week twenty - labour room

after a week like this i realize it is getting more and more difficult to try and sum up my days in a single blog without going over bored in details probably boring those of you reading. so i’m thinking that maybe i’ll just write a few short stories from the week to give you an idea of what i’m experiencing out here.

this week: Labour Ward
first day, uniforms on, name tags in place and my lovely, but terribly uncomfortable, labour room shoes on, i’m ready.... as ready as one can be going off three months of education heading into a developing nations hospital where supplies are limited and women are all labouring together in the same room.

i’ll try and paint the picture of what this ‘ward’ looks like. you walk through the doorway and directly in front you have a desk in which the doctors and nurses like to hang out behind. record books are kept on this desk that list each birth that happens and a cardboard box holds each women’s card. (their card is kinda like their ‘file’ which holds there information, name, town their from, how many children they have etc..) to the right there are two rows of beds, nine in total. to the left there are another set of beds, five, and two ‘cribs’ with the sides down where the new borns are placed upon and a scale to weigh upon birth.

i guess that first day was a bit of a ‘welcome to the labour ward’ for me. we arrived around ten and were set right into the thick of things. the nurses being very trusting and short staffed assume that we can do anything and at times would ‘disappear’ leaving our staff and us six students to take care of things. so around eleven we had a catalyst of babies deciding to be born. at one point we had four heads crowning all at the same time. the phrase being heard through the room was ‘Melisa (staff) we have a head!’ “Melisa another head over here!” “Melisa, help!” she handled things very well and a few nurses stepped in to help deliver the babies that you just can’t tell to wait! my jobs for that day included getting things set up for the mama’s that were close to deliver,( getting the kidney dish, clamps, sterile gloves, razor (to cut the cord) and oxcytocin ready to inject after delivery to help with the placenta coming out and preparing against blood clots), and caring for the newborns. we saw around ten babies delivered that day, one lady delivered while sharing a bed with another women. because in case i didn’t mention although there are only 14 beds, there are sometimes women on the floor or sharing a bed. the day ended with a women labouring hard to have her breech baby born. it was the neatest things to see this little foot coming our first.... the doctors stepped in and got the baby out safe and sound, but not without a lot of work.

tuesday started off similar but with more women.... all the beds were full plus about an extra eight women on the floor. really crazy circumstances. things are meant to be sterile but kept on a metal shelf, resources are very low. gloves, syringes, catheters and others are hard to come by. women are responsible for providing there own cord clamp, gloves, razor and syringe. can you even imagine in Canada if you had to bring all your own supplies with you? crazy thought eh? i spent alot of the day taking care of the new borns. wrapping them in a dry conga, weighing them and then labeling them. by label i mean getting a piece of tape, writing the mothers name, babies sex, weight, APGAR score (how they are doing) and the date and then sticking that piece of tape to the conga. different eh? i think the hardest part of tuesday was a baby that me and Celia (my partner for the day) named Grace. she was born without a heartbeat so we rushed to one of the cribs and started recessitating. we worked on her for about 45 minutes, her heartbeat came back but was slow and uneven. we continued to pray and give oxygen but you could hear her little lungs struggling to take a breath. the scariest part was her eyes. from the time she was born they were unresponsive. they stayed open the entire time, she looked dead. even when we had to leave at the end of the day she still had no response. you could watch her chest rise and fall with pain.... we found out the next day her and her mother were transferred to a different hospital. i don’t know how if she made it through the night but have to take trust that she is in the Lords hands.

my next challenge happened the next day. i walked in to the left side of the ward and Melisa asked me how comfortable i felt to deliver..... i thought well, i think i can handle it. so i got my sterile gloves on and my partner, Celia came ready to help and take the baby after birth. this mama was not a fan of delivering, she was extremely difficult, she kept fighting us by closing her legs, which i can imagine is a little difficult to do when you have a head coming through. at one point her leg went up and around my neck... yes you can imagine the awkwardness of that situation! luckily a nurse came over to communicate with her that she had to let us do our job to help her. so with my elbows out trying to hold her legs and Melisa’s hands on mine, she helped me guide the baby out. a beautiful baby boy weighing 3.5kg! i dried him off and clamped and cut the cord and Celia took him to be weighed and further inspected. while Melisa and i waited for the placenta. a very difficult process, the mama lost a lot of blood and because she was not a fan of the pain she was in she kept moving around trying to ‘get away’ from us. (sorry if this is too descriptive for some) blood was everywhere, on the floor, on us, all up her back and all over the bed. the placenta finally came and i was guided in how to deliver it and get out any left over blood clots. to spare some details. when all was out i was left to clean up. the thing about deliveries here is the mama brings with her a bag of conga’s and they are used throughout the labouring process, delivery, as well as to clean up. so you use her conga’s to clean up as much as you can and then there is sanitary solution to wipe down the beds with. when she is cleaned up and a nurse has come to check for any tears the women are free to be moved to the post natal bed until they can walk to the post natal ward (sometimes the time that a women has between she delivers to the time she leaves for the post natal ward is less than an hour) this particular women remained on the bed for a while due to her large loss of blood. an iv was put in and her baby brought to her so she could be with him. my first birth. defiantly one i will not forget.

the rest of the week i did the basic labour room things, clean up, weigh newborns, assist those delivering and try my best to comfort the women in labour. a very productive, but exhausting week!

till next time.....