Sunday, November 19, 2006

Midwifery diaries, part 2

This is part 2 of the midwifery diaries, a series that started yesterday.

[Note: All of the names and initials have been changed, and any identifying characteristics have been omitted or modified, to protect everyone's privacy.]

Sally slipped the lip and AG quickly thereafter had her baby, which I caught. Beautiful, healthy, no repair. Very smooth and easy. Her whole family came it for it--and everyone was celebrating. AG, being a multip and a supermom, was quick to get up, shower, eat, and then settle down in the living room on the couch to be around everyone. She was already tandem nursing within the first 1⁄2 hour. In the meantime, her father was cooking a huge meal in the kitchen and everyone was milling around, taking it all in. I was loving all of it--having come from a large family, too--and was so excited about the upcoming meal and the festivities of the evening. I was hanging out, talking with people, soaking it in for about a half hour. And then it suddenly occurred to me that I wasn't doing any work. I was totally caught up and had forgotten I was the midwife and had to do this whole postpartum thing--and that we weren't staying for dinner--we were leaving so they could HAVE dinner. It was quite a blow--and made the postpartum period a little disorganized for everyone, because I took so long to get my act together. It made me laugh, though--and certainly made me super organized with every PP after that.

That night we had another birth--which again went smoothly. Another multip (a woman who has had a baby before), at 9cm when we checked, and no problems.

The next night, I was called for another multip birth. This woman was fairly new to the practice--having just moved to the area. She (HT) is very intense and vibey. Everything has meaning to her--and her needs are very specific. I was sort of dreading her birth--only because I worried about how intense it would be for her and for us. When I got there, Sally and I gathered around her and the three of us supported her for awhile through what appeared to be an early labor.

Finally, after about an hour--she asked to be checked, though again was nervous as to what she would be. Sally and I talked about it right before I did the exam and we both agreed that it would be a blessing if she was 6cm. She had just been LCP at the office and her contractions still seemed pretty mild. So--I did the exam in the tub and felt nothing but head. I was totally put off by this--expecting her to be half that. Given the story that Sally had just told and the confusion I felt at AG's birth--I was so nervous to say she was fully. Not to mention, she is such an intense person and I DID NOT want to ruin her vibe. So, I said that I thought she was fully, but felt unsure and did Sally want to recheck? Sally said no--let's wait and see.

HT said she felt like that was higher than she expected. But then immediately after the exam her labor got super intense and she started to panic. I worried that my ambiguous exam was affecting her and tried to get her to focus on being in the present again – letting the exam go. But things had kicked up so much--and she was definitely FD, with a baby on the way. She had been laying in the tub, but got frantic as the head descended and grabbed onto us to squat.

The head came down fast and was huge when it was born. We tried to help her stay calm as much as possible--by guiding the head with her hands and by reminding her again and again that everything was normal. She was moving around a lot and I noticed that the head came out of the water for a half second before being submerged again for the birth of the body. The baby--possibly from this--was pretty stunned.

When he was born, he didn't come to right away. We got HT out of the tub immediately and onto the bed--then cut the cord and worked on stimulation. Sally then grabbed the oxygen tank and started to bag and mask the baby. It only took a few puffs--but the baby was definitely slow to come around and to get color. It was a lot of stimulation, bulb suction, then bag and mask, then stim, bulb suction, etc. But finally he came to--and then regulated without problem. It was the first homebirth resuscitation I had seen--and I learned a lot from it. I was sort of frustrated that Sally hadn't let me do more--but I also understood that you have to move fast and she wasn't thinking a lot of teaching at that moment.

Overall, AK and her husband were really happy. AK felt great about the birth--which made me really happy--especially given how intense she is, but I'm very upset with myself from when I was checking her vagina for tears.

Find out what upset her so much tomorrow . . .

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  1. Thanks PB for the fascinating midwife posts. A little bittersweet for me, as my birth experience with a midwife was not very positive. But it's good to hear how things are from the midwife's perspective, especially learning on the job.

  2. This is REALLY, really interesting stuff.

    With Sadie, I didn't call in time to get a midwife - even though I called as soon as I knew I was pregnant. Apparently, I should have called before we had sex ... just in case.

    With Oscar, I called the day after we had sex (perhaps this is tmi ...?) and got midwives and LOVED them and then moved to a different city. The midwives in my new city were (at that time) terrible. I couldn't connect with them AT ALL. They seemed completely old-fashioned (not hip and cool like my former midwives and like all of my friends' midwives and like all of the midwives I know) and not sympathetic AT ALL.

    So I dropped them and went to a family friend who is an ob/gyn.


  3. Thanks for sharing these stories. One of my favorite parts of meeting with my mw was hearing her birth stories. It makes me wonder how she will tell mine. I love our mw and know I would not have been able to get the birth I wanted if it had not been for her. She was just so patient and supportive.