Misadventure in a Maternity Hospital. There is probably no maternity hospital that is as busy as the one I went to during training. It's jam-packed with patients and it's like a newborn factory. Anybody who would want to have exposure to maternal and newborn care, this institution won't disappoint you. It is a government-owned charity maternity hospital with a 200+ bed capacity and situated in the heart of the over-populated metropolis of a developing country, that's why it gets a lot of admissions. It can sometimes reach to a hundred admissions a day, I heard. Services are free, except for the drugs and materials to be used. Since it's a charity institution, this is where students and practitioners go and get cases. Let me share with you my bloopers & guffaws.
Day 1 in this institution, I can already say it exceeded my expectations. An adventurous health care provider looking for action, I was excited to have my first assist. As I went inside, I can hear the four wheels of the stretcher roll against the tiled floor goin' to and fro, in and out of the rooms. There were voices yelling "push" here, "push" there. Moans from labor pains range from the discreet & weak to the ear-piercing shrieks. Some have high threshold for pain and some just make you want to plug your ears...or their mouths (just a thought). Looking at the scene, I got goosebumps...a lot must've responded to the mating call 9 months ago, I said to myself with a snicker. After picking up my jaw that had dropped, I went for my first case.
A 45-year-old multigravida, 39 weeks age of gestation, G14P13...wow...G14...does she has a record to beat or something? And at 45, huh...After an assessment, she was good for normal spontaneous delivery and just as I thought, labor was as easy as coughing the newborn out. She was even smiling at me throughout the supposedly "ordeal" she went through. I jokingly told her that it was a good thing she didn't try to pass flatus on the way here... the newborn would've gone with it.
One fact in the admission of obstetric patients coming from the lowest socio-economic bracket in a developing country is that they often didn't have regular prenatal check-ups. So, they are unaware if there is any abnormality with their pregnancy. Also, since they usually don't have the finances to be admitted and confined at least a day before their expected date, they come rushing to the emergency room due to true labor pains & are already in the first stage of labor.
One time, a patient was wheeled-in into the delivery room and it was my turn to assist. So I rushed to the patient & to my surprise...the newborn's left lower leg was sticking out of the lady partsl opening. I called for the resident obstetrician on duty because that was way beyond my skills. While waiting for the obstetrician and preparing the patient, the patient asked a question. She was wondering what the gender could be. Still shocked after seeing a breach case such as this, I confusedly answered the patient's query. I replied "Well, judging from how the leg looks...I certainly have no idea." What the...?
The delivery room was one big room with 10 delivery tables that were arranged next to each other. I have colleagues working with me with only curtains separating us from each other. This allowed each of us to see each other's work and compare notes. When I was about to pack up and call it a day, a nervous and fidgety colleague on her first day was beside me preparing her last case for the day. She would often come to me for help whenever she was in a bind, so she requested that I stay a bit longer because she feels confident having someone by her side. Being the helpful, ladies' man that I am, I obliged. She was kind of cute to watch because even if this was already her 7th time to assist, she was still fidgety. But this case that she was having, it was different from the other 6 she had. The bag of water hasn't been broken yet. So, she needs to manually break it. I jogged her memory when I suggested that she use an amniotomy or toothed forceps to puncture the water bag. I assumed she's good to go on her own after giving her the tip, so I went back to packing up my things. Upon crowning, she proceeded to puncture the membranes. But there was something I forgot to warn her about. She was so into carefully manipulating the membranes that she didn't realize her face was already directly in front of it. Pop went the water bag and it was amniotic goo-fest all the way. I think the patient also had polyhydramnios... That's about 2000 cc of amniotic fluid right smack in her face! She had to facilitate the delivery, suction the newborn's mouth and cut the cord while having an all-natural facial cream on her face, neck, and shoulders. HCG is good for the skin anyway, right?
- Finding humor in everything that happens in my life makes the hardships easier for me to deal with.-
