Death by Primip
SB called at about 10:30 AM on 8/21 to report she'd been having contractions every 10" since 7:30 AM when she woke up. She said they hurt more than the BH UCs she'd been having and was planning to go home from work to rest. I offered to see her if she wanted. She and J. came by that afternoon for an exam and reported that UCs were every 7-8 minutes. She was 3cms dilated. I encouraged her to rest and sleep if she could that night since things were moving slowly. At 8pm, UCs were still q7-8 so I advised Benadryl and sleep.
J. called next morning at 8:00 and said she hadn't slept well at all cuz of UCs all night, still q7". Now having nausea and vomited 1x. I said she MUST drink and get some calories to have the energy required for labor, and that I would come check on her after my morning clients.
Anita and I arrived at their home at 12:45 to find SB resting but tearful: "I'm so tired of being in labor" Her UCs were q5-7". She was 5 cms dilated and still struggling with nausea, although she had kept down a donut and Mountain Dew. J's mom met us at the door with the announcement that she had expected to see us the night before when she arrived. I have been accused of thinking I know what people are thinking, and this time I thought she was thinking I SHOULD have been there the night before. Oh well, I explained that we don't come until client is in active labor.
We spent the afternoon trying to get SB hydrated and labor progressing better. She really was a trooper - trying to appease us, but usually throwing up several minutes after drinking and/or eating. I suggested an IV. She would have complied, but Anita pointed out that she was progressing (slowly) and mom and baby vital signs were fine. She hates IVs, and I hate trying to start them since I don't get enough practice to be good at it anymore, so it was pretty easy to talk me out of it. At 5:30 Anita and I left to go eat a nice sit down dinner at Texas Roadhouse while SB and J. were to try to stir things up with intimacy and rest. We suggested to J's mom and SB's sister and fiance that they go eat so S and J could rest, but I think they thought (there I go again) we were CRAZY for leaving.
By the time we got back to the house, we now had another person in the "waiting" room. SBs mom was there and unable (or unwilling) to hide her great displeasure with the whole thing. Even though I told her mom and baby were doing fine, she said it was taking too long. I didn't venture downstairs anymore as I felt palpable hostility.
At 7PM when we returned to find J. sawing logs and S. quietly and calmly laboring away. She announced that she couldn't do this for much longer. She was 7-8 cms. now. Her water broke at 8:43 PM with clear fluid and baby was doing great. We were sure she would start feeling pushy soon. However, had we considered the fact that it had taken 36 hours to dilate 8 cms, we could have done the math and figured we still had about 9 hours to go. By 11pm, Anita told me she needed someone to encourage her since she was starting to doubt that we would have a baby at home. We prayed for a homebirth, for all of our sakes. For me, because of my fear of persecution by the medical community if I went to the hospital. I could just seeing someone reporting me for providing care that was below the "standard" such as 2 days of labor, use of herbs to augment labor, alternative GBS prophylaxis, etc. Anita begged for a homebirth so she could get her "numbers" done and finish her educational program. Having cast our own cares on Him, we started praying for safety and protection for mom and baby, energy and strengthh for SB, that the enemy would be bound and we would feel no fear, that we would have wisdom and discernment, that God would show His glory by delivering the baby without hospital helps so that all of the doubting people downstairs would see that birth works. Anita also prayed that if we had to stay into the wee hours of the morning, that we would have patience and stamnia. It took me several seconds to get on board with that request. I did not WANT to stay into the wee hours.
THen with renewed confidence, we went and checked SB and found her to be completely dilated, even though she wasn't feeling like pushing. We coached her through about an hour of pushing with very little progress and then noticed that she still have a cervial lip. ANita suggested some tricks to reduce the lip.
By this time it was 12:30 on 8/23 and I knew that SB needed some sleep to be able to finish the job. I suggested taking Stadol and sleeping for an hour or 2 and waiting to push until she just HAD to push. She agreed and after giving her a shot of Stadol, it was lights out and we all went to lie down and try to sleep. I knew Anita hated using STadol and doubted the wisdom of it, but I was certain that this was a prudent intervention. I don't usually feel so confident, but I knew that I have many more years (and numbers of births) to draw on. I'd seen Stadol work wonders in this situation before so I wasn't willing to be talked out of it. The family members kept vigil on the stairs, crying and taking turns going in and out of the house, opening and closing the noisy front door.
At 2:00 AM, J. came and told us that SB felt like she had to push. She was complete this time. She made steady progress and delivered her baby girl at 3:11 AM. Baby was great, mom didn't hemorrhage (which I was prepared for due to the LONG labor) and all was well. After cleanup and some nursing, family was invited upstairs to admire the baby and take pictures. Never did any of them make eye contact with Anita or I or offer a word of thanks. Not that we really cared. We were on cloud 9 to see our prayers all answered and to be heading home after a long labor that didn't end in transport!
On the way home, I assured Anita that I don't have any more Primips until January, so the rest of the year should be easier.
J. called next morning at 8:00 and said she hadn't slept well at all cuz of UCs all night, still q7". Now having nausea and vomited 1x. I said she MUST drink and get some calories to have the energy required for labor, and that I would come check on her after my morning clients.
Anita and I arrived at their home at 12:45 to find SB resting but tearful: "I'm so tired of being in labor" Her UCs were q5-7". She was 5 cms dilated and still struggling with nausea, although she had kept down a donut and Mountain Dew. J's mom met us at the door with the announcement that she had expected to see us the night before when she arrived. I have been accused of thinking I know what people are thinking, and this time I thought she was thinking I SHOULD have been there the night before. Oh well, I explained that we don't come until client is in active labor.
We spent the afternoon trying to get SB hydrated and labor progressing better. She really was a trooper - trying to appease us, but usually throwing up several minutes after drinking and/or eating. I suggested an IV. She would have complied, but Anita pointed out that she was progressing (slowly) and mom and baby vital signs were fine. She hates IVs, and I hate trying to start them since I don't get enough practice to be good at it anymore, so it was pretty easy to talk me out of it. At 5:30 Anita and I left to go eat a nice sit down dinner at Texas Roadhouse while SB and J. were to try to stir things up with intimacy and rest. We suggested to J's mom and SB's sister and fiance that they go eat so S and J could rest, but I think they thought (there I go again) we were CRAZY for leaving.
By the time we got back to the house, we now had another person in the "waiting" room. SBs mom was there and unable (or unwilling) to hide her great displeasure with the whole thing. Even though I told her mom and baby were doing fine, she said it was taking too long. I didn't venture downstairs anymore as I felt palpable hostility.
At 7PM when we returned to find J. sawing logs and S. quietly and calmly laboring away. She announced that she couldn't do this for much longer. She was 7-8 cms. now. Her water broke at 8:43 PM with clear fluid and baby was doing great. We were sure she would start feeling pushy soon. However, had we considered the fact that it had taken 36 hours to dilate 8 cms, we could have done the math and figured we still had about 9 hours to go. By 11pm, Anita told me she needed someone to encourage her since she was starting to doubt that we would have a baby at home. We prayed for a homebirth, for all of our sakes. For me, because of my fear of persecution by the medical community if I went to the hospital. I could just seeing someone reporting me for providing care that was below the "standard" such as 2 days of labor, use of herbs to augment labor, alternative GBS prophylaxis, etc. Anita begged for a homebirth so she could get her "numbers" done and finish her educational program. Having cast our own cares on Him, we started praying for safety and protection for mom and baby, energy and strengthh for SB, that the enemy would be bound and we would feel no fear, that we would have wisdom and discernment, that God would show His glory by delivering the baby without hospital helps so that all of the doubting people downstairs would see that birth works. Anita also prayed that if we had to stay into the wee hours of the morning, that we would have patience and stamnia. It took me several seconds to get on board with that request. I did not WANT to stay into the wee hours.
THen with renewed confidence, we went and checked SB and found her to be completely dilated, even though she wasn't feeling like pushing. We coached her through about an hour of pushing with very little progress and then noticed that she still have a cervial lip. ANita suggested some tricks to reduce the lip.
By this time it was 12:30 on 8/23 and I knew that SB needed some sleep to be able to finish the job. I suggested taking Stadol and sleeping for an hour or 2 and waiting to push until she just HAD to push. She agreed and after giving her a shot of Stadol, it was lights out and we all went to lie down and try to sleep. I knew Anita hated using STadol and doubted the wisdom of it, but I was certain that this was a prudent intervention. I don't usually feel so confident, but I knew that I have many more years (and numbers of births) to draw on. I'd seen Stadol work wonders in this situation before so I wasn't willing to be talked out of it. The family members kept vigil on the stairs, crying and taking turns going in and out of the house, opening and closing the noisy front door.
At 2:00 AM, J. came and told us that SB felt like she had to push. She was complete this time. She made steady progress and delivered her baby girl at 3:11 AM. Baby was great, mom didn't hemorrhage (which I was prepared for due to the LONG labor) and all was well. After cleanup and some nursing, family was invited upstairs to admire the baby and take pictures. Never did any of them make eye contact with Anita or I or offer a word of thanks. Not that we really cared. We were on cloud 9 to see our prayers all answered and to be heading home after a long labor that didn't end in transport!
On the way home, I assured Anita that I don't have any more Primips until January, so the rest of the year should be easier.
posted by kirsten | 6:49 PM
2 Comments:
Wow,
what a grueling birth. I was on pins and needles just reading it. I was sure it would end in a transport as I read about the hostility of the family. My heart goes out to you. I would never allow that kind of energy to be present at my birth. Those folks would have to go. I was amazed to see the power of prayer at work in this situation.
yes, the prayer was definitely a turning point in my outlook. I felt certain that she would birth eventually after we prayed. But that mother! Even when we made a postpartum visit, she was hostile! I try to learn from each birth, and this time I learned that I have a new rule: nobody will be allowed to be at the birth that we haven't discussed ahead of time, and they won't be called to come before I give the OK that we are in active labor. The woman was awesome and strong. And her husband never wavered either, which is why it didn't end in transport I'm sure.
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