Monday, November 07, 2005

The Birth Story

Crazy it is, too. So my friend's water broke Friday afternoon. She was 41w1d. When her water broke, she noticed that there was some meconium staining, so they dropped off the kids and headed over to the hospital. After an initial half hour monitoring, the baby checked out okay, and my friend started walking the halls in hopes of encouraging contractions to begin. After a while, she went to the bathroom and noticed that the meconium was getting thicker. So she went back on the monitors, and sure enough the baby's heart showed decels. So the dr decided to do an amnioinfusion (put a saline solution back into the uterus to flush out some of the meconium and provide an artificial "cushion" for the baby). This really helped the baby stabilize, but also meant that my friend was stuck in bed. Her contractions started slowing down, and after about 1.5 hours the baby's heartrate started dropping again. At this point, she was only 3 cm dilated, and the dr was getting worried. He basically told her that if her labor wasn't picking up anytime soon, he'd have to do a c/s because the baby wasn't doing very well. So my friend asked to try some pitocin to make her contractions stronger. They started her on the lowest possible dose, and it kicked right in. Her contractions went to 2 minutes apart, and were definitely stronger. After a while, she got checked again and was found to be at 5.5 cm. At her request, the pitocin was turned off, and sure enough, the contractions kept on coming. Within half an hour, she was complete and ready to push. Since she had had two previous 4th degree lacerations (episiotomies that extended into tears into the rectal tissue), she wanted to push lying on her side to reduce stress on her perineum. So, it was time to push, and the real fun began. Everyone kept telling her to get on her back and push push push. She felt irritated, as that was not what she had wanted. Then even her doula (who's also a lay midwife) helped move her to her back, and encouraged her to push. Even pushing while holding her breath, and between contractions. My friend hadn't had any pain medication, so she felt the pushing urge full force. She didn't really notice anything going on around her, but was just so turned into herself and NOT wanting to be on her back and holding her breath etc., she really felt irritated. Anyway, the baby came out really quickly, and she was then informed that while she was pushing on her side, the baby's heartrate dropped down to the 30's and wasn't coming back up. That's why the dr and doula wanted her on her back and pushing hard even between contractions. It obviously worked, and the baby was quickly born. The dr also apologized to her for doing a little episiotomy, since she had been really adament about not wanting one (based on her previous experience...). But seeing as the baby needed to be born fast, it was truly necessary. It ended up only being a 1st degree, just a couple of stitches. When the placenta was born, they found out why the baby had had problems. Apparently, the cord was attached on the side of the placenta instead of the middle where it's supposed to come out (like a candle on a b-day cake), and the cord was also very very thin. Everything was also quite badly stained, indicating that the meconium had been there for a while. The baby had swallowed a lot of mecomium, but thankfully didn't inhale any during birth. Unfortunately, he had problems with his blood sugar, though, and had to be in NICU for a couple of days on a glucose IV. But all is well now, and my friend was able to bring him home when she checked out of the hospital last night. She also says she feels much better than she did after her other two babies were born (epidural/episiotomy/4th degree tear births). Laboring with the water broken, and some pitocin at one time, was intense for her, but she says she's glad she chose to have the baby naturally. She feels very empowered, and I think also has renewed faith in her body's ability to birth and push out a baby without tearing all the way to the rectum. We all are greatful to an awesome doctor, who was patient and respected a birthing mother's wishes. Most other doctors would most likely have done a c/s much earlier, when the baby's heart rate started dropping into 70's even after the amnioinfusion, even between contractions, and was slow to recover. In fact, my friend's doula commented that she had never seen a baby birthed vaginally after decels like her baby had. They usually end in c/s. So yay for a healthy baby and no abdominal surgery! :o)

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