Thursday, December 23, 2010

Sunrise

Two really nice births.....It had been a long week. My youngest daughter was in the hospital with rotavirus when 1 of the 3 calls came in with gals in early labor. I was wondering how this was all gonna work out. This particular mom, Mrs T, is one that I have delivered before. She had a 9 pounder with a large head on her first one. Needless to say we were expecting another big boy:) She called around 3 pm with ruptured membranes but no contractions. I went over to see her and check on baby. She had been some what concerned about movement. Baby had a significant arrhythmia so I was listening to heart tones carefully and was cautiously optimistic that she would be able to deliver at home. I also had Kathy listen to affirm that all was well. Bethany was planning to assist so I put she and Christy on alert. We all agreed I could go on to another mom in labor, especially since Mrs T was not contracting very much. My other mom was moving right along so Bethany agreed to check on Mrs. T at 10. At that point contractions still weren't consistent so after listening to baby Bethany headed back to Hutch at midnight. I finished the hospital birth around 1:30 which went GREAT for a first time mom:) While I was at the hospital another one of my moms called to report that her water had broke, unfortunately this mom was only 7 months along in her pregnancy. She came to St Joe and Dr Jensen took over her care. (She delivered 2 days later, baby is still in NICU but he is doing great too). Anyway, back to Mrs T...I got in my van..no heat working and freezing temperatures...brrrr and drove over to her house around 2am. I decided to stay because she had made some progress plus I didn't relish the idea of getting back out again. Contraction picked up shortly after I got there but mom decided to rest in the recliner for a bit. I called Christy to come and lied down for a short nap. Mom woke me up at about 5:15 with close contx I checked her and she was 6-7 cm. She got in the bathtub but not before stopping at the toilet where it was evident that she was progressing QUICKLY. I called Bethany..realizing at that point that she probably wouldn't make it:( Mrs T began making pushing noises after only a short time in the tub. Just after 6am she got out of the tub came over to the bed and delivered an almost 9lb baby in a few short pushes. The baby let out his first big cry and his big brother, now a toddler, who was asleep on the other side of the bed popped up with a sleepy look on his face and took a very brief look at baby then immediately plopped back down and went back to sleep. I couldn't help but notice through the bedroom window a beautiful sunrise in the distance. The day was November 14th and it was a lovely crisp cool winter day. Thank you Father for the birth of these 2 babies and for the birth of my own daughter 12 years ago this day. I stand amazed! by:Deidre DeGrado

Saturday, September 11, 2010

Mrs Sticky

What were you doing on September 11, 2001? I was at a birth in Elbing Kansas. I remember arriving at the home and everyone was gathered around the TV, glued to the set, staring, quiet, somber, watching the Town Towers go up in smoke. I didn't have a TV back then so I had no idea what was happening in our country. We were all scared, and shocked at what was happening. 'I'm not sure why but after looking back at my previous 9 years of calendars since 9/11/2001, I've had the privilege of delivering a baby on 8 of the past 9 years. Maybe this is God's way of giving 'Beauty for Ashes'.
Mrs S: Gravid 13 Para 9, came to her prenatal on Thursday September 9th 2010. When she walked in I thought ,Oh Boy,we've had a growth spurt. She could hardly walk down the stairs and I could tell with a quick glance that she was miserable and ready to have her 10th baby. I've been blessed to assist Mrs. S in several of her births, she has a history of no dilation until she is in active labor and has always gone a week or two late. When I saw her in the office I immediately thought she isn't going to make it 2 more weeks. She also has a history of having large babies, 10 lbs. or greater, thankfully without much difficulty. When I checked her she was 45-46 cms. WOW! and she isn't even late. That is the most she has ever measured. We both agreed that we needed to be proactive and get the baby out SOON to prevent difficulties with her delivery. We decided to have her come to the Birth Inn and have her baby the next day. A Plan right? By the way Dad had thought all along that his baby would be born on 9/11 but we decided to get things going on the 10th. A man makes plans but the Lord has His.
This is how her last several births have gone: strip the membranes, labor candy, walk a lot, dink around, then after several hours of that she is 4-5 cms dilated, contractions slow down and mom needs a rest, so the midwives leave to let the dogs out and rest, mom goes to bed to rest for a while and wait for the contraction to pick up. About 30 to 45 minutes later her water breaks and we're off, scurrying back to the BI. A good plan right?

That day Mrs S., her precious husband and I, spent the day sharing our testimonies while mom was dinking around with her usual slow to start labor pattern, we reviewed her previous births and mom said several times well I usually... So when I got the call water just broke, return to the BI I just laughed and thought to myself, she has a plan and she is STICKING with it, thus the name Mrs. Sticky. I checked her, no change in the cervix, still 4-5 cms.
Mom was very tired and wanted to get things going.
She walked around, changed position, but her cervix was posterior and not opening. She has a very pendulous uterus, which means her her large baby was falling forward which made her uterus tip forward, making her cervix posterior. When the cervix is posterior is just doesn't open, and to make things even worse the baby was posterior ( baby is looking towards moms abdomen rather than the preferred face pointing towards mom's back position.) We call this the humble baby position, that is what to pray for when you are expecting, a humble baby. The only way we could get labor to progress was to have mom on her back. UGH not preferred but productive for this mom and we wanted progress. We tried in the past to bind up her abdomen to help pull her uterus into an upright position but it never seemed to work for her. Lying on her back seemed to be the ticket. It is now September 11 and 1:24 am mom is complete and pushing. She was crowning at 1:26, Deidre and I looked at each other thinking this is a very big baby. Deidre looped the nucal cord over the babies head had the mom push again and the cutiest , chubby cheeked, baby girl slipped right out. She was slightly blue and her muscle tone was not the greatest but with suction, stimulation and mom talking to her, she started crying, music to my ears. Praise the Lord, He again was faithful to bring forth a health baby. Dad's premonition was right the baby was born on September 11, 2010, 'Beauty for Ashes'.

Monday, September 6, 2010

Mrs. Pokey

Mrs. P was gravid 4 pare 3. I helped her with her first and second deliveries, then she moved to another state and had number 3. She has a history of going late and followed that pattern with number 4. Mrs P was 42 weeks and started having irregular contraction on the evening of September 5th. When she arrived at the Birth Inn she was 3 cms. and 90% effaced. Her contractions were 12 to 15 min. apart. but strong enough to convince her she was in active labor however, after arriving she decided she wanted to rest, so to bed we all went thinking she would wake us during the night in active labor.
At 7:00 am on Labor Day we woke and mom said she had contractions most of the night and was 4-5 cms. She was tired and wanted to sleep because her contractions had slowed down. I recommended a walk to see if we could get things moving and she agreed. It really didn't help so we decided to let her rest and I went home to shower and let my dogs out. They were very happy to see me.
At 3:00 pm mom called and said her contrx. had picked up and were getting stronger. I went over around 4:00 pm and mom was gone. Hmmmmm. They had gone out for a while and arrived back around 4:30 I checked her again and she was 6-7 cms. Yea!
Contractions really would not get close unless she walked so we did enchourage her to be active. As long as she walked they were consistant but not really close together. We discussed options and she decided to go out for a walk again. When they returned it seemed the contrx. were picking up in strength. At 7:30 we put her in hands and knees, she was ac ( almost complete) but her contractions were anywhere from 5-10 mins. apart. Cynthia suggested she move to the toliet and mom agreed. She walked over and sat down and had a few contraactions that were 3-4 mins apart. Good toliet move. I've always said things come out on the toliet. The next contrax. she seemed to bear down and she lookd up at me as if to say what now. I moved over quickly and helped her stand and lean on her strong hubby to prevent the baby from getting a swirley. I was going to get her back to the bed but was prompted to but my hand back behind her and check, as I suspected the baby was crowning. I just sat my own behind down on the toliet and caught the baby. My first delivery with me on the toliet. It was funny.
Mom and baby (a girl) are both great and happy to be delivered . Baby weighed 8lbs.2oz.
They are going on the mission field soon, to Mongolia. Now that has to be a callling from God.
I just love birth it can be most challenging but also very rewarding. I thank God for calling me into this ministry and for his faithfulness.

Sunday, August 8, 2010

A fast one!

This was a fast and exciting birth:) At Mrs. A's 38 week visit she was 4-5 cm dialated, 100% effaced and a bulging bag of waters. The condition of her cervix was very good news because she had experienced a 4th degree tear with her first birth, so I was hoping that she would go into labor earlier and wouldn't have a bigger baby than last time (8lb 3oz).So that her chances of a bad tear would be minimized. Needless to say I told her,"baby would probably arrive any day." I fully expected her to go into labor that night. Open mouth insert foot...first lesson in midwifery NEVER tell them when you think they will have their baby. I can hear Kathy saying " You don't have a crystal ball and your not God." You'd think I'd know this by now;)...Her cervix just seemed so ripe...Needless to say 10 days later still no baby. We discussed options over the weekend as we were all getting more concerned that the baby was getting big and a minimal tear to the perineum becoming less and less likely. We agreed to meet Monday morning for a prenatal. Fortunately she had some contractions during the night...but by morning they had mostly pittled out. I met them at the Birth Inn at 9:30am..I listened to baby, palpated for size and presentation and did a vaginal check. Baby sounded great, she was in an anterior position, I estimated at 8.5 lbs, the cervix was 5-6cm dialated with bloody show and the head well applied to the cervix at 0 station. I had suggested breaking the water, which as I told her I had never done with a mom not in full blown labor. I just had a sense in this case it would work. I'd been praying, we all had and I felt God's peace. They agreed that it was time:) So at 9:38 we had rupture of membranes with clear fluid and a happy baby. They went out for a short walk as it was VERY hot outside. When she came back and she had some contractions with a few hard ones. She labored inside for another 15 minutes or so then hubby said they needed to get back out walking. I decided to run home and get my car as my hubby had dropped me off. It's now 10:30am...10 minutes later my assistant, Christy, calls to inform me that things had picked up significantly..at which point I start speeding back. She gets the tub going and has mom on her side who a few short minutes later informs her that she needs to have a BM. This usually means baby is COMING soon! My new assistant is now getting nervous so she text's me as mom throws up. Christy gets her in the tub..as I'm pulling up she says "it's burning". We get mom back to the bed because we want her on her side for a slow controlled delivery to help preserve her perineum, (otherwise a water birth would have been great)! I check her she is complete and plus 2 station. I apply the warm compress and arnica oil. We do a 4 handed delivery with mom in excellent control of her pushing, dad did a great job coaching her and she did so well letting just her body do the pushing. After a slow crowning the head appears then out pops a little hand. (Same thing happened with the last one.) I slowly deliver the shoulders. A beautiful baby girl emerges and I put her up on mom. Baby weighed in at 9lb 3oz! Good news is she only had a 2 degree tear! Praise the Lord! A full pound bigger and a smaller tear! God knows what he is doing.
posted by Deidre

Friday, July 16, 2010

Mrs. Abundance of amniotic fluid

Mrs. AF is a gravid 4 para 2. She is one week from her due date, I saw her in the office on the 15 of July for her regular prenatal appt. She was measuring 40 cm which is usually what you measure at term. She had been having some light contractions and had bloody show this am and lost her mucous plug. She asked "when should I call you" and I responded with the standard answer, when your contractions are getting stronger or lasting longer or more intense, when they change and feel different, or lasting longer. She said ok then we decided to do a check of her cervix to see if anything was happpening. Well it sure was, she was 5-6 cms fully efffaced cervix soft, stretchy, with a bulging bow. They lived one hour away so I instucted them to call as soon as her contractions changed. She call back around 8:00 and said I think you should come. With her last birth when I arrived she was 8 cms but not having a lot of contrx. The same was true this time just mild contrx but more consistant. She was 8 cms with a bulgingbow. Mom wanted me to break her bag so she would have the baby sooner , I agreed that would probably be the case so we did break the bag and a flood came forth. She must have had a gallon of amniotic fluid that was slightly stained with mec. Very pale yellow in color. The heart tones were really good. As we thought would happen labor progressed very quickly. Mom was up walking around in the living room and said well I think it is time so we followed her to the bedroom. She was planning to have her baby lying on her side. She stood by the bed for a couple of contractions then said ok its time. She laid down I checked her and she had only an anterior lip. I had her get in her hands and knees for several contracions then gently moved the very slight lip over the baby's head and she pushed a beautiful baby girl out in 2 pushes.
The last 3 births I've had I've had to do a manual removal of the placenta UGHHHHHH! I have been praying that we would not be faced with that again, because it is very painful for the mom. The placenta came without any problems. This mom is a very petite mom and her other children weighed 7 lbs. This big girl weighed in at 8 lbs 9 oz.

A very interesting part of this birth story is that the dad of this baby was born in the very room that his daughter was born in. The midwife that caught him was a midwife that I trained with 20 years ago. Cycle of life just continuing on.
All is well with mom and baby.

I have missed blogging about 7 births I will try to do a better job.

Monday, March 8, 2010

Mrs.Sunny side up

Who came up with that name? When I think of sunny side up, I think of bright, sunny, warm, fuzzy feelings. Well for any of you that have had an OP delivery (posterior position) its not at all warm and fuzzy is it??? It's very painful and presents with a variety of symptoms and sometimes complications with the delivery.

On Thursday, Mrs. Sunnyside up comes to the Birth Inn after having lots of contrx. She was dilated to 4-5 cms. and her cervix was a little thick. Deidre was coming to this birth to get a primary care birth under my supervision. She doesn't really need supervision but she is getting her national certification (CPM) and needed some numbers within the last 3 years. Deidre had checked her that morning and said her cervix was a little thick and tweeked her, at the mom's request of course. She started having contractions within an hour and commented that she was having a lot of pain down her leg. Her contractions were really hard when standing up but would slack off when sitting.

A dysfunctional labor means there is a lack of progress being made with labor. When this happens consider the cause; it's almost always the position of the baby. HMMMM. This was number six for her, so this mom was very in tune to her body and what was happening or not happening. Having these kinds of contrxs. with no progress was quite different for her. After a few hours of this in previous births, she would have already delivered.

We were praying for her and trying to decide what we could do to help her. We tried different positions and tried putting her in the jacuzzi but it really did not help. When Deidre arrived I had her check the mom again and she determined the baby was OP (Occiput Posterior) and high. Sometimes when there is a BBOW (bulging bag of water ) it can be difficult to determine the baby's position. Usually there is an increase in back pain but this mom was not really complaining of severe back pain only the pain in her legs.


As most of you know, we do not break the BOW unless there is good reason and /or a benefit to mother or baby, but we usually do not break the water until transition. After prayer and discussion we determined it might help to do this with this mom. Problems can come with that intervention so you must use that tool wisely. The contractions usually pick up and get much stronger after ROM. We already have a mom with increased pain we sure don't want to add to her pain and it not be beneficial.

After discussing it with mom, we decided to rupture the bag and attempt to turn the baby during it's decent into the pelvis. With one attempt, Deidre turned the baby and it just flipped over. That is an awesome feeling! (for both mother and the Midwife.) Within two contractions the baby was born. PTL.

Intervention can be helpful or harmful so we must try to have discernment. Our motto is, "First Do No Harm". I praise the Lord for his direction and wisdom. Without it, it is impossible to please HIM or the mom.

Congrats DG. We love you and consider it a blessing to serve God and his precious people during Childbirth. Another child brought into this sinful world to make a change for Christ. That my dear friends is why we do what we do.

Saturday, February 27, 2010

A Miracle

This story is more than just a birth story, it's a story of a miracle. I can't just blog the birth because it began long before the birth. It is a story of pain and disappointment....it is the story of God's giving and taking away. This mom is a friend of mine. I met her at our church more than 14 years ago. They were raising one daughter who was from mom's previous marriage but dad had adopted shortly after they were married. Some years after they were married she had a tubal pregnancy unbeknown to her and nearly lost her life when it ruptured. Needles to say the fallopian tube (where conception takes place) was destroyed and partially removed. In Oct of 2000 she found out she was pregnant again. Not long after finding out we went to an ultrasound as she was having some signs of miscarriage. Sadly we found out that this little life was in the remaining tube. She was taken to the hospital where it was removed prior to rupture. The dr. said he did his best to put the tube back together. Fast forward 10 years....my friend who is now 42 finds herself not feeling well....I reluctantly suggest a pregnancy test. Low and behold it comes back positive to every ones surprise. I immediately scheduled her for an ultrasound because the likely hood that it would be in the tube again is HIGH, due to the scar tissue from the previous tubal pregnancy. I pray a lot wondering if this is gonna be the same book but another devastating chapter. Having already sat through this with them once I simply couldn't imagine watching them going through this for the third time. Most of the time this ministry yields such precious moments but when it's bad its very bad. I hold her hand when we get there, she asks me to pray, but of course that is all I can do is pray.... and hope for a miracle. We soon see the heartbeat. A miracle it is! Sitting right where its suppose to be in the uterus:) We cry and rejoice that God has made the impossible..POSSIBLE! When I meet with them the first time to discuss their birthing options the dad tells me that he never gave up hope that they would have a baby...What faith! Fast forward a very long 9 months to 2-24-10.
Miracle Mom calls Wednesday evening to say that she thinks she is in labor, questioning if her water may be broke and having mild contractions. I give her the things to do to protect the baby from bacteria..(since her water may be broke) and tell her to go to bed and try to rest. Instruct her when she should call me. I don't hear from them all night so I call her the next morning 2-25-10 encourage her to take a good walk and see me in the office later in the morning. When she comes in she is contracting regularly but mildly. I find her to be 4 cm dialated and 90% effaced and what I think is a bulging bag of water (an indication that her water may not be broke). I tell them to walk and have lunch and keep me posted. She called after lunch feeling tired and a bit discouraged as things had not picked up. Brenda met them at the Birth Inn at 2:30, finding no change in the cervix. They continued to walk and used the breast pump to stimulate contractions. At 5pm I decide to go over and asses things.On the way there I prayed a lot and asked the Lord for His wisdom. I felt the Lord directing me to break her water. I don't regularly do this but there have been times when I have sensed the Lord direction to do it and when I have it has made things go very quickly. One can never assume that it will always do that, so it must be done with caution because it does increase the pain and the likely hood of infection because the barrier is gone. When I get to the Birth Inn I ask them if they feel ok about me breaking the water...they are more than ok with it. She is almost a week over due at this point. So I break the water and it has meconium (the babies first poop). It can be a sign that the baby is under stress or it can be simply from being over due, which she is. At this point it is obvious that what she thought was her water breaking the previous night was not, since what she saw earlier was clear. I listen to the baby who sounds very good. I head home as I have my baby with me. I barely get home when I get the call from Brenda that things have picked up considerably. I give my baby a quick nursing and head over. When I walk in the door to the Birth Inn Brenda tells me to get my gloves on! The baby is coming! Its only been a little over an hour since I left. I honestly still can't believe that she is having a baby. She looks so determined...and is relieved when I encourage her to go ahead and push (which she had been fight the urge to do because she wasn't sure if she should). She focuses very well pushes great with help from big sister (who is 22) and dad.The baby's head eases out. I find a tight nuchal cord...can't slip it over. Consider clamping and cutting it right there..then feel the shoulders trying to come so I kind of summersault the baby through the cord. I unwrap the cord which is not only around her neck but under her arm and suction her good. She is a bit stunned but makes a gurgle and little cry. I hand her up to mom , dad talks to her and she lets out a big cry. My friends now have a 22 year old daughter, a newborn and 2 they will meet in heaven someday. A few minutes later dad holds baby who they name Jendie with tears running down his face. They name her after their moms (Judy and Wendy) who have passed on already. It was a birth permeated with the miraculous presence of a loving God who against all human odds brought forth life. Praise be to Him! By Deidre DeGrado

Wednesday, January 13, 2010

Labor or No Labor Mrs SJ

Mrs. J. had a false alarm of labor on Sunday night along with another mom. I was beginning to think that I would have to call my back-up midwife for help, but both moms fizzled out. Being up during the night with no fruit of labor is hard for mom, dad, and the midwife. I feel sorry for the mom who is sure her hour has come and have it stop. VERY DISCOURAGING. Anyway back to Mrs. J's birth. She came to the Birth Inn this morning and Brenda checked her (4cms) and gave her a little tweak. She laid around, not much was happening. She started to have some contrx. around 8:30 but they just didn't get very strong. She decided to go out for a walk which really didn't do much. At 12:30 Brenda checked her again because she was thinking about going home since she really wasn't having many contrx. No change in cx. After the check she started having stronger contrx. I went over and when I got there 15 min. later she was AC (almost complete) and her water broke. We put mom in the tub which she really loved. She started pushing at 1:00 pm and crowning at 1:40 the baby would not come. Actually the baby's head would not come over the perineum. We (well the strong husband) got her out of the water (ugh for her)and put her in a supported squat and the baby's head still would not come. I pushed the perineum over the baby's head and discovered a very tight cord. The baby was not coming through the loop of the cord so I tried lifting it over the baby's head, it broke and the baby shot out like a bullet. That's a little scarry and messy I might add. The baby did great, we quickly but a clamp on the cord and handed to baby off to mom and he started crying right away without much help from us. Praise the Lord He was faithful once again.
During the labor we were checking the baby's heart rate regularly and only had a few brief decels, nothing severe. I was thinking we had some sort of cord situation but we had reassurring signs that the baby was doing great.
Mom and baby are doing wonderful and the baby's apgar was 7-9-10. PTL

By the way this was number 11 for this precious family. The children all came over to meet their new sibling and were so excited. What a blessing that was to witness. In the past year we've been blessed to be involved assisting some families having their 10th 11th and two moms having their 13th baby. WOW. It is wonderful seeing responsible, Godly, caring families having children to carry on the Good News of our Lord and Saviour. If you are one of the families sacrificing your life to raise up a godly seed. My praise to you. God Bless you. It is very hard, and I know you are ridiciuled, but you are truly "suffering for rightousness sake".