I watched the sun rise this morning after a long night of pacing the rooms, walking in between my study area and the labour ward, and finding ways to keep myself occupied and awake.
It was a long shift, and I was let off early because nothing was going to happen in the time I had left on shift.
*Medical / possibly gross alert. Skip this part if you don’t like reading… about medical specifics*
Basically there’s 3 stages to labour. First stage is everything up until the mother is ready to push. Second stage is the pushing and delivery. Third stage is the delivery of the placenta.
And within first stage there’s two parts, related to cervical effacement and dilatation. Basically the cervix is the barrier that is stopping the baby from coming out, and effacement is when the cervix gets thinner, while dilatation is… the dilatation of the cervix to accommodate the baby’s passage. The first part of first stage is from dilation of 0 to 4cm, and is usually when the cervix completely thins out. This part is more variable in duration, and it’s here that my patient spent most of the night.
Once you’ve reached 4cm, then labour can be said to be “established”, and you’re looking at a dilatation rate of about 1cm per hour, to a full dilation of 10cm. I remember the warning of an upper-year med student in the past: if she’s not in established labour by about 2am, think about going home.
Doing the math, 1cm/hr for 6 hours would bring you to full dilatation at around 8am, and by then your mind is back in order and refreshed by the impending birth.
Unfortunately by 6.30am she wasn’t close to delivery, so my sleepless night didn’t result in my involvement with the delivery. It did however give me a chance to talk to the mother and father a few times during the night, giving them their privacy when they needed and being involved in the tense anticipation that comes before a birth.
On the drive home this morning, it was surreal going “the wrong way”, against all the traffic and heading home after a long night’s work.
I don’t think I can get used to this, but again, it’s good to be here.
ED: looking over this post, it’s really poorly written. I blame sleep deprivation.