The First of Three

Friday morning, August 8, 2008, I fell out of bed and went to my knees to thank God. I was alive. I know that sounds dramatic, but I had just completed one of the hardest weeks of my life, and I was deeply grateful to the Almighty.

I did three births that week. Now that may not sound like much to an OB/GYN, or to a nurse who works in labor and delivery. Or even to another midwife. But the facts are that these three births were all to first-time moms, and they were all hard. And they were all successful home births. Needless to say, the parents and the grandparents and other family who were present were all ecstatic. And we were all also tired. I spoke with one of the grandmothers (my sister) last night about the whole event that she witnessed, and she said she still thinks with fear and trembling about how long and hard her daughter labored. That was the last of the three births. Let me go back to the first...

Oh, and, by the way, I will change the names of the people in the first two births. The last birth happened to my niece, and I have permission to use their real names.

On July 30, I called Babette to reschedule our appointment, as I had a nasty head cold, and I didn't want to give it to her. She told me then that she had had bloody show and mucus plug and some contractions. Well, she wasn't due until August 29, so I told her I would check on her as soon as possible, and to please try and rest and not go to work. I was hoping, as happens often, that her baby had just moved down into the pelvis, causing contractions, and soon they would quit.

The next day I went to her home to check on her. She had had contractions 10 minutes apart all day with an achy back. Uh oh. That sounded like early labor. I went ahead and did a vaginal check...Oh, my goodness. She was 5 cm dilated, completely effaced, and the baby was +2 station (translated that means really low). I gave her some herbs which eased the contractions down considerably, and left her with instructions to take them every 30 minutes until bedtime.

Her husband, Earl, called me at 10 pm to tell me that her water had broken. Well, pooey. No going back. I had estimated the baby's weight at 6 Lbs. 5 Oz. that evening, so I believed that we were okay with going ahead with the home birth, even at 36 weeks. (In Texas, midwives can legally attend births from 36 weeks of gestation forward.)

I arrived at their house a little after midnight on July 31. Since her water was ruptured, I did no vaginal exam. I try to do as few of those as possible under those circumstances, because of the possibility of introducing bacteria into the baby's world. Babette labored well, and soon was completely dilated and ready to push.

Pushing, however, took just as long as dilating -- nearly. We pushed in one position, then shifted to another, then another, then another. She was making progress, slowly, so we kept on going. My assistant asked me later if I had ever given up hope during this stage of this labor. I looked at her blankly, because that thought had never really crossed my mind. Obviously it had hers. But Babette kept going, and we finally began to see more and more head visible.

We did a sort of no-no at this birth. I have a birth stool that I use often to help with pushing, but I seldom use it for the actual birth of the baby because it's harder to keep the mom's tissues from tearing in this position. However, Babette gave birth on the birth stool. She just made wonderful progress there, and really didn't want to move at the end. I don't blame her. Baby Abigail's head came forth. I asked Babette to pause while I checked for cord around the neck. No cord. Okay, Earl, get ready to help me catch your baby! Her shoulders start to come forth with the next push. Oh, hold it, Babette, the baby has a hand up! Hang onto the baby Earl, as I e-a-s-e the baby's hand out while protecting Babette's tissues! Okay, we've got it, here comes the baby! Whew! Over three hours of pushing! Man! All postpartum "stuff" is okay. Oh, and by the way, it's a girl. We didn't know beforehand. I love the surprises...

Abigail is 7 Lbs., 1 Oz. And Babette is intact. Even with birthing on the stool. As evidence of how hard she pushed she's still having some tailbone pain. I suggested that she go see her chiropractor. Her tailbone may be bruised, or fractured. She confessed that she had had a hairline fracture in her tailbone when she was younger. So she might have re-injured it in the process of pushing out Abigail. Did I say she pushed hard?

Babette sure dilates quickly for a first-time mom! And with her next baby, I foretell that pushing won't be quite as hard as it was this time...