Thursday, September 29, 2016

Time To Cut the Cord

A little over two years ago, I attended a pretty scary shoulder dystocia birth.  Everything worked out fine, but those first couple minutes were very nerve-wracking!  So when my client told me she was expecting again, I knew shoulder dystocia would be a big concern this time around.  

After several weeks of having contractions, my client was admitted to the hospital late Tuesday evening, dilated to 5-6 cm.  They called me around 11:40 and I arrived shortly after midnight.  Contractions were coming regularly, and mom was sitting on the birth ball and swaying,  After about an hour, mom climbed into bed to rest... and totally fell asleep!  By 3:00 am, contractions had pretty much stopped and mom was given the choice to sleep or have her water broken.  

Mom decided to continue sleeping and have her water broken in the morning.  So I went home to grab a few hours of sleep, too.  

At 9:30 am, her midwife broke her water.  She was 7 cm, but still not in active labor!  To encourage her contractions to pick up, we went walking outside in the courtyard.

The fall leaves were gorgeous, even though it was about 80 degrees outside!  Mom leaned over during her contractions and swayed her hips while I provided counter pressure.

The midwife came back around noon to discuss what would happen if this baby also had shoulder dystocia.  She recommended a drastic position change.  This information is great to have beforehand, as I have had clients with shoulder dystocia be very confused and alarmed when a team of nurses is suddenly forcing them into a different position.  

By 12:20 contractions were strong, and at 12:40 mom said "I must be in transition because I don't think I can do this!"  But she was doing it and doing it extremely well!  She was so focused and calm, back on the birth ball and listening to music.  Several minutes later I could tell we were close, so I ran out to find the midwife.  At 12:50 mom was 9 1/2 cm and starting to feel the urge to push!

Mom pushed in a modified hands and knees position on the bed.  Once the head was out, our fears were confirmed and it appeared that shoulder dystocia was preventing her baby from fully being delivered.  Quickly, everyone helped mom flip over onto her back.  The shoulders started coming, but something else was holding this baby in.  He was all wrapped up in the cord.  So wrapped up that the midwife clamped and cut the cord right then and there!

In 13 years of attending births, I have NEVER seen the cord cut before the baby is delivered.  But once it was cut, this little cutie slipped into the world at 1:17 pm, Wednesday, September 28th, 2016.

Tipping the scale at 8 pounds 13 ounces, he was a little shell shocked, but not near as bad as his brother had been.  The nurse took care of him while the midwife continued to care for the mom.

We all agreed it wasn't as scary as the last time, but I'm sure it still had dad's heart racing.  Here he is watching his little boy figure out his new environment.

It's hard to not hold your baby right away, but it didn't take too long to reunite these two.  Even though this baby was struggling at first, he perked up quickly and was perfectly latched about an hour after birth.  

Welcome to the world, Weston!

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