Wednesday, October 8, 2008

Chapter 36 - Preterm Labor

December 25, 1948

Molly Taylor tried to suckle her newborn while Solomon waited for her placenta to deliver. He watched the snow falling outside. It was peppering down as Pa Shiver used to say. Morning light revealed almost a foot already. I’ll have to put chains on the truck to get back to Rooster Cove, he thought.

“Nurse dammit!” Molly’s frustration drew him out of his reverie. She was tired from twelve hours of labor—a labor which had interrupted Solomon and Becky’s Christmas Eve.

Solomon placed his hand under the infant and lifted it slightly. “Hold her mouth close to your nipple,” he said as he stimulated Molly’s nipple by touching it with his fingertip. It responded by getting hard and elongating. “See, it’s like erectile tissue,” he said. Her newborn’s round little mouth moved back and forth like a baby bird until it found the nipple, and then she locked onto it. Molly relaxed and smiled.

Solomon beat the snow off his toboggan and his coat as he climbed into the truck. It was coming down faster than he’d ever seen it snow. He slowly accelerated the engine. The chains clanked against the underside of the truck as he drove onto Black Fort Highway. The usually busy highway was deserted. Only the telephone poles let Solomon know where the road was. Slow and steady, he said to himself.

Finally, he turned onto Rooster Cove Road. That took over an hour, he thought. There was more than a foot of snow on the ground now, and the wind was picking up. Ten years ago this snow would have been cause for delight to him. Today, it was cause for concern. He hoped that his patients would stay home and stay safe and stay pregnant until the roads cleared. He grinned at his assessment of the situation.

He stopped the truck in front of his house and left it running. He grabbed the home delivery equipment from the seat beside of him. He got out and slung the big duffel bag over his shoulder. He wanted to check on Ma, and he wanted to trade the bag for a fully stocked one. Ma and he had three home delivery kits that they could take into a patient’s house. Each one weighed more than fifty pounds and contained about anything that might be needed to deliver a baby.

The front porch steps were already covered with drifting snow. It looked like a ramp instead of steps. Snow was mounded halfway up the front door. Solomon walked to the back of the house so he could go in by way of the back door. As soon as he opened it, he smelled the wood stove and realized that the power was off. Ma sat in the kitchen drinking coffee. “Hey son, I’m glad ye got back. Jerry called about an hour ago and said that Becky wuz acting funny.”

“Funny?” Solomon repeated as he reached for the phone.

“The telephone and the power lines went down right after I talked to him,” Ma said.
Solomon held the mute telephone to his ear. He looked concerned.

“Jerry said she wuz pacing the floor and acting cranky. Maybe ‘cause it’s Christmas day, and ye’re not there with her,” Ma smiled and winked at him.

“Are you okay here?” he asked. “Do you want to go with me?”

“I’m fine as frog hair. I’d rather stay here in case a patient comes by,” Ma said dragging another bag across the floor. “This one’s stocked,” she said. “Ye handle that end of the cove, and I’ll handle this one,” she chuckled.

“Good idea,” Solomon said as he hugged her. He picked up the bag and headed for the truck.

Jerry’s cabin was catching the brunt of the snowdrifts because of the way it backed up to Buzzard Mountain. The storm was coming from the southwest, and the air was full of water from the Gulf of Mexico. Solomon figured this snowstorm might dump a few feet before it quit. He threw the heavy duffel bag over his shoulder and started around the house. Jerry met Solomon at the back door. “I thought you were Santa Claus coming across the front yard,” he laughed. “What’s in your bag?”

“It’s my equipment for home deliveries,” Solomon said. “I don’t want the IV fluids to freeze out there.”

“I’m glad you brought it. Becky’s acting awful funny, man.” Jerry shut the door behind them and pushed a towel against the bottom of it.

Solomon pulled off his boots and overcoat so he wouldn’t track snowmelt into the rest of the cabin. “What do you mean?”

“She acts like she’s scared,” Jerry said. “She cried when I asked her what was wrong.”

Becky sat at the kitchen table playing solitaire with a deck of cards advertising a bank in Knoxville. She stopped and looked at Solomon when he came into the room.

“Brrrr,” he said rubbing his hands together, “this isn’t going away anytime soon.”

Becky continued silently playing solitaire.

Solomon poured a cup of coffee and sat down in the chair beside of her. Jerry stoked the fire in the fireplace.

Nobody spoke for a while, and then Becky stopped playing cards. She kept looking at them as if she were considering her next move. Then she closed her eyes and breathed a little deeper.

Solomon reached over and put his hand on top of her belly. It was hard. He looked at his watch. When her belly softened again, he asked, “Did that hurt?”

She shook her head, no.

“Good, it’s probably just Braxton-Hicks contractions,” he said.

Jerry sat down across from Solomon and said, “How about a game of gin rummy?”

“Sounds good,” said Solomon.

“Okay,” Becky said.

Nine minutes later Becky stopped and shut her eyes as she breathed slowly. Solomon put his hand on top of her belly again. It was hard again.

Jerry watched Becky and Solomon’s faces. He thought, uh oh, something is going on with Becky. Thank God Solomon’s here.

Solomon poured Becky a big glass of apple juice. “Sip on this,” he said.

Ten minutes later Becky’s belly was tightening up again. When it passed, Solomon stood up and slid his chair back. Then he pulled her chair away from the table and took her hand. “I want you to go to the bathroom, and then I want you to lie down on the couch.” He wasn’t giving her a choice.

While she was in the bathroom, Jerry asked, “Is she in labor?”

“I don’t know yet. Possibly,” Solomon looked worried.

When she came out, Solomon led her over to the couch. “Lie on your left side,” he said, “and I want you to tell me when you have another contraction.”

“I’m having one now,” she said.

Solomon knelt down beside of her. Sure enough, her belly was bowed up again with a contraction. When it relaxed, he said, “Becky, more than four contractions an hour, whether they hurt or not, indicate preterm labor. I’m going to try to stop it.”

Tears welled up in her eyes.

“It could be because you’re dehydrated. If that’s the case, oxytocin levels in your blood will be higher. That’s the hormone that causes uterine contractions. I’m going to start an IV to increase your blood volume, so the percentage isn’t so high.” He looked at Jerry and said, “Bring that apple juice to her.”

Solomon opened the duffel bag and began unloading equipment out of it. He said, “Jerry, I need a way to hang this IV bottle. Can you rig something?”

“Sure thing,” he said pulling the hat rack over to the couch.

“Boil some water too, please,” he said to Jerry. Solomon dug his blood pressure cuff and stethoscope out of the bag and said to Becky, “I want to get a set of vitals before I start this IV.” Her pressure was lower than normal, and her pulse was higher than normal. Maybe she’s just dehydrated, he thought. I hope so.

When he stuck her, Becky turned her head and squinched up her eyes.

“I’m sorry,” he said, and then he attached the tubing and added magnesium sulfate to her IV bottle.

“What’s that?” she asked.

“It’s a smooth muscle relaxant,” he said. “Hopefully, it will stop your contractions.”

Becky laid her head back on the pillow and got quiet. “What happens if it doesn’t stop?”

Solomon pulled a kitchen chair up beside her and sat down. He leaned over with his elbows on his knees. “Then we’ll have a baby,” he said.

“It’s too early,” she said.

“You’re twenty-seven weeks. A baby’s viable at twenty-six weeks. It can survive.” He smiled trying to hide the fact that he was scared. “You haven’t had any bleeding since that incident last month, have you?”

She shook her head no and rubbed her belly again. “It’s another one,” she said.

Solomon put his hand on her belly and looked at his watch.

“Would you please stop hovering? she snapped.

“I need to know how long it lasts,” he said leaving his hand on her. When the contraction ended, he said, “Forty-five seconds.” He smiled and said, “I’ll try to quit hovering.”

Solomon went into the kitchen and sat where he could still see her. Jerry dealt himself a hand of solitaire.

Twenty minutes passed, and Solomon saw that Becky was trying to sit up. He got up and went to her.

“I’ve got to go to the bathroom again,” she said. “You’ve pumped me so full of fluid, what else can I do?”

Solomon straightened out her IV tubing and lifted the IV bottle off the hook. He held the tubing and the bottle in one hand and held Becky’s arm with the other. “Take it slow,” he said to her.

“You’re not staying in the bathroom with me.” She said adamantly.

“I know,” Solomon nodded as he hung the bottle from the knob on the medicine cabinet. He felt uneasy about leaving her, but he knew that she wasn’t ready to accept his help yet. He had dealt with a lot of modest mothers, and he knew that Becky’s modesty would fly out the door when hard labor started.

Jerry said, “Man, I have a whole new respect for what you do for a living. I didn’t know women got that cranky in labor.”

Solomon said, “She’s scared. She’s in a situation where she has no control over her body. She feels helpless. She doesn’t know what’s going to happen next. She’s uncomfortable now, and she knows it’s going to get a lot worse before it’s over. She’s embarrassed, and yet she needs help. You and I have to walk a fine line between being there for her and staying out of her way.”

“She needs our support. She needs to know that we love her no matter what she says, no matter what she does, no matter what body part she exposes, no matter what sounds she makes, no matter if she vomits, or urinates, or has a bowel movement in front of us. She needs to feel like it’s okay. She’s in a vulnerable position, and we have to make it as easy for her as we possibly can.”

“I know you’re right. I’ve just never seen her like this,” said Jerry.

“Have you ever seen a baby being born?” Solomon asked.

“No,” he said shaking his head.

“Well, it’s amazing,” Solomon said.

Copyright © 2008 by Robbin Renee Bridges
Coping with Grief through Afterlife Communication

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