Saturday, March 14, 2009

Last night for a while...I hope!

Ok, 6 days a week at the hospital is a lot. I just got home from another 5+ hrs extra this week. It's been insane! I think they had 13 babies on dayshift today, then another 5 after 7. When I left we had the board cleaned up nicely, one ante and one patient who was deciding what she was going to do. I did a delivery about 2100, moved her over and was out of there. Ah...I told them "no" for the next few nights. I just can't make myself go back for 7 in a row. I think things will calm down over the weekend, at least I sure hope so!

So the last couple days there has been a 19wk PROM staying on our unit. Her history is complicated, and it's made me do a lot of thinking. She came in ruptured, and they did some antibiotics, etc, and after thinking about it and considering her history, she decided that really at 19wks, she didn't want to sit in the hospital for the next 5 or 6 weeks waiting until viable age, and so wanted to go ahead and induce delivery which would basically result in a termination of the pregnancy with the baby not being viable. The baby is still alive and they've been dopplering heart tones, etc, but she and her doctor went ahead with the decision to induce. So yesterday they did cervidil/laminaria to manually dilate the cervix. Then this morning they were going to do cytotec and she told the nurse she had been really feeling the baby move all night and didn't want to continue on the induction route. So the doctor came in and talked to her, and I guess she went ahead with the cytotec this morning. Then tonight, she told the night nurse the same thing, that she'd really been thinking about it and really didn't want to go on with the induction and really wanted to just go home. She said if her body kicked in and delivered on it's own then that was OK with her, but she didn't want to go on with the induction. The doctor said whatever she wanted to do and that she didn't have any further advice for her. I'm not sure what's going to happen, but it really made me think. I don't want to start an abortion/termination debate, but seriously I have no idea what I would do if I was in that situation. I know the risks of infection are super, super high, especially after the cervidil/laminaria, etc, but at the same time, I don't know that I could go ahead with the induction, deliver a live but non-viable baby with a clear conscious. I just pray I'm never faced with that decision...My heart goes way out to this woman.

Babies today: 1f
Babies total: 38M/38F = 76
Vag:28M/30F = 58
C/S: 10M8F = 18
Babies 'caught' = 1f

6 comments:

  1. Holy crap! 6 in a row?!? Is that even legal?

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  2. It is interesting that you just brought this up. I just met a girl who has to be induced last year at 18 weeks because there was an infection and there wasn't anything wrong with the baby. Her doctor told her she was going to die or lose her reproductive organs if she did not go ahead with the induction?? How often does that happen and why can't they try to clear up the infection with antibiotics? Just curious.

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  3. Do all hospitals actually allow that?!? Inducing a baby that is not of viable age?!? Unbelievable.

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  4. Tough decision for the mother, but I am glad that option is available. A prolonged rupture of the membranes poses a great risk to the mother & the fetus.

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  5. I too hope to never be faced with that decision...that's a tough one.

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  6. Drofen...I guess it's legal, I still have a job anyways :) I wasn't scheduled for this many shifts, but we can't tell a laboring mom "sorry, we don't have any nurses to take care of you. Come back tomorrow!" So instead we get woken up at odd hours of the night and asked if we want to come in. We can choose to say "yes" or "no" but I know how it feels to be scheduled to work and have it start raining babies, so I usually go into help!

    Morgan...I know it's a hard thing about these little babies and these mom's who are faced with the hard decisions. It kind of comes down to two options: don't induce the delivery of a non-viable baby and risk losing BOTH mom and baby because of infection, or induce delivery and probably lose the baby but ultimatly save the mom's life and prevent further complications. I keep praying that I never have to make that decision and I pray for the people who do have to make it. There's NO easy answer unfortunatly :(

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