Lady in labor with a convulsion. Not good-as I talked to the nurse I grabbed my medical bag and when out the door in my jeans, house sandals, an PG top under my hoodie. I had planned to end my day by looking at a couple of new magazines that Kathleen sent up this afternoon.
Calling for Chris as I went past their house-I was thankful for his flashlight as we made our way to the clinic-and you can bet I was praying all the way. Already thankful with the news that the baby had a heart beat and that she was 10 cm-but not so encouraged that it was her first baby.
First while listening to the report I took off my hoodie, rolled up my sleeves and took off my watch. Short gloves just don't protect that much.
Quickly putting on gloves-AROM, scan fluid with Mec. Gave orders for MgSO4 IV slowly. Then we piggy backed a second IV with Pit. Lots of prayer because we only had a Macro gtt. She was nice and fairly with it for an Eclamptic. Her headache improved as we waited for good contractions. She wasn't due until the end of January so I was hopeful that baby wasn't to big-and she had had some urine output earlier in the afternoon.
Finally after waiting and pushing she started to bring the head down-the generator stopped. Pitch black!!!! A few tense seconds later it was back on. Then off. Then On. The nurse went to investigate and someone else brought in a kerosene lamp which thankfully left the room shortly.
She was a good pusher for a first timer with Eclampsia. Soon we had a squalling baby boy!!!! Some mild capping but not bad. He had a normal newborn exam. I asked the nurse if he had had his Vit. K only to learn that we DON'T give them routinely!!!! Because they cost 25 gouds-.62 cents USA. Having watched babies hemorrhage to death because they didn't get Vit. K or got expired I found this shocking!!!! You can bet that someone is going to hear my opinion about this. He got his dose ASAP.
Not done yet-despite active management of the third stage of labor the placenta decided that it didn't want to leave quietly. I gently maintained traction with counter pressure on the uterus for a good 25 min. Then I tried to gently explore manually [she would disagree on the gentle part] but no good. A gentle tug was all that was needed to see the uterus move in response. So I ungloved, did the newborn exam and wrote in the chart.
Seeing that the husband hadn't made any effort to go arrange for a vehicle to take her to Limbe as I had told him from the start I tried again. Then finally 1 hour after delivery, still no placenta, after her 4 IM MgSO4 shots of 10 cc each because we only had one strength I told him again point blank that she had to GO!!!! No money for the ride....so I called on my wonderful husband who is now driving her to Limbe.
Nope didn't make them pay for the delivery or medications either. Told Miss Armadine when she asked that she should write up a bill and talk to the administrator. I don't deal with money. They were going to just lay this poor lady in the back of the truck on a thin blanket-so I also pulled the foam cushion off our ER bed and sent that with Cory.
One of those mixed feelings-I'm thrilled that we have a good baby and that we had the truck here to transport her to Limbe. But it is just so sad to have such limited care in a serious case like her's. With proper treatment she has a good chance to recover fully but without it her darling newborn boy will never know his mom.
In the USA the care that she got tonight would be grounds for a law suit, lost of licence and likely jail time for negligence. But we did the best we could and compared to the care she would of gotten at home or other clinics-she got above average care-more medications for both her and baby, transferred without paying her bill, transferred without paying for the ride, plus a foam mattress, baby got to ride in the cab....
Please pray for this family and for medical care throughout Haiti. I told her I was praying..they are Catholic. May the Lord's love be felt by them all and have an impact for the Kingdom.
2 comments:
OH Wow...so thankful the Lord led her and the baby to you. I'm drained just from reading about it! Please keep us posted on the mom's recovery.
Will do IF I hear anything. Too often I never hear again about interesting cases-glad the Lord knows. Thanks for praying.
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