Thursday, November 15, 2007

Strong women stories

Hello,
I have grown and learned so much this placement and although I tell you all bits and peices, it is truly difficult for me to express the depth of my experiences with Sunday evening chats, so hooray for blogs.
I have done some neat things; I delivered an upside-down baby (not breech but posterior), otherwise known as "sunny-side up". It was a nice surprise, the woman pushed like a champion for 2 hours which really is average for a first baby so I am quite amazed! I have delivered a baby pretty much on my own, I have started IVs, I have given so many drugs through IV, I have sutured and tied knots and really grown in my confidence and skills.
But enough about me, really, I need to honour the strength of the women whom I am so honoured to help:
1: This young woman laboured and delivered with our support and no pain medications. Her husband was a bit useless in terms of providing support, asking me inappropriate, irrelevant questions while she was contracting and while I was talking her through them; I guess midwives truly need all sorts of skills. Some of which I clearly picked up while working at The Freeway.
2: I have experience my first significant post partum hemorrhage. I was with the woman all day (relieving the midwives who were with her all night). She had an epidural but still felt quite a bit of pain and an extrememly long labour. She started to develop a fever and her baby's heart rate started to go up with it. We got antibiotics in her and after talking with the OB, decided a vaccuum to c-section would be the best planned sequence to get the baby out. She did end up having a vaccum delivery which is great but her bleeding did not stop. She was panicked and in so much pain and could not even meet her baby right away; he needed a little bit of resuscitation but thankfully was fine. While being born his shoulders were stuck for a little bit and she required a huge episiotomy. Coming into the labour, she had low blood platelets. All of these things play a contributing role into a postpartum bleed. It was scary for me to see the nurses go through all of the lines of action; all of the drugs to stop bleeding, starting a second IV, the OB manually removed clots and bimanually compressed the uterus and by the end she needed a transfusion and some oxygen. I felt so helpless as I held her baby and repeatedly checked his temperature to make sure he didn't have the fever his mother presented with. I was also trying to communicate with the father what was happening in a sensitive and appropriate way - trying not to worry him until needed sort of thing. Thankfully, bleeding was stable after loosing an estimated 1500ml , she became stable and baby was stable. She is currently breastfeeding and fine, amazing.
3: Another significant birth for me was more recent. I pretty much managed everything on my own; the induction, the IV, the meds, the monitoring, the support, the catheterization... She had a 17 hour labour so I felt good by the time pushing came and we were worried that this would also be long. One push, she stretched her tissue right out, so impressive! A few more pushes and I could start to see the head appear and then retreat. I called the second midwife while my preceptor went to update the nurses. With more pushes, the head stayed crowning so I decided to put my gloves on. A few more pushes and the baby was born; our second midwife did not get there in time so I was the primary and my preceptor was the second. It was quite exciting. I am so happy for her to have pushed her baby out, she felt so defeated throughout her long, slow labour. She was young and it was truly beautiful for her to feel empowered in that way, she is also breastfeeding which thrills her and me of course. She has had and continues to have a difficult journey and it is strange and amazing that I can be such a supportive role - it really reinforces why I am doing this.