Wednesday, January 13, 2010

waterbirth: first birth in Houston, first boy, first birth center all-nighter

Happy early early hours of Wednesday. It's hump day, but just barely. My "hump" is actually making it through this all-nighter here at the birth center. (And most of you know that all nighters and I are generally not friends)! Then of course, I need to make it through a full clinic day tomorrow before a blissful night of sleep tomorrow night. . . Anyway.

A woman came into the clinic today claiming she was in labor. Well, there are different types of "labor" and she was in the very early kind that is mildly painful, but not too much, and doesn't cause any real cervical change. So, my preceptor sent her home and told her to call at 10pm or sooner if she felt that things were really picking up.

I rushed home from a ACNM (American College of Nurse Midwives) meeting at 8pm and scarfed down some dinner in attempt to jump into bed for a nap before getting called into the clinic. Alas, it was not in the stars.

At 9pm, as I was eating my last bites of dinner, my preceptor called and told me to meet her at the clinic at 10pm - we were in labor, but it was going to be a long night.

The dreaded night labor - somehow (aside from the still birth that happened at 11pm after evening induction and which was filled with so much emotion and processing that I hardly noticed it was night) I have avoided middle of the night labor and birth until now. Admittedly, I took as few night call shifts as possible and somehow was lucky enough not to be called in for those I had taken. Of course, sleepless nights are part of this profession I've chosen. It's never been something I've been able to do easily and usually leaves me rather nauseous. But, this summer, with the outbreak of H1N1 at summer camp, I made it through about 4 days on around 8hrs sleep if I'm being generous. So, I know I can do it. Still, I was disappointed and nervous about what lay ahead of me this evening.

10pm - birth center. The patient is clearly in more serious labor than she was this afternoon. Her cervix is still only about 4cm (as opposed to 2cm around 4:30 when we sent her home) and it looks like we have a long night ahead of us.

But it's her second baby and things were getting moving, so by 11:45, she'd progressed to about 7-8 centimeters and was really wanting some pain relief. We broke her water to speed things along, got her in the bath with the jets going and (begrudgingly .... perhaps only because they threatened to go to the hospital) gave her some IV pain meds...which pretty much knocked her out right away. She became really groggy and was practically asleep in the tub.

12:00....12:15 - baby stable, mom groggy but stable, water warm, dad present, grandma (well, frankly she had a knack for thinking of, and verbalizing, just about anything that could possibly go wrong....not.helpful.)

Every 10 minutes or so listening to the baby's heart rate and using a flashlight to check to water for signs of imminent birth (only small lamps and candles on in the room).

12:45 - a short vocal "oooohhh" from the mama which prompted a "flashlight check"

A HEAD!.... well, not the whole head, but the crown of it with beautiful hair.

Two pushes...well, two contractions...mama was still a little asleep from the pain meds...and baby smoothly entered the world - from one water world into another... then dry land. It's nice to transition smoothly then land in a hug!

Amazing - nothing happens so smoothly and gracefully in the hospital....there it is always dramatic - voices, lights, counting, urgency. Here just life - easy and delightful. It was (finally!) one of the most beautiful things I've ever seen.

I pulled the baby out of the water and put him on the mama's chest, continued to pour warm water over him to keep his temp up and helped daddy cut the cord.

After a few minutes, we helped mama out of the tub and to the bed to take care of all the "after birth stuff" that is the least favorite part of my job. But, I didn't get woozy (which, unfortunately, has been quite a challenge for me when placentas are involved) and sat on the bed with the mom while we took care of her. I was a little unsure - this was so different from doing these things in the hospital - but my preceptor very patiently guided me through them and it was ultimately a success.

Believe it or not, this was the first boy that I have caught. Nine girls up to this point. Now, the magic 10th was a sweet little boy with very good lungs - started crying just as soon as I brought him out of the water.

What a different experience. I loved it!

click here for more information on waterbirth -articles and information


Susie G said...

beautiful! love it. i want one!!

Barbara Harper said...

Congratulations for being able to see birth as I have seen it for 25 years!!
Would love to have you come to my waterbirth certification workshop in Houston, Saturday February 13th. It is a great all day workshop. Spread the word to the nurse midwifery students and instructors and hospital nurses and midwives - not to mention the birth center!!
All my blessings,
Barbara Harper