What Mothers go through for their children

A few days ago I had the pleasure of being at a birth of a mom who thought she would never get pregnant. She tried for years  and after 8 years of trying she gave up. Soon after she found out she was 2 months pregnant.  It was beautiful to see the Joy on her face and her sweet husbands face when their son finally made his debut.

Last night was an interesting shift. I walked in to find out there was an 18 year old mom who was at about 5 cm and not coping well. I did some back rubbing and breathing with her but at the peak of a contraction she screamed almost every time. I was starting to think she was more than 6 and luckily so did the new nurse coming on the shift with me. So we checked her and she was fully meaning  shes complete or fully dialated. I know this term is used in Canada and I’m guessing the UK, I just love it for some reason. 

The nurse and I set up and suddenly there were about 5 eager medical students in the room watching our every move.

Let me back up. So the midwives do the births and they have nursing students and midwifery students. The doctors help with high risk situations but don’t tend to be the ones to manage births unless there is a complication that comes up or a need for a C-section.  These medical students usually follow the Doctors around but they are all new and EXTREMLEY eager to see birth and learn about it in all its glory, which is great but something I’m so not use to. Having 5 other bodies that just stand and stare as you do your job feels really weird for me so I can only imagine how I would feel if I was the one pushing this baby out.

Ok back to the birth. So this first time mom pushed for about 15min and her sweet baby boy was out.  (back home it’s typical for first time moms to push an hour or maybe two) We put her baby on her chest and she started glowing!!  Next comes the hard part, the placenta. Usually placentas come out within 15min after the baby is born and in my world if the placenta isn’t out 30min after we get a little anxious. (If we can’t get it out and she’s bleeding we go in for it, and if she’s not bleeding and we've tried everything we can to get it out we go to the hospital)   So her placenta wasn’t coming and she wasn’t having any contractions to help it come. Basically she went from 5cm to fully to baby really fast and her uterus was tired and didn’t want to keep working. We gave her oxytocin in her IV bag, I made her do nipple stimulation, the midwifes have patients breath into a brown paper bag to get them to relax and they say this usually helps. I asked the midwife to rub her stomach to make sure her uterus wasn’t filling up with blood and sure enough gush after gush came and then it would stop. In St. Lucia if the placenta doesn’t come after 30min they call the Dr. and find out how to manage the situation. (Although they know how to manage they just need the okay from the Dr.)  It’s now 45min and she’s still bleeding and in my head I’m thinking “OMG people just go in and get it out PLEASE” But I of course just stayed calm and waited because I’m trying to be respectful of different management styles and seeing how the retained placenta that happened last week was in for 4 hours and came out without anyone going in after it I was feeling hopeful.  So I rubbed (Mind you every time I rub her uterus she’s screaming at me and pushing my hands away because as all you mothers who have had this done know, it does NOT feel good) and I rubbed some more and gush gush, PLACENTA!!! Woohoo!!!  I soon learned upon inspection that this was not an ordinary placenta it had what’s called a succenturiate lobe (almost like a mini placenta attached to the normal placenta) and a battledore cord insertion (the cord inserted at the edge of the placenta). The lobe explained why it was likely not coming. Phew glad that one was over.  After controlling her bleeding and her blood pressure finally going down I was happily able to snuggle her and her baby back to their room for the night.

After they were all settled in we had a readmission of a mom who I became close with last week. She was induced and labored for a few days and eventually ended up with a C-section.  After that she stayed in the hospital to recover for about 5 more days.  Both Caity and I became close to her and helped her with breastfeeding and postpartum support. I really enjoyed her and was excited to learn she was going to be moving back to NJ where the father of the baby lives in a month or two once she was strong enough.

She was back because she had a seizure at home that day and when she came in I didn’t even recognize her. She was likely hit by the silently and occasionally deadly eclampsia. I think pregnant moms know about pre-eclampsia happening prenatally because it’s talked about so much but it’s not talked about as much postpartum. 

At home I feel like I’m constantly reviewing the signs and symptoms with moms who have elevated blood pressure. It goes like this “If you have a really bad headache, vision changes, right upper quadrant pain or any extreme swelling especially in your face please page the midwife”

 When she was discharged her blood pressures were on the high but normal side.  And in 24 hours things changed fast. It was heartbreaking to see this typically smiling chatty woman in this state, her baby crying to be fed and her unable to hold her baby or even focus on your face.  

This situation happens no matter where in the world you are. It’s happened with midwives I know and it came very close to happening to a client I had this past year. So scary and so frustrating because we don't really know why it happens!

I guess I shouldn’t end on a sad note. So here is a sweet picture of the baby boy I caught. I held him for a bit last night to allow his mom the opportunity to eat.  He just kept staring at me and it's always so sweet to see new moms instantly fall in love!