Thursday, September 18, 2008


It’s a perfect day to welcome a perfect sweet baby!

Be warned, it's a LONG story

Mom was having contx and some spotting, so she came to see me.  I checked her to put her mind at ease.  She wasn’t dilated yet, and spotting was very minimal.  Baby’s heartbeat was strong.  I explained that sometimes as you efface and dilate, small capillaries break and can cause small spotting.  I teach mom’s to check their own cervix if they are comfortable with that, and sometimes this can irritate the cervix a little and cause spotting also.  I liken effacement and dilation to sucking on a lifesaver.  As the lifesaver gets thinner, this is like effacement, and as the hole gets bigger, this is like dilation. 

After checking mom’s cervix this is what I felt was causing the spotting, it appeared to be very normal.  The other advice I gave mom is to hydrate herself.  Dehydration will cause contx prematurely and give you a false sense of labor.  It is in everyone’s best interest if you don’t start into labor dehydrated. 

I was pleasantly surprised to wake up Sunday morning with a good nights sleep.  Contx continued all day and it was time for the midwife to come.  As I turned down her street I had in my mind their house was the second one in.  They told me to pull into the driveway and park under the basketball hoop.  I thought it was kind of funny that they wanted to me park here, but didn’t have the garage door open like they said they would, they must have forgotten.  I grabbed all my bags from the back of car; I try to only make one trip, which means I have full arms.  I walked around to the front of the house, struggled to open the gate with full arms, went to the door and knocked.  No one answered, but that doesn’t surprise me, I’m sure they are busy, so I knock and walk in with a “helloooooo”.  Some women whom I didn’t recognize says, "Aaaa…...can I help you"?  Instantly I realize I’m in the WRONG house!  I’m tripping out the door over my apologies; I can’t believe I have just WALKED into some stranger's house hollering helloooo like I owned the place.  Oh my goodness, I was sooooo embarrassed!  This strange women is trying to help me with directions, I assure I know exactly where I’m going, NOT! It turns out these two houses are identical and I was supposed to go to the 2nd house from the end of the street, not the 2nd from the beginning of the street.  Sure enough the house I supposed to be at had the garage door open for me, this time, as I’m a little skittish, I knocked and waited for an answer!  I took a couple of deep breaths, and no one was any wiser.

So…now for the birth story.

4:30 PM - I checked mom’s cervix and I was excited to report that she was dilated 7-8 cm. and 90% effaced.  She had a gush of water around 4:00 PM that we suspected was her bag of waters.  I called my assistant to let her know it was time to come NOW and quickly.  I prepared the room for the birth, and filled the garden tub as this is where she wanted to birth.

5:15 PM - Mom is feeling a VERY strong urge to push.  I called my assistant again to affirm she was almost here.  She said she was still about 20 minutes out.  I encouraged mom to get in the tub to help her relax and get ready to welcome her baby.  With the reality of her baby being born soon, fear came showing its face also.  As we talked about what she might be afraid of, and I reassure her everything is going perfect.  Baby has a strong, happy heartbeat, but fear is a strong emotion, and there is a shift.

6:00 PM - I checked her cervix to see what exactly was going on, and I was surprised to find she had closed down to 1 cm!  Now, I can’t tell mom this, she would be devastated, I just said, she had closed down a bit, and so for the next several contx we would just breathe through them as we had before.

9:00 PM - Transition finally comes.  Again, LOTS of hormones being released, mom is shaking uncontrollable, contx one on top of the other, with no break in between.  Once again we set the room up for birth.

9:30 PM - Another shift, hormones gone, urge to push is gone, contx backed off.  I check her cervix, (I’ve already done more vaginal exams in this one partial labor than I normally do in 2-3 complete labors) and find her cervix is 3 cm dilated!  I can’t believe this is happening.  The common thread in both shifts is FEAR.  There is actually a lot of emotions playing out here.  A little back ground history…mom and dad have been separated most of this pregnancy due to the military.  When you are not with your partner through a pregnancy there can be some startling reality checks when you come together again.  Mom has been through the physical part of pregnancy.  It is her body that has changed drastically, she has experienced the aches and pains, the tiny bladder, the absent-minded memory, among many other physical changes, but dad hasn’t.  This can cause mom to feel unappreciated for what she is going through, and dad is feeling left out of the loop and in denial.

I’m not saying this is what was going on emotionally with this mom and dad, because I really don’t know.  But there was certainly something going on and it was powerful enough to digress labor from nearing the end to nearing the beginning.

After this cervical check, I told mom and dad straight up what was going on with her cervix.  We talked about fear, about relationships, about any dynamic that could be going on subconsciously.  I said, what we are doing isn’t working, so lets do something different.  Go for a walk outside, away from everyone, just the two of them and talk or go to bed, again just the two of them, and go to sleep.  She chose sleep.  She took some valerian root tincture to help her relax and went to bed.  This is where I took advantage and laid down too.

Rest didn’t last very long.  I could hear mom cry so I went into check on her, she was sitting on the toilet crying in a child’s voice, “I want my mommy”.  Again a bit of history here… her mom passed away a few years ago, and a schoolteacher took her in as her own and has been a surrogate mom to her every since.  That being said, my heart ached for this mom…NOW I was beginning to see a small glimpse of what was going on for this young new mom to be.

I assured her that her mommy was here, she is here in spirit and she is helping her baby find it’s way to be born and would soon be in her arms.  We talked about nicknames her mom called her, and songs she sang to her when she was a child.  I went for my back of tricks (homeopathy) and found a remedy for fear and grief, two VERY powerful emotions.  No wonder her cervix closed down.

Mom and dad settled into a rhythmic labor pattern, surrogate mom was a great help as she supported her and gave her the physical touch that a mom would give.  Thank goodness for assistances to take turns laboring with mom so another can rest. 

2:00 AM - Mom has been back and forth from bed, hands and knees, to side lying, on the toilet, and sleeping some in between contx.  Mom is feeling that STRONG urge to push again, but I’m not about to check her cervix, as I still don’t know for sure that a vaginal exam isn’t what is causing her to shut down.  We will know when it’s time when we see a head crowning!

4:00 AM - Mom can’t take it anymore, she can’t help not to push, so reluctantly I check for dilation one more time, she is 7 cm.  I tell her no pushing, I encourage her to breathe through these contx and explain that pushing before she is fully dilated can cause the cervix to swell and close down.  Then we will have to wait for the swelling to go down and the cervix to open again.

This focused breathing was very difficult and required a lot of help.  She looked into my eyes and said, "I can’t do this anymore, it is too hard”.  It was just she and I for the last couple of hours, as everyone else was resting.  I looked right back at her and said, “Yes you can do this, you are doing this, and you only have to breathe through one contx at a time.  When this one is finished, you don’t have to do that one again.”  Each minute seemed like an hour.  This is such hard work, and I was amazed at this young mom’s strength.

6:15 AM - Mom is begging me to check her AGAIN, so as I repeat in my mind, “I’m grateful she is 10 cm”!  I check her cervix once again, and let out a sigh of relief and excitement, as I am dong the “happy dance” she IS complete!  I rallied up the birth team, dad and surrogate mom, and finally give mom permission to gently push her baby out.

6:50 AM - We welcome a sweet baby girl weighing 7 lbs, 9 oz.

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