Wednesday, October 16, 2013

Four Births in Four Days

Four births in four days! As usual, each birth brought lessons and unexpected surprises.  Together as a group they are a lovely picture of what out of hospital birth can be and do.

Birth #1
A first time Mama.  Another one of my midwife sisters had been with this family through their labor, I was called in to assist because the birth center became very busy. By the time I arrived, she had been working for quite some time, her first stage of labor had been long at just over 24 hours.  Her second stage was also long at just over 4 hours.  She was so brave, tough and dedicated to her birth.  I never heard her complain or falter...even through a difficult second stage that involved what I call "Birth Gymnastics", meaning multiple position changes, in every possible position imaginable.  Finally, as her darling baby began to crown, the reason for the hard work became apparent; her daughter was direct occiput posterior!  Mama worked hard but did eventually birth her lovely 9lb daughter, direct OP, to her loving arms.  Since I had not be present for most of her process, I inquired later about her labor pattern and contractions, wondering if the baby had given any clues to her position.  Apparently, other than a long labor, there had been no other signs.

Birth #2
A second time Mama came in in the early morning.  She had previously been to the birth center a couple days before and was sent home after her labor took a break.  This morning she was very nervous about it being another "false alarm".  She was laboring, but it did seem to still be in the early phase, so I suggested that she and her husband go out for some breakfast.  A while later, they returned, her labor was a little stronger but still not active.  They decided to go for a walk.  Her labor moved along slowly but surely, picking up little bits of steam here and there.  And then, the switch flipped!  After hours and hours of watchful waiting the baby decided to make his move and he did not fuss around. She had a beautiful waterbirth 13 hours after her first contraction of the day.

Birth #3
Another second time Mama who had also spent time in the birth center a day earlier and went home after her labor took a break.  She returned to birth center, clearly ready to birth her baby this time.  She had the look about her, the labor look.  When a woman is not really part of our reality, she seems to float above us and is so focused on her work.  After her round of stopping and starting, this time her whole process was completed in under four hours.  She had been nervous prenatally as with her first babe she had a serious postpartum hemorrhage and a fourth degree laceration.  I am happy to report that neither repeated themselves and she birthed a beautiful son with the sunrise.

Birth #4
Another first time Mama.  Her husband had called me that morning stating that her contractions had just become the 3-1-1 pattern.  Usually, with a first baby there is still some work to do at this point, so we discussed some coping techniques and support measures.  I asked him to call me back in one hour to check in.  When he called back, I did not need to hear his full "report" because I could hear his wife in the background and I told him to just get in the car and head over to the center.  When they arrived all I needed was one look to know that we would very soon be welcoming their child to the world.  Just under five hours from her first contraction she had her darling son snuggled in her arms.

All of these births had lessons within them.  What do you think some of those were?.....

11 comments:

  1. It seems that each of these births involved the natural fear of the birthing mother and the body instinctively knowing how to birth. "Trust the process"

    ReplyDelete
  2. The most important tools a midwife can bring to any birth are keen observation and patience.

    ReplyDelete
  3. Love both those answers! I was out walking today and was thinking about how I had all of my most valuable midwifery tools with me at all times; my eyes, ears, hands, heart and head. Birth #2 is one that makes me think of a traditional hospital practice and how her birth could potentially been very different. When I sent her out to breakfast, she as a multip was 5cm dilated and she was having contractions albeit very mild ones. It would have been very easy to rupture her bag of waters and "just have the baby", but instead we waited and let her body and her baby work out the timing together.

    ReplyDelete
  4. LOVE it! To me the most striking element is the range of normal - significant variability in labor length and pattern but all with beautiful, safe outcomes- nature knows best! In the hospital setting, would mama #1 have been diagnosed w/ failure to progress during her long first stage or long second stage and coerced into a section? Would mamas #2 and #3 have been pressured into augmentation when their labors slowed the first time? Would that have led to emergency sections? I think this is a perfect example of trusting birth. Trust in birth is not blind - it's active: when mom is doing well and baby is doing well - trust in the process, nature knows best. :)

    ReplyDelete
    Replies
    1. Talk about hitting the nail on the head Danielle! The range of "normal" in childbirth is so wide. One of my friends says "normal is a setting on the dryer, not people". Each MotherBaby will have their own version of normal. Patience is def one of the keys.

      Delete
  5. Love how you described each birth. I had a direct OP son with horrible back labor, yet we were never really sure which way he was facing as I was not checked often and was in a hospital. I'd say the greatest thing I can take from this is that you must be patient. You must trust mama and her body to get things going and when it's time, it's time! :)

    ReplyDelete
    Replies
    1. OP babies can be so difficult...or not, which is one of my lessons. Of the four babies that I have caught who were born direct OP only in this last one, Birth #1, were there any signs, ie her long labor. The other three were a complete surprise. I have been at a lot of labors where the baby is OP and it is causing "issues", we address it and get the baby to rotate. OP is really just a variation of normal.

      Delete
  6. This comment has been removed by the author.

    ReplyDelete
    Replies
    1. This comment has been removed by the author.

      Delete
  7. I just shared this with a client who is giving birth in a hospital. I love the range of normal that is so perfectly captured, and the inherent mantra of "Don't rush birth". Thanks for writing this up!

    ReplyDelete
    Replies
    1. You're welcome! There is such wide range of "normal" in birth, just as there are so many different women and lives. It is unfortunately a fact that get easily get lost in the shuffle at times.

      Delete