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.