The after birth story
When I left off, mom had delivered the baby, the placenta was in the freezer, baby was healthy, and all were resting.
Having measured the blood loss we noted that there was at least 1L that we were able to collect - and anything over 500ml is considered a hemmorhage. So we kept taking mom's blood pressure and monitoring her pulse, and trying to get her to drink water.
At the same time, during the birth mom had torn a bit (2nd degree tear), so the midwife had to do some stitiches for repair. I stood there, holding a flashlight as she sewed mom up. She explained to mom what she was doing, used some lidocaine, and then went to work stitching her up. One of the things this helped with was reducing the blood loss.
Once this was done, we got mom comfortable and the midwife worked with her on getting the baby to latch onto a boob and feed.
So far, so good.
The assistant who was there headed out around 330 or 4. Shortly after she left, we tired to get mom to pee - I placed a urinal tray under her bottom and gave her a bit of privacy. But nothing happened. We let it sit there for a bit - but still nothing. So the midwife decided we needed to get mom up and to the toilet so she could pee. As they were getting up and getting to the bathroom, I was busy cleaning the blood off the instruments and the birthing chair, and also putting fresh non-bloody sheets on the bed for mom and dad.
As I was getting the fitted sheet in place, the midwife called for me from the bathroom. Mom had fainted briefly while on the toilet. So we gently got her off and laid her on the bathroom floor. We tried to get her to drink some water, but it wasn't enough. So it was at that point the midwife decided to get an IV started and get some fluids into mom. I sat with mom as the midwife grabbed all she needed to start the IV. I watched her place the IV and get the fluids running. Once it was running, and it was clear that I was okay sitting with mom and keeping an eye on her and the IV, the midwife went to do the official newborn exam - weight, length, other measurements, as well as Vitamin K shot and erythromycin in the eyes (luckily I'd helped with all of that during my Maternity rotation, so I didn't feel like I was missing anything).
As the measurements were taken, I'd convey the info to mom, who at this point was dozing off and on as she lay on the bathroom floor. I basically just sat with her, and made sure the fluid got into her as fast as possible.
Once half the bag was empty (500mL), the midwife decided to try to get mom back into bed. First thing we did was get mom up to the toilet again. After a couple minutes, we went to get her to stand up, and she went pale and started to fade again. So we immediately laid her back down on the floor, with her laying against my chest. (Now mind you, this entire time mom is stark naked. We had her covered in a sheet and blanket while lying on the floor). It was clear mom was still bleeding as well (mainly due to the blood left on the toilet seat and the small puddles on the floor). So the midwife decided to empty the bag, then try again. She was also going to do a second bag, this one with glucose - to give the mom not only more fluid (to replace all she had lost with the blood), but to also give her some energy, since she hadn't really eaten much in over 24 hours.
I again sat with mom, rubbing her and keeping an eye on the IV drip. As I sat there the midwife picked up her things and straightened up a bit. Dad had the baby on his chest, dozing off on the couch, waking on occasion to keep an eye on mom and me in the bathroom.
Once the IV bag was empty, we got mom up again onto the toilet. This time she looked much better, and was more present. When she stood to walk to the bed, she was better as well - we were able to get her back into bed. As she walked I carred the IV bag. While it hung on a wire hanger placed on the shower curtain rod in the bathroom, in the bedroom we had to work to find something else. I ended up suggesting the round switch on the torchiere light near the bed.
As soon as she was in bed, the midwife got the new IV bag spiked and we hung it. As the midwife did vitals on mom again, I took it upon myself to clean up the bathroom - grabbed the container of wipes and cleaned up the toilet seat, the floor, and placed the blood-stained rug in with all the other dirty linens. This was the point where I gained an additional appreciation for housekeeping - in the hospital a nurse would never be asked to do this. But in this situation, one did what was needed. I knew mom and dad had enough to deal with already, so I just did it.
After I had finished cleaning up, and mom was clearly stable, the midwife pulled me aside and said that I could head home, and that she was going to stick around to keep an eye on mom (which I expected - I would have been concerned if we were going to leave her at this point).
It was now 6am. I had been there since 8pm the night before. 10 hours. Maybe 15 minutes of sleep in that time. And I hated to leave without seeing how it all resolved. But i also knew that there was very little for me to do at this point - I had done all that I really could. If I stayed I would just be observing and not really adding much.
I changed my blood-stained socks (from the bathroom floor), and packed up my stuff. I went in to the bedroom to say goodbye to mom and dad and baby. They were so grateful and thankful for me being there, heaping praise upon praise on me. Walking out, I gave the midwife her car keys and told her where she was parked (since I had parked her car for her all those hours before). She gave me a huge hug and thanked me for everything, telling me how much she appreciated having me there. I saw it as just doing what needed to be done. But I also was incredibly grateful and thankful for being given the chance to be part of this incredible experience.
Even now, more than 24 hours later, I still can't belive that not only was I present at a home birth, but that I participated in it - my presence there was an asset, I wasn't just an observer (as I feared I might be). I was charting, taking vitals, and when I could just taking the initiative and doing what needed to get done. I thought I would cry at the birth (since I did at the ones in the hospital), but I didn't - I was too involved in what was going on around the birth, even though I was able to appreciate the significance of the moment.
This experience proved to me that nursing is what I am supposed to be doing. There was never a moment during the whole event that I was freaked out or grossed out or scared. Yes, there were moments of uncertainty, but those were more about being in a new situation than about me. When the situation called for it, I was calm and focused and sure of myself. When decsions were made, I understood why without having to ask. I was part of the team, and it just felt right.
Tonight, talking more about this birth, Ed asked me if this experience made me want to be a midwife even more. The answer? Not really. But what it has done is show me something that I could do, and will do, eventually. Being part of this event is unlike anything I have ever done - even with all the words I've used to describe, it's still hard to really capture what it is like. But the reason I went into Nursing was to help those who needed it most. I still want to start out in Pediatrics, but I see a future where I go back for my Masters and get my NP and Nurse Midwife, and when I need a chance from the NICU and Oncology, I can help bring new lives into the world. This is definitely in my future, it's more a question of how far down the road it will happen.
I haven't even really started yet, but I already LOVE my new career! I just wanna know what the fuck took me so long to figure out what I should be when I grew up???
Having measured the blood loss we noted that there was at least 1L that we were able to collect - and anything over 500ml is considered a hemmorhage. So we kept taking mom's blood pressure and monitoring her pulse, and trying to get her to drink water.
At the same time, during the birth mom had torn a bit (2nd degree tear), so the midwife had to do some stitiches for repair. I stood there, holding a flashlight as she sewed mom up. She explained to mom what she was doing, used some lidocaine, and then went to work stitching her up. One of the things this helped with was reducing the blood loss.
Once this was done, we got mom comfortable and the midwife worked with her on getting the baby to latch onto a boob and feed.
So far, so good.
The assistant who was there headed out around 330 or 4. Shortly after she left, we tired to get mom to pee - I placed a urinal tray under her bottom and gave her a bit of privacy. But nothing happened. We let it sit there for a bit - but still nothing. So the midwife decided we needed to get mom up and to the toilet so she could pee. As they were getting up and getting to the bathroom, I was busy cleaning the blood off the instruments and the birthing chair, and also putting fresh non-bloody sheets on the bed for mom and dad.
As I was getting the fitted sheet in place, the midwife called for me from the bathroom. Mom had fainted briefly while on the toilet. So we gently got her off and laid her on the bathroom floor. We tried to get her to drink some water, but it wasn't enough. So it was at that point the midwife decided to get an IV started and get some fluids into mom. I sat with mom as the midwife grabbed all she needed to start the IV. I watched her place the IV and get the fluids running. Once it was running, and it was clear that I was okay sitting with mom and keeping an eye on her and the IV, the midwife went to do the official newborn exam - weight, length, other measurements, as well as Vitamin K shot and erythromycin in the eyes (luckily I'd helped with all of that during my Maternity rotation, so I didn't feel like I was missing anything).
As the measurements were taken, I'd convey the info to mom, who at this point was dozing off and on as she lay on the bathroom floor. I basically just sat with her, and made sure the fluid got into her as fast as possible.
Once half the bag was empty (500mL), the midwife decided to try to get mom back into bed. First thing we did was get mom up to the toilet again. After a couple minutes, we went to get her to stand up, and she went pale and started to fade again. So we immediately laid her back down on the floor, with her laying against my chest. (Now mind you, this entire time mom is stark naked. We had her covered in a sheet and blanket while lying on the floor). It was clear mom was still bleeding as well (mainly due to the blood left on the toilet seat and the small puddles on the floor). So the midwife decided to empty the bag, then try again. She was also going to do a second bag, this one with glucose - to give the mom not only more fluid (to replace all she had lost with the blood), but to also give her some energy, since she hadn't really eaten much in over 24 hours.
I again sat with mom, rubbing her and keeping an eye on the IV drip. As I sat there the midwife picked up her things and straightened up a bit. Dad had the baby on his chest, dozing off on the couch, waking on occasion to keep an eye on mom and me in the bathroom.
Once the IV bag was empty, we got mom up again onto the toilet. This time she looked much better, and was more present. When she stood to walk to the bed, she was better as well - we were able to get her back into bed. As she walked I carred the IV bag. While it hung on a wire hanger placed on the shower curtain rod in the bathroom, in the bedroom we had to work to find something else. I ended up suggesting the round switch on the torchiere light near the bed.
As soon as she was in bed, the midwife got the new IV bag spiked and we hung it. As the midwife did vitals on mom again, I took it upon myself to clean up the bathroom - grabbed the container of wipes and cleaned up the toilet seat, the floor, and placed the blood-stained rug in with all the other dirty linens. This was the point where I gained an additional appreciation for housekeeping - in the hospital a nurse would never be asked to do this. But in this situation, one did what was needed. I knew mom and dad had enough to deal with already, so I just did it.
After I had finished cleaning up, and mom was clearly stable, the midwife pulled me aside and said that I could head home, and that she was going to stick around to keep an eye on mom (which I expected - I would have been concerned if we were going to leave her at this point).
It was now 6am. I had been there since 8pm the night before. 10 hours. Maybe 15 minutes of sleep in that time. And I hated to leave without seeing how it all resolved. But i also knew that there was very little for me to do at this point - I had done all that I really could. If I stayed I would just be observing and not really adding much.
I changed my blood-stained socks (from the bathroom floor), and packed up my stuff. I went in to the bedroom to say goodbye to mom and dad and baby. They were so grateful and thankful for me being there, heaping praise upon praise on me. Walking out, I gave the midwife her car keys and told her where she was parked (since I had parked her car for her all those hours before). She gave me a huge hug and thanked me for everything, telling me how much she appreciated having me there. I saw it as just doing what needed to be done. But I also was incredibly grateful and thankful for being given the chance to be part of this incredible experience.
Even now, more than 24 hours later, I still can't belive that not only was I present at a home birth, but that I participated in it - my presence there was an asset, I wasn't just an observer (as I feared I might be). I was charting, taking vitals, and when I could just taking the initiative and doing what needed to get done. I thought I would cry at the birth (since I did at the ones in the hospital), but I didn't - I was too involved in what was going on around the birth, even though I was able to appreciate the significance of the moment.
This experience proved to me that nursing is what I am supposed to be doing. There was never a moment during the whole event that I was freaked out or grossed out or scared. Yes, there were moments of uncertainty, but those were more about being in a new situation than about me. When the situation called for it, I was calm and focused and sure of myself. When decsions were made, I understood why without having to ask. I was part of the team, and it just felt right.
Tonight, talking more about this birth, Ed asked me if this experience made me want to be a midwife even more. The answer? Not really. But what it has done is show me something that I could do, and will do, eventually. Being part of this event is unlike anything I have ever done - even with all the words I've used to describe, it's still hard to really capture what it is like. But the reason I went into Nursing was to help those who needed it most. I still want to start out in Pediatrics, but I see a future where I go back for my Masters and get my NP and Nurse Midwife, and when I need a chance from the NICU and Oncology, I can help bring new lives into the world. This is definitely in my future, it's more a question of how far down the road it will happen.
I haven't even really started yet, but I already LOVE my new career! I just wanna know what the fuck took me so long to figure out what I should be when I grew up???