Busy day...4/6/10

Today was a very exciting day at the hospital. I stayed there all day because there was so much going on. I used to always love it when it was crazy busy at MLL (Maternidad La Luz). So, I really enjoyed the craziness of today.
First off, we had 2 normal vaginal births. There are several volunteer American midwives here this week, so there were a couple helping in each birth--helping a student to catch. I helped one student, and at the same time, the other woman was birthing (in the open room where everyone gives birth). The woman I was helping with, it was her 6th baby I think. 5th or 6th. Her placenta was partially detached and after trying for a little while just with cord traction I just put on a sterile glove and went in and detached the rest of it--it was VERY easy--totally different than the other one the other day. That was it.
After this, there was a woman who had given birth at home but come in for sutures. I helped a student with that, but ended up doing alot of it myself. It was an easy 2nd degree.
While this is going on of course there are alot of other women in and out, and the other staff working with them. I try to help with births when I'm there with the students. The other staff is very gracious about letting us come in and work. I am pretty amazed actually by how easygoing they are with it.
So, after this, there is this woman who comes in, and I'm trying to figure out why...well, all she said was that they sent her from another hospital, because the bb wasn't coming well. So I'm thinking: not coming in a good position? Or has not good fetal heart tones? Well, finally someone pulls out this letter of reference from a hospital 2 hours away, stating that the cord is coming first. I look, and there it is: a piece of gauze in her underwear, and the cord in the gauze. She had come 2 HOURS to the hospital with the cord hanging out of her vagina. I immediately put her in knees chest position and put the cord inside and held it inside. Well, her bb was coming transverse. So I could feel a hand, arm, foot. It took a little while to get in action for the c-section but finally it happened, and the bb was actually ok. The woman, she was just praying the whole time. The mother. She was full of grace, just praying. It was beautiful. The bb needed resusitaion, of course, but was fine. I got to watch the whole c-section, which was cool. Both the Cuban OB and the Haitian OB were in there. Good outcome. I still can't believe she came 2 hours. The other hospital, they don't have the facilities to do c-sections.
After this, I returned to the delivery room, and it was still full. There were a few labor assessments to do, and a few people in labor, and a woman waiting for a curettage who had an incomplete abortion.
Two of the laboring women were laboring with twins!
The first to birth, it was her 11th pregnancy. Both bb's were cephalic. She birthed fine, the bb's were a little premature--maybe 35 weeks or so (from what they looked like)--weighing around 1800g. Marthonie was able to get oxygen, which they needed, and we kept that on them for awhile. 2 of the American volunteers stayed on the bb's until we finally moved them to pp with their mom. I was and still am a little worried about them--they could have used supplemental oxygen still--and they weren't breastfeeding too well yet. Alot of moms, they put their baby to the side, maybe for the whole night, without BF them at all--and the staff doesn't usually notice/help with this. I saw a baby die here once who I think basically had been left all night by herself without any contact with mom, and she just faded away. By the time someone noticed, it was too late, she was almost gone. Anyway, so I really try to help the new moms start breastfeeding and holding their babies.
The next lady with twins, she also birthed fine. Her babies were bigger. They looked term. They were also both cephalic. This lady had 2 seperate placentas, joined by membranes. The other lady had a fused placenta.
It was so great to have 2 MOMS with twins laboring at the same time...plus alot of other stuff going on--everyone was busy.
When I left tonight, there was still one woman in labor. She was 10cms, just with no urge to push. For atleast an hour.
Being busy at the hospital is fun, and gratifying, and interesting. But, however much I may be helping or teaching, I am aware that there is alot of stuff that I don't know enough about yet to really help. Like: I did a couple of assessments on ladies who just needed to go home and rest, everything was fine--and Marthonie agreed with me--then there was this other lady, who also was fine, who I was going to send home, but Marthonie prescribed her anti-vomiting meds. It's the pharmacology that I don't know enough about yet.
I guess there is stuff that I am teaching that is very important and needed and there is some other stuff that I don't know enough about to be helpful with, and that will just have to be OK. I wish I could be proficient at everything, but that is impossible. And I know that what I am bringing is valuable.
I really noticed the students today doing well with the laboring moms. Being sweet with them, massaging them. I wasn't seeing that at all when I first came. The other volunteers who come have been modelling that behavior as well. It is rubbing off...I hope it sticks.
I am going to the US for 2 weeks on Monday 4/12. I am going to a Midwives for Haiti retreat/brainstorming session. I am briefly going to see my family, which I am so thankful for. I have missed them SO MUCH. I would like to see other people but there just isn't time this time. I will be home after this fall. And have time so see people. This may be the last blog before I go. So if it is...thank you to all of you who are reading it and keeping up with my life here. Thank you for being present with me and sending your love and support.
Love...
Reina