It smells like hot amniotic fluid

Bonjour!

Yesterday I did my first shift. When I got there, a woman was pushing. Because it was a first time mom they did an episiotomy :S Because of the demand on health care and lack of resources many students here run the show and do a big part of the work without much supervision. A nursing student was catching this baby on her own, with no one else with gloves on to help her. (today a student asked me to help her with a delivery, I dont think anyone else would have had time to help her, and so when she did her episiotomy I made her do it small). So this TINY baby was born and taken away. I never saw it again, and found out today in the registration book that the baby's weight was 2.5 kg (or 5lbs 8 oz). When a baby is born, they show the mother the sex of the baby and take it away to the relatives. I do not understand why as this is different from the way we do it at home. Once a male relative sees the sex of the baby he must sign in a book or stamp his thumb if he is illiterate. The rest of the shift was boring.

This morning we arrived in the labour room and looked through everyone's charts. most patients weren't in labour. But then all of a sudden a woman comes in on a bed with her legs spread apart and the bottom half of a baby and part of the umbilical cord sticking out of her vagina! The baby was a weird colour and dead. (29 weeks gestational age or about 7 months). Who knows how long the baby was there for. The nurses started an IV, got her on another bed, got the delivery table set up, etc. A nurse maneuvered this baby out. The baby was afterwards wrapped in newspaper and handed over to the mom in a plastic bag. Another woman was soon fully dilated after the breech stillbirth. When the baby was born Leah and I brought it to the warmer to help her breath (but before we did that, we had to show the baby's sex to the mother, who was disappointed it was a girl.). We gave her oxygen and suctioned her and stimulated her. I couldn't tell you her apgar scores because we didn't find a stethoscope for the first few minutes. Another baby was born maybe 2 minutes after this one and desperately needed resuscitation, so we couldn't give O2 to the other baby any longer (like we would have liked to). When I brought the baby back to the mother and put her skin to skin to help with breathing, the mother told me to take her baby off. !!! ??? What do you do then? There are many things I do not understand and I know that I am looking at things here through my western cultural lens.

Before Leah and I were about to leave to see a c section, one mom popped her baby out. This baby was thankfully born vigorous and well. Then we went to see a c section. Reason for c-section: unknown. Filip, a young doctor from Slovakia who is staying with us at the guest house arranged for me to be an assistant. It was fun but the doctor was more used to having experienced med students do this work. He would do something without explaining and ask me to do it next. WHAT! I am not a surgeon. However I did do a tubal ligation on one side. Thankfully Filip was the anesthesiologist and looked over what was happening and was explaining how i should do things. . The c-section baby was born, and suctioned and it took a while to realize the cord was wrapped around the neck. I tried to reach over and untangle the baby but wasn't able to. The cord was wrapped around 4 times. Leah took the baby to the warmer and helped teach the nurse how to bag the baby. We hope to get to teach the nursing students neonatal resuscitation now.


Certain drugs they give in labour, are unknown to us. :S

Apart from that living in the guest house is great. Filip, Leah, Lee (another volunteer, from South Korea) and I play card games in the evening and discuss what we have seen over the day. Filip is always so excited about the work he does and always wants to do more. Last night we had some pumpkin pie! DELISH! The electricity goes out often here. maybe 12x a day. I hope it doesn't happen when i'm about to catch a baby at night. There are many little lizards walking on the walls everywhere. People like them because they eat mosquitoes. We are now running out of toilet paper because we didn't find any at the market yet. :P


I'm hot and sweaty and probably stinky! :P