29 January 2011

Catching Babies!!

I’m on Ob right now, which basically boils down to me catching babies!!

I wish I had a cool picture to post with this blog, but I don’t, so maybe I’ll do a picture posting blog later about all the fun stuff I do with my free time.  I have a relatively large amount of free time even though I work about 50ish hours a week: I work two 12 hour days and then two 5 hour days, for 6 days each week.  But we start work around 5 am each day, meaning I’m done by 10 am on my 5 hour days, making it feel like a day off! I tend to go to bed around 9 every night though…

Thursday I caught my first baby.  I had done c-sections before (assisted in them) and delivered a placenta, but I had never gotten to help with a vaginal delivery. 

I was on L&D West, which is where they send all the “high risk” pregnancies (women with diabetes, high blood pressure, etc).  I was on c-section duty that day, but two babies were ready to be delivered at one time, so the resident I was working with got shifted from c-sections to immediate birth, and I followed!  It was just me and the resident and a nurse in the room.  The mom was ready to deliver (we could see the baby’s head!) and we had her give three big “pushes” coinciding with her contractions, then she would have gotten a rest period, but on her 3rd push, the baby came out! 

Traditionally, the baby’s face delivers first, then it turns outward and its first shoulder gets delivered, then the rest of the baby slides out.  We got the baby out together, then I suctioned out the yuck from his nose and mouth, then clamped the umbilical cord, and handed him to the nurse.  We started to clean up the mom, and the dad was with the nurse taking pictures of the precious new baby boy. 

But the mom wouldn’t stop bleeding. 

We went through about 10 towels of blood as my resident looked for a cut on the inside of the mother.
She finally found one on the cervix, which traditionally bleeds a lot! She called in an upper level resident to fix it (she was a first year resident, so she called in the 4th year)  Who was followed by two attendings.
As they worked to repair the cut (which wasn’t deep, just far inside) the mom kept bleeding.  

A lot.

So they turned the delivery room into a full out operating room (the L&D west rooms are set up like operating rooms in case something bad happens, but this was supposed to be a low-risk delivery, nothing bad was supposed to happen!)

I turned into a makeshift scrub nurse (the person responsible for handing the doctors instruments when they call for them: imagine like it is on TV when the doctor calls for a scalpel and then someone hands it to them, but that someone was me!) 

Only they called for “suction” and towels and instruments with funny names that I didn’t know and then for needles….

So they sewed up the cervix but the mom KEPT bleeding.

Turns out she had uterine atony, which is basically when the uterus (which is full of blood vessels that just kept the baby alive) doesn’t clamp down like it should so all the vessels keep bleeding. (you can read about it here: http://en.wikipedia.org/wiki/Uterine_atony )

But thankfully, it was only the lower 1/3 of the uterus and we had anesthesia doctors to help keep the mom sedated.

And finally, after 3 hours and 3 liters of blood, we finally got her to stop bleeding.


So my first baby was delivered and thankfully both mom and baby are doing great! I had a lot of fun delivering the baby, watching a new life be born right before my eyes! It was really neat to share such a personal experience with the family, they were so excited and so happy to have a new baby!

Not everything on L&D is so fun or so rewarding (some things are downright hard, like when a woman younger than me (and I’m 23) who has been pregnant 8 times says she doesn’t want birth control because she thinks an IUD gave her cousin cervical cancer…which is impossible, cervical cancer is an STD) it’s heartbreaking seeing the cycle of misunderstanding and un-education continue.

I’d love to one day explain to women how their bodies work, help them become more educated so the cycles of poverty stop with them. 

Maybe one day…

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