Sunday, March 31, 2019

Face Presentation

 My latest client is a repeat client from Oct. 2017.  Her last baby came 9 days late, so we weren't expecting an early delivery this time around.  Once 41 weeks hit, talk of induction was abounding, but this mama did not want to induce.  She scheduled an induction for the very last day possible, and ended up giving birth the day before her time was up!

Her contractions began early Saturday morning, around 2:00 am.  But by sunrise they had stalled out quite a bit.  We kept in touch throughout the day.  She contracted sporadically and lost her mucus plug around 5:00 pm on Saturday.  But by bedtime things were pretty chill, so we both went to bed.  She woke up with contractions every 10-15 minutes at 3:30 am, and by 7:00, it was time to head to the hospital.

I arrived at 8:00 am and found mom laboring in bed with dad offering support and encouragement.  Mom was feeling "shaky and emotional", which is a pretty normal way to feel in labor!  She was 6 cm, and we assumed things would progress really fast like last time. (Last time we arrived at the hospital at 6 cm, and her baby was born 68 minutes later.)

 At 9:00 the OB arrived and mom was now 8 cm, 90% effaced and her baby was at zero station.  There was a bulging bag of water, too.  

We spent the next couple hours changing positions.  I rubbed mom's back during contractions while dad pretended not to have a headache.  (Poor guy suffers from chronic, cluster headaches.  I kept telling him he could take a break, but he wouldn't leave his wife's side.)  After a trip to use the restroom, mom literally crawled across the floor and back into the bed.  Not a glamorous way to get around, but a great way to change positions and encourage good positioning!

At 11:30 we were all a little surprised that things weren't progressing.  I kept wondering what would happen if the water broke.  In an attempt to see if gravity could help us break the water, mom got out of bed and did some leaning and lunging on the edge of the bed, and at 11:40 her water leaked.  It wasn't a gush, but there was definitely something.  But it didn't change anything.

At 12:30 the OB came back in and mom was 9 cm, but there was still a bulging bag of waters.  The OB offered to break the water to see if that would encourage the baby to descend more.  She broke the water and exclaimed that the baby "came down miles", ha!  

Things did intensify a bit, but I was surprised that the urge to push wasn't taking over yet.  Dad and I held each of mom's hands while she moaned almost continuously.  She was totally in the zone.

At 1:10 mom said she wanted to push, so she was checked again and was complete, and baby was almost at +2 station.  I could tell the urge to push was still a little off, but mom worked hard and figured it out! 

Several minutes later we were all surprised to see a little face presenting instead of the crown of the baby's head.  A face presentation is rare, and often requires a cesarean.  But with the skilled technique of the OB and mom's incredible strength, this baby girl was born at 1:36.

Weighing 8 pounds 6 ounces

I was so happy my client was able to have the natural birth she desired and was able to go into labor before she needed to be induced!  So often women feel like they will never go into labor, but they will.  :)  Even if it is 12 days late.

Tuesday, March 5, 2019

44 Hours

 My latest client started texting me Sunday morning saying she was having low back pain, and what felt like menstrual cramps.  We kept in touch throughout the day, and I made sure to get a Sunday nap because I assumed we would be up all night!  She went to the hospital at 7:00 pm, but was sent home with a sleeping pill because she was only dilated 1 cm.  At 3:30 am her husband called saying they had been admitted to the hospital at 4 cm/80% effaced.  

I arrived at 4:3o am and mom was still struggling with back pain.  So we did lots of position changes and I provided back massage during contractions.  At 6:15 an ultrasound confirmed that baby was posterior, so we continued working to get baby to rotate by moving often and utilizing hands and knees positioning.  At 6:40 her husband turned to me and said "I'm so glad you are here!".  :)

At 7:50 mom spent some time in the tub, but her contractions were so spaced out she decided to get out and move around more.  She arrived at the hospital with contractions coming every 4-5 minutes, but now they were every 6-9 minutes.  The nurse mentioned breaking the water or starting some pitocin, but my client wanted to keep working with her naturally progressing labor.  We also discussed the possibility of going home for a while if the cervix wasn't changing.

At 10:20 mom endured 3 cervical exams before the nurse with the longest fingers confirmed that mom was now at 6 cm.  To be honest, I was pretty surprised!  I didn't think we would be making progress with so few contractions.   So the option to go home was gone, but we still needed to speed up contractions.

Mom was motivated and energized.  She walked up and down several flights of stairs, stopping to lunge during her contractions.  Things started to pick up and mom said it was "a good pain".  

The entire day mom was all smiles.  She had originally planned on getting an epidural, but found that she could easily cope with her contractions, and that she preferred being able to move and work with her labor. 

At 2:30 pm her OB stopped by to check on things.  Mom was now 7 cm and 90% effaced.  She offered to break mom's water, but mom wanted to let things progress the way they were.  At 3:30 mom decided to get in bed and rest in between contractions, and they spaced out to 10 minutes apart!

Mom got out of bed at 4:15 pm and contractions picked up again.  Her own mother attended the labor and offered lots of physical and emotional support throughout.

We hit the hallway again to keep things moving and stopped in the family waiting room to talk to all the expectant grandparents.  Both sets of grandparents came from India for the birth.  I loved learning more about their culture and awesome family values.  I met them all about a week ago and answered many questions about birth in America and the support I would be giving their daughter.  It was such a fun night!

At 5:30 pm mom was now 8 cm, but progress was coming slowly and night was quickly approaching.  We were starting to worry about mom being able to maintain her energy throughout the night, so the decision was made to break the water, which would hopefully speed things up.  Losing the water put extra pressure on the baby and we worked with the nurse to find positions that worked well for both mom and baby. 

At 8:30 pm mom was still 8 cm.  Contractions were getting more painful and closer together, but it was clear that the birth was still hours away.  Mom opted for an epidural and a well deserved nap.  After sleeping for a few hours, mom was at 9 cm, so some pitocin was started to help mom get through the final dilation.  But baby didn't like the pitocin, so it wasn't on for long.  

At 3:30 mom was finally dilated to 10 cm and it was time to push.  I assumed that pushing would take several hours because everything had progressed slowly throughout the entire labor, and because she was a first time mom.  But I was wrong!  

Less than an hour later, this sweet little girl arrived!

She had so much thick, dark hair.  So adorable!

What a journey!  Approximately 44 hours from the first text to holding her baby!

Welcome sweet baby girl!
Born Tuesday, March 5th 2019 at 4:14 am
One day before her due date.
Weighing 6 pounds 2 ounces