Thursday, September 10, 2009

Welcome Back, B.

Greetings! Thanks for reading and commenting on the last few posts. The encouragement and wisdom has been such a blessing.

Wednesday morning I had the opportunity of returning to the birth room. With peers from my class missing and new ones present, I jumped into a fairly quiet birth shift and caught up with all the changes made while I was away as well as some of the highlights of summer from other midwives. AND, my first shift yielded my first delivery back in the saddle.

Grace walked in at 9:45 am and was sent to the CR (washroom) by my new friend, Mary. I was just finishing getting some meds dispensed for another patient waiting, when Grace decided that going to the CR was NOT going to be a good idea. I took one look at her and another at Mary and we decided it was time to get Grace into the birth bed.

Gloves donned, birth cart set, Grace knew her part....she rolled on to the bed and began to push. I laughed...Grace had done this before and was quite ready to meet her baby. No instructions needed. We exchanged names and stories between contractions. This was her second baby and she had a little girl at home....she was hoping this one was a boy. Vital signs were normal....38 weeks and 2's head became visible with next contraction. Grace smiled as I reported what I was seeing on my end.

Head was slowly coming as I instructed Grace to push only a little and breathe through her contractions.....a little more head came....and then a bit of a pop...

9:54 am, Ivan Jay was born with his hand glued to his head. He used his little man-hand to pop a small split into his mom's perineum. But he was strong, healthy and a good 7 lbs. His cry was immediate and alarming as though he was reporting on HIS birth experience. Grace smiled gracefully and without words, immediately brought Ivan to her to breastfeed. She knew the drill. Awesome.

Grace bled....a bit more than normal. We had to manage a small hemorrhage, but the bleeding subsided after some oxytocin, breastfeeding, and massage. Her small tear needed suturing and Ate Susan allowed me to sew Grace up. Ate Susan is a remarkable and patient teacher. Grace was good as new by the end of it all...and she was ready to go home. But we had to monitor her bleeding and urine output a while longer.

A great birth. Perfect. An awesome welcome back gift from God. And Grace got her baby boy. :)

Thursday ushered in another birth shift. This one was quite a bit different. Quiet came 4 labors. Two patients active and another two high risk. My patient, Liza, was having her third baby, but was significantly overdue. After two treatments with Evening Primrose Oil and labor stimulation, Liza was not having strong contractions.

Together Liza and I went through a regimen of labor induction that, unfortunately, did not pay off. We tried one more dose of Evening Primrose Oil and a stripping of her membranes....she was 4 cm dilated, then one full glass of natural laxative (I took it, too, just to be kind...that stuff sucks.) and together we ate a whole papaya. Her labor picked up....contractions were was doing well...then it was shift change and I had to go...not to the washroom, but shift was over and I had to pass her on to the next set of midwives.

I went over to the clinic that night to check on Liza's progress....after 5 hours, she was now 5 cm and her BP had risen to the point where IV fluids were necessary. I prayed for her and reassured her that her midwife would make the right call whether to transport or allow her to stay. I am not sure the outcome, but I imagine that she was transported. I will update you on that later. Please pray for Liza.

The laxatives worked. Nuff said.

And currently, I am on my way to shift number 3 for this week. I am excited to be back, though I am reminded of the physical and emotional exhaustion from an intense week of work.

Promise is still struggling these days....mostly from teething, but she now has a pretty nasty cold and diarrhea....oi. Please be praying for her. She has been such a trooper trying to adjust to all the newness. What a joy she is. Please also be praying for Tim, as he hangs with her while I am working and vice versa. Thank you all again for your prayers and encouragements. I leave you with two pics of Grace, her bana, Al, and baby Ivan. Be blessed.


Kate said...

So glad your first birth back was a great one! It is so amazing how you connect with your patients. (Glad to hear the laxatives worked, though I hope not too early in the shift!) I'll be praying for Liza, Promise and Tim! You too :)

love kate

navieira said...

Sounds like you're right back where you want to be my friend. We'll be praying for all of you!
Love Nicole

Jenny said...

What a wonderful welcome back gift. Beautiful births are the best... Good job.