Wednesday, December 18, 2013

A Surprise Delivery

So today at the clinic a baby girl was born…but not in your typical way. The maternity ward is on the outside of the clinic building, and this afternoon one of the counselors at the clinic ran into the main area of the clinic looking for Rhoda, one of our midwives, and told her to hurry as a baby was about to be born. Now I had heard from Rhoda about 2 hours earlier that the mother was dilated only 4cm, and Rhoda had figured she wouldn’t deliver for several more hours. I went back with Rhoda as she examined the mother and found her membranes still intact and her not dilated very far. Rhoda explained this to the mother and then went back to her meeting in the main area of the ward while the women was left on the delivery bed to wait. About half an hour later a women came running into the clinic yelling, “we need a nurse!” I heard this and came around the corner to find Rhoda running and Anne following her. I asked what all the screaming was about and a co-worker told me that a baby was born. Oh, I thought another false alarm, this woman needs to learn that she still has a ways to go before she will deliver. However, upon entering the delivery room I found that indeed a baby had been born. The mother was no longer lying on the bed, but instead was squatting on the floor while Christine, another one of the midwives squatted next to her while cutting the cord and subsequently disconnecting the baby from the mother. A huge puddle of blood and amniotic fluid surrounded the woman. Instantly, my NICU mind started going. At Rush I was used to carrying around a pager signaling a delivery, and occasionally the NICU team and I would find the room was not prepared for a  delivery or we arrived within seconds of the baby being born. However, in this case there was no light on in the room (power was out) and the room was dark, but I could tell that the baby was blue and not crying. The midwife had a bulb suction and used it as she stimulated the baby. I searched for gloves and then was able to help weigh the baby, wrap her, and give her a Vitamin K injection and erythromycin eye ointment as the midwife helped the mother get back into the delivery bed, deliver the placenta that was still inside her, and stitch her up. This mother was a multip which helped account for her quick labor, but still I was surprised that the baby was indeed born that quickly. Lesson learned, always listen to a laboring mother, they know their body best even if they don’t have the medical background to prove it. This whole experience reminded me of the Rush NICU stories about babies being born at home, in ambulances, in the ER (which we nurses had to run to- and it was not close!) in the toilet, and in the antenatal room. Being a newer nurse I was often assigned first admit, meaning I wore a pager and was the nurse assigned to deliveries for the day. This left a lot to the unexpected and some days my pager would signal an emergency meaning I would have to quickly grab a heavy red emergency supply bag and run to wherever the delivery was. Although some were false alarms they always had my heart racing and adrenaline flowing. Although there is no pager system here or emergency bag my heart was racing as my mind went into “NICU mode” like old times.

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