Saturday, March 20, 2010

FEBRUARY BIRTHS

Susan was my first February birth, she was expecting her second baby. Rita, my assistant had known her from her first birth. My other assistant, Tera, came along also, so that she & Rita could have more opportunities to work together. Susan had a doula there, who also was a patient of mine. So with 4 women, and her partner's support, Susan walked, rocked. and breathed through her contractions through the night. For a while her cute little boy, hung out with us, showing us his favorite toys, playing hide & seek, & from his point of view, it was a fun party! Then he went to bed, very late, and things got serious. We filled the pool, and Susan delivered her little girl, 8# 11oz.

Friday, March 5, 2010

Quick, Lovely Birth

My last birth in January, after my surprise breech, was a lovely family, expecting their second baby. It's always restorative to have a nice vaginal birth after a c/section. The mom's family background was Polish, and her family was upset about her having a home birth. Even though her father had been born at home himself! My couple showed the parents all the research and explained all the preparations, and safety equipment I would bring. Her father even went on talk radio to ask about home birth safety! Anyway, her family was not present at the birth, but happy with the results! We arrived about 2-3 hours before the birth. The pool was in the process of being filled, pizza was in the kitchen, and their daughter was very excited. Mom was calm and breathing through contractions, until she was ready to get into the pool. Her husband helped support her in the tub and then she slowly pushed her baby girl out, still in the caul! Big sister was thrilled to see her little sister emerge. Now that's a beautiful birth!

Thursday, March 4, 2010

Catching Up/ or Why Resolutions Fail

Okay, so I'm way behind on my birth stories! I had two more January births. One was a wonderful first-time mom, in great shape, well-prepared, starts labor at around 10pm. I had checked her 3 days before, on her due date, she was 2 cm, 80% effaced, head at 0 station, rope and ready to go. They called me at 1am, to let me know her bag had broken, and the contractions were picking up but they were fine for now. At 3:30am they called again, and said they were ready for me to come, and so approximately 30 minutes later, I arrived at the home with my assistant. The patient was leaning on the table, breathing through contractions, and sounding a little pushy. So I offered to check her, she was 8 cm, but instead of a head, there was meconium and a frank butt! Even though I have delivered quite a few breeches, this was a primip, which makes it more complicated than a quick multip breech. I called Dr. Gomez, my collaborative physician, to see if he wanted me to bring her to him, but since she was starting to feel pushy, and having a relatively quick labor, we decided to go to the nearest hospital, which was Norwegian! So, I called ahead and let them know I was bringing in a surprise breech primip at 8-9cm. When we arrived at the hospital, after the usual hospital bureaucratic stuff (different nurses fighting over who would take us up), stopping on every floor in the elevator, with my poor patient on hands and knees in the wheel chair, because it was more comfortable for her - we finally arrive at L&D, and are put in triage, then moved to a room, then moved back to triage! Finally the attending comes in, and checks my patient, only to find a pair of balls sitting at my patient's perineum. So now we knew we were having a boy! I turn to the MD, and asked if she would consider delivering her vaginally, since the baby was right there. She told me she had never done a breech delivery. So she took my patient back into the OR, let her try pushing once, and then started cutting, Boo Hoo! At the end of the c/s the OB surgeon arrived, they had been calling the wrong pager for her, and wouldn't you know it, she had more than twenty years of experience under her belt, and delivered many breeches.
The good news is my patient feels like she had a vaginal birth and a c/s, and with luck the attending MD will decide to learn how to deliver a breech, especially when they fall into your hands, and especially when even midwives know how to do it!

Tuesday, January 26, 2010

January 17th Birth

Oops, forgot a birth! January 17th, I had a wonderful birth in Naperville. My mom had a previous history of gestational diabetes, diet-controlled. She was still following the diet, but wanted to avoid all the sugar testing. Which I was fine with, as long as her random sugar was fine, her weight gain reasonable, and she wasn't spilling sugar. Her blood pressure was borderline and as birth got closer her anxiety about birth started increasing. Not about home birth, but she had some previous history of vaginismus, and sexual abuse as a child, so her fears were mounting. But she was fantastic! She labored beautifully in the tub, breathing through her contractions,while her older daughter slept in the other room. Her partner helping her by his calm presence. With pushing, her fear surfaced again, but she pushed past it and through it with some encouraging words from all of us. And soon enough, delivered a beautiful baby boy, 9 # 2 oz, my second boy that weekend.

Saturday, January 23, 2010

TWO BIRTHS ON 01/20/10

What a fantastic day! At 9 am, I heard from A.H.,my one of my primips (expecting 1st baby) that she was in labor and doing fine. I talked to her & her husband about using the shower as a tool to help deal with contractions, eating & drinking fluids, and resting now if possible to get ready for the hard work ahead. Then I hurried off to make some of my prenatal home visits. On my way, I contacted one of my assistants, Mandy, since she was also the doula for AH, to see when she was planning on getting there, and if she could assess and contact me on AH's labor progress. A little after noon, I heard from Mandy that AH was 7 cm already! and so I rescheduled my office appointments and headed off to AH's place. When I arrived, the pool was being filled, and AH was on her hands and knees, using the ball, and breathing beautifully through her contractions, with her partner by her side, reassuring her. Mandy & I continued setting up equipment, AH's friend made us all some coffee, and another doula assistant, Regan arrived. We all worked together, helping AH with her back pain, getting her to nibble on food and keep hydrated, as she worked through the last few centimeters. After a while she wanted the pool. She leaned over the side on her knees, sat back on the built-in stool as the pressure in her pelvis increased and she started getting the urge to push. After a few trial pushes, I checked her, and she had a tiny right-sided cervical lip still to breathe through until she could push. We tilted her a bit that direction, to help it reduce, thus insuring the head was well-applied to the cervix. And a few contractions later, her water broke and she started pushing in earnest. At first she sat on my portable birth stool that we placed in the pool, and the she went back to hands & knees, and finally back to the built-in pool cushion, and after an hour of good pushing, we were seeing a beautiful amount of dark,thick hair at AH's perineum, and then in no time, the rest of her 8# 1oz baby was out. None of us saw the sex of the baby, until AH reached down with her hand, under the towel, to feel the sex of the baby! A baby girl! Total labor time: 8am to 5:43, like a day at work, but so much better!
In the mean time, I heard from another client JY, expecting her 2nd baby, that what she had been ignoring for the last hour or two, was labor! So I called another assistant, Rita, the Super Doula!, to head over there. JY said she didn't need anybody yet, but I always worry about my second baby moms, underestimating how quickly they might go. It is hard to believe after a long first birth, that your body can do all that it needs to do, without hours & hours of pain. So sometimes my moms wait to be in pain, and then usually that is too late, because that means the baby is coming! So when Rita & her assistant Casey arrived, the timing was perfect. The contractions were just starting to get more difficult, and JY was glad they were there to help. I called, and said I would be on my way there shortly. I finished up with AH, the repair - (the baby had a compound presentation with her posterior hand, which sometimes gauges out the lower vaginal tissue), started breastfeeding teaching, and quickly did my newborn exam. Mandy, my asst remained with the family a while longer to help.
When I arrived at JY's, she was in the tub, and starting to feel pushy...so I was just in time! My assistants helped set up my equipment, and then JY's daughter told us all about the vagina, and that some day she was going to have a baby through her vagina also! So now that we all knew where to look, JY started pushing, and felt a pop as her bag ruptured. She tried several different positions, on her knees helped with her back pain, along with Rita's magic fingers. But eventually we encouraged her to sit back, because the water was a little low ( it was a kiddie pool, not a birth pool) and my worry was the baby would deliver half-in and half-out of the water, which won't work. Once baby's head is exposed to air, it will try and breathe, and we don't want it to breathe in pool water. So we leaned her back, which meant also that JY could reach down and catch her own baby, which she proceeded to do with our encouragement. We helped reduce a nuchal cord, and then she brought her gorgeous baby boy to her chest. Within 10 minutes, that boy was nursing away! After we got mom all cleaned up, the rest of the family came over, and his proud older sister held him in her lap, as us, the tired assistants, ate pizza! What a fun day, 2 babies, first a girl & then a boy. One 8# 1oz, and the next 8# 2oz.

Sunday, January 17, 2010

FINALLY, A BOY!

A long-time couple of mine, finally delivered a gorgeous baby boy! While their 2 little girls were sleeping upstairs, my mom (I'll call her Frieda!) finally had a planned home waterbirth. After a previous, exciting, unplanned home birth on the bathroom floor with #2 baby, as I unknowingly, drove past the emergency vehicles on my way to supposedly meet them at West Suburban Hospital. So this time, I was there in time, and Frieda had to work a little harder to get this baby out, which is the way of third babies sometimes. Though this labor was only 2 hours long, I know Dad was happy to have some other hands there to help catch the baby and reduce the tight nuchal cord. Third babies are always interesting, I think we always compare labors to our last one. So after a long difficult first labor, sometimes we are caught off guard with how relatively easy & fast the second baby is, which leads to realizing with the third baby, that though remembering how easy #2 seemed, the reality is that birth still requires some hard work.
We, midwives, know that third births are always an unknown; that they just can be a little more difficult, but Frieda was wonderful, and just quickly rose to the challenge of working a little harder to bring her baby boy into the world. So congratulations to my family, thanks for including me in your births, we have had a lot of fun over the years.

Friday, January 8, 2010

NEW YEAR'S RESOLUTION

My New Year's Resolution, besides the usual to lose weight, exercise more, donate more time & money & the big one: promote world peace; is to write about each birth, which is probably the only one I can accomplish!
And so to start the New Year off - of course there was a New Year's Day baby, but fortunately it was a lovely primip mother. She had been having contractions for several days; annoying, painful contractions every 7 to 15 minutes since Tuesday night. By New Year's Eve, she was exhausted. Her parents had come in to town, to support her & her partner through labor, and everyone was tired. When I arrived Thurs evening, she was still only 2 cm! And so we decided a little sleep would only help everyone, and it worked! In the morning, she was in a much better frame of mind, ready to get everything going. When I arrived back at her lovely 3rd floor home in Hyde Park, she was 5 cm & stretchy to 7cm, yeah! I then swept her really well, releasing prostaglandins, and she continued slowly progressing all day; however, her contractions mostly stayed around 5 minutes apart, but were still easier for her to deal with than her earlier latent labor contractions the day before. She walked, showered, & Oomed her way through contractions, eventually spontaneously ruptured her bag of waters, and pushed for 2 hours to deliver a beautiful little baby girl, 6# 6oz. We all felt like we had accomplished something! If we had been in a hospital, she would have been pitted, and probably given an epidural or a sedative drug. The whole family got to watch & participate, seeing that patience & belief in a normal labor, even a long labor, can be successful and wonderful. My new mom thought the prenatal yoga tapes helped her the most to deal with her labor. And I'm sure that a birth date of 01/01/10 must be auspicious.