Bakers dozen

This morning 12-22-09 Mrs. BD came in from Hutchinson to hopefully have her 13th baby. She has had all but 2 of her children at home and I have had the privilege to be a part of each of her home births. The weather is supposed to get bad over the next couple of days and then Christmas on Friday. The daddy of these precious babies is an amazing man, husband and father . He works very hard to provide for and care for his family. His mother passed away this week and her funeral will be on Monday December 28th.
Mom's due date was 12-20- 2009. As you can imagine the pressure was on for the timing of this new addition.
Anyway this morning she arrived at the BI.. She went back to sleep for a while and then went out for a walk. Her contractions started around 3:00pm and were mild. Daddy checked her at 3:30 and she was 5 cms. but doing great. Mind you that this mom has a history of going quite fast once she gets started. I called Brenda and she went on over. I told them I was going to stop and get a sandwich and eat it at the BI. They thought I would have plenty of time to do that .I arrived at 4:25pm and went into the kitchen to stuff down my sandwich. This mom who is extremely layed backed said casually you might want to check me before you start eating. I knew what that meant and quickly went in to do the check. I took one look at her and told Brenda never mind eating now just hand me a pair of gloves because once she moves ( she was sitting on her bottom) the baby is going to slip right out. Sure enough she slipped off the couch into a squat and pushed the baby out. Her little head was perfectly round with no molding what so ever.
An interesting thing is that she had her last baby exactly the same way and same time just 2 years ago. I would say she has birthing down to an exact science.
Mom said after birth that she was very grateful to the Lord for giving her this birth. She said five minutes after the birth that it wasn't painful just "mostly discomfort".
WOW IF only all the Birth's would be like that. But I guess I would be out of work if they were.

Mrs Beauty.

It was Tuesday morning 5 am, (2 days before I would have to how to host 30 for Thanksgiving dinner) Mrs B says she thinks her water has broke, she is a week and a half from her due date. Every first time moms dream..to go early:) We talk about it a bit, she reports that it is clear and baby is active. We talk about what to watch for from here and agree on a time to meet to check on her and baby. Mid-morning she calls still not having contractions but feeling some minor cramping. I encourage to go walk like crazy and stay hydrated. After lunch she comes in with her sister and is having mild contractions 10 minutes apart. We decide to check her cervix which is 3 cm dialated and 50% effaced, I give it a little tweek and note that the baby is high in the pelvis. Heart tones are great and mom is excited. I instruct her to go walking again and to call me when things pick up. Less than an hour later..she reports that things have definitely changed the contractions are closer and stronger..she is at Target, buying the carseat and wonders what to do. I suggested she finish what she is doing and see how things go. She calls back a few minutes later to say they want to head to the Birth Inn. I let Brenda know and they all meet there a short time later. Brenda checks her but there has been no change in the cervix it's 3:30pm, so they get settled in and go walking again. At 5:oopm Mrs Beauty calls Brenda again and says it's getting harder, dad is putting the carseat together. Brenda goes over to the Birth Inn and listens to baby and checks her cervix again finding it still 3 cm. Mrs Beauty is determined to do what it takes and takes to walking again. At 7:30pm I go over to find mom just coming in from a walk. She is tolerating the labor very well. Upon exam I find the cervix 4 cm and 80% effaced with the baby still high in the pelvis. She decides to get in the tub which she finds very relaxing. At 9pm I check her again before I head home to nurse my baby. She is 4cm 90%effaced and the baby has come down significantly and is well applied to the cervix...yea. Many 1st time moms have to fully efface before making much progress with dialation. This is obviously true for her. The next hour she gets out of the tub sits on the birth ball they pray and sing. Brenda I both observe how completely beautiful she looks relaxing in the tub. She soon begins to feel some rectal pressure and is now 7 cm it's 10:20pm! At 11:30pm she is complete and moves from the toilet to the bed where she begins to push. The baby comes right down, she comes up to a squat and births the head, we lay her back and she delivers and 7lb girl at 11:43pm. t
The moral of this story is..sometimes 1st time moms take a lot of time getting going but once they get effaced things can move very quickly and sometimes they even deliver without a long pushing stage:) Nothing could be sweeter because the latent phase (0-3cm) is usually the easiest phase. This mom did what it took and didn't get discouraged despite the early slow progress! ddd

first time mom speedy delivery

Mrs speedy primip started with some contractions this morning at 9:00 and had some leaking water. I saw her at 10:30 and her contrx. were only lasting 20 seconds. I told her she may not have the baby till tomorrow. HA HA little did I know. She and her hubby went to play frisby golf this afternoon and then went home to take a nap. A short one. They called at 2:45pm and said that she was vomiting and her contrx. were getting stronger and were lasting one minute. She came to the Birth Inn and was 8 cms. WOW way to go. She did wonderful. Soooo relaxed between contrxs.
This first time mom was faithful with her walking the last month and I think that really helped her, So expecting moms start walking it really does help.
She gave birth to a 7lb. 12 oz baby boy at 4:34 pm.
Awesome and a daytime birth for Brenda and I. That's an extra blessing.
Nice

Mrs. Leaky waters

PTL> Mrs. Leaky waters finally went into active labor around 5pm last evening. She made great progress and delivered a 7lb. 14 oz. baby girl at 10:10pm. All went well and mom and baby are doing great.

Mrs. Leaky waters

Well here we are again another mom with PROM. UGH! I can't beleive we have so many moms with this. Mrs. Leaky is at the Birth Inn and is at 35 hours ruptured. Starting to have some contractions.

Lady Nola

Lady Nola's history: 5 previous births all of them were born early anywhere from 34 weeks to 37 weeks. Obviously she had small babies. She was now over 38 weeks and getting very anxious and wanted to have her baby. We had her come in 8-17-09 and checked her, she was having some contractions but not in active labor. She started having stronger harder contraction. YEAH! She was very excited. She delivered her baby 2 hours later. 6lbs 6oz. She thought he was soooo big. Brenda and I just laughted. We know what a BIG baby is. They went home 2 hours after the birth and were exstatic. PTL.

Mrs. Sk

We helped Mrs SK with her first baby 3 years ago (a boy). She had a very nice first delivery but she did tear pretty bad. Our goal was to help her have her second without tearing. At 8 cm she was walking around smiling not believing she was that far along. Her contractions were very irregular sometimes 15- 20 minutes apart. She was walking her long legs off. Mrs SK had a doula with her and that seemed to give her comfort but she was really was doing great. On her first exam I determined the baby was in the posterior position and attempted to turn her. I was able to get the baby halfway turned but needed strong contraction to help do the rest.

It was getting late and she really wanted to be done. She was walking, changing positions, and finally we decided to put her on the breast pump which work incredible well. She started having really good contractions and was sitting on the toilet and was beginning to have increase pressure. I checked her an hour after starting the pump she was complete and her water broke. Things started picking up then and the contractions got harder and more consistant. She pushed for one hour and and when she started to crown we had her pant and ease the baby out while I gave her perineal support. There was a nuchal cord which I slipped over the baby's head easily and then the the baby came out with her arm reaching out. I tried to hold it close to the baby to keep it from tearing her but I thought it probably didn't help. To my surprise when I checked her after the placenta delivered there were no tears PTL Success! Mom was delighted. A baby girl weighing 7lbs 14oz.

Mrs. Lots of Boys (MK),
Mrs. Mk had prom for 30 hours before she delivered. The slow steady kind of birth that went very well. She had a few contractions off and on since her water broke, but nothing regular. This was new to her. In previous births once her labor started it just took off and she had her baby within 6-8 hours. I think God uses many different ways to keep us trusting him, just when we think we have something down He lets us know who's really in control.

Anyway back to Mrs. MK's birth. She was content taking things slow until she passed the 24 hour mark of ROM. She called me and asked if there was anything we could do to get things going. I went over and checked her and she was 6-7 cms but not having contractions after walking for hours. She was getting tired. I stretched her cervix and had her do nipple stimulation for a while but she just didn't kick in to active labor. Her labor kicked in and she had another baby boy (7) 2 hours later. They were so happy. We kept her at the Birth Inn for 3 hours. She wanted to get home to her family. No tears and minimal bleeding. PTL Thank you God for another safe beautiful birth.

NOTE: It's great to be patient and allow a mom to labor at her own pace however when a mom is approaching second stage it is very important to have regular strong contractions to help push the baby out. You really don't want to have a baby deep in the pelvis and no contractions. By the way I've found over the years of assisting many grandmultip moms they sometimes do have stalled out labors. I guess the uterus just gets tired and doesn't work as efficiently as it once did.

Mrs.AA cont.

This morning started out with the phone ringing as it does often times. Last night I didn't sleep very well , I kept thinking that my phone would ring any time and Mrs. A would tell me she was in active labor and for us to come over. Well she did call but her labor was not active. She had a few contractions during the night and continued to leak fluid, and she thought her labor was beginning to pick up. I told her I would do some prenatals and if she was not in active labor I would come at noon and jump start her. She is a VBAC so our options were limited. The last thing you want to do with a VBAC is start labor with powerful meds and take the chance of rupturing her uterus. Not a good option.
An hour later Mrs. Speedy Birther called and said she thought she might be in early labor. This mom has a history of going early and very fast (precipitously). She lives about an hour from me so I think she was a little nervous. I told her to go to bed and drink alot of water after an hour or two she whould know if her labor is the real thing.

Mrs. Lots of Boys called an hour later and said her water was broke. Not in active labor. Same song second dance. Full moon. Same instructions to her and the additional info regarding PROM. She has done this in previous pregnancies so she was fine with the plan. We have helped her with several of her births. This will be her 9th.

At 11:30 I head over to the Birth Inn to help Mrs AA and decide she is doing great, so we decide to give her some more time. I did check her and she was 5-6 cm.'s 90% effaced and station +1 Yeah!!

While I am waiting on Mrs. AA I get a call from Mrs. Speedy Birther and she is still having contractions. I told her to come on in and I would check her.

By the way I am alone at the Birth Inn, Brenda is at the Dr.s with her husband who is having minor surgery. HMMMMM what to do. Deidre my loyal, sweet, fantastic backup offered to come and help. She just had her baby 3 months ago. The Lord does provide all we need.

Mrs. Speedy was sent home disappointed, fingertip dilated and thick. I was a little relieved but felt sorry for her.

Brenda arrived. YEAH! So I canceled Deidre.

Back to Mrs. AA .She was 7-8 cms at 2:20pm and was getting very dischouraged. She wanted to be done and I don't blame her, we gave her a little help and she had a beautiful hydrabirth 20 minutes later. She was so happy to have her 5th baby. Not one problem. The baby was great and no signs of infection. If a mom is GBS negative there is little risk of infection if you are patient and DO NOT CHECK HER. Observing is the best policy. She will let you know when its safe to check her. She was very excited not to tear. The baby did have a cord around her neck (nuchal cord) but it presented no problems (occurs with 50% of all deliveries.) Rarley do nuchal cords cause any problems. If the cord is really tight the baby might not come down into the pelvis. Then you suspect a problem and can deal with it appropiately. I'll probably have some stories about this some day and how it was handled. They went home at 7:00 this evening.

SROM

This mom is para 5 and gravid 4. One csec last pregnancy for a face presentation. I saw her in the office yesterday for a routine prenatal. Everything looked good. During the night she call with ruptured membranes and no labor (PROM). She walked all day and came to the Birth Inn this afternoon with a few contractions. Baby has been active I went over hygiene and fluid intake. She is GBS negative (group b strept) ptl. Heart rate good no signs of infection. We decided to let her have a good night sleep and evaluate in the am. Maybe she will kick in during the night. That would be great. I thick we are in a season of testing which comes with midwifery. We have had a very good year with non complicated births but the of seasons of birth do change. Now we are in the challenging mode. Thats ok it keeps us dependant on the Lord.
I'll let you know how the birth goes.

Mrs. E's 7th baby

This mom had a normal pregnancy without any problems. On her last visit I did think the baby was getting a little big but I was not overly concerned. She called Saturday morning and said she had contractions during the night but they were short and irregular. She ask a doula in training to come to the birth to help her. The doula was great: very attentive, had good comfort measures and was alert to details, like knowing when to call me. I was impressed. Doula's are wonderful to have with you during birth. Their sole job is to help the mom in any way possible. Brenda and I usually do this at the birth's we attend but when you are the main caregiver watching over mom and baby it is great having someone focused on the mom. Doula's are angels giving selflessly sometimes for many hours to aid birthing women. Also it has been proven just having another person at your birth decreases your chance of an unnecessary Csec by more than 50%.

We arrived at the home and were greeted with 3 eager siblings ready and willing to help us unload the car. They were so helpful and attentive to their mom. Concerned was on their faces but this mom had prepared them. With her first cervical check she was 8-9 cms with a bulging BOW. We set up every thing and moved her to the birthing chair. She wasn't excited to move at all but wanted to use the chair. She adjusted. Usually any change in position during labor is not comfortable at first but after a few contractions the mom settles in and adjust.



She started pushing soon after moving and the baby was slow to come down. We decided to help her with a little augmentation just to help her along. She would have done it her self given enough time but she was getting very tired and was open to some help. After that she had the baby in 2 contractions. A little tear right along the previous episotomy. If a mom is allowed to tear and not given an episotomy she has a better chance of not tearing all on future births. The rate of episotomies are decreasing in the Wichita area but there are still a few 'old school' Dr.s ready and eager to speed up the birth and cut the mom. If you have never had an episotomy then you would not understand why you want to avoid them unless it was a matter of the babies safty. They are very painful and take a long time to heal and can be painful for years. We put in 4 stitches. The baby girl weighed 9lbs 4 oz. This mom's biggest. It was a delight to attend this birth and having it in the day time was another bonus. The siblings were soooo excited.

Mrs.B's water birth

Mrs. B had 2 previous births in the hospital which went well but she decided she wanted to have her baby at home this time. Her pregnancy went very good everything was normal. SHe also was 10 days late. I guess we are in a season of late moms. SHe called this morning with contractions every five minutes. Brenda headed up to her home. She was doing great walking around sitting on the birth ball and talking and laughing. Things were not progressing as fast as she wanted and in her other births when her water broke she delivered quickly so she wanted her water broke. Ater that things did pick up quickly and she decided to get in the kiddy pool to help her relax. After only 30 minutes she seemed to be getting close so I checked her and she was about an 8 but her cervix was very posterior so we healed it forward and in 4 contractions she was comlplete. She did push very hard for 20 minutes and the head was born but very slow. This is a sign of possible shoulder dystocia. We got her out of the water even though she was not exactly happy about this but the process of lifting her leg over and getting in a squat the baby was born. He had a tight nuchal cord (cord around the neck) He was quite huge 10lbs and 4 oz. She did have a minor tear but it was right along side the 2 previous episotomys. They are happy to have a boy after 2 girls. Hard birth but all was well. PTL

Mrs. M. not so late afterall

The Lord is good to those who wait.
Boy was this ever true. God intervened in so many ways. He is good and does not fail.

1. We found another new fantastic backup Dr. He was the greatest. I think he has a midwife's heart. This couple had insurance for the baby but not the mom. So the labor and birth was out of pocket for them. The Dr. was very understanding about this and tried very hard to keep the cost down.
2. The wonderful nurse also got on board and tried to help eliminate unnecessary expenses. This nurse attended a few home births with me years ago so when she saw my name as the attending midwife she said she would be their nurse. Only God could time this so perfect.

3.The other great thing I was able to finish all my prenatels on Thursday and as soon as I finished they called for me to come to the hospital. Perfect timing!

4. The baby's gestational age was 40 weeks not late at all, but he did weigh 9lbs 1oz.
Something for you moms to keep in mind. If you miss a period take the pg test right away. It helps eliminate these confusing date issues. Don't just assume you are pregnant if you are late. Confirm. PLEASEEEE. If in doubt an early ultrasound also help confirm dates. This mom was just sure she had her dates right but she didn't. You can be fooled. You would think after 10 previous births you would have it down but things are not always as they seem.

Another failure to start Mrs. M"s labor. I felt overwhelmed and stressed about this but the Lord has been very faithful and I have learned a lot about faith and trust. It has pressed me to the Lord almost every minute. That is a truly "a good thing". Wonder what Martha Stewart would think about that?
We all agreed that Tomorrow was the deadline and the baby needed to come for several reasons. Thus I started the search for a Doctor to take her on and induce her tomorrow. My faithful Dr. for the last 22 years appears to no longer be available. Not sure what is going on there even though he says he will always help us out (as long as they have insurance). His new office nurse has attitude problems and is very against midwives and out of hospital births thus will not return my calls. That was very discouraging. I decided to call a family practice Doc that has referred patients to me several times. He was wonderful and very happy to take her on and scheduled her for an induction tomorrow at 7:30 am. His attitude was great and very kind. The Lord was sooooo good. I'll let you know tomorrow how this turns out. I also have a mom Mrs.B that is now 9 days late. HMMMMM what is it? The weather, the water, the season, I don't know.
Over the years I can recall many such patterns. The old saying, trouble comes in 3"s I believe it. Well I hope and trust that the '3' season is over soon and we can move to a more pleasant season. What ever, we WILL keep pressing on.

Going out to see Mrs. M in the morning at 7:oo for one last try. I think I'll use our special labor tricks.. Pray it works.

Waiting patiently

Mrs M.'s story. Day 23. Still waiting. I am assisting a 46 year old in the birth of her 11th baby. This mom has a history of going 2-3 weeks late in her previous births. We expected this one to be late also. At 10 days late and a failure to start her labor with natural methods and much discussing we decided that she was probably off on her dates. She did not take a pregnancy test until after her second missed period she also did not feel movement until 2-3 weeks later than she usually does. We decided with much prayer to wait and give her more time. We all felt peaceful about this decision. We also had a biophysical which confirmed our decision. At 17 days late we tried again and failed. Not one contraction or change in her cervix. We started checking the baby daily for reassuring signs and the baby's weight seemed average 7lbs ish. Dad needs to go oot August 2nd and wants to spend time with his wife and baby before he leaves. He also doesn't want to go to the hospital yet and neither does the mom. We tried again to start her on day 21 and 24 only this time she did have some contractions. She has been having contractions daily and is also having an increase in mucous. Finally some signs of labor. We have decided that she must go in thursday for a hospital induction, out last attempt for a home birth will be tomorrow. This has been very challenging and has increased my faith and trust on a daily basis. I so hope to enter the results of a beautiful birth at home tomorrow. If not you'll get the details day by day. In the middle of waiting for Mrs. M we had 2 other births one of a 47 year old mom with previous csec. and another mom that was 35 weeks with PPROM and GBS (Group B Strept) positive. Hospital delivery but turned out great. Healthy mom and baby.