Friday, April 28, 2017

4 Hours of Pushing is Enough

After texting throughout the day on Wednesday, I was pretty convinced my client wasn't in early labor.  Boy was I wrong!  Her husband called me at 3:30 am on Thursday and told me contractions were consistent and gaining intensity.  By 5:00 am, I will with them at their home.  I found mom on the birth ball, in a dark room, listening to music and breathing through her contractions.  She was doing great! 

The plan was to labor at home as long as possible, but things seemed to be picking up fast, so we left for the birth center shortly before 6:00 am.

Baby sounded awesome all day.  No matter how hard labor got, his heart sounded like running horses every time. 

Mom was incredibly instinctive.  She often swayed, and changed positions frequently.   She would spend time in the tub, then get out and walk, then squat, then kneel.  Things would get intense and she would become very quiet, then they would ease up and she perk up and chat a bit.   She also had periods of energy and fatigue, and would usually lay down to rest every couple hours.  She labored beautifully for hours.  Very relaxed and focused.

Always by her side was her awesome husband, who offered tons of physical and emotional support.  As you can see from the pictures, these two are an amazing team.

Mom's water broke on its own while she was laboring on the birth stool. After several hours of almost having the urge to push, we all hoped this would be the event that got the ball rolling. 

Around 1:45 we were all confused as to why the birth wasn't moving along, so the midwife offered to do a cervical exam.  Without a contraction, her cervix was only 4 cm dilated, but would open up to 9 cm during the contractions.  Some nerves and emotions kicked in, as they often do, and mom decided to look at some of the cute baby clothes she packed to help her visualize her birth and find the strength she needed to keep going. 

Contractions continued to grow in intensity, but the urge to push was still absent, and mom was getting tired and a little discouraged.  She opted to use the nitrous for a while, and was able to rest and remain calm.  She was checked again at 3:30 and had just an anterior lip left on her cervix.  The midwife broke the bag of water a little more and suggest we spend some time on hands and knees to help get rid of the cervical lip. 

 We tried every position and every comfort measure to help this mom cope and this baby descend.  By 5:10 pm, it was time to really start pushing. 

She pushed on the birth stool...

She pushed in the water...

She pushed on her side.  She pushed in the bed.  She pushed standing up.   She pushed on the toiled.  She would have pushed on the roof if we had asked her to.  I really am in awe of her strength and endurance.  This woman is beyond tough.

 Baby was coming down, but it was happening slowly.  His heart rate started to slightly drop and the midwife began to worry that much more pushing would put the baby into distress.  Around 8:50 we began discussing transferring to the hospital for a vacuum delivery.  It was a hard decision to make, and not at all what anyone wanted to do, but this baby needed a little extra help getting here. 

I think we can all imagine how uncomfortable a drive to the hospital would be after almost 4 hours of pushing!  But with the help of a vacuum, this woman was finally able to get her baby out!  His head came out a little crooked and he was a little stressed, so he was quickly put in the care of the NICU team.

Welcome Mason
Born Thursday, April 27th, 9:48 pm
8 pounds 6 ounces

Baby needed some help with his breathing, but dad was able to spend some time talking to him and was able to head up to the NICU with his son.

Thankfully, mom was able to steal a quick snuggle before her baby was taken up to the NICU.  Separating mom and baby can be really difficult, and is never on anyone's birth plan.  Baby is improving quickly, so he must get his strength from his amazing mom who endured so many hours of labor and pushing to get him here. 

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