Saturday, January 26, 2019

A Difficult Induction

My latest client texted me Thursday afternoon letting me know that she was in the hospital being induced!  A combination of labs and high pressure made the induction necessary, even though she was just 37 1/2 weeks.  Her bishop score was about as low as it could be, so the OB prescribed cytotec to ripen the cervix.  Ripening can take a long time, especially with a first time mom with a closed cervix.  So I prepped them for a long road ahead, and was really surprised when they called me about 12 hours later to join them at the hospital!

During the night, contractions had started and her water had broken.  She also had the added bonus of vomiting profusely for a while.  I arrived at 3:30 am and found mom laboring in the tub.  She was vocalizing through her contractions.  She got out of the tub at 4:15 and we tried some different positions to help baby rotate.  Over the next few hours we tried many different positions and techniques for pain management and progress.  At 5:30 am she turned to me and said "it's getting more intense and I'm not loving it."  Totally cracked me up. 

At 6:30 am the nurse went over some options, explaining that the OB would be in soon and would want to check her and probably start pitocin.  At 7:20 the OB arrived and checked my client, and after all that she had been through, she wasn't even quite 1 cm dilated.  Her baby was high in the pelvis and her cervix was 50% effaced. 

We kept walking and leaning and breathing and massaging as the morning continued.  We listened to music, walked the halls, and used the rebozo.  The baby's heart rate was near impossible to find, and my poor client was constantly being poked and prodded as the nurse unsuccessfully searched for a good place to put the monitor on.  Pitocin was started and things were intensifying quickly.  At 10:00 a doctor was called in to do an ultrasound to help locate the heart, but even that was fruitless.  What finally did make the difference was an adhesive monitor. 

Mom was coping through her contractions beautifully and was starting to even have bloody show.  I was feeling so encouraged about her progress!  The heart rate was finally being monitored but mom's back pain continued to sky rocket.  We tried everything to get that baby to rotate! She opted for some nitrous, but it brought back her nausea, so that was a no-go. 

At 11:20 mom asked for her cervix to be checked again.  By this time the cervix had come forward and fully effaced, and baby had descended and engaged in the pelvis, but she was still only dilated 1 cm.  Very discouraging after almost 24 hours of hard work! Mom needed a break, and she got one.  By noon she had an epidural, and we all said "good night".

At 2:15 mom was 5 cm and baby had descended further into the pelvis!  I couldn't believe it!  Things were finally going smoothly.  But it didn't last long.  Shortly before 5:00 pm the baby started to have issues with his heart rate and mom's cervix began to swell.  The decision was made to deliver the baby via cesarean. 

Some tears were shed.  It's an emotional crossroad when a mom has to say goodbye to her birth plan in order to say hello to her baby.  Of course the main goal is to always get to the baby, but a woman's experience and goals are meaningful, too.  Inductions make those goals harder to reach, but sometimes factors beyond our control make inductions necessary. 


  1. The amazing didn’t stop there. It had been great to see Marie add so much positivity and try to guide things to a good outcome, but as she described didn’t end as was envisioned. But skip to now a day later and both are doing fantastic. I will add to the story as I saw it. What I have described in my own life as ptsd from a son in the NICU a decade ago, turned out here to give me the strength and knowledge myself to know what to do and when to raise my hand when my child can’t. And to stay calm through all of this somehow.

    C-section is something I didn’t realize really what that means. It means as a woman you give everything up and it all comes outside your body so baby can be healthy. Baby is rudely ejected into the world into the most protective place with the perfect people to make sure life is sustained and all is going to be well.
    While mommy was being put back together our baby was struggling to breath and get all the amniotic fluid out of his lungs. He looked at me with one eye partially open and clearly was surprised to be there also. But he took all their prodding and tests like a champ and they kept seeing his blood ox go down in the 75% to 80% and did some warning and I touched him. He recovered into low 90% and was able to move to mommy still being reassembled 35 min later. She lit up with love and I cried with her in joy. I was taking Wyatt to the recovery room and there as soon as we sat down I noticed he was changing color going darker and not pink enough.
    So back to the monitors and 80%. As soon as gave some oxygen it shot up. Take it away back down, so NICU called back in and unfortunately as mom came in we had to leave and take him there.
    I have seen this once before is like a symphony of people all with one focus, Wyatt and I held hands as they poked prodded, glued sensors to him, at no time did anyone seem worried or not know what to do they divided tasks and communicated with each other in the same way Ferrari parts are all synced to get you from 0 to 200 in 6 seconds.
    Wyatt was where he needed to be and as things settled all of the people then began reassuring me and telling me what their thing did, the respiratory therapist about his oxygen and humidifier cpap that was now keeping his so2 at 98% and the neonatologist a Jedi in the ways of babies telling what they saw and what was the plan going forward and how everything together was meant to get him back to normal.
    His sugar was very low, so he didn’t cough strong enough to get it all out and some fluid was still in his lungs causing the issues. Fluid that could have an infection so all precautions were in place to to get his energy up and scans showed exactly what was up. Plus they looked at everything because they can. Heart strong, brains hopefully better then mine they fully analyzed everything so fast.
    An hour or so later it was just me and his nurse a truly amazing human who was so in touch with Wyatt she had prePrepared everything she knew each person would ask for as the came in one after another they asked her to get this or that she told them where it was next to him ready. Was amazingly amazing. I don’t know if there was extra stuff but he got what he needed faster because of her magic.
    Wyatt was actually fine with it all and the monitors all showed the correct numbers something I knew how to look at from a prior nicu visit. He was actually crying a bit but also looking around and starting to explore life. He held my finger very tightly assuring me of his strength.

  2. Mommy was a wreck but was able to come down and visit I think still in a state of shell shock but it was so good to see her well and I saw Wyatt respond to her touch he knew it was mommy.
    With some help with all the wires she was able to hold him skin to skin and he got to go to my favorite spot right were her neck meets her chest, a happy spot of perfection that smells like peaceful. He and she got some time even with all the sensors and tubes to connect. Still when oxygen cut off his SO2 dipped but not as bad as before.
    I went back to the room with Mommy and was pleased to hear all my fears of her being in several pieces were irrational and she was glad I had stayed with baby. She was upset about it all and exhausted as she ever had been in life but had already gotten to whatever baby needs and I don’t care just want him good. And she was happy but worried I tried to tell her all the positive things and was good for us to touch.
    At midnight when I went back to visit Wyatt, dramatic progress had already been made. He looked better, less oxygen was needed to sustain his blood oxygen and literally everything they told me they were going to do was having the effect they said it would.

    The why I typed this.
    My wife is the strongest person I have ever known. She just gets everything done. And here she did pregnancy great, gave it more then every shot to do a vaginal birth, and then did exactly what was best for her and baby to use everything available to ensure the best possible outcomes for both. With out a single pause stepping up to every challenge just like she was ready to do.

    And this-

    Never ever don’t go where the science is. For the Boise area this means deliver at downtown St. Lukes. Not Meridian St. Lukes, go look up levels of NICU. Go to the highest NICU level you have in your area. No home birth, no birthing centers, this idea of gluten free organic birth is the dumbest idea ever and goes along with the anti-vaccine movement as one of the biggest harm of children in the history of earth. You might not need the NICU, but if you do, will be the best decision your child will deserve.

    And seriously.
    It is entirely natural to use electricity and natural to not use wood fire to heat your house. An iPhone is 100% naturally the way we communicate, find things organize have a camera no one will ever go back to using all 27 devices the modern phone has naturally replaced.
    If you need you life protected, the best there is, who cares about money, life is more important go to a NICU. Stop thinking ancient times is better, and make natural include what we as humans have developed overtime and using evidence based on the scientific method that ensures the decisions made are based on facts, not feelings. Not some dumbshit online making stuff up to sell an idea so fowl it kills people. Fuck the celebrity saying it causes autism when they are clearly autistic themselves to believe that. Look at journals, read science textbooks look to MIT or other elite schools and stopping looking at tv, or other online people just like yourself all grouping up together to prove they all believe the wrong idea so it must be good. Any statistics you are getting about so called natural stuff isn’t real, no blind studies no facts complete lies to push a fake idea. Doctors know shit, believe it before you need it.
    Love is all you need, there is a song about it, and love is all there is in a quality NICU I really know this now.