Baby Catcher

Tuesday

Baby Catching!

I have some exciting news!!! I caught a baby lastnight!!!!! Actually two babies in one shift! I am on such a high I just can't stop thinking about it. The clinic has been crazy lately. We went through a few days where every shift was having 3 or more babies. Then we had a few days where it was completely dead. Only one or two births a day. It was very strange. So I showed up to my night shift with only one labor. I was first up to catch (my first time) and received the patient after shift change. She was feeling a little pushy and 40 minutes later I caught her baby boy with the help of my peers talking me through it. It went well! I supported the perineum with one hand and the head with the other. When the head was completely out there was nucal cord so I pulled it over the head so it was no longer wrapped around the neck. I almost got all my paper work done and patient settled in the postpartum area when I was surprised to see another labor came in. It was not the only labor! One after another laboring women came in and we had all five beds full with labors. I got the fifth labor who looked like she was going to have her baby very soon! I had her go to the CR to void and wash before having her lay down for vitals. She was having contractions that were probably only a minute or less apart. I was hurrying to get vitals done so I could give my supervisor a quick update and ask her what I should do next. Before that even happened I found myself yelling "Ate Estef, I see head!" She made it to my cubical and said, "We have another labor!?" I told her yes and she told me to proceed as she walked away to help with other births. I few seconds later a student came in my cubical to help. She was giving me directions of things I should do but I cut her off saying, "Ok, 4cm, 5cm, head out! Nucal cord, baby out!" Seriously all in one breath! If you looked at most charts there would be 30 minutes to hours of labor watching with vitals and fetal heart tones. Our labor sheet took up half the piece of paper. It looked something like this: 2:53am (Vitals), 3:01am 1cm visible without pushing, 3:02am baby out, 3:12am placenta out. I kinda had to laugh as I was sitting there taking it all in. That birth was so fast and I had only delivered one baby before in my life, about 4 hours ago. Then I was stuck in a cubical pretty much doing it on my own  as every bed beside me was taken with an active labor. Students were contantely moving from curtain to curtain assisting with births or charting during the process. So as I laid my second baby on the mother's stomach and was waiting for the placenta to be delivered I heard the guard yell that we had another labor. All of the beds were taken and luckily she was not super active and was able to wait for a bed to open. I just had to smile and shake my head thinking oh my gosh this is so crazy! We had six delivers on our shift and two more labors walk in as we changed shifts. What an amazing, amazing night!
Just for a glimpse of the excitement here is the times of the labors on our night shift (10-6).
10:40 pm My first catch!
2:43 am
3:02 am My second catch!
3:10 am
3:28 am
4:30 am
It was an awesome experience! They families I had were very nice and luckily for me spoke English. I could have some very different stories for you if they hadnt! Im sure those stories may still be waiting for me in the near future. Now that I have personally delivered the babies I am in charge of scheduled baby checks. The mother and baby need to come in for a 1 day, 3 day, 1 week, 3 week, and 6 week check up. I have them scheduled and will be seeing them tomorrow!

My first catches on the same shift! :)

Keizer Dale and Paul Jay

Thursday

Thursday was another day filled with labors! I was last up to catch and didnt think I would get the opportunity until a few more pregnant ladies walked through our doors :) The shift I was working was from 6am-2pm and from 8:15-8:58 we had three babies born. I remember when the fourth labor walked in I assisted her to a bed. Right beside us was a woman just yelling and grunting about to have her baby. I heard about three staff members run in and said head was out. All of the sudden I heard a loud explosion and flash with a small piece of ash float in the air. I pulled open the curtain to ask if everyone was ok. I guess someone stepped on the cord to the birth cart and it snapped in half. There was a nice black mark on the wall! What an experience that woman was having! On the other side of the curtain I just had to smile at my patient and pretend we couldnt hear all the ruckus going on beside us. I took her vitals and monitored her for awhile. Two of my baby check ups arrived so I left my laboring patient to get the checks done. In between one of my checks I went to check on my labor because I thought she was pushing but my supervisor told me not to check and to do the next baby check up. I almost finished the check when I heard my name called from the labor room, "Kelsey! Kelsey! Kelsey, put gloves on!" I hurried in trying to put gloves on quickly. I walk in to my supervisor holding a blanket between the mother's legs with one hand. I got into position at the end of the bed to see the head crowning! The head got stuck between a few contractions and we could not find fetal heart tones in the panic that we were kind of in so we did head stimulation. Next we had a brown out. I have heard of these but one has not happened yet. The entire city lost electricity. Our supervisor just went on like nothing happened. The baby was delivered fine but had a lot of fluid in his lungs. My supervisor went to use the suction and realized we had no electricty. We used a bulb syringe and everything was fine. At the end of the shift we all got our picture together with our babies. That is what always makes the situtation real. When I can look back and say "wow, look what we did today."

Allen Jr

Friday

I worked clinic and swing today. Not a lot happened except that we moved the clinic from the old dorm back to the real clinic since the painting was done. The painting I thought was suppose to take 3 days...3 weeks later here we are! It was well worth it tho. The clinic looks very nice with new pain and curtains. Tomorrow I am going on a boat trip with about 45 students, visitors, and families. We will be snorkeling and floating in the ocean all day! I am sure it will be a lot of fun! After the boat trip I plan to take a nap because I work night shift :/ Please pray that I have a lot of energy or maybe a quiet night with no labors :)

Fun Fact: I am basically a midwife this summer not an intern. I do everything you could ever do for a labor and delivery except suture tears. I even do I.E.'s (Internal exams)...I have yet to guess correctly how dilated a cervix is! :D

Babies, Beauties, and Chicks

Wednesday was a busy shift. We had quite a few labors and I helped with two assists and two postpartums. Both births went smoothly and we had two healthy babies when we endorsed to the next shift.

Austin Santino

Jhon Steven

 Thursday I had outreach and swing shift. I headed to the clinic around 7:30am to get the outreach bag packed and ready. Four of us headed in the ambulance to Isla Verde where there is a big bagial/gypsy and Muslim population. The Bagials live on one side of the community and the Muslims live on the other. In the past the Bagials use to be part of the Muslim culture but the Muslims will not claim them as part of their tribe now. The Bagials are not educated and do not wish to be. They do not know a word of English and cannot sign their own name. When they come into the clinic they have to sign birth certificates with a thumb print and ink. I on the other hand do not speak Visayan and sometimes the Bagials speak a different dialect than the students. Luckily there was a nice you lady who helped me translate while I was at this clinic. The clinic was someones home with an extended roof over the front of the house. This Filippino family provides a clinic a few times a week and allows doctors and clinics such ourselves to come in and provide care. While we were there we had a few elderly ladies come in to get their blood pressure read. I tried to speak some Visayan but my patients just laughed and got all nervous so I was happy I had my own translator! The morning went great and the family invited us to stay for lunch. We had a wonderful meal with pot roast, limpia, and rice. They were expecting several people for lunch but told us they were not coming anymore. As soon as we sat down the group arrived! Good thing there was enough food to go around! The visitor were some American high schoolers that are staying for a few weeks with one of our students. Her husband use to be their youth leader and they wanted to come visit and do some mission work so it was set up.

The clinic in Isla Verde

Yum :)

Swing shift was not as busy. I was endorsed a postpartum patient who was pretty easy. I checked vitals, filled out the birth certificate information, and gave the baby a bath. One of our interns brought some donated Bibles and when I gave my patient one she was very excited. She asked, "for me?" and when I answered yes she tried to cover her smile with the Bible. She was very excited. I guess I did not think it would be a big deal. I took for granted that almost everyone in the states owns a Bible. It made me think how many lives have been changed because of this clinic. These woman come to prenatal every couple of weeks and are greeted by warm face that soon become familiar. We do devotions with them and pray with them individually after each check up. We pray for them if they are in pain and having a long labor as well as praying for them before discharge. And a Bible to top it all off! I'm sure they feel safe and loved at the clinic and from what I have heard about the public hospital, I am very glad this clinic is running.
One night Tilly, Casey and I decided to go out to eat. We went to G-mall which has 5 floors. You would not be the impressed by the inside but on the very top you can walk on the roof. It is nicely designed and modern. You can see across some of the city which is neat. They are in the process of opening restaurants but about three were already open. We ate at an Italian restaurant and was greeted by the owner. He was a little Italian man who quickly told us about his son. Apparently his son was on one of those cooking shows and is one of the top 10 chef in the U.S. Jenifer Lopez really likes his dessert :) The owner also use to work in Chicago for at least 15 years and just moved to the Philippines a year and a half ago. He must have like us because he continued to send us complementary things such as cheese and olives and brushetta. He told me more than once how beautiful my blue eyes and blonde hair was. It was only a little awkward since he was old enough to be my father. By the end of the night he gave us his business card just incase we wanted to contact him. We told him we were missionaries but that did not slow his complements any. The food was great and we all probably paid only $8 USD for our meal. It is hard to believe that most people in the Philippines cannot afford to eat there. That seems so cheap to me but I guess I haven't worked for $3-5 a day and had to provide for a family.

The roof of the Mall

Over looking the city

Yay for table napkins!

Pasta with peas and ham

Our little Italian Man

One the way home from the mall Casey and I were alone because Tilly had to leave a little earlier for shift and we wanted to get pedicures. The mall was closing so that did not workout for us! We went outside to catch a jeepney and got one right away. It was filled of course! One our way across town it started to rain and the jeepneys have plastic windows you can roll down and snap to the side. We saw all the Filippinos do their part and Casey tried to snap her corner. Lets just say it was not working out and Casey had her arm out the window holding it down while we drove quite a ways. I was laughing and soon Casey was too. I think we were the entertainment on another jeepney ride. We hoped off at our stop and it was still down pouring. Our house is at least 3 big blocks away so we thought we would sit in a restaurant and wait it out. It did not stop raining so we decided we would just walk in the rain. We crossed the street to the gas station. There just so happened to be a tricey there (a motorcycle with a cap connected). We asked him if he would take us to San Pedro just down the street. He said he was not allowed into the gated community and we assured him we would talk to the guard. As we pulled up we yelled at the guard if it was ok for him to take us to our house in the pouring rain. It was our favorite guard :) He looked both ways and waved his had to make it quick, obviously breaking the rules! It was so funny! Our little driver was about our age and loved every minute of the adventure. It was another fun night on the town!

Waiting for the rain to stop

Fun Fact: The neighbor's chicken jumped the fence and has been laying eggs in one of our bushes. Pretty sure they are going to hatch soon. We plan on keeping the chicks. The neighbor can keep that loud roster though!

Our neighbor's Chicken

Our soon to be little chicks

I stopped in to see how the painting was going at the clinic

I guess our workers get a lunch/nap break

Assisting

Sunday

Sunday morning I went to church with two other girls. We went to Victory Church in a different part of town. I'm not sure I would know how to get there again :) Might need some assistance next week. When church started there were only a few chairs filled but after a few songs it filled up. Almost every chair was taken. The service was in English and very contemporary. The pastor did a Father's Day sermon. It was interesting because he used statistics and famous people from the U.S. as examples. He gave examples like 36% of children in the US do not have a father in their life. 70% of fatherless children drop out of school. 70% of inmates in a juvenile institute come from fatherless homes. The statistics went on and on as the pastor made his point of how important it was for fathers to step  up and take responsibility for their families. He then quoted President Truman talked about Al Capone, Easy Eddie, and Butch O'hare. The pastor mainly focused on Easy Eddie, Al Capone's lawyer, and how he was providing for his family but it was not enough. Easy Eddie was able to provide his son with a huge house, food, education ect ect but he was not able to provide his son with a good name. His son would always have a tainted name from his dad helping Al Capone. Easy Eddie then stopped working for Al Capone and went against him in court. Al Capone was given jail time and Easy Eddie was soon assassinated. He paid the biggest price for his son but provided him with a good name in the end. Next the pastor talked about Butch O'hare's service in the Navy. Butch was flying fighter planes and was on a mission. He shot down some Japanese bombing planes before he himself was shot down. He became a hero and then the pastor told the congregation that Butch O'hare was Easy Eddie's son.

I worked swing shift so I went to work after lunch. We were busy! We had at least 5 labors come in. We sent at least three home and transferred one to the hospital for failure to progress. We did have two births which I got to assist with. My job was to take the fetal heart rate with the doppler after every contraction. When the head was finally out I wiped the face and placed the baby on the mom's stomach. I did APGAR scores at 1 and 5 minutes after birth. When the placenta was out I clamped the cord and allowed the family member to cut the cord. One grandmother would not cut the cord so I got to do it! After that I did fundal checks every 5 minutes for 30 minutes to make sure the uterus was firm and I had to estimate how much blood loss their was with each check. There is a higher risk for hemorrhaging with Asians so we massage the fundus every five minutes to make sure all the clots are out. When all of our checks were over I restocked the birth cart and started on some paperwork before doing a newborn exam. I learned so much assisting I was just amazed! There are a lot of things you can not pick up from just observing a birth. My first assist was a little overwhelming but my second one went much smoother. I am very excited for my next shift to do it again!

A few baby names I have heard so far:
(first name only)
Queen Elizabeth
Cris Paul
Sarah Joy

*One morning around 5:30am I was heading to the clinic with a roommate when an elderly lady who was on a walk stopped us. She informed us that she was going to be having a party at her house in a week and wanted us to come. She pointed down the street to where she lived and told us the date and time. She was adorable! Hopefully some of us will be able to make an appearance.

All the seats were filled once the service started

Cris Paul my first assist

Time is Flying!

Thursday

Thursday morning I attended an outreach in another section of town. The clinic provides outreaches for women who can not afford a ride to the clinic to make their prenatals so we go to them. We met at Foursquare Church where we only had 5 clients. There are usually more but not many showed up that day. The church was interesting because it was under construction so there was scaffolding everywhere. I am not sure where anyone would stand/sit for church but apparently they still have services. The history of the Dacaudo side of town is its reputation for danger. Apparently a long time ago that part of town was so dangerous that the mayor built a gate around it and locked it at night to keep the crime in. There were serial killings and police would just clean up the bodies in the morning before opening the gate. That does not happen anymore and the crime rate has gone down tremendously in the last few years. The last mayor was a strict. He inforced a law that if you committed a crime you were sentenced to death. His daughter is now mayor and has also kept the law inforced. Many of the gangs in town have moved out to the mountains because they are afraid of being shot by police. The female mayor now apparently made world wide news for beating up a construction worker. Her and her father really are ones in favor of justice being served.

Thursday I also worked night shift. It wasn't too busy so I got quite a bit of sleep. We had a few labors but they did not deliver on my shift. I did help care for a 16 yr old girl who had probably been abused. With every contraction she was yelling and rolling around the bed uncontrollably. When a student went to do an internal exam (I.E.) she freaked out, screaming and pinching her legs together. The student told me that is a big sign that they have probably been abused and it is reminding them of the pain they once felt. 

Foursquare Gospel Church

Interviewing clients and doing health teaching

Vitals

Fetal heart rate monitor and fundal height checks

Tetanus Shots!

Friday

Friday was my day of and we were all pretty tired so it was a lazy day. A lot of napping went on in our house but after supper we gathered enough energy to watch a movie. We may have watched an hour of it before it started skipping so we just called it a night!

Saturday

Today was a long 8hr shift. There was not a lot of patients so the shift seemed to drag. We had one postpartum patient we cared for all shift and about 3 labors that came in but we sent home because they were not dilated enough or having frequent contractions. After shift I headed home to shower since I had a date....A date with Casey and Tilly of course! We went to TGI Friday and had a blast. I'm pretty sure we took pictures with every statue and security guard from the restaurant to the Jeepney ride to Jollibee to the guards outside our gate. The night was filled with smiles and laughter. I loved every minute of it!

TGI Friday Statue #1

Jeepney Ride. The jeep was so packed I had to sit on Casey's lap.

That lasted a second and the driver made these boys scoot over so we sat hip to hip.

They had a great laugh listening to us girls!

The Jollibee character and the guard.

The guard at our gated community. His name: Chua (chewa)

A few things you might find interesting... Most of the Filipino midwifes that live at the clinic are from towns far away. They work 4-5 days then go home to see their husbands or family for a few days. The clinic also supports Filipino midwifes by paying for a few chosen ones to go to school in the Philippines and then are repaid with two years of work at the clinic. This allows young women in rural parts of the Philippines, especially the mountains, to be able get an education that their family would not be able to afford.

When entering a mall or grocery store the security guards make you open your bag. All they do is check one pocket and glance at the item on top using a drum stick as a utensil. Funny guys!

Fun Fact: The three story mall was filled with people tonight. There were dancers on stage with a mascot and some pretty hip music. We were wondering what was was going on and realized they were advertising detergent. Wow! Pretty extravagant way to sell detergent but that mall was filled like it was the Mall of America! We think there was a concert afterward though.

The stage was filled with people and the upper two floors wrap around and were completely filled with bodies! I have never seen a mall so packed!

Time is flying! Today the girls had to remind me that tomorrow is Sunday so I do not work a double. I guess I didn't even know what day of the week it was! I was planning on getting up to make it to the clinic by 7:30am. I am so glad I get to catch up on some sleep. I am so surprised it is the weekend already. June is half over and I am dreading that my trip is coming to end. I am so thankful I get to stay for two months tho! Everyday has been amazing and a blessing.
Love you all!
Thanks for your support!
-Kelsey

Not So Text Book Perfect Deliveries

I have been officially volunteering at the clinic for ten days and have already put in 70 amazing hours in. I have learned so much in the last week and a half I can't imagine what my skills will look like by August 1st. I have volunteered 7 of the 10 days and have seen/charted for at least 12 births and practiced many other skills/assessments. God has been good to me and many others at the clinic.

Tuesday

At 6 am on Tuesday morning I started my day off with a scare. There was a labor progressing so I went into the birth room to observe. The mother was having trouble pushing the baby out but it soon came. Once the baby was out it was blue with little tone. An APGAR score of 2 out of 10 was yelled and our supervisor ran in. The students began PPV (positive pressure ventilation) with a hand bag hooked to O2. They did this for 9 minutes while another student got the transfer papers filled out and the ambulance ready. The mother was crying and I held back tears as I watched 7 staff members working together to handle the situation. The emotion in the room was overwhelming to me but the staff stayed strong and continued to stimulate the baby. When the hand bag was removed the baby was breathing on its own and was quickly transferred to the hospital so fast that the grandmother never made it to the ambulance to ride along! We got her to the hospital a little later. Before my shift ended I heard the baby was doing much better and it looked like every thing was going to be ok. Praise God! We stayed busy the rest of the shift with a few more deliveries. After my shift I walked home and realized Casey, Tilly and I were all off for once! We walked to the other gated community which we figured out has a very nice pool, tennis courts, and indoor basketball court. We went for a swim in the nice warm water before supper.

Wednesday

Today I was at the clinic a little after 7 for prenatal check ups. The staff and students begin their day with a small devotional before moving into a larger room with the clients. Next door where the clients are waiting we sing a few songs with them before they have a devotional and health teaching. After that is over, in about an hour, they file in a few at a time into the prenatal room where there are 6 beds for check ups. I again was paired with a student to practice my fetal heart rate monitoring and fundal height checks. Luckily most of our patients today spoke English but I need to work on my Visayan. Together we probably did prenatal check on 60-80 women today.

After that I headed over to the birth room where I started my swing shift at 2:00. We were busy all afternoon/night with about 3 births and a few postpartum patients. I should have been assisting for the births today but there were a few chaotic moments so the staff just had me chart during the births which was fine with me. I will start assisting tomorrow night. Our first birth went fine and I charted for that and the suturing afterward. Our next patient was a 16 year old girl who's boyfriend looked much older than her but he was funny and truly cared about her and the baby. As the patient pushed her water finally broke. A student began to monitor the fetal heart rate which began to drop. The normal is 120-160/min and this one dropped to 80/min. I became a little nervous and wondered if we would transport her if she was this far along. Our supervisor was in the room and was taking charge of the situation from a distance. We had the mother push a few more times and the baby did come out. It was a little blue with a cord wrapped around its neck but it began crying and with an APGAR score of 9 my heart could beat again. There were three women with this patient and her boyfriend dressed in head dresses. They were Muslim and the nicest people I have met yet! I was impressed on how good their English was and how talkative they were. I guess I had this impression that they would be shy and not make eye contact let alone talk to us. They seemed like amazing women so we will see how much more contact I have with them.

The evening was full of many surprises. Two American/Canadian girls showed up and the Filipino midwives began screaming. I guess they were students a few years ago and surprised everyone. One has a sister who is a student right now. They will be staying for a month and volunteering at the clinic while visiting friends they made. Soon after that surprise we heard someone outside yell "emergency!" I heard a siren and lights flashing and wondered what was going on. When I walked out the gate a I saw a ambulance looking truck that said police on the side. At least 10 people were filing out of the back yelling I'm not sure what. Three men were then carrying a woman inside. I kept looking for massive bleeding or something but saw nothing. The woman did not look completely with it and looked as though she might pass out. When we got her chart we found out she was blind and could not see. We laid her down in bed and did an internal exam. Turns out she was only 2cm so there was no rush. The group that came on the police truck were gypsies. They kept us pretty entertained for the rest of the night as we did them. They spoke a different dialect than our students so they would laugh when they the spoke and told the midwives they could not understand us. Although the woman was only 2cm we kept her because this was her 5th pregnancy so it could move fast and she was blind and would have trouble in the dark getting home and back to the clinic even with her entourage. Her chart said she had 4 other births but only one living child. When asked we asked her helpers what had happened they said they did not know her history. When I left my shift the woman was not close to giving birth yet. I got a ride home in our ambulance driven by one of the midwives and three other midwives who wanted to ride along. They are a funny bunch those Filipinos! Tonight they had the guard carry a tv from their housing in the clinic to our make shift clinic so they could watch a soap opera while we ate supper! One started crying while she was watching it! Haha they are so funny! As we were pulling away in the ambulance I saw our guard taking the tv back to their home. Those guards sure do spoil us!

I just realized it is one in the morning. I better get to bed because tomorrow morning I am heading to a different part of town for outreach. Sounds like we will be meeting more gypsies. Then I work night shift. Should be an exciting day!

Talk to you soon!
-Kelsey

Our awesome warm pool

Homemade bread with garlic butter made by our lovely cook

Singing before prenatals

Women waiting for prenatals

Students performing prenatals

Michelle and I..(A Filipino midwife)

My supervisor and I were trying to sneak a picture behind Michelle.

It didnt workout for us

We found out the girls have Hammocks so we tied one up.

We may be going 'camping' in a hut on some beach one day