Delivering Babies

Tuesday, June 8, 2010

Today is our third day at the Minga Mission Hospital. We have delivered several babies, and although I have assisted and watched, I have not delivered one myself. One of the few things I dreaded about medical school was labor and delivery. I have never had any desire to deliver a baby and to be honest, the whole thing makes me nervous because I feel like I have no control over the situation. Dr. Fee was great about explaining everything ahead of time so that I knew what was coming. After watching a few I decided it was time to deliver one myself.

As we finished breakfast this morning, one of the nuns told us that there were three women in labor. Sharla and Mike have delivered a few babies and are kind of done with the labor and delivery ward, so MaryBeth and I headed over with Dr. Fee. I delivered the first baby and MaryBeth delivered the second, both without much difficulty. About an hour after I delivered the first baby, the baby’s grandmother came in looking for whoever delivered her grandchild. Dr. Fee pointed to me, and she immediately began dancing and calling out in excitement. She danced around me for a while, there was a lot of hip thrusting and I was kind of shocked. She told the midwife that her daughter had been in labor at home for two days and could not deliver, and she was endlessly grateful for such a successful delivery.

I spent a few hours with the third woman in labor. She was 19 years old, and this was her first baby. She was screaming and crying a lot throughout the labor. Dr. Fee instructed me on positions that may make her more comfortable, and I rubbed her back but she was inconsolable. She was thrashing around a lot and yelling. She kept saying “Help me Medicine” because I think she forgot the English word for Doctor. As her labor progressed, she seemed to start to remember more English. She started trying to rationalize with me, saying that she “had no power to deliver” because she had been up all night. She was asking for “some medicine to drink” but the only pain medicine we have is acetaminophen (panadol) and we can’t give it to them until after they deliver. When I explained to her that we couldn’t give her medicine until the baby was out she screamed even louder. Eventually she began begging for a C-section, which was completely out of the question. Twice during the labor, as she was kicking and screaming she almost threw herself off of the bed. I caught her once, and the second time she caught the bedpost just in time.

When the woman was finally ready to deliver, she kept rolling on her side and closing her legs every time she had a contraction. The midwife explained to her that she needed to push, so eventually she rolled on her back. As the baby was crowning, she started kicking and screaming and trying to pull my hands away and grab the baby herself. I was fighting her off with my elbows because I was trying to keep my gloves sterile, and MaryBeth and the midwife were attempting to hold her legs down. As the head came out, her perineum tore. I delivered the baby and started to clean her up while she continued to kick and scream every time I touched her. From behind the curtain, Dr. Fee asked me how the perineum looked and I guess I was still in shock because the only reply I could muster was “It’s…. not…. there?”. She took a look and concluded that the tear would need to be repaired. Dr. Fee and the midwife gave me the syringe of lidocaine and said, “you know how to inject, right?”. I know how to inject for vaccination, but not lidocaine! They were trying to explain the technique to me, but as I looked at the perineum it just looked like a mess. The midwife offered to do the first injection so I could see how it is done, and as soon as the needle touched the woman she started kicking, screaming, thrusting her hips and trying to grab the syringe out of the midwife’s hand. We decided the midwife had better do the injections and I would attempt to hold the patient down on the bed. The woman screamed the whole time the midwife was suturing. When she was finished, I left to meet the rest of the group at the convent for lunch. I was shaking and covered in sweat, and as I looked down I saw scratch marks all over my arms. Although delivering babies wasn’t as bad as I expected, I think I can safely rule it out as my calling in medicine.