Tuesday, March 13, 2007

Birthin babies

I've had another beautiful vaginal delivery of a little baby at 41 weeks. A challenging vaginal delivery with a nuchal (around the neck) cord while mom was standing in the bathroom and a cesarean delivery over the past few days. Frankly, I'm tired.
My 41 week delivery was really nice except for the baby poop that was in the amniotic fluid (this often happens). That was easily taken care of and all was well. My bathroom delivery was a total comedy. BirthMom was 7 centimeters and wanted to go to the bathroom - I assisted her there. While on the toilet she whispers that she needs to push. I ask her if she plans to deliver there or go back to the bed. She says that she'll go back after the next contraction. The next contraction comes and she whispers to me "I think the head is right there" I have no gloves on but reach in to check and sure enough she is right - the baby's head is on the perineium. I ask if she is going to deliver on the toilet or stand and head back to bed. BirthMom says she will go back to bed. I help her stand up and we take 2 steps and she begins to push and promptly delivers the baby's head. I still have no gloves on. I support the head and feel around the neck where there is a very tight cord. The baby cannot birth the rest of the way until the cord is cut and unwrapped. So I have my nurse push the delivery cart into the bathroom and open it up. I grab the clamps and clamp the cord twice and cut between the clamps, unwrap the cord and deliver the baby. I ask for help, but the help gets sent to the wrong room number so I don't get any help. I put BirthMom in a rolling chair and go help with the resuscitation of the baby. I then wheel BirthMom to the bed and deliver the placenta. Evaluation of her bottom reveals a perineal laceration which I numb and suture. We get baby to breast and all is well. BirthMom says that this birth was much nicer than last time because it hardly hurt at all. I think this birth was much more stressful than the last one, but am pleased that she is happy. I think the bathroom and the birth room looked like a murder scene once I was done and it will take housekeeping hours to clean up all the places that I got blood. For this I'm really sorry, as I try to be neat and tidy. Sometimes it just doesn't work out. We'll see what happens next. I'll tell you things are never boring.

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