Just in Time!

4:00 AM mom calls to say she has been having contx for an hour and they were about every 10 minutes. She said, you said to call you when there is change. (Note to self, tell mom’s unless you need me there now, if change happens in the middle of the night, and it's not an emergency, let me know of change in the morning). Actually this was a good call, I was glad she called and I'm reminded that everything is always perfect, because as I lay there in bed I knew to call my student who lives an hour and half away, and tell her to be on her way. Mom said she could probably get a little more rest, and she would call when there was more change. I went back to sleep until about 5:50, then I got up to unlock the front door so when my student arrived, she could just let herself in.

6:15 AM dad calls to say mom’s contx were 5 minutes apart now, and they were strong, but she still didn’t want me there. I got up and ready to go anyway, because I know how fast second babies can come, and I wanted to be ready. I called my midwife partner to let her know, she said she would be on her way soon. She was about 30-40 minutes away.

6:28 AM dad calls to say, okay she said you could come now, later I hear from mom what she wanted him to say was PLEASE COME NOW! I brushed my teeth and grabbed a few miscellanies supplies that I had left out from the birth just a couple days before and headed out the door. I called my student to let her know to go directly to mom’s house, I didn’t call my partner because I knew she was probably already on the road.

6:41 AM dad calls back and in a VERY CALM voice, (I can’t emphasize “very calm” enough) he says, mom’s water just broke, and her body was pushing. I said, okay, well, I’m in my garage right now just leaving. As I am driving down my street, I say to myself, did he just say she is pushing???

6:44 AM I phone him back immediately, and ask if he said she was pushing, he said VERY CALMLY, yes. I asked if she was in the water, as this was a planned water birth. He said yes, I said, well I am just going to stay on the phone with you until I get there. Now keep in mind, I am driving NOT as calm as he sounds, I am hearing my tires squeal, as I leave my neighborhood, and once again as I round each corner. I come to an intersection with a RED light, not a smart light, it’s not going to change anytime soon, soon being relative, so I look all directions, mostly for a police car, and zipped across the intersection seeing RED! Still on the phone with dad, I am instructing him what to do with the next contx as mom pushes. I tell him I’m pulling into his street right now, so I am hanging up. I grabbed my instruments, and oxygen tank from the back of my car and RAN into the house. Sure enough mom is leaned over the side of the tub trying not to puch, they are both happy to see me. I commented on how dad is about the MOST calm person I have ever met. I did not hear ANY birth is imminent, in his voice. He said, he just trusts birth, and the process, no need to be in a panic. Mom wanted the birth videoed, and since it was just mom and dad and myself, because my assistants hadn’t made it yet, dad was the cameraman.

Mom was a little worried about tearing, because with her 1^st baby the cord came out with the head, and so she didn’t get a chance to push slow and easy, I needed her to push with all she had to bring the baby out quick because I didn’t want the cord to be compressed any longer, so we talked about pushing with this baby, and how it would be slow and very controlled. She didn’t even need to push, baby would come out even without pushing. Sure enough she could feel the baby move down without her pushing, so with my instruction, she just breathed through each contx, and the baby gently came down. I wanted to give some counter pressure on her bottom to protect from a spinning baby, this is when the baby turns as it is coming out, and sometimes an elbow ends up tearing the perineum, but mom didn’t want me to, that didn’t feel right to her. So I just let mom and baby figure it out together. The head would come out a bit, then goes back in, and with the next contx, it did the same thing. Then with the next one, the head stayed out just part way. This process was perfect because it allowed for mom’s perineum to stretch much like when you stretch out a balloon before blowing it up. It makes blowing it up much easier.

6:55 AM with the next contx the head is out, and mom is still just breathing, this contx is strong, and baby pushes itself right out with that one contx. I instruct mom to turn over as I am untangling the cord from baby, it was around her neck and body. Mom said, “is she out”? It was so smooth; she didn’t even realize her baby was here. I said, "yes, she’s here"! I gently lifted her sweet baby girl up to meet her new mom. Baby weighs in at 8 pounds 15 oz, and 21 ¾ inches long. An hour later she meets her new big sister and a family has just grown from three to four. An incredible mom, an incredibly calm dad, and two incredibly ADORABLE daughters!

10:00 AM Mom has eaten, mom and babe have had their herb bath, this a giant tea bath, with lots of herbs to help moms bottom heal, it’s anti-bacterial, and a stringent, it is very relaxing for mom and babe. Grandma has come to take big sister to her house, exciting phone calls have been made, mom and babe are tucked back in bed with fresh sheets, and are successfully nursing. Laundry is washing, and dishes are done. As I drive away I am in awe at the miracle that just happened in this home, and the world doesn’t even know.

Is this the flu or is it LABOR?

Mom calls in the evening to say she has been having contx today, but really she just doesn’t feel well. She thinks she might have picked up the flu from someone, because she feels kind of achy all over and just not herself. She checks back in an hour later, and says, it must be the flu, because contx backed off, and she was going to hopefully get a full nights rest tonight.

6:20 AM I receive a call, mom woke up feeling like she was in transition, very shaky and not able to focus on anything but labor. The plan was for her to go to a “Birth Place” to have her baby, her husband had worked really hard on the construction of it, and they felt more comfortable there than at home, but it sounded like things were moving a bit to fast for her to get to the “Birth Place”, so we were coming to her.

6:35 AM I arrive at the house. Dad is so excited he can hardly see straight, and mom is very calmly resting on her bed. I checked mom’s dilation and she was 7 cm. How would it be to just wake up in the morning and already be 7 cm dilated? Things were moving along quickly, but I felt like they had time to still drive to the “Birth Place” if they really wanted to. I wanted them to have the birth they wanted, I had all my supplies and equipment in my car, but I knew that wasn’t their plan. I gave mom and dad a few minutes alone to decide what they wanted. They decided since there was time, they really wanted to go to the “Birth Place”. We hurried to put a few things in a bag, as the timing was a bit unexpected while Dad was on the phone to arrange a babysitter for their youngest son.

7:15 AM we arrive at the “Birth Place”, and mom’s contx are every 3-5 minutes, and very strong. The “Birth Place” is still under construction, but the essentials are there, and mom was happy. I organized a tray with all the birth supplies on it, like baby hat, instruments, sterile gloves, etc. Just in time, as mom contx are picking up a bit.

7:30 AM Contx are 2-3 minutes, and mom is really in need of some help breathing through them. Dad continues to be full of excitement; he can’t believe his wife is about to give birth any minute. He phones his mother in law, to let her know where to come to, and to hurry!

7:45 AM mom feels like she needs to go to the bathroom, as she stands up, her water breaks, and she heads to the toilet. She sits down with a VERY strong contx, and gives an involuntary push. I put my hand there to be ready to catch a baby, and sure enough the head is coming. I called for dad; he grabbed the camera, and put his arm around their daughter who was also there to welcome a new baby sister or brother. I didn’t have time to put my gloves on, sometimes it just happens too quickly, the most important thing is to have a dry warm towel or blanket to dry baby off when it is born, so I grabbed a towel, and put my hand down to guard mom’s bottom as the head came out. The other midwife dawned gloves by then, so she took over, and encouraged dad to come closer to receive his baby. Mom remains so very calm, she isn’t pushing, her baby is just coming out very slowly. As she contx, baby pushes itself out.

7:51 AM dad’s reaches down, and his hands welcome their new baby son into the family. He weighs 7 pounds and comes to a family full of love.

Every hour of sleep worth 2 hours.

10:00 PM mom calls to say she has been having contx all day, but they are getting a little closer now and definitely stronger. She was a little shy of calling me because she has been through this two other times and went to sleep, but when she woke up in the morning, she was disappointed to still be pregnant. She was hoping this time was going to be different.

I was actually HOPING for a full nights sleep because I just got home from a VERY long birth out of town and was looking forward to sleeping all night in my comfy bed. My partner is still with the mom that delivered earlier today, so she was feeling even more lack of sleep than me, at least I was home, eaten, showered and in bed ready to get some sleep. My student that works with me was out of town at her midwifery school she attends two weeks every other month. I called another midwife in town, but she had the flu, so it was just going to be me on my own for this birth, which I had a feeling it would be a week or so earlier. Every now and again my Angels give me a heads up on what to be prepared for. °Ü°

2:00 AM mom calls with contx every 5 minutes and much stronger. She wants me to come over and check in, so I got up, surprisingly feeling somewhat rested. When I miss out on sleep, I ask my angels to make each hour of sleep I get be worth two hours to my body, and they definitely came through for me tonight. I dressed in a hurry, brushed my teeth and was out the door in 10 minutes.

3:00 AM mom’s contx are every 2-3 minutes, and stronger than before. She bends over with each contx and dad gives her some counter backpressure. This is their first home birth experience, so even though they had other children, it was still new to them and a lot of unknown factors, but this didn’t seem to effect mom, she was staying very relaxed and continues to move around to help baby move down through the birth canal.

I finished getting all my supplies ready, and set up my oxygen tank. I cut ginger and set it on the stove to simmer for perineum compresses. I feel the most amazing feeling in my body. I said a prayer of gratitude, as I realize I am not along at this birth, I am gently reminded that I am NEVER alone at births. I am ever so grateful for this knowledge. As I write this, I am overcome with an abundance of love and gratitude. THANK YOU!

4:00 AM I checked mom for dilation, and to her and dads surprise she was 8 cm and 100% effaced. Mom was so relieved that it probably wouldn’t be too much longer. . The other children are all sleeping quietly in their bedrooms. They are happily dreaming, and when they awake they will have a new baby brother or sister.

4:50 AM mom’s water breaks, it is clear, and I can put the delee away. A delee is a very small tube that I use when there is meconium (baby poop) in the water usually because baby is post-dates, or has been stressed at some point during this pregnancy. I put it down baby’s nostrils to suck out any meconium that baby might have aspirated. Anyway… I see amniotic fluid is clear, so I can put the delee a way.

5:00 AM mom’s contx back off to every 7-8 minutes, this often happens just before mom has the urge to push. It’s her body’s way of giving her a break to gather strength to push her baby out. Mom is SOOOooo very tiered, she doesn’t know how she has the strength to go on. She drinks a little apple juice in hopes that it will bring some energy to her exhausted body.

5:30 AM as she pushes, I can see that semi reclining on the bed, (the only way she has ever given birth in the hospital) is not the best choice for her. I encouraged her to walk to the bathroom. The combination of walking and being able to fully let go on the toilet is all that we need to bring a baby to her arms. She has one contx on the toilet, with a strong urge to push; she says, “here comes the baby”!

5:35 AM I have her scoot forward on the toilet, and put my hands there to guard her perineum to avoid a tear, and sure enough with one push, out comes baby’s head. Unfortunately, I do feel a little give in my hand as baby’s head comes out; sometimes there are no slowing things down. In the same push the rest of the baby slides right out. I lift baby up to mom’s arms, and dad grabbed a towel to dry and cover baby.

5:40 AM dad and I help mom move to the bed so I can keep an eye on her bleeding. It still amazes me how easily moms can move when there is no pain medication and they are allowed to give birth naturally on their terms. Taking as much time as needed, not rushing the process, and gently pushing as opposed to force pushing to the count of 10, three time with each contx.

7:30 AM Mom has been sutured, (yes unfortunately I had to put about three stitches in) she has been up and showered and peed, baby cleaned up, measured and weighed, dressed, and has a full belly. Everything is cleaned up, and laundry is in the washer. Mom is tucked in bed with her baby in her arms just in time for dad to open the door with three little kids waiting to see their new baby SISTER! She weighs in at 7 pounds, and is 20 inches long. Each of the kids takes a turn holding their baby sister before going off to school.

It just doesn't get any better than this!

4:30 AM Tuesday morning my cell phone rings.  Dad is calling to let me know his wife has been having contx since around 1:00 AM.  They are about 10 minutes apart, definitely getting stronger and lasting nearly a minute.  They didn’t want me to come yet; generally first time moms have long labors.  I said, call me back when there is ANY change because I had a little over an hours drive. 

I laid there in bed wide awake for about 30 minutes, listening to a whisper that said, this won’t be a long labor, you should get up and get ready. 

5:15 AM I get up and take a quick shower, get things ready for the day, and 6:00 AM dad calls again.  Contx are 4-5 minutes apart and she would like my support there now.  I was already ready, so I headed out the door.  I called my partner to let her know, she would be heading out as well.

7:30 AM We arrive at moms house to find her VERY much in labor, working VERY hard and relaxing perfectly during her contx.  Baby has a happy healthy heart rate, and mom can feel her baby move down into the birth canal as she contx.

8:30 AM Mom wants to move to the birthing tub.  Contx are every 1-2 minutes and even stronger than before.  The tub feels so good to her; she says she is able to relax much easier in the warm water.

9:00 AM I check mom to make sure she is complete because she is feeling a strong urge to push, but not making much progress.  She is completely dilated and effaced; we can have a baby any time now.  Baby’s heart rate sounds GREAT.  Dad is making sure his sweetheart has sips of juice and keeps Chap Stick on her lips.  He was so sweet to put towels between the tub and the walls because the noise was interfering with mom’s concentration.  ANYTHING she wanted, he was all over it, usually before she even spoke it.

10:30 AM Mom is pushing, but very gently, and not through the whole contx.  This was perfect, because she was bringing her baby down through the birth canal, but not wearing herself out.  Contx are still VERY strong, but had back off just a bit so now they were only every 7-8 minuets.  I suggested she get out of the tub and walk to the bathroom, it had been a while since she had emptied her bladder, and walking would be VERY helpful in moving her baby down.

11:00 AM Mom was back in the tub, moving back and forth from hands and knees to semi reclining.  Her hands and knees felt best, but they needed a rest in between contx, and mom was able to even fall asleep during that resting time.  Contx continued to be every 7-8 minutes, so she often would get a long rest.  Baby appears to still be very happy and healthy, as I listen to its heart rate I can hear good variability.  This means when baby moves the heart rate goes up just a bit, and when mom has a contx the heart rate lowers a bit, but comes immediately back up.  If I were to chart it out, I would want to see a horizontal zigzag pattern.  For example, 152-157-158-150-148-150-154 etc. is a good variability hear rate.  By now, mom is pretty tired; she says she doesn’t know if she can do this much longer.   I am glad when we get to this point, because that means we don’t have much longer to wait.  I can say about 99% of moms get to this point, and voice it.  We encourage her by saying, “it won’t be much longer”, and “you can do this”.  I always let mom know she just has to do one contx at a time, and never the same contx twice. 

11:50 AM We are seeing lots of dark hair.  Mom took her time and gave slow gentle pushes, being in the water, we can’t do oil or ginger compresses to help avoid tearing, but slow gentle, controlled pushes really helps.

11:56 AM The head finally comes all the way out.  It is fully under water, and I remind mom and dad to breath, because baby doesn’t take it’s first breath until it reaches air.  This baby has lots of dark curly hair just like it’s mom and dad.

11:59 AM With tears in our eyes we welcome the cutest baby girl on the block!  She weighs in at 7 pounds, 10 ounces, and she’s 21 inches long.

A few hours later, mom and babe have had a nice relaxing herb bath; they are happily tucked in bed with full tummies.  The laundry is done; the tub is emptied and outside to dry.  I LOVE, LOVE, LOVE butter births like this one, it’s 4:00 PM, and we are off to our next prenatal already scheduled.  This mom had her baby on the day we were already going to be seeing her for a prenatal and it was during day, no missed sleep, and no rearranging prenatal appointments.  It just doesn’t get any better than that.

Decisions, Decisions!

A few months ago I received a phone call from a mom in another state.  She was seeing midwives where she was living, but at 36 weeks her family would be moving to AZ.  We discussed her options, like hospital, birth center or home birth; she decided she wanted a home birth.  Her other three children were born in a birth center, and she really wanted a home birth this time, so I agreed to take her on.  She called me when they started their trek across the country and checked in when they arrived in town. 

Wednesday I did her first prenatal and all seemed well, except there was a glitch in her insurance.  They would pay 100% where they came from, but here in AZ they wouldn’t pay hardly anything.  (I just don’t understand insurance companies some time, actually most of the time).

She and her husband talked about the new insurance discovery, and decided to go to the hospital this time because of the finances.  That night after making that decision, she was in GREAT turmoil, she didn’t sleep, she was on edge, and overall just couldn’t picture herself in the hospital.

The next afternoon (Saturday), she phoned me to see if I would still take her, she told me about her experience the night before, and just felt like she was supposed to have this baby at home.  I agreed to take her.  She said she had the best night sleep that night than she had had her whole pregnancy. 

Monday around 3:15 PM she phoned and said she thought she was in labor.  She was having contx, she hadn’t really been paying attention to how far apart they were, but she thought they were only about 20-30 minutes apart.  She was just letting me know there was change, because I tell my clients when there is change call me.  I told her to pay attention in the next hour to how close they really were, and if they were getting stronger, and call me back in one hour.   I wanted time to call my birth team, and they had a ways to drive. 

3:30 PM only 15 minutes later mom calls to say, “these are much closer than I thought, they were more like 4-5 minutes apart, and definitely stronger”.  She has 3 other small children, and didn’t know anyone here in town as they have only been here a week, so I waited until Whitney (my daughter) got home from work, and brought her along with me to help with the other children.  I called my birth team, and told them to be on their way, things were moving along quickly.

4:00 PM Mom is working very hard through these contx, she has a warm rice sock under her belly, this helps her relax through the with the contx.  Every couple of minute’s mom bends over the bed, stops talking, and puts all her concentration and focus inward during a contx. 

5:00 PM Mom decides to get in the tub to rinse off a bit and relax.  She wasn’t quiet as comfortable in the tub as she was out walking around with her rice sock, so she got out after about 20 minutes, and that movement was definitely what she needed to get baby moving down.  I listen to baby’s heart rate, and everything sounds GREAT!  Mom is feeling lots of pressure; we can tell it won’t be much longer.

6:00 PM Mom’s water broke, and it was clear.  I always check what color the amniotic fluid is because this gives a good indication of how baby is doing.  When the water is stained, this means the baby has been stressed and pooped in utero.  I listen to baby’s heart again to make sure it is still a happy baby, and the heart rate sounds GREAT!  Mom is on her hands and knees on the bedroom floor, and has a strong urge to push.  She gives a couple of slow gentle pushes and we soon see baby’s head.  Dad is up by mom’s head encouraging her, and helping her focus.  I put a little bit of helichrysm essential oil on mom’s perineum, to help lubricate, and keep the circulation going so she doesn’t tear.  It is also good for bruising and swelling, if some gets on baby’s head, all the better, because of the molding that happens as baby comes down through the birth canal.

6:10 PM We welcome a sweet baby boy into this family of girls!  He weighed in at 7 pounds even and 20 inches long.  Mom and dad were both so happy to have their baby here, three weeks early, but evidently it was perfect timing for him.  They were especially glad to have this little one gently born in their home.

 

A Midwife’s Midwife!

It’s so fun to be a midwife’s midwife!  We are just like any other pregnant mom who feels like we have lost our brain for 9 months.  All the blood that is normally circulating in the brain is now circulating around that uterus.  We have no memory for nine months just like most other pregnant moms.  We forget that an estimated due date is just that, an ESTIMATE, and we forget even the most common sense things that we know we know.  We sometimes forget to eat, drink and take care of ourselves, because we are too busy taking care of everyone else.  You see; we really are no different from the ordinary pregnant mom.

I tell my clients that by the time they deliver we are BEST friends!  We really have a trusting relationship and are usually on the phone everyday the last week.  This mom was no different, we stayed in touch because she was having a lot of contractions, and at the same time was moving into a new house with lots of finishing work still to be done, had sick children, then she caught the bug herself, it was hunting season, and she didn’t want her husband and son to miss out on this father/son experience, not to mention a LOT of other outside pressure. 

It was midnight, and mom calls to let me know what was going on.  She didn’t want me to come quite yet, but “just be ready so when I call you can come quick”, she said.  I already had all my ducks in a row, I called my assistant and she came to sleep at my house until we got THE call.

3:00 AM Dad calls and says it’s time, contx are 2 minutes apart, and mom wanted me to come NOW!  My assistant and I were up, dressed, teeth brushed, contacts in, and out the door in less than 10 minutes.  When we arrived mom was on the toilet breathing through contx like an experienced mom.  I listen to baby’s heart rate and he sounds GREAT.  I locate all the birth supplies and get everything set up and in order, ready for a birth.  Mom likes her privacy, so I backed off and hung out in the front room, while she and dad were in her bedroom and master bath.  I could hear everything going on, I listen closely to her breathing, because this tells me how close mom is, and what best way to assist her is.

4:00 AM Mom wants to get into the tub, as she lowers herself a sigh is heard as she feels instant relief.  She and dad are breathing together and working through contx like she had done this five times before! 

5:15 AM Mom request a dilation check so I checked her while in the tub and she is 7 cm.  Mom feels a little overheated, so we cool the bath water down, put a cool cloth on her head and have her get out to go to the bathroom.  Baby’s heart rate is a little high, I attribute this to mom being overheated, so when we cool mom down, I listen again and sure enough, baby was back to his base-line heart rate.  Mom was eating ice chips because that is what she is craving.  They ate a late dinner, so food wasn’t appealing at all.  For the next hour mom was in and out of the tub to the bathroom, and I am listening to baby frequently as I don’t want his heart rate to jump high again, it continued to stay at his perfect base-line.

6:15 AM Mom is feeling lots of pressure, she wanted her other children present, actually, THEY wanted to be present, they missed the last birth because they were at grandma and grandpa’s, and they weren’t about to miss this one.  So my assistant went to each of their rooms and woke them up.  They all hung out on mom and dads bed to watch their baby brother be born in the large garden bathtub.  Well, they started out on the bed, they soon gathered ‘round the tub to get a closer look.

6:25 AM Mom gently pushes out her baby’s head, I had my hands down to help guard her so she wouldn’t tear, but she pushed my hands away, so I honored this, and just held the space for her to receive her 9 lb baby boy with grace and ease!  The whole family was gathered ‘round the tub in sheer delight!

Butter Birth!

I love births when their most important lesson is how easy birth can be when we give women the tools they need to birth with confidence.  We celebrate the accomplishment of what the women’s body is able to do as we surround her with supportive and empowering people who trust birth.

5:15 AM Mom calls with contx about 6 minutes apart.  They had been 20 minutes then jumped to 6-7 minutes within an hour.  This is her second baby, so we expect for labor to progress quicker than the last one.  I got a quick shower to wake me up for an hour drive.  I was on the road by 5:45 AM.

7:00 AM I arrive at the house, and mom is working hard through contx, with what looks like with ease.  As we start to set up the birth tub we are thinking, “were not going to get this filled before baby gets here”, so we changed plans and disinfect the tub in her bathroom instead.  She has a large garden tub, so it will be plenty big. 

We make her bed in the specific way we do for a home birth.  We put clean sheets on bed in normal order; fitted, flat, & blanket, then we cover the bed with a waterproof sheet or drop cloth (lg. Shower curtain works well also).  Then continue to make the bed again over the top of blanket with an old set of sheets; fitted, flat etc.  This makes it an easy and quick bed change after baby is born.  When mom gets up to go to the bathroom, we take the top set off and leave a fresh clean set for mom to return to bed with.  We make the bed like this even if the plan is to have a water birth, because we never know which plan is going to play out, and we want to be prepared for every plan.

7:30 AM When the tub is ready so was mom, she gets in and feels relief as she is emerges herself in water.  At this point comfortable is not in mom’s vocabulary.  Nothing or any position is comfortable now, but mom is breathing and rocking her hips through contx, and now she is feeling like she needs to poop, so she gets out of the tub and sits on the toilet.  She gives a couple of pushes on the toilet and we encourage her to go back to the tub, but she says no, she can’t move.  We tell her she can, and we will help her, but she still refuses.  We always trust that mom knows what her body needs and what position is best for her. Just to give you an idea of positions, and trusting mom to do whatever is best for her.  We asked mom to scoot forward on the toilet, but she said she couldn’t, instead she stood up and was in a supported, stand with her knees slightly bent, as she did this baby came right down the birth canal without even a push.  The next contx mom gave a gentle push and the head was born.  Within 5 seconds, no pushing, the body was born.  One midwife supported mom’s perineum and the other one received this beautiful baby girl in a soft towel.  Mom sat back on the toilet and we lifted baby into her arms.  The placenta came after the cord finished pulsing, and Dad cut the cord.  No bleeding, only a VERY small tear, and clean up was instant.  It doesn’t get any easier than that.  We call these “butter births”.   

8:13 AM Mom and Dad welcome their sweet baby girl into their family weighing in at 8 lbs 1 oz!

Slow and Gently Born

9:30 AM Mom calls with contx 5 minutes apart.  This is her second birth with us, and she has a family history of having very quick labors.  Her last birth was normal in length, not really fast, but not long either.  She lives about 1 ½ hours away, so I didn’t want to wait too long.  I had appointments this day, so I called and canceled them and headed out to a birth. 

When I arrived I saw mom outside doing yard work, I thought, okay, this doesn’t look like a mom that is moving through labor very quickly, and I was right.  The good thing is we were out in the country, so it was a nice leisurely day as we waited for labor to progress.   We went to a ride into town to the little produce market and got a few groceries for dinner, (it was noon, but we know we’d be there for dinner).

7:30 PM labor finally picked up and contx were much stronger now.  Mom had to work through them with a bit more effort.  Still only wanting her husbands support we stayed in the front room to offer support when she needed it.

11:30 PM Mom wanted to get into the birth tub to help manage the intensity of contx.  We warmed the water to about 98 degrees, and mom was very happy to finally emerge herself in water.

12:00 AM Mom continues to work through contx, still really only wanting her husbands support, but we can tell that it is getting close.  The tub was in the dining room and she had a curtain set up as a privacy curtain in between the dining area and the front room.  As we listen to mom’s breath, we could hear a little catch in it as she breathes through contx.  This lets us know that the baby is coming down and mom will soon feel an urge to push her baby out.

1:00 AM  Mom is actively pushing now.  There is a little anterior cervical lip just at the top of baby’s head, as she has another contx and pushes we hold the lip back so the head can come down in front of it.  Within a few minutes of pushing we see the head crowning, and mom VERY slowly and with VERY controlled pushes, gently pushes her baby’s head out.  The head doesn’t rotate, so we ask her to turn over on her hands and knees, this opens the pelvic a bit more to make more room for baby to come through.  This rotation opened up the way for baby to be born.  Because of mom’s gentle, slow and controlled pushing she doesn’t tear, and Mom and dad welcomed their son at 1:17 AM

Not according to “OUR” plan

When things don’t go according to “our” plan, we often wonder why?  As we look hindsight, we find this WAS the plan after all, we just didn’t see it clearly.  Looking back with 20/20 vision is very enlightening.   I’m grateful for that enlightenment, because it helps us understand the events that we didn’t plan for, and it helps us grasp a hold of the lessons that are there for us to learn from.

8:30 AM Mom calls with contx, they have been very regular, every 5 minutes for a couple of hours.  We visit on the phone, and she is doing great.  She is going about her regular activity and will call me when there is a change.  Three hours later I go over to her house to check on her and babe.  All is well, she is working well with contx, and not needing me there, so I send mom and dad out to walk, and I head back home.  We are in contact with each other throughout the day as she continues to have contx getting a little stronger and closer together.

9:00 PM I arrive at her home after she calls and feels like she would like me there now.  She is having strong contx 3-5 minutes, I check dilation and she is 6 cm and 90% effaced.  This would be considered “active labor”.  For the next several hours’ mom and dad labor together, dad doesn’t leave her side, he is very devoted and treats his wife like the queen she is.   My two assistants and myself continue to give labor support, checking heart rate, and take our turns resting.  I could give an hour-by-hour detailed story of the next six hours, but it would be suffice to say that mom and dad are an amazing team.  The two of them went from the tub to the bed to the toilet and back again several times, while eating lightly to keep energy levels up and keeping well hydrated.

4:00 AM Mom is feeling like she wants to push, she is feeling some pressure and pushing feels better.  Mom tries for a bit to push, but we aren’t seeing any progress, so I check her, and she feels complete, but baby has moved up out of the pelvic a little bit.  I suggest she lay on her side, with one leg propped up on a stool with pillows; sometimes this helps to bring the baby down.  Mom continues to lie on her side for bit, then up to the bathroom to do a few contx on the toilet, and then back to laying on her other side. 

9:00 AM  Mom is back in the tub, she complains of incredible back pain, and not able to support her back in the tub, so dad gets in with her, to give back support and allow mom to rest on him in between contx. 

11:30 AM Mom is feeling like she needs to push again, so I check for cervical dilation, and she is back to 9 cm., but baby had moved back down into the pelvic.  I can feel a bulging bag of water and mention to mom that we can break it, and this will probably help have a baby sooner, as I mentioned this her cervix closed down a couple of cm, so I decided it wasn’t a good idea to break her bag of waters at this time, (for some reason I felt I wasn’t supposed to do this), I suggested we go a head and let it be, and tell mom it shouldn’t be much longer. 

12:30 PM Contx are very strong with bringing with them a strong urge to push.  I encouraged mom to push through a few contx on the toilet, and then back to the bed.  She wanted to go back to the tub, but earlier I had an impression we were not going to do a water birth.  I couldn’t tell you why, just that I felt we were to go to the bed.  So I encouraged mom to go to the bed, we would check her one more time just to make sure the entire cervix was gone and it was okay to push. 

1:30 PM Still only dilated 9 cm, with a bulging bag of water, so we decided to go a head and break it this time.  When we did, the amniotic fluid was stained with meconium.  Meconium is normally stored in the infant's intestines until after birth, but sometimes (often in response to fetal distress) it is expelled into the amniotic fluid prior to birth, or during labor. If the baby then inhales the contaminated fluid, respiratory problems may occur.   

There are different degrees of meconium, and this was the most severe.  Amniotic fluid is usually clear, but this looked more like chunky pea soup.  My assistant and I looked at each other, not wanting to alarm mom and dad, but they knew something was up.  I wanted to make sure my assistant and I were on the same page about transporting before I said something to mom and dad.  It was clear to me that baby wasn’t coming down through the birth canal anytime soon, so we discussed a transport to the local hospital.  We discussed calling an ambulance, but it didn’t appear to be an “emergency”.  I felt we had plenty of time, and baby sounded GREAT.  Heart tones were proving to be very strong and responsive, so we packed up and drove to the hospital in our own vehicle.

When a situation calls for a transport like this, I call a head to the hospital and talk to the Doctor on call.  I let him know that I have a patient I am bringing in; I give him the pertinent details, and ask to have a room ready for her.  I bring with me a transport form that gives the information needed about labor history and why I am transporting.  I come in with my client and I am with her throughout her labor.  I continue to give labor support and act as an advocate for my clients.  I help bridge the gap between home and hospital.  This transition can be a very difficult time for both parents.  We came from a home environment where everything is natural and familiar to the hospital where nothing is natural or familiar.  We are in the hospital because there is a problem and mom and or baby needs to be very closely monitored.  Now there are IV’s, monitors, machines, catheters, no eating or drinking, everything but natural.

2:30 PM We arrive at the hospital, get checked into a room, and settled in.  The nurse checks for dilation and mom is still 9 cm.  I am thrilled, because sometimes just the transport and all the emotions and fear that go along with it will close the cervix down a bit, but not this time.  The nurse asked mom on a scale from 1-10 with 1 being nothing 10 being most severe, what was her pain level at.  Mom said a 5! I couldn’t believe this, she was handling these contx, as if they were nothing, and anyone who has been through labor knows that when you are that close to complete, contx are VERY intense.  The nurse commented that mom acted like she had an epidural in.

4:00 PM The nurse checked mom’s cervix and said she was complete and could start pushing.  We are excited and doing the “Happy Dance”.  This is great news!  Mom pushes with great strength, for about an hour.  It’s now the change of shift and a new nurse comes on.

5:00 PM New nurse checks mom’s cervix and says she’s 9 cm.  She asks the charge nurse to come in and double check, sure enough she is back to 9 cm.  They have mom roll to her side, and breathe through contx for ANOTHER hour.  Can you say AMAZING, because that is definitely what this mom is!  Her strength is incredible!  In her mind she intuitively feels she should have a c-section, she has felt this from the time we drove to the hospital, but she keeps on going and doing exactly what the nurses tell her.

6:00 PM Mom has had enough; she is tired, and doesn’t feel like she can do this anymore.  I give her a pep talk, and go get the nurse.  The charge nurse comes in to check her one more time, and again she is complete.  The nurse continues to give vaginal support while mom pushes with all her strength.  Dad and I are holding her legs up and back for her and counting her breaths as she pushes.  During the hour and half, Doctor is in and out a couple of times checking progress, and mom continues to find strength she had no idea she had.

7:30 PM The Doctor orders pitocin for mom to help create even stronger contx to hopefully bring baby down.  Mom is directed to NOT push during these, again VERY STRONG contx to give pitocin enough time to work.  I encouraged dad to go to a vending machine and grab a snack and take a 10-minute break, he comes back 5 minutes later with a sack lunch the nurse hooked him up with.  The nurse came in with one for me as well, and I have to say, food never looked or tasted so good.  Neither of us had eaten all day. 

7:45 PM Mom resumes pushing; I can’t even imagine how tired she is, no, how EXAHSTED she is, but somehow she finds what little energy there is left and continues to push.

8:15 PM The nurse went to get the Doctor and brief him on her progress, I knew this wasn’t good.  Doctor came in and sure enough the baby was still just as high in the birth canal as it was when we came in several hours before.  He discussed her lack of progress despite her efforts, and his recommendation was a c-section.   He wanted to give her until 9:00 PM, but mom said, NO!  She really felt like the only way this baby was coming out was through a c-section, so by 8:30 PM everyone consented to a c-section.  Preparations were made, and into the OR she went.

After a VERY long and strenuous labor, this AMAZING Mom and Dad welcomed a sweet baby boy 8 lbs 4 oz, at 9:04 PM by c-section, baby was posterior, (face up).

20/20 VISION:

As I look back on this experience there are details that come to my mind that give me hints of the outcome.  I don’t think these hints are meant to second guess myself, or kick myself because “it was right there, why didn’t I see it?”  I think they are there to help us understand this was the plan all along for some reason, and there was nothing you could have done to change things, a kind of resolve. 

When I first met this mom, something struck me just slightly that we would be transporting.  I quickly put that thought out of my mind, I can’t tell you why I thought this, it was just a flash that came and went very quickly.  As I got to know her more intimately through our prenatal visits, I was impressed by her outlook on life and was pleased to have met someone with such a like mind as mine.  (This doesn’t happen very often).  Wrinkles were smoothed out in my mind, and I became very excited for this birth, I knew it would be wonderful and this mom had something to teach me.

In one of our prenatals we discussed making a “mind movie”.  This is much like a creation board; only it is in a slide show presentation with music.  It was to represent everything you expect your birth to be like.  We talked about making it as personal as she could, because the more personal the more powerful.  She came the next prenatal and shared it with me.  I was impressed that she followed through with this suggestion.  It was beautiful, and very personal; the one thing I noticed right away was there weren’t any pictures of “home birth”.  In my mind I thought of having pictures of women laboring at home, birth tubs, midwifes, etc., but that aspect wasn’t there.  Again, it was beautiful and very personal, with lots of GREAT affirmations, but that main aspect was missing.

I didn’t want her in the tub to have this baby, why? Probably 75% of my babies are water births.  I love water births, but this one didn’t feel right.  I’m glad mom’s water broke on the bed instead of in the water.  It might have looked more diluted, and I may have not thought it was as dark stained as it really was.

I wanted to break her bag of waters the first time I checked and she was dilated 7 cm, but something stopped me.  Why? I don’t know, but I do know there was lots of divine communication going on here, lots of messages coming through.  This labor was one that many angels attended bringing with them a powerful love, strength and most of all protection.

This baby was posterior, and that makes for a very long, hard labor.  It also makes it hard for baby to fit into the birth canal.  It’s like fitting a tight puzzle together.  I don’t think baby was posterior the whole time.  It think he turned around 4:00 AM when I checked mom and felt baby had moved up and out of the pelvic.  Why?  Again, I don’t know, was there a short cord, was it a weak cord, was it wrapped around him, was the cord in a space that it would compress coming down the birth canal?  Did we just need to be in the hospital for baby’s sake?  Baby stayed in the hospital for a few days; did mom need to deliver there, as not to be separated from baby?  I don’t know these answers, but what I do know, is this baby is very smart, he helped us make the choice to transport when we did, he knew what he had to do to help us make that choice, and I have no regrets about that.  For whatever reasons, I know this birth happened just the way it was supposed to happen, and we were all divinely guided.

I also know, this mom is TRULY one of the most AMAZING mom’s I know.  This was an incredibly long labor, and with her innate knowledge of knowing this baby would be born by c-section at 1:30 PM as we were driving to the hospital, and still giving it her all, finding strength and energy she didn’t know she had for HOURS longer, not giving up, truly enduring to the end with grace, and with what looked like ease, but we all know it wasn’t ease at all.