Agony and Ecstasy
A somewhat young, shy woman having her 2nd baby called me with bleeding: two clots the size of toonies. No contractions, baby moving well. Went in at 1730 for an non-stress test, which was normal (or "reactive"). Literally five minutes after I put her on the monitor, she had a contraction. After checking her (and she was 3 cm with the head nicely down at -1) I did an OB consult for antenatal bleeding, and the decision was made to wait and observe her. An hour later the OB checked her and Sure enough, she went into labour!
During the waiting period between when we did her NST and when her contractions were strong enough to bring her to L&D we had a discussion about labour and pain relief. She had expressed a desire prenatally to avoid an epidural. She had one with her first, which was a really hard back labour, and wanted to avoid one this time. So We came up wtih a strategy: cope as long as possible with different positions, then get in the bath, then if things get really bad, then try the nitrous oxide (laughing gas). She was keen on this plan, and I was excited about this labour, as I feel that having made this plan with her somehow bonded us.
About 9pm she said that they were strong enough that she would have paged me. So, with contractions every 5-6 minutes at about 1030pm I took her from triage to a labour room to break her water and get her on the way. I checked her at that point and she was four cm but the head was way up at -4!! So needless to say, I didn't break her water. A cord prolapse was the last thing I wanted! So had her walk and do squats for an hour and the head came down nicely to -2 and five cm. So at midnight I broke her water for lots and lots of clear fluid. Her contractions took about an hour to pick up, and she was coping nicely while sitting on the ball. Checked her at 4am and she was still 5 but the head was down to 0 station and the cervix had thinned to about 1cm (from being about 1 inch thick), so no intervention necessary. After 2.5 hours, was 6 but was completely thinned out. After that, she wanted into the bath, which relaxed her nicely, but after half an hour, the contractions were getting stronger and she wanted out.
Then things really started picking up. She started the "I can't do this" and wanted something for pain, so I got out the gas, which worked nicely for about 1/2 an hour, then she requested an epidural. So I went through the drill with her about how I would check her first, then we would have to run an IV, and sometimes in a second baby the baby comes before we could get it in. Did she still want to go for it? YES!!! Okay, so I paged neighbour midwife to come in as my epidural certification is not through yet. As soon as I came back in the room, she gave an involuntary push! Checked her, 8cm. Repaged midwife to hurry. With next contraction, saw head (then madly rushed around getting everything together). The contraction after that, there was a good 2 inches of head showing. I took the mom's hand and put it on her baby's head, and the joy of touching her baby and knowing that she was so very nearly done was beautiful. And then she did what I have not ever seen a mother do, and that is keep her hand on the baby as she gently birthed the head, then as the body glided out. She controlled the birth of the head so beautifully that she didn't tear in the least - no stitches! Seeing her ecstasy at the birth was so beautiful. What a glorious birth!
During the waiting period between when we did her NST and when her contractions were strong enough to bring her to L&D we had a discussion about labour and pain relief. She had expressed a desire prenatally to avoid an epidural. She had one with her first, which was a really hard back labour, and wanted to avoid one this time. So We came up wtih a strategy: cope as long as possible with different positions, then get in the bath, then if things get really bad, then try the nitrous oxide (laughing gas). She was keen on this plan, and I was excited about this labour, as I feel that having made this plan with her somehow bonded us.
About 9pm she said that they were strong enough that she would have paged me. So, with contractions every 5-6 minutes at about 1030pm I took her from triage to a labour room to break her water and get her on the way. I checked her at that point and she was four cm but the head was way up at -4!! So needless to say, I didn't break her water. A cord prolapse was the last thing I wanted! So had her walk and do squats for an hour and the head came down nicely to -2 and five cm. So at midnight I broke her water for lots and lots of clear fluid. Her contractions took about an hour to pick up, and she was coping nicely while sitting on the ball. Checked her at 4am and she was still 5 but the head was down to 0 station and the cervix had thinned to about 1cm (from being about 1 inch thick), so no intervention necessary. After 2.5 hours, was 6 but was completely thinned out. After that, she wanted into the bath, which relaxed her nicely, but after half an hour, the contractions were getting stronger and she wanted out.
Then things really started picking up. She started the "I can't do this" and wanted something for pain, so I got out the gas, which worked nicely for about 1/2 an hour, then she requested an epidural. So I went through the drill with her about how I would check her first, then we would have to run an IV, and sometimes in a second baby the baby comes before we could get it in. Did she still want to go for it? YES!!! Okay, so I paged neighbour midwife to come in as my epidural certification is not through yet. As soon as I came back in the room, she gave an involuntary push! Checked her, 8cm. Repaged midwife to hurry. With next contraction, saw head (then madly rushed around getting everything together). The contraction after that, there was a good 2 inches of head showing. I took the mom's hand and put it on her baby's head, and the joy of touching her baby and knowing that she was so very nearly done was beautiful. And then she did what I have not ever seen a mother do, and that is keep her hand on the baby as she gently birthed the head, then as the body glided out. She controlled the birth of the head so beautifully that she didn't tear in the least - no stitches! Seeing her ecstasy at the birth was so beautiful. What a glorious birth!
posted by Stork at 8:28 AM
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