21st/22nd Catch in 4 Hours

Another night shift, and this shift was by far the craziest shift, possibly ever in the last 3 months. First of all, after working Night Shift last night (Sunday), I slept for a few hours, and then went to the clinic for baby checks, and spent most of Swing shift there (which Karissa was working), and read a midwifery book (very interesting!!), and slept...and had fun with the on-duty midwives.

Karissa was scheduled to work Night Shift as well (and she had worked Clinic before Swing, so talk about a crazy long day/night!!), and her midwife friend-Danielle from Manila was in town, and came to shadow the last couple hours of Swing shift as well as Night shift.

Danielle with one of Karissa's catches and one of mine. (Danielle is 17 y/o and about 6' tall)

I finally went home around 8pm, showered and brought back scrubs for me and Danielle, and quickly was caught up in the action, a baby being born at 9:28pm and Karissa receiving a labor, and another labor coming in at 9cm, ready to push. Ends up, I quickly got endorsed the latter labor, since I was first up...and an experience that was!!

Here this gal is, in active labor, semi-pushing, and she and her bana are arguing! She was constantly complaining about the pain (this was her 5th baby, at age 30), and blamed her bana for the pregnancy, while her bana blamed her for how long the labor was taking (which started at 1pm), and when she would reach out for his hand, he wouldn't take it, so when he finally did, she wouldn't take it in a sort-of retaliation...talk about marital issues!!

Thus, here the baby was in the canal, close to almost visible, and it really was all their own fault the baby wasn't born already... We let them try to work things out while we did endorsements.

Beautiful baby girl!!

She then informed me (still trying to push), that she wanted to get an IUD after the baby was born. (Inside I was like "Whoa lady! You haven't even had this baby yet, and you talking about what?!?") I informed her that that would be discussed at her 6 week baby check (which thankfully I won't be here for, since that is something I can't support or encourage..).

Anyway, we inserted D5LR because of maternal tiredness, and were I was doing new shift vitals (even though I'd been with her for the last hour of Swing Shift), when she and her bana informed me that they would like to be transported to the hospital to be induced. (Umm....lol..whatever!)

At this point, after talking to them, I decided to call my supervisor in to talk with them, and she informed them that first we would try to do labor stim/perineal pressure/hot compresses (catheterized twice), since the baby was right there. However, heart tones started going all over the place, and since she was still making no progress, I started filling out transport papers.

One tired but very happy midwife with her 2 catches (within 4 hours)

Everyone then left the cubicle except my assistant, and just then, my patient decided to push effectively. When asked why, she said she just 'felt like it now'...I guess she and her bana got things figured out??
5 minutes later, a beautiful 6lb 1oz, 52.5cm long baby girl was born, at 11:05pm. APGAR Scores of 7, 9 with O2. Placenta took a long time to come...but only 100 ebl and small 1st degree tear.

Funniest part was that as soon as the baby was born, the couple's attitude completely changed, and they became the sweetest couple and were so in love with eachother and their baby, and had no other issues..

Come to find out, their 4 other kids (11, 8, 5 and 1) were at home alone, they had no cellphone, and NO one (no neighbors or anything) knew where they were..and they had no way to communicate to anyone to get a bantay so the bana could go home...and they couldn't leave until at least 5 am. Well, the bana ended up slipping out to 'go get kwarta (money)"..

I had almost gotten all of her paperwork done, between charting 2 other births (there were 4 midwives catching and 2 assisting-only, plus Danielle-who was indispenable), when another labor (26 y/o, G4P3) walked in at 3:28am, and since it was my turn again, I checked her in.

Karissa and I with 4 of God's beautiful miracles!!

She was 9cm+ also with borderline hypertension, so we had her drink water, and left side lie...well, it was more painful for her to side-lie instead of sit, and she wouldn't cooperate, even when we did what we could. She then spontaneously went to hands and knees, and started pushing (3:40am), not listening to anything I said. Oh well! lol

Ate Jobs came in, and she finally consented to laying down with a wedge, and SROM happened. At 3:44am, a baby BOY born, after having sticky shoulders (not quite a shoulder dystocia). He had APGAR scores of 7, 8 and got O2 as well. This placenta also took a long time to come..but only had 200ebl with a slight 1st degree tear.

Baby boy at 1 wk. old

That wasn't the half of it....Karissa's delivered her first of the night at 1:29am and Eileen's (who came in fully and almost pushing) delivered at 1:42am. Then Ate´Jhobee caught her baby at 3:07 am (came in almost fully), and I delivered my 2nd baby at 3:44am (another fully). Then, Karissa's 2nd labor came in at 5:23am, and literally barely got to the cubicle, and had her baby. Karissa was in the postpartum with her patient, and so I called for her to come pus-pus, and she barely had time to put gloves on before catching...  Then, Eva's continuity patient who had been laboring all night finally gave birth at 6:01am.
So, that made 7 babies born on OUR shift (including the one born at 9:28pm).

One crazy shift!! (Notice all the "Came in Fully"s)

Praise God, Krys was on Day Shift--very good, since it would have overwhelmed some of the other supervisors... Endorsements finally happened around 6:30am, since we were all still scrambling around, and I still had over half my paperwork left to finish.

Leizel and her baby boy at 3 weeks old

Worse yet, we only have 10 beds total (5 birth beds and 5 postpartum), and so my last catch had her entire 'continued postpartum' in her birthing bed because there was 'no room in the inn' in the continued postpartum area!!

So a few of us were sitting around (finally relaxing), filling out reports and talking to Krys, when an ambulance drives up and 3 EMTs carried a pregnant women in on a stretcher--to MERCY! (not to the hospital!!). This is the 2nd time ever it has happened here..and one of the funniest feelings ever. She was in active labor.

I didn't end up finishing my paperwork until almost 8am, and had finally just gone to change my clothes and barely slipped into my dress when I hear Karissa yelling that I'm needed to chart a birth!! I thought "What in the world?? They have a bunch of midwives on shift..why would they need me?!?"

Well, our Ambulance girl's baby's heart tones were way too low, and different people were busy inserting an IV, giving O2, delivering the baby, etc. etc. (and other labors were going on too). So, I guess Eva said "We need a good charter, get Sarah!" So I charted. (what an honor!) Krys was there helping to deliver the baby, and after asking if I was really up to this after a crazy night shift (which I was), she gave me a whole ton of info to write down, and at 7:47am, a beautiful baby was born.

My 22nd Catch and I at 3 weeks old

Then, another baby was born at 8:02am. Making 10 babies in 10 hours!!! When I left, they had 2 labors waiting to be admitted--one was active and the other wasn't quite. If they were both admitted, that would leave ONLY 1 spot on the board left, and NO beds!!!!

Thankfully, it was 8am, and since the minimum stay is 6 hours, there were a bunch who could be discharged..however, to be discharged, you have to have midwives available to discharge..yeah, exactly. lol I don't know how they all did it...definitely triage, I'm just glad I was on Night shift instead of Day Shift!! A little intimidating.. Talk about a crazy shift!!!

As of now today, I feel confident enough to deliver in the Bukid as a solitary midwife, which as far as I know, is what it will be. Praise God! By His grace, I know I will be a help to these women. God has shown me, as in all other things, if I look to Him in all things, He gives wisdom, strength, grace..all we had to do is receive it.