Hospital–Maternity Floor

Many of our team members were very interested in spending some time on the maternity floor, so we had people rotate in and out during our day in the hospital.  It ended up that we were supposed to meet back at 7:00pm to change out of our scrubs and head home, but when we all made our way back up to maternity, a patient with whom the student had been working was fully dilated and of course we wanted to stay to see her give birth.  The patient was Haitian, as were a number of other patients on the floor.  She did not speak Spanish, and the nurses only spoke a few words of Creole.  We saw the importance of communication and how patient care is in some ways very dependent on this ability to communicate.

We understood that the patient was “happy” to have us all with her in the room for the delivery.  We all crowded around the delivery table in the small, dimly lit, hot, humid room.  One student noted how different the sounds were in the delivery room compared with those in hospitals in the US.  The window was open, so we could hear cars passing, music playing, people talking outside.  There were no sounds of the fetal heart monitor beeping telling us the baby’s heart rate was accelerating as it should.  The woman, though it was her first birth, made barely a sound.  The auxilary nurse who has much experience, yet little formal nursing education, delivered the baby, and this was not because the OB doctor or even resident didn’t make it there in time,  it was because in the DR normal births are performed by the nurses.   After the birth, the nurse stitched up the small tear by the light of one small lamp, and our students performed the newborn assessments with the guidance of Dr. Foster.  There was much excitement in the room; for some of us this was the first birth we had seen, while others on our team are planning to continue to study midwifery.

It had been a busy day on the Maternity floor; they had so many women deliver, that they actually had some women sharing beds in the post-partem ward.  Before we barely had time to wipe down the table, another woman, also Haitian, was wheeled into the room ready to deliver.  We were excited to see another birth and once again everyone crowded around to watch the nurse deliver the baby.  However, as she delivered the excitement in the room quickly dampened as the baby was stillborn.  Later it was decided that the baby had probably been dead for about 10 days, and the causes were congenital.  It was hard for us to watch the events that ensued; it is difficult to imagine what these nurses experience when the deliver sometimes multiple births such as this every day.  After a woman delivers in the DR it is not customary to show the woman the child, and this is especially the case after a stillborn birth.  Dr. Foster and other students wanted the woman to be able to see her baby, as we were not sure that she even understood that she knew that her baby was dead.  The nurse had put the baby on the floor and was waiting for another nurse to bring her a cardboard box which is where they put stillborn babies.  Dr. Foster though was able to convince the nurse to let the mother hold her baby as studies have shown that this helps the mother to cope and decreases post-partem depression.  We are not sure whether the woman actually understood what had happend until that moment since she also only spoke Creole.  She just laid there for a couple minutes with her baby on her chest looking sad and confused.  We later found out that a resident had performed an ultrasound on her and had done an assessment earlier that day and had charted that everything was fine.

As there were more women ready to deliver, we helped the woman off the table into a wheelchair and accompanied her into the post-partem ward with at least 10 other happy mothers and their babies who had delivered that day.  At first our team members felt very upset that this woman who had just lost her baby had to be in such a room, without even any family with her.  However, as we sat with her in the room trying to comfort her, another woman in the ward, a sister of another patient walked over took her hand and shared a glass of juice with her.  Then slowly others approached her, held her hand, and told us they would take care of her.  We asked one woman if she was a friend or family member, and she replied “Today we are all family”

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