Birth story #1

My 111th birth handled.

My patient Rebecca, 17 y.o, G1P0 (means first pregnancy) came to the clinic on 4/09/00. I did an IE (internal examination) and she was 7cm open, 90% effaced, +1 station and intact Bag of Water. She was very quiet and handled her labor well.

Then after a while she wanted to push, so I did another IE to make sure she’s 10 cm so she can start pushing but she was already 8-9 cm. I lie down on the bed next to hers. I was about 5am in the morning she told me that she really wanted to push. She was almost 10cm. There was still an anterior cervical lip above the baby’s head. I let her breath and lie on her side. There should be no cervix above the baby’s head because it will be swollen with the pressure and it makes it harder for the baby’s head to come down.

After awhile she can’t helped but push so I pushed the anterior cervical lip up above the head of the baby so it will not come out together with the baby’s head. She was really a good pusher. After few times pushing her Bag of Water ruptured with slight meconium stain (meaning her baby already pooped inside which means the baby is already distressed). She was pushing for a while and there was only a little progress. So I let her on full squat then on birth stool.

Then the baby’s head was already visible and then after few pushes the head crowned with a caput formation. Then the head was out and was rotating 180 degrees. That was great! Usually, the baby’s head only rotates 90 degrees. The baby was out at 6:45am to a healthy baby girl named Jezelyn, with apgar score of 9/9, weighed 2523 grms/ 5.9 lbs. Glory to God.

The caput was huge found near in the frontal lobe. It means the baby’s was not properly position during the birth process. We immediately gave the baby a vitamin K to prevent bleeding. Usually we gave vitamin K after few hours after birth but in cases of huge caput we need to give it immediately. The baby was doing great.
The placenta was out at 7:00am but the membranes were not complete so we put the patient on methergine tabs. The patient has a labial laceration but no need of suturing. She only lost 100cc of estimated blood loss. I endorsed her to my co worker Sara Jones. Present at birth: Julie Tinio, Kristen Grubb, Lynn Jones.
1st stage- 20 hrs 08 mins
2nd stage- 46 mins
3rd stage- 6 mins
Admitted- 6 hrs.

PROTECT AGAINST TETANUS

As nurse or midwife we need to be sure that all pregnant women who are coming in for prenatal check-up should be injected with TT (tetanus toxoid)injection.

Every pregnant women living in an area where there is neonatal tetanus should be vaccinated against tetanus at the first antenatal visit or every pregnancy. If she has not previously had the full course of tetanus protection, she should be vaccinated again 1-2 months later, then again 6 months after that.

CARE DURING PREGNANCY

If pregnant women get even the most simple, basic and cheap antenatal care it can make their pregnancy and birth much safer. What is done during an antenatal or prenatal visit depends of the level of training on the health worker, the equipment and laboratory tests which are available to them, how often the come to visits and the health problems which are common in the area.
Antenatal care aim to :
• Develop kind and respectful relationship between the each woman and the health workers, so that she will attend for antenatal care and be more likely to talk about any problems. She many also be more accepting of any advice given.
• Find and treat any illness the woman already has.
• Identify which women can safely deliver at home or in the clinic and which women are more likely to have complications and should deliver in the hospital.
• Explain to women the danger signs that can occur during pregnancy, labour and delivery so that they seek help early.

EDUCATED WOMEN MAKE HEALTHIER CHOICES.

In my experience I observe that pregnant women are highly educated are more concern and interested on what is going on in her pregnancy. They tend to make good decisions. Education gives people skill and confidence, and makes them aware of the choices they can make in their lives. Educated women are more likely to marry later, have their first pregnancy later and have fewer children. In addition, they are more likely to know about contraception, start to use it earlier and rely on modern rather than traditional methods. Educated women are more likely to attend for antenatal care during pregnancy.

Getting a good start

The conditions of a woman’s life affect her health and that of her children. For women to be healthy during pregnancy and childbirth they need: good nutrition, especially during childhood, several years of education (beyond primary level), respect and consideration in their home and their society.
By the time a woman becomes pregnant, many things will have happened in her life which affect her and health. For example, the food she ate as a child – the type and the amount – will make a big difference.

WW: Roses

happy WW everyone.!

Crazy nurse/midwife with oxygen on

A day to remember with me and my best friend. We had only one patient this time. The patient was still in early labor so we told her to walk around while we were doing crazy things unimaginable.
We didn't know what went to our heads. It was just out of blue we decided to have oxygen on and of course, we had to take pictures.
The funny thing is we really do look like real patients. Aren't we? We could be good models for oxygen, don't you think? We do accept though that when we are together we get so crazy and wild. lol.