Diving into D

Kudjip Station Doctors

Over the last two weeks, I have been re-immersed into the world of Obstetrics and Gynecology. What I had requested was a little more exposure to the decision-making processes that dictate how and when a mother delivers her baby. The physiology and pathology, surgical interventions, and even the medicines used, are a far cry from anything I have learned in my training as a Pediatrician. Fortunately, I’m not too far from medical school to have forgotten the basics that all med students learn, so over the last 6 months, I have been building upon that knowledge base – whether scanning pregnant bellies in clinic, or helping with deliveries overnight while covering call. However, what I recently realized is that just occasionally thinking about these things isn’t enough – I needed immersion in order to really see and manage enough of the in-the-moment critical decisions to feel comfortable with it. The bonus is that we currently have Dr. Scott Pringle here on Station, an OB/GYN from the States with 30+ years experience under his belt, and who is a fantastic teacher.

My days have started rounding on those mothers admitted to D Ward who need to be seen by the doctor. Many mothers come to Kudjip and vaginally deliver their babies (without complication) into the very experienced hands of our nursing staff. These mothers rarely need more than a Doctor check when they arrive, and sometimes not even that if they deliver quickly. So, the mothers I see have had some complication in their delivery process – required a C-section, have blood pressure issues, are sick with infection, had a miscarriage and require a D&C, or maybe are requesting tubal ligation. So, every morning I’ll roll the cart down the row of beds, stopping at those with a chart, and sit bedside asking questions, reading vitals, and writing orders for the day. The Pediatrician inside of me always craves to also examine the newborn babies who are invariable bundled at their mother’s side, and sometimes I’ll take a little peek and share a smile and word of congrats. Even the smallest attention means so much to these mamas.

After rounding on the Ward, while Dr Scott is checking my orders, I head back to the Delivery rooms, where a line of very pregnant ladies are waiting to be checked. The new ones get a full work-up – questions, ultrasound, and vaginal exam – while the repeat offenders (who haven’t delivered yet) just get a vaginal check to determine progress. Performing pre-natal checks on my own in clinic has become second nature to me, and I feel perfectly comfortable scanning their belly for the important measurements. The D-Ward ante-natal checks are not too different, except now I'm wrangling a much larger baby and a mom who is occasionally squirming with contractions. More importantly, being close to their delivery time, I am seeing, feeling, and learning precisely what the next course of action is to be. Is it safe for the baby to allow normal progress, or are medications needed to help the uterus open? How long have the contractions been going, and where is the baby’s head? Are the baby and placenta in the right position for a vaginal delivery? How long has the mother’s water been broken? These, and MANY other questions, have been on my mind as I check each mother.

I delivered this little guy yesterday using a vaccuum, and was subsequently splattered with amniotic fluid ...excellent way to start the day!   :-)

Many times, even after 2 weeks, I’ll have a question for Dr Scott – something on ultrasound I haven’t seen before, or just reassurance that I’ve written the correct order. Choosing the wrong pathway in this process can easily cost a life – an outcome I have seen enough times in my months here. The burden of this responsibility, I hesitate to consider myself yet ready to undertake, but that is why I have chosen to learn more. Someday, God may ask Rachel and me to serve somewhere that Dr Scott isn’t a phone call away. What I learn now may save lives in the future – what an amazing responsibility. In the meantime, while thankfully I always have the back-up of well-experienced doctors here on Station, this new knowledge will help guide me for those 2AM calls from D Ward. 

Please pray for my brain - 

that God will make me a sponge for this life-saving knowledge. 

Please pray for our D Ward staff - 

that, despite being bone tired and covered in all sorts of bodily fluids, they are filled with wisdom and joy in bringing so many new lives into the World.

Please pray for all the mothers and babies - 

for healthy outcomes, for open hearts to the Gospel while staying with us, and healing for those who lose babies.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

A big THANK YOU to our dear friend, Dr. Maggie Landgrebe, who generously purchased a new digital scale for the D-Ward babies (just arrived on the shipping crate yesterday!). 

All the staff are SO excited to start using it!