More birth tales..And why we'd like to own an elephant

Our third week in Bharatpur has come to an end. It is hard to believe we have just over one week left at the Bharatpur Hospital. It has come to feel like home and we have fallen so much in love with this country.

This week we attended our 100th birth since our arrival in Nepal! Yup, that's right, in three weeks we witnessed over 100 gorgeous little Nepalese babies enter the world and every day we have had to resist the temptation to stuff our pockets with them to bring them home. We also continue to be amazed by the strength and grace with which the Nepalese women labour and by the beauty and magic of birth itself. Below are a few stories of the births that made our week interesting...

- We started the week by observing our first cesarean section (C/S) since arriving in Nepal. The indication for the surgery was a previous C/S. Vaginal birth after cesarean (VBAC) is not common in Nepal if women come to the hospital for their birth.This woman had had a classical (vertical) skin incision for her first C/S, which is now uncommon in Canada. Surgically, the C/S was identical to a C/S at home. One big difference, however, is that it was a nurse - not an anesthesiologist - who did the spinal. Here nurse can get special training to administer spinal anaesthesia, and anesthesiologists are only called in when patients need general anesthetic. It was also an all-female team performing the cesarean (including the surgeon, 1st assist and scrub nurses). We felt very happy to see these women in leadership roles. Above you can see us in our Operating Theatre scrubs!

- The power often goes out in the hospital for 20-40 minutes at a time, which can be challenging at times when the light and equipment are sorely needed. Yarrow caught a baby in the dark during a powerout, after a third-time mother gave only a few pushes. She looped the umbilical cord from around his neck and the rest of the body came smoothly. However, he was not vigorous at birth and Lauren had to run with the baby down the dark hall to the delivery room, where the resuscitation equipment was. Miraculously, the suction was working (sometimes the backup generator kicks in, which saves the day), and the baby gave a good strong cry after some suction.

- Lauren helped deliver a premature baby (by dates, she was 35 weeks, but from her size she looked even earlier), who weighed only 3lbs 13.5oz. She was not vigorous at birth, so Lauren suctioned her and Yarrow gave her some bag & mask respirations. Strangely, when she began breathing on her own, she never once cried. We worked on her for about 15 minutes, yet she barely made a peep! In the end, we had to leave her with her mother while her heart and respiration rates were still higher than normal. We hope she's doing well and feel spoiled that in Canada it is so much easier to access Pediatricians and other specialists for consults. This baby could have used one!

- Yarrow had a very precipitous birth with a first time mother. She came in to the delivery room "squalking" (part squatting, part walking: she is so close to delivering her baby), climbed onto the delivery table, and Yarrow began setting up the delivery kit. When she turned back to the woman a few seconds later, the baby's head was already out! The delivery was smooth, but unfortunately the mother had a postpartum hemorrhage and lost 1000mL of blood. She also had a very complicated tear. Yarrow managed it very well and did an awesome suture repair (this is Lauren typing now!)


- That birth was part of a string of three baby boys who were all born within minutes of each other. Lauren could barely change her gloves fast enough to be second attendant for the births and make sure all three boys were healthy and transitioning well. It was pretty crowded on the baby warmer! It was a very fun way to end our week at the hospital. Here they are, cuddled up with each other...

















We felt very ready for a holiday, and thankfully had two days off to spend in the Chitwan National Park for a Jungle Safari. Our trip there was an adventure - the bus we had planned to take was caught behind an accident and delayed for hours, so instead we took a local bus and then an hour horse and buggy ride to the jungle lodge. It was a great way to see the countryside - we saw many goats, water buffalo, chickens, piles of maize, grains drying in the sun, rice paddies, clay houses, and women in beautiful saris & kurtas.

When we got to Sauraha (the jungle village), we took a walk through the village and down to the river where we saw our first one-horned rhino and some gorgeous Indian elephants.

After sunset, we went to a cultural centre in the village and watched a traditional stick dance performed by an enthusiastic group of boys & young men. The drumming, singing, and dancing were very entertaining.

In the morning, we got up early and set off for an elephant ride through the jungle. We were pretty excited!!

It was a bumpy and very fun ride. We saw another rhino, a crocodile, deer, and brilliant birds. Our elephant took us through the cool shade of the jungle, through a beautiful river and along waving grassy paths.

At the end of the ride, Yarrow and Matthew were pretty nauseous from the bumpiness but we were all really glad to have taken the ride.
























Now we're starting another week at the hospital, feeling well rested and hoping to see some more interesting births. If you can believe it, we missed the only breech and twin births all month while we were riding this elephant yesterday morning!

We send everyone at home our love. We're drinking fresh mango juice and eating delicious momo's (a favorite Nepali snack) for you all.

Love us...