& Birth Art
thing she did
was not even tangible. . .
her calm presence & absolute
in the process
made me feel
--ejd, mother of 2
E.S. called at 12 am on Wednesday to tell me she was feeling very crampy and that she was seeing some blood when she went to the bathroom. She wanted to know if she was in labor or how long until she would be. I assured her that things were coming along perfectly but that everyone was a little different. We agreed to speak as things progressed and she called at 6 am to tell me she had gone to the hospital to get checked and was sent home at 2-3cm. At 10:30am she called again to say things felt “different” and she wanted me to meet her at the hospital. I arrived at 11am and was informed that she was 3-4cm and in the shower. She loved the shower and we stayed there exclusively except every couple of hours when the nurse or doctor would come and check her.
I massaged her back with every contraction (ctx) and soon found that this would become her ritual. If I was doing anything else (getting her water, fetching the nurse, etc), she would yell for me, at first, politely; eventually, in a more frantic tone. N.S. was a nervous father, asking each time as I exited the bathroom if she was okay, whether everything was going well. I replied emphatically how well E.S. was doing and how perfectly things were coming along.
And they were. Labor progressed almost exactly as the experts prefer, 1cm/hr. This allowed us our sanctuary in the shower. However, at 1pm, the nurse informed us during the vaginal exam that there was something wrong with the equipment in that room and could we switch rooms, to which we quickly agreed, as long as they upgraded the shower if possible.
And in fact they did. We found ourselves in a larger suite with a much bigger shower which gave me better access to E.S. and allowed me to actually get in there with her for much of it. My arms were getting sore from all the massaging and I looked for other ways to support her. We tried different positions and movements to encourage the baby to come down and move into a better position. The baby wasn’t exactly posterior but sideways and hurting E.S. more on the right side of her back. We did some lunges but eventually it was hard on E.S.’s feet to be standing the whole time so we alternated between sitting and having one foot up on the bench. But regardless of all the position changes and hip rocking, she needed massage and/or pressure with every ctx. It seemed that as a novice, I had pulled out the big guns just a bit too early.
Things pretty much continued this way until the next vaginal exam at 3pm at which point she was 6-7cms and 100% effaced. E.S. was amazing. She had fought the nurse for everything: to be off the monitor; to stay in the shower; to stay off an IV; and for each vaginal exam (“the baby will come when she comes, no?”). She was informed and not afraid to ask for what she wanted. However, at 4:45, the doctor wanted to perform an amniotomy to get the baby to come down further. She was dilating but the baby wasn’t coming down the vaginal canal as far as they would have liked. And E.S. responded in kind. How much time will that really save? Can we try doing something else instead? Can I get off my back? But eventually she gave in without too much incidence. If this was all she would have to acquiesce she would be okay with that. At 5pm she was 8 cm and saying she wanted to push.
The doctor was incredulous but told her to go ahead if she felt like it. She quickly opened up to full dilation but the baby kept slipping back up. She preferred directed pushing and liked the nurse to count and direct her breathing. We tried many different positions (sitting, legs pulled back; kneeling, with arms draped over the back of bed; sitting, slightly reclined with legs in stirrups; on her side, with top leg pulled up; and on all fours) until finally settling into a semi-sitting position with her legs open wide, each against the nurse’s and my bodies. During the pushing phase she was in need of constant encouragement that she was doing okay and that the baby was coming down at a normal pace. We all assured her that this was typical, especially for her first baby. It took close to an hour but eventually the baby was crowning and from there, it was a few pushes away before her baby girl was born!
She was amazed and immediately alert and laughing! They showed her the baby and immediately took it for newborn procedures while she spent the next half hour delivering the placenta and being repaired from the tear. Finally, she was handed her baby and she spent some time talking to her while she was getting cleaned up. The nurse came back in a little later and initiated breastfeeding and left just as quickly, after she assumed things were established. This being my first full birth, I was initially looking for pointers from the nurse, but quickly realized I would have to be E.S.’s main support for breastfeeding. As expected the baby didn’t stay latched and E.S. said she wasn’t actually sucking. I encouraged her to unwrap the baby a little and get him rooting around, more skin-to-skin, and to be patient. I explained how the baby would most likely lick and smell and eventually find what she wanted and latch on correctly, which is what happened within 15 minutes. Shortly thereafter, the nurse came back in and almost had a conniption that the baby wasn’t wrapped up like a mummy. She proceeded to “swaddle” it, consequently disrupting the nursing. E.S. said she wanted to eat anyways so the nurse put the baby in the warmer and N.S. came back in, along with her mother.
This birth was amazing! I learned how important a strong and well-educated mother is to having a natural birth in a hospital. I also learned how quickly a bond of trust can be established. This birth was through a hospital doula program and I had never met E.S. previously to the day of the birth. And one of my best lessons from this birth was to try other comfort measures first and to offer back massages and hip squeezes as things intensify more, not necessarily right from the start. (My arms and hands were sore for nearly a week afterwards!) I also learned that although I thought it was always best to let mothers push when and how they want to, sometimes they really want more instruction.
D.S. called at 9:30am on Friday to say she had been having relatively light contractions (ctxs) since around 2am that morning. They were about 20 minutes apart currently. As we spoke she decided she wanted to wait and see how things progressed and we agreed to talk in a few hours.
In the meantime, I went to work and when I hadn’t heard from her by 12:30pm, I gave her a call and caught her right after a “big one,” catching her breath. She said they were still maybe 10 mins apart. We talked for a while and I tried to get a sense of where she was. It seemed like things were much more intense but she sounded unsure and wanted to see if they all were going to be that intense. Her husband, G.S., called back in 15 mins, at 1pm, to say they were going to leave for the hospital. I left and met them there a bit before 2pm.
She was 4cm dilated at admittance. The nurse was setting her up with an IV of Penicillin. Apparently she had tested positive for Group Beta Strepp and was quite unhappy that her doctor had not informed her of this fact. Since the doctor hadn’t said anything, she assumed it was negative. Otherwise, she was in good spirits between ctxs and was handling ctxs well considering her position and relative immobility while the IV was being administered. She also mentioned that her ctxs had slowed down since the car ride when they were close to 5 mins apart. She said her back hurt, so we got her on her side while the nurse did the IV and I tried counter pressure on her back which helped until we could get her sitting up more and I could get better access to her back. Once the IV was in, I suggested the birth ball, but she just wanted to sit at the edge of the bed slung over the bedside table (which was on wheels). G.S. held the table in place and in this way was able to face her and keep eye contact while I worked on her back and whispered encouragement in her ear from behind.
During this time, the nurse came back in with the admitting papers and it took forever to answer many frivolous questions while she was in the throws of labor. It was very distracting as things became more serious, as they quickly did, and before D.S. could catch her breath the nurse was asking her another question. During this time, she instructed me on how to work on her back in sync with the rhythm of her breathing. When she breathed in, I started at the middle of her back and stroked down as she exhaled, pressing into her lower back. She and G.S. had figured this out at home and it helped her a lot. At first I was struggling with the Electronic Fetal Monitor straps, which were soon removed.
Things were happening quickly and were becoming much more intense and serious. Even shortly after I got there, the doctor arrived to check her (2:30pm) and she was already at 7cm. She was starting to shake and mentioned how intense the pain in her back was becoming. We tried moving her onto her knees to take some pressure off the back and the doctor suggested that we get the bar set up, which D.S. liked for a few contractions.
At one point, the question was raised about the Jewish holiday. There were some concerns regarding Shabbos and the Pesach holiday. It was after 3pm on Friday and Pesach ran straight into Monday. The head nurse from Mother and Baby came in to inform her that she could not stay at the hospital until Monday and would have to leave on Sunday, speaking at some points during her ctxs. D.S. was almost in tears. Where will we go, she insisted. G.S. reassured her that he was taking care of it and would go home to get the car seat so they could go home in a taxi. He was going to leave right then, until the doctor and I convinced him that they were going to have their baby very shortly!
In fact, in another ctx or so, D.S. mentioned that it felt like she needed to go to the bathroom. The doctor waited while D.S.’s urge to push grew stronger. She ruptured her membranes shortly thereafter (3:35pm, 9cm) while we found the right way for her to push. She was a little lost at first and really wanted direction. I assured her she was doing quite well and once we found the right position and support, she relaxed a bit and became more focused. We worked with her ctxs and she pushed through the center of her body. I reminded her that her baby was pushing the pain away. Once she got the hang of it (maybe 3 ctxs) she pushed her baby boy out in 4 pushes without even a tear.
The doctor was great about stretching and massaging the vaginal/perineal opening so she wouldn’t tear. They put him on her chest briefly while the doctor clamped and cut the cord. They asked to take the baby for the newborn procedures, to which she agreed. I stayed with D.S. to comfort her while she experienced the subsequent uterine ctxs helping to expel the placenta. The doctor was cleaning her up when she asked to see her baby and he was promptly placed in her arms. She cooed at him for a while and wondered in amazement how he was there in her arms; how amazing it was that she did it.
After everyone left, including her husband (to go get the car seat before sundown), she decided to breastfeed. I suggested she let him root around and find things on his own. She put him close to her breast and before 2 mins he was latched. Not just there, but latched and feeding! It was the easiest nursing I ever saw. He nursed for about 15 mins and when she went to switch, he wasn’t interested. At this point she spent time talking to him, cooing and giggling in amazement, telling him how she knows how much she will love him. He never once cried while in D.S.’s arms. I left the room briefly to give her some time alone until G.S. got back. And when he did, I stayed briefly and then I gently departed. We agreed to speak in a few days once Passover was over and she was at home.
I learned so much from this birth. Mostly, how amazing it was to see how smoothly everything can go when there is as little fussing with the process as possible. The doctor was very patient even though she hadn’t slept at all the night before because of another birth. She literally sat and waited for D.S. to feel the urge to push. I know that in the future, I will have mothers ask their doctors outright whether or not they have GBS, because this was initially quite upsetting for D.S.. I will also encourage them to pre-register as well and fill out their medical questionnaire so as to avoid the annoyance of constant questioning in the midst of some pretty serious contractions.