Sunday, August 3, 2014

Catching Babies: The Heat Is On


Obstetrician, “Do you know why we put hats on babies as soon as they’re born?”
Anaesthetist, “Isn’t it to keep them warm?”
Obstetrician, “Actually no. You see, there’s a pressure differential between the uterus and the external environment. This means the baby’s head can actually expand and cause intracranial damage.”
Anaesthetist, “Really?”
Obstetrician, “Yes, in fact if left unchecked the cranial vault can actually explode in severe cases.”
Anaesthetist, “Oh wow. Really? I’m ashamed to say I didn’t know that.”
Obstetrician, “Oh. My. God. I can’t believe you actually fell for that!”
Anaesthetist, “You arsehole!”

And thus the tone was set for the hot, crazy month of July. As the temperatures soared outside, so did the heat in the labour ward. The air conditioning was misbehaving again. The temperature in the room Eve and I had got stuck in was approximately thirty degrees and we spent the majority of our time there wearing plastic aprons, gloves and goggles which were actually fogging up so much that I gave up and took them off so I could see. I resigned myself to spending most of the day wet as sweat trickled down my temples. “When this baby is born,” I said to Eve softly as the mother caught her breath between pushes. “We need to get the hell away from this room to the other end of labour ward. Where the air-con is working slightly.” A few more pushes and the baby slipped from its mother’s body and gave an indignant cry. I thought gratefully of a belated breakfast, and air I could actually breathe as I sat down to suture.

Alas it was not to be. Well, we did get breakfast. But no sooner had we finished eating when the phone rang again and we were called back for another delivery and the only room free and clean was the same one we had just vacated. I bit back a groan and braced myself. This was going to be a long day. Our second baby was not quite as quick as the first but he made his way into the world without too much drama. Eve’s eyes met mine in the kind of excitement you only find from a student. “Two in one day, wow!” I smiled back at her. Thinking my god. Two already, and it’s only just past lunchtime.

The next phone call came as we had finished transferring our second patient. The message was that someone was coming to labour ward for more intensive monitoring of her baby’s heartbeat as there had been dips in the heart rate on the ward monitor. It was her second baby so I knew she could labour quickly. We set up our room accordingly, put on our gloves and waited. The patient who arrived was not what I was expecting. She was ranting, irrational, aggressive and totally out of control. It was obvious in the first few minutes that she had psychiatric problems. I couldn’t get her to stay in the room, let alone on the bed to get the monitor back on. I, her partner and another midwife quite literally followed her the circumference of the labour ward and back trying to reason with her while other staff looked on wide-eyed. She sobbed, yelled and beat her fists on the walls and repeated over and over that she was going home. As she got to the exit, that’s exactly where she headed with her partner and the transfer midwife following her, pleading. I stopped at the door having been told by the charge midwife not to follow them. The student looked at me in shock. “So what do we do?”

The answer was nothing. Security had been called. There was nothing we could do to make her stay. It’s a hospital, not a prison and although she had psychiatric issues she had been assessed as fit to look after herself and make decisions. My heart ached for the baby inside her whose fate was uncertain. We went back to the room to document events. As I finished writing the room door was flung open and the woman and her entourage burst back in. She threw herself onto the bed and screaming herself hoarse she gave an almighty push and delivered. For a moment there was silence then the coughing, sputtering cry of the baby broke the tension. Tears stung my eyes as relief flooded me.
“Thank you.” Said the new mother. “I’m so sorry.”
I met her eyes. “It’s okay. Everything is fine, you’re all safe now.”

As we leave July and enter August there have been many other babies. As I bid goodbye to my student, Eve, she has delivered twenty-five of her three-year goal of forty. It’s been a busy, chaotic month but that one, very lucky baby has stuck in my mind. I hope she grows to be happy and healthy. I hope her mother gets the help she needs.
I know I’ll probably never find out.