Saturday, May 4, 2013
Claire had been woken up, the morning she turned 37 weeks, by the sensation of her water breaking. The fluid was clear and the baby was moving well. At the beginning of her pregnancy she had tested positive for GBS (group beta strep) in her urine, so she and her husband came in for an evaluation and a dose of IV antibiotics. When they arrived, Claire was not yet having contractions. Everything checked out good; her waters had definitely ruptured, the fluid was clear, baby and Mama were both doing great. I started an IV and gave her a dose of penicillin. Since she was not yet in labor I did not do a vaginal exam. Claire and her husband then went back home to have some breakfast. Four hours later, they returned to the birth center. Again, everything checked out good and I gave Claire her next dose of antibiotics. Because she was GBS positive, we talked about encouraging her labor to start. Claire and her husband both agreed that they would like to get proactive. I sent them home again, this time with some herbs. I did not do a vaginal exam.
Another four hours passed, Claire and her husband returned, and they were joined by their 5 year old son and Claire's mother. It was obvious that things had shifted and Claire was starting to labor. She was in that sweet foggy stage of early labor, when women seem to be floating above the world, mildly aware of what is going on around them. I gave her the next dose of medicine and we all settled in. In a short time Claire shifted again, moving into the active phase of labor. It was lovely to watch. She was supported wonderfully by her family and she easily let go to the process. She moved well, walking around with the contractions and swaying with her husband. Eventually, she asked to get in the birth pool. Very shortly after sinking down into the water she began grunting at the top of her contractions and then proceeded to birth her sweet 7lb 2oz. baby boy into the world.
And all of this without one single vaginal exam! Of course, I think that is awesome. A couple hours after the birth, Claire and I were talking about it. She asked why I never did one and I told her that besides the fact that her waters were ruptured, I didn't need to do one. It was clear that her labor was progressing and I did not want to disrupt the flow of that progress. Claire said that during her labor, she briefly wondered why I wasn't checking her cervix but then reasoned that I knew what I was doing and let the thought pass. It is important to remember that there are so many ways, other than a vaginal exam, to assess labor progression. Sharp eyes, clear ears and an open heart are just as valuable. What are some of those other signs to watch for as a woman labors?