The florescent lights light up a thin woman about 17 year old. I call her a woman because this is her second child. The first one died at birth. She is black skinned and very trim from working in the gardens. She lies on the delivery table exposed to the people present in the room. They happen to be her mother, and an uncle. The husband has already left the hospital. He came just to drop her off. She started to have contractions at home. Then when the labor stayed on for quite a few hours, she went to the nearest health clinic. There she broke her “water”. { Not pertinent to her- many women think that when you vomit during labor that you are vomiting the amniotic fluid} As she broke her water the umbilical cord prolapsed out. This is very dangerous for the child. If the child is not held in until delivered by a C-section then the pressure on the cord cuts off the blood supply to the baby and it dies. This was, of course, not adhered to and after staying there a few hours was referred to the hospital.
I brought the ultrasound but the battery was dead. I again felt the abdomen. It was an odd shape with kind of an oblique tilt to the uterus. As I did a vaginal exam I felt two feet and a hand, and a dark thrombosed (clotted/spasmed) cord. The child was transverse. I called Jacques and Yaouke helped also. The three of us went to the OR.
She writhed around in pain. The spinal needle bent as she squirmed. I couldn’t find the spinal canal. I gave up and gave here Ketamine knowing already that the baby was dead. She was finally calm. As I opened her abdomen, everything looked normal. I opened the uterus low. It seemed very tight. Ketamine! I also cant seem to find the head of the baby. I extend the incision up along the midline of the uterus. The head and the buttocks are nearly together, with legs and arm and chest heading for the outlet. I pull out the baby boy; his skin is macerated. The uterus seems very thick. I pull it out to take a better look. It is a bifid uterus. It is kind of shaped like a heart (this shape ©!). We close it up. At the end of the operation we clean the operating room to be prepared if anything else comes tonight. As I step outside the air is cool. It is dry and dusty. All outside lights have a halo of dust. I can smell it in the air at times, but I’m pretty used to it now. Jacques is riding home on his moto and he offers me a ride. I feel cold in the 75deg air as we go. At home I hear the peep- peep of the sleeping chicks in their cage. They are in a woven cage at night so that the ring tailed wild cats don’t eat them. I try to sleep but Im unsuccessful. So I write to you. Maybe sleep will come now. Good Night.
Greg
Shanksteps # 144