Thursday, February 3, 2011

AROM to the Rescue!

Crhisma is one of my prenatal girls. Expecting her second little one, she came as soon as her contractions got strong. They had started earlier that morning, giving her plenty of time to beat me to the clinic. Her contractions were strong and frequent, giving the impression it was time to push. But after trying to push a few times, I didn’t see progress, so I chose to do an exam. She was 5 cm but in a G2 (second time mom) that could mean anything.

She labored beautifully, choosing to alternate between walking and resting for several hours. The contractions stayed remarkably strong and regular, so I expected progress when I checked her again later that day (by her request). However, she had regressed to 4 cm and her cervix had become somewhat swollen. Even after, six hours of regular, painful contractions, there was no progress. I was confused.

Her cervix showed signs of softening (very good sign), so I chose to rupture her membranes to see if that might move things along. A warm bath of vernix stained waters gushed out in a wave,  surprising me a little. I wasn’t excited about the intense pain she would experience from this point on, but I, also, didn’t want her to get exhausted.

She chose to stand and walk furiously with each contraction, which fortunately kicked up a notch. She is the first woman I have ever seen actually walk DURING the height of a contraction. Normally, they walk between them and pause with the pain -- but not her. It was unique and powerful.

I prayed things would progress, as the possibility of transporting her weighed on my mind. As I watched the sun settle in the west, I wondered if this wasn’t a case of CPD. If so, could I get her to Wau in time? I prayed for wisdom and then sat back and watched her walk.

Remarkably, only 30 minutes after rupturing her membranes, she started pushing. I didn’t stop her. Instead, I set up the room in anticipation. So what if she was only 4 cm a few minutes ago. If she needed to push, perhaps it was time.

She pushed on her knees with my translator at her back. She pushed well-- focused and determined. She pushed joyfully and even laughed when she saw her precious boy emerge! Crhisma was thrilled with the birth, which is all that mattered to me.

Afterward, while holding her boy to her breast she smiled sweetly and told me in her limited English, “You give name. Christian name. You!” She was honoring me with the joy of giving her son an English (aka: Christian) name.

The friends in the room were surprised by this honor, and so was I. They smiled at me expectantly while I thought. Images of strength and beauty flooded my mind and the only name I could think of was Samson. So I told her, I wanted him to be called Samson. Would she mind? She shook her head and smiled. No, that would do fine!

The problem was (and this is a problem I keep forgetting when handing out names), Samson is difficult for Dinka speakers to say. The “S” sound comes out like a “F”. So, as she said his name, it sounded more like “Fanfon”! It was adorable.

She and her friends, happily whispered his name over and over to themselves in practice. Eventually, they mastered it and kissed him each time they said it. Sigh. It was so fun!

I really do love my job! How could I not, when you have little ‘Fanfons’ populating the world?