Monday, July 16, 2012
This birth recently happened, and I love how it points out some differences between the midwifery model and the medical model..... A client, Sara, called, she was having her first baby and had been in early labor for several hours. She was one week past her due date. Sara reported regular contractions every 3-4 minutes, good fetal movement and did not think her water had broken, but had had some bloody show. Excellent! I tell them to head on in. In the meantime, it got busy! I had to call in my back up midwife. She is fantastic, I love working with her and her presence in labor. She is also a brand new "baby midwife". When Sara arrived, she walked in the door and my first thought was "Oh darn, it is too early for her to be here!" She was calm, smiling and talkative and her contractions were now every 8-10 minutes and "mild". I took her back to the birth room, checked her vital signs, listened to baby and checked her cervix. She was 9cm/100%effaced/+1 station!!! I had another Mama who also very close to birthing, so I went to be with her while my midwife-partner stayed with Sara. Four hours later, the other Mama had birthed and Sara was still pregnant. Her contractions were still mild and spaced out. Her vital signs were good, the baby was doing great, so there seemed no reason to rush things. About an hour later, Sara got frustrated and asked for an exam. We discussed AROM (artificial rupture of membranes) and Sara and her husband asked for that as well. My midwife-partner checked her and found the exam un-changed from the previous one. However, this time she noted that the baby was in the OP (posterior)position, which can make birth more difficult. So, we did not AROM, instead we did lots of good positions and activities to help turn the baby to the anterior position. About an hour later, Sara's contractions changed dramatically. They became stronger and very regular, she began to have the urge to push. A while later, while standing next to the birth pool, Sara and her husband welcomed their beautiful son to the world. Would this birth have progressed so "naturally" in a hospital setting? Of course, it is impossible to say for sure, but it seems unlikely. Most likely, she would have had her waters ruptured, which may have "locked" the babe in that tough position, leading to a much harder birth. In the midwifery model, there was nothing wrong, so no reason to intervene until the Mother desired it. The interventions to turn the baby were appropriate and very successful. All in all it was a grand birth!