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.