Tag Archives: labor

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Honey and the ants

Honey is in her second year working. She escapes clinic because she has a labor patient. In the daytime! Not on a weekend or at 2 am! Hooray!

She has to hang out, because this is baby number five, so it could come really really fast. Everything is cool. The mom has more experience than she does, nearly. Well, Honey has done more deliveries, but has only had one baby.

Honey starts to feel itchy. Agitated. It’s not skin at all. Something is bugging her. She goes in and out of the room. The nurse seems totally unperturbed, but Honey feels like ants are attacking her, from the inside. She goes out the room and studies the rhythm strip, the baby’s heartbeat. There is a printer feeding out in the central nurses station.

Screw it, thinks Honey. I make look stupid, but I don’t care. She calls the obstetrician. It’s the woman who is on. Honey is a Family Medicine physician. They are in rival clinics. “Hi,” says Honey, identifying herself, “I need a consult on this woman.” She reels off the medical details, Gravida 5, Para 4, all vaginal deliveries, no complications. “I just feel like there is something wrong. There isn’t anything really bad on the strip. But I need you to come.”

The woman obstetrician comes. She sits and studies the heartbeat strip. Honey still feels like ants are biting from inside. The OB puts the strip down. “There is nothing on this that would get you in trouble. But you’re right: something is wrong. Come on.”

Honey has not told the patient that she’s calling the obstetrician. The patient might be annoyed. They go in the room. The obstetrician introduces herself. “Dr. B called me to consult. We have a bad feeling. We want to do a cesarean section.” Honey is sure the patient will say no. She is wrong.

“Me too,” says the patient. “Do it.”

They do the paperwork and move quickly to the operating room. Not a crash cesarean, not an emergency, so spinal anesthesia, not general. Honey assists.

They are in. There it is. The umbilical cord is wrapped four times around the infant’s neck. It has not tightened down. Honey has goosebumps as they gently unwrap the cord and do the delivery. The baby is fine, no problems, apgars of 9 and 9. They complete the surgery, mom is doing fine too. Honey still feels rattled but the ants have gone away.

The mother is relieved when she wakes, glad they did it, glad to hold her fifth child. The obstetrician is in charge of post operative and Honey is managing the baby. They don’t really talk about it, everyone acts as if it’s all routine. If the cord had tightened down, everything still could have been ok, but it would be a crash cesarean section, general anesthesia, more risky for everyone. It could also have not been ok.

Honey is relieved to go home, adrenaline draining away and leaving her very very tired.

Honey decides that she will listen to those ants, that feeling, any time it shows up.

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Based on a true story, at least, on memories, that are unreliable. Aren’t they?

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Birth

I am born today anew. Why does birth feel like a rejection, like a spitting out from the shelter of a womb, a body, a mother, a community, a job? I gasp in the new unfamiliar air, unsure how to use my lungs in this place. This labor was not terrible, not as hard as ones in the past. The air and light are shocking, I open my eyes, what is this place? Too bright, I close them. Hands have me and then I am back with my mother. Not inside but against her skin. The lights are down and I open my eyes. It was dark, dark, dark in that womb, so I open my eyes wide, to take in all the new information. I am shocked and afraid, but my mother’s heartbeat reassures me. I hope I won’t be eaten. What is this place? And now I am hungry and I start to search, not sure how to do it, search for food.

For the Ragtag Daily Prompt: birthday.

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daily work

For the Ragtag Daily Prompt: labour. Or labor.

Happy Labor Day! I have been gone, out of the reach of wifi, out of the reach of an outlet, hidden in the woods. I did have batteries and took photographs. What is the work of a woodpecker, what is their daily task? Do they want to take a vacation day, are there days where they slack, are there days where they do not do much?

I am happy to be back and sad too….

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Love, labor, laughter

Blogging from A to Z, my theme is happy things. Love, labor, laughter, I love my labor, my work (except when it is driving me nuts, of course). I love my family, including my cat, my friends, taking photographs, writing and blogging, the list goes on and on. I have a very silly streak and love to laugh.

I love being in my local Rotary. I get to work on real world problems, local and international, meet exchange students, and work with a diverse group of people in my town.

The photograph is of Patrick, in Hawaii, with my “stealthie” shadow, up at 9600 feet.

And we found a Rotary meeting in Waemea and showed up and were welcomed. We had a delicious lunch. This photograph is of the club banners brought to their club from all over the world! I didn’t think to bring a banner from our club, but will take one on the next trip.

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I’m still a day late, but hooray for the letter L.

L

 

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death in childbirth

When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”

We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….

Preeclampsia? No. Not that common. Eclampsia? Ditto.

“What if a woman is in labor and the baby is stuck? What do they die of?”

Ick. “Bleeding?”

“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”

We were all silent.

When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.

We would like to think this is in the past, but it isn’t. It still is going on, right now, inΒ  poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…

When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….

http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-43

http://www.msf.org/en/article/perils-childbirth-democratic-republic-congo

http://www.who.int/maternal_child_adolescent/documents/childbirth/en/

http://www.who.int/mediacentre/factsheets/fs348/en/

Donate:Β  http://www.doctorswithoutborders.org/

The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.