Baby delivery…
Last Wednesday was my 5th and last visit to Puskesmas (primary health care) in this block.
After my visit in the morning, me and my friends left our phone number at the puskesmas for the midwife to call us if there’s any baby delivery, so that we can go there and watch and assist.
Much less to our expectation, with a baby delivery in the morning, we didn’t expect to be called soon until days later. But, that afternoon, around 4pm, I received a call from the midwife, saying there’s a pregnant woman who is going to give birth soon, in stage 1 with cervix dilatation of 3cm. We thought that it might be fast, as the baby delivery that we missed in the morning took place in less than 2 hours from first contraction. Little did we knew that this mother is a nullipara or primigravida (first time pregnant)! Hence, we spend around 6 hours waiting for the mother to give birth in the puskesmas.
FYI: Stage 1: regular uterus contraction and cervix dilatation. The full dilatation of cervix is 10cm, with latent phase 1-3cm lasting around 8 hours, followed by active phase from 4-10cm occurring around 1cm per hour for primigravida and >1-2cm per hour for multipara. Anyway, me and Sari (only two of us) waited from 4 to 7pm to reassess the mother for cervix dilatation by performing bimanual examination. We tried and I can’t really felt anything cause the mother is in pain. The midwife waited for the pain to subside and did bimanual again. At that time, it was 7cm. we even use Doppler to listen to the fetal’s heart sound and counted the heart rate. I was quite excited to hear the “lub-dub” of the baby!
We nearly gave up and wanted to go home to rest as we still have class and assignment to finish for class tomorrow morning. We didn’t of course, not wanting to miss our very first experience.
Around 8.45pm, the mother’s amniotic membrane ruptured. Amniotic fluid flowed out. It was a sign that the cervix had reached full dilatation and the crowning of baby’s head was taking place. Stage 2 had started. There’s difference in nullipara and multipara, lasting for 2hours and 1 hour respectively. We waited patiently beside the mother and help prepare things we need to receive the baby soon. From baby’s wrapping clothed to the equipment needed. At this moment, the baby’s head was going from the cervix to vagina, hence pushing on the mother’s rectum, causing feces to come out from the anus involuntarily and urine flowed out as well.
When the mother felt less contraction, the midwife taught the mother how to position herself correctly during the birth process, also known as lithotomy position (using her own hands to hold her own legs at thigh, pulling into a frog-like pattern), and how to bear down correctly and effectively, where she was asked to take long breath and hold it and push down forcefully. From her first hour of starting labour till now, she was in great pain and easily agitated. Scary!
Around 10pm, the baby’s head was seen at external opening of vagina! Vulva opened. Perineum started to strain and thin. Anus dilated (O or D shape). Then before I realize, the mother was in great pain. The baby’s head push against the rigid perineum. When the mother pushed again, the baby’s head can’t seemed to come out. The midwife decided to do episiotomy (cutting the perineum) at mediolateral position (to the left side of the mother). After cutting, the baby had a wider opening and came out faster during the next forceful pushed of the mom. After the delivering the head, the shoulder and rest of the body was delivery in a split second. 10.15pm! The baby was born safely! After that, the midwife asked me to inject oxytocin i.m. at 1/3 lateral thigh. I did it! First time in real patient!
At this point, i can see and felt the changes in the mother's facial expression very well... a relieve, satisfied, happy, and the pain and anger just left! It was wonderful to see the baby out finally! =)
Moving on, the baby was placed on the cloth on the mother’s chest. Mucous from his (the baby is a boy!) mouth was sucked, and the baby started crying! What a relieved and excited feeling I had! Then the umbilical cord was clamped and cut. He was then placed on his mother chest for initial feeding (the smell of the amniotic fluid on him is the same as the smell of the mother's breast).
Next, it was time for placenta to be delivered- Stage 3. The umbilical cord was pulled a bit, massage was performed at symphysis pubis. The placenta came out and was totally released from uterus within 5 minutes. The colour was so whitish (the membrane covering it). Then the cotyledons on the placenta were checked to confirm there was no retention of placenta in the uterus. The placenta is the placed in a jar and given to the family to be buried.
Stage 4: 2 hours after placenta delivery, where the mother is closely monitored for bleeding and other complications. Now, the perineum cut was sutured. More than fifteen stitches if I’m not mistaken, divided into 3 layers. The slight laceration at the upper perineum was sutured as well.
Now, the baby was wrapped in a cloth into a “cocoon”. Before that, the baby was wiped, weighed (he’s 2.8kg!) and his legs’ print was taken. Baby can’t be bathed so soon, and normally will be bathed after a few hours or one day (prevent hypothermia and retain the smell of amniotic fluid).
The excited me surely would not miss the chance to take photo with the baby! Here’s it!
Cute isn’t he?
p/s: watching the process of labour actually scared me a bit. I wondered how my mom gave birth to me as from what I knew, I was 3.8kg during birth!
Mother’s day coming soon. I would like to take this opportunity to tell my mummy, Tan Bee Luan, I LOVE YOU VERY MUCH! Thank you for going through the pregnancy, pain of labour, and process of raising me up to be who I am today with daddy, Tan Boon Din!
Happy Mother’s Day! You’re the greatest mom!
After my visit in the morning, me and my friends left our phone number at the puskesmas for the midwife to call us if there’s any baby delivery, so that we can go there and watch and assist.
Much less to our expectation, with a baby delivery in the morning, we didn’t expect to be called soon until days later. But, that afternoon, around 4pm, I received a call from the midwife, saying there’s a pregnant woman who is going to give birth soon, in stage 1 with cervix dilatation of 3cm. We thought that it might be fast, as the baby delivery that we missed in the morning took place in less than 2 hours from first contraction. Little did we knew that this mother is a nullipara or primigravida (first time pregnant)! Hence, we spend around 6 hours waiting for the mother to give birth in the puskesmas.
FYI: Stage 1: regular uterus contraction and cervix dilatation. The full dilatation of cervix is 10cm, with latent phase 1-3cm lasting around 8 hours, followed by active phase from 4-10cm occurring around 1cm per hour for primigravida and >1-2cm per hour for multipara. Anyway, me and Sari (only two of us) waited from 4 to 7pm to reassess the mother for cervix dilatation by performing bimanual examination. We tried and I can’t really felt anything cause the mother is in pain. The midwife waited for the pain to subside and did bimanual again. At that time, it was 7cm. we even use Doppler to listen to the fetal’s heart sound and counted the heart rate. I was quite excited to hear the “lub-dub” of the baby!
We nearly gave up and wanted to go home to rest as we still have class and assignment to finish for class tomorrow morning. We didn’t of course, not wanting to miss our very first experience.
Around 8.45pm, the mother’s amniotic membrane ruptured. Amniotic fluid flowed out. It was a sign that the cervix had reached full dilatation and the crowning of baby’s head was taking place. Stage 2 had started. There’s difference in nullipara and multipara, lasting for 2hours and 1 hour respectively. We waited patiently beside the mother and help prepare things we need to receive the baby soon. From baby’s wrapping clothed to the equipment needed. At this moment, the baby’s head was going from the cervix to vagina, hence pushing on the mother’s rectum, causing feces to come out from the anus involuntarily and urine flowed out as well.
When the mother felt less contraction, the midwife taught the mother how to position herself correctly during the birth process, also known as lithotomy position (using her own hands to hold her own legs at thigh, pulling into a frog-like pattern), and how to bear down correctly and effectively, where she was asked to take long breath and hold it and push down forcefully. From her first hour of starting labour till now, she was in great pain and easily agitated. Scary!
Around 10pm, the baby’s head was seen at external opening of vagina! Vulva opened. Perineum started to strain and thin. Anus dilated (O or D shape). Then before I realize, the mother was in great pain. The baby’s head push against the rigid perineum. When the mother pushed again, the baby’s head can’t seemed to come out. The midwife decided to do episiotomy (cutting the perineum) at mediolateral position (to the left side of the mother). After cutting, the baby had a wider opening and came out faster during the next forceful pushed of the mom. After the delivering the head, the shoulder and rest of the body was delivery in a split second. 10.15pm! The baby was born safely! After that, the midwife asked me to inject oxytocin i.m. at 1/3 lateral thigh. I did it! First time in real patient!
At this point, i can see and felt the changes in the mother's facial expression very well... a relieve, satisfied, happy, and the pain and anger just left! It was wonderful to see the baby out finally! =)
Moving on, the baby was placed on the cloth on the mother’s chest. Mucous from his (the baby is a boy!) mouth was sucked, and the baby started crying! What a relieved and excited feeling I had! Then the umbilical cord was clamped and cut. He was then placed on his mother chest for initial feeding (the smell of the amniotic fluid on him is the same as the smell of the mother's breast).
Next, it was time for placenta to be delivered- Stage 3. The umbilical cord was pulled a bit, massage was performed at symphysis pubis. The placenta came out and was totally released from uterus within 5 minutes. The colour was so whitish (the membrane covering it). Then the cotyledons on the placenta were checked to confirm there was no retention of placenta in the uterus. The placenta is the placed in a jar and given to the family to be buried.
Stage 4: 2 hours after placenta delivery, where the mother is closely monitored for bleeding and other complications. Now, the perineum cut was sutured. More than fifteen stitches if I’m not mistaken, divided into 3 layers. The slight laceration at the upper perineum was sutured as well.
Now, the baby was wrapped in a cloth into a “cocoon”. Before that, the baby was wiped, weighed (he’s 2.8kg!) and his legs’ print was taken. Baby can’t be bathed so soon, and normally will be bathed after a few hours or one day (prevent hypothermia and retain the smell of amniotic fluid).
The excited me surely would not miss the chance to take photo with the baby! Here’s it!
Cute isn’t he?
p/s: watching the process of labour actually scared me a bit. I wondered how my mom gave birth to me as from what I knew, I was 3.8kg during birth!
Mother’s day coming soon. I would like to take this opportunity to tell my mummy, Tan Bee Luan, I LOVE YOU VERY MUCH! Thank you for going through the pregnancy, pain of labour, and process of raising me up to be who I am today with daddy, Tan Boon Din!
Happy Mother’s Day! You’re the greatest mom!
Comments
Keep it up! Yay! :D