Birth #0020

This birth story has been shared with the permission of the birthing mama, and is shared in hopes that people who read it will learn and grow from it.


At 41 weeks, the mama I worked with was getting anxious to meet her baby. In our prenatal meetings, she had communicated that she wanted to have an unmedicated birth and use hypnosis techniques during her birthing time. During the week following her due date, the mother would awake nightly to the full moon, beaming through her window, accompanied by consistent contractions. Every morning, her labor would slow back down and eventually nothing seemed to be happening. The family called me over to talk about how frustrating it was that things weren't happening. I spent some time talking with them through some of their frustrations and fears as well as hopes for their birthing time. The mama was able to admit to me that she was unsure if she could handle the discomforts that labor and birth would bring. I reminded her of all of the techniques she had been practicing for weeks, and that she had absolutely all of the power and strength that she would need to birth her baby. I reminded her that women experience labor all over the world, and that she would be able to do it too. I stayed with them, got them comfortable and helped the mama try to relax. She began experiencing contractions soon, and I reminded her of all of the tools she had to cope with the whole process. I decided to go to my day job, and they told me that they would check in with me throughout the day and let me know when they would want me to come back. Throughout the day, the mama continued to have consistent contractions, and mom and dad where both enjoying spending time together, relaxing and resting in preparation to meet their baby boy. After I was done with work, I came over to see how things were going. The mama was coping beautifully and making each one look so easy. She was quiet, focused, and centered. We continued to stay at home for a couple of hours, and decided to order some food so that we would all have energy for what would lie ahead. 


Soon after the food arrived, the mama decided that we should probably head to the hospital soon. I packed up the car, and Dad stayed close to mom's side. I drove and dad and mom rode together in the back seat of the car. I dropped them off at the front entrance, and met them upstairs. When the nurse checked her, she was at 4cm! Everyone was excited to hear of such wonderful progress. The mama now tried sitting on the ball through some contractions, now getting more intense, but she was still making everything look so easy. She soon decided to try getting into the tub, and said "This feels really good!"  I sat with the mama so that the dad could rest for a while, and be refreshed for all that would come next. When she was done in the tub, she decided to get out and try some different positions, eat and drink a little bit, and try a cool cloth on her forehead. When her partner woke up from his nap, he was right by her side again-- coaching her and being right with her through each pressure wave. When mom was re-checked, she was still at 4cm, and decided that maybe it would help to rest a little bit. She also decided that it may help to have some pain medication to get some rest. I rested for a while now, while dad and mom continued to work together.


After resting a little while, she was soon up and moving around again. Her contractions were now coming every few minutes. The mom was doing awesome at this point, completely calm, relaxed, peaceful, and breathing down each contractions with eyes closed and loose lips. Now dad and I switched again, so that he could try to rest a little more. Soon, a new midwife came in to re-check progress. She was now open to 7cm, baby was at 0 station! Everyone was very happy and proud of her for the progress she and baby had made. They began to fill the birthing tub now, as she had wanted to have a water birth. We all moved into the water birthing room. As I came in and saw her in the tub resting, she gave me a big smile, so I knew that she was feeling really good in the tub. Baby's heart rate was sounding good. Her contractions slowed a bit now, so she was taking advantage of the resting time in between. A couple of hours later, when she was re-checked, her progress was about the same. 


The midwife wanted to talk about maybe helping things move along, since the mamas uterus had been working a long time now and was probably starting to get tired. After talking about the pros and cons of all the options and taking time to think about it, mom and dad decided to try some medication to get a nap, and so that dad could get a nap too. Then they decided that they would try some pitocin to start contractions again. The midwife, nurse, student midwife, myself and her partner were all there together to give her a pep talk at her request. We reminded her of all the wonderful progress she had made, and that she was doing a great job; that she was only getting closer each step of the way. 


Pitocin was started, now almost 20hrs after we had first arrived at the hospital. After an hour, the nurse came in to see how things were going, and the mama asked that the pitocin


An hour later, mom was now open to 8 1/2 or 9 cm! She was now 90% effaced, with a bulging bag of waters. Rachel was trying to walk a lot and use gravity to help finish dilation. A few hours later, the midwife ruptured the bag of waters to help with dilation. Even as the contractions have ramped up, the mother continued to cope beautifully and was completely relaxed breathing down each one. The entire time, dad was repeating a mantra to mom as she breathed-- "Great. Good job. Just like that. Nice and relaxed. Let all of your muscles be loose," always followed by a sweet kiss on the forehead.


Everyone moved into the birthing tub area again to get ready for the birth. Mom was continuing to use gravity, swaying while standing in the tub, opening her hips, walking and squatting, sitting on the toilet, etc. Two hours later, her progress was still the same. The midwife now suggested that she try an IUPC (intrauterine pressure catheter) to try to monitor the contractions more closely. At this point, the mom was exhausted, and felt like being done. She told the midwife, "I just want a c-section." I felt terrible that she felt this discouraged, Dad and I and her midwife reminded her that there were still other things she could try-- such as an epidural. The mom seemed relieved by this as she did not know that it was still an option for her since she was so far progressed. The midwife explained that in this situation it was still an option since her progress had slowed. The mom decided that she did want to try that. 


Soon her epidural was placed, as well as the IUPC and all of us tried to get a good nap in. The dad told me later that it was pretty difficult to sleep, "because of all of the beeps and the blood pressure cuff going off all the time." A few hours later, the dad woke me up to tell me that the mom was completely dilated and ready to push. I hurried into her room to be with her, and got coffee for dad and I. It took a little time, as it usually does with first time moms, for the mom to get her pushing technique down. Soon she was doing great, pushing with all that she has. After a couple of hours of pushing and slowly moving the baby down, the midwife started talking about having an OB come in to try using the vacuum. The mom decided to try a little longer on her own. Everyone was so proud of her endurance, strength, and power!


The OB came in after a while, and assessed the situation. He explained that it seemed like the baby was caught on the top of the mamas pubic bone, and is pushing his head up against that, which explains why the pushing had been difficult. The OB explained that he could try using the vacuum, but that it may not be affective with how the baby was positioned, and that the next step may be cesarean. Everyone talked through the options and weighed the pros and cons, as well as if there were any alternatives. It seemed like cesarean was the best option, given that mom and dad had given plenty of time, tried various positioning techniques, and had exhausted all medical interventions. The mom seemed very confident of her decision to do this, and everyone was very supportive. All got prepped for surgery, and dad was soon in scrubs. The doctors explained the procedures for the cesarean, and what things typically looked like. The mother's support also spent some time reminding her how incredibly strong, and powerful she had been this entire time. After over 60 hours of labor, this momma was ready to hold her babe in arms. I sat outside of the OR, waiting to hear the news, just processing all of this wonderful work that this mother had done, giving her baby the gift of labor, and now the reality of cesarean birth. I was so amazed. She had more strength than any mother I had worked with yet-- to labor so long, and with such focus, and to maintain her strength, even when she could not control the circumstances. Sometimes, that happens in birth. That is what happened here. And I had more admiration for this family because of it. They did all that they could. 


Soon I could hear the cries of a baby. And it was the best sound I had heard in three days. He was here, right with his mother, safe, and healthy. Where he belonged.