I hope all of you are enjoying what you are doing right now, as we need to work to earn for our living. There’s no such thing as sit down and doing nothing as long as we are fit enough to do something.
Back to labour room, there’s a story I would like to share. There’s a lady, primigravida, in early 20s, admitted to labour room as she was in labour due to increasing contraction pain and os was already 4cm.
Primigravida is the term used for a woman who is pregnant for the first time. That means, this is her first child. So, she doesn’t have any experience related to pregnancy and how to bear down etcetera.
As soon as she felt like bearing down, we encouraged the mother to do so. We tried our best to motivate the mother to bear down, as she had no experience before. She always gave up trying as she felt exhausted everytime she bear down.
We didn’t gave up easily. As long as she could delivered normally, we would try again and again to support her. If she went for Caesarean section, few measures had to be taken care post operatively. The safest mode of delivery is by normal delivery, provided that patient doesn’t have any underlying serious medical problem.
As time went by, it was almost 1 hour the lady was in 2nd stage of labour. We asked her to bear down in an appropriate manner, so that the baby could be delivered safely. She looked tired, and had no energy at all.
Decision had to be made. Whether should be normally, or by operation.
Came our senior officer in the room. She was so eager to deliver the baby via normal vaginal delivery. The head of the baby was already seen. What was remaining, the effort of the mother to bear down correctly.
Episiotomy was perfomed. Everybody taking turns to give fundal pressure, in order to assist the delivery. Time was running out. The baby must be delivered by hook or by crook. Otherwise, he/she would be in distress due to lack of oxygen.
After few times of trying, we managed to deliver the baby safely. But wait, the baby was not crying! Huh?
Moderate meconium was seen coming out together with the baby! The baby was born flat! Something has to be done.
The officer cut the umbilical cord and warned us not to stimulate the baby. We were suspecting that there could be meconium in the oral cavity. Aspiration of meconium should be avoided.
The baby was brought to the incubator and resuscitation was performed. Direct suction was done. SPO2 was checked to assess the concentration of oxygen in the body. Subcostal recession was observed and the baby was still not crying. The baby could be in respiratory distress.
Paediatric team reached the labour room. The baby was then intubated, and transferred to NICU. Closed monitoring of the baby must be done. We have to rule out possibility of meconium aspiration syndrome.
That’s one of few episodes in labour room, which requires immediate action as it is an emergency condition. The more we delay, the more problems the baby would have in the future.
It is never easy. Once occurred, everybody has to take part and help each other. The immediate action is very important.
Ok then. Till we meet again.