Tuesday, June 17, 2008

75+ Baby Celebration









From the beginning, my girls and me :) have thought it fitting to celebrate certain landmarks. We celebrated once everyone had caught/delivered 25 babies, then 50, but then life got insanely busy, and our 75 baby celebration got semi delayed, that's why it's called 75+. Most of us are in the 80's now, with Superstar TK being in the lead with 97!! But the important thing is that the celebration did happen, and as expected, it was an amazing time had by all.

We went to the mall first for a Filipino ice treat called halo-halo and were playing the card game scum when we were told cards were not allowed in the mall! Opps... So we finished up there, and went bowling which was so great. After that we were pretty hungry so we tried out this new Indian restaurant and the food was amazing! To get to the restaurant though we got in a jeep that didn't look as full as it really was, so a couple people were on laps thus the pic of me and my human picture frame :)

After dinner we got off the jeepney early and walked the rest of the way home and had a blast taking different pictures. The shadow ones are so much fun - try and figure out what we are doing in both - hint the first one is semi-midwifery related, and the second has to do with us graduating this year. If you figure it out - leave a comment :)

Sunday, June 15, 2008

Chix and my 21 hour shift


I took Chix as a continuity (meaning I am responsible for all her care during pregnancy and birth and after. I did her initial prenatal, and ended up doing 10 prenatals with her - all of them! (unusual because sometimes scheduling conflicts can arise and another midwife may cover for another, but in Chix' case I did them all). I took her as a continuity because through pregnancy she was 16 years old (turned 17 in January) and a vegan! I didn't know they had vegans in this country, but I guess they do! Both her and her partner are vegans, and I wanted her to have one-on-one care to make sure nutritionally she was caring for herself and her baby well.

She came into the clinic yesterday (6/14) at 8:40pm while I was on shift (I was there from 2-10pm) but was still in early labor, so I sent her home to rest and labor a little more before returning. I tried to stress it would take many more hours, and to try and wait until the next morning to come back (I was on shift again from 6am-2pm the next day), but through a group effort I was finally woken up at 1am saying she was back and more active.

So I got to the clinic some minutes later carrying my pillow and asking God for strength to do what was ahead of me. I checked her in, and sure enough, she had just passed over the early labor phase and was entering into active labor. It was a long night for all three of us, but John (her partner) was a great support to her and as 6am rolled around, she was ready to have her baby.

WARNING: The story continues in a semi-detailed manner below this picture - not for the faint of heart (and/or stomach) :)

When her water broke it looked like thick mud instead of clear water. I immediately called in reinforcements and we did everything we could including me using alot of muscle to get the baby out as fast as we could. Fortunately her baby handled birth well, and she pushed like a pro. We gave Chix oxygen and that helped the process immensely, along with lots of prayer of course.

The baby was born pretty stable, although with low normal apgar scores of 5 and 7 (10is best). We still had a plan to refer him though because of the meconium staining in the water. We got him to breastfeed finally and were packing him up to go to the hospital, but waited a little while longer because Chix needed attention, and although I will spare you the details on that one, suffice to say her uterus wouldn't clamp down and stop bleeding so we transported them both at the same time.

I returned from the hospital at 9:30am and even though I was bordering on exhaustion, I needed to remain at the clinic because I was on shift until 2pm. The good thing was that it wasn't busy at all, so we were all able to rest a little bit.

I left the clinic at 2pm after being there for 21 hours 2pm on 6/14 - 2pm on 6/15 with only a 3 hour break from 10pm to 1am. I slept for a few hours this afternoon and plan to do a little more sleeping after finishing this post :) Both mom and baby are stable at the hospital now, and I will be able to visit them in the morning.

Friday, June 6, 2008

A God Thing

I met Analou about 2 weeks ago. She was 39 weeks pregnant and her baby was transverse (horizontal in the mom's tummy intead of up and down)It was easy to move the baby to a cephalic (head down position) so we sent her home saying she needed to start doing things to stimulate labor and to do deep squatting to help the head stay down.

The next week, a supervisor midwife did the prenatal on her, and she was breech :( She tried to turn the baby to cephalic, but it didn't work, so she advised her to prepare money now for a possible hospital transport later.

Then, today Analou texts me this morning asking if I will do a prenatal on her, but I was recovering from a long night shift so I told her unless she really needed me to come, to please have another midwife on duty do the prenatal. She was fine with that and a different supervisor did the prenatal declaring her breech and for transport.

Analou then texted me again this evening saying she was sorry for disturbing me (which I promptly informed her she was not doing) but would I be able to do a prenatal on her this evening again? She would come back to Mercy. She was so sure that if i did the prenatal she wouldn't be breech anymore. I warned her that the likelyhood of that being true was slim to none, but that I would love to see her tonight anyway and do what I could to help.

When I first felt her baby's position it screamed cephalic position to me, the head was felt clearly in the lower abdomen, but I didn't want to give her false hope, so i continued to palpate much longer than necessary, checked for fetal heart tones and then even called in a supervisor to double check. She confirmed that the baby was indeed cephalic, so we "untransported" her, put her file back in the working cabinate and told her to come back on Tuesday.

Please pray with me that her baby stays cephalic - his head is still pretty high which means he can move back to breech pretty easily. I told her to do squatting exercises and pray with me, but it would be wonderful if we could have more than just the two of us praying.

Thanks! I will keep you updated.

Tuesday, June 3, 2008

WAHOOO!!!!!

Hi Jennifer,

We have just reviewed and updated your file. It is complete and we will be able to send the permission letter to NARM for you to take the exam in August.

Good luck,

Lisa & Anna