17 April 2012

Defender of Life


Well, after taking a bit of a break from being in the birth room for the last 3 weeks, I have really missed it! I had day shift today, and I was first up!
I had a slightly nutzo birth... The patient was a G6 (as in it was her 6th baby). She was pretty funny... Sort of. Didn't exactly want to listen to me, or anyone for that matter.
Let me just say that I love ALL my patients very much, some just take a little more patience! This patient may be one of those... Lets just say that at one point, she made some pretty gnarly marks in my arm with her fingernails.
She didn't like our beds very much, because they are flat. She wanted a bed where she could put her feet up in the stirrups. But she didn't want to try any of the other labor positions I suggested that might help her. So she said she wanted to transfer to the hospital. As she cried out to go somewhere else, I encouraged her "Kayananimo! Kusgan kaayo ka!" or "You can do it! You are very strong!"
As she was in the middle of begging me to take her to the hospital (with a death grip on my thumb) all of the sudden her husband cried out! I scrambled to look down to see if the baby was coming and looked to see about 4cm of the head! Before I knew it, the baby's head had already popped out! (Gosh I hope nothing tore as that happened...) By the way... I was not prepared with gloves yet (because I had just checked her and she was only about 7cm dilated with a VERY thick cervix, which usually means it will be a bit). Then again G6... I should have known better and not ever have taken my gloves off!!
So anyway, Im sitting there, with one hand lifting up the cover sheet, looking down at the baby's head and the other hand trying to break free of this amazonlaborwoman deathgrip!!! As I screamed "ATE!!!! ATE SUUUUUS!!!!!" (Ate Susan was my supervisor)... This all happened in a matter of minutes or seconds... I'm not quite sure. SO as I reach into the pocket of my scrubs to grab a glove and somehow finagle my other hand free and slide a glove onto it (which I only got about halfway initially), some reinforcements came busting into the cubicle. I finished gloving up... Not without getting a small amount of amniotic fluid and blood on my hands... GROSS.
As I directed mom to push the body out, and I went to grab the shoulders of the baby, I realized it was going to be a little tight! So Ate Sus directed me in turning her sideways so her shoulders would fit through the pelvis. I turned her and pulled, turned and pulled... Then about 2 minutes (scary) after her head popped out, the rest of her little body made its debut into the world! Fantastic! THANKYOUJESUS. THEN, before the placenta was out, she started bleeding! Ate Sus reached in a manually removed the placenta, as I massaged her fundus (top of the uterus) to make it contract (so the bleeding would stop). I completely missed what was happening with the baby (who was doing just fine, and being watched by my assist), as we managed the hemorrhage. We had to work a bit to get her to stop bleeding, but thankfully (after 20 units Pitocin and an Methergine injection - fast acting drugs used to contract the uterus) she stopped at 700 ml/cc of estimated blood loss.
After she was so tired but I encouraged her how amazing she did, how I knew she could do it, and that was it! Its over now! She fell into the bed, and closed her eyes, breathing hard.
After I washed up, helped to clean up after the birth, and checked my patient's vital signs. She smiled huge and thanked me! I was not expecting that, but I was SO very pleased. I told her your very welcome, and thank you for being my patient! I'll see you tomorrow for your baby check-up!
I felt like this was a good birth... The complications were serious, but they were so easily and swiftly resolved. I love working with my supervisor Ate Susan, because she is always so in tuned with what is happening. Her instincts are so amazing, and they are so driven by the Holy Spirit. Sometimes she acts before something even happens and it turns out to be that she did exactly what she needed to. It was pretty cool too though... Because she allowed me to manage a lot of the birth and complications! She was very intuitive to knowing exactly what I could handle. This was one of the first times that MY instincts kicked in in the birth room though. There was no freaking out, no UH-OH what do I do!? Just my awesome teacher + adrenaline + the skills I have learned + intuition/holy spirit. Apparently all of that = defending life. Ate Sus was the supervisor I was working with when I saw my first "floppy baby" born. It was a pretty terrifying experience actually. But I learned from watching her in that moment that midwives are "Defenders of Life" and that thats what she was! When I told her that, she grabbed my hand and said, "You also will be a defender of life!" and then hugged me.

Someone recently told me that midwives are the female version of Navy SEALS... I'd have to agree.

That's a really scary thought honestly... I mean to be responsible for two lives and make decisions in quick moments that other people's lives are depending on!? Yeah... I don't want that kind of responsibility either. Its not as romantic or cool as it sounds.
But God wants me to have it, apparently. God trusts me. And I don't trust myself, but I trust Christ in me. So, I am so thankful that I am on my way... I am a sproutling, but I have begun the journey, and I have seen little glimpses of what is ahead. And I'm less scared now. I'm excited. I get to defend life. Which is the most precious thing to God.