Hemorrhage day

Hello everyone,

I see that many aren't able to post on the blog site, just keep those emails coming. They make me happy. Send me some of your news I try to get to the computer 1x a day.

Today we missed a birth by one minute. The baby was born term and well, which we were happy to see. Shift was starting and the nurses were starting to pray, all while a student was telling us that the woman who had just delivered was bleeding. Leah went to see and took charge while I was running around like a chicken with my head cut off to get drugs and IV equipment. Leah had to teach the student to put pressure on the fundus (top of the uterus) (this is the first thing we do when someone is bleeding). Because I took so long to get everything, Leah had to tell the student to do a bimanual compression (it's really aweful, we put our gloved hand inside the vagina to compress it), something neither one of us have done or seen before, but have been trained to do in emergencies. The oxytocin in the IV bag resolved the bleeding. What a great start to a day, eh?

Then a woman came in at term and bleeding. Ultrasound found that the woman had placenta previa (which means that the placenta is implanted near or on the cervix. when these women start dilating, the placenta starts bleeding out. The placenta is what keeps the baby alive before birth). So we followed this woman when she went for a c-setion. the baby was born healthy.

Things were then calm for maybe an hour. During that time, Leah an I make cotton balls and fold gauze, before it gets sterilised. We still haven't taken a picture of the mountain of cotton balls we have made. Fuzzies get into our eyes and mouth which is a bit irritating but e enjoy the time we get to sit and talk.

A few women got into active labour later on, so we decided to go eat lunch before we all got busy. But as we were leaving a student nurse told us that a woman was seriously bleeding. The blood pressure was 70\40. She was about 16 weeks pregnant and bleeding heavily and barely conscious. We kept having to wake her up. I did my first IV under major pressure. The first one failed because Leah couldnt find the IV tubing on time and the blood clotted in the canula. !!!!! Things aren't very organised here. When her skirt was lifted, we saw a part of the placenta hanging at the opening of her vagina. We pumped the woman with IV fluids. When we left from our shift, hours later, she was still in the same bed. I think she was waiting to go to the operating room.

After lunch, when we came back, a mother started pushing. A student caught that baby. While everyone was around that mother, I noticed another mom pushing, and one that I thought would go fast. i quickly decided to put those rubber boots on we are supposed to wear when catching a baby, and caught a baby my way! The woman didn't tear and therefore didn't need suturing. :D
And I didn't put cotton balls in her vagina, like I see everyone doing. YUCK! Leah was great and acted as my second midwife. It's interesting how we communicate with these women. I can only say the word push, and big baby. But I always ask permission to do examinations, etc. Today most women understood my question. Half an hour later, another woman started pushing. I was the only one that kept an eye on her (when she was pushing). A student wanted to catch this baby with me, and so we did a 4 hand catch. this student was eager to learn. It was her 12th birth. (and she is used to catching babies on her own! these poor students) I hope that the message she took was to better protect the uterus when delivering the placenta. Other than that she did great. Again this woman did not need suturing. YAY! These 3 last babies were born term and well.

Most moms today had baby girls. All were disapointed. :( Dowries should be abolished!!! What is the governement waiting for. One woman covered herself and started crying. I am guessing accroding to books i have read before, that these women don't want their children to live the lives that they are living, or they are scared of being blamed for having a child girl or knowing that the family will later kill the child. Infanticide is common here and probably impossible to keep track of.

Right before we left, a woman came in. She looked like she was 12 yrs old, though she was 28 (the oldest patient we have seen yet). While Leah was drawing her blood (to check for exposure to diseases, etc) the woman went unconscious. IVs were kickly started, etc etc. We later found out the woman was 7 weeks pregnant. Had been bleeding and having pains for 20 days before she came in.

When we left the labour room, we felt like an elephant had kept squashing us down the whole 8 hours. Though one good thing that happened today was that the nurses realised that we are skilled and here to help. We know what we are doing, more so then the rest of the students who are thrown in there. The students do so much, because of the MAJOR lack of staff and ressources.

Enough for today?
Tomorrow is our day OFF! :D