The pause before the storm

The title sounds ominous, but it actually isn't. We just didn't have any babies born from Friday until today (Tuesday). When that happens, it means the moms are "planning an attack" according to Ate Lyds. In other words, we'll go from a completely quiet birth center to 4 women giving birth and two more texting us that they're in labor. And of course it will be a prenatal day and we'll be busting at the seams and spinning in circles and having a blast. Lol.

Today, a mom came in at 6am but was only 2cm so we sent her home. At 11:30, she came back with the "I have a baby between my legs" speed waddle and raced to the birth room. She was so close to delivering, she was pulling her underwear down while waddling to the room. Just a few minutes later, her little girl was born with one push. It was a wild ride!

The baby, about three hours after birth

Ate Lyds with baby Jupiter

Picture Time!

Things have been extremely busy here at Shiphrah! In fact, it's been almost a week since I've had the opportunity or ability to leave the birth center because we've been averaging 1-2 births a day and have lots of prenatals every day! Tomorrow, I'm taking the day off to go to church, rest, and get caught up on sleep. Except for whatever reason, I'm starting to have difficulty sleeping. It's probably just the stress of the last few weeks (nclex, need I say more? Lol) catching up to me.

Last Friday, we had another neonatal code. The baby was having late decelerations and his mom was having difficulty stretching to "free" him. The heart beat kept dropping lower and lower, finally reaching the 70s. When he was born, we instantly jumped into resuscitation. This time, I was very calm and could clearly think through what needed to be done. After the midwives gave several rescue breaths, I listened to the hear beat for 6 seconds and heard 6 beats, meaning a heart beat of 60. I instantly began chest compressions and we continued the code for another 10 minutes until the babybegan to breath on his own. During that time, Deborah was called and she helped us assess and stabilize the baby. Thankfully, baby is ok now and is healthy!

Enjoy the pictures!

This picture makes me happy since Ate Bhel, Ate Dolor, and I had been up all night helping with two births. While we were doing postpartum checks until 4am, one of the new dads went to KFC and bought us a late night snack. It was very ma sarap!

 

A shoulder dystocia and neonatal resuscitation

Last night, I was caring for a laboring woman who had been laboring all day. I labored with her throughout the night until she started pushing. The baby's head was making a slow decent but we didn't think too much about it because that can be normal. The head crowned, slowly was born, and turned. With the next contraction, I expected the rest of the body to slip out, but it didn't so I attempted to lightly move the shoulders to assist the baby to be born. However, the shoulders didn't budge at all. I decided to try one more time with the next contraction but they didn't budge. At all. I've never had a true shoulder dystocia, but knew it was an emergency so I had the more experienced midwives take over. We moved mom to the hands and knees position which is the best position for birthing a shoulder dystocia, but the baby still didn't budge.

While the midwives attempted to deliver the baby, I jumped up and began to gather supplies for an emergency. I cleared an area for resuscitating the baby, set up the equipment, prayed, and watched. Next to me, the midwives were also praying out loud and trying every trick to get the baby out. However, the baby had an entry dystocia so was stuck at the entrance to the pelvis instead of the pubic bone in a way we couldn't easily deliver. They took turns trying to reach the baby's shoulder and arm to try and pull the arm above the head, decreasing the diameter of the shoulders. However, the baby was wedged so tightly, it took ten minutes of the midwives pulling and the mom pushing before finally the midwives got a grip on the baby. Those ten minutes felt like years. At first, the baby's head was a normal color and she moved her mouth and made faces. However, as time went on and she didn't receive oxygenation because she was so stuck, her face turned a deep, dark plum purple and she went very still. 

The moment the baby was born, the midwives laid her floppy body on the floor and began "bagging" the baby (using a resuscitation bag to breathe for the baby) and rubbing her briskly with a towel. Her head was a deep, dark purple but her body was completely white. Because we were resuscitating her on the floor right next to the mom, we were able to keep the cord intact which probably made the difference between life and death as the baby received oxygenation via the ventilations and the blood. While the midwives bagged, I grabbed a stethoscope and listened to the baby's heart rate. Counting for six seconds, I heard eight beats (a heart rate of 80) and told the midwives. For a newborn heart rate less than 100, the next step on the resuscitation protocol is to begin chest compressions. I helped bag the baby while we began chest compressions. The baby was still limp, pale, and unconscious. 

After a minute or so, I listened to the heart again and heard twelve beats (a heart rate of 120) so we were able to stop chest compressions. The baby was still limp and unresponsive but her body was starting to pink up. It felt like an eternity before she gained muscle tone and began to cry. Never have I been so happy to hear a newborn scream and cry! When she began to cry, i clamped and cut the cord and one midwife took the baby to one bed to continue giving oxygen while the other midwife took the mom to the other bed to make sure she wasn't hemorrhaging. As soon as the placenta was out, I gave the mom oxytocin (pitocin) and methergine to make sure she didn't hemorrhage.

Once everyone was stable, we all stepped back and took a deep breath. What a Ride! It felt like an eternity, but the dystocia lasted about ten minutes and the resuscitation lasted another ten minutes. My hands started shaking so bad and I wanted to cry, realizing we almost had a baby die on us. However, after discussing what happened with the director of the birth center, she said, "don't think of it as 'I almost had a baby die!', think of it as, 'I helped save a baby's life!'

Thankfully, mom and baby are both healthy and suffering no ill effects from this morning's scare. The baby is chunky and cute and has a very boisterous cry. Each time I hear it ring throughout the birth center, I smile and praise Jesus for that cry. 

Snapshots

I probably won't be as photo-crazy as I was last time I was here, but here are some quick snapshots I've taken today.

The view out the front door of Shiphrah. Since I was last here, they built a huge play fort and hang-out area for the neighborhood kids. It looks like a lot of fun and there are usually kids climbing all over it.

Mango! Filipino mango is truly the best mango ever!

Saw this at the mall this morning. I've heard of moms encapsulating and eating their placentas, but never heard of placenta soap!

This sweet baby was born last night. Her mom came in at 8:20 and was 3-4cm. At 9:00 she said she felt like she had to push. I went to check her and ended up catching a baby! Surprise! 

Arrived in Manila!

Early this morning (1am), I landed in Manila and was picked up at the airport by Jeri and Darren. I almost missed my flight since my flight to Beijing was delayed two hours and I only had a one hour, forty minute layover. Thankfully, my plane landed 30 minutes before my flight to Manila departed. The Beijing airport, I discovered, doesn't care if your flight is about to leave. You still have to wait your turn in line for immigration and security. Thankfully, I saw that my plane was about to leave and begged someone at the front of the security line if I could cut in front of them. They were gracious enough to let me cut in front of them, otherwise I would have been in the line for 30-40 more minutes and completely missed my flight.

After getting through security, I started racing for my gate but it was on the other side of the airport so someone gave me a ride to my gate. He said they had just announced the last call for Manila five minutes before and he was able to radio the plane to wait. Thankfully, the flight was full and not everyone's carry-ons fit so there were a bunch of bags being checked. They were taking a separate vehicle to the plane with just the carry-ons but they allowed me to ride in the vehicle onto the tarmac and left the plane door open so I could get on. Right after I got on the plane, they closed the doors and off we went!

The whole ride across the tarmac, I was praising God for holding the plane for me, as well as giggling at the ridiculousness of riding with all the baggage. 

Now I'm here and exhausted from jet lag. But God is good and I am safe, in one piece, and ready for my month in Manila!

Two More Days!

I probably should have updated sooner, but life has been crazy these past few weeks. Anyway, I leave Wednesday for Manila! I'm so excited!

Three weeks ago, I graduated nursing school and last week I passed the NCLEX, making me Danielle Wilson, RN! It's been two years since I've just relaxed and not had to study, so it's been really weird not having to study this past week. Thankfully, I've been able to hang out and have fun with my family. I've included a few photos from graduation. I was so honored that Aunt Carole, the only other nurse in the family, was able to fly to North Carolina to pin me. (And thanks to my grandpa for taking these photos!)

(Most of) my family. Grace and Joshua are not pictured

If y'all could be praying for safety with traveling and also that I will be somewhat comfortable on the planes (my knees are usually pressed into the seat in front of me because my legs are so long...) that would be fabulous.

Next time I post, I'll be in Manila!

Thanks everyone!

Guess What?! I'm Going Back!

It's been four years, but this summer, I'm heading back to the Philippines again for the month of June. I'll be working with Shiphrah Birthing Home again and am so excited!

When I left in November 2012, I promised myself and the midwives that I would return when I finished nursing school. Well, I'll graduate nursing school in two weeks (Hallelujah! Praise Jesus!), then I'll hopefully take the NCLEX (nurse licensing exam) at the end of May. My tentative departure date for Manila is June 1 and I'll stay until July 12, or so, giving me one week to readjust to North Carolina's time zone before starting my new job in the Emergency Department in Pinehurst. Busy? Yes! Am I excited? You betcha!

I know it's a little last-minute, but I just wanted to make a quick post about how you can get involved. I still need to raise about $2000 and am hoping to do that through my photography. Over the last few years, my business, Rising Dawn Services, has grown and improved so now I am a very good portrait photographer (if I do say so myself... Oh wait, I do...). I don't like to straight-out ask for money, so if you hire me to do your photos, it's a win-win situation. You get the gorgeous photos you've always wanted while I get funds to go back to Shiphrah Birthing Home. I'll be taking photography clients up until the last week of May, or so. Please check out my portfolio and photography information on my website: http://www.risingdawnservices.com/.

Another way you can get involved is to pray. Pray for me, Shiphrah Birthing Home, the amazing midwives and staff there, and for the moms, newborns, and families we care for.

So basically, that's life in a nutshell and it's a busy whirlwind (nursing school...need I say more?!) but I am so excited to see what God has for me in these next few months!

Thanks!

Danielle
danielle_wilson_hm@hotmail.com