Friday, May 24, 2013

Uh, I don't think it's supposed to come out that way

The phone rang just as I was finishing up a bite of lunch. “Transfer from a health center. Hand presentation of a second twin.” I told them to prepare for a C-section, and that I was on the way. So I got there just a few minutes later. I thought I’d check, just to be sure that the hand wasn't sitting beside the head and able to be pushed back. So I put on my glove and pulled up the cover – but no exam necessary. The whole arm was out between the mothers thighs. She was having to be careful not to sit on it. I rushed to help get her moved to the stretcher, knowing that there could already be damage to the nerves in the neck and arm from the amount of stretch allowing the arm to extend so far outside the uterus. I also was thinking of how at any moment, a slight movement of either the mother or baby could clamp off the umbilical cord’s blood supply and it could all be finished for the baby.

So, we shuffled her onto the stretcher. I held the bag of IV fluid and squeezed it tightly to make the water inside flow more quickly into the veins. I always enjoy that part of transport, squeezing the bag as we rush the stretcher to the OR. It gives me a sense of excitement and urgency. It also gives my nurses that same sense of urgency (which can often be difficult to muster from within them), when I am right over top of them with the bag held high. Things move much more quickly. I yelled in that we needed to go “now, now” as I gave the stretcher one last push through the OR doors. The words “this is an emergency” have been used so often that they don’t sway to pressure or stress as they ideally ought to do, but “now, now” seems to convey it and get a better response. I threw on my rainboots and a plastic gown (necessary accessories for any C-section due to what can be a big gush of amniotic fluid around baby and the whole yucky mess of baby poop, blood, fluid, etc all combined – gross, huh?).

Out she came, awkward and floppy appearing as she lay there for a moment while I clamped and cut the cord. I told the midwife to get ready to resuscitate as I handed off the lifeless appearing blob of a baby. Within a few moments, little cries began to be whimpered from over in the baby warmer. Ahhhh, what a beautiful sound. Attention always turns to the baby, everyone’s attention but mine that is. At this point it is routine surgery for me, baby is out and it is time to put mom back together again. Sew her up, watch to make sure there are no more areas of bleeding and no unforeseen injuries, and then, done. I congratulated her as I passed by to leave – “Thank the Lord for two new babies”. Indeed. Thanks Lord.

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