Wednesday, May 13, 2015

Stitches?


The third birth I observed seemed normal enough to begin with. The mother was 27 years old and expecting her second child.

When we arrived, her contractions were strong and frequent but she seemed to be handling them well. Within no time, her water broke displaying a yellowish puddle of meconium stained fluid.

The nurse set up the room for the birth (which means she got a bed pan, some non-sterile gauze, and a birth kit and placed it at the foot of the bed). The bed pan was slipped under the mother's bottom and she was told to push.

She pushed for only 5 minutes for the head to be born. But then the nurse reached in and wrenched him out. The mother stayed quiet while the nurse literally pushed and pulled and twisted and turned his little body every which way imaginable.

Two minutes later, the nurse lifted his body free of the mother with a gush of more mec-stained fluid.

The nurse then injected her with oxytocin to precipitate the placental detachment, then started massaging her uterus.

She massaged and pushed on it externally until 4 minutes postpartum it popped out in a gush of clots and blood.

She placed the boy in his mother's arms and evaluated her tear.

There was a tear but it was not deep. At most i would have put it at a shallow 2nd degree. However, as the nurse considered it, I overheard her worry how she was 'out of stock'.

I thought nothing of it, until a few minutes later I watched her suture her up with 3-0 acrylic (aka: non-absorbable) suture material.

She placed interrupted stitch after interrupted stitch, burying the deeper stitched beneath the more shallow ones.

My jaw dropped in surprise and my legs snapped closed in horror... but I didn't say anything. How could I?

We were guests there. I could not make those kind of calls... nor could I criticize them in their work. But I confess, I worry still what those buried sutures might do. Perhaps her body just rejected them and the string fell out as they healed.

That is my hope at least.