Saturday, August 24, 2013

24 hour call

At 7 am, three out of our four labor and delivery rooms were occupied. We had another in triage. Perfect, I thought. If I have to be here for 24 hours, might as well make it a busy one! I'll get to see at least 4 more deliveries and maybe they'll let me catch another baby! They were four healthy women, no major medical problems, and we were anticipating nice, normal deliveries for all of them.

Here I am, 14 hours later, just scrubbed out of a c-section we had to do on a young Indian woman for failure to descent, e.g. the baby just got stuck. After pushing with her for 2 hours (I held the leg most of the time, but at the end, we "played" tug of war, meaning I held one end of a sheet and she held the other one to make her push harder. She was the one in labor, but I was out of breath from pulling so hard!), the doctor finally made the call to go to surgery because that baby's head would not make it through her pelvic arch. In the OR, she was the first patient I've seen that was in real danger because her uterus wouldn't contract and shrink down like it should after we delivered the baby (something we call uterine atony, a major cause of postpartum hemorrjage). We had to give her a few doses of Methergen and Hemabate, both drugs to help her uterus contract, to stop the massive bleeding. After a few minutes, we all breathed a sigh of relief and ended the surgery in good spirits. But add that to a difficult labor in the morning where we were also pushing for an hour, then I stepped out for a minute, and then the baby just slipped out, the day has not turned out like anything I had planned. We still have 2 of those women who still have to deliver. Who knows what else the next 10 hours will bring?

Update: I finally caught a baby! Albeit it was at 5 am where I had just been woken up 10 minutes ago, groggy and half-awake, but this time, I got to guide the entire baby out (and then immediately put it down so we could wipe it down -- and so I wouldn't drop it). My midwife had let me go sleep around 11 pm and promised to wake me up when our remaining two ladies were about to deliver, but I ended up missed the birth  the one woman who I admitted in triage this morning because they forgot to call me. Womp womp. However, lady #4 was getting ready to deliver immediately after her, and so I finally made it -- and caught my own baby -- at 5 am. So all in all, I was 3 out of 4. And quickly escaped at 6:30 am before I would be sucked into another delivery. A new lady in room 1 who was just admitted because she was 7 cm dilated. And the cycle begins again.

1 comment: