5.30.2007

Friends and Phone Conversations

I received a phone call today from a past client and friend, Shar*, She attended classes with me throughout her first pregnancy and she had a beautiful birth 10 months ago. She is now 34 weeks along with her second and is preparing for the birth. We reminisced awhile and I reassured her that she and her husband would do just fine without me (I now live 9 hours away) while I secretly longed to be able to attend this one as well. She had a wonderfully intervention-free birth and she is a strong and beautiful laboring woman!

Here is her birth story:

On July 10th, 2006, we held class 12 of our Bradley® series. I mentioned at that time that you looked like you had dropped considerably. At that mention, you commented on a slight backache and lots of pelvic pressure that you had been experiencing. I thought it would not be unreasonable to assume you very well could go into labor that weekend.

On July 17th, 2006, I received a phone call from Shar around 2:00pm. You had let me know that you went to the bathroom and was unable to stop the flow once you were finished on the toilet. Thinking something was up; you changed your pad and returned to work. The next pad that you changed had ‘yellowish green color’ to the fluid. Your water had definitely broken and seemed to have light meconium in it. I recommended lying down, drinking a lot of fluids, making sure you had a high protein snack and calling Maryanne after you had established if you were experiencing any contractions.

Arriving at Maryanne’s office around 3:30pm, you were advised to go home and wait for solid contractions. I spoke to you again around 4pm and it was decided I would go ahead with my first class of a new series and you would call me if things were getting interesting. Around 8:30pm, I put in a movie for the class to watch at the same time that Calvin received a call from Tom. He brought the phone to me and you explained that Shar was having contractions around every 5 minutes and that I might want to start getting ready as I would probably be called on sometime soon. After the movie, we cut class a little short and I began preparing to leave.

Around 9:30, I received my third call of the day that contractions were going really well, but that it was time for me to head on over to your place. By this time, the thunderstorm that had been building itself up all day was beginning to pour itself out. I arrived at your place at 10pm. Contractions seemed to be coming between 2 and 4 minutes apart and were relatively strong. You were in good spirits between contractions but very serious and in no mood for idle conversation. Tom found the best way to help you at this point was to assume the ‘labor dance’ position and give verbal encouragement and lower back massage.

You were having good contractions that were quickly moving lower in your pelvis. You alternated hanging on Tom to hanging on the mantle of the fireplace. I applied lower back pressure while following your lead in vocalization. Around 10:40, you began feeling nauseous. I thought it best to call Maryanne with an update. She mentioned staying at the house for another 15 minutes before packing up to leave. While Tom was on the phone, Shar began expressing uncertainty about her contractions and the feeling of pressure getting intensely low. Combined with her nausea, Tom and I exchanged a look and we started getting ready to walk out the door – you were moving into transition.

While Tom was finishing putting items into the car and getting an umbrella, I moved you onto all-fours over the birthing ball, hoping to slow down the decent of the baby until we could get moving into the car. Three contractions later, we had you up and walking to the car. During the trip to the hospital, you knelt over the backseat while I sat in the front, turned posterior, and applied pressure to your lower back. The ride to the hospital was an adventure in and of itself. You continued to mention how the pressure ‘down there’ was getting intense and the contractions were radiating to the front. On top of that, Tom encountered many flooded streets and stopped traffic, torrential downpours, and fallen trees on the roadside; but he still managed to get you there in 15 minutes. I believe we both felt the urgency of the situation.

Your mother, MommaElder, and sister, who had been to your house just previous to me earlier in the evening, met us at ER receiving. Also in attendance was your close friend, and Doula-apprentice, Kelly.

Your little one could not have chosen a more intense evening to make her appearance. As the storm was raging outside, the ER reception area was hectic. We stood in the reception area for a good 10 minutes before I mentioned to MommaElder that we might get moved upstairs to L&D a lot sooner if someone mentioned that you were feeling a little ‘pushy’. She adequately persuaded them with this bit of information, and we had someone meet us within 5 minutes to be our escort to Labor and Delivery.

Though the head nurse was not happy about your decision to walk upstairs to L&D, you were adamant and I was proud! It took 3 contractions to get to the elevators (about 5 minutes), 1 contraction in the elevator, and 3 contractions in the L&D hallways (about 5 minutes) to get to your room. Once we were in your room, we had the daunting task of getting you out of your street clothes and into a hospital gown. This newest challenge went something like this:

Shirt off…

Contraction…

Bra off…

Contraction…

Shorts off…

Contraction…

Underwear off…

Contraction…

Gown on… Success!!!

After you were gowned, and noticing how quickly your contractions were coming, coupled with recently entering transition, the nurses asked permission to do a 20 minute strip and to perform a vaginal check. As soon as you were in the bed, though, your contractions spaced out again to about 4 minutes apart and lasting 60 seconds. Your nurse was wonderful and considerate, taking her time getting you hooked up to the monitor. The pressure was too intense though, and, after only a few contractions on the EFM, you asked for a vaginal check. You were found to be 7cm and 0 station.

Within 10 minutes, and while still on the monitor (around 2 contractions later) you mentioned the need to use the restroom. I confirmed that you meant you felt pressure in your rectum and I mentioned it might be good to find Maryanne and to find out where you were again. The nurse hesitated as she had just performed a vaginal on you only 10 minutes prior. After watching one more contraction while removing the EFM belts, though, she agreed. She found you to be 8cm and +1 station.

Bless her heart; she flew out of the room to try to find out where Maryanne was. Maryanne’s pager was not working because of the storm and she was attempting to get out of her flooded drive.

You were not handling contractions as well in the bed, and I began to suspect that you were going to have a posterior baby because of the level of rear pressure that you were describing. I mentioned that getting up would probably feel better on your back. You did not want to move from where you were at. At that point, moving out of the bed would have probably sped your labor more and Maryanne may not have gotten there in time. As you wanted her there for the birth, we simply moved you onto your knees on the bed, with the back of the bed raised so that you could rest on it. Your contractions quickly changed to grunting at the peak; Tom at your right shoulder and I at your left shared a quick glance that confirmed it – you were pushing at the peak of contractions on your body’s own volition.

Maryanne made it into your room around midnight and had you move onto your back again to check you. You were 9cm with a small anterior lip of cervix and +2 station. She had you move onto your hands and knees, which provided Kelly and I the opportunity to apply much-needed counterpressure to your sacral joints and tailbone. Tom continued to coach you through contractions as they were coming slightly closer together (about 4 minutes) and you were beginning to show a little hesitancy over the pushing stage. He offered you water between contractions and whispered encouragement as your body began the process of bringing a life from your womb and into the world.

Being on all fours allowed Maryanne to manually maneuver the anterior lip back and confirm that yes, your little one was posterior. She attempted to move into an anterior position, but kept sliding back into a posterior position. As soon as the anterior lip of cervix was gone, Maryanne gave you the ok to push to your hearts content.

Pushing seemed to be a really confusing time for you. I believe a lot of it had to do with the odd nature of your pushing contractions. Before Maryanne arrived, your contractions seemed to be making your body push spontaneously on its own. Once she arrived though, your contractions changed to more of a ‘decision’ to push rather than an overwhelming urge. Her posterior position could have contributed to that, or it could be that you were on your hands and knees, keeping the pressure off of your back, and thus, off of your pushing reflex (Ferguson). In any event, it only took you 3 contractions to move her down to the point where we could see her hair.

At this point, I have to interject a funny memory. While Tom was working on verbally encouraging you, I and Kelly were busy providing massage and counterpressure, and Maryanne was busy providing perineal massage, Lisa was at the foot of the bed watching the gradual approach of her niece. From my vantage point, I could only see your back. Because of that, my perception was this: your sister pointing a camera at your derrière, smiling from ear to ear, and remarking ‘oh, it’s got HAIR! I can see it! I can see it!!’... Shortly after that, her remarks changed to ‘Oh, aren’t you cute?!’ (among other baby-babble) while her head emerged.

Back on track, her decent was quick, and it did not take long for you to breath/push her down. Her head emerged smoothly and her body was right behind. In 2 contractions from the first of her crowning, she was fully born. Baby YaYa was born nearly a quarter after 1am on Tuesday morning, July 18th, 2006. Immediately, we moved you onto your back so that you could hold her. She was slow to breath, which was not a problem as, at the time, her cord was doing everything for her. Once her cord stopped pulsing and it was cut, though, she still showed little interest in doing anything except gazing around at her mommy and daddy, so the nurse took her to get her a little agitated and breathing better.

As soon as she was yelling sufficiently to appease the nurse, she returned to your side, where she latched on in the side-lying position on the first attempt. A champion nurser from the start! You only had two small skids (shallow tears), one anterior (probably from her position) and one in the vaginal wall (probably from her quick birth after crowning). You did beautifully! As a team, Tom and Shar, you were a remarkable and beautiful family to behold! Congratulations and welcome to parenthood!

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