15th June--The Night Shift

The Maternity ward.

 
    I did my first night shift last yesterday night and last night (Monday and Tuesday night) from 6.45pm-7am.  It is now Wednesday morning and I'm heading to bed after I write theses notes.  I really really liked the night shift, it was me, one or two other volunteers and two nurses in the maternity ward.  On the left hand side of the ward there is a room for expectant mothers, in the centre are three bed for birthing and exams, and then on the right is another room for post-birth mothers and their baby. 

Monday night: me + one volunteer.  There were 5 births overall, my first time seeing a live birth and all that comes with it including paper work.  I observed several pelvic exams, long labours, actual deliveries, cuttings of cords, placenta delivery etc.  It was amazing to watch really, and exciting every time once the baby was born.  There was one complication through the night, being a long labour from an 18 year old, her first baby.  Took her 20 or so minutes to push the baby out and then after all that the baby wasn't breathing :(  I felt so bad, but the nurses worked on him straight away:  hanging him upside down and rubbing his back, to stimulate his lungs.  Also did this crunch looking thing with the baby like you would an accordion, put him on oxygen and after a while he started breathing on his own! I was so happy when he took his breath because I just thought, this mother didn't go through all of this pain for nothing.  I had held her hand throughout the delivery and gave her a thumbs up sign when he started breathing and she did one back with a smile. It was really nice.  Didn't get really slow until about 4am where there was no more births, a few admissions I entered into the books, so I got to read and drink really sugary black tea that the nurses had in the 'staff room'

Taking the patient to have a C-Section

The beds that the patients give birth on and examined.

The tables to hold the babies until Mum is ready

Tuesday night:  Me + 2 other volunteers.  4 births and one C-section.  The C-section was the first part of the night, had to wheel her on a stretcher from maternity to major theatre over REALLY bumpy and rocky pavement. They cut her open and a bit of dark dark red pieces were coming out of the uterus...not good apparently, after the baby was born not breathing and completely lifeless and the nurses didn't seem to care or do anything, I had to ask what was going on.  Turns out that the placenta had ruptured at the start of contractions, the woman had had a previous c-section and it could have left the uterus weak?  I asked if she'd be able to have any more children and the doctor said that the chances of this happening again were really high, that she was considering suggesting to the mum to have her tubes tied.  Since she only has had one child, this is probably not going to happen.  Another volunteer, Chloe, and I suggested that for the next pregnancy, just do a C-section before the contractions start! Take the baby out a few weeks early, and the doctor paused to think and said:  "That's a good idea, I didn't think about that.  I will suggest it to the mother" and then proceeded to tell us that the only negative thing with that is that the ultrasound at this hospital is really crap and they can't tell how old the fetus is and often the mothers don't have any idea either.  It's a real shame...
      The other births were straight forward and I got to do a pelvic exam! At first I had no idea what I was supposed to be feeling for but then I found the cervix! yay.  I weighed the babies, most were around 3.2-3.8kg,  and made sure they were put under the heat lamp to stay warm even though they were wrapped in so many layers of Kangas (the colourful garment that you would typically see in African photos) and got to listen to heart beats before the baby was born using a metal tube like thing with indentations on either side, small for the ear and large for the belly.

Questions/Observations:
       1)  Glucose in a syringe is fed to the infants if the mother's milk isn't flowing or the baby can't seem to latch on to the nipple...What do we give to the babies in this situation?
       2) No Epidural or any drug is give to the mothers during labour or delivery. (only Oxytocin injections to ease the placenta out) The moms hardly shout or make any kind of noises, a few mutterings and heavy breathing but otherwise quiet.  NOT what you see on tv of birthing shows.  These women are tough!
        3)  Mother's before and after birth share beds in the two rooms as there are not enough for everyone.  It's actually really great to see the mom's all helping each other out and being really caring, like it's one large family.
     **4)  Many women were circumcised I noticed.  Either the clitoris was removed, or the labia, or in some cases both.  It depended on what tribe she was part of, really sad.  Apparently a lot of these rituals cause the mom to tear during labour (which I saw two tears lastnight) because the vagina healed very tightly.
        5)  The generator at the hospital doesn't always come back on straight away, it did really quick on Monday night and then took about 5 or so minutes to come back on the second night.  It happened whilst the doctors were suturing up the women who had the C-section, the worst part was that they were trying to go quickly because she was waking up!! and we had to rely on using torch lights and ipod/iphone/mobile phone torches too! insane.
      6) There is a resident rat living in the maternity ward that just runs around sometimes...and cockroaches. Reason why we had to keep our bags on chairs or on the desk in the staff room. Lovely.

 Really liked the night shift :D definitely going to do it again!  Next week is my last week though...I'm very sad about that, I'm starting to really get used to everything and don't want to leave.