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.