The Second Hard Birth

Ok, ok, I've had at least one request that I get on with the job of blogging, so I'm hauling my lazy self out of browsing other people's blogs, and getting on with the job at hand.



The last blog told about the first of three first time moms giving birth in one week. I will now continue the mini-saga.



I had gotten over birth number one. I want that to be a fact. I had rested from birth number one. It usually takes me two nights to recover from a birth. Usually. Sometimes I recover sooner, sometimes later. And since I've been taking Melaleuca brand vitamins, I recover quicker. That's a good thing.



Anyway, #1 had been born at 4:57 a.m. on July 31. Sam* called me at 7 a.m. on August 5. See, I had plenty of time to rest! Daisy* had started having bloody show and seeing her mucus plug the day before. So Sam called the next morning to tell me how she was handling her contractions. It sounded to me like she was doing fine for a first-time mom. Of course, she was fit as a fiddle. She loves to climb mountains (not here in central Texas, of course!), and ride her bicycle, etc. So she was doing well. I called back at 8, and Sam then told me that her water had broken at 2:45 a.m! What! You're supposed to call me immediately when that happens! So I hurry my rear end over to their house, and sure enough, things are very calm. Baby Birch is doing fine, and so is Daisy.



I take vitals on everyone and then settle in. Her contractions are coming regularly. At 1o:30 a.m, she hits a pause on the recliner and gets in a mini-nap. Yay! Even 20 minutes are very welcome, and then her contractions start back in at every 3 to 5 minutes. She's drinking and moving, and generally staying very relaxed with the contractions. She's rented my birth pool, and it's filled and ready to go. So she gets in around noon and relaxes in the warm water. She stays in the water about 2 and 1/2 hours, and gets out around 3 p.m.



I'm observing her, and when she gets out of the tub, her contractions are every 3-4 minutes. When she gets out, they begin to space apart. That can be a sign of complete dilation. So I ask to check her. She's complete. Dilated to a 10. So I watch for signs of an urge to push. I watch and I wait. Hmmm. No urge to push. I'm a pretty patient midwife, but after an hour and a half of watching and waiting, I realize that we need to do something. I check her again to make sure that the baby's position is good, and that she really is complete. Baby is perfect and she really is complete.



So I give her instructions on how to push. Still no urge to push. She begins pushing at a little before 5 p.m. We use different positions to see if one is a better position for making faster progress, and we settle on the McRoberts position -- flat on the back with two people on either side pulling up the legs to get the bottom off the bed. It sounds terrible, but it really works! After an hour of pushing, we start to see Birch's dark, abundant long hair. Her head starts to show between pushing, not just during the big pushing, and that is always so encouraging to me. Birch is big. And she's the first baby that Daisy has ever pushed out. She works so hard with every push. And when I'm seeing a good-sized wedge of head, she declares, "Oh, there's an urge to push!" That's the only urge to push that she ever has during the birth. Anyway, at this point, I ask, "Are you feeling a burn?" When the perineum is being stretched like that, it burns. Kind of like taking your index fingers and putting them in the corners of your mouth and pulling. So when she feels the burn, I ask her to slow down on the pushing. It helps the tissues to s-t-r-e-t-c-h instead of tearing. And she does admirably. Slowly, slowly, Birch is being born.



I ask Ashlea, my assistant, to trade places with Sam so that he can help catch Birch. So Ashlea takes over lifting Daisy's left leg during pushing. And Sam gets himself ready for his baby girl. Oh, what a moment! I call out "full crown!" when the biggest part of the head is out. This is the forehead right before the eyebrows. The head is then born seconds later. I ask Daisy to pause while I check for cord. None. And Sam gets ready to grasp the shoulders as they emerge. Oh. Wait. Birch has a hand up. Hang onto the baby, Sam, while I ease her hand out. Ok, catch the baby! Oh, look at her! And put her onto Daisy's waiting belly. She starts breathing even before she's born. She starts looking around even before she's fully born. And Daisy starts to bleed.



Oh boy. Bleeding is my least favorite complication to handle. I quickly order Ashlea to give her Angelica tincture that will bring the placenta. The bleeding slows. We deliver the placenta as soon as it detaches, and then more bleeding. So we give her two droppersful of Shepherd's Purse and sweep out the blood and any clots that may be filling up the uterus. Thankfully, she stops bleeding after the Shepherd's Purse.



But she's tired and the bleeding really drains her. About 45 minutes after Birch is born and Daisy is nursing her, Daisy faints. We quickly get her lying down and she comes to in probably 5 seconds. Then we give her oxygen until my big tank is empty, and start giving her straight chlorophyll out of the bottle. (It usually tastes terrible, but she's so needy of it that it tastes good to her and she drains 8 oz. readily.) So she doesn't get an herb bath. I don't want her up at all, much less in a warm tub. The herbs are all ready, so we instruct family on how to make up the bath for the next day, when Daisy will feel better.



Birch is born at 6:54 p.m. When I check for tears, I find one. I haven't had to stitch a client in so long that Ashlea doesn't remember where I keep the suturing materials. I have to smile at that. I love what I do, and I'm glad that I can do a good job at keeping women intact. In this case, I blame the little baby's hand. Or something like that. So since Daisy has to lie flat, I go ahead and suture her. She's nearly sleeping while I work. She's so tired.



I leave at about 11 p.m. It's been a long birth. The pushing without an urge is nearly a first for me. I have only had one other birth in which that happened, and it turned out the baby was in a bad position, and we had to go to the hospital to finish the birth. I am very grateful that this one did not turn out that way. I go home, very satisfied with the birth and the beautiful little baby girl that has just made her arrival. Oh, she's not so little; she weighs 9 pounds, 2 ounces!



One thing that happened at this birth is so funny! The UPS man brought a package during the labor, and Sam must have told him that Daisy was having the baby. Sometime in the middle of pushing, the doorbell rang. Sam's mom went to the door. When she came back, she said it was the UPS man wanting to know if the baby had been born! I guess he's into all kinds of deliveries! I've never had that happen before. We laughed a lot.



One more thing. The next morning, as I'm heading to Lynet's temporary home, I get a call. It's raining cats and dogs, and my cell reception is sketchy at best. It's Sam, and I wonder what's going on. He says they're having to evacuate. The rain from Hurricane Edouard has just circled and circled their house, almost stationary. It's not letting up, and they have water in the house. So Sam gathers up all his girls and takes them to his mom's house, which is about an hour's drive away. Talk about a rough postpartum!



Daisy actually gets her herb bath at her mother-in-law's house! They actually remember to take the herbs with them as they're evacuating!



I get a little sleep that night. Emily comes in from Colorado that night at 3:30 a.m., and it wakes me up. I have only gotten two hours' sleep by that point. And then I can't go back to sleep until around 5 a.m. Then Lynet calls me at 8 a.m. telling me that she thinks she's in labor. There's no way that I'm rested. It's about this time that I begin to be grateful that Sam and Daisy didn't call me when her water broke...(to be continued)

*Names have been changed, of course.

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...

Zanzibari's, are you ready? Here I come!

I know, I know, it hasn't been a month since I last posted, but I'm going to again anyway!

Ever since I was a midwife student, one of the things I longed to do was to serve missionaries. I'm a missionary kid, and my parents had four children on the mission field. I was one of those children. So I know the desires of some missionaries to just stay put for the big happening. And I also know that some missionaries just don't have access to good care during labor and delivery. So, one of the goals I have had is to deliver babies for missionaries.

I have that chance this year. Bob and Rachael Gwassa, for whom I delivered their first baby on January 1, 2007, are now missionaries on the island of Zanzibar, off the east coast of Africa. They left to go there in December of 2007. Now they are expecting a second child, and we would all like it if I could be there again for this birth.

I will be leaving for Zanzibar on December 1 or 2 of this year, as Rachael's due date is December 12. I plan to be back home for Christmas!!

I will not be receiving a fee for this service, and I am asking for donations to cover the cost of supplies and the trip to Zanzibar. This will take approximately $2000. If you would like to help with this mission of love, you may send money to: Betsy Robinett, 509 S. Bell St., De Leon, TX 76444. If you would like for your gift to be tax-deductible, you may make your check out to Teach the Children International. If you would like more information, you may contact me at mrsnett@cctc.net.

The Whirlwind

Wow! Time does get away.


Let me catch you up. There has been a lot going on...


The baby we were waiting for did come. And he was worth the wait. His was a very nice birth that had a surprise ending as far as where he was actually born -- not the bedroom but the bathroom. When he was ready to descend, he didn't fool around any at all. There were only three minutes from going to the toilet to the birth. Whew!


Then, Jackie and I went to see the kids. First we went to Lake City, Colorado. Shari and Emily reserved a cabin for us there. Lake City is so nice. It's small; you can walk anywhere in town. The elevation is approximately 8,600 feet. There are legends of cannibal guides, and there are old mines, and there are 5 "14er's" close by. "14er's" are mountains that are above 14,000 feet in elevation. We opted to climb Crystal Mountain, just behind Lake City, with an elevation of 12, 990-something feet. We didn't make it to the crest, or to Crystal Lake, but we had a very strenuous walk. We wobbled back down to our car and went to the local bakery for some much-needed lunch!



We went to the Hard Tack Mine and were led around by the guide. It was very cold and dark, informative and enjoyable.


We also took in a play while we were there. The theater is really small, and the chairs are folding chairs. The play was pretty good; we were definitely entertained. The actors were local, and the playwright for the play ("Anchor Baby") is from Colorado Springs. And the main actor reminded me of my webhost, Fred!! He both looked and acted like him.




We stayed in Lake City for two days, made sure Timothy and Emily are doing well, and then we headed toward Natalie in North Carolina.





Um. That was a long trip. We left at 6 a.m. It took us until 2:30 p.m. to get to the Colorado-Kansas border. Then, oh, Kansas is flat! And the same for hundreds of miles. Every 15 miles or so, you see a town in the distance with a white grain elevator, one or two church spires, some trees, and a water tower. But the state is very neat and clean, I'll give those farmers that. We crossed into Missouri at about 10 p.m., and went halfway through that state before we quit for the night in Columbia.


The next day we went through the rest of Missouri, then cornered through Illinois and Kentucky into Tennessee, stayed there for a while, and finally reached the Smokies. Ah, the Smokies! They hug you to their bosom! They are such welcoming mountains. I love them! With fog curling around every hollow, and trees covering all available space. We crossed over into North Carolina, and went to Natalie's camp, just south of Morganton. There we spent the night.

The next morning we took Natalie and journeyed all the way to the East Coast of North Carolina, a little spot called Swanquarter, where the ferry for Ocracoke Island leaves four times daily during the summer. It's a two-and-a-half hour ferry ride, and we sailed into Silver Lake Harbor on Ocracoke at about 6:30 p.m.



We made camp at the National Park and went out on the sand for a while. Oh that's a lovely island! The crabs scuttled around in the dark, scaring Natalie. We saw the lighthouse from our beach, a neat thing in the dark. We ate lobster and fish, and the next day we jumped the waves and scoured the sand for seashells. Jackie found a big sand dollar! He got the prize. It was a lovely sand dollar, a great memento of our day there.


During the hot part of the day, we went to the village and looked through the biggest part of their shops, got wonderful coffee confections at the coffee shop, and had a picnic where we could see some guys cleaning the catch they had made that day. Then back to the beach, to lay out on the sand after jumping some more waves.


We had to leave really early the next day, as all the ferries but that one were booked. Yes, you have to make reservations for the ferry. So we left at 6 a.m. and we took Natalie back to camp, and then continued on our way home. I felt that we needed to get back by July 14, as I was on call for another midwife who was leaving that day. So we bedded down around Commerce, Georgia.


Late that night/early the next morning, we got the phone call. It was 2:45 eastern time. Jackie's mother, our dear, dear Elsie, had just passed away. Saddened, we continued on our journey early the next morning. I know our server at the Cracker Barrel restaurant where we were having breakfast was really worried about me. I was crying all over my pancakes, and trying not to. She just said, and repeated it, "Just pray about it." Well, it was a good hard thing, and you just have to cry when you need to.


Natalie flew to Dallas that day, and got there before us. We picked her up on our way back to De Leon, arriving here at midnight. Emily and Timothy drove in from Lake City the next day. So we were all together. The funeral was Wednesday, July 16, and we all said good-bye to a grand lady. She is in no pain now, and with Jesus. We're glad, but we miss you, Elsie.


The kids all drove back to their respective states on Saturday. So that brings me up to date. Waiting for the next babies...

Busy and Waiting

I've been having a wonderful time lately being a midwife. And I've been having a wonderful time lately being a person. I guess for me the two just mesh. I'm very thankful that I have a calling that fits who I am. I know that to do what you love is a gift that not very many people have.

I looked at my picture gallery (http://www.firstlightmidwife.com/) and realized that I've helped with nine births so far this year. And every single one of them has been special in a unique way. One of the interesting things about this year is that so far I have twice as many boys as girls. From April 30 to June 4, a period of five weeks, I did five births. And only one of them was a girl! Other years I've "done" more girls. I think this is actually the first year that there have been more boys. Go, boys!

So my busyness has been one of the reasons that I haven't blogged lately. Other reasons include Timothy graduating from high school. He's the last one of my children, so my days of home schooling are done. He had a graduation ceremony on May 24, along with five other homeschoolers in the area. The graduation was very nice, with each family awarding their child his or her diploma, a special speaker, a slide show, and music for their entrance that was not "Pomp and Circumstance!" (How did that piece get to be so special?!!) The day after he graduated, he and older sister Emily and their friend Melody loaded up Melody's car and left for the summer. They are currently working in Melody's sister's restaurant in Colorado. Suffering. Poor things. Jackie and I plan to go see them for a couple of days if the births that I have pending work out so that there are a couple of weeks that are "free."

Anyway, I haven't made any major changes in his bedroom since he left. His room has just become a repository (read dumping ground) for the other things that I've been rearranging around the house. I don't get all gung ho about rearranging, so I only hope that when he returns for a couple of weeks in August that he has a place cleared off to sleep and a little pathway through his room. He won't care. I know, because one of the places to be cleaned is under his bed, and I'm seriously considering using gloves when I do it. Ugh! What was he thinking!

I miss him and Emily and Natalie. Natalie is in North Carolina for the summer. She is the girls' staff coordinator at a summer camp there. This is the third year she has worked at the camp, so evidently she loves it and the people she works with. And I think they also love her. I would also like to go see her if the babies cooperate. I would love to scoop her up from camp and take her to the little island of Ocracoke off the coast of North Carolina for a day or two! Ah, the beach! It's so lovely.

Lately I've been actively waiting with my client for the birth of the next baby. Waiting is so hard, especially when your due date passes with no signs of baby coming. It's hard on the midwife, too, to keep her hands out of it! And in our instant society it really is not politically correct to wait for anything. Waiting is an art that is not in vogue, and very little practiced. It's one of the hardest things I do as a midwife. But the longer I'm a midwife, the more I realize that waiting is worth it. And I also realize that when you fiddle with the natural order of things, things get funky. If I try to get things going (read "induce labor" with natural means), invariably labor just doesn't cooperate, or the labor is long and we have to nurse it along. But it gets harder and harder for the pregnant mom and her husband to explain to all their friends and relatives that no, nothing is dangerous for the baby. The midwife is really keeping an eye on everything. It's really safe to wait. Really. So they resort to screening their calls. Sometimes they put messages on the answering machine that say something like, "Junior hasn't been born. We'll let you know when he is. Everyone's ok. Good-bye!"

Anyway, whenever he is born, we will all rejoice! And he will have been worth the wait. It will be a good birth. And you'll soon see his picture in the picture gallery. I love what I do. Have I mentioned that before?

Happy Birthday, Elsie!

Today is Elsie's birthday. Elsie Robinett is my dear mother-in-law. She is 91 today. We had dinner with her and her four remaining children (we still miss you, Marilyn!)

This is my husband, Jackie, sitting with Elsie just before we ate. The wonderful meal was prepared by Sharon and Carolyn! Thank you, ladies!

And Happy Birthday, Grandma Elsie! We love you!

Transport Tryouts or Bathtub Hubbub

Boy oh boy! I know, I haven't posted in two weeks. I've been thinking about different possibilities for posts, such as the completed quilt that I've been working on for four (yes, four!) years for Emily, or the wonderful radishes and strawberries that are coming out of our garden.

But what I really want to write about is the birth that happened two days ago. So I will.

I was called at 12:30 am by Betty (not her real name) to let me know her water had just broken. Everything was good. The water was clear, baby was moving, no contractions -- yet.

So I told her to see if she could go back to sleep. I tried to. It never works for me. She called again at oh, 1:30 to 2 am, I can't remember exactly when. She was now having contractions every 5 minutes, and no, she couldn't sleep. Uh huh. I couldn't either. But I didn't go to her house yet. She still sounded cheerful. First-time mom. Just a little early.

At 3 am, when Umbert (not his real name) called, I could hear Betty in the background, really working with the contractions, and she had two in the brief conversation that he and I shared. Ok, now it's time to go!

So I got there at 3:15. At 3:30, I check her and she's already at an 8! Wow! Fast for a first-time mom. By 6 am, she's pushing hard. She pushes for an hour and a half before she poops out. She's pushing with pain every time. It's hard to keep going when there's pain with the pushing. There's a bit of cervix that keeps slipping down over the baby's head and she pushes against it every time. Ouch! I try to push the cervix out of the way for her, but the baby's head is so molded that the cervix just slips right back down. It's not much cervix, just 1-2 mm thick, but enough to cause her to give up.

She wants to go to the hospital for pain relief. So we go. The problem is, the hospital won't give pain relief when you're completely dilated. So we stayed at the hospital for a whopping 20 minutes, then Betty signed out "Against Medical Advice" and we left.

The problem at this point is that she's been "complete" since 6 am, and it's now 10 am, and the contractions haven't quit, she just hasn't been pushing since 7:30 or so. Baby is fine. Mom is fine, but hurting with every expulsive contraction every 4-5 minutes. Really ouch! I mention before we leave the hospital that I have a daughter in this town. She has an apartment we might borrow, instead of having another 45-minute drive back home. Surprisingly, Betty takes me up on it!

Now I have to call Emily. Emily is thunderstruck (weirded out -- she's only 20 years old), but responds by calling me when I text her the following message: "Where are you? We need your apartment to have a birth in. This is not a joke!"

We then meet her at her apartment where she is frantically vacuuming. Oh well. We didn't come to see how clean it is, although we thank her for her efforts wordlessly. She and her roommate clear out. Funny how they don't want to be there. I would have! And I really would have appreciated some help, but oh well. Birth is not everyone's cup of tea...

So we clean the bathtub, fill it up, put Betty in it, and she gets going on the pushing again. It's now 10:47. She pushes very hard, but we're still not seeing head, although it's getting close. She gets tired after about 45 minutes, and I suggest draining the water out of the bathtub to clean it and refill it. She complies, lies on the bed for about 30 minutes, taking another break from pushing.

Back into the tub at 11:57, and this time, when she begins to push, we get another burst of energy. It's called hope! Because now, we begin to see baby's head as she's pushing. She redoubles her efforts. By 12:30 pm the baby's head is crowning, and finally, finally! her head is born. Then, her fit is so tight that I have trouble checking for cord around neck, but soon ascertain that there is none. I also realize that I will have to help this baby. Her shoulders are stuck. So I tell mom first to get on her knees in the water, then I tell her she'll have to stand up with one leg on the side of the tub. I finally get a little leverage on the baby's shoulders and we get her born. She responds very quickly to me stimulating her and suctioning a little with a bulb syringe.

At 5 minutes after the 12:41 birth, she is a perfect 10! I'm not sure what Emily will think about this birth in her bathtub, but I think it's pretty cool!

It's a good thing I thought before we left their house that I might need some basic birthing supplies in case she had the baby on the side of the road. We really made use of them at Emily's apartment!

As it was, we couldn't weigh the baby or do some of the other things we normally do postpartum until we got back home. She weighed 8 pounds, 14 ounces! Big baby, first-time mom. Oh, by the way, no stitches were needed for mom.

And we cleaned Emily's bathtub before we left.