The nurse practitioner Steve hastily walks up and says, "Grace, are you allowed in the OR?" I reply, "It depends on your rules and if you allow me to be in the OR." He motions me to go with him and says, "C'mon we're going to see a C-section!" I jump out of my chair and half run beside him.
As we walked down the halls and rode in the elevator he prepared me for what I was about to see. His first questions were, "Have you ever seen a surgery? Are you ok with blood? And have you eaten today?" He explained that if I felt nauseous at all, I could step out right away because if I fainted, I would have to go to the ER and it would be a big ordeal. He told me that it happens quite often and not to be embarassed if I feel like I can't watch. He explained that once we got to the seventh floor, I would need to put on hair and shoe covers, a face mask, and a jacket to cover down to my wrists. He also warned me that sometimes the smell can be overwhelming and hard to get used to.
He opened the OR door, and we walked into the bright white room with a bed that was completely surrounded with people wearing blue scrubs. They were already pulling the baby's head out! Steve got me to a place where I could see them get the rest of the baby out of the incision. It was very bloody, but it didn't make me nauseous, and I thought it was amazing to see the process of cutting into a belly and pulling out a little baby! Once the baby was out, I followed Steve into a small room where I watched him evaluate the baby and take Apgar scores. Everything happened so fast because we got there right in the nick of time. Eventually I think it would be amazing to see everything from the time the doctors make the first cut into the belly.
Less than an hour later, Steve walked up to me again and said, "Follow me if you want to come see a vaginal delivery!" Of course I jumped up and followed him again. The NICU doesn't get called to every delivery, especially if it is expected to go smoothly, but in this case, the baby was in danger of Meconium Aspiration Syndrome (MAS). Again, as we made our way to the seventh floor, Steve talked to me the whole way, explaining exactly what was going on with this delivery. He explained that MAS occurs when the baby stools in the amniotic fluid, which isn't supposed to happen and can be an indicator that the baby is in distress and something isn't right. This meconium can get into the lungs with the amniotic fluid, which can then block the alveoli. He used a balloon analogy and explained that air can still get into the alveoli and lungs, but with the blockage, that air wouldn't be able to exit back out. In other words, the meconium can cause serious respiratory issues.
We got to the seventh floor and opened the room, but the baby had already been delivered a couple minutes before we got there, which was a bummer, but I got to watch Steve evaluate the baby. He told me that they can get a good idea of how long the baby has been sitting in the meconium by looking at how green the umbilical cord, fingernails, and vernix covering the baby are. He asked me if I had ever seen a normal umbilical cord, which I had, and the one on this baby was spotted with dark green, which meant that the baby had been floating in the meconium for awhile. Her fingernails were also tinted green, as was the vernix on her body, but she was crying and kicking and otherwise looked great, which is a good sign that she likely doesn't have MAS.
Like I said in my first blog, I didn't know exactly what this intensive would bring, and I definitely did not expect to see a C-section! I can't really make that a goal now that it's already over, but it's something that I can add to the list of many things I have been able to see and do throughout this independent study!
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