Step into the world of Amanda, a vibrant 30-year-old Latin American woman who entered the hospital, wrestling with the discomfort of abdominal pain. As she reached the triage area, a whirlwind of assessments and monitoring devices claimed her attention. Despite her primary language being Spanish, Amanda courageously attempted to communicate in English, the language she had been diligently learning.
The language barrier became less daunting for Amanda during her intake, thanks to the nurse's clever use of an online interpreter. In this exchange, Amanda revealed that this was her second pregnancy, with a child eagerly awaiting her return home. Sharing her due date led to the surprising discovery by the healthcare team that she was at an advanced 39.1 weeks of pregnancy.
As her initial intake concluded, the nurse briefly stepped out, leaving Amanda in suspense about the unfolding events. Lying in the triage bed, her pain intensified, creating a palpably tense atmosphere.
Finally, the provider arrived to examine her, disclosing that Amanda was 4cm, almost 5cm dilated, around 4 pm. Given her gestational age and examination results, Amanda found herself admitted to the labor and delivery unit. Transferred to a labor room, she welcomed the presence of her spouse, but her pain persisted as she awaited the next examination.
Around 7 pm, the pain escalated, and contractions grew more frequent. Through a translator, Amanda expressed heightened discomfort and the urge to push. Recognizing her previous childbirth experience, the medical team decided to conduct an examination.
The revelation of her being 9cm/90%/0 brought a sudden rush of progress and pain, prompting Amanda to opt for an epidural. As the nurse prepared her with a fluid bolus for the epidural, a shift change introduced a new team to Amanda's night.
With the epidural administered, Amanda finally found relief, allowing her body to labor more comfortably. Shortly thereafter, the providers returned to discuss her plan of care. They requested her spouse to exit for a sensitive discussion that would impact the course of her labor.
Alone with the medical team, Amanda received surprising information: her OB expressed concerns to them about a potential herpes outbreak. Stunned by the revelation, which conflicted with her previous understanding of a potential HPV issue, she listened intently as a translator conveyed the information. The providers then requested to check her for confirmation.
"¿Podemos verificarlo para confirmar?" the provider asked.
Concerned about her baby's well-being, Amanda consented to the examination, confirming the presence of a lesion, pointing towards an active herpes infection. The gravity of the situation hit Amanda hard when the providers explained the increased risk of infection for her baby during a vaginal delivery. They recommended a C-section. Grappling with the idea, Amanda asked for time to discuss the situation with her spouse before moving forward.
Amidst emotional turmoil and the continuing labor process, Amanda's baby faced late decelerations, prompting the nurse to reposition her for optimal oxygenation. The team stepped out of the room, giving the couple privacy to discuss their options.
While waiting for Amanda to call the nurse with her decision, the team was prompted to return to the room due to seeing signs of Amanda pushing on the monitors outside the room. They returned to a startling scene – Amanda was actively pushing.
Swiftly, the providers entered, finding the infant's head beginning to emerge. Despite the unexpected circumstances, they donned gloves and allowed Amanda to finish the delivery. However, the baby was found to have terminal meconium and a tight nuchal cord around the neck.
The NICU team was summoned to assess the baby further. Due to the recent herpes outbreak, Amanda received the sobering news that her baby would need monitoring in the NICU for potential infection. The journey for Amanda and her newborn had taken an unexpected turn, prompting a cascade of decisions and emotions in the whirlwind of childbirth.
This is her story. What's yours?
The language barrier became less daunting for Amanda during her intake, thanks to the nurse's clever use of an online interpreter. In this exchange, Amanda revealed that this was her second pregnancy, with a child eagerly awaiting her return home. Sharing her due date led to the surprising discovery by the healthcare team that she was at an advanced 39.1 weeks of pregnancy.
As her initial intake concluded, the nurse briefly stepped out, leaving Amanda in suspense about the unfolding events. Lying in the triage bed, her pain intensified, creating a palpably tense atmosphere.
Finally, the provider arrived to examine her, disclosing that Amanda was 4cm, almost 5cm dilated, around 4 pm. Given her gestational age and examination results, Amanda found herself admitted to the labor and delivery unit. Transferred to a labor room, she welcomed the presence of her spouse, but her pain persisted as she awaited the next examination.
Around 7 pm, the pain escalated, and contractions grew more frequent. Through a translator, Amanda expressed heightened discomfort and the urge to push. Recognizing her previous childbirth experience, the medical team decided to conduct an examination.
The revelation of her being 9cm/90%/0 brought a sudden rush of progress and pain, prompting Amanda to opt for an epidural. As the nurse prepared her with a fluid bolus for the epidural, a shift change introduced a new team to Amanda's night.
With the epidural administered, Amanda finally found relief, allowing her body to labor more comfortably. Shortly thereafter, the providers returned to discuss her plan of care. They requested her spouse to exit for a sensitive discussion that would impact the course of her labor.
Alone with the medical team, Amanda received surprising information: her OB expressed concerns to them about a potential herpes outbreak. Stunned by the revelation, which conflicted with her previous understanding of a potential HPV issue, she listened intently as a translator conveyed the information. The providers then requested to check her for confirmation.
"¿Podemos verificarlo para confirmar?" the provider asked.
Concerned about her baby's well-being, Amanda consented to the examination, confirming the presence of a lesion, pointing towards an active herpes infection. The gravity of the situation hit Amanda hard when the providers explained the increased risk of infection for her baby during a vaginal delivery. They recommended a C-section. Grappling with the idea, Amanda asked for time to discuss the situation with her spouse before moving forward.
Amidst emotional turmoil and the continuing labor process, Amanda's baby faced late decelerations, prompting the nurse to reposition her for optimal oxygenation. The team stepped out of the room, giving the couple privacy to discuss their options.
While waiting for Amanda to call the nurse with her decision, the team was prompted to return to the room due to seeing signs of Amanda pushing on the monitors outside the room. They returned to a startling scene – Amanda was actively pushing.
Swiftly, the providers entered, finding the infant's head beginning to emerge. Despite the unexpected circumstances, they donned gloves and allowed Amanda to finish the delivery. However, the baby was found to have terminal meconium and a tight nuchal cord around the neck.
The NICU team was summoned to assess the baby further. Due to the recent herpes outbreak, Amanda received the sobering news that her baby would need monitoring in the NICU for potential infection. The journey for Amanda and her newborn had taken an unexpected turn, prompting a cascade of decisions and emotions in the whirlwind of childbirth.
This is her story. What's yours?