Tuesday, January 8, 2008

Little wonders

I had a day at work today that has left me very reflective about the privilege of being a midwife, and very moved to be honest. As I drove later in the day I heard this song on the radio that about summed it up.

Little Wonders, sung by Rob Thomas from http://www.stlyrics.com/lyrics/meettherobinsons/littlewonders.htm

Let it go, let it roll right off your shoulder

don't you know the hardest part is over

let it in, let your clarity define you

in the end we will only just remember how it feels

Our lives are made in these small hours,

these little wonders, these twists & turns of fate

time falls away, but these small hours,

these small hours still remain

Let it slide, let your troubles fall behind you

let it shine until you feel it all around you

and i don't mind if it's me you need to turn to

we'll get by, it's the heart that really matters in the end

Our lives are made, in these small hours

these little wonders, these twists & turns of fate

time falls away, but these small hours,

these small hours still remain

All of my regret will wash away somehow

but i can not forget the way i feel right now in these small hours

these little wonders, these twists & turns of fate

time falls away but these small hours, these small hours, still remain

So...it was a morning shift and I entered a room to a woman struggling with a less than ideal epidural. Probably heading for a C-section as she was 'stuck' at 8cm. She'd had two previous vaginal births so it was a shame that after labouring spontaneously she would not go the full way. However with epidural tweaking of drugs we began to win, and when the Doc came back 30 mins later she was suddenly fully dilated and a head was close-ish. Yippee!

Unfortunately there it stayed for an hour and a half. Mum pushed really well, and moved around alot, which should have freed up the little tacker to descend but he wasn't coming out to play! We could see his head regularly but it didn't get any closer. She was scared, and tired and I turned her on her side, covered her with a warm blanket and gave her a big hug for a minute or so and promised her we would birth this baby, in this room, pretty soon. I called the doc back, and finally, as she was about to examine her, the head started to emerge properly. Yay! A slow and gentle birth, intact perineum (a first for this mum) now just wait for the placenta. And wait. For 15 minutes. Out it comes. For once I examined it there and then on the bed, suspiciously wondering if there was any reason it had taken so long - no, definitely complete, no bits missing. But then...

Trickle, stop, pour, stop, gush, stop, spurt...oh shit... Waaaay too much blood all of a sudden. Hit the bell, warn the parents the room is about to fill up with people and I want it to! Thank God it does. 2300mls later it stopped. That's close to 4 pints of blood. Out of one small woman. She was pretty pale. And shocked. But alive - because we all worked hard in a well rehearsed manner to keep her alive with drugs and fluids and massage to get that uterus firmly contracted instead of the flabby (bleeding) sack it kept trying to resemble.

The dad was really calm and brave. He happened to be holding the little one as it happened and just took himself off to one side and turned his back to us (I later found out that he wasn't good with blood). Various midwives would have a brief encouraging word with him as they stepped around him and his new son (who had been pretty grunty and mucousy at birth and I was already a bit concerned about). But he coped fine cuddled up with his dad.

The storm troopers left after 35 minutes and we got her bed changed (and weighed the extra blood in the linen for the final loss total) and after a nap of an hour she woke up and had a big cuddle of her boy, all 4kg of him (8lbs 8 1/2 oz). He was a sweetie, and she declared him well worth the effort and the drama, and was very grateful for the small blessing of an intact perineum! She headed off to the special care unit with bub, and may need transfusions but is alive to tell the tale.

I love to see a normal spontaneous birth. But I trained bloody hard in order to be capable of responding to emergencies such as that one. We hope we never need our training. But by God I'm grateful to have it. And access to drugs that save women's lives.

We saved a woman's life today. Just one. Many more throughout the world were not so lucky.

Our lives are made in these small hours, these twists and turns of fate.

And these little wonders still remain.
P.S. This is my friend Jo -2 previous PPHs - and her husband Iain and son Thomas - who I caught - in the caul - with no PPH.
I love being a midwife.


Natalie said...

"Sometimes blogging is like thinking aloud...but of course Natalie! You say that like its a bad thing!

We blog because we DO think."

Ah, not *bad*, but sometimes I feel a bit rambly and not all of my insights and brilliant thoughts are publish worthy... lol.

Natalie said...

What a great story, and I love that your skills were sharp and ready... Very Good. Very, very good.

I just got your comment about the fabric food, as I was responding to Helen's comment about going in to the *food* business. I was telling her what a surprise it has been to hear such positive feedback. Thank you for your generous remarks. I am sitting a little taller.

Natalie said...

So delightful... now when I don't see an updated post, I think: Oh, she's off helping a new life emerge. And it makes me really happy.

Jennifer said...

Hello there! You were kind enough to stop by my blog and post, so I wanted to come over and see what you were up to. I was interested to see that you were a midwife and immediately had lots of questions for you, then read this amazing post and had most of my questions answered. I was fortunate, when I had my son (sigh, almost 10 years ago!) to be able to be attended by a midwife within one of the top hospitals in the US for having babies (Brigham and Women's Hospital in Boston); my challenges weren't to the extent of this woman's life whom you saved, but it turned out still to be very important to have that best-of-both-worlds combination -- a midwife in a supportive (and staffed and equipped) hospital setting. Hurray for the wonderful people like you who choose your profession and do so much good in the world!

fiveandtwo said...

You are SOME WOMAN. I wish you'd been my midwife when I had my babies. I really do.

infomidwife said...

What a great reflection, I like the way you related to the wonderful song "little wonders" it is one of my favourites as well. Keep up the good work.