Wednesday, March 21, 2012


In the hospital we have a term for certain doctors. We call them......."poop" magnets, if you catch my drift. This means that for whatever reason, whenever they're on call or around, you know that you're going to have a rough night. The crazies seem to come out of the woodwork for these folks and you're going to be busy. I'm beginning to have that complex about myself. Yesterday someone made the comment that it seems like when I'm in the OB ward, things get crazy. It definitely felt that way yesterday.

I walked into the OB ward at about 8:15am and the nurse that had been on the night before called out from the labor ward "Emily, come and catch this baby!" So I went and caught the baby. Both mom and baby were doing fine....not a bad way to start the day! :)

About 20 minutes later we got a call for the ambulance. Then we got another call for the ambulance. Two places to go, only one ambulance. Since nobody seems to really like going on the ambulance runs and I still get a little adrenaline rush from it, I volunteered (along with a friend of mine that's visiting from Canada). They told us to go to the farthest place first. I asked how far it was and was told it's "far small". I've learned better than to try to get more specific but since they didn't tell me it was close, I knew we were looking at at least an hour.

Off we went.

Whenever I go in the ambulance, I always get the "Oh my gosh I can't believe this is my life" feeling. Traveling at breakneck speeds over some of the worst roads of my life with the siren going full blast and people in small villages jumping out of the way, will do that to a person. Toss in the fact that we're in the middle of nowhere and headed into who knows what kind of a situation where there may or may not be cell service.....and you can get a bit of a rush. That's what my friend and I were feeling as we were flying down the road.

After a little backtracking and about 1 hour, 20 minutes on the road, we found the village we were looking for. I got out our little maternity box and headed into the health center. When I got to the room I saw that the pregnant woman was walking around so least I know she's not almost dead. I laid her down to examine her and asked the nurse what the problem was. She told me that this was the woman's ninth pregnancy and she has eight living children. She had been in labor for 1-2 days but had just come to the health center that morning. She was concerned because the child was breech was afraid that her uterus would be more prone to rupture because it had been pregnant so many times. Valid concern.

I checked her for myself and sure enough, there was the little tooshie right there ready to come out. Ok, that's enough for me...let's go. I was afraid that she might drop that baby right then and really didn't want to try and deliver a breech baby by myself. I really, really didn't want to deliver a breech baby by myself, on that road!

As we turned to leave, the nurse told me that there was another woman who had come to the clinic complaining of severe headache and although she had been treated for malaria, continued to have the headache. Sure, throw her in too.

I told my friend that I wanted to sit in the back with the patient because I just wasn't convinced things weren't going to fall out. As they piled more and more people in the back, I began to question my choice. But at that point it was too late, so off we went.

I can't imagine being in labor and driving on that road. She couldn't brace herself very well because she was lying down and there was a metal box right by her head so I spent the trip trying to brace myself and trying to protect her from splitting her head open on the corner of the box. I had multiple arms grabbing onto my own as we were tossed about in the back. All of the sudden I hear someone heaving and....sure enough, the woman next to me is tossing her cookies. A few minutes later the grandmother lost her lunch in the back of the ambulance and another woman followed after that. Lord, please please please let us get there soon!!

After what seemed like an eternity we finally got back to the hospital with our two pregnant women, their families, their rice and the majority of their earthly possessions.

I wasn't feeling so hot after that ride so I delegated someone else to take the next ambulance run and went to check on the women we'd just brought. We checked the woman in labor first. No fetal heart tones. Crap. I hate that. We decided to try and augment to see if we could get her to push this baby out. If she failed to progress, we'd go ahead and do a c-section. We try to avoid that when we can.

About the time we finished with the first woman, the second ambulance returned with a young girl, about 17 who had been in labor for about a day and was failing to progress. We checked her and she was about 6 cm dilated with strong fetal heart tones!! Woo hoo! She was pretty small but it was her first baby so we wanted to give her a chance to birth the baby for herself.

After about 2 hours we decided that the breech lady just wasn't going to be able to deliver for herself so we took her to the OR. They pulled the baby out...and it was rough. You could tell it had been dead for awhile. The smell....ugh. It was a boy and he had been a big one. I cleaned him up and gave him to the family.

In between cases I checked on the woman who had come with the headache. She was about 32 weeks and said the last time she'd felt the baby move had been the day before. But maybe she had felt it that morning. We listened for fetal heart tones and didn't hear anything. Then we got out the ultrasound to see if we saw any little heart beating. Nothing. Darnit.

I moved on to prepare for the next c-section. Our smaller girl just wasn't going to be able to birth this one. I got everything ready with more adrenaline this time. This woman had been in labor for a while, but she still had fetal heart tones. The baby might not be doing well though, so I went through my mental checklist of what I could/would do if the baby came out in distress. The surgeon made the cut and I got my receiving blanket ready. As he pulled out the little kiddo he gave a good scream. Ah, I love it when that happens. I took him and got him all cleaned up and ready to show the family. There's always lots of onlookers and everyone gets so excited when there's a new baby. Some things just cross all cultures. :)

It was a long day with ups and a lot of days here. But two mamas got to go home with babies that they might not if they hadn't come so....we are trying, small small. :)

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