Sent: Sunday, July 22, 2001 8:57 PM
Subject: birth stories. (long)
Just to change the subject slightly...
Recently I had two clients call me with premature rupture of membranes,
no labour. Just great! thinks I. How can I manage this as they
live at each end of the freeway (almost)? Well two other colleagues
helped me to monitor them when in turn I was with the other. Thanks
friends, you know who you are.
Number One client, due in 9 days, G5P4, wandering B/P (essential
hypertension), clear liquor pouring out. No labour. Really wanted a
homebirth as she had birthed before with midwives in South Africa (a
waterbirth) and NZ. (Domino).
5 days before baby had been in Transverse (similar story for 2 other
pregnancies) and now Cephalic but ballotable. 2am I checked her
out, left the Doppler for her to check baby and strict instructions to call if
any mec liquor etc. Take temperature regularly.
Client number two. Primip, Cephalic, all other parameters normal except
for being only just 36 weeks by u/s dating. (felt good size
abdominally). Called by her at 9am after 8 hrs of leaking liquor,
no labour. Left her partner a Pinnards to check heartbeat, take
temperature, call if anything changes as above. I then went on my way
doing postnatals and organising my car boot for two births.
Well, neither of them went into labour! both definitely
resisting the thought that they may have to go to hospital, have antibiotics,
be induced etc. as per hospital protocol.
OUTCOMES
Client No 1. B/P climbing, no labour, so we went to hospital
at 36 hrs post rupture. V.E done by RMO... 3cm, bulge of forewaters,
head 4/5ths, ARM, low vaginal swab, insert IV "bung" and iv antibiotics, leave
alone to get going herself. (Subsequently no growth on the LVS) We walked the
stairs and the corridors all day until 4pm when contractions were 2-3
mins Lovely!. She stood at the end of the bed swaying with that
characteristic knees bent stance, with low moans during contractions. I
put a mattress at her feet as she requested. Outside the window in a
large whitegum tree were a flock of grey and pink Galahs, raucously fighting
over nuts and territory and then the rain started (very
welcome). I had closed over the net curtains thinking to minimise
distractions and she walked over and opened them so she could focus on
the scene. When the head was coming very low she knelt down and the very
discreet attending midwife caught her baby and passed it between her legs for
her to pick up. It was a really lovely birth. After 6 hrs (2 of
these with IVI Syntocinon as per hospital protocol for G5s) she went home at
midnight to her family with her new baby boy. She told me that it was
the first birth where no-one told her how to birth the baby. No
instructions how or when to push etc.
She really appreciated it and felt that this was truly HER birth, even
tho it wasn't the homebirth she planned.
Meanwhile, client No 2 STILL was not in labour. During the day, my
colleague had taken her to another hospital for CTG and Low vaginal swab
& assessment of cervix (speculum). Cervix 1cm, very posterior os.
Definitely did not want to stay, have antibiotics or be induced so
signed herself out and went home. She and her partner with the help of
my colleague intermittently monitored events.
Next morning,after 1/2 hrly contractions overnight stimulated by wild
flower therapy, (now 56 hrs rupt membranes no labour.) I advised
them that I thought it time to go to hospital and encourage this baby to
be born before everyone got too tired. Very reluctantly they agreed that
if I supported them for a few more hours at home and still no labour, they
would go to hospital at midday.
They sadly packed the hospital bag and on my suggestion included
personal items like her own special pillow and pictures etc and bunnyrugs and
hat for baby as well as clothes to return home in. They chose a
little purple crocheted beanie with a feather on the top. We
turned up at the hospital at 60hrs post ruptured membranes, no labour!
The medical staff felt they had fully informed her of the risks of no iv
antibiotics etc (her LVS was NAD) and at 2pm put up Syntocinon , 1/2hr
CTG trace. She has a very good friend who is a W.A. Wild Flower
Therapist and all through the day dropped remedies on her head , annointed her
with creams and encouraged her to squat and intensify the pressure on the
cervix. She walked, squatted on the mattress we had put on the floor and
sat on the toilet for a little privacy and elimination. The hospital
midwives were very respectful of her wishes of minimal interuptions and low
level lighting. When she said "Isn't it nearly time yet?" and "come on
baby" I thought Aha! and took her to the bath tub filled with warm water and
sprinkled with remedies. She moaned and groaned her way through the next
two hrs, pushed instinctively and without instruciton until crowning when I
reminded her to be gentle on herself and the baby and ... out slid a 3kg baby
Apgars 7, 9, 10. over an intact perineum. After 4 hrs she was on
her way home with her little baby with his purple feathered
hat. She is delighted and says while she didn't labour
in her ideal place, but she had the birth she dreamed of.
Thank you to those midwives who supported her (and me) through what was a
stressful time with wonderful outcomes.
