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Grab a hanky or a tissue and take a seat. This is a precious story, that, well, it almost brought me to tears, but it definitely touched my heart deeper than any other birth!
Yesterday my shift was swing, from 2-10pm. It was quiet except for one girls continuity patient (cont). Then, just before 2:00 a labor walked in reporting BOW rupture at 12:30pm. She was checked in by day shift and endorsed to us on swing. I was first up!
Upon reviewing her chart there were two things that stood out. The first was that an ultrasound had been requested back in March, but no report made and no copy of the ultrasound was anywhere to be found in her chart. Second was that since her second visit (of five visits) her fundal height had not matched her gestational age (GA) by anywhere from 5-7 cm. Quite odd. So, i just asked, "Gang, Na'ay ang ultrasound?" "Oo." (yes) was the reply. Oh, "Can i have it?" This was, hopefully a good sign, except nothing was really going for her.
She was already BOW rup, thus on a 12 hour time limit before we would be required to transport...she was only 2cm and a G1 (her first baby). She was 70% effaced though, so that was in her favor. Not in her favor, either was the continued discrepancy between current gestational age of 39 weeks and fundal height of 34cm. Hmmm. My gut was feeling a transport.
According to LMP (Last Menstruation) she was 39 weeks, according to the ultrasound she was 36 weeks. Hmmm.... Normally we transport, unless they are 37 weeks. We had a little problem though, we had made a little intervention. Castor Oil. This can help labor progress well and because she was 39 weeks and BOW Rup, this was good management.
So, my supervisor continued to struggle with the best choice. We will give better care, but if the baby really is little, then we will have to transport. Her fundal height was still small, even for 36 weeks... still, she was stalling. What's the best option. At least she would see her little baby if it was born here.
She began getting active, so we prepared for birth. Within about 20 minutes her little man was born. Her bana had gone home at some point and was still not present, but we had a lovely time! Her baby was sooo little.
Yesterday my shift was swing, from 2-10pm. It was quiet except for one girls continuity patient (cont). Then, just before 2:00 a labor walked in reporting BOW rupture at 12:30pm. She was checked in by day shift and endorsed to us on swing. I was first up!
Upon reviewing her chart there were two things that stood out. The first was that an ultrasound had been requested back in March, but no report made and no copy of the ultrasound was anywhere to be found in her chart. Second was that since her second visit (of five visits) her fundal height had not matched her gestational age (GA) by anywhere from 5-7 cm. Quite odd. So, i just asked, "Gang, Na'ay ang ultrasound?" "Oo." (yes) was the reply. Oh, "Can i have it?" This was, hopefully a good sign, except nothing was really going for her.
She was already BOW rup, thus on a 12 hour time limit before we would be required to transport...she was only 2cm and a G1 (her first baby). She was 70% effaced though, so that was in her favor. Not in her favor, either was the continued discrepancy between current gestational age of 39 weeks and fundal height of 34cm. Hmmm. My gut was feeling a transport.
According to LMP (Last Menstruation) she was 39 weeks, according to the ultrasound she was 36 weeks. Hmmm.... Normally we transport, unless they are 37 weeks. We had a little problem though, we had made a little intervention. Castor Oil. This can help labor progress well and because she was 39 weeks and BOW Rup, this was good management.
So, my supervisor continued to struggle with the best choice. We will give better care, but if the baby really is little, then we will have to transport. Her fundal height was still small, even for 36 weeks... still, she was stalling. What's the best option. At least she would see her little baby if it was born here.
She began getting active, so we prepared for birth. Within about 20 minutes her little man was born. Her bana had gone home at some point and was still not present, but we had a lovely time! Her baby was sooo little.
Please pray for and welcome Robert Gabriel, 2000g (4lbs 7oz) length: 49cm
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