Please Don't Let My Baby Die!

I know that I haven't blogged much since I got the kids, and believe me, there is much to blog about. I will continue to share some of my stories from this last year, BUT I have to cut in the middle and share one "fine" day here in El Paso.

I know the title to this blog seems dramatic, but it will make more sense as I re-tell these 12 hours that I had worked. I will not mention who or when this happened, but I have to sort through this.

My shift begins at 8 am and I try to get there a little early so I have time to gather myself mentally for the rush of prenatals; unfortunately I was 10 minutes late to this shift. When I had arrived , there were was a waiting room full of women and only one other person available for prenatals, not to mention a laboring woman vocalizing her pain in a very LOUD way. I felt bad for the women waiting for their prenatals...you couldn't go anywhere to escape hearing her pain. I can't imagine the fear they felt thinking they would experience the same thing she was experienceing. Although, not everyone does that and that's hard to explain that not many scream, yell and wail! I will refer to the woman in labor as Lady G. As I walk into her room, I was told by the Midwife ending her shift that Lady G was a VBAC (Vaginal Birth After Cesarean). Now in this country...VBACS are dangerous, considered high risk, and, in certain states, illegal. HERE it's legal and there are risks, but better and safer for the woman to deliver vaginally than have a repeat surgery. Anyhow, Lady G was different...she had a baby that died halfway through her previous pregnancy and had made the decision "to get the baby out", so a c-section in Mexico was performed. This meant that her uterine scar would be higher on this now well stretched uterus and her risks of complications in labor higher. I then found out that her Doctor in Mexico said if she had not delivered by Friday the he would go in and "get the baby out" yet again. I really think this poor woman's "cries" were more than just the physical pain but the emotional pain of losing the first baby mixed with the fear of losing this one with all the other pressure to deliver by Friday.

I had left her room to get some of the prenatals done and found it difficult to focus with Lady G in labor down the hall. One of the prenatals was a first time Mom (Lady C) who had not been due for another week and was anticipating the childbirth class for the following week. Upon her exam, she had said she had not felt or had any contractions, but her cervix told me different. She was 5-6 cms, almost completely effaced and her baby's head was low. I had told her to send someone to get her stuff because she would probably have her baby by the end of the day. She was SHOCKED...Fortunately, there was a childbirth class going on that afternoon that she could sit in on..lol! I sent her to class with the intention of admitting her to the birth center later that day.

I returned to Lady G who was really wanting to push. Yes, she was complete...I felt overwhelmed and nervous...I have had not so successful outcomes with the last couple VBACs (they had to be transported and sectioned again)and I was fighting the head games of the risks we face with VBACs. She had only been pushing 10 minutes, when one of the secretaries informed we of another woman who walked in with her water broken but no contractions....all I could think was NO BUENO!!! (I'll explain why later) Since she wasn't in hard labor so she was going to have to wait. I returned to Lady G who was struggling with the pain....I now know why it was so hard for her...the baby's heart rate was fluctuating but still within normal. Now, it isn't all that great to have a VBAC push for too long so you don't strain the uterus causing it to possibly rupture. If a ruptue occurs both woman and baby can die. She began to complain of a constant pain inconsistent with normal labor. I became concerned. There were no other signs of a uterine rupture or close to it, so the pushing continued. She pushed for 1 hour 47 minutes....then we could see Baby's Head! Finally, she would be done very soon. His head began to emerge, then crown slowly. Once his head was out, that was it...nothing. No further descent, no movement....He was stuck. I had had a feeling and had prepared the interns in the room ..we quickly went into emergency mode, calmly. All I could hear was Lady G praying at the top of her lungs. Why? Because when I finally pulled him out, he was limp and lifeless. All I wanted him to do was breathe....breathe, Baby just Breathe! At 1 minute postpartum (after birth) all I could get was heart rate, no reflex, no breath, no color, no muscle tone! By 5 minutes, I was able to get him to cry and pink up. Thank you, Lord! My heart was racing....this woman needed her baby to be healthy, but alive more than anything. As soon as the baby was stable, I had to focus on getting the placenta out.....came out no problems, except for the fact that Lady G began to hemorrhage. Once we had her stablize, she was able to bond with her son....who when he cried she cried. I asled her if something was the matter and her response was beautiful...." No mas estoy feliz que el llora" ( It just makes me happy that he cries). That's when I knew her labor cries were very much so emotional more than physical.


Moving on with the day, I had to check on Lady M, the one who came in with her waters broken and no contractions. With the protocol of the birth center, the ladies have 24 HOURS to deliver post rupture or they have to be transferred to the hospital. I don't like to worry about time restraints. I wasn't all that worried even though she was only 3 cms, but the day was just too crazy. I gave her 1T of castor oil at 9:30 and again at 10:30. Fortunately by Noon, she was contracting every 10 minutes. At 1:30 pm, there was a waiting room full of women for afternoon prenatals and childbirth classes. By 2:00pm, Prenatals were done and the women were in class, to include Lady C who had just begun to feel some contractions. At this point Lady M was really contracting ever 3 minutes! I checked her at 3:00pm and moved her to active labor since she was 6 cms. At 3:15, she wanted to push; at 3:30, she was complete and Baby Boy was born at 3:38pm. He basically flew out! I didn't yet realize that the parents did not know the sex of the baby and when I announced it was a boy, both Lady M and Hubby cried! He was long awaited for after their have two little girls at home! It was another beautiful birth and much more peaceful that the one I had earlier!

By 4pm, the class was let out and the childbirth educator had informed me that Lady C's contractions were right on top of each other evidenced by her pacing back and forth furing the class. I had sent her into the only birth room available and was going to check her to see if she was further along. She was still very "happy" and did not make it noticeable that she was in heavy labor. In fact, it appeared as if she was in early labor. I check and fellt a 9.5 cm dilated cervix! She was near done, sort of. Because she was a first time mom and first time babies may take a long time to be pushed out, I had her continue to walk around during contractions to help lower the baby. About an hour and a half had passed and Lady C had too much of an urge to push to not. She was freezing cold just as we began second stage (pushing), but ready to get the baby out. Minutes into her pushing, she bcame overheated, couldn't breathe, and "lost her sight". Her vitals were quickly checked to include the baby's heart beat and all was within normal. Her whole countenance had changed and something was the matter. I had asked her if she was scared and she looked me in the eye saying, "SI, tengo miedo" (YES, I am scared). I had asked why she was scared and she began to cry out, "No le deje a morir! Quiero que nada le pasa a la bebe" (Don't let the baby die! I don't want anything to happen to the baby.) UMMM WHAT!!!??? I tried analyzing why she would think this baby would die. She continued to tell me how she her husband had died just two months before and did not want this baby to be taken from her too. Everyone in the room was filled with tears. My heart ached for her and I found it difficult to keep it together. I had given her the option of transporting to the hospital if it would make her feel better, and according to her response, she was NOT GOING to the hospital. She just needed constant reassurance. I tried to reassure her with the sounds of a normal heartbeat from her baby and telling her how her husband was there with her. He was inside her heart and uterus, she was going to give birth to a large part of him. For a while it felt as if nothing was reassurning and she kept repeating and crying out, "No le deje Morir!!" (Don't let her die). I had to leave the room to regain myself and the role I needed to play in this birth- the strong one who was not freaking out! I re-entered the room with a slightly different approach with a touch of tough love. She then had wiped her tears and changed her fear into determination. She pushed like mad and that baby slid out. Once she was born, the baby immediately opened her eyes to look at mommy and screamed! Lady C reached for her daughter with cries of joy and stated how she looked like her daddy! I believe he was there with her. It was so special and beautiful to watch Lady C's adoration for her daughter...so complete, but with a small hole in both of them.

The day shift had come to an end...it was all I could handle, and God knew it since the rest of the night was quiet. It was a day of firsts. First baby after a previous dead baby, first boy to a family of girls, and a first to an unintended single mother. Some days, I wish I had a "normal" job, but my job is anything but. It isn't even a glamorous or high paying one, but I wouldn't trade it for anything in the world. It is strange to think I can go from resucitating a baby, dealing with a hemorrhage, or transporting a woman who cannot deliver naturally any longer much to her disappointement, to going to work out, parent meetings, football games almost as a secret double life. I feel as if I live a double life. Sometimes, I resent it; sometimes, I want to go and share these life changing experiences to all I know in a very real way. Some appear to be disgusted or weirded out by my profession, and don't realize that I deal with life in an unfamiliar reality. I am proud of what I do. It is difficult, but is a high calling; it is one that not just anybody can or would do. After a day like this, I just know ...that I was made for today...to weep and rejoice with these beautiful women on the momentous occasions.