Friday, February 17, 2012

Speed Birthing.

Prayer night had just ended, and I was settling in for the night when I heard a timid knock at my door and went to answer it.

-- “Moses needs you,” our new guard whispered. Moses, one of our health workers, was working the night shift.
-- “Is there a labor?” I asked.
-- “Yes. Mother in labor,” he continued quietly.

When a health worker is too busy to come himself.... there’s an emergency. When he’s calling ME... there’s a birthing emergency.

I didn’t bother changing into scrubs. If it was a birth, I’d never get there in time if I did. So I grabbed my watch, a pen, and slipped on my flip-flops.

I didn’t run though. I find that running in flip-flops in the middle of the night can be hazardous to my toes. Plus, you’ve got to take your time in scorpion season. You’ve just gotta!

I arrived a minute later to find a mother pushing so hard she trembled.
    -- No wonder he sent the guard to get me!

Moses was moving faster than normal to get the room set up, but it had only been a few minutes since she arrived. It still wasn’t prepared.

As I watched silently off to one side for her contraction to fade, I took note of her body language.  She was having this baby; and she was having it fast!

Jaws clenched in determination, she continued to push on the edge of the bed. And just as the contraction peaked, a clear jet of waters jumped across the room, splattering four feet away.

Moses was still gathering the basics, so I asked her her name.
-- “My name is Adut,” she grunted between contractions.
-- “Adut, where’s your booklet?”
-- “At home. Forgot it.”
-- “Do you have a file with us?” I continued. I’ve started keeping records at the clinic, for just such occasions.
-- “No. You did not give me a file....”

Humm... that’s odd. Her face was ober familiar. I was almost sure I had a file on her.

-- “Give me your full name... I’m going to look it up.”

She gave it to me through clenched teeth, and in between purple pushes. But then it occurred to me, I’d never have time to look it up anyway.

Instead I slipped a pad under her butt, and started looking for heart tones. They were low (100s, 90s), but that’s normal right before the birth, due to head compression.

All I knew about her was that she had been here before (because her face was so familiar), her name was Adut, and she really wanted to push.

So I let her.

-- “Push hard, Adut. You can do it!” I coaxed. The head was already started to peak out.
A friend supported her head while I supported her perineum, and Moses stood to one side, handing me things.

Three minutes later her precious boy was born!

She delivered exactly 6 minutes after arriving at the clinic! And it wasn’t another five minutes after that when her placenta plopped into my hands. It had an additional lobe, so I took the time to show it to Moses so he could learn. 

As I inspected it, Adut cocked her head slightly in disgust, but Moses came in closer for a better view. It’s not everyday a Dinka man is willing to get so close to a placenta. Kudos to his teachable spirit!

-- “Adut, your placenta is healthy. I’m just looking at it to see if it’s all there,” I explained.
She nodded she’d heard me... but the look of disgust didn’t fade.

Another five minutes later, she was breastfeeding her munchkin and asking to go home.

-- “Normally I ask you to stay for a few hours for observation. Can you stay the night and go home tomorrow?” I asked a little pleadingly.
-- “No. There is no one else to care for my kids at home. I cannot stay.”

I had suspected as much. Frankly, the fact she came at all was a miracle. She had stayed at home until the very last minute. And now that the baby was out she needed to hurry home... and soon.

Her bleeding was very slight. So I promised her she could go home early if no clots came.

They didn’t.

And an hour postpartum she was cleaned, dressed, and prayed for. I discharged her with a few mild warnings, and she was off.

She walked out without the slightest hint of pain in her gait. Her friend walked beside carrying her little boy in her arms.

Humm.... I’m still not sure what to think. All I know is the women around her are STRONG!