Where is the key?

Yesterday Carolyn and I caught 1 baby each at the end of the day and then went for beans and rice for dinner at the Banana Chick Hunger Care Centre (sounds simple but it is such a pleasure the odd time we get beans). The lady from the grocery store we shop at treated us each to a banana for dessert. Carolyn has patiently taught Alix how to play whist and crib and we enjoy playing cards and drinking a beer on the patio of the Zebra in the evenings.

This morning all the moms were for CS but one, mom #1. The obstetric Operating Room was in use for general surgery all morning- an Ear/Nose/Throat doctor had been in surgery for several hours removing a foreign object lodged in a young boy's throat. One of the women waiting for c-section was in labour with her second baby. She had quite a bit of bleeding for 6cm and a bandal's ring was starting to form (separation of the upper and lower segments of the uterus- a warning sign of uterine rupture). Wisely Prossy advocated for her to be the first c-section noting pending rupture. She was right- by the time the c-section was done the uterus had ruptured along the scar from a previous c-section. The baby thankfully survived but the woman needed complicated surgery because her uterus had also adhered to her bladder with scar tissue. 

Another woman today had a blood pressure of 240/160- more than twice the healthy blood pressure. For some reason she hadn't received any blood pressure medication yesterday and was only being induced today. To make matters worse they are out of Magnesium Sulphate, a medication used to prevent seizures in women with pre-eclampsia. For a woman to buy her own costs 90,000 UShl ($35) -more than anyone delivering in a public hospital could afford. I hope she will be ok.

Carolyn caught baby #1- a very cute and healthy little girl and mom's perineum was intact- yay! Next a woman came in from home- she had been pushing for 4 hours and her baby's head was swollen with a blister and her vulva was swollen with a blister. The fetal heart was very fast. I didn't expect her to deliver but when I was assessing mom #3 she did. Baby #2 was born with a heart rate of 40, not breathing. Carolyn quickly began bagging the baby and then moved to chest compressions. She was about to give up when it moved its leg so she continued. Prossy told us to move to the nursery (where she could start an IV on the baby) so Carolyn and I walked carrying the baby down the hall while I listened to the heart and Carolyn bagged it- but the key to the nursery was missing so we had to stand in the hall holding the baby in a bloody blanket in between us while waiting for the key to be found. The baby never did breathe on its own and after 20 minutes we ceased our efforts and gave the news to the mom.

While we were resuscitating baby #2- mom #3 delivered in the first stage room. She had given birth to 5 previous babiess and had only been 5cm with mild contractions half an hour before. 10 min earlier when I had checked her blood pressure she still appeared to be in early labour...the is why we have a saying, "never turn your back on a multip!"

Tonight the administration has invited Carolyn and I and the group of Danish nursing students who are here to dinner to give them feedback on how they could improve. We are flattered that our humble student opinion is valued and look forward to the social time. Tomorrow we will do our mandatory shift in the antenatal ward.  We are braced to see up to 100 patients in only 8 hours!!!