My first ceasar

Something i've been vowing i'd do ever since i arrived at Zithulele is to watch at least one natural birth and one ceasar. Working in a small hospital where you know all the doctors if the perfect opportunity. I have delayed as long as possible, because i'm scared i will be put off having children as a result. I have had many chats with the doctors about childbirth and they have convinced me that if i watch both natural and ceasar i will see that natural is the lesser of two evils. So i decided i would force myself to watch both before i leave.

Not having got as far as actually setting a date for the bloody entertainment, and forgetting i'd ever made the decision, i was thrown in the deep end the other day. The power was out, so we were running parts of the hospital on generator. The pharmacy, not being on the generator circuit and having no windows, turns into The Bat Cave when the power's out, so Kayleigh had come to work in the therapy department. Being next door to theatre sometimes has its advantages as we get to be on the generator circuit :) (There are also plenty of disadvantages such as hearing screaming patients and the irritating beeping of the blood fridge when its power goes off).

So Kayleigh and i were sitting at a desk working on our computers when, from over the wooden "wall" that separates us from theatre, we hear Liz's voice. So we climb onto the old wooden box (labled "disaster box") to see what Liz is up to. She is somewhat surprised to see us, but tells us she's about to do a ceasar. When i curiously ask - How long will it take? She invites me join her. Somehow Kayleigh manages to talk me into it - i guess being a non-doctor who has watched several, makes me trust her, and because Liz is doing it, i won't feel too embarrassed. Since the hospital and therapy department were quiet, i bravely decided to seize the day.

This might be a good time to mention that i tend to faint at the sight of blood. Also, that the only other time i've ever seen a theatre procedure was a desloughing (removing dead skin from a burn) which is pretty tame compared to cutting someone open.

20 minutes later, i got a message from Liz to say that the spinal is going in and i should come get dressed. So, already strarting to shake, i pulled on some scrubs and cap. I skipped the mask as there seemed to be a shortage and i wasn't planning on standing that close to the patient. I skipped the gloves too, not planning to touch anything.

When i walked into the theatre, the poor naked pregnant lady was still waiting for the spinal to kick in and to be positioned on the bed. Joff and Liz were doing the ceasar together, with a bunch of amusing lovely theatre nurses i hadn't met. I watched Liz and Joff carefully cover the woman with sheets and prep the incision area. And then, the moment i'd been dreading, the initial cut. It wasn't bad at all. When i saw Liz cutting through the layers of fat and fascia, it was comfortingly familiar, reminding me of my disection days. Except, of course, that cadavas don't have blood - big difference actually.

I had to take a slight break after 5 mins as the bright lights were entering my vision (- first sign of fainting). After a two min rest i was back on my feet and peering into a woman's abdomen. Then the action began, i'm not quite sure what was happening, but Liz told me to get Karl. So i ran out and phoned Karl, who ran in 2 seconds later. Next thing i knew, Liz was holding a baby and passing it to Karl who was saying something about an infection. So i missed the big moment of getting the baby out. Then Liz was removing the placenta that was so huge that for a sec i thought she was giving the woman a hysterectomoy. For the rest of the procedure i alternated between watching the mom, watching the baby and sitting down to avoid the faint reflex. It was very peculiar seeing a uterus sitting on top of a woman's abdomen being stitched up. Actually, very peculiar seeing a uterus, full stop.

I enjoyed watching the newborn baby who was a large girl. I couldn't believe how no-one was particularly interested in showing the mom her baby. But eventually they did, briefly, before they took the baby away. Liz did a great job of stitching up the (larger than i expected) incision. Her comment: "she'll never know she had a ceasar except for presence of a 4kg baby". The poor woman's comment on the whole procedure was: "I though i was going to die!". Hopefully, she is referring to the labour pains and not that the spinal didn't work - i guess she would have been screaming blue murder if that was the case.

The 3 things that stood out in my memory were:

• How unremarkable the whole procedure was. Probably because i missed most of it between leaving the room to call Karl and having to sit down frequently to avoid passing out.
• How rough and unprecise surgery looks: taking parts out, stuffing them back in again.
• Watching the baby's nostrils flaring as she breathes and wondering at how amazing it is that i am seeing her experience this new process, something she will continue to do for the rest of her life.

So, as an end result, i have decided i need to see another one - that was just a practice run, i should cope better next time. And, that it is not childbirth that is horrific and barbaric, but surgery in general. So i am going to try extra hard not to land up on the table. Thanks Kayleigh for talking me into it!