Births, Boudhanath, and Busy Kathmandu

Yarrow and I spent our last day at the Maternity Hospital in Thapathali, Kathmandu on May 12th. It was another busy one! In all, we attended 24 births in four days.

The pace on the maternity ward is very different from the pace at home. It didn't feel busy all the time (Yarrow and I did squeeze in a few Sudoku puzzles in between births), but just when we would call it "quiet", there would be a wave of births that would happen - babies would come one after the other. Luckily, no births happened at the exact same moment so we were able to witness them all!

There were moments that were amazing, nerve-wracking, or sad:
- A primip (first-time mum) whose active labour was only 35 minutes - from four centimeters dilation until the birth!
- A woman whose cervix prolapsed after the birth and who developed a hematoma which sent her to the operating room.
- After a birth, an umbilical cord snapped as the nurse attempted to deliver the placenta, leaving it trapped inside. Despite many painful attempts to remove the placenta in the delivery room, the mother had to be taken to the operating room to have it removed under general anaesthesia.
- A stillborn baby, delivered while we were not there the night before, being collected by the family in the morning.
- 11 episiotomies, many of which were given prior to crowning and without local anaesthetic.
- A beautiful birth when a second time mum progressed from 4cm to full dilation in only 45 minutes - suddenly she was pushing out her intact bag of waters! The nurse ruptured the membranes with all of us shielding our eyes from getting splashed. In a moment, her baby's head was born and she delivered her son in another push. Her entire labour took 50 minutes. She had lost her previous baby, so it was wonderful to witness her safe and healthy birth.

Our time at the Maternity Hospital was full of learning and teaching. We think it has prepared us well for what is ahead in Bharatpur and are excited to catch some Nepalese babies soon! Now it is time for us to enjoy a week off and take in another part of Nepal.

Tomorrow we are leaving for an 8 day trek through the Langtang region. We will take lots of pictures and update our blog with our adventures upon our return.

Today Lauren and I are presenting at a midwifery Continuing Medical Education day at the university teaching hospital. We have prepared a presentation on "Management of the Second Stage of Labour: an evidence based approach". We will be talking about routine vs restricted use of episiotomies, pushing positions, and perineal support. We hope to have some good interaction with the 15 skilled birth attendent participants.

We will leave you with a few photos of our trip to Boudhanath Stupa, one of the largest Buddist temples in the world and a World Heritage Site. It is known in Kathmandu as "Stupa", and we spent the afternoon there yesterday. It was a beautiful mix of colour, ringing of bells, prayer flags flying in the wind, monks circling the temple and children laughing and playing in the square. Overall it was one of the highlights of our sightseeing so far.

Much love,
Yarrow & Lauren