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7 januari 2017
Work work work
After a great relaxing day next to the pool, Thursday morning was a fresh start at the Maternity ward. When we walked in we found out there was a woman going for c section because of fetal distress. Eline decided to go with the c section. Lisanne and I decided to check out the childrens ward, because the senior nurse of that ward asked us when we were coming by. She showed us around and told us that most children were atmitted with malaria. One of the children was really happy to see a Mzungu and she wanted to hold my hand. It was good to see that most of them were doing well.
When I walked back in the labour room I saw Eline showing something to the other students. I immediately knew something was wrong with the baby. Eline had done a rescucitation, but the baby had died. It was very clear that the baby had abnormalities on the head, hands and feet. This sounds hard, but this made it easier that the baby had died. Imagine the life he would have had being alive.
Around 10.15 a woman with contractions walked in, she was a Gravida 6 Para 5 (meaning 6th pregnancy and she had already delivered 5 times). The midwives here also call it 'para many'. All previous deliveries were normal and had gone well. She was at 4cm dilatation. Eline and I thought finally a delivery again and would do it together. We went back to have a quick lunch and were back around 11.30. But sadly the contractions weren't really increasing and the dilatation went very slow. While waiting a midwife was teaching me some Luganda. The woman in labour was very nice and tried to speak with me. We communicated with some words and our hands. At 15.30 she was at 5cm and the head of the baby wasn't engaging. Eline and I both had the feeling there must be a reason for this, because she can deliver normally. But the midwife said lets wait, she agreed to call the doctor and discuss, but I am not sure that happened.
In the meantime another 'para many' came in, she was a G10P9. She was send in from a health centre with breech position and 8cm dilatation. We were really excited to finally see a breech birth here. The bummer was the woman had barely any contractions. I did a VE (vaginal exam) and the woman was 9cm dilatated and the baby was definitely in breech. I could also feel a foot. The midwife told me she wouldn't give oxytocin because she was a gravida many. When she was fully dilatated there were still just 2 short contractions in 10minutes, not enough. The woman tried to push, but it wasn't effective. Again the midwife would call the doctor and he would come check. I didn't feel stress, because I knew the baby was in good condition. But I was a bit annoyed by waiting for the doctor.
While waiting I hear a man scream for another labour room, I can hear panic in his voice. I know they just atmitted a woman with pre-eclampsia. I take a quick look around the corner and see the man in panic with his wife in his arms. She is having an eclamptic seizure. I ran in the room and take over the woman from her husband. I turn her over on her side and make sure that her airway is free. It is strange to see what is happening, she is completely away and but her body is so strong. I have to hold her and make sure she doesn't fall of the bed. She starts to drool and the seizure is strong. The midwives prepare medication and give it to her. Her body is relaxing more, but it takes at least 10 more minutes before she becomes more aware. The solution for this severe case of pre-eclampsia is to get the baby out. But the bloodpressure is still too high to go in for c section, first they have to stabilise her.
It is past 17.30. The doctor still didn't see the two woman in labour, he is now just seeing the woman with pre-eclampsia. All three of us are exhausted and decide it was enough for the day. There were no babies born, but I did feel usefull and learned a lot. When I came back to the house it is time for a cold shower, dinner and relaxing.
The next morning when I walk in the labour room I see the woman I left yesterday at 5cm. When I left yesterday I said I will see you tomorrow with your baby. I am amazed that she didn't deliver yet, she is being prepared for a c section. I am trying to block that it is already taking so long and blocking what would have happened in the Netherlands. The woman is happy to see me and I decide I will go with the c section. I am a bit scared that the baby might need rescucitation when it is born, because it has endured so much. But when the baby is born, he screams immediately and looks perfect. Baby number 13, a boy, is born and for the baby list he is named Miguel. During the rest of the day Eline also goes with a c section and Lisanne does a delivery all by herself, there was no midwife in the room! Baby 14, Nadine, and baby 15, Olivia, are born.
I am more used to working like the midwives in the hospital, but sometimes my mind is still blown about things. There is just 4 days of internship left and I hope we are able to do more deliveries. Time is going really fast, but I am also happy that coming Friday our week off starts.
Webale! Meaning thank you. Thank you for reading my blogs and all the nice responses.
Lots of love from Uganda
7 januari 2017 11:20 | Door: Saarkwadraat
Hee lieve meiden! Wat een verhalen weer !! We leven met jullie mee, bijzonder om te lezen allemaal. Geniet van jullie laatste dagen stage en daarna vooral ook van jullie welverdiende vakantie. Heel veel liefs vanuit het zwembad hier in Sri lanka xxx saar&saar