Thursday, September 2, 2010


6,7,8,9,10...BIG BREATH! And again!" If you had walked thru the L&D unit two Saturdays ago this is what you would have heard myself and a nursing trainee saying for a good hour as we coached a mom through her delivery!

It was our final day of OB clinical. While I was mentally "checked out" of class, I was excited for clinical since I was in L&D and desperately wanted to assist in a delivery. At pre-conference, Vanessa and I joked about how it would be our luck that no one would deliver again on our shift. But we were wrong! We both were assigned to laboring moms and one of the most incredible days began!

I was assigned to an interesting case. Our laboring mom was considered high risk for multiple reasons. First being she was AMA...advanced maternal age.This was their third time with in vitro, the first two ended in a miscarriage, and they were now preparing to deliver a baby girl. During pregnancy she developed Idiopathic Thrombocytopenic Purpura, a clotting/bleeding disorder where the body has low platelets and blood is unable to clot. She was a high risk for hemorrhaging during and after delivery. Because of her platelet disorder she was not allowed an epidural. Her only choice was a natural birth and I have never seen someone handle one so well. She had a doula. That's all I will say about that. I do have stories & I could go on, but the main point I will say is a doula should not be in the hospital because overstepping a doctor who is trying to save two lives is just not going to go over well!

This mom did fabulous! She was prepared and breathed through the contractions perfectly. It really showed me that a natural labor is possible. My mom did 4 naturally and I always thought she was crazy until now! I've learned that labor is about being a team & your teammate needs to be tuned in on distraction techniques as well as working you through each contraction. As long as you have control of the pain, breathing, and contraction, an epidural free delivery is not a bad idea....this mom proved that! The baby took a long time to come out from under her pelvic bone....over an hour to be exact. I can't imagine the pressure she felt as the head was crammed under the bone. But she managed to crack jokes and smile during it all! The delivery room was full since UCI is a teaching hospital. Therefore, an intern, third year resident, and an attending were assigned to the case. An RN, myself, and a RN trainee were also involved along with the scrub tech to set up the sterile environment. 

With each push the resident and attending were watching the monitor of the baby's heart rate and how it was reacting to each contraction. After pushing for so long the baby was not tolerating labor well at all. In fact, the heart rate was so dangerously low that if she had been already born and had a herat rate of that, CPR would have been performed. It was interesting watching the attending and resident communicate with no words as to not alarm the mom. The NICU team was called because they knew the baby was going to be born in distress. The neonatologist and RN came in an instant. Finally, a sweet little girl was delivered. I have no shame in admitting that tears were streaming down my face during this time. It is such a magical experience and completely overwhelming....and it wasn't even my child! She was born blue....central cyanosis....meaning that the blood oxygenation to her little lungs was really bad as well as in all her vessels. She was whisked to the NICU team before the mom could notice she was blue as it's better to keep the mom out of the loop that something is that wrong until the mom is stable. The doctors went to work quickly to birth the placenta and stitch her up because they were worried about her bleeding out. The baby was put on oxygen and was revived by the NICU team. It was incredible to watch them work. They took this limp, lifeless, blue baby who needed much more than a pat on the back and saved her. Yes, more tears. Watching her be placed on her moms chest, than into her dad's arms was emotional for all as the staff knew how long they had been waiting for their sweet girl. I took pictures of the dad as he proudly cut the cord. 

What a day! It was a great last OB clinical. A experience unlike any other. I will carry that day with me forever! I am so thankful for the opportunity to have trained at UCI and been taught by sch incredible physicians and nurses. 

Hmmmmm, labor and delivery.....will you be my specialty?!!?

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