Last week OB

This week had me in L/D and at SPA. I was fortunate to see 2 deliveries. First mom was having her fourth child, baby was presenting brow first and it took longer than expected to get the baby pushed out. As baby's head cleared blood began pouring from her tiny mouth and nose. As the shoulders cleared more blood came gushing out of mom and when the baby was completely out a large piece of placenta came sliding down the umbilical cord and plopped on to the baby's body. The doctor said that there was a 15 to 20% placental tear. Baby was put into the baby warmer and the "Baby Catcher" started suctioning and respiratory was called in. Baby was making some noises but no active. lusty crying. Mom was still bleeding more than I was expecting to see with a vaginal delivery. The doctor asked mom to continue pushing with contractions and he was gently pulling on the cord, after two pushes with no movement of the placenta the doctor reached up inside mom and grabbed the placenta and manually removed it. mom continued to bleed alot but the Doctor did not seem concerned and the nurse was massaging the fundus. Yikes!!! Baby girl was still being worked on by respiratory but was starting to get a stronger cry. It was difficult watching both since things were going on with both mom and baby and that little ones muscle tone was horrible for the first little bit. she was limp and when they lifted her leg and dropped it, it was like an accordion collapsing on itself. :-(
Next delivery was a first time mom with ineffective pushing. Doctor suggested using the vacuum and mom looked freaked but her nurse did a great job explaining what would happen and after resting for about 30 minutes the doctor came in and baby boy was delivered in short order. HUGE hematoma on one side of his little head. No, it did not cross the suture lines. But bless his little heart his head was a mess. Mom was doing great and even with her episiotomy she was not bleeding even half as much as the first mom. All in all both were exciting to watch although my inexperience had me scared for the first mom and her little one. Great experience!!!
The SPA was good also, great RN to follow. Saw the great need for Spanish speaking medical personnel.