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At the hospital

I’ve spent four days at the hospital. It is a busy place, and seems understaffed and as if the maternity has been squeezed into too small a space.

I’m learning their routines, and getting faster at my planning and doing. It felt good to be in control of a birth today – and for a little two kilo boy. He wad the second baby I’ve had with tachypnia without nasal flaring, grunting, retractions or off color. The first I blame on too vigerous suctioning from the nurse. But this little guy stumped me.

I was using all my good patho study to figure it out. He was full term, IUGR. I did the neonatal exam and saw the placenta myself so no doubt about true gestatiknal age. My best guess is his lack of body weight means he doesn’t have good fat deposits and is trying really hard to keep warm. My plan would be kangaroo care to help stabilize nary temp and frequent nursing to prevent hypoglycemia. But I plan to do more study on Friday to make sure my understanding is correct.

Tomorrow we head to a village to do some antenatal work and travel with a medical team to do care in an even more rural village.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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