Its time for an update again. I spent Sunday "on call" at the medical center. This means that from 8am Sunday morning until 8am Monday morning, I was at PIMC (with my midwife preceptor) seeing patients that came into OB triage and managing the laboring patients. When we came on there wasn't a whole lot going on, except for one patient who we might have to induce for having high blood pressure. Well, it didn't take long before Triage was busy with pregnant women, coming in with everything from mastitis (breast infections) to nausea/vomiting (at term, so this isn't 1st trimester discomforts or anything) to women who thought they were in labor, and were hoping we would confirm their suspicions with the all-conclusive fetal monitor and vaginal exam.
Not too far into the day we decided that C.L. (the pt with high blood pressure) was going to need to be induced. But, right when we decided that, 2 patients in Triage came in who were really in labor. So we admitted them to Labor and Delivery (L&D) and got them set up with epidurals (as they both requested them). We really only have 2 labor rooms, so we decided to postpone inducing C.L. until the other 2 were done. Well, these 2 ladies were neck-in-neck, and sure enough around 3 they both reached 10cm. Well, F.G.'s epidural was working a bit too well, so she had no sensation to push. We decided to take advantage of this and let her be for a bit since M.B. was feeling the urge. The whole time we were with M.B. we kepting praying that F.G. wouldn't start pushing without us. It wasn't long before M.B. pushed her beautiful healthy baby boy out, and as soon as the placenta was out we went nextdoor to check on F.G. Well, she still wasn't feeling anything below her waist, but when we checked, the baby was just sitting in her birth canal. So, palpating her abdomen so we knew when contractions were, we gave her her knees and instructed her in when to push. Sure enough, not more than an hour after M.B., we caught another boy! No complications there. Until the placenta. We waited and wated for that placenta, and it just didn't want to come. Well, it finally did, but not without spewing a fountain of blood across the room, covering the delivery instruments, floor, wall to the bathroom, and dad (who had a great view with the camera). Somehow the midwife and I both escaped relatively clean! We gave Pitocin, methergine and cytotec to decrease the bleeding, and pretty soon she was set. A good day's work?
Well, now it was almost 5pm and time to induce C.L. So we got her an epidural and started her on Pitocin. Somewhere in there we scarffed down lunch and dinner (not at the same time). Well, things kind of quieted down, and by 11pm we decided it was time to nap. We had to check on C.L. every 2 hours (unless of course the nurse paged us sooner), so we set our alarms for 90 minute naps. We got about 3 of those in before 5:30 am, checking on C.L. intermittently. She made some progress, but not much, so at 6, we decided with the MD that it was time for a section, and C.L. was so tired by this time, she was ready for anything to get that baby out. Well, right as they are getting ready to move her to the OR, T.S. walks into triage definitely in labor. She's 5cm dilated and looks like she's moving right along. Well, the only problem is that the midwife has to assist with the C-section unless we call someone in to help, and the midwife can't assist with the section and deliver T.S. So, we called in the midwife who was going to replace us at 8am, and she left her house (45 min away) to come in early. Meanwhile, the midwife goes back to the section, and I'm left to follow T.S. with the labor nurse. Well, less than an hour later, she's 8cm, and we're walking her back to L7D. Thankfully, right was we were getting worried about someone being there to help me with the delivery, the next midwife walks in. T.S. ended up taking a bit longer to have her baby, but by 8:45 I had caught my 3rd baby of the 24-hours, and was more than ready to call it a day.
This morning I was back at it again, and by the time I came home at 5:45, I had caught 2 more babies, for a total of 7 in the 2 weeks I've been here. 7 down, 33 to go!
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