Two days later I was called back to watch the same lady's oxytocin drip. She was numb by this point. She would lay on the bed and stare at the wall. I wanted to talk to her although I don't know what I would say. I wanted to comfort her. It was hard to sit there quietly for hours saying nothing. I really need to learn French.
While I was watching the drip another lady was rushed in. After preping and waiting about a hour she delivered a healthy baby boy. The boy came out scream right as another lady ran into the delivery writhing with labor pains.
There are only two beds in the delivery room, and both were occupied. One bed held the lady with the oxytocin drip, while the other held the new mother who was waiting to deliver her placenta. The only spot open was the floor. So, we took the lady's headwrap and laid it on the cement floor so she could sit. While we were preparing the floor for occupancy we hear something drop onto the metal bed. We missed catching the placenta!
The nurse ran to tend to the mother, while I checked on the oxytocin drip. As I was
counting the drops I felt a hand on my leg and a strong tug. I caught myself on a rusty metal container as my leg slipped from under me. (Praise God I didn't split my head open on the container).
Danae had just walked in and saw the whole thing. Everyone was laughing, but also a little concerned about my safety. We tore the lady's hand from my leg and told her to stop. We even positioned her so she could grab onto a pole on one of the beds. But she liked my leg. The lady on the ground decided I looked like a wonderful stress ball and used me as all she wanted. She squeezed twisted and pulled at my legs. I finally got fed up and let her abuse my leg. No matter what I did or said helped the situation.
Finally, the drops were in cadance and the bed was ready for the lady waiting on the ground. (By this point there were ants feasting on the bodily fluids the lady left on the cement floor. We have a very sterile atmosphere if you haven't noticed). She was a difficult woman to deal with although the baby came out with ease. It was a healthy baby girl. She latched onto the breast and wouldn't let go, just like the placenta.
The placenta tore on its way out. We had to clamp the remaining piece and wait for it to slough off. Thankfully, the placenta came out after a few minutes of waiting. We tried to remove the blood clots that coagulated in the uterus, but the woman was stubborn. She said that it hurt and she wanted us to stop. She kept trying to push our hands away and close her legs. In the struggle she knocked the basin onto the floor. The basin contained her placenta and other things we didn't want all over the floor.
Blood and feces splattered everywhere. It covered most of the floor. Danae got frustrated and told the lady that she would leave the clots in her uterus. She would continue to bleed until all the clots came out. The lady didn't care. She rolled over and fell asleep while she cuddled the baby.
Another lady ran into the room, before we could start cleaning the floor. To top things off, the couple from France walked into the room. (The wife is a midwife and the husband used to work for SAR (search and rescue) in France. I don't really know what the husband will be doing here, but the wife is helping Danae). Perfect timing right? We found the cleanest spot on the floor and had the woman sit. We doused the floor with bleach and swept the liquid outside. We finished cleaning everything as fast as we could as the French lady, Ana, watched. The nurse check the mother's uterus and sent her out of the room. Everything was fine for that particular mother.
After cleaning the bed, we helped the woman on the floor into it. Danae went home to feed her baby, so she left Ana in charge. Ana had some...unusual tactics.
She made the mother get into weird positions and push. I'm sure it was meant to make things more comfortable, but Ana was confusing everyone. The mother was listening to Ana, but was getting a little frustrated. I was completely in the dark while Ana explained to the nurese why she was doing what she was doing. It was like I ceased to exsist and the nurse took my place as student.
It got closer to delievery time and Ana wanted to check for a heartbeat. She had given up on positioning the woman into more comfortable positions. The mother simply laid on her back and grabbed her legs. Ana tried to find the baby's heartbeat, but couldn't. She didn't like the machine the hospital had and wanted her own tools. (She even tried to put her ear to the stomach hoping to hear the heartbeat. Her mouth was very close to the lady's vagina and it made me uncomfortable). So she left the room and went all the way to her house just to get her bag of toys.
By the time she returned the nurse had already found the heartbeat, which was slow, and we prepared the needed tools (the aspirator and bag valve). The head was already in the birth canal, so there was very little for Ana to do. However, she continued to try. Ana pulled out her steoscope and listened for a heartbeat. (I honestly don't know if she found the heartbeat or not).
By the time the baby was born Ana completely took over. Without gloves she caught and aspirated the baby, then massaged the uterus. To make matters worse. I was ready with the aspirator, but she wanted to use her own tools. So she ran to her bag and grabbed her own. Hers wasn't working, but she still didn't want to use the hospitals. She took off one of the tubes and put it down the babies nose. She sucked away occasionally stopping to spit the amniotic fluid out of her mouth. Ana took her time and didn't use proper BSI (body substance isolation). Tchad is known for HIV and AIDS, along with many other diseases passed through bodily fluids. I am glad that she isn't afraid to get dirty, but she needs to take preventive measures.
Also, the baby had a slow and weak heartbeat. She should have quickly aspirated the baby and tried to stimulate a cry. The saying in the maternity ward is "you have to beat them hard or else they will die". Ana wanted to rub the feet and the back and wouldn't let me or the nurse touch the baby. I praise God the baby didn't die. This is the first time I have seen soft rubbing work on a Tchadian baby. At times I would try to stimulate cries with sternum rubs using my knucles and the baby still wouldn't cry. You have to hold them upside down and give them 3+ slaps on the back like you are spiking a volleyball.
All in all, I am more worried about working with Ana then Danae at this point. Ana is use to working alone and speaks very little English. Not only does she do all the work, she can't explain everything that is going on because of the language barrier. The sign language and broken English/French that the nurses and I use are to much for her to handle. I would be exposed to labor and deliveries shadowing Ana, however, I wouldn't learn, or do, as much as I can with Danae and the other nurses.
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