a happy ending from my last post...

Jan 19/09

well, the smell in our room was becoming intolerable & this evening the exterminator came to check out the attic. Rose called it – dead animal smell! (I’m reminded of Cornelius, Hannah’s cat, graciously bringing her a dead animal and leaving it under her bed to discover.) there were 2 dead rats in the crawl space, most likely the ones we heard the 1st week when the rain was coming down hard. apparently this house had been abandoned for some time prior to us moving in and rodents had taken over, lol. wow, Arun & Christina must have had a lot of work to do in preparing.

practical skills class today was a continuation, covering maternal & fetal complications; the topic was weighing on me, maybe Sunday’s delivery is just way different than Whapio’s. after that it was a brief class on the release of DMT in the brain (naturally & through plant medicine) and altered states; tomorrow morning we start with Egyptian Alchemy & Medical Astrology. learning about Egypt in Peru is music to my ears! maybe Egypt will be next…

tonight I finally attended my first hospital shift. Belen Pampa’s delivery room is still delayed, the head nurse told Kai, until February! so I’ve jumped onto Hospital Regional de Cusco, which is on our street, Avenue de la Cultura and within walking distance. I went with Emily & Kate for a 7pm start. there wasn’t much happening in maternity/postpartum, so we walked over to the “normal” delivery dept. a woman was about to push her baby out and we hung by the doorway instead of bombarding her with 3 new faces. Kate stayed close to this Quechua woman, who was having her 3rd child, while she was being cleaned up. Emily & I went with the newborn 3.45kg nino (boy) – I’d seen plenty of newborn exams as a doula, but had never really paid close attention to what they were doing. it turned out to be the usual hospital deal: vitamin K injection to the leg, erythromycin ointment in the eyes, baby’s weight/length/head circumference, rubbing off all the vernex/amniotic fluid, and then suctioning – now this part was really messed up! the baby’s Apgar score was great & this was probably at 4 minutes; vigorous, pink, great tone, loud cry, etc, NO NEED to suction! the nurse shoved a long thin plastic tube down past the crying baby’s mouth, to suction out what??? any fluid that came up was completely clear! there was no meconium at all on baby when he came out! it was SO assaulting, I nearly fainted. I wondered what they would do to me if I fainted…I pulled my energy in close to stay centered. “welcome to the world: bright lights, being handled, taken away from mom, a shot in the leg, eyes pulled open to apply blurring gel, stretched out straight after spending 9+ months curled up like a ball, then a tube shoved into both orifices to be suctioned.” all I could do was focus on the baby with love.

afterwards, we wandered back to maternity though not much was going on. we sat down to go over our Spanish when some nurses came along asking why we weren’t working; we’d perused some rooms but mostly all were asleep. we found a postpartum woman who was awake & I began doing my best to understand and translate for Kate & Em. her & her husband own a hostel, she spoke minimal English being in tourism and she asked if we’d visited Machu Pichu yet. Ayde had delivered via c-section & was heading home tomorrow.

then a Spanish woman was being wheeled down the hall to the OR. this petite Peruvian woman was Josefina Segundo, her baby was in a transverse lie, and “required” an emergency c-section. what defines emergency?? would the baby stay inside forever if we did nothing?? I’m having such déjà-vu right now. the nurse stopped in the hall, asked if we spoke Spanish, and explained there were 2 c-sections that would be occurring and only 1 of us could attend.

I introduced myself to the “patient” laying below me on the gurney. shortly after a male “medico” came by and said we could all attend. I was so thankful I wouldn’t be attending alone since I’d not fully recuperated from 10 minutes ago. i threw on green OR scrubs overtop of my maroon ones, my reusable green booties, hair cap and face mask. I scrubbed my hands to elbow, dried off then headed into the OR. Josefina was already prepped and the medico was explaining what was going on. he watched her vitals, kept her fluids full, administered antibiotics and oxytocin. she’d had an epidural a while ago, perhaps it wasn’t topped off properly, (what combo of drugs is used here??) but she could feel “dolor”, pain. the baby was pulled out feet first and was covered in meconium: thick, dark, tar-like poo, usually a sign of fetal distress when the sphincters are lacking tone and pressure on the baby’s body pushes it out. I’d never seen a baby so floppy and limp. Emily and I followed the baby while Kate stayed with mom. the baby girl wasn’t moving, I softly spoke to the baby asking her to come into her body, to breathe. a soft cry emerged, her irregular breathing was labored and her bellybutton was shaking. she was being suctioned for meconium in the lungs and dried off. we relayed to mom the baby was okay and that she was a nina! the women aren’t communicated to really, during this process.

I watched as they sutured Josefina up, her uterus hanging out of her body while they inspected to ensure everything was lining up and complete. oh, and cauterizing? well, the smell of burning flesh is something I can do without. I wondered what it’d be like if I were laying there with my guts open while H was at my head talking with me and simultaneously able to see the science of my body ripped open. the suturing was really well done, the doctor was super calm and focused. mom was asking me something but I couldn’t understand. she passed out, her BP was down to 84/45, her pulse was 76. the nurse began oxygen, her vitals slowly picked up and she came back around. when finished, she’d be moved to recovery before being moved back upstairs to postpartum.

the 2nd c/section was already being started next door, it was also an “emergency” and I could see the woman being given an epidural. Ana Maria Valencia’s baby was also in a transverse lie, she was overweight (an excuse they use sometimes to section) and apparently wasn’t coping well. she too cried out when they were cutting her belly open and pulling her baby boy out. this nino had some meconium on his body, but not like the first baby and he cried right away. after seeing baby was fine, I walked back over to Ana Maria to tell her it was a boy. she was passing in and out, I stood beside her and held her hand so she'd know she wasn't alone - she gave a squeeze back.

Emily wanted to leave after that; it was only 9:30pm and we’d seen 3 deliveries! I definitely needed to sit down. I roamed the halls checking in on all the rooms, asked some women if they needed assistance but everyone was doing well. Kate was off with someone who was in labour. the nurse who’d asked us to attend the c/sections brought me downstairs to the recovery room so we could bring Josefina to the postpartum area. I tried helping her transfer from one stretcher to the other. it’s crazy that after having major abdominal surgery, these women aren’t lifted off one and onto the other gurney. they all have to wiggle themselves over with not much assistance, while everyone watches! only when I said “she’s in pain” did anyone sort of begin to help. we wheeled her up to her room and again, another transfer, now from the gurney into her bed. she had to take off the hospital gown and put on her own clothes she brought. she was still bleeding a bit, we tucked in her blankets, set up her IV pole and the nurse left. I asked if she needed anything, she was cold, so I pulled the blankets up to her neck, pulled the blanket close to her feet and turned her light off. she was in a room with 5 other women. the nurses would come in loudly while others tried to sleep, and would blast the overhead lights on. I took on light patrol and the closing of doors to avoid the hallway noise.

just as I was about to leave the room, another woman asked me over. “?es una amiga de Makenna?” she spoke softly. it was Maria Elena, the woman who Makenna had been with yet wasn’t permitted to attend her c/section. I introduced myself, told her our class had heard about what had happened and began tearing up. I felt so honoured to meet her! I hung out chatting with her in my broken Spanish for a ½ hr, then she wrote Makenna a note with her phone & email info. Makenna has been deemed the child's godparent!! Maria Elena was being discharged tomorrow. while she wrote the note, the woman beside her woke up. she didn’t need anything, but I gently rubbed her back until she fell asleep. what a gift the night was.

i used to say i wanted to cover the entire scope of practice: from abortion to c-section. i think i'll leave c-sections to the surgeons.