I'm still new enough to the doula
profession that many births bring me a "first:" first VBAC
, first stillbirth, first twins, first delivery out of bed, first hemorrhage
, etc. Many firsts have yet to happen in my experience. I am waiting for my first water birth, home birth, breech birth (right!), car birth and birth in an unruptured
I was already going to write about how my most recent client was my first client to have preeclampsia
. She was diagnosed yesterday, nearly 2 weeks past her due date, and promptly admitted to the hospital.
Last night began her induction. She had gotten a gel earlier in the day. Around seven they began cytotec
. At 11 she was contracting regularly so they opted not to go another round with cytotec
and instead began a low dose pitocin
After all this she remained dilated the same 1-2 centimeters she had been for weeks. They sent her spouse home to sleep, gave her Ambien
and a little morphine so she could sleep, and sat back for the pitocin
to start its long work.
At 1:00 my client suddenly found herself in serious discomfort and was quickly given the epidural she requested. When the doctor checked her at 4:00 she was complete. She called in her spouse and after less than 1/2 hour of pushing, delivered her healthy baby.
This is what her spouse told me over the phone this morning when he called to say the baby had been born. I assumed the call was for me to come in to the hospital because she was getting uncomfortable with contractions. When I heard a baby crying in the background my heart jumped. I thought her blood pressure must have risen precipitously and they'd had to do an emergency c-section. No.
Everything was okay. She just didn't call me. It was the first birth I've ever missed.
I visited them this morning. It sounds like two things accounted for my full night's rest. First, when things got uncomfortable, they did so quickly. And just as quickly the epidural eased her pain and she rested some more. Her spouse didn't even know she was getting an epidural. He was at home, resting up for the long haul.
Second, my client was very dopey. She said that between the Ambien
and the morphine, she had a difficult time even understanding what was going on. She slept when they said sleep and called her spouse when they said it was time to call. No one said call the doula
Her spouse said this morning that they'd much rather have had this kind of birth than one where they really needed a doula
. Indeed, that was the birth we all were anticipating.
I have been replaying the night over and over. Despite their reassurances to the contrary, I can't help but feel like I failed in my job. I saw her at the hospital early yesterday evening, before they started cytotec
. At everyone's
urging -- the mother's, the doctor's, my own id's -- I went home to rest up.
No one thought this would be a quick birth. I have been an many an induction where the first 24 hours are all sitting and waiting for contractions to even start.
But I do not like leaving clients alone for this very reason. One never knows what will happen. Especially when cytotec
, that jackhammer of a drug, is involved. Yes, she could have had 24 hours of cytotec
and never responded. I have seen that before. Or she could have done what she did, jump all over it.
I don't think the birth would have gone differently. No one is saying it went poorly. But the thought of my client laboring alone haunts me.
I know this won't be my last missed birth, but I hope it's the last I miss from letting my guard down.