Thursday, July 25, 2013

A birth story....with educational editorials.

Yesterday, although the moon was not technically full, it was still very big, and very round...and one cervix got the idea to follow.  It was one of those blessed events in the life of a Doula, or any other on call professional, a 7 am call following a full night of sleep.  After hearing about what was happening so far, I told her that I was ready to walk out the door at any time, nothing planned, I was up and at 'em.  She had a contraction while I listened and she said they would call again.  "Ok", I thought, knowing it wouldn't be long...and it wasn't.  Maybe 15 minutes later I was told that they were headed to the Eastside Birth Center (a gorgeous 2 room, out of hospital birthing center Bellevue, Wa) after they woke their daughter and delivered her to pre-school.  I left the house quickly because I very rarely travel in peak traffic, in fact I've almost arranged my life around NOT being out driving in that mess, and didn't know how long to expect to sit and wait.  It wasn't too bad and I arrived an hour or so before they did.  The first person I saw was her Dad.  He was to be the photographer, as well as additional support. I want to specifically take a moment here to give him a compliment.  Now, I know that men can be nurturers.  I, myself have managed to surround myself with openly kind, nurturing men to the point that the lack of that characteristic defines a person as "less manly" to me.  I believe it is in their nature and that men who suppress it are being inauthentic, trying to live up to perceived social expectations. Not man enough to be real.  But this father, well, he took it to another level.  Dad's, meaning the father of the mother in labor, are rarely in the room for the delivery.  I have never really questioned it.  This Daddy redefined the circle around a laboring woman in my mind yesterday and opened it up.  It made me wonder why I didn't have my own Daddy in the room, and if he (even though he might not admit it) wished he could have been there, or wished that I wanted him there.  I think now, after witnessing this birth, that I would have liked to have had him in the room, he always makes me feel safe and confident. Not that this is about me, but I do really mean it when I say that every birth is continuing education and every mother is my teacher. I look for lessons everywhere.
Soon then, everyone else arrived. I'm so happy that this Mama had the team she had.  Her husband, also a nurturer, her Mom, her best friend (also expecting and due any minute), me, and her midwifery team.  A real circle of support. They all arrived around 9:30am.
We stood for quite some time, massaging her back and talking her through contractions as she got settled into the new environment.  Contractions never really slowed down, a great sign that labor was progressing.  Very often, the car ride causes a spike in adrenaline or cortisol (fear, excitement, anxiety, nervousness, stress all induce a hormonal response) which can interfere with labor hormones.  Our bodies are designed to slow/stop physical processes when stress/fear erupts.  As if your body still thinks it lives in a cave on a prairie and adrenaline means there is a predator stalking you.  Interrupt labor to seek safety.  Once in active labor, however, a little adrenaline is unlikely to have much of an effect, so when the contraction pattern doesn't change in response to a car ride and dropping your daughter off at pre-school while in labor, it's a good sign!  After a short time, Mama wanted in the tub.  We had her spend a few minutes in the leu, which help labor progress (since we're trained since toddlerhood to relax the pelvic floor muscles while perched here) and allows her to empty the bladder.  While she was there I noticed that she had "the purple line", a line that presents by a laboring woman's natal cleft.  It was appoximately 5cm in length and 1cm off center.  See this article for more information:
I've only recently started looking for this, but so far I'm 3 for 3.
She then moved to a beautiful corner soaking tub with enough room to move and change positions freely with less gravity acting on the body(ies).  She labored beautifully, moaning/vocalizing through her contractions and changing position often.  Her very attentive husband was sitting up on the edge in the corner, feet in the tub, to rub her back and put pressure in the right spots.  The rest of us were around the front of the tub, the midwives periodically creeping in to take blood pressure, listen to baby, and check in.  Because Mama was GBS+ (tested positive for the Group Beta Strep bacteria), the midwife sat by her side and held her hand, and her arm as she administered antibiotics via I.V., helping Mama to keep the needle still during contractions.  After awhile in the tub, her noises began to change, lower deeper moans, with an audible downward press, which could verify my earlier assessment of her dilation using the purple line as the indicator, at about 8-9cm.  There were no exams, there was no imposed technique, she was listening to her body's queue's and following it's direction, perfectly.  She began to give occasional true pushes and moved a likely anterior lip out of the way on her own without guidance or assistance.  Once she began to really push, baby was already very low, the water broke after a few pushes and the baby followed, only requiring active pushing for about 30 minutes.
Mama was calm, beautiful, powerful, and then shocked and thrilled to be holding her son.  There were tears all around, joyful and adoring.  He began to "pink up" right away, crying and making noises.  He was brought up to Mama's belly/breast and there he stayed,  opening his eyes and seeing the world and his parents faces for the first time, as we watched.  The cord pulsed, he got his blood, then it was cut by Daddy, right there in the tub.  The placenta was effortless and painless. After that is was really a reception, a relaxing few hours spent supporting them as they looked over and adored their new baby.  Welcome baby T.

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