For my nursing friends, at least you weren't getting transfer report from me this morning. Me: "I'm bringing you this patient from Obule Health Center. She is a G2P0 in active labor.She was c-sectioned last pregnancy. I don't know when her labor started as she won't talk. Her water broke about 25 minutes ago. I don't know how dilated she is as she won't let me check. I don't know FHTs as she won't let me near her. She is mad (meaning mentally ill) and HIV positive. This pregnancy is the result of insestual rape." Nurse midwife receiving report: ".............." Me: "Which doctor is on today?" Her: "No doctors currently on duty." Me: ".............."

So, update:  Lets start with the good news. Mother did finally get her c-section.  Both mother and baby survived the experience.  Ummmm, I think that is about where the good news ends. Keep praying.  Mother responded very poorly to anesthesia (general, not spinal). First under anesthetized, then way over. Now, out of her mind. Kicking, hitting, biting. She has pulled out two IVs and her foley. The baby was next to her on the bed for a few minutes and she almost successfully threw it on the floor. Baby is doing slightly better than her mother but also needed serious resuscitation (possibly for the same reason her mother did?!) Tiny little girl. Weighs four pounds. She can't seem to keep her body temp up and power is off so they aren't putting her in an incubator but at least now her sats are holding. We have not successfully gotten Retrovir  (infant antiretroviral prophylaxis) because it is the weekend, but hopefully tomorrow. 

This is baby girl with her grandmother. 

Mother after we had to knock her back out to keep her from hurting herself and us. 

My sediments exactly, kid!