The induction ended. Well. I don't know which was more significant. The ending or the ending well! Of course I'm kidding, but I suspect the mother, at least in the moments after delivery, shared those sentiments.
Actually the labor itself wasn't so bad. It was the preceeding 14 hours of chemical induction that set the tone for the whole experience. For some reason they start inductions at night at this particular hospital. So at 9 p.m. the mother was tucked into bed with prostaglandins on her cervix and told to rest. Like that's gonna happen.
But she gave it her best shot and got maybe 2-3 hours of sleep. In the morning she had made no cervical change, so they switched to pitocin. After six hours on pitocin, again with no cervical change, she asked for a break. She asked them to stop the pitocin so she could sleep.
At that point, however, her body had taken over and her contractions continued with the same frequency and intensity. Over the next six hours she made steady progress, working so amazingly patiently with each contraction. Finally she asked to have her water broken and the caregivers complied. Twenty minutes later her son arrived, robust and healthy, after three pushes.
Every birth is a learning experience and this birth gave me more insight into why some midwives never induce labor. For though this baby was technically 10 days overdue, he did not have signs of being a late baby. He has some vernix on him. His placenta was very healthy looking (I even asked the midwife to show me what calcification looked like, since I haven't seen many "old" placentas, and she couldn't find any). And after watching hour after hour of exhaustion and pain that the mother went through with the induction, it was pretty clear that her body could have used some more time to get ready for labor. She endured it so well, and without an epidural, which was her goal, but much of it seemed unnecessary; given another few days or a week, how much more quickly would it have gone?
I don't feel like I'm making myself clear. Let me try again. I am extremely proud of this woman and the effort she gave. I am in awe of her determination. Knowing what she has inside her, I wish she could have been allowed to get a better labor, which I believe would have happened if she wasn't induced.
The other thing I learned at this labor was just how quickly a mother can go from transition to birth. She was seven centimeters when the midwife broke her water. After watching a few contractions, the midwife left to check on another patient. Then the nurse left to run down the hall for a second. And no sooner was the room empty than the mother had a contraction where she said, "I'm pushing. I can't help it." I said "O.K. I'll call for the nurse." I pushed the call button and said we needed the nurse. The mother pushed again, this time a hard whole-body push. She said, "The head is right there!" And it was. At least three centimeters of scalp.
I pressed the call button again and said, "We need the midwife in here!" The midwife walked in during the next push and was able to talk the mother through a slow delivery of the head, followed by the rest of his body. It was so fast. In one picture you can see the nurse arriving and putting a glove on, but the baby's already resting on the mother's belly.
Quite a nice, memorable ending to a grueling 26-hour induction.