Monday, October 16, 2006

Baby Girl

One of the two clients I currently have had her baby on Saturday. I was getting nervous because she and the other client were both due yesterday. What are the odds of them delivering on the same day? Slim. But increasing with each day that neither delivers.

Anyway, I got a call at 4:30 a.m. Saturday from her husband saying they were heading in to the hospital. Althought this was a first baby, the mother was dilated to 4 cm at her last checkup, so the doctor advised them to head in once her contractions became regular, regardless of how far apart they were.

I met them in triage. A cervical check found the mother at 5 cm. At that point she was uncomfortable with, but breathing well through, contractions. This mother wanted an epidural from the get go. We had discussed a goal of having her be in active labor before getting one. As soon as she was in her labor room, they put a call in to anesthesia.

During that first hour I was with her at the hospital, her contractions picked up considerably. They were coming every 3-4 minutes and lasting 45 seconds. She was having a lot of back labor and working hard. She had an epidural in place by breakfast time and was much happier. "Blissed out" was the term she used.

Then it was the usual waiting game. Fortunately, there were no epidural complications. No slow-down of contractions, no fetal reaction. At some point later in the morning her doctor broke her water. She was 8 cm at that point. The baby was positioned posteriorly.

The baby didn't like the mother lying on one side, so she was limited to her back and her other side. We tried some position shifts and some leg cocking to move her pelvis as much as we could.

By noon the mother had lots of rectal pressure. The doctor checked and said the baby was +3 and no cervix. A little over an hour later, a healthy little baby girl was born.

At the time of delivery, the room contained: mother and father, doula, two nurses (one for mother one for baby), attending physician, resident, medical student (who caught the baby), EMT student and a partridge in a pear tree.

The doctor said before joining his current practice, he was in solo practice for twenty some years. He said he delivered about 25 babies a month. I can't fathom that. Even if he was doing the tradition doctor thing of showing up for the delivery only, that is A LOT of babies to be solely responsible for. And then office visits on top of that. When did the man ever catch up on sleep?

He also said that when he was a medical student, long before the routine use of monitors and medicine pumps, two of his jobs on the OB rotation were to count IV drips to determine the rate of drug administration and to keep a hand on the mother's belly to tell when contractions were starting and stopping. "That is one of the reasons I'm here today," he said to the student. "Once I put my hand on the mother's belly, I didn't want to leave."

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Anonymous Marianne said...

An out loud chuckle. I love the "partridge in a pear tree" comment. Chuckle I might, but that is a sad realization sometimes. My daughter, who is in med school, was just telling me about the myriad of people in a c-section when she was doing an anesthiology rotation. But her amazement was that she counted all these people and not one was going forward to soothe the mother. Since she is pregnant again, she was reminiscent of her wonderful birth team when she had my grandson in Mexico. But this poor birthing mama was a teen, alone, and very very frightened. And yes, Shannon stepped forward, even if it wasn't her place, and comforted the mama! Yours is a wonderful calling so needed in our society. Thank you!

10:21 PM  
Blogger Jen said...

what a great doctor, to feel that way. love this blog. I just became a Doula and I also just applied to a midwifery program, fingers crossed!

5:46 PM  
Blogger doulicia said...

crossing fingers for you, Jen! Welcome, too, to the doula community.

10:22 AM  

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