So obviously, I'm way behind on posting. I've been working as a CNM for over 3 months now, and have been a part of numerous pre-natal visits, too many IUD insertions to count, and a dozen births. I have not caught all of those babies, because sometimes my student midwives get to catch, and one delivered in the car . . . but I'm getting ahead of myself.
Here are some moments I remember from each of those births, in no particular order:
At my first (and only, to date) homebirth as a CNM, the mom's labor had stalled around 5 am, so I sent my student into town to retrieve some things we were missing in our births bags, and finished up charting at the tall counter between the kitchen and great room. I was standing there, focusing on my writing, thinking I was alone in the mostly dark room, while the mom was in her bedroom resting with her husband and doula. It was not quite 6 am. I heard the sound of another human in the room. Huh!? Strange. I looked around. Sitting on the long, sectional couch, amid several pillows, I finally spotted him. The almost-four-year-old. Wanting to be seen, but not wanting to be seen. I said, "Hi! Can I help you get back into bed?" I knew the mom didn't want him and his older brother up yet. He responded with, "Why are you here?" in a somewhat angry/protective voice. I said, "I'm here because your mom is having her baby." "Where's my mom?" "She's in her bed, resting. Can I help you get back to bed?" He looked at me some more, finally got up, and went back to his room. All by himself.
His sister was born about 4 hours later, on the floor in his parent's bathroom, apparently less than a foot from where he'd been born almost exactly four years earlier. He and his brother were very excited to meet the new baby! After things had settled down, I made some eggs for us to eat. By then, he and I were friends. When it came time to eat, he wanted me to eat with him at his "toddler" table. But one of the chairs was in his parent's room being used . . . so there was only one chair at his table. I offered to sit on the floor, and while I was serving eggs to others, he pulled up a chair from the adult table to his table so I could eat with him. I was glad we ended up being buddies after the scare I gave him early in the morning!
The car birth . . . funny and sort of sad, with a happy ending, thankfully. This was a second-time mom who had a long early labor, and was pretty cranky that we would not let her come to the birth center for the birth. "It isn't time yet" we kept telling her, knowing from her strange contraction pattern that if she "moved" in, we'd all be there for a long time, maybe days. She'd asked one of my midwife partners at 4 AM Monday morning, and again around 6 PM the same day. She paged me at midnight, and again at 2 AM, wanting to meet at the birth center at 3. When I suggested she call me back in 30-60 minutes to give me an update, and then woke up 4+ hours later, I was sure she'd taken herself to the hospital to see if they would admit her. But she was still home, trying to sleep between contractions that were 6-7 minutes apart.
We met at the birth center at 8:30 AM. Baby sounded fine. Her cervix was only 2-3 cm open. She was pretty frustrated, and even more embarrassed. I sent her home with a pep talk and an Ambien, so that she could try to sleep, not having had much in the past 2 nights. She called back around 4:30. She'd had 4-5 hours of sleep, and her contractions were still in a similar pattern, although they sounded longer and stronger on the phone. She didn't want to come in at that point - she was tired and embarrassed - just asking for another sleeping pill. I called in a prescription . . . only to get a call from her at 5:15 saying she'd just had a "10 minute contraction with only a few seconds of a break, and now I feel like I have to push." I suggested she head into the birth center. Now.
She lived 5-6 miles away. Not far, right?? Her husband called back at 5:33 to tell us that "she thinks the baby is coming, and we're stuck in rush hour traffic." (NB: I live in a pretty small city. This is not LA or DC traffic we're talking about . . . to be clear. But it's all relative, right?) He wanted to know if they should just keep driving, which I encouraged him to do. I asked him to hand her the phone, and I talked her through her contractions, trying to convince her to breathe through them rather than push with them. I'm not sure I succeeded much, though, and later she said, "I'm really sorry I didn't listen better." But as the baby's head gets lower, the instinct to push is VERY strong . . . and I know that. I asked her to put her seat back (she was in the front) and lie on her side, rather than sitting up. I breathed into the phone like I wanted her to breathe (panting, sort of), rather than pushing. I tried to calm her down. I asked where they were a couple of times, surprised that she knew. Eventually, as I could tell the baby was closer, I asked her if she had her pants on . . . and then told her to take them off! (Every so often, I'd hear the dad say, "Oh MY GOD! OH MY GOD!") Then "the head came out" and then "the head went back in" (must of been crowning), and then was really born. I asked her to talk to her baby, and rub her back, "I need to hear the baby crying" - knowing that crying is breathing. The arrived at the birth center at 5:44, 3 minutes after the baby was born. The newborn was pink and healthy, the mom was overwhelmed, and the dad was shaking and crying as he got out of the car. We were waiting for them in our parking lot, wearing gloves, with towels, cord clamps, etc. We dried off the baby, cut the cord, and Dad took her inside with one of the midwives. We got mom up and out of the car, and inside too, where we delivered the placenta. By the time they were discharged a few hours later, they were laughing about the experience, and we were all happy with the good outcome.
As for the others, each has a story. There was the woman who marched around the birth center until her water broke in the waiting room, then crawled/walked/scooted across the room towards the bed, delivering in a standing position. There was the intense laboring mom who wanted to make eye contact, chanted, sang, moaned . . . and ended with a lovely water birth. There was the mom who finally got herself into labor just before 42 weeks with castor oil. When she arrived at the birth center she looked like a deer in the headlights, her contractions were so strong and she was just holding on to control . . . but then calmed down and regained her ability to deal with them. There was the 23 year old VBAC whose cervix was so far back my colleague couldn't reach it at 5:30 PM, and had her baby before midnight. If we hadn't acted faster, she would have delivered at the Motel 6, where they were staying, since they were from out of town.
It's been fun and exhausting and wonderful. Every time I wonder how long it will take, how strong this woman will be, if she'll think she can do it, if I'm helping enough or too much. Every time I'm amazed with the process - watching the mom labor, and then push, and then finally seeing the head, and then wow - there's the baby! Into momma's arms. Taking a first breath, turning pinker, opening eyes, looking around. Amazing. Watching partners and families interact is also quite entertaining, interesting, intriguing. The whole experience is such an honor to be a part of.
More later . . . there's an update for now.
