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Showing posts with label vacuum extractor. Show all posts
Showing posts with label vacuum extractor. Show all posts

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.

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....