so...we are into our 2nd week of clinicals with the students at St Therese hospital, and our 3rd week of classes. this morning we had a beautiful birth! i feel so happy. this was how it went: a first timer, 19 years old, who came in in active labor and then soon started pushing...she was tired--hadn't slept or eaten for 2 days, and was pushing weakly and not making much progress. she pushed only for about 1 1/2 hours maybe--maybe a little longer--and at the end of her push, we gave her an IV with pitocin in it to help her contractions get closer together so she could push her baby out--it really worked. we also got her squatting on the floor, and she pushed there for awhile and brought her baby down. i caught her baby; she had the placenta there on the floor too. everything was good. she had a small laceration that i sutured...the students tight now, they are more observing, and practicing their basic skills, but they're not catching babies yet or suturing, for example. what i really loved about this birth was that we were such a team! i had one person documenting everything--every fetal heart tone count we got, everything--and one person assisting--listening to FHT's after each contraction--it really felt like a team, plus, we were able to get her onto the floor which helped her so much. she did a really good job, even though she was so exhausted. it was a nice slow birth where i was really able to explain alot of things to the students and get them involved in supporting her.
last week: it was a little crazier. there was one day where we had a woman who was only 10 weeks pregnant--severely anemic--her hemoglobin was 4.6--maybe it was 3.6--she was having a hard time--we were going to do a blood transfusion but the red cross had no blood. i don't know what happened with her. at the same time as she was there, i was catching this lady's baby who had died inside of her--an IUFD (intrauterine fetal demise)--she was "8 months" pregnant but the baby looked more like 20 or 22 weeks (5 months)--so i caught her baby, and really tried to get the students right there by her side supporting her, stroking her, massaging her...we had induced her that morning with 100 mcg misoprostol (cytotec)--she had her baby like 5 hours later--a footling breech--so, she had cried some, i thad told the students not to tell her not to cry--to encourage her to let herself cry and that we were there with her--so she had cried some before, and now too, and then now, with this bring her 1st baby, and being 18 years old, after all of this hardship, there was another problem: her placenta was partially separated and she was bleeding...we decided to do a manual removal (after trying uterine massage and giving pit)--so i had to do that. we had no anesthesia to give her. she did her best to cooperate but she was up the wall and i had to follow her up the bed. it was excruciatingly painful for her. as soon as i was done i looked at the placenta, which was complete, and showed it to her and everyone else, and then got up right next to her and agnowledged that this had been really traumatic for her and that i was sorry...i am really trying to model compassionate behavior for the students...also for these other students who are at the hospital...they have no supervisor...they don't know anything...they just watch and sometimes help with something...these other students are in an auxialliare school (like nurse's aid)....
besides this IUFD, there was a twin birth maybe the day before, or maybe it was the same day...an 8th timer...with polyhydramnios (too much amniotic fluid)...the babies were premature (24-26 weeks?) and didn't make it...there was a midwife here last week, Jill, who just so happened to be the one who held all the babies as they were dying...there were the twins, then there was another baby that died who was premature, who she held as he was dying...she used this opportunity to model behavior to everyone that basically was showing love to a dying baby....counting babies born already dead as well as those who died after birth last week, there were 6.
the premature baby i just mentioned was born to a very sick mom the day before. she was severely preeclamptic, to the point of having pulmonary edema. she had very labored breathing and also was coughing alot and appeared to have something else going on with her lungs. she also ended up with a manual removal of her placenta---really hard---she is still sick and was also very anemic. i am going oto check on her today when we return to the hospital.
the household here is going pretty well. alot of things to orchestrate all the time and lalot of communication to do with the volunteers. but it is going well. we have also finally 'more or less planned our upcoming classes, so that is a relief.
blada and i are doing great. i love living with him and spending time with him. there are so many things we want to do together. little by little we do them.
i am really enjoying being back in haiti and feeling that my comprehension of creole is on a new plateau. really exciting to see the progression. languages are so interesting. seeing where words and expressions come from...it is endlessly interesting.
i love all you guys...