Wednesday, January 30, 2008

John Loyd and Janice~ baby # 15

This birth was my third baby in three days... yup... that was a pretty busy week! No wonder January sort of flew by! :-)

But to get to their story...

Janice came in very active just after lunch. I did and IE to see how far along she was and she was fully dilated with a +3 station. What that means for you that don't speak the rare language of obstetrics is, she was ready to have her baby!!! :-) Great! So I told her that she could start pushing with her contractions. She looked at me, smiled and then gazed off all dreamy eyed. She would attempt to push when I asked her to, but they were not effective. She wasn't really making an effort. I was going to wait it out but my supervisor wanted her to push so that's what we did. She seemed very disinterested in the whole process, almost as if she were watching a vacuum salesman promote the latest SLR5000 model. It was very surreal. This was her second baby so i expected her to know how to push. But it took an hour of pushing (small and ineffectual) to get the baby's head out. But then she stopped pushing completely. She looked as if she was done... like she had done all the pushing she was going to do but her baby's body was still inside. I asked her to push again but she refused. I had to reach in then lift and pull her baby out! It was all very strange. Afterwards, she was very serene and calm.... happy and somewhat detached. Both are doing great and I'm happy to say, both seem very attached to one another now! :-)

Monday, January 28, 2008

Baby Luis Justin~ baby # 14

Marilyn, Justin's mother came in with a low grade fever of 99.9 degrees. We gave her an IV and monitored her to see if it could come down before we transported her to the hospital. When we did an internal exam, she was already 9 cm along. The IV helped and her fever came down somewhat so we kept a close eye on her and allowed her to labor at the clinic. She wasn't there long when she felt the need to push. This was her first baby so she was still learning how to push and making room for the baby to come. She pushed for about an hour, steady and slow and as a result didn't get more than a tiny skin split. All in all, it was a great birth.

Sunday, January 27, 2008

Precious Stones and Purple Flowers!

I got a call one evening around 9pm telling me that my continuity had just arrived at the clinic in labor. I had been praying for this lovely girl for quite some time after taking her as a continuity when I learned of her gynecological history. Her last two babies were delivered stillborn at the local hospital at 8 months and the doctors could not explain why.

This was her fourth pregnancy. She has a little boy at home who is five years old and seemed a bit nervous about her newest addition. I prayed with her, followed up on fetal movement charts and encouraged her to get an ultrasound. After she moved on into her 8th month and approached her due date, the fear of losing her baby was not as palatable even if it was still possible. She started looking happy and even excited about the birth. But she stayed reserved about it.

So when she came to the clinic in labor, I rushed over. It was a strange birth in so many ways. Her husband was attentive but I could tell he was a ball of nerves. I don't know why it never occurred to me before that he would be just as concerned as she that this baby live. I guess since I didn't see him for check ups, I sort of forgot about him.

Ruby was only 4 cm when I first checked her but her labor progressed well. She started getting "pushy" 3 1/2 hours later but she had a anterior cervical lip that needed to addressed. I got her on her hands and knees and let her push through several contractions that way, but she started showing signs of not coping well. It wasn't the physical but the emotional pain that was holding her back. My supervisor came to help and did perineal pressure to help the baby's head descend. She pretended to push somewhat but it was evident (at least from our end) she was not pushing at all. She tensed her body, she strained her neck, she got in the right position but SHE DID NOT PUSH!

We walked her through it for over an hour, we tried talking to her and asked what she was thinking. We encouraged her in every way we knew how but there was no progress. In fact, she was litterally crawling backwards on the bed away from me and my supervisor. We had to tell her to scoot back to the center of the bed twice. She thrashed and pretended to push but still didn't. Her baby's heart tones dropped dramatically and I have to admit there was a lot more stress in the room than I would have liked. One of my colleagues started telling her in Vasaya that if she didn't have her baby soon then we'd have to transport her to the hospital. It wasn't to that point yet, but apparently it got her attention and she pushed for real. From that point on, I believe little baby Iris was born within 15 minutes!

Iris came out completely posterior meaning she was looking up at me instead down at the bed when she was born. She was healthy and breathed well from the first minute. Ruby however fainted immediately. I believe it was the strain of the emotional stress because she had not lost much blood at all. She was perfectly normal when it came to her vital signs. It was just the fear and the potential pain. She woke up quickly afterwards and both have been doing great since then. Iris is healthy and strong and Ruby is doing very well recovering from the birth. This picture is of us all at their three week check.

An Even Dozen! (aka: baby #12)

The cute one in the bunny rabbit wrap is named Eugene. He came into the world quickly. His mother, Elgen, had a short labor and only 14 minutes of pushing! Her water broke while going to the bathroom and immediately she wanted to push. I did an internal exam to make sure she was fully dilated and she was!

Little Eugene came out with his hand right next to his cheek (aka: nuchal hand). This caused her to tear along a previous suture. I got to suture this! (This was my first time suturing!) It was challenging but unforgettable.

Sunday, January 6, 2008

Baby # 11 "John Rey"

Jashiel, John Rey's mother came into the clinic very active. As I was doing her initial vitals she had moderate to strong contractions. Immediately afterwards, she had bloody show and looked ready to push. I asked her not to push immediately but to breath through her contractions if she could. I waited a minute looking for progress then did an internal exam. She was 9 + cm and was very "stretchy". While I was in there, I felt the baby's head move from +1 to +3 Station in one push!!! She had her baby minutes later!
She commented afterward that this was her longest labor at MMC! But she had only been at the clinic 45 minutes in all! :- ) I think she was trying to chide me for not letting her push earlier :-) But still... what a quick birth! :-) Pas-pas kaayo! (vasayan for "very fast!")

Saturday, January 5, 2008

A New Year! A New Life!!!

Meet Little Christian! He was born on new years day! I worked on the swing shift and got to the clinic a little early. Lolita, Christian's mother had just barely arrived. She was active and getting "pushy". I finished checking her in by doing her vitals... and she started pushing! She had her baby 16 minutes later! She was amazing! Little Christian needed some extra help, he was cyanotic (aka: blue) for the first few minutes of life but with some oxygen and suction, he pinked right up! :-)

Tuesday, January 1, 2008

Baby # 9 Cendrella!!!

This lovely mother came in fairly active one morning at 6 cm. Her baby's head was in a posterior face presentation. That means the baby face was where the back of her head should have been. It was strange doing the IE as instead of a smooth hairy ball shape, I felt ridges! It couldn't quite place what I was feeling so I had my supervisor check her too. And sure enough, it was her baby's nose I was feeling!

She had some time before things got going fast so we had her do pelvic rocking to try and turn the baby into a better position and to get the baby's head to flex down. She was faithful to do the exercises, she moved a lot and was cheerful about it even though she was already quite tired.

About 2 1/5 hours later she felt the need to push so we had her push for a while. She did an amazing job at going slowly and breathing well. Her baby's head stayed close to crowing for almost 20 minutes as her perineum slowly stretched. When her girl was born, she only had a small tear that didn't need to be sutured. Later because she was still losing blood, I got to insert my first IV which went in with no problem the first time. Later we found a laceration internally that needed to be sutured.

Everything went remarkably well! She gave birth to a 7 lb 12 oz little girl and named her Cendrella! I told them that they had their very own fairy tale on their hands. And if they were going to name her Cendrella then, she would not be allowed to scrub floors, only marry Prince Charming!

Some interesting things about this mother. She had come in the day before to my prenatal clinic where I did the health teaching. This was not her normal prenatal day but she had missed her appointment and came the following day instead. After seeing me, she said she prayed that I would be her midwife and was so excited when she came in and there I was! Believe it or not, I was her answered prayer. :- ) She was a blessing to me as well! I look forward to getting to know her better.