This quarter I have a Childbearing Families rotation on 15 Long at UCSF every Friday. I'm assigned to a different part of the unit each week; postpartum, high-risk antepartum, lactation, well-baby nursery, and the BEST... labor and delivery. Last Friday during the 7am nursing hand-off, my nurse and I got pulled away because the patient we were assigned to was having continued decelerations (where the baby's heart rate drops significantly and takes a few minutes to go back up to baseline). Some decels are normal (with contractions, for example) and decels with variability (where the baby basically bounces itself back to normal) are typically ok. But this little stinker was having sustained lowered heart rates and was making everyone nervous for most of the night before and into that morning. We tried a number of nursing interventions on mama, but ultimately she had to sign the consent forms for a C-Section and by 10:30am we were suiting up for the OR.
Five layers of tissue (skin, fat, fascia, muscle, uterus) and an hour or so later, baby boy got pulled out of mama and we heard him use his little lungs after the peds team went to work a bit. My thoughts on the whole C-Section process? Other than fetal demise or injury, I can't think of a worse pregnancy outcome than a C-Section. Are they necessary? Yes. As much as we do them here in the States? Come on. It is incredibly invasive and traumatic and sterile. It is SO far from what our bodies intend for the childbirth experience. But I digress. Either way, it was pretty CRAZY to see a huge melon-sized uterus resting on top of mama's stomach while they sewed it back up. Fallopian tubes, ovaries, and all.
A few hours postpartum, I was standing next to mama while baby was trying to breastfeed for the first time. My nurse (who had been a nurse midwife for 36 years!!) showed me how she wanted me to hold baby's head against mama's breast in order to facilitate his latching on since mama couldn't hold him quite right because of her surgery. So I basically planted myself there for the next two hours with one hand on the back of baby's head and one hand coaxing her nipple to protrude or pushing against her breast so his little nostrils were clear to breathe. During orientation for this site, my professors said we should allow ourselves to fall in love with the mamas we are working with. And from small talk with her in the morning to giving her reassuring smiles with my eyes in the OR since my mask was on to helping her breastfeed her son for the very first time in either of their lives, I did indeed fall in love with her.
About 24 hours after that, I was sitting at a funeral for a 24 year-old who I have known since he was born too. And today marks one year since Praise died. I'm just finding myself taking it all in, you know? I'm far from uncomfortable with death. I feel like there has been enough of it now - indiscriminate of age or reasons why - it just happens. People die. People are born. Keira was born. Geoff died. Brendon died. Baby boy was born. Still, it's a strange juxtaposition when it happens so concurrently. Just trying to take it all in. "It can open your heart, it can break you apart, and it never even slows down..."
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