Thursday, April 15, 2010

On Call Like Whoa

Ever since the calendar changed to the month of April I have been a combination of excited eagerness and anxious nervousness.  I have two clients due this month and two due in May which will all hopefully go well enough to count for my doula certification birth requirements.

I've been "on-call" for my first client for the past two weeks. Today is her actual Estimated Due Date, so while I've been saying for 14 days that she could "go any time," now she REALLY can go at any time! So I carry my phone with me around the house and everywhere that I go, anxious every time it rings.

And then last night it rang. But it wasn't client #1, it was client #3 (I'm numbering them in order of their EDDs). Client number three wanted to let me know that she thinks her water has been leaking since the night before but she wasn't sure so she's going to the hospital to have them test it and she'll let me know. Now I'm freaking out. Client number 3 is barely 37 weeks and I definitely did not want her to be my very first birth doula experience. I was counting on client #1, a nice peaceful home birth! With no crazy hospital staff to deal with as I advocate for a drug-free birth, no one timing the mom to see if she fails to progress within their desired time frame, and no hospital waiting rooms or triage or beeping or smells. I really want the home birth to be my first so I could practice everything in a calm environment!

So as I await her call to let me know if I will be meeting her at the hospital tonight or not, I read up on leaking amniotic fluid. Here's the info: you can indeed be leaking amniotic fluid for quite some time in Prelabor (the time period during which you are not yet in labor but are having irregular contractions and your cervix is beginning to dilate and efface). Sometimes the leak closes itself back up again. It is a preliminary sign that labor is imminent.
Sometimes the hospital considers it the beginning of labor (membranes are "sort of" ruptured) and they'll consider your labor started. That starts the clock - they don't want you to have your membranes ruptured for longer than 24 hours, and if you are GBS positive they will start you on antibiotics. They'll admit you and put you on pitocin to get you going.

And during this time I also started to realize that if I could potentially be going to client #3's labor, whose EDD wasn't for another 3 weeks, then I'm also officially on-call for client #2, in addition to #1!

And there you have it, all of a sudden I am On Call Like Whoa.

My client called me a little after 10pm last night to let me know they had tested her fluid and it is not amniotic fluid, probably just a large amount of discharge simply due to the fact that she's pregnant and that happens sometimes. Phew!

Positive Signs of Labor
While there are many preliminary signs of labor, there are only three positive signs of labor.

1. Progressing contractions of the uterus. These are contractions that become longer, stronger, and/or closer together as time passes. Contractions can sometimes be on again, off again for hours and days which is confusing. Timing contractions and keeping a record will let you know if they are progressing.
2. Rupture of the membranes with a gush. Most of the time, the membranes do not rupture until active phase of labor or later. But when ROM occurs with a gush, labor usually starts within a few hours.
3. Changes in the cervix confirmed by a vaginal exam. Your caregiver notes that progressing contractions are indeed causing changes in the position, ripening, effacement and dilation of your cervix.

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