TOH EE MING
As a staff nurse at Doti Hospital, I had gone to bed after dinner after my all-day shift. Just after midnight, my phone rang, it could only mean one thing. I rushed to the maternity ward and found that a health post in Baglekh had referred a pregnant woman to us.
Her uterus was wide open and the amniotic fluid was leaking out. The baby’s umbilical cord was already showing, but it was choking on the muconium. The heart beat was 138 when I checked the pulse on the cord. The baby was still alive.
Because this was going to be a complicated case, I got someone to inform the medical officer what was happening. He came at once. Our GP, Srijana Gauchan was on holiday, so there was no question of surgery. We decided it would be ideal if we could somehow get her to a better equipped hospital. But she had already been pregnant six times, had aborted once. She could die on the highway.
I called Srijana, and she advised us to stay put. I had studied about these complicated pregnancies in medical books but nothing prepared me for the real case. I knew it would be very difficult if she gave birth here, but I also knew if I didn’t do anything, something worse might happen. We decided to go for it.
I told the husband very clearly what was happening, and what we had decided to do. He told me they already had four children and implored us to save the mother’s life. Still I didn’t want to take any chances so I made him sign a letter.
A colleague and I prepared the equipment. Because the baby had swallowed a lot of its stool, it could have choked on it. The baby’s blood pressure had dropped to 90/60 so we gave it intravenous lactate solution. Meanwhile, I instructed the mother to push hard. I had to save the mother’s life no matter what, but I also was concerned for the child.
When she pushed, you could see the umbilical cord emerging and it was important that it wasn’t squeezed. So I held the baby’s head firmly with one hand and tried to maneuvre the cord safely. The medical officer helped me out, making sure her perineum didn’t tear. After some time, both the baby’s head and cord emerged. I urged her to give a final push and the baby was born.
I immediately injected the mother with syntocin and focused on reviving the choking baby whose condition steadily improved. We also saved the mother, and we congratulated the mother and ourselves. I was very happy because I found out you learn more from practice than from books. I will remember for a long time, the day I dared to deliver.