First day at the Maternity Ward

I arrived a little before shift change, met with one of the midwives as I came in. I unloaded the supplies that I brought with me across town- Gloves,disposable speculum, syringes, gauze, and some goodies for the midwives. As I'm unloading I can tell she's hoping to see something- Chux pads, the disposable blue under-pads that we take for granted in the US and other developed countries. I brought some but wasn't able to fit them in my bag today to bring them to the hospital. Then after I did the first birth without one I understood. Honestly beside the gloves I wish I had brought only chux pads, because that is obviously what they want. There is one other New Zealand student midwife volunteering, and her school doesn't have the relationship with the hospital that mine does, so she wasn't as prepared with supplies to donate. Then at the same time it's much closer to Vanuatu, so she may have many more opportunities to bring supplies over. The afternoon was relatively quiet, there was one baby boy born about 2 hours after I arrived. He was healthy 3740gm, baby #3 for his mama who had a longer than average 3rd stage (delivery of placenta), even with active management (pitocin) it took 40 minutes and a lot of controlled cord traction to deliver the placenta. It was hard to watch the very sweet Ni-Vanuatu OB work with force to encourage the placenta to detach. The mama was not having any contractions (or not strong enough ones) to detach the placenta. In the states, we would have had her nurse the baby which encourages the physiological separation of the placenta, and clamping off the blood vessels to prevent PPH (excessive bleeding). The Ni-Vanuatu women really are strong, she barely made a peep about the whole birth process, and soon was moved to postpartum recovery and left be. later when i was reviewing her chart, I noted that she had quite high blood pressure (I wasn't managing her birth so didn't get a look at her earlier), i have no idea if it was checked again after the birth. The rest of the night was spent chatting with the other student midwife, prepping supplies (folding gauze swabs, rolling cotton balls- then soaking them in alcohol) for the ward, checking charts, keeping an eye on the 3 mama's that were barely laboring, and admitting 4 ladies just before the 11pm shift change. The staff midwives were nice enough to have me driven home by their family member/friend who picked them up. I am thinking about changing hotels closer to the hospital- it's not as private but much closer walking distance, and a bit cheaper overall.

Now time to head over to the hospital again.