Mangua was laying on the dirty floor, writhing, screaming and crying. I guessed she was 8 or 9 centimeters dilated by the little grunt at the peak of each contraction. (although I always keep in the back of my mind that some labors just don't follow the rules and can look like that at 5 cm.) Her lips were dry and I offered her water. I wiped her sweat beaded face with a cool cloth and started fanning her. It is very hot and humid here and there are no fans or AC in the maternity ward.
Her contractions were one on top of the other as I held her hand and rubbed her back. She calmed down considerably.
Meanwhile I looked up at the wall and had to smile at the sign I read. Translated, it said, "To all mamas: please take your placentas home with you and bury them. We are tired of finding them tossed in the road and under the bushes. Thank you!"
Then I witnessed what I think of as "the last hurrah." I've seen it over and over again in births that have not been altered with medications. It is when there is a 3-4 minute unbearable contraction and then peace. It seems to be the last bit of dilation and then the mama experiences what midwives call the "rest and be thankful stage." There is such a change in demeanor at the end of that last long contraction. The contractions sometimes do continue, but they are different. Has anyone else seen this?
After about 20 more minutes she said, "the baby is coming!" and I supported her as we wobbled down the hall to the delivery room.
Meanwhile Leali, I had been supporting, but who was coping much more quietly, passed us in the hall with her hand between her legs. She too was on her way to the "haus bilong karim" (the room where they are supposed to push out their babies).
Mangua and Leali both got up on delivery tables with about 12 inches between them and Mangua's water broke. It was very stained by meconium. A very thin, and very pale baby emerged as I fanned and encouraged her. A boy.
Leili delivered a healthy and very vocal little girl. It soon became apparent that Mangua's baby was not okay and needed help with breathing. About this time, Leali began to hemorrhage. She was weak and unable to hold her baby on the narrow table. So my job at that point was to hold and comfort the tiny and very opinionated little newborn. I sang to her and walked the halls while I prayed for the other baby that it would breath. And for her mama that she would stop bleeding.
My prayers were answered. When I left both mom's and both babies were doing great. There was another lady yesterday too, but I'll leave her story for another day.
Showing posts with label rough birth. Show all posts
Showing posts with label rough birth. Show all posts
Saturday, 26 April 2014
Saturday, 5 October 2013
Classy Doulas and Lifeless Babies
Today I stepped in a pile of poop and then tracked it all the way around the hospital bed before I realized it. It was really very classy.
With in minutes of arriving, my doula friend and I each stopped to talk to a couple of laboring women. With in a few more minutes, there were 2 baby heads emerging. (from 2 different women, not the same one - in case you were worried.) The race was on! Two first time moms yelling, "It's coming!" The foot of their beds had only about 10 feet between them.
Anya's baby was coming, but slowly. She was pushing well and just wanted a hand to hold and someone to give her sips of water. She had been completely alone for many hours.
Julie was HIV positive and her bag of waters was still intact. Her baby was coming very quickly! Before I knew it, the baby's head, inside the water bag was completely out. It was soon followed by the rest of the baby girl. She splashed into this world as she slipped onto the bed and her water cushion broke simultaneously. What a blessing that she was protected from the vaginal fluids on her way out. I didn't get to hear if she was born HIV positive or not.
Meanwhile, Anya kept pushing. She gently delivered a baby girl about 10 minutes later. No tears, even thought the baby was delivered with a fist by her cheek. It was a very peaceful birth.
The entire rest of the day was spent with Mikal. She was also there to meet her first child. She dilated quickly, but once she hit 10 centimeters, she grinned at us and basically fell asleep for three hours. For awhile we encouraged her into a position that would move the second stage of labor along, but she was just not into it, so we let her sleep. Eventually she awoke, crawled down off the bed, and squatted noisily. The grunts became screams and I guessed that she was crowning. Sure enough a peek proved my suspicions were true. Within the next few minutes, a tiny,. white, lifeless little baby boy emerged.
After about 20 minutes of prayer, oxygen, and CPR, he was breathing, struggling...but breathing. At that point we all breathed a sigh of relief. I'm glad he wasn't one of the majority of babies in the county who are born out in the jungle and left for dead if they do not breathe immediately on their own. The midwives did a great job on that one.
In the end, everybody was doing great...and we headed home after another awesome day of loving the women God loves.
With in minutes of arriving, my doula friend and I each stopped to talk to a couple of laboring women. With in a few more minutes, there were 2 baby heads emerging. (from 2 different women, not the same one - in case you were worried.) The race was on! Two first time moms yelling, "It's coming!" The foot of their beds had only about 10 feet between them.
Anya's baby was coming, but slowly. She was pushing well and just wanted a hand to hold and someone to give her sips of water. She had been completely alone for many hours.
Julie was HIV positive and her bag of waters was still intact. Her baby was coming very quickly! Before I knew it, the baby's head, inside the water bag was completely out. It was soon followed by the rest of the baby girl. She splashed into this world as she slipped onto the bed and her water cushion broke simultaneously. What a blessing that she was protected from the vaginal fluids on her way out. I didn't get to hear if she was born HIV positive or not.
Meanwhile, Anya kept pushing. She gently delivered a baby girl about 10 minutes later. No tears, even thought the baby was delivered with a fist by her cheek. It was a very peaceful birth.
The entire rest of the day was spent with Mikal. She was also there to meet her first child. She dilated quickly, but once she hit 10 centimeters, she grinned at us and basically fell asleep for three hours. For awhile we encouraged her into a position that would move the second stage of labor along, but she was just not into it, so we let her sleep. Eventually she awoke, crawled down off the bed, and squatted noisily. The grunts became screams and I guessed that she was crowning. Sure enough a peek proved my suspicions were true. Within the next few minutes, a tiny,. white, lifeless little baby boy emerged.
After about 20 minutes of prayer, oxygen, and CPR, he was breathing, struggling...but breathing. At that point we all breathed a sigh of relief. I'm glad he wasn't one of the majority of babies in the county who are born out in the jungle and left for dead if they do not breathe immediately on their own. The midwives did a great job on that one.
In the end, everybody was doing great...and we headed home after another awesome day of loving the women God loves.
Saturday, 13 July 2013
Baby Heads and Doula Smiles
I smiled a lot yesterday while I was with all the laboring moms.
I smiled when Rosa pushed out a baby boy with ease.
I smiled when Rosa dressed him up super cute and I could tell she was in love with her new little bundle. She had her tubes tied a few years ago, so he was quite a surprise.
I smiled when Helley gave me a skeptical look when I told her that her baby was coming soon and she was going to be okay. It was a look that said "you are insane, I know I am going to die."
I smiled when Helley came back from the bathroom a few minutes later and lifted her skirt to show me what was going on. I could see quite a bit of baby head. She was holding a baby boy just a few minutes later. Now she had a look on her face that said she was quite pleased with herself for having delivered her first child.
I smiled when Toola and I finally worked out a system to get her calmly through her contractions without going screaming and rolling around in panic and terror. I had never seen a woman quite so active and creative with her laboring postitions.
I smiled when Toola's baby girl finally emerged. It took awhile and the little one arrived with a short cord 3x around her neck. I smiled because she was okay despite that. I was so glad the midwife had arrived on that one, her head was halfway out before the midwife came.
I smiled when Toolah made it safely through a post partum hemmorage and when her baby girl finally latched on and nursed.
I smiled when Mallinah delivered her ten and a half pound baby boy (most babies here are between 5-7lb). She was 44 weeks pregnant. Yes, I meant to write 44. She measured 44 weeks, and her dates said 44 weeks. She had been completely dilated for hours, but the head was too high and not engaged. She walked, she lunged, she sat on the toilet. We had no birthball, that would have been helpful. She was so drained and still the babe was high. Her water finally broke and eventually she felt like pushing. After 2 more hours I finally convinced her to squat and push. She did and within 15 minutes there was a baby head. The midwife was there just in time to see the rest of it's body slide out.
There were five births and 7 moms and it was just really fun as well as really amazing. I'm getting more comfortable in my role as a doula and in trusting the mom's own instincts. I am also amazed at what a woman can birth if she squats instead of laying on her back!
I smiled when Rosa pushed out a baby boy with ease.
I smiled when Rosa dressed him up super cute and I could tell she was in love with her new little bundle. She had her tubes tied a few years ago, so he was quite a surprise.
I smiled when Helley gave me a skeptical look when I told her that her baby was coming soon and she was going to be okay. It was a look that said "you are insane, I know I am going to die."
I smiled when Helley came back from the bathroom a few minutes later and lifted her skirt to show me what was going on. I could see quite a bit of baby head. She was holding a baby boy just a few minutes later. Now she had a look on her face that said she was quite pleased with herself for having delivered her first child.
I smiled when Toola and I finally worked out a system to get her calmly through her contractions without going screaming and rolling around in panic and terror. I had never seen a woman quite so active and creative with her laboring postitions.
I smiled when Toola's baby girl finally emerged. It took awhile and the little one arrived with a short cord 3x around her neck. I smiled because she was okay despite that. I was so glad the midwife had arrived on that one, her head was halfway out before the midwife came.
I smiled when Toolah made it safely through a post partum hemmorage and when her baby girl finally latched on and nursed.
I smiled when Mallinah delivered her ten and a half pound baby boy (most babies here are between 5-7lb). She was 44 weeks pregnant. Yes, I meant to write 44. She measured 44 weeks, and her dates said 44 weeks. She had been completely dilated for hours, but the head was too high and not engaged. She walked, she lunged, she sat on the toilet. We had no birthball, that would have been helpful. She was so drained and still the babe was high. Her water finally broke and eventually she felt like pushing. After 2 more hours I finally convinced her to squat and push. She did and within 15 minutes there was a baby head. The midwife was there just in time to see the rest of it's body slide out.
There were five births and 7 moms and it was just really fun as well as really amazing. I'm getting more comfortable in my role as a doula and in trusting the mom's own instincts. I am also amazed at what a woman can birth if she squats instead of laying on her back!
Saturday, 29 June 2013
Twins and a Prolapsed Cord
This weekend at the hospital was nuts. There were naked women on the dirty floor yelling, "The baby is coming!" There were not enough beds for them all, and there were more pukers than usual.
The operating theatre was not "in service" due to the air conditioner being broken. I am not sure why the air-con is necessary to operate, but apparently it is. The vacuum extractor was also broken.
So into this environment, a lady named Malley (not her real name) walked in. Her belly was HUGE (in an adorable way) and she had not had prenatal care. She walked around until a baby started to fall out bum first. A little girl was born breech. Then another baby started to make his way into the room head first. Unfortunately his umbilical cord led the way. So now the midwives were dealing with a prolapsed cord.
The midwives flipped her over to a head down/ on her knees position and tried to push the cord back up into the mom. They also pushed the head up and then flipped her back to her back and applied suprapubic pressure in an upward direction to hold the head up off the chord while trying to fix the vacuum extractor. They couldn't get it to work and they called the doctor. Meanwhile there was still a heartbeat. I was holding Malley's hand, praying with her and comforting her. She asked me to sing a hymn while we waited. Singing is not my gift, but we sang anyway.
The doctor arrived and without the option of C section or the vacuum, he proceeded to just have her try to deliver the baby quickly. Two contractions later the head was in the birth canal and the chord had stopped pulsating. Two more contractions. We all started to anticipate a dead baby. I prayed and prayed. A very grey and limp 5lb baby emerged. After some stimulation though he pinked up and cried. I checked on him a lot throughout the rest of the day. He was a champion nurser and very alert little guy. I'm so thankful that he is okay.
The operating theatre was not "in service" due to the air conditioner being broken. I am not sure why the air-con is necessary to operate, but apparently it is. The vacuum extractor was also broken.
So into this environment, a lady named Malley (not her real name) walked in. Her belly was HUGE (in an adorable way) and she had not had prenatal care. She walked around until a baby started to fall out bum first. A little girl was born breech. Then another baby started to make his way into the room head first. Unfortunately his umbilical cord led the way. So now the midwives were dealing with a prolapsed cord.
The midwives flipped her over to a head down/ on her knees position and tried to push the cord back up into the mom. They also pushed the head up and then flipped her back to her back and applied suprapubic pressure in an upward direction to hold the head up off the chord while trying to fix the vacuum extractor. They couldn't get it to work and they called the doctor. Meanwhile there was still a heartbeat. I was holding Malley's hand, praying with her and comforting her. She asked me to sing a hymn while we waited. Singing is not my gift, but we sang anyway.
The doctor arrived and without the option of C section or the vacuum, he proceeded to just have her try to deliver the baby quickly. Two contractions later the head was in the birth canal and the chord had stopped pulsating. Two more contractions. We all started to anticipate a dead baby. I prayed and prayed. A very grey and limp 5lb baby emerged. After some stimulation though he pinked up and cried. I checked on him a lot throughout the rest of the day. He was a champion nurser and very alert little guy. I'm so thankful that he is okay.
Saturday, 15 June 2013
Vaccuming a Baby Head
So, apart from accidently cussing and fainting yesterday...I also got to see my first vacuum extraction birth. It was brutal, but mom and baby are alive and happy, so it seems to me it was worth it in the end.
These days, I tend to judge a birth by whether or not everyone lived. I would love to see each mother satisfied with her experience...it just doesn't take much for these women...if they are alive in the end, they are happy.
I could hear Mavis (not her real name) yelling long before I got to the labor and delivery room. This was her first baby and she was NOT afraid to make noise. When the midwives told her to quiet down, ( they actually were pretty kind and concerned for her) she just looked at them and screamed louder. She alternated biting the mattress, rolling around on the floor and throwing things. ( So much for the "women in other countries just squat, push out a baby, and keep on working in the field" theory.)
When I arrived she had been in active labor for 24 hours. She had been at 9 centimeters for 3 hours. Her baby was slightly transverse. (Basically it was laying diagonally with the side of head and ear trying to head down the birth canal. It is a good thing that she was one of the 30% of women in this country who had a skilled birth attendant for her birth.
I walked in to be with her and she clung to me and begged me not to leave. She was sick of being alone and in pain. It was one of the roughest births I have helped with so far (except for the ones where there was a death). We worked with gravity trying to jiggle the baby down into the right position. I had her try polar bear position alternated with standing and dancing the baby down. Interestingly, it seemed that she naturally wanted to do those things anyway.
She was complete by 8:30 am and then started pushing. She pushed for six hours. At this point she was going on 48 hours of active labor and was refusing food and drink of any kind. She was constantly falling asleep standing up, and I was trying to keep her from falling over. She was about 100 pounds more than I was and it wasn't an easy task. I used every "trick" I could think of.
After 3 hours, I begged the midwives to come check for fetal heart tones, something they hadn't done at all since I had arrived. It took them awhile to hear anything, and when they did, the baby was in distress. Her head had moved into a better position to come down though. After two more hours of pushing they brought in a broken vacuum extractor (it would only go up to half of the suction it was supposed to have) and gave her a huge episiotomy and finally dragged out a beautiful baby girl.
It was not a pleasant birth, but when I left, mom and baby were alive, healthy and happy. Oh, and Mavis named the little girl after me. I was so proud of her making it through....
These days, I tend to judge a birth by whether or not everyone lived. I would love to see each mother satisfied with her experience...it just doesn't take much for these women...if they are alive in the end, they are happy.
I could hear Mavis (not her real name) yelling long before I got to the labor and delivery room. This was her first baby and she was NOT afraid to make noise. When the midwives told her to quiet down, ( they actually were pretty kind and concerned for her) she just looked at them and screamed louder. She alternated biting the mattress, rolling around on the floor and throwing things. ( So much for the "women in other countries just squat, push out a baby, and keep on working in the field" theory.)
When I arrived she had been in active labor for 24 hours. She had been at 9 centimeters for 3 hours. Her baby was slightly transverse. (Basically it was laying diagonally with the side of head and ear trying to head down the birth canal. It is a good thing that she was one of the 30% of women in this country who had a skilled birth attendant for her birth.
I walked in to be with her and she clung to me and begged me not to leave. She was sick of being alone and in pain. It was one of the roughest births I have helped with so far (except for the ones where there was a death). We worked with gravity trying to jiggle the baby down into the right position. I had her try polar bear position alternated with standing and dancing the baby down. Interestingly, it seemed that she naturally wanted to do those things anyway.
She was complete by 8:30 am and then started pushing. She pushed for six hours. At this point she was going on 48 hours of active labor and was refusing food and drink of any kind. She was constantly falling asleep standing up, and I was trying to keep her from falling over. She was about 100 pounds more than I was and it wasn't an easy task. I used every "trick" I could think of.
After 3 hours, I begged the midwives to come check for fetal heart tones, something they hadn't done at all since I had arrived. It took them awhile to hear anything, and when they did, the baby was in distress. Her head had moved into a better position to come down though. After two more hours of pushing they brought in a broken vacuum extractor (it would only go up to half of the suction it was supposed to have) and gave her a huge episiotomy and finally dragged out a beautiful baby girl.
It was not a pleasant birth, but when I left, mom and baby were alive, healthy and happy. Oh, and Mavis named the little girl after me. I was so proud of her making it through....
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