Saturday, October 28, 2017

Third Time's a Charm

Wanting a completely different experience than with her first 2 children (both born in the hospital), my latest client opted for a birth center this time around.  Being almost a week past her due date, we've been checking in with each other often the last few days. I checked in with her in the early afternoon yesterday, and the poor thing was sick in bed with the flu.  But as we texted throughout the day, I started to wonder if it was really the flu or if it was early labor.  By early evening I was getting more convinced.  Her contractions were coming about every 7 minutes and lasting about 40 seconds.  A great early labor pattern, but she did say they were already really uncomfortable and she was worried about how much worse they would get.

Since I live quite a distance from her home, we decided to meet at the birth center.  She arrived at 10:30 pm and said that her contractions had spaced out a little more during the drive, but that they were still painful.  We quickly headed upstairs to the birth suite to figure out where we were.  The midwife listened to the baby's heart rate, and was somewhat concerned because it was elevated.

Mom was checked at 11:05 pm and was 5 cm and 50% effaced.  Contractions were intense, but still short, and the baby's heart rate was still elevated.  Since mom hadn't been feeling well that day, she wasn't able to eat or drink much, so the midwife decided to do a bag of iv fluids.  If mom was dehydrated, that could be the reason the baby's heart rate was so high.  And if we couldn't get the heart rate lower, we'd have to transfer to the hospital.


After a few pokes, the iv was in place.  In situations like these I usually see the iv really speed things up, or really slow things down!  But by 12:30 am, mom's contractions were visibly more intense.  I put on relaxing music and helped mom remember to release her tension on the exhale.  As soon as her iv was out, she hopped in the tub, around 12:45 am.  Dad hopped in, too!


The tub brought relief and mom was in the zone.  She was tired and rested in between contractions.  She had been chatting up until this point, but once she was in the tub, she really started to tune out the world.  By 1:15 am her contractions were really close together, and by 1:35 she was needing to vocalize through each one.  I reminded her to keep her voice low and relaxed, and I knew she sounded like a woman who was about to have a baby!  


I even made it into a picture.  The sweet midwife on call snapped this on her phone.  :)

 

At 1:55 mom announced she was feeling a lot of pressure.  Dad turned on some music they had wanted to listen to and told his wife how proud he was of her.  He was beaming with anticipation, just like a child on Christmas Eve.  He kept saying how he couldn't wait to the hold the baby, and he provided counter pressure on mom's back during each contraction.


At 2:05 the urge to push was very strong.  Several minutes mom announced the head was out and dad was extremely thrilled to be holding the head in the water.  And at 2:10 am, their baby was born.


Welcome Becks!  Born Saturday, October 28th 2017 at 2:10 am.

(And at 2:15, they took their first family selfie.)


Dad had some much anticipated one-on-one time while mom got out of the tub. This might be the happiest dad I've ever seen!


By 2:50, mom and baby were both ready to start nursing, and by 3:15, he was latched perfectly.  There was a rousing Halloween party nextdoor, but I'm pretty sure we had an even better night!

Monday, October 23, 2017

Just in Time!

Sitting at 41 weeks and 2 days, my client's water broke around 7:30 am on Sunday, Oct. 22nd.  To be honest, I hate when the water breaks before labor starts.  It puts mom in this weird limbo phase of not being in labor, but not able to live life normally either.  Her contractions were mild and far apart, and her water leakage was abundant.  We kept in touch over text throughout the day, but there seemed to be little to report.  

In the early evening, mom and dad began to wonder if they should go to the hospital to get some antibiotics since she was GBS+.  It's such a hard decision.  She wasn't in labor, and once you go to the hospital, it's unlikely that you'll leave.  But they also didn't want to risk anything.  I encouraged her to talk to her care provider and see if they could get permission to get the antibiotics and then go home.  

Her doctor was very supportive and told her it was up to her, but while she was on the phone, her contractions suddenly picked up!  Starting at 8:00 pm, her contractions were intense and coming every 4 minutes!  We could quickly tell that it was time for me to head over!

I arrived at 9:00 pm and found mom laying on the floor of her living room and dad rubbing her back during contractions. I encouraged her to slow down her breathing, but overall she was coping wonderfully.  We stayed like this for a while, and at 9:45 dad gave mom a religious blessing.  He blessed her with power and capacity, and told her that her baby already loves her.  Shortly after, dad's parents arrived and his own father gave him a blessing, as well.


Mom was coping well, but I could tell that each contraction was stronger than the one before it, and I felt it was time to head to the hospital.  With such short breaks in between, it was quite difficult for mom to get ready to leave the house.  There was even a moment or two that I worried we wouldn't make it in time!

 (I loved seeing my book on their shelf!) :)

Thankfully, we avoided a roadside delivery and arrived at the hospital at 10:30 pm.  I quickly updated the nurse on the situation.  At 10:40 mom was checked and was 6 cm.  I felt she was further along than that!  Several minutes later mom said she was starting to feel the urge to push and was making low vocalizations, very typical of a woman about to enter the pushing phase.  


I put on some relaxing music and encouraged dad to sit down next to the bed.  (He suffers from chronic pain and I could tell it was starting to happen.)  The doctor arrived at 11:00, and mom was happy to see that her personal doctor had made it to her birth.  She was checked again and was 9 cm!  That's more like it!  Mom was totally in the zone.  Breathing deeply and even appeared to be sleeping in between contractions.  The contractions spaced out a bit, which is typical right before pushing.


At 11:30 mom was complete and the urge to push was coming.  I could tell dad was really struggling with his own discomfort, but he never left his wife's side.  We were so close!  Mom found her inner strength and quickly  figured out how to push effectively.


And at 11:48 pm, on Sunday, Oct0ber 22nd 2018, this little chunk slipped in to the world!


Weighing 8 pounds 3 ounces, and 21 inches long.


Mom and dad looked their son over, commenting on how he got his mom's fingers and toes, and his dad's neck.  


By 12:10 am, baby was nursing like a champ!

Thursday, September 28, 2017

It's a Girl!

I received a text from my latest client early Tuesday morning letting me know that her water had broken around 4:00 am!  Water breaking is always exciting, but it doesn't always mean that labor is in full swing.  My client was only have mild and infrequent contractions, so we planned to keep in touch throughout the day.  Several hours later she felt like her water had a yellow color to it (which can mean the baby has already had a bowel movement), so she decided to head to the hospital to get things checked out.

I arrived at the hospital at 7:45 pm.  Mom was admitted because of the water breaking, but she wasn't in active labor yet.  The nurse came in around 8:30 to talk about options.  Her main concern was mom being GBS+ and the risk of that spreading into the uterus since the water was broken. After receiving some antibiotics, mom opted for a bluetooth monitoring system so she could get some rest and the nurse could monitor the baby.  (Most labors do not require continuous monitoring, but this one did because mom was going for a VBAC, had ruptured membranes, was GBS+...)


The nurse literally had to use sand paper on mom's abdomen before placing on the monitoring system.  Dad told her to pretend she was at the spa getting a microderm abrasion.  :)  Once everything was set up, mom and dad settled in for some sleep and I went home to do the same.  I was called back shortly after midnight, as contractions had begun to quickly intensify.  But they were short-lived, and after a couple hours, we all decided to get some more sleep.

I arrived the next day at 11:15 am.  Mom had been on pitocin for a little over an hour.  Contractions were definitely intensifying, and mom was finding comfort on the birth ball.  She circled her hips and breathed deeply.

Mom was determined to do anything she could to help labor progress and help baby engage into her pelvis.  At this point in things, her cervix hadn't dilated at all.  So shortly after noon we did some laps.  From that smile, it's hard to tell this woman is even in labor!


Back in the room we listened to "Beauty and the Beast", and tried lots of different positions and comfort techniques.  By 1:45 mom was ready for the tub.  She liked the short relief it brought to her aching hips and tired legs.


Around 3:00 mom was starting to "have her doubts".  Labor is a very emotional experience that can definitely feel like a mind game.  We doubt ourselves and we worry about how long it will last and if we will be able to cope.  Her husband offered snacks and lots of physical and emotional support.  Mom opted for some nitrous to help her relax, and it appeared to help with that quite a bit.  At 3:15 the nurse checked her and she was 2 cm, 80% effaced, and she could even feel the top of the baby's head!  So not the progress we were hoping for, but progress still!  This mom only dilated to 1 cm with her first labor, so this news was still encouraging.

But the contractions were intense and mom was tired.  She wanted an epidural, but she said getting one would make her feel like a failure.  :(  We talked about it and I reminded her that labor is not a pass/fail experience.  After some inner turmoil, mom opted for the epidural and received it shortly after 4:00 pm.  It quickly took the pain away, but not the anxiety of the experience.  We talked for quite some time as mom processed all that she and her baby had gone through that last 36 hours.  

The doctor came in to check on things at 6:30 pm and we found out that mom was dilated 5 cm!  Amazing progress!  Baby was still high, about negative 2 station, but the cervix was thin and was responding well to the contractions.  Such great news!  Since mom was going to settled in for a nap, I ran home to tuck my kids into bed.  We touched base at 9:20 pm.  Mom had been checked again at 8:00 pm and was still about 5, maybe 6 cm.  She was planning on going back to sleep and said she would call me when she was ready to push or if she had any questions or needs I could help her with.

I was surprised when my phone rang at 10:14 pm.  It was easy to hear the sadness and disappointed in mom's voice when she told me her baby was having signs of fetal distress and they were going to do a cesarean.  My heart sank.  It really seemed like everything was lining up perfectly for her VBAC.  I jumped in my car and arrived just in time to snap this photo.

Mom's emotions had shifted quite a bit by the time I got there.  She had taken some time to process the events of the day, and was now focusing on the joy of meeting her baby!  They didn't even know the gender!  Mom was quickly taken back to the OR to be prepped, and dad was taken back at 11:10 pm.


It's a girl!
Dad really loved his one on one time with his little girl while mom was still in recovery.  They took some selfies and there was some serious bonding going on.



Welcome Eva!
Born on her due date
Wednesday, Sept. 27th at 11:22 pm
(about 43 hours after her water broke)
Weighing 7 pounds 12 ounces



This sweet girl was nursing perfectly by 12:02 am!  She may have had a hard time getting out of mom, but she sure knew what to do once she was.

Saturday, August 26, 2017

Homebirth VBAC

I heard from my client at 7:50 Friday evening, saying she was having mild contractions about every 10 minutes.  We both figured it would be a while, but by 9:00 pm she was having contractions every 5 to 6 minutes, and I was on my way to meet her in her home for her planned homebirth. 


I arrived at 9:45 and was in awe at how beautiful her birthing room had been set up.  The glow of Christmas lights, birth affirmations, Hawaiian music, and a doting partner made for the perfect combination of beauty and support.



The room wasn't the only beautiful thing.  At 10:30 pm dad said "Babe, you look so pretty right now."  She really was stunning, and was coping beautifully.  After spending some time sitting, mom decided she was ready to move a bit, so we set out for a late night walk around the block at 10:45.  It was a warm, summer night with stars and crickets, and unfortunately, vomiting.  (If you ever wake up with vomit in front of your side walk, a laboring mom just might have walked by!)


The water enticed mom when we got home, but she was too warm to get in.  So she spent some time sitting on the birth ball and leaning on the tub for support.  I rubbed her back and squeezed her hips.  She breathed deeply and vocalized.  Her mom checked in on her and set out snacks and coffee.  Contractions continued to intensify and at 12:50 she was ready for water.


The water brought back mom's smile and enhanced how much she enjoyed listening to her music.  Both she and dad began to sing along.  The midwives arrived shortly before 1:00, and things quickly intensified again.  By 1:20 mom was needing to focus much more and announced "you're not funny anymore" to her partner.  This is an emotional sign post of transition, and is a good sign of things progressing!

After some more vocalizing and vomiting, mom asked the midwife to check her cervix at 1:45, and she was 8 cm and baby was very low. At 2:15 her water broke and the urge to push began to build.  She pushed in a couple different positions in the tub, and at 2:35 am the midwife suggested getting out and pushing on the birth stool.
 


The position change was just what mom needed, and at 2:47 am on her due date of Saturday, August 26th, her baby boy was born!


Tears of joy came instantly as this sweet couple welcomed their baby.  After a cesarean several years ago, and homebirth VBAC was a dream come true.


The dark pictures don't do any justice to this cute, little boy.  He had so much dark hair, too!


By 3:15, baby was nursing perfectly and mom was overcome with emotions.  


It was a wonderful experience to support this couple as they achieved the birth they longed for!