Yesterday I heard the yoodle of a push and ran into my patient's room. I threw back the covers to see a head! Quickly I put on gloves and caught the baby's body. Mama had a 2 degree tear (probably from that head coming barreling out without a helper there to slow it down), but baby was perfectly fine with 9/9 apgars. She was unmedicated and I had a gut instinct that she was getting ready to deliver 10 min earlier when I was in the room, but I didn't check her because my other patient (an induction for ancephaly) was up to the bathroom. Big mistake!I had just checked her within the last hour and she was 4-5, but paper thin. I knew that she was going to go fast. Looking back on the strip, I had one minute where I lost the baby's heartbeat. Was the baby's head out for that whole minute? I really don't know and that bothers me.
This is a perfect example of why I hate that my hospital does not follow AWHONN standards concerning nurse/patient ration. AWHONN states that all fetal demises should be one on one, that women in the active labor stage and beyond should be one on one. So clearly, there should of been two of me to take care of these two patients.
One of the things that I love about out-of-hospital birth is that your midwife is there with you. In the hospital, you really just have the monitor with you during your labor and a nurse that comes and goes.
Btw, baby was 8lbs 3oz :). Cute little guy.