In which the mother labored all weekend…

October 1, 2010

Clients: JMB & SB

Place of birth: St. David’s Medical Center

Date of birth: September 27th, 2010

Whoa. This one taught me a ton. Not only for my doula practices, but in patience and as a reminder of the strength of a laboring mother and her partner.

The clients called me early on Saturday morning. It was around 6am. I knew immediately it was them as I heard my phone chime from downstairs. She was almost a week overdue.

Contractions were strong, having started around 245am and they were heading into Austin and waiting on a return call from the doctor. JMB and SB sounded excited. They immediately starting doing the positions we had gone over once the contractions started, especially since she was feeling them in her back. A lot.

“Good, it sounds like labor to me. But that is for your doctor to decide, especially after they do a pelvic exam.” I told them.

In the meantime, I was gathering up my things, trying to get organized and get coffee all at the same time. Again, my husband and baby were awake to drive me to the hospital and I was there about 730am.

JMB was 1cm dilated and maybe 30% effaced.

Yikes.

She was also having major back cramps. I immediately went to massaging her back, doing the double hip squeeze while they monitored her. I could feel her muscles tense incredibly with each contraction. Once the nurses got the all clear from the doctor, JMB was up out of the bed and slow dancing with her partner. To see them together was a sight. They make a great team. He encouraged her, smiled and joked with her, supported her and she completely trusted him. Although I knew she was in pain with each contraction, the slow dancing looked sublime.

The contractions, however, were fickle. They came faster, then slower, the faster, then not for a long time. About an hour later, they checked her again. Nothing. 1cm. Her cervix was still posterior and very tender to the pelvic exams. JMB was not amused, especially when the doctor dismissed them from the hospital.

No problem, I thought. We can labor in the comfort of a house, get her to relax and help her open right up.

By 1pm on Saturday, we got her relaxed enough to sleep and the contractions were very far apart. We decided I should leave, to get some rest too, in case they went into labor that night.

Nothing. The back contractions were still intense but seemed to ease with resting in bed or in hot water. The doctor told JMB she was in false labor.

Let me get on a soapbox for a minute: I am not a doctor. I am not a nurse. I have no medical training. But I do know what it feels like to be in labor, physically and emotionally. To be told that you are in ‘false labor’ is like being told the pain being felt is not real. Also, that the contractions aren’t ‘doing anything’. They are. Of course they are. Her cervix had to become anterior and soften at some point. Just because a woman isn’t in active labor does not mean her body is getting ready, sometimes with painful early labor contractions.

Soapbox ended. I kept up with the couple throughout the evening. I rested. I prepared. Sunday morning was the same as Saturday: difficult to work through back contractions coming in at regular intervals when standing, swaying, on hands and knees….but they backed off when lying down. Again, all I could do was tell them to rest.

Sunday evening rolls around and JMB is pretty exhausted after having only about 6 hours of sleep for the past two days. They talk to the on-call doctor again, who tells them the same thing, she is in ‘false labor’. I remind JMB that her body is working towards the goal of labor and just because it is a part of labor the doctor doesn’t deal with does not mean it is not labor. Also I tell them to start thinking about their options: to wait and call their own doctor on Monday morning, call the hospital and ask about inductions; or wait it out and see if the contractions become steady even with different positions.

Sometime during Sunday evening/Monday morning, the contractions picked up. Even while lying down, they were still 5 minutes apart. They called their doctor and got into the office first thing Monday morning: 4cm! Active labor!! Hallelujah!

I arrive at noon where JMB is in bed, prepping for her epidural. The momma needed her rest. She looked worn down. As did her dedicated partner, SB.

Since again, she was stuck in bed, I did my best to help her relax to help her dilate. Pelvic, lower back massages, hip massages, effleurage on her stomach and front of her hips and feet and head massages. Although unable to sleep completely, JMB was able to recharge, even discussing feats of athleticism her and her partner have achieved together over the years. (They are uber-athletes). I would like to think my massaging helped, but really I think it was the talking about biking, running and swimming that helped her feel the most at ease. By 430pm I was famished, so I snuck away to eat, receiving a text message as I was finishing up saying she was 9.5cm! Hooray!

Really she was 10cm but had a slight lip remain. More relaxation helped her finish opening right up and by 5pm she was all ready to push. And push she did. We were worried about her being too tired, too close to getting the epidural to push correctly; but JMB is a team player, she knows how to listen to coaching. And our nurse was a coach, cheerleader and athletic director all in one. She was in charge, right under the doctor that is. We knew where the pecking order was with her and I was at the very bottom, which I knew if I didn’t play it right and defer to her, she would give me a scathing evaluation (needed for my certification). So, I asked her before I did anything. I asked her advice. I said to others how awesome it was to have such great nurses (yes, I am a suck up but I got a decent evaluation from an ‘i am the one in charge and helping the patient’ sort of nurse, so there).  So, when it came time for JMB to push with SB on one side holding her leg and me on the other, I mimicked what the nurse did (not obviously, of course). I counted for the pushes, encouraged JMB through pushing and between in the same manner as the nurse was doing.

At 532pm, a healthy baby boy was born. Just over 30 minutes of pushing. JMB and her partner did great. The new grandparents got to witness the event and when JJB was born and gave a healthy cry (a 9.9 apgar cry!), we all had tears in our eyes.

Welcome to the world JJB! Your parents were strong and determined to see you arrive safely. And my sincerest thanks to the parents for letting me witness such a long, tiring and beautiful birth. Good job guys.

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