Thursday, October 20, 2011



I’ve told you guys a few birth stories and so far, they’ve all been good. But, it’s not always like that. I transport a lot of patients to the hospital. I’ve probably transported more than I’ve delivered. Sometimes it’s easy. It’s a patient who is ok with being transported. You haven’t made any attachments to her. You’ve only spent 10-20 minutes with her while you were checking her in. Other times, it’s really hard. It’s a patient who, when you tell her that you’ve got to transport her, buries her face in your shoulder and starts sobbing because she is so scared. It’s a patient who you’ve labored with for the last 8 hours and have really connected with. It’s a continuity that you’ve done all her prenatals for since she was 7 weeks pregnant. Those are hard.

I’ve had a couple of difficult transports in the last couple of weeks. My first one wasn’t a labor, it was a baby check. I’d delivered the baby a couple of days before. The mother was this really adorable 16 year old. It’s interesting with 16 year olds. Some of them who come in, they’re women. They’re grown up. Others are really still just kids. This is one of the ones who was just a kid still. She labored really well. The birth was a little difficult. The baby was a bit stuck because the girl’s perineum was really tight and we were sure that we were going to have to do an episiotomy. In the end, we didn’t have to. I thought for sure her tear would be huge, but it was actually really small. In the end, I was really proud of this girl.

So, on Sunday, they came in for their 3 day baby check. Everything seemed normal, until I checked the baby’s heart rate. It was 68. The average for a baby’s heart rate is about 120-140. I called the supervisor to have her recheck. She got 80. With massive amounts of stimulation we could get it up to 116. Something wasn’t right. We explained to the girl and her mother that something was wrong with the baby’s heart and they needed to go to the hospital to have it looked at. So I went with them to the emergency room and staid until I was sure that they were getting care. I’m still waiting to hear back on what the doctor says. I should know next week when they come for their one week baby check.

My second hard transport was a few nights later. I was endorsed a patient when I got to swing shift. It was a really sweet 38 year old. It was her fifth baby. Her second baby had been born in the hospital and was a still birth. Her last two babies were born at Mercy. I labored with her for all of shift. She was great! She was walking around, drinking, going to the bathroom often. She was happy and talkative between contractions, joking with the midwifes and baby checks who were there. She was a perfect labor. Anything I asked her to do she did. I had really good feelings about this birth.

Around 7:30 she was in a lot of pain and her contractions were really frequent. I went and sat with her in her cubical and just rubber her back. Then I asked her if I could pray for her. She said yes and I did. Just as I finished my prayer, she asked for a birth stool. I was so excited! Usually the women here want to give birth flat on their back. When they want to give birth squatting or on the birth stool it’s always a special treat. It’s a more natural position than laying down. They’re less likely to tear. And it’s just a nice change up from what we usually see. So we get her on the birth stool. I get a mirror and flashlight so I can see what’s going on. She pushes a little with contractions and I see what looks like her bag of water. My supervisor is holding the flashlight for me and she says that it looks a little funny. So she repositions the flashlight so we can see a little better. It’s definitely not the bag of water. It’s her bladder. Our first response to such a distended bladder this late in the game is to catheterize. So we did that and then just tried to hold the bladder up. I was having trouble holding it though so my supervisor decided to help me out. She took over. The moment she slid her fingers in she went, “Something’s wrong.”

The woman wasn’t fully dilated, but neither I or my supervisor could really tell how far along she was. Her cervix was mushy and flappy and strange. The supervisor speculated that it was possibly a previously torn cervix that hadn’t been sutured. Either way, we just aren’t equipped to deal with what we were up against. The baby’s head would come down well with pushing, but it would get caught against the bladder and cervix. If she kept pushing there was a possibility that her bladder would rupture. So we explained to her that we were going to have to transport. She cried. I wanted to cry. I was now doing three things at one time. I was trying to coach her in breathing through contractions, help the supervisor put an IV in, and help a first year fill out transport papers. Finally, we were able to get the woman into a wheelchair and to the ambulance. On the way to the hospital I could see how scared she was. I’m pretty sure it was because the last time she gave birth in the hospital, her baby was stillborn. I did the only thing I could at that point. I reached my hand over and placed it ok her belly and just prayed. I prayed that she would have peace. I prayed that the doctors would have wisdom and compassion. I prayed that her delivery would go well and that both her baby and her would be fine. When I was done, she looked at me through her tears and thanked me. I told her that I was so sorry there was nothing else I could do, but I would continue to pray for her. That seemed to help calm her.

We got to the hospital and I explained the situation to the doctor. The doctors have always been pretty nice to me and this time was no different. They took my patient and got her to the birth bed immediately. The doctor told me I could go. I went back to the ambulance and just continued to pray for the woman. Sometimes there’s nothing else you can do.

So there you have it. Yes, there are good births and good shifts. There are also hard births and hard shifts. There are so many situations that only prayer gets you through. And that’s not just midwifery, that’s with missionary life in general.

Ok. Enough about the birth room. Here’s what I’ve been up to other than babies. I went to the beach with one of the first years on Saturday. We spent the entire afternoon laying in hammocks, eating deep fried bananas, and drinking coke. It was exquisite. Afterwards, around dinner time, we went to Precious Gardens Resort for dinner.

We ate down on the beach. Our waiter was great! He was a Baptist who had a million questions for us. We ate our dinner and just talked with him about God and the Bible and everything. There were a few times when he started tearing up. It was really refreshing to have a genuine conversation with a Filipino and know that he wasn’t just talking to me because I’m white. He was very sincere with us and I really appreciated it. He also told me that I have a nice smile.

Other than that I’ve been pretty busy with my assignment and birth room shifts. I caught six babies in September! Five of them were within two weeks of each other! So I’ve been pretty busy!

My birthday was last week. I didn’t really do much. But hey, I’m 21 now... I don’t really have any plans until after I’m finished with this assignment, but I’m probably going to the beach for a couple of days. I could use a break. As always, thank you all for your prayer and support! It’s all greatly appreciated!