Delivery

I delivered a baby today. A 7.5 pound baby boy to a first-time mother of 20 years. I was actually only planning to work during the morning prenatal check-ups but then one of the women who came for a routine check up got an exam that revealed she was 4 cm dilated. She claimed she didn't feel any pain. There were signs she was having contractions as her belly would tighten frequently. Four hours later she was 6 centimeters dilated and still no pain or sign of even the slightest discomfort! We all were amazed and kept asking her, "Really? No pain yet?" She just giggled and said, Nope, not yet. So we gave her some herbal medicine to strengthen contractions and waited another 2 hours. Next check up she was 7 centimeters. Still no pain.

The baby's head was well engaged in her pelvis so we decided to break her water. Almost immediately she went from no signs of labor to being in very active labor. She started sweating profusely and her toes were curling. I stayed with her and encouraged her to breath and keep her body relaxed, which she was already an expert at somehow. Amazing.

She started to bear down spontaneously. She said she wanted to push. We encouraged her to breath. She really insisted she was ready. So we took her upstairs to the delivery room. Checked to see if she really was ready and she was 9+ centimeters dilated. We supported her cervix and waited for the baby's head to move low enough for the cervix to slip behind the baby's head, which was accomplished after about 20 minutes.

After trying several positions and finding the right one that allowed her to push effectively and after about 1 hour of pushing, her baby was born. Cute baby James Ronald.

Thankfully the placenta was delivered without incident but her uterus was just so reluctant to contract adequately that we had to give her pitocin intramuscularly and then soon after when it became apparent this wasn't enough, we hooked her to Dextrose IV and added more pitocin to the IV fluids. After that, her uterus had enough power to contract properly. Whew.

I ended the day by spending an hour and a half suturing in three different areas. Ouch. I used to be so dead against episiotomy but one has to wonder, could three jagged tears in difficult to heal areas be prevented by inflicting one straight tear? I honestly don't know but it makes me wonder. All primis (first time mothers) in hospitals and most clinics in the Philippines get routine episiotomies. I have to say, I can kind of understand it. I still have never cut an episiotomy and I'm not sure I ever could unless it were an emergency but I can at least say I understand where others are coming from. I really felt for this poor young mom who will have a very sore bum for a few weeks. I will say, that with Hilary's help and expertise, our young mom will look as good as new once the healing is done. And that's what we told her. "You'll be back to beautiful." Despite her discomfort, she gave us a genuine smile and said, "Thanks."