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Saturday, September 23, 2006

Twins

Wed night before shift, I dreamt that I gave birth to twins. The dream was incredibly real. Shift on Thursday was an echo into reality of my dream or was my dream an echo of things to come?

When I came in, the clinic was hopping. One birth in the night, 1 woman pushing, 2 in labor. There had been 4-5 labor checks through the night...One of those labor checks was Esmeralda (not her real name). E was a mama that I had done a cita on 3 days before that was very difficult. She had many issues out of my scope of new student understanding, but the one that I could fully connect with was that she was 17 and afraid of labor. That day I hoped that somehow I would be able to serve her but who knew?
Before we went to morning class I was told that E had come in, I asked my group for a special request: if the opportunity presented itself, I would like to be at the birth even if it were not my rotation.
I love the universe and how it works out. After class, we came back and 4 of us were assigned various tasks, including shadowing a birth. I walked in to one of the smallest rooms to observe but it was so crowded! I slipped out feeling akward about watching such an intimate event and not being invited or without having the opportunity to ask permission as this mamma was pushing. I instead let the other student take that rotation who had less births than me.
As I walked through the kitchen from that room one of the interns grabbed me and asked: Do you know how to do labor support? Ok how am I supposed to answer that one? OF COURSE! She steered me into the sala (sectioned off part of the clinic because all of the birth rooms were taken) and right into the more intense gaze of E looking desperate for support.
My heart soared! She looked at me with her liquid brown eyes and softly said "no puedo, me duele, no puedo" (I can't, it hurts, I can't).
For the next 15 minutes I held her hand, emptied a vomit filled trash can, and said "si, se puede, lo esta haciendo, y si le duele" (yes you can, you are doing it and yes it hurts-I am not good at lying, I believe that, one of the worst things you can say to a woman is that it doesn't hurt). That little bit of encouragement seemed to work wonders and she settled into her labor with grace that awed me. A staff midwife drifted in and out during this sacred time, I took heart tones and vitals as well as gave labor support. After about 2 hours of this routine, she was moved to a room that became available. She was listless and tired, her family was difficult and this was the way she shut them out. She tuned in during contractions, and drifted off to sleep in between. At one point her mother yanked off her underwear and said "get this over with, have your baby, start pushing" I was stunned and ummm a little angry! But the gruffness of her mother was an indication that she was worried, I was able to help her understand and she eased up. Her energy began to change and her anger gone
.
After that E began to get a little grunty during the peak of contractions so she had a "tacto" and was 4-5 cm. Not time to push....This was a little torturous for us all as her urge to push became stronger in the next 15 minutes. Getting her to stop pushing is not fun and I just let up with my mantra "sople sople, no es tiempo para empujar"(blow, blow, its not time yet to push). There is a lot of anxiousness in the clinic over a swollen cervix. I don't share that fear(yet, who knows if that one will concern me) but I had to relay the message.
E was a determined woman, and she began to push pretty adamantly on her side. The staff midwife came in to make sure her cervix wasn't comepletely swollen (there was talk of transfering her) to find that there was a head there and not a cervix!!!

Now one of my favorite things is when a woman is so tuned into her body that her urges are right on. Only 6 hours had passed from her entrance into the clinic, she came in at 1cm. She was a 17 year old goddess in my opinion. I could hardly contain my enthusiasm as I watcher E push her baby into the world. At one point she reached down and touched the babies head as it was crowning. I was so excited that I docummented 5 minutes of of incorrect times on the labor flow sheet, including the time of birth! It was quickly remedied, I was made fun of and then forgiven.
A little girl 6 lbs 2 oz came gently into the world, into her estatic mothers arms. She had a solid latch within the 1st 30 minutes, very little blood, lots of photos, and mom, family and newborn left an hour early.

Such a gorgeous birth. What a wonderful blessing as it was the 1st time I was given responsibility and not just shadowing someone.

Now you might be wondering about the twin dream I had? Where is the other baby? Time has gotten away from me so I will tell the other story later. Suffice to say that I had an experience quite the opposite of that birth 12 hours later, as my shift ended. I will get to that story soon.

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