Essential Birth Equipment

I was honored and challenged to be invited to midwife an experienced homebirth advocate in her birth of baby number 9. It was such a pleasure to work with someone who "gets it" about birthing at home with a midwife. She believes in it so much that she wanted to use her pregnancy and birth to influence others to maybe trust natural birth through her experience. She hired a husband-wife team (Larry and Lucy) to make a documentary of her labor and birth. I thought this was really cool. During the labor I realized that I found it a little bit intimidating. Lucy told me that they have done some "market research" in the area of healthcare, looking at the interactions between patients and doctors. Throughout this labor I found myself just shaking my head (inside) at the irony of how different this must have seemed to her. Here I was, the nurse midwife, lying prostrate on the floor next to my "patient" as I stretched to locate the baby's heart with the doppler so that I could evaluate his wellbeing. But I found myself being glad that they were there to document it as it truely was representative of the woman/midwife relationship that is worlds apart from that of patient/doctor. It symbolized the idea that a midwife is there to serve and meet the needs of the woman and unborn baby rather than have the woman position herself to make the job easier on her provider. Anyway, I want to document my lesson learned yesterday. Near the end of labor I heard the baby's heartrate drop in a way that indicated some possible umbilical cord compression. As I continued to listen, it happened for several contractions. I disucussed this finding with my client, who, being a labor and delivery nurse, understood it's significance. Up until that point, I had interferred very little in that I tried not to make suggestions to S. She is a very well educated woman and knew that she wanted to birth intuitively and it was my role to honor that. However, when the FHR varibles presented, I knew that it was time for me to help guide S. through by giving suggestions for improving the siutation. A woman near transition in labor is not using her "thinking" part of her brain so it was time for me problem solve. After all, this is why S. hired me - in case she needed help. She agreed to a pelvic exam to find out how far from birth we were. She was 7 cms. So, upon my suggestion, she drank 4 bottles of water within 45 minutes. During this time the videographer asked what was happening and I tried to explain. The varibles stopped about 30 minutes after the water drinking started.

We discussed the pros and cons of breaking her water. She asked if I thought that would bring baby any faster and if I thought we should do that. With only slight hesitation (because this was all going on tape) I said I thought we needed to pray. ("Now there's something most doctors don't suggest during a crisis" I was thinking as the camera was fixed on me) I couldn't help but wonder what in the world Lucy was thinking - if this was just blowing her English mind. Oh well, I reminded myself, this is why she's here, to see what homebirth in America is like. And homebirth with me definitely includes accessing the power of God through prayer. So, after S. and C agreed, I prayed thanks for them and their baby, for God's plan for the baby, for His protection and safe delivery of the baby and for wisdom for us in decision making. After praying, as I listened to baby's heart, I was reassured that he was doing well with only mild variables. And S. seemed to be making good progress as she said the baby was very low. So, we decided not to break her water. About an hour from when S. was 7 cms, she very quickly (1 pushing contraction) delivered a healthy, vigorous boy. S. was the one to see the cord wrapped around his neck and to remove it as she brought him to her chest. His apgar score was 9/9/9.

As I have reflected on this labor I realized that of course God would ordain it that there would be something a little out of the ordinary so that we would need to pray. While I don't like hearing non-reassuring FHTs, I DO very much like to see Jehovah the healer, provider, and sheperd make his power and presence known. I know it may have seemed very unconventional to Lucy as I bowed my head and called upon the name of Jesus. Heck, it's probably way outside the "standard of care" if those who are opposed to homebirth wanted to complain about me being an unsafe practitioner. But anyway, when I am not in the hospital with all of the support of extra staff to help out quickly, to start an IV or provide some other "heroic" task, I am REALLY glad that I have God with me to intervene. And I am really glad that He answered all of my prayers yesterday and showed Himself to be the great physician. And I hope that the documentary doesn't cut that prayer out. Maybe even just 1 woman will see that and it will cause her to stop and rethink her position, "Do I place my trust in God or in man?" To be able to place our trust in God in birth is so very rewarding. I wish more women who call themselves Christians would only see that.

Thank Goodness for Butter

I just had to record my nice, easy 4 hour labor I attended last week. HF (well, her husband, actually) called me at 5:30 to report labor since 4 AM. I arrived at 6:30 to find her working hard. No vag exams per her request. By 7:30 she was bearing down and at 8:08 she birthed a 9lb, 12oz baby over an intact perineum. I was home in time for lunch. It just doesn't get any better than that. How I wish all women in America could have watched and learned from that how simple it can be to birth a baby!!