When it is about to rain, in pour the labors. It was no exception to that rule this evening. We had 3 at once. It seems that there really is something to the falling Barometer deal.
The first one was a mom who had been laboring here all afternoon. Her name is Beautilyn and she did a wonderful job at pushing her baby out. At 4:57 pm she had a baby boy. Only thing is that she bled and kept on bleeding off and on. At one point, her banti helped her change her diaper (pad) and then told the guard that she was bleeding… but didn’t bother to tell the midwives… so we do not know HOW MUCH she bled. She was looking pale and weak, so we started an IV and did a manual removal of clots and found a membrane piece and maybe a small piece of cotyledon from the placenta. She stopped bleeding after that.
The next mom, Calle Deosyl, came in at 8 cm and pushed a baby out 9 minutes after the above mom did. I was able to assist both of the births by actually receiving baby and helping evaluate apgar score, cutting the cord and charting. Calle gave birth at 5:06 pm to a baby girl. She also bled a huge amount after placenta came out and we started an IV on her right away. EBL 800. She stopped after the major gush with the placenta. It just was a WHOLE lot at once.
The third mom, Ma. Cindy Traabucon was a G3 P3 and came in during the hemorrhage management of the two above and was 8 – 9 cm. She gave birth at 6:49 pm. EBL only 75cc, thankfully. I assisted by charting and doing most of the immediate postpartum checks. Her estimated due date was 9/18/07 and her baby boy looked really frosted with vernix when he came out. There was moderate to heavy fresh meconium in the water, so this baby was deep suctioned immediately upon coming out. Deep suctioning means that they put a thin tube down the baby’s throat and nose to get the fluid out of the esophagus and stomach and nasal passages. This may or may not help, but is hospital protocol. They also use the bulb syringe routinely because it is hospital protocol. So even if the baby is not gurgling, we use the bulb syringe. I use it sort of as a token suck in the mouth then nose and then put it down. Babies do fine without it, for the most part.
Earlier this afternoon, we had an 18 year old mom in labor with her first baby, that we worked with all morning in labor and then for about an hour and ½ with pushing. This was the first “wild” woman episode I have seen here. She was flailing around on the bed, screaming in pain. She grabbed her bana and shook him. She hauled on his neck, his waist and anyone else that got near. Bruises all around for anyone within reach, I am sure. She kept crying out in pain while pushing and was literally sobbing and begging for help. She would lift her bottom up from the bed and try to crawl away from the pain, literally. We had her try various positions and tried to comfort her. The Pinoy midwives were a little annoyed with her for acting out like this. Their culture dictates that a woman labors quietly and makes no noise… not even with pushing. She desperately needed a mommy. And although her mom was there, she wasn’t much help, but just looked on horrifed and kept trying to get her to be quiet. Although it is fine here to make noise while in labor and pushing here at the clinic, many times the bana or banti will try to shsush the birth mom from making any nose louder than a talking voice. This mom was yelling so loud, we were afraid that the neighbors would complain. Thankfully the clinic was almost empty at the time, except for a few woman and their babies waiting for their postnatal and newborn check ups and the last of the woman just leaving from their prenatals upstairs. This mom eventually did get down to work to push very well for quite a while, but the baby’s head just would not come under the pubic bone, no matter what position we tried. Then the baby started getting tired and having late decels of 70….80…. and 90, so we transported. I could hear her yelling outside and even in the ambulance as they drove away. The way the ambulance driver gunned it out of here, I think he was in a hurry too, for the sake of his ears.
So that was the gist of my shift today along with 12 prenatals in the clinic this morning. One breech baby, one mom who thought she was 17 weeks along, but no baby to be seen. And several moms with very low iron and one with a raging UTI or vaginal infection of some kind. It seems that all of these moms are high risk, with the exception of a few souls that try hard to eat well. Actually eating enough vegetables is not hard here, it is the everyday protein issue. But eggs are fairly cheap and can be bought individually. An egg a day and a plate of greens would go a huge way in making a healthy baby and mom. But instead, their diet of white, processed bread products, lots and lots of white rice and minimal protein creates unhealthy placentas and babies that are not very vigorous. There are no whole grain bread products for sale here and most families do not have any way to bake anything. Oats, and cornmeal are available in the grocery store in the mall. It is expensive for them and I can tell that mostly the white foreigners buy it because it doesn’t move very fast. I really have to watch the shelf date. Grainola and hot cereal are available here and I have literally lived on it for breakfast while I am here. This hopefully counteracts the white rice I eat everyday.