11th handle

  I arrived an hour early to Swing Shift because Michaela had a class that she needed to attend.  She endorsed a labor to me.  At 12:20, this patient, Remie Grace, was 5 cm.  She was 23 years old & a G2P0.

  Ok, I know some people were wondering about what I mean by GPAL.  “G” stands for ‘gravida’ meaning pregnant.  So, if I say G2, that means that this patient has been pregnant 2 times.  “P” stands for ‘para’ meaning given birth.  So, P0, means that this patient has never given birth.  “A” stands for ‘abortion’, but it usually means miscarriage in this form of classification system.  “L” stands for ‘living’, so how many children are still alive.  So, Remie Grace had been pregnant 2 times & had a miscarriage at 4 months. 

  Things seemed pretty normal, though FHT’s dropped to the high 80’s – 100’s range a few times.  I suspected nuchal cord – cord wrapped around the neck, which is ok as long as it’s not tight. 

  Remie – or better known as Monding – wanted to push about  later.  We let her do some trial pushes, but nothing was progressing, so we again encouraged her to breathe.  Her bana, or herself, informed me every few minutes that she wanted to push, & I kept encouraging her to breathe through the contractions. 

  We were getting ready to transport her, but Ate Krys was successful in getting baby to descend, so once baby’s head was crowning, I finished delivering him.  Yes, it was a boy!

  Baby did have a nuchal cord & so I unwrapped it, once he was born.  As I did so, Krys noticed that baby’s tongue was hanging out.  She began massaging him with a towel & called for the deep-suctioning machine.  After deep-suctioning him, Ate Krys began using PPV – positive pressure ventilation.  On being told there was nothing physically that I could do, I began praying aloud. 

  His first Apgar score was 1.  Normal is between 7-10.  The only thing that showed that he had life still in his body was a slow heartbeat in the 80’s range.  Normal for babies is 120 – 160. 

    The emergency buzzer was rung, which meant that our little cubicle was full of midwives in seconds!  Plus, there were lots of people outside ready to help.  What an amazing support group! 

  He began to pink up with the PPV & shortly thereafter began a small cry, which quickly grew louder – much to our great relief! 

  I was doing ok, up to this point, but after things had normalized, I wanted to go home & cry. So, I just focused on the next thing that needed done.

  Immediate postpartum went well.  Baby nursed well, after he told the world that he was alive & well.  Monding was able to go to the CR & move over to the postpartum rooms soon after birth.  They were both still doing really well, when I endorsed their care to the night shift.