A Labor Nurse Story…

Before I write this next post, I feel the need to explain why I write.  It’s more for my own sort of therapeutic outlet, really, rather than for your entertainment.  But sometimes I let you peek into my heart through these words. I write because these are the moments I don’t want to forget.  These are the moments burdening my mind and I want to sort them out in words.  These are the moments I want to praise God for.  These are the moments I want to look back on and say, “He was faithful!”  These are the moments that if I cling to, will help me get through another difficult time and I can say with confidence, “He did then, and He will reveal His power now!”

And so this is why I write.  And for these reasons I am sharing this very recent experience with you too.

I was minding my own business cleaning and organizing the clinic when Samantha (our nurse student missionary) let me know there was a labor patient that just walked in.  She escorted her over to our one-bed labor ward and I soon followed.

Upon initial assessment she looked very early, fundal height was low, and after calculating her dates she was 30 weeks and 3 dates gestation.  OB red flag #1.  Please be in false labor!

Next was the vaginal exam.  Where’s the head?! That’s NOT a head! That’s a little baby but!  And she’s ruptured!  And it’s not clear. And it’s not just meconium. It’s thick, pea-soup meconium!  And she is about 8 cm.  OB red flag #2, 3, 4, and 5.

At home I wouldn’t want this type of patient to walk through our lovely hospital doors, let alone a remote clinic an hour or two away from Lusaka!  But like a seamless production our little of team of 3 set in motion.

“Call emergency transport now. Get them on the way!” Field started making phone calls to arrange an ambulance and the ETA was up to an hour out.  That was NOT soon enough.  Breath mom, breath!  You can do this!

“Check fetal heart tones.”  Samantha retrieved the doppler and we found reassuring heart tones.

Mom was starting to vomit and was in obvious transition.  So we made plan B and verbally rehearsed plan of action for delivery and resuscitation, if needed.

Then, without warning, mom practically jumped off the table, and with a wail squatted on the floor.  It’s happening!

My tone of calm command turned to earnest demand as I slipped my gloves on and guided the frank breech little bottom.  “Lay back!!”  There was no room to manipulate and control the delivery like this.  Once the legs and arms were delivered my heart raced as I held this limp little body in my hands.  We just need the head.  

“Pray!  Everyone say a prayer!” That’s all I could mutter as I begged God to guide my hands. I could feel the prayers going up.  My mind flashed back to the one vaginal breech delivery I assisted a physician with about 11 years ago.  I stretched the recesses of my mind for the visual memory of his skillfully trained hands in that moment.  I had also recently reviewed a video of breech deliveries in the event anything like this should happen, and replicated what I had learned there.

Push! PUSH! Come, baby, come!

Somewhere between a second and eternity, the head delivered.  But before we could revel in the emotion of slight relief, we waited for that cry.  After vigorous stimulation it didn’t happen.

Clamp, clamp, cut!  With it’s life-line severed, and leaving mom on the floor, we lifted baby up to the table where we could easily do CPR.

The ambu bag was already in reach.  While Field skillfully placed it over his little mouth and nose, I began chest compressions.

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, breath-breath. 

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, breath-breath. 

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, breath-breath. 

I don’t know how many cycles we did, but it was successful.  When she finally opened her eyes and started coughing, we started to breath again ourselves.  With a little more stimulation she was crying and breathing on her own.

When this 2.3 kg little stinker was stable, we placed her skin to skin on mom’s chest for optimal warmth and safety until the ambulance arrived.  She was grunting and retracting significantly by now, so we were anxious to get her to the hospital for a good dose of C-PAP (continuous positive airway pressure).  In the wait, Samantha tenderly continued her post-partum care and assessments.  So thankful for her by my side this morning.

While this is not a situation we would seek to manage at our clinic, our little team of three this morning is praising God for his direction, guidance and intervention.

“To God be the glory, great things He hath done…” You know that song? Yea, I’m singing that right now.

Baby girl born at the Riverside Clinic.

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I am thankful she didn’t decide to deliver at home as so many mothers choose to do in order to maintain the impression that they are capable and competent in their role in life to bear children.  Had she done so, I’m afraid of the consequences she and her baby could have suffered. Our concern for many women here is that they feel obligated to deliver at home to avoid the guilt and shame that comes from being viewed as a failure by their family/community.  This is why, during prenatal education classes, we try to educate and encourage these moms that it’s okay and safer to deliver at a clinic at least, so that we can provide basic emergency interventions and get transport, if needed, to the nearest appropriate hospital.  Gift baskets with baby supples to be given after delivery may be a huge incentive for young moms to come deliver at the clinic, boost their confidence in this system, and hopefully help promote their experience to their peers.  So, that my friends, is a project coming up next!

9 thoughts on “A Labor Nurse Story…

  1. I can’t even imagine how frightened you were……I NEVER had anything like that happen to me, although I watched every breech delivery my docs did just in case! Hope the baby is doing well- much love to all of you. XO

  2. You were placed there for such a specific, beautiful purpose. Your prayers are being answered and he IS using you to make His miracles happen. How lucky are we that you share such amazing stories from so far away! 🙂

  3. God is so able to refresh your memory and guide your hands, as He did today. So thankful you are there to help those sweet moms. You are God’s hands and feet for them. Thank you for that beautiful story:)
    Yes, “Great things He hath done.”

  4. Praise the Lord! You definitely are needed in your role in the Clinic there! Continue to press on and He will continue to use you in amazing ways as happened on that day.

  5. Wow, I am always amazed at how you get things done! God is with you and your team.
    Thanks for being there for these precious people.
    What a blessing you are!
    Praying!
    Vicki

  6. I could almost see us providing care to this mom and infant. As we have done a 10000 Times side by side. God guided your hands and mind! What a blessing!
    Missing you daily! Love and prayers!
    Ang

    1. Oh how I wish we could have cared for this mom and baby side-by-side again too! Love and miss you ALWAYS.

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