Sunday, February 3, 2008

Pink and pretty

I got one!

A baby - at last! Well, the student midwife technically got it as primary accoucheur, but I was hands on too, and it was lovely to see a birth again after a break of a few weeks.

I'm learning heaps.

Had a woman go to theatre the night before for a placental abruption - her trace looked pretty dodgy as I walked in the door and I now know that it was happening right there and then! Mum had just passed a large clot, but no further and contraction were weak. She wasn't sectioned for another 90 mins. The baby made it - just. Another 15 mins and she may not have. Even though she was premature she was in extra trouble due to the bleed and the parents were very grateful to have the nursery on hand. After removing lots of blood from her airways and stomach she was doing much better. Much examining of the trace and discussion of the clinical symptoms which in retrospect added up. A good timely call that saved a life. I learned a lot.

Later that same night I looked after another couple with baby no 1, who went on to birth a few hours into the day shift. Another nice normal birth, of a premature baby who wouldn't wait, but all OK.

My second night shift. A beautiful young mother and her partner, being induced, well overdue with baby no. 1 ( from Jan 19th!) who contracted heaps but was not distressed at all, and gently dilated a bit, but the last click of hormones got her well and truly going! Its one of those things you just can't convey without scaring the bejeesus out of them - that they kinda must get a bit intense before the finish line.

We turned the hormones off after 7 hours (at 4cm) as baby was getting a bit stressed, but she was finally off and racing. And yes, transition still sucks, but she just made it through, after begging for an epidural after an intense 20 mins. At 8cm I called the anaesthetist who arrived promptly and had the chat, but as she was about to sign she contracted and said "what was that?". It was a gush of amniotic fluid and a secondary mucous plug heralding the arrival of second stage!

She was excited to hear that she was fully dilated and happily waved goodbye to the anaesthetist. We got her up to quickly change the copious wet stuff beneath her and had a baby about 20 mins later!

I've never seen such an easy descent and second stage for a first-time Mum. It was lovely to see. She just pushed a bit as she wanted to, side lying, using a bit of gas, but baby was making her own way out and crowned slowly over 3 contractions. Mum gasped at that moment when the biggest bit has passed - such a sting, but such a relief. We waited for a minute for the head to rotate and gently drew her out helped by a couple of pushes and she was BORN! Baby Chloe had a little squawk before looking up at her delighted parents who quite rightly thought they were the cleverest people in the world for making such a gorgeous baby! Intact perineum (yay). . .

Followed (boo) by a PPH, dammit. I had called another midwife in as back-up during crowning to make up some extra hormones for a possible PPH. Once again I was onto it early and called the troops - the student midwife thought I was a bit quick, but I just had an inkling it was going to get worse. Sadly the midwife didn't make it up as there wasn't much blood by 8 mins after the birth when she left to register the birth, and she hadn't torn obviously. However I am starting to really trust that inkling! 1400 mls. Luckily she had been taking iron religiously and her haemoglobin was at an all time high prior to the birth. She wasn't feeling too bad considering.

The clinical midwife who was present at the birth said it was a lovely birth and she was shocked to hear about the PPH and confessed to not making up the extra as I requested. Which explained why, after I pushed the assist bell, the troops couldn't find the bag made up as I had requested and assumed HAD happened somewhere behind me while I was guiding the birth. Oh well. Baby Chloe hadn't left Mum and Dad's arms the whole time while we were messing around wading through blood at the other end so they barely noticed all the fuss as they drank their daughter in! She was so adorable with great big dark eyes, creamy pink skin, so alert and drug free and keen for a feed.

The day staff came on, there were kisses all round and many congratulations for being the cleverest primip we had seen (shame about the PPH).

Have you heard? I love being a midwife.

1 comment:

Lisa W. said...

you are learning to listen to your inner voice! that little angel on your shoulder whispering that you need to preplan for the trouble just ahead! glad everything worked out well..and congrats on a nice nice job. And the RED DRESS! GORGEOUS! you will look stunning in it of course! and your vocabulary/rice game....loved it! i stayed between 44-47 the entire time...amazed my daughter with the lexiconography! (mostly dumb luck from 1..reading so much and 2...knowing 3 diff languages and guessing from the root words..but lots and lots of fun..)thanks for the link to the michigan midwife..great post she had! hope you're having a nice WARM's 20 degrees BELOW FREAKIN' ZERO here today!