Wednesday, June 09, 2010

Rough Day

*This is a very detailed and graphic post with material that is inappropriate for children.

Well this is one of those nights where my body wants to fall in bed but my mind just can't stop. And I know if I don't share the day now it won't happen.

Today we lost a baby. Today was the most horrific delivery I have ever assisted in. Really, really horrific. I just can't post all of the details here because it is to horrible. But we had a breech delivery. We didn't know that it was breech until the delivery was way too far gone for us to do anything about it.

As the mom was pushing I kept having doubts about the presentation (which part of the baby is delivering first) but my colleagues kept assuring me they felt confident it was the head. When we could finally see something, I felt confident that it was in fact, not a head. It was a little boy who came boy parts first. He got stuck. Really, really stuck. We did everything we possible could to get him out. Did I mention it was horrible?

There finally came this point where I was 95% sure that the baby wouldn't make it if we hadn't lost him already. The point when I had to fix my mindset on saving the mom because it was coming to the point where her life could be in danger. It takes more than an hour to get to the hospital from our clinic. So once a woman starts pushing it's pretty much impossible for us to refer. But the thought went through my head that maybe we would have to send her even in her current state because we wouldn't have another choice.

Then I had this thought that we needed to use gravity. So I asked everybody to help me get her off the delivery table. We put sheets on the floor and had her squat. Okay, I'm getting a more detailed than I planned. But let me just say that after much work we finally got the baby out. I was already mentally prepared for him to be gone. But I told the staff we would do ten minutes of CPR so that we all knew that we had tried.

After the first cycle of CPR I checked and found a strong heart beat. Since we had a heartbeat we all felt that we needed to do our best. We did two hours of support resuscitation. At one point I actually came very close to passing out. (I passed out on my very first day of nursing school and felt that same feeling washing over me.) I hadn't eaten or been able to use the restroom in over eight hours. I was overheated working over the baby who had the warmer blowing hot air on him. I broke out in a sweat and saw the room spin. Yet it occurred to me that everyone in the room was looking to me. So I asked someone to bring me some water, took a deep breath, pulled up a chair next to the warmer, and pulled it together.

Every time we got close to giving up, the baby would take a few gasping breaths and we would start up again. Finally after the two hours I told the family that we had done everything we possibly could. It was now in God's hands. We wrapped the baby skin-to-skin with his mom while he struggled to breathe. It didn't take long before the gasping stopped. Within fifteen minutes his heart stopped beating.

I laid my hands on his little body and prayed that the Lord would receive his spirit and comfort, love and care for him until his mom would one day join him. It was a horrible, yet somehow holy, moment.

Obviously I'm still processing the day. I would appreciate your prayers for the mama as she has to endure the physical pain of recovering from a traumatic delivery at the same time as she goes through the emotional agony of empty arms.

And I'm frustrated. Extremely, extremely, frustrated. Because you see, we have an ultrasound machine at the clinic. But we have had a terrible time trying to use. We desperately need a professional to come and train our staff on it. It seems like it should be easy, but every time we try, we feel lucky when we find the heartbeat. We have yet to be able to figure out the position of any baby we have tried to ultrasound. If only we knew how to use it! We could do a sixty second ultrasound on every mom who was admitted in labor. Then we would know immediately that a referral to the hospital for a C-section needed to be made. Maybe this baby we delivered today would be happily breast-feeding instead of wrapped in blankets in preparation for his burial in his mother's yard tomorrow morning.

7 comments:

SMC said...

That is so frustrating. It's so hard to fathom when it would be an "easy" thing in the US to do a C-section. I'm so sorry. You and the mom will be in my prayers.

I'm sending this to my brother-in-law, an OB/GYN, to see if any of his techs might be interested in going (or know someone who would be).

Isaiah 55 says that God's Word will not return void--keep proclaiming those promises even when you are frustrated and distraught.

amanda said...

Oh Michelle, how terrible! I know words will fail to comfort, but please know my prayers are with you with the family.

Anonymous said...

Man that was terrifying. You and your staff really are some of the best people in kenya. Wish you all the best and pass my condolences to the family.

Heidi said...

My sister in law shared this with me. Thanks for sharing that (as horrible as it is). But it shows me how lucky we are, and how grateful I am (both my babies were cesarean). I was dissapointed, but how blessed to have this technology, now we just need others like you to help those who are NOT as fortunate as us! Thanks for this emotional post.

Africa Expat Wife said...

This story is so sad. Our third daughter was delivered naturally, breech, here in Nairobi, at the Aga Khan hospital. It was a very quick labour in the middle of the night and we didn't realise she had turned until she was well on her way out. Luckily the obstetrician made it to the hospital and was fantastic. I realise now how extremely fortunate we were.

Thanks for your comments on Africa Expat Wives Club. I have added a link to your blog to mine. xx

angela centra said...

Hi Michelle, this is a very sad post. just stumbled on your blog today, and cant believe the agony that women are going through. Have you managed to get somebody to train your staff on the ultrasound machine.. how can we assist. Im not a doctor, but i can imagine the agony of labour and then going home empty handed.

Michelle Kiprop said...

Angela, thanks for your interest in helping. As it turns out I will be traveling to the USA this fall and I have recently learned of an ultrasound class for nurse practitioners that will be offered while I am there. I am currently fund-raising to be able to attend the course. All donations are tax-deductable in the USA as I work for a non-profit there. Please e-mail me if you are interested in contributing. Thank you!