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VBA2C Wooo hooo!

If you read the last post you already know something about VBAC and the risks involved so I won't repost those statistics. The birth that I want to share this time was even more gratifying than the last. It involves a mom who had 2 c-sections. She really wanted a vbac after her 1st c-section, but it didn't happened and she was really grieved over it. So this time she did more research, prayed even more and became more resolved. They hired me a few months before the birth. We talked, planned and prayed. This time she had a doctor that I knew we could count on if the goings got tough. I knew he wouldn't bail for convenience or fear. Dad was fully on board and encouraged her in her exercise regime. She called to let me know Wed morning that she was crampy, having bloody show and contracting occasionally. She went about her day normally but taking time to rest. Wed evening things had gotten more regular (10min apart).At 10 pm I checked her cervix and found her to be 3-4 cm dilated and baby's heart tones were great. I suggested she continue to take it easy if she could and be active if she couldn't. At 1:30am on Thursday morning dad called to say that contx had gotten very close and much harder. We planned to meet at the Birth Inn at 2. (I thought the change of scenery would be good) When she arrived she was 5 cm and working very hard with her contx, but doubting her ability to cope. We encouraged her regularly, listened to baby, and changed positions a lot! She found the shower to be helpful. By 5am she was 6 cm and very disappointed to have only progressed 1 cm in 3 hours. I assured her that any progress was good. She felt discouraged but persevered. Her husband was amazing and refused to get discouraged and kept her focused. At 8 am things were still the same with contx 2 min apart and hard. She began having some pressure in certain positions, the baby was coming down. While she wasn't making progress in dilation things were changing and progress was being made We decided to go to the hospital (this was a planned hosp birth) for a scene change. We got checked in by 9am. Still 6 cm:(  Mind you she has now been 6 cm since sometime before 5am:(  She found the tub to be most helpful! Of course she had to be monitored regularly so this gave us position change and the movement was good. This mom was constantly questioning herself but amazed me in her resolve, which seemed to grow ever more strong with each passing hour. The nurse checked her at 11am and found her to be 8cm! PTL!!! PROGRESS at last! She was encouraged, finally. At noon Dr J came in, she was still 8 cm. She got back in the tub, which really did help her to relax. We discussed options, I knew she was running out of steam. Of course the epidural was on the fore front of our minds. As much as I wanted her to have relif and give it to her I just felt  that we still needed to keep it natural. Especially since she had gotten blocked in the birth before and had failed to progress afterwords. I also got some encouragement from grandma that helped me know that I too need to help this mom stay the course. (Grandma reminded me that this mom was terribly disappointed after the last section.) At 12:30 K began to do lunges with one foot on the side of the tub, alternating legs and coming down into squates, with a lot of dads help.. He was working up a sweat as well..This  really worked to increase the intensity of the contx and bring baby down into the pelvis. At 12:40 pressure was increasing a lot. She beared down about 4-5 times. At 12:55 she moved from the bathroom to the room. At this point the baby was crowning, she crowned her for 4 more contx and baby burst forth:) A beautiful girl weighing 8lb 4oz and 19in long! Dad was as satisfied as ever beaming with pride and emotion! Mom exclaimed, "I did it, I can't believe I really did it!" Honestly....I thought, "I can't believe you did it!" This was the hardest birth I had been to in awhile but  the gratification was so worth it....I'll forever have etched in my mind the words that burst forth from her mouth when it was all over....."I DID IT" K I am soooooooooooooo proud of you!

Women were made to birth, if we just believe in them and trust the Lord!

Middle east

This couple called me last year and we initially met for lunch. They (mostly she) asked questions I told them about what I do. She is expecting her 2nd, her first was a C-Section for breech presentation, 11 years earlier. Dad had 2 children born via c-section from a previous marriage. They had been to the doctor and of course he had scared dad to death telling them it could be life threatening for mom and babe to have a VBAC (Vaginal birth after cesarean). Which is true, but, what he left out was how rare an actual uterine rupture is in a vaginal birth after cesarean that is not induced or augmented.The statistics are: Uterine rupture is the major concern in terms of VBAC and while it can be catastrophic, it is rare (National Institutes of Health, 2010).Permitting labor to begin naturally after one prior low transverse (“bikini cut”) cesarean carries a 0.4% risk of rupture. This rate can increase with pitocin induction or augmentation.  (Which I don't do out of a hospital.) Several of this mom's friends had delivered with me and she was very interested in natural birth. A compromise was met between mom and dad..She would see the OB and me and keep praying about the location of the delivery. I thought this was a good compromise. It gave dad some time to process and being an avid reader he could take time to research:) I continued to see mom throughout the pregnancy she worked hard on diet, exercise and taking her thoughts captive. They came to childbirth classes mine and Bradley. God gave them the verse Josh 1:9." be strong and courageous". A little more than half way through the pregnancy dad began talking to mom about serving in a ministerial capacity in the middle east. To which his wise wife answered she would be happy to surrender her husband to such an endeavor if the risk of death were equal to or less than a VBAC:)  Needless to say I think he got the point. Most importantly he was doing his research and praying fervently.  While I was never really sure what dad was thinking, as he was very hard to read, you know quiet methodical type, I could tell that he was allowing God to lead step by step.I kept thinking of  dad in the context of Isaiah 30:15 "in quietness and trust is your strength."
On March 31st B woke up in the middle of night and her water broke. We met at the Birth Inn at 9am in active labor. She was dilated to 6cm.  She was doing great with the labor, dad near by supporting her thru each contraction. Both grandmothers, and her sister-in-law were their to encourage her and cheer her on as well. She spent time laboring on the toilet and used the tub. She began having an urge to push in the tub but wasn't all that comfortable so she moved to the bed on her side. She pushed very effectively...the heart tones began dipping down a bit so we moved her to a squat and she delivered close to 1pm. It was a perfect VBAC:). A few days after the birth the reserved dad's heart side was revealed and I got to see an expressive grateful man. He told me he could hardly imagine having another baby in the hospital.
  I wonder if he will be going to the middle east soon?
Thank you Lord for being the repairer of the breech.

Mrs. Dancer

Sunday March 27th.

This precious 5' 3 " primip (first time)21 year old mom came to me at the beginning of her pregnancy asking if we could attend her birth. I was thrilled. First of all, they are the sweetest young couple and I just loved them from the start. They're Newly married, both love the Lord and have the innocence of youth, in reality they were just a tad clueless about labor and birth. But very eager to learn and wanted to do the right things during pregnancy to prepare. Secondly, I had the privilege of delivering this dad's siblings. I've gotten to know this sweet family over the years and consider it an honor to be a part of the first grandchild in their family.

Mom is a dancer and continued dancing until 6 weeks before her birth. She faithfully walked and ate healthy all of her pregnancy. On her last prenatal visit the baby was quite high and not even close to engaging. I thought to myself, "Oh Boy, this may be a challenge, as we are close to the due date and baby has not engaged". Typically with a primip you want the baby to engage 2 weeks before the onset of labor. I thought, "Is she going to go two weeks late and have a really big baby"? Oh Kathy, ye of little faith.

This morning I went to church and Mrs. Dancer was heavy on my heart. I prayed for her several times and said, "Lord if it be your will could she please let go into labor soon"? Mrs. Dancer's mom had a c-section with her babies so that added a little more concern.

I came home from church and was resting when the phone rang. It was Mrs Dancer and she been laboring most of the night. Dad went off to work this morning and mom continued to have contractions. Yes that's right! Mom labored most of the day by herself. Can you believe it? She wanted to come over and get checked before she called dad to come home. I was so happy when I checked her. Actually I was dumbfounded. Mom was 7 cms. Praise the Lord. I asked her if she thought she could drive or if I should drive her and she said no I only have a block to drive, I can do it. What a trooper! This birth really amazed me. When mom arrived at the Birth Inn she was still doing very well as she was working with her contractions and continuing to move around. After she was here about an hour Girl Thursday got a call from her doula birth mom and had to leave and go help her. Girl Tuesday and I held the Birth Inn down with Mrs. Dancer, while Girl Thursday went to be with her other mom.

By 6:20pm, Mrs. Dancer was complete and on the toilet and making pushing sounds. She pushed for 19 minutes and out came a healthy baby boy with his cord wrapped, rather snugly, around his neck. Mom gave another push and the baby somersaulted through the loop. No problem! Mom tore just a nick and all was well.

Moral of the story; Dance moms, dance, and Kathy don't judge a book by it's cover.

This was the perfect finale to our March Madness!

Life as we know it

It was a busy day for prenatal visits. I'm not sure why, but everything seemed a little rushed and maybe a bit hectic. That's why when I got a text from a first time mom saying she felt a little "crampy" I handed the phone to Girl Thursday and asked her to call and get details. She asked if the crampiness came in waves and if it felt the same as the braxton hicks contractions. Mommy replied that up until this point she had felt nothing.....never a braxton hicks! Girl Thursday advised her to start looking at the clock and see if there was a pattern to the cramps and to call back after an hour of observing. By the way, this young first time mom was still at work cleaning houses!
It was 45 minutes later when this mommy called back and asked if it would be ok to come over be checked because she thought she was feeling contractions. When she walked down the stairs some 20 minutes later, she was flushed but still smiling. I took her back to the room and asked Girl Thursday to check her. As Girl Thursday was checking with her right hand, she was showing me with her left hand the dilation measurement. We looked at each other in disbelief when we realized that she was a good 6cm!
She insisted on driving herself to the Birth Inn (her bag had been packed and in the car for a few weeks) So I called Girl Tuesday and off to the BI we all went!
It didn't take long for our mommy's mother to show up, then finally daddy made it. Daddy was a little overwhelmed and unsure of what to do, but mommy most definitely was prepared and ready for the birth.
She wanted in the jacuzzi. It took her several positions in the tub before she found the one that she liked. Rather than being in the tub longways, she sat facing us with her feet poised on the side for good leverage. It didn't take long before she was ready to push. Daddy was a bit squeamish and still unsure of his role in helping. After a few pushes, baby was out. The cord was clamped and I invited daddy to come cut the cord. After some skin to skin bonding with mommy,I draped a warm towel over daddy's arms and placed the baby in the towel. I told daddy to sit in the chair and spend a few moments just looking at his child.
As we attended to mom, I glanced in the direction of the chair. There was daddy, looking into the face of his newborn son with so much emotion spilling from his eyes. It was a moment. The very moment that the father son bond is made. The moment that a union becomes a family. The moment when he realizes that life as he knows it is forever changed. The moment that a parent realizes the awesomeness of Christ's love for us and our responsibility as a parent to train this child in the way of the Lord.

Mommy and baby are doing great, and this mom is another testament to the importance of being fit and active during the days of pregnancy.....it sure pays off in the end!
Baby Boy wt. 8lbs. 8oz. Born at 02:15 pm Total labor 3hours and 15 min. Awesome for a primip

The Motor Boat Mom

It has been a busy few days at the Birth Inn, and today proves no different! But then, what would one expect with 8 mommies due in March!!
It was nearly 6:30 am and the phone rang. Sure enough, it was a mommy calling. Contractions started at 4:30, and by 6:30 it was time to make plans to get to the Birth Inn. This baby is already showing signs of obedience, today is the actual DUE DATE! We have often discussed that maybe it would be best if we eliminated due dates and instead gave 'due weeks', or 'due windows'

Mom arrived at the Birth Inn around 7:30am and was already dilated to 7. We started drawing the water in the tub because Mommy was sure she wanted an 'aqua-dural' Mommy labored well in the warm water. We left her and dad alone for a bit. From the living room we could hear mom making the sound of a motor boat. "brrrrrr, brrrrrrr, brrrrrrr." My assistants and I looked at each other with questioning looks. We know that every mom finds her own way to relax, but I have to say that the raspberry motorboat sound isn't the normal relaxation sound!
Very soon the motorboat turned to groans and we knew that baby was on the way. This mom had a very long labor with her first baby...over 24 hours actually. Second babies usually come much faster and it is so fun to watch the surprise of the parents when things move so much more quickly with baby 2.
Mom felt so much more comfortable in the jacuzzi tub and things progressed quickly. She decided that a hydrabirth would be wonderful so we prepared as such. It took only a few pushes and the head was out. A quick sweep around the neck revealed no nuchal cord. Baby restituted slightly, light downward pressure on the head....nothing. We asked the mom to quickly get out of the tub and get on her hands and knees on the floor, slight pressure and......nothing. We asked mom to sit on the step of the tub in a semi squat. more downward pressure.....finally, the shoulders emerged. It wasn't shoulder dystocia, but it was a case of snug shoulders!!

Baby boy, 9lbs even and Mommy doing quite well. Later, while relaxing in the Birth Inn living room, Mommy was telling me that she had read a book that proved to be quite helpful. The book talked about the relationship between the jaw muscles and the perineum. she read that if the jaw remains loose, the perineum is able to relax. The suggestion was made to blow air across the lips making a motorboat sound. Looks like it worked!!

Tale of Two (I mean THREE) Mommies cont.

I left you Friday night at at 10:30. Mommy B was resting and my assistants and I were looking forward to a few (hopefully several) hours of sleep. I went home, let the dogs out of their confinement and settled into bed around midnight. Sleep, sweet sleep!
NOT!! It was 1:35am when my phone rang. "Well, let's get baby B here!" I thought. I answered the phone expecting to hear the calm voice of Daddy B, but instead I heard the panicked voice of Daddy C!
Oh My! I could hear the distressed sounds of Mommy C in the background. I instructed them to go to the Birth Inn, called girls Tuesday and Thursday, put on my scrubs and headed out the door.

Let me give you a little background on Mommy C. Mommy C is a young newly wed and this is her first baby. She has been so careful to follow any and all instruction that I have given her. She has changed her eating habits, started exercising and has made water her best friend. Three weeks ago Mommy C came to the Birth Inn having long and frequent contractions. Because she was GBS positive, she decided to start taking antibiotics. After laboring for more than 12 hours, and dilating to 6cm, her contractions stopped. She spent the night at the birth Inn but by morning there was no sign of contractions. I sent her home expecting to see her in a day or two.

Now here it is, three weeks later, 4 days past her due date, and Mommy C is ready to give birth! I checked her as soon as she arrived and she was an easy 8-9 cm. Suddenly her water broke and out gushed green liquid. Baby C had passed meconium and now it was urgent to get her out! We set up the birthing chair and moved mom into position. Although she had been faced with the impending labor for 3 weeks, the pain was still shocking to her. She was a trooper and pushed with vigor. Baby was born at 3:04am.....just 45 minutes after arriving at the Birth Inn!! WOW!!

Baby girl. 8lbs 6 oz. 21" long Babies are a gift from God!

Meanwhile as Mommy C is birthing, Mommy B has started having contractions...the kind she can't talk through.
After Mommy A and Mommy C have delivered and gone home, the big inviting jacuzzi tub is open for Mommy B. See how God works?? In his perfect time! Lights are dimmed,music soft, Mommy B allowing the gentle jets to massage her tired body. Eventually she gets out of the tub, but now she is feeling the ominous pain in her back....has this baby turned posterior?? Mommy B must move to the dreaded position...in bed, on her left side, right knee hiked to her chest. C'mon, many of you know that position!!
Hopefully Mommy B will rest. She is tired and has had little sleep. Sleep does not come and as the minutes and hours tick by, Mommy B becomes more exhausted. She experienced a large gush of fluid while in the bed, but the pain remained in her back.
Girl Tuesday and Girl Thursday spent a few hours with mom helping her try different positions. The best positions seemed to be dad sitting and mom leaning over him gently rocking and swaying. The baby was moving down. Around 10:00am blood started to drip as she contracted. Not like a hemorrhage, but still enough for me to take notice. We decided to give Mommy B's very tired legs a rest and set up the birthing chair for her. I helped the cervix with each contraction and was surprised to feel a bulging bag. Remember, she thought her water broke the morning before, and she had a large gush of fluid earlier today. A pocket must have formed in the membrane because when it broke, the fluid was green. Yep, second meconium birth of the day!
The blood increased and clots were being expelled. Mom was losing the drive to continue. We put the breast pump on her hoping to increase the intensity of the contractions, but although that worked, she was just too tired.

We discussed options. Was baby too big to come down? Was baby in a poor position? Was the bleeding becoming a problem? How long was the meconium present? The meonium was not a great surprise since she was 2 weeks past her due date but , having clear water earlier it did bring some ?'s as to what was going on. Did mom have the strength to get baby out on her own?

Finally dad made the decision........Transport her to the hospital.

We explained that it would take at least an hour before she would get an epidural, and there was a chance that this decision would result in a c-section. Mom agreed, she was out of energy.
We loaded up and went in. Once in the hospital she was taken to the maternity floor. They put in an IV, wrapped the fetal monitor around her, put a finger oxygen monitor on her and started with the barrage of questions. Once the epidural was administered, mom finally was able to relax. Her body began doing what it was designed to do....push baby out.
The attending doctor was amazing. He patiently waited as baby B started to appear. Finally he spoke the words everyone wanted to her. "Deep breath and blow out, now deep breath and hold. Push."
The team was ready; complete with NICU nurses just incase. A few minutes later Baby B was born. He was face down, restituted to the left, then did an unexpected twist to the right, his little hand under his chin and the umbilical cord wrapped around his arm. Dr rushed him to the the NICU nurses to be suctioned (remember the meconium?) He was checked over then wrapped up and brought over to meet his mommy. Sigh of relief..... everybody is fine. Mommy didn't even need a stitch!

Baby B.....8lbs 15oz Boy Dark hair and looks just like his daddy!

While many in America were enjoying March Madness, we had 30 hours of our own March Madness! After much needed sleep, we are more than ready for our next mommy to call!

Our scripture for these 30 hours......Isaiah 66:9 Shall I bring to the birth, and not cause to bring forth? saith the Lord


Two days in the life of Kathy
written by Girl Thursday