new babies, something men around here aren't very active in at all. Sadly, I am pretty sure he got shut out of the delivery room, although he didn't look upset...just excited about all the babies he was seeing come through the ward.

T got some pictures of the twin c-section, look at her blog (link to the right) to see if she posts any!

We left the hospital in relatively good shape, and made it back to the "resort" before a major rain hit. Maybe that's why so many women were in labor today.

I am missing my family tonight, after BittyPrincess had some tears while we talked on Skype. I'm taking some solace in the fact that she probably wouldn't have started up if she hadn't been shushed because she kept interrupting everybody else to shout random things at me.

The business plan - this is a school assignment - needs some work tonight, as does the senior paper. Tomorrow, a day off, and a touristy around-the-island excursion for T and me.

Settling In

Another day in the hospital today. It seems like the staff there, and the women too, are getting used to us (maybe as the staff increasingly acts like we just belong there).

On our personal development/learning agenda, I think today turned out to be intake day. Several women - all but one of them primips - presented over the course of the day in varying states of labor-or-not. One woman at 41w5d had misoprostol placed. One woman at 19w presenting with lower abdominal pain remained pretty much unexplained, the assumption being infection. We admitted two women, sent two home with half-hearted dehydration not-labor. Another midwife finally admitted a primip in good hard labor, 8cm. When we told the midwives at the shift change that we were staying until she had her baby, one of them told us to break her water and have a baby. So I did. Crazy molded-headed baby boy (wun smol boy) born through moderate mec, totally happy and healthy. Mom wanted to touch her baby's head as it came out and the midwife that was supervising said no (drat!). This woman would also have been game for a wet slippery baby handed straight to her, but that's not the way it's done. Urgh.

After that, we headed off to the market, and walked home, overheated, in the dark, heavy-laden with fresh greens and groceries. We're back in the air conditioning now, drinking Tusker (local beer) and watching not-so-great Australian TV. I think the key words in that last sentence were "in the air conditioning now," though. Happily off to bed soon, to do it again.

Ah, and I'll end this post with a photo of the mom/baby from yesterday:

Monday, March 16, 2009

First Catch in Vanuatu!

This morning when we arrived at the hospital, a woman was laboring in the hall. Not quite two hours later, we were in the labor ward with one of the midwives, intending to observe. "You really wanna observe this one? You can do it?" After a brief exchange, I stepped forward and just a few minutes later, there was a baby in my hands. The birth happened just in time for the newborn room to be occupied by a veritable mob of other mamas and babies waiting to be discharged or back for weight rechecks, and this mom was (unusually) game for cuddling and nursing her unwashed baby, so we settled in for a just-slightly more American-midwifery postpartum.

Less than two hours later, with that mama/baby pair still across the hall (although washed up and about ready to move into the main ward), T caught her first Vanuatu baby.

Maybe tomorrow I'll see if the woman whose baby I caught was up for photos. For now, me logging my first Vanuatu birth in the big-book-of-births:

We settled postpartum women, rewashed labor rooms and redid beds, and left about 15 minutes before the shift officially ended. Tonight, beer and pizza by the pool, and early to bed.

Sunday, March 15, 2009

Ah, the Weekend

We spent Saturday - yes, all of it - working on our senior papers. Why I didn't finish mine in the dreariness of Seattle before coming to Vanuatu, I don't know. It was mildly gratifying that it rained/drizzled/poured on and off all day, as we worked in our "cabana" thing, or near the pool. Satisfyingly, my paper is about done. Unsatisfyingly, we didn't do anything else that day.

On Sunday, we went to Erakor Island and did some snorkeling and beach-sitting. I finished one of the books I brought with me. We ate lunch, swam again, and got back in time to do a half-shift starting at 3pm. We *just* missed a baby before we got there, did some postpartum, and then T nearly caught a baby by accident (one minute the midwife was there and the woman was not pushing, the next minute the midwife was gone and the head was visible!) By next week that scenario won't be such an issue, but this was the first birth there and we were planning to observe and assist. *A* midwife, although not the one who was supposed to be at this birth, arrived in time and we were spared that fiasco.

Off to bed, and back to the hospital in the morning.