Hi Mary,
Lovely stories! Kalgoorlie is indeed going to be very
fortunate to have you for two days in August for your
"Wonders of Water" workshop.
Cheers,
Raelene
--- Mary Murphy <[EMAIL PROTECTED]> wrote:
> 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.
>
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