Birth #1: fun birth last week was a good reminder not to think we can understand the mystery of birth. A, a second time mom, came in Sunday, 2 cm. Monday 3 cm. Wednesday, 4 cm. She got in the tub (my trepidation was known), 15 min after her exam, SROM, 15 min later she asked me if she could push, and then with the next ctx said, "I can't NOT push . . . ugh - something came out!!!" Yep - the HEAD! Her baby was born 35 minutes after her exam. WOW! i didn't have gloves on (insert sad face here) so the LM caught the baby. Oh well. Fun birth.
Birth #2: M was a G1 who dilated quickly, and then pushed for hours without any change. I was pretty sure that her baby was military & LOP (what this means is that the baby's head was not flexed, and was basically sunny-side up - and her head was STUCK!). When we transferred TO the hospital (to an asshole doc, unfortunately), I asked him what position the baby was in. He said, "LOA, of course!" So after her cesarean, I looked at that head. Guess what? Bruising on the forehead, caput (swelling) just above that. LOA my ASS! (The point is, the baby's head proved that my assessment was correct. LOA is sort of the "best" position for a baby to be in as they begin to descend through the pelvis - which isn't a straight shot! It's actually a bit of a maze - babies have to rotate their heads and shoulders in different directions at different times . . .)*
Birth #3: I was in the car on my way to the birth center when I got a call to let me know that the birth had already happened. Bummer! This was a first time mom (G1) who woke up at 7:30 AM with contractions, thought she was being a wuss, told her partner she was in labor, he had a hangover so went back to sleep for an hour. When she woke him up again at 8:30, her water had just broken, and she felt like she needed to push. They arrived at the birth center at 9:00, and when the midwife made it to the car, (after a frantic dad came to get her!) and pulled the mom's pants down, the head was already out! The rest of the delivery happened right there in the car, and when I arrived, they were nicely settled in the birth center, getting to know their son. Crazy!
Birth #4: I had an amazing VBAC over the weekend - mom must have said 100 times "I just want this to be over, I just want to meet this baby . . ." and ONCE I said, "you need to dig deep," which didn't go so well. She said, "I am digging deep!" I decided not to use that line anymore. We did offer a hospital transfer for an epidural (gently) and her response was, "I'm having my baby here." She had a lovely birth in the end, with a 7#8oz baby with a nuchal cord, nuchal hand, minor periurethral skid marks. Score! She was an amazing and controlled pusher. Wow! (nuchal is a fancy way of saying neck - cord around the neck, hand up by the neck - a hand by the neck or face means an elbow by the shoulders, which make the baby even bigger, making descent (and pushing) usually slower!)
I do love it here. I love it that these ladies don't have epidural as a real option. I have to admit, every time someone asked for an epidural when I was training at the hospital, my heart broke just a little. I know it's not my birth, but it is just so amazing to be a part of an unmedicated birth, and to see the mom's utter thrill when she delivers her baby!
*Epidurals change labor. They really do. Sure, they make the mom more comfortable. But they also make it a lot harder for baby to rotate through the pelvis because mom is static, and usually laying down. An unmediated mom is moving around, rocking her pelvis, walking, lifting her legs, etc. - and all of this helps the baby negotiate the pelvis. Without movement, the baby is more likely to get stuck = more likely to have a cesarean.
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