Obstetras

Hospital Nuevo Amanecer en Vivo

A couple of low quality cell phone videos of Hospital Nuevo Amenecer to fill in the imagination!

600-715pm

The lights flickered and dimmed. The dark of dusk fell over the barrio as the lights went out in the Cocal. They say that in December the lights fail more often than not. Everyday for the past week the lights have gone out at least one time. I found myself lighting the way with my cell phone, its small square of yellow guiding me through my dark home. I searched for my teal green scrubs and pulled them on, feeling my way for the drawstring that distinguishes the front from the back of the shapeless pants. I locked up the top of my home and walked down the stairs to the kitchen to throw together a simple dinner to bring to the hospital. There had been avocados in the market earlier that morning, so I threw one in my bag with a package of mini toasts. Outside the lingering light from sunset carved out silhouettes of trees, buildings, and neighbours walking to their homes. Armed with my cell phone I passed through the metal gate and dared to trudge through the thick clay colored mud that currently lines the alley from my house to the street. At the mouth of the river that is my alley I awaited a taxi to whisk me though the pitch black for a night shift at Hospital Nuevo Amanecer.

As we sped down the gravel road there was a stillness that I could detect in the air. When the lights go out the chugging generator of the city quiets itself, and the black night draws people into their homes, away from the possible dangers lurking in the shadows. Quite nights like these make for lovely births.

I entered the hospital and walked back to Labor and delivery at 600pm. The delicate hum of the air conditioner whispered in the background mingling with the heavy breathing of two women in labor. One, the 43 year old matron, preparing to have her ninth baby stood in the corner providing guidance to the other, 20 year old first time mom. It was a crap shoot who would deliver first, but I placed my bets on the experienced matron. I led her to the delivery table, carting the small plastic bag of blood that was transfusing into her vein. An older woman, with anemia, and a history of many deliveries is at high risk for a hemorrhage after birth. I mentally prepared myself for the worst, running through my steps for managing a postpartum hemorrhage. The matron climbed onto the table, telling me that this was her fifth delivery in the hospital. She grinned, revealing a smile only half full with teeth. She was complete and began bearing down like a professional. I was the only midwife available to attend the delivery as the other one had stepped out. Gradually her baby´s head made its journey from inside to outside. Her neck was rounded by a tight loop of cord too tight to slip over her head. A quick somersault and the baby´s body was delivered and the cord then removed. No hemorrhage. That was at 700 pm. As I am waiting, and waiting for the placenta to deliver I´m starting to become concerned that she might have a retained placenta as I hear the deep guttural groans of a pregnant woman who is ready to bring her child to light. Finally the placenta slips out and I pass the multiparous patient off to the young physician for her to inspect.

I slip my head into the labor room and see the first time mom eyes wide with surprise staring up at me. I whisper to her, “its time” and help her to her feet. We move to the delivery table and she clambers her way up onto the blue vinyl cushion. The black curls on her baby´s head are just barely visible as she begins to bear down with all her strength. The midwife comes up to me and asks me if I’m going to cut. I shake my head no. “I think she´ll stretch”. “Don’t do it then” she says. I sense the still black night outside, hear the buzz of the air conditioner, and feel honoured to be sealed up in this labor and delivery suite at the end of the earth. The first time mom pushes with control to deliver her baby boy, tight nuchal cord, with one hand reaching up and out into the world. She delivered beautifully and empowered. Of course there was a little tear, but nothing a little suturing couldn´t fix. That was at 715 pm.