A birth

Warning: this post may be a bit intense.  The other day the health post was very exciting.  It started when an elderly woman with high blood pressure came in with a really gnarly wound on her palm.  She clearly needed stitches but I guess people were a little concerned that the extra stress might kill her off.  We determined that she had been taking her pressure meds and so decided to proceed with the stitches.  The wound was very deep and had plenty of exciting fat and stuff squishing out of it.  Since she was going to need quite a few stitches we decided to give her some numbing.  So the young lady I work with stuck a needle into her gaping wound and started applying lignocaine into the tissue.  This did not look very pleasant for that old lady, but more excitingly I did not pass out or even feel light headed.  Then I got to hold her hand still while my co-worker started stitching her up.  The first stitch was too close to the edge of the cut so when it was tightened the thread just pulled through the skin.  At this point my counterpart intervened who has more experience with jagged wound stitching and just flew through the rest of the stitches.  I was impressed.  It was like watching a tailor.

As we were closing down for the day a lady in labor came in and I was invited to stay and check out the birth.  I ran and grabbed us all some snacks and then settled in for the ride.  The lady was put onto the stainless steel birthing table then we just waited.  It was just me, the soon to be mom, and two of the health post ladies.  I was told that if I was asked if I were a doctor to just say yes.  The younger lady would occasionally put on a glove and stick her hand inside the mother to check on the baby position.  This would make the mother gasp in pain, but I’m sure it was nothing compared to what was coming.

The younger lady is a pencil thin but very pretty 20 year old.  She is probably 30kg soaking wet.  She has really gorgeous light brown, sparkling, almond shaped “Indian Princess” eyes that are offset a bit by a slightly abnormally large gap between her two front teeth.  The older woman is tall for a Nepali with very good smile-crinkles around her eyes.  She tends to slouch some which makes her appear as if she has a bit of a belly.  She is not very good at communicating with a non-native speaker.  She speaks very fast, and tends to garble her words a lot, but I’m learning to understand what she is saying.  I remembered the preggers lady from her pre-natal visits to the health post because she has these insanely striking, almost golden eyes.  Every time I saw her she looked a bit haggard and uncomfortable from being close to 9 months pregnant, but I can imagine her eyes would light up like a sunset when she laughed and would be like staring into the eyes of a wolf when she was angry.

We had to insert an IV drip for oxytocin, and I was really nervous about watching this go down since last time I was around an IV I passed out.  But, as I’ve mentioned, I gotta nut up.  So I watched all of it.  The whole set up, then slapping the back of the lady’s hand while she made a fist to get a vein to pop out.  Then the little needle was inserted, and I still had it together enough to tape the IV down.  Later on in the process something didn’t go right with the IV and the lady’s blood started working its way back up IV tube.  This again made we feel a bit queasy, but I didn’t pass out.

Before we knew it, the time had come to start pushing out the child.  First we had to drain the bladder.  So the younger lady inserted a tube up into the ladies bladder and judging by the way the patient cried out this was not a comfortable experience.  I got light headed at this point and had to stare out the window for a bit.  The urine was drained onto some absorbent pads that were placed between the ladies legs, ready to catch the blood that was surely coming.  I was given the task of supporting the lady’s head and keep her chin on her chest when she was pushing really hard.  I’m not sure why this was necessary, but I did as I was told.

I could see a little head of full of black hair starting to pop out.  The ladies kept telling the lady to push and she kept trying to get the head out, but was having trouble.  After about the third attempt the younger lady takes a deep breath and in English says, “Shit.”  This just struck me as interesting for some reason.  Each time the lady gave up the little head would slip back in a little bit.  At one point the head got really close to coming out, the patient started to relax, but the young lady says, “Do it!!”  So I didn’t let the lady lay back down and rest, and she gave it one last push and out came the baby in a whoosh of thick, dark red blood.  The baby had a very elongated head and looked really pale and almost bluish and I thought, “Oh no, something is wrong!!”  But it turns out I know nothing about newborns and the little alien took a deep breath and let out a good throaty wail.  It was a girl, which I’m sure the family was bummed about, but I thought was pretty great.  The ladies put two clamps on the umbilical cord, leaving about three inches sticking out of the baby’s belly and cut in between the clamps.  The baby was taken over and weighed, and then the older lady tied a few small strings around the rest of the umbilical cord, the last being as close to the belly was she could get it.  Apparently it falls off in about 24 hours or so.  I cut the strings for her.  While this was going on, the younger lady pulled the rest of the placenta out which was pretty bloody as well.  It looked like a purple and slimy old leather wine skin of the sort you might find as part of an old trapper’s clothing.

Now it was time to clean the lady up.  The younger lady did most of the dirty work on this.  She put her hand in and scooped out as much blood as she could, and then started inserting absorbent pads to get the blood that had pooled up out.  Then she grabbed a stitching needle and some thread and stitched up a tear inside the patient’s vagina.  Holy shit.  That looked intense as hell.  At this point the ladies decided that the patient was bleeding a bit too much for their comfort and decided to give my counterpart a call for instructions.  Since their hands were covered in blood, they asked me to dial him up, and hold the phone up to the younger lady’s ear.  I did this, and now I’m getting all sorts of shit from her because she says that my hand was shaking.  I don’t buy it.  We gave the baby to the waiting family, and my counterpart showed up and took a look at the lady.  She was okay.

They got the patient up started to walk her out to her family.  She had lost quite a bit of blood and had just fucking given birth about 30 minutes earlier, so of course she passed out.  They carried her out to the second of two rooms in the birthing center, and laid her on the bed.  I guess they really wanted to clean the room up and get home, but getting her up that quick was a bit too soon in my very uninformed opinion.  One last disturbing thing happened on my way out.  The family had brought their own cloth for the birthing table since the health post doesn’t have any. I thought it was understood that those sheets would be thrown out in some sanitary way.  Nope.  The grandmother comes in and collects this cloth which is just soaked in blood and carries it out to the other room with blood dripping all over the floor and shoves it in her bag with her other things.  Um… okay.  The cloth was just scraps, but maybe they needed it for something.