Wednesday, September 9, 2009

Ready for Another Baby

So let's see...I haven't had a baby in a good week! I think I'm failing in the "delivery" part of my job! I can labor them fine apparently...but I have a hard time getting the baby out! I have had 3 nice (well, exciting if nothing else) births the last couple weeks.

1st baby was a super fun couple that I cervidiled one night and then ended up doing the section for the next night because her cervix stopped at 9cm. They were lots of fun and their baby was ADORABLE! Honestly, most newborns aren't that impressive looking...but this little guys was super cute :) I even went back to visit them the next day on my day off to see how they were doing. I love stories like that!

Next delivery was one of those "all of a sudden" ones where I had the C/S papers sitting on the desk because she'd been about 4cm for the last 3hrs. We had put in an IUPC and said we'd give her 2hrs and then were going to the back. 2hrs later she was complete! Yay!!! She did super and half way through pushing we were chatting and come to find out, Dad was an ICU doctor at one of the other hospitals in town. Great! Thanks for the heads up...He was quick to point out that he didn't know anything about L&D but still...a doctor is a doctor! They did an OB rotation in school and he's probably actually "caught" more babies than I have! Oh well...he was a great help when Mom passed out X2 in the bathroom on me 3hrs after delivery. Sigh...I had another nurse in the bathroom with me and the 2nd time Mom went down she really went down to the floor. So there's two L&D nurses sitting on the floor with a naked patient (she'd puked all over her gown on the way down...) on top of them and ICU-doc-Dad holding Mom's head and nobody could reach the wheelchair. So I hit my emergency badge and when everyone else from the floor came thundering into the room there we all were! Sitting on the bathroom floor! All we needed was a wheelchair...

Next baby was the "exciting one". Problem #1: Mom was 5'0"...Dad was 6'4". Not a good combo for a baby. Sure enough, baby was pretty big, we pushed for 2hrs and baby was "gettable" but not quite coming out on her own. So doc came in and put on the vacuum and pulled baby out...all 9#5oz of her! Well, when all of baby came out, poor mom got a really bad 4th degree tear. It wasn't very pretty. So doc gets ready to repair...and Mom's still bleeding...and bleeding...and bleeding. 3 bag of pitocin, 2 doses of Methergine, 1 dose of hemabate, 400mcg cytotec orally and 400mcg rectally...2000cc EBL and doc could start the repair (8 sutures...). Yahoo for nursing teamwork!! We didn't leave that room for an hour and half after delivery. Mom did fantastic afterwards...but she's going to be SORE for the next several weeks!!

Within an hour of my hemorrhage there was a scary delivery next door with a Family Practice doctor. I know many women go to family practice doctors and continue with them for their OB care. It's nice...same doctor can take care of you before, during, after your pregnancy and you can throw in the kid's visit at your doctors appointments too! But think about this: would you let a family practice doctor take care of your heart attack and do open heart surgery on you? I didn't think so...consult the experts for your OB care too...just a word from a labor nurse. Take it or leave it :)

Anyway...this baby was 10#, had a NASTY strip, a bad dystocia (shoulders and body) and then it took the placenta an hour to come out after delivery. We had to call in the OB backup (all family practice doctors have to have an OB back them up during deliveries for emergencies, C/S's etc.) to get the placenta out. Scary stuff.

I don't know if they don't trust me after my Mom hemorrhaged or what, but I've done nothing but antes and triage's since! I did 8 triages the other night...that is craziness!! Here's hoping for some actual babies in the near future!

Babies today: 1m/2f
Babies total: 59M/72F = 131
Vag:44M/54F = 98
C/S: 15M18F = 33
Babies 'caught' = 2f0.5m

7 comments:

  1. I agree about seeing an OB for childbirth rather than a general practitioner. I prefer seeing someone who has specializes in birth rather than someone who only does deliveries here and there. I feel the same way about my children seeing a pediatrician vs. a general practitioner.

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  2. An advantage to family practice docs is they aren't as anxious to C/S since they can't do it themselves. There are some really great ones out there with great experience, and there are some OBs who are real idiots. You have to go on a case by case basis.

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  3. I also have to agree that women need to see OBs for prenatal care. Ugh!

    Why did it take the placenta so long to come out? With my firstborn, they literally just ripped that sucker out of me, without my consent or even telling me! A nurse just jumped up on my stomach while the doctor pulled. I was NOT happy about that.

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  4. Actually, most European women see midwives for prenatal care, and doctors are only called in if the women are no longer low-risk.

    Most placentas detach within 15 minutes or less, although some take longer. I've even heard of placentas taking a couple of hours to detach, without further incident.

    My sister's OB for her 3rd birth also manually removed the placenta -- the baby was born just after midnight, and he pulled the placenta out one minute after the baby's birth. My sister knew that, because they announced the baby's birth time for charting, and then one minute later, the doctor said, "Placenta out, 12:02." Then, because he had pulled the placenta out, some pieces were retained, and then he had to manually remove them. He started it without even telling my sister. Fortunately, she had had an epidural, so it didn't hurt, but she could still feel him rummaging around her insides, and said, "WHAT ARE YOU DOING??" **Then** he explained it to her.

    I can understand the doc wanting to go home and get some sleep -- he probably had a full day's load at the office the next day, so he didn't want to spend 15 minutes waiting for the placenta to come out, but *still*!

    -Kathy

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  5. As someone who lives in a rural community where there is no OB at all in our hospital that serves an area with a population of 20,000 (we are in rural Alaska, off the road system), I find this post interesting. I have had my most recent 2 (out of 5) babies with a family practice doctor attending and received excellent care.

    What are your feelings on midwives vs. OB vs. FP doc care?

    In any event... I had to chuckle a little because if you have a heart attack out here, you will be seeing the FP doctor doing ER work, or the ER doctor who also functions as a FP doctor... it's just one of the "risks" of living out here. At our hospital, they don't even offer epidurals. If a crash c/s is in order, they either do a spinal or go straight to general depending on how emergent it is.

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  6. It is important that you consult your OB every month or even every week. It will be more easier for you to give birth if someone professional take cares and monitors your baby. www.bigjobsboard.com

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  7. @RecruiterLady... Seriously? "Someone professional"? I'm not about to dismiss the professionality of my family practice doctor who went to medical school, residency, has been practicing medicine for 9 years, and delivers many babies.

    Interesting use of words.

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