Thursday, April 29, 2010

Doula Double Header: Part 1

Two days ago I had my first doula double header! It was a crazy incredible night! I'm so honored to have witnessed the beautiful births of two amazingly strong women... and also quite proud of myself. Here is the birth story of the first birth of the night, from my new doula eyes.

My Second Birth as a Doula

On Monday afternoon you called me to tell me you had just left your doctor's office and she had performed a membrane sweep. You had gotten yourself worked up about it because you had heard it would hurt, but you were surprised to find that it didn't hurt much at all. You were hoping to go into labor this week because next week you had a law final exam that you did not want to stress out about while nearing your due date! Your OB seemed confident that you would go into labor soon after the sweep since you were already 4 cm dilated and 80% effaced. After chatting about some concerns and hopes we hung up. You called me about an hour and a half later to say your contractions were definitely intensifying, and you had been walking around the neighborhood with your husband. I suggested you try laying down, drinking water, and so forth while timing your contractions for an hour to see how long and far apart they were. Because my other doula client had also been calling me throughout the day with what seemed like early labor contractions, I called my volunteer emergency back up to let her know I might have two births in one night and just to give her a heads-up, I might need some help!

You called me an hour later saying you were in the bath tub while your husband got your daughter ready to go to grandma's house for the night just in case. You told me you couldn't tell if your contractions were regular because they were varying at 4-5 min apart and 40-50 seconds long. While we were on the phone you had 3 contractions within a short time so I knew you were definitely in labor. I said I'd get my things together and call when I was on my way. I called my doula mentor, B, to discuss both your and my other mama's labor signs. She said I'd better suggest to meet you and your husband at the hospital because as a second time mom already at a 4 you could go quick! I was about to call you to tell you this when your husband called me and told me your contractions were definitely picking up and a lot more painful so I should meet them at the hospital.

I beat you to the hospital by a few minutes, at around 9 o clock. You came into the emergency room moaning and yelling and they called for a wheelchair and someone to take you up to L&D. An obstetrician happened to be down there and heard you vocalizing and offered to take you up in the wheelchair himself to speed things along. He was being funny and friendly, joking about how he was pushing you while also holding two giant bags of take-out food, but you didn't notice and could have cared less! We got to L&D and you had another contractions, yelling audibly. I reminded you to breathe, relax your face, blow out. They got you into a delivery room quickly and you asked for an epidural. Your contractions were so painful, and you'd only been in labor for about 3 hours, you were SURE you were going to be in labor for hours at this pain level or worse.

They suggested they do an internal check first to see where you were at. You were already at 8 cm dilated, 100% effaced, +1 station! You asked if it was too late for the epidural and I reminded you that if you got one it would only slow things down, you were so far already. You declined the epidural. They tried to put an IV in you but you didn't want to get on the bed right away during your intense contractions (I don't blame you!) Did end up putting an IV in your hand. Your husband and I were by your side, reminding you to breathe, not scream, make low sounds and relax your body. We told you you were doing great, you're almost there.

Your obstetrician prepped the bed for you to push. They had you lay on your back and told you to pull your legs up to your chest and push, but you weren't able to do it that way. You weren't feeling any urge to push in that position. You asked to be able to squat (I was so proud!!). The OB and nurse glanced at one another, said "sure, why not? ...how would we do that? on the floor?" And they got you down on the floor in a squat at the foot of the bed. Your husband supported you on one side and the nurse on the other. You definitely felt the urge to push then! The OB guided the baby's head out. You reached out and caught your baby boy after only two pushes, held him to you, stood up and backed onto the bed. He was born at 9:26, 20 minutes after you arrived at the hospital, about 3 and a half hours after your contractions started.

You and your husband marveled at how different your birth experience was this time. Last time you were induced at 41 weeks, on pitocin for 25 hours in the hospital with no drugs before pushing. This time labor was so fast that you were racing down the highway and dad was afraid baby would be born in the car! Your body was ready and so were you. Your son weighed 7 lb 5 ounces. You only tore a little bit along your previous tear scar tissue. You held the baby for a while, then dad got his turn. In one of the most wonderful moments of the evening, dad took his first son to the other side of the room and talked to him, telling him all about his birth, his family, his older sister, and how life would be. I couldn't hear it all because the talk was meant for the baby, but I gushed at how sweet the moment was.

We did hit one road bump. The nurse swaddled the baby and told the mom that she could not yet breastfeed because the baby had fluid in his lungs from her pushing him out so fast. I wasn't sure if this was BS or not so I got on twitter on my phone (when I had a moment) to ask. Most people said this was probably BS, that nursing would help clear it out. But the nurse then said the baby was breathing too quickly and wouldn't be able to nurse and they had to take him to the nursery to monitor him. I knew nothing about fast breathing, but I did wonder why they couldn't monitor him while he was skin-to-skin with mom, which they would both benefit from even if they couldn't breastfeed. Skin-to-skin has amazing benefits premature babies, surely if would help his "fast breathing"? Mom asked if she would be able to breastfeed him within the first two hours and the nurse said yes, so she seemed satisfied with that. I didn't know what to say to try and get mom and dad to insist on baby being with them sooner. (Any tips?) She was moved to the postpartum room, and we were told they were washing baby and then they had to dress him and get him warm before he could come. I was so silently irritated. Mom could warm him better than a warmer! It took almost 3 hours from birth before mom finally started breastfeeding. Luckily, he latched on and breastfed great! I was so thankful!

The hospital birth was definitely way more intense than the home birth. Mom was screaming and had a hard time getting her breathing in-check, and the staff were all over her with questions and commands and sticking her with needles, telling her when and how to push. I was also minorly annoyed with the nurse who didn't seem breastfeeding-support friendly. The OB was nice and I was so pleased she caught the baby on the ground while mom squatted, and she filled out my evaluation (though the birth was too quick to count for DONA certification). I was also a little peeved at one of the nurses hanging out in the nurse's station. Mom said after the birth she was feeling some back soreness so I grabbed my heating pad and went to find a microwave. Didn't see one so I asked at the nurses station. The nurse turned to another and asked if I could use the microwave, who looked at me and my rice sock and shook her head with a mean look on her face (must have been anti-doula). So I went back in the delivery room and asked my client's nurse where to find the microwave, because the nurse at the desk said she couldn't show it to me. She directed me where to find it and I found it myself! And mom said it felt really great on her back, so there you mean nurse!

Gave the mom and dad hugs and left the hospital at around 12:30 am. Was in my car thinking about what I would eat when I got home because I was hungry, and how nice it would be to sink into my comfy bed and sleep...

Then my phone rang. And that was the start of birth adventure number two...

TO BE CONTINUED!

7 comments:

Amber said...

made me all tight throated and choked up. Hurray for the floor squatting! I hate it when the nurses don't have a formal breastfeeding ed and make it harder for mom and baby. GRRRRR.

Amber said...

I know you probably didn't plan this, but you have a nestle google ad on your site. In case you are anti-nestle, thought you'd like to know.

Jill said...

A note about the rice socks... At BC Womens hospital you are not allowed to bring in home made rice socks. This stems from one occurrence where a rice sock had maggots. Also, since the hospital cannot guarantee that it has been properly washed and cared for (you can't really bleach or autoclave a rice sock) they often will not support you putting one in their microwave.

For the hospital, I recommended click-heats or hot water bottles, since they don't require the use of a microwave.

Emily, Anthro Doula said...

Ack! Thank you! I know I can somehow get control over ads but I'll have to go figure that out...

Emily, Anthro Doula said...

Wow, I've never heard anything about maggots in rice socks... Ick. I have heard of a doula who accidentally burned a woman who had an epidural and couldn't feel that the heat pad was too hot. That may have been the fear. It could happen with any heat pad, though, and anyway you probably shouldn't use it on a woman with anesthesia.

I have a back-up heating pad that doesn't need to be microwaved, the one with the gel and you click the metal and it becomes warm crystals or something. The problem with that is I can only use it once, since it requires boiling to re-set.

The Bailey Family said...

Hi stopping by from SITS! I'm a new follower, so come by and follow me as I embark on my journey starting May 8th in being a stay at home wife and mother.

We are planning on trying for #2 in a year and I'm hoping for an unmedicated VBAC. I'm planning on having a doula and I'd love to have you follow along as I embark on this journey in my future!

Rebecca said...

How frustrating is that skin-to-skin stuff...you were absolutely right that baby would be better off with mom than in a warmer. But that is a systems change that needs to happen in the hospital and apart from encouraging the parents to request that they hold the baby skin-to-skin for a few minutes and see if that helps, there is relatively little you can do.

Your first births are coming fast & furious! Exciting!

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