Monday, December 31, 2012

Baby F The One I Wept Over



This is the baby I wept over.  I realize now that God was giving me some easy births under my belt before a really tough one. This is the birth where I learned that I know absolutely nothing about birth, a truly humbling experience indeed.  If you read baby “E”s story you know that baby “F” came in the same day. Frankly this birth was not going to be in an ideal situation or anything close. Take two cats, 2 dogs and a tiny apartment that is definitely not clean and toss in a tiny bedroom with just a mattress on the floor; with clutter and dirt and hair everywhere and you have an unpleasant visual. Did I mention that all the above caused an odor to emanate from every spot in the house?  Perhaps it was the rather large litter box on the dining room table that added to the unpleasantness!  So picture all that in your mind and let me get started on the birth.

When we got to the apartment Mama was already dilated to an 8.  I think the team was thrilled, thinking perhaps we can be out of here in less than four or five hours.  Mama had already been laboring since early morning and had made great progress. We rolled up our sleeves and got to work helping relieve the pain. In my doula training I was taught to use counter pressure on both the head and the hips.  On the head you take our left hand and put it horizontally at t he base of the skull and the right hand across the forehead and squeeze together. Usually Mama likes the head squeezed pretty hard. The hip squeeze is similar. If you end up doing counter pressure with every contraction you will be very sore in your wrists and your biceps.  We did the head and hip squeeze for hours and hours.  The contractions were starting to pile on top of each other yet Mama remained at 8 centimeters.

Mama had been certain all along that she did not want a water birth.  She said she did not like the bathtub so she couldn’t imagine using a tub.  The water is a natural epidural but if Mama says no then it’s a no.  Her water had not broken yet so with every contraction that water became a very tight ball holding in all the pressure. When you sit at eight centimeters for hour after hour the pressure is intense. Mama became exhausted at one point and finally asked to go into her tub. There was instant relief from the pain.  We still did the head squeeze but couldn’t reach the hips for obvious reasons.  She labored in the tub for about two hours but still was only at an eight when she got out. Baby was head down in the pelvis but it became apparent that his position was not quite right.  By this point most hospitals would have given up and done a C-section telling Mom that the baby wouldn’t fit through the birth canal.  So what do midwives do?  We spin the baby of course!

I had heard about spinning babies and had hoped to take a workshop on it but I had never seen it done.  The purpose of spinning is to bring the baby back out of the birth canal first, readjust the position of the baby and then bring baby back down into the birth canal the correct way. I bet you are wondering how in the world you do that!  You get Mama to put her head flat on the ground and her back side as high in the air as possible.  Then you take a rebozo which is a piece of fabric or a sheet twisted up and put it around the belly with plenty of room to hold both ends of the fabric in your hand. With each contraction you shimmy the cloth back and forth in your hands. With gravity and the shimming the baby comes back out of the birth canal.  It takes multiple contractions to bring the baby back out of the birth canal and it is not comfortable. When you are done spinning the baby you bring the Mama back upright and the baby is suppose to reenter the birth canal properly. It seemed to work.

Mama continued to labor and the contractions were once again right on top of each other but still at an eight. Mama felt a ton of pressure on her perineum but with no relief.  It was decided to go ahead and break the water and that brought a smile of utter relief for Mama. During the tub and the spinning Dad had fallen face down on the bed with his glasses on into a sound sleep.  With all of that still no baby. One part of the cervix would simply not open so my mentor decided to guide the baby herself through the birth canal.  It was a very slow process because that tiny part of the cervix which looked like a dark brown little eraser would simply not move out of the way for baby to come. The next hour was in slow motion. Mama stayed up on her hands and knees for the last hour. One head squeeze after another, one contraction that never ended and a very slow descending baby seemed to just freeze time. Dad is awake and sitting on the bed in front of Mama encouraging her to not give up. Finally the baby’s head starts to emerge with each push but then as soon as Mama stopped pushing the head went right back in.  We are now in the second hour of this part.  Mama is exhausted and her pushing is not effective at this point.  Manually the head is slowly brought out. First the crown, then the forehead, then the nose and then finally the chin.  All of this is in very slow motion.  I am right next to babies head and he is just sitting there. A baby can’t sit half in and half out for more than a couple of minutes. I have been praying non-stop for about two hours now, fervently praying that God will bring this baby safely  to Mama’s arms. Our team member is still working sweeping the opening to help baby come out. She asks how long the head has been out and two minutes is called out. There really is only one more minute to get the body out. The babies shoulder is stuck. Our mentor continues to move around and around and was finally able to get a finger under the babies shoulder to the arm pit. Once she was able to get a finger out of the arm pit all the had to do was pop it out. Once that happened the baby just popped out right into Daddy’s arms.

Even though all of this was stressful on the inside, everyone stayed calm. We wanted Mama as calm as possible. Immediately after baby was born his skin started to pink right up which just did me in.  My emotions just burst like a dam being opened for the first time.  I finally stood up after being on my knees forever and just started to weep.  I left the room and leaned against the wall just thanking God over and over again for His great mercy. I realized I still had a lot of work to do so I wiped my tears on my apron and went back in calm on the outside. Baby was put skin to skin right away and he let out a huge cry.  Baby was perfect, pinking right up and breathing great. We try and give the new parents some privacy at this point and just let them bond.  We notice that the cord has immediately stopped pulsing which was way early.  The cord usually keeps working for another 30-45 minutes before the placenta is delivered but not in this case.  The placenta came in just a matter of a couple of minutes.

Mama was so relieved.  The pain was instantly gone that she had endured for 27 long hours. She was an amazing woman.  Never once did lose her cool.  She stayed focused on her breathing to help baby the entire time. She worked with the contractions instead of against them. She would talk to the baby, rubbing her belly telling the baby that pretty soon he would be in Mama’s arm where he belonged.  Until the baby was born no one had any idea if it was a boy or a girl. They were so thrilled baby was a boy.  She talked so tenderly to him.

We did need to suture her up after delivering the shoulder the way she did. It didn’t take very long to put in just a couple of stitches.  We cleaned everything up and started the laundry from the labor and birth.  A job well done. I doubt I will ever forget this birth.  I learned SO much.  It was my privilege to help this woman give birth the way she wanted.  All praise and honor goes to my Father who guided that baby into Mama’s arms.  He used the wonderful hands of a gal  named Wendy who is my mentor. She is a wise woman who is cool as a cucumber. She knew what to do and for that I am so grateful.
 



Be the kind of woman that when your feet hit the ground each morning Satan says, "Oh crud, she's up".

Friday, December 28, 2012

Welcome Baby E

Yesterday we spent the day doing prenatals at the office.  We have three women due at the same time. All three of them would really like to deliver and deliver now, thank you very much!  I did get to do my first cervical exam yesterday afternoon.  Very cool, the babies head was so low you could feel it. Isn't that awesome?

I got home last night around 6:30 and was greeted with great smelling chili hubby made.  Now I know he felt all those years when he came home after a very long day and the house smelled delish. The chili was made from the buck he got in November; a nice addition to the chili.  We had a quiet evening.  After the prenatals I was almost positive we would have a birth last night.  I was right, just wrong on which Mama would go first!

The call came at 11 just a little bit after going to bed.  Mama had just started her contractions. This is baby number 2 for her and the other birth went pretty fast. At midnight it was obvious she was really in labor so I headed out.  I might have gotten a half hour of sleep.  Our team arrived and Mama was already in the birth tub.  We have two that we loan out for water births. The family has to pay for the disposable liner and special hose before hand.  Dad had already set it up and filled it for us. I was impressed.

The next three hours were one serious contraction after another.  This Mama is pretty young and has never been to a childbirth education class before.  Yet, she handled her labor with such amazing grace. She kept her eyes closed and very calm.  She focused on her breathing the whole time. Contraction after contraction.

I think I have written before about water births.  I will say it again, water births are amazing. It is truly a natural epidural for Mama's. The warm water helps her relax. It makes it so easy to move around which is great for the baby.  Position is everythinig in birth.  Like deciding on what home to buy a realtor will say, location, location, location.  In birth it is position, position and position!

Mama was in sync with the baby which means she worked with the contractions along with the baby instead of working against the contractions and baby.  Our natural reaction to pain is to tense up which only makes the contractions worse.  In my doula training I was taught how to help with the pain using different techniques. This Mama allowed me to do the hip and head squeeze. I had Baby "C"s Mama sure she would not have survived without those counter pressure measures.

It was time to push and Dad decided to get into the birth pool with Mama.  We really try to empower Mama and Dad to do the birth the way they chose. We try to stay hands off as much as possible. We love for the Mama to actually "catch" her own baby, or Dad if Mom can't.  Our Dad was so nervous about catching the baby that I looked eye ball to eye ball with him and assured him if Mama could handle this birth with so much grace than he can "catch" his own child. I reassured him we were right there if a problem arose. Like a champ he caught the baby and brought her up so the baby could be skin to skin with Mama right away.

Unless there is a breathing problem we can stand back and give the new family time to bond. Another time I will share the "golden hour" with you.  It took over an hour for the placenta to come out so we transferred Mom and Baby to the couch after they were ready to get out of the tub.

The least favorite part of the job for me is all the clean up, especially the birth tub. We do have an electric pump to drain it into the toilet, which makes it easier.  After the placenta was delivered we get the new Mama and baby into their regular tub with an herbal bath.  That gives us a chance to get everything put back in order and start a load of laundry before tucking Mama and baby in bed.  We leave if all the vitals are good right after they are in bed.

By this point it was after 7 in the morning. I was wide awake and hungry and so my partners so we went to a 24 hour restaurant.  The food was yummy and I have started to realize that midwives have weird senses of humor.  We laughed and laughed.  We also spent a few moments thanking God that Baby "E" had arrived and was safe and sound.

God truly is the giver of all good things.  Praise God for a safe birth.  Now, one down and two to go in the next few days.  Hopefully a little sleep in between.

In Christ Alone,
Jill



Be the kind of woman that when your feet hit the ground each morning Satan says, "Oh crud, she's up".

Monday, December 24, 2012

Baby "D" the Adventure I Will Never Forget



Baby “D” was the wildest wide so far on my journey to midwifery.  I will have to go back and tell you the back story before I tell you about the birth.
When I was first looking for a mentor to train me in midwifery I found the perfect teacher. She would allow me to go at my own pace, which in my case is mach 3! In the interview process she told me about a couple who lived out my way who were due to deliver the middle of December.

A few weeks later I went to the couples house she had told me about for their home visit.  In the practice I work for you make a home visit a month before the baby is due.  We not only do the prenatal but plan the birth while there.  Most women who want a home birth also want a water birth. We provide the birth pool and they order a birth kit that contains a one use liner along with all the necessary supplies for a birth.

Mama wanted her birth to be in the living room with the Christmas tree ablaze and the real fire place crackling in the background.  We try hard to give a birth mom exactly the experience she wants.  Mama had delivered two other babies in the hospital.  She delivered with very little labor and did it quick.  When I walked out of their house at that home visit I thought to myself, “I am going to deliver this baby myself” The thought scared me to death and I scolded myself for being a drama queen!  The thought would not go away.

So for the next 6 weeks I dreamed about this birth. I prayed everyday that if I was to deliver the baby I wanted to be smart and ready. So, every day I worked through the scenario of how to deliver the baby alone.  So Baby “C” was born and I came home and slept a couple of hours. I decided to go to the pool and stretch out my sore muscles. I met my work out buddy and we headed to the locker room. No sooner had I taken off my coat while telling my buddy about the birth the night before that the phone rang. It was my mentor.

I grabbed my coat and ran out.  Baby “D” was on her way.  I was 5 minutes from their house and I flew down the road, practicing in my head.  I got there and jumped out of the car, took a breath and went in.  I went in just like I had pictured in my mind, cool, calm and collected. I saw the grandma in the kitchen as I walked in.  She was calmly washing dishes. Since I had been there before I knew where the bedroom was. When I walked in mama was flat on the bed just moaning. My mentor was on the phone with them and I quickly got an update. She wanted to know if I wanted her to stay on the phone but I said no we should be okay and hung up. Mom was having back pain so I worked on her back for a couple of contractions.  Mama really needed to get off her back and upright so I helped her off the bed and  did the famous hip squeeze while she bent over the bed.  All the while I was having Dad get things ready around the birth pool he had already set up. The birth kit was opened and ready to go.

We both helped Mom into the tub. I looked around and noticed the pool was right where she had wanted it when the birth was planned a month before. The Christmas tree was glowing and the fire was crackling. I said to her, “look honey, you are getting the birth you have dreamed about.  When you have a water birth the sensations are so very different. Using a birth tub is called a Midwifes natural epidural.  The contractions are easier to handle in a pool of warm water.  During the next ten minutes Dad and Grandma collected everything I asked for. Once my sterile gloves were on mama had the urge to push so I reached down and there was baby’s head.  It took several minutes for the head to gradually come all the way out. It felt like everything was going in slow motion. I remembered that baby does not have to breathe right after delivery in water as long as they stay underwater.

In my mind I practiced the NRP I had just finished only a couple of days before in case I needed it. Once the head was out it took only one push to get the entire body out. I picked her up and slowly brought her out of the water and put her right on Mama’s chest.  It was so peaceful.  The baby did not cry at first. In fact her first cry was about 2-3 minutes after being born. I took one warm baby blanket after another and wiped off the baby. Her entire back side was covered in vernex.  I have never seen it so thick before, it was amazing. I wiped her head and face.  She was starting to pink up quickly.  Mama kept saying she couldn’t believe what just happened. 

Once the baby cried we all had tears.  I had my hand on baby and Grandma was beside the pool with Dad so I took the opportunity to pray out loud with the family. Thanking God for a beautiful and healthy baby, for God’s tender mercy to bring a new life into this world and that this precious little baby would grow to be a godly young lady some day.  If the family does not have a relationship with Jesus then I would pray quietly but this family including Grandma loves Jesus.

It was time to take mom and baby out of the tub so we could deliver the placenta. After getting her out mom got lightheaded so we didn’t make it to the bed but rather set her down right next to the tub with some pillows and towels.  My mentor arrived right before getting her out and I asked if I could also deliver the placenta. She told me since I could obviously deliver a baby on my own then delivering a placenta was a piece of cake!  J  There is a right way and a wrong way to deliver the placenta so she walked me through it.  The placenta was delivered about 10 minutes later.  After I clamped the cord Dad cut it and we got Mom and baby up to get them both in bed.

The rest of the family started to come once news spread the baby had arrived. At one point I had the placenta in the pan on the kitchen counter. Apparently one of the Grandpas’ or Uncles’ had passed by the kitchen and seen the contents of the pan.  When I went back in for Mom I was explaining the findings of our check of the placenta.  One of the Aunt’s was totally grossed out and found out mama was going to encapsulate it.  I asked if she would like to see it and I was promptly turned down L  Couldn’t understand why!

Mama had some low blood pressure so we stayed about 3 hours afterwards, keeping her vitals in check along with doing the newborn assessment which she also let me do. Once we were sure they were both doing well we left.  We always go back 24 hours later to do the series of metabolic tests on the baby that are required by law.  We also do another set of vitals and checks for both mama and baby.

The visit the next day went well. We all talked about the birth and especially listened to Mom and her feelings.  She brought up the prayer and thanked me for praying over them. She said that they were both overwhelmed with what just happened that they were shaken back to reality with the prayer. She said it helped them focus on God’s amazing provision. 

None of them knew before that I had never delivered a baby by myself before.  Afterwards Grandma said I could deliver any baby of hers I wanted!  This was God’s amazing plan.  He helped prepare me for this birth. My neonatal resuscitation class had just finished 4 days earlier and God prepared me and for that I am truly grateful.  All praise and honor and glory to the ONE who brings precious lives into this world. May this precious baby girl grow up to be a mighty force for God.

In Christ Alone,
Jill



Be the kind of woman that when your feet hit the ground each morning Satan says, "Oh crud, she's up".

Sunday, December 23, 2012

Baby "C"



Baby “C” was a week late.  This was a hospital birth that I would supply doula support.  When I first went into midwifery I was asked to become a doula as part of my training.  I learned so much during the initial training and the required reading list afterwards.  This would be my first “formal” doula job. I spent several hours with both mom and dad getting them ready for their first birth.

Mom wanted a natural birth and Dad wanted a planned C-section. My job was to help them navigate the wide gap between the two birth plans. Once a decision was made to have a doula help them work through the labor, we started working on strategies.  They had been working with a doctor that was pretty meanable to trying natural methods. However, the doctor gave her 7 days after the due date to deliver naturally or an induction would occur. Mama didn’t want an induction so she walked, and she walked and she walked some more!

The day arrived for the induction and time was running short. She was to arrive at the hospital that night at 9p.m. The sun came up that day and labor started on its own, thank you God!  I arrived at her home around 11a.m. and started to work with Mom. Dad arrived an hour later and we became a team. Our goal was to bring this precious baby into the world as natural as you can in a hospital setting.  The labor progressed in a typical fashion. First the contractions were 15 minutes a part and then 10 and down to 5 minutes apart. Contractions have to last a minute each to count as labor contractions.  Since this was my first hospital birth as a doula I wanted to be able to gauge how long to wait before going to the hospital.

Mom wanted to do most of the labor at home so we waited till she was having contractions 2 minutes apart.  We had a plan where we would continue to labor in the hospital waiting room till Mom was comfortable going in.  We stopped in the entry way during several contractions and helped her though them.  Several people passed us staring and I would just say Mom is fine, she is just in labor! One man said, “that doesn’t look like fun” Had to laugh  J

It wasn’t long before Mom was ready to go in. When we got to triage there were three nurses there. Mom was bending over the desk going through one contraction after another. I was doing the hip squeeze during each one. One of the nurses asked me, “Are you a midwife? Boy I wish I had had you when I was going through labor!”  It was decided, yes mom was in labor so we could go in.  We met the nurse who seemed to be not thrilled with a doula no matter how nice I was, bummer.

The three of us continued to work as a team to work through one contraction after another. In my training I  had learned the hip squeeze and the head squeeze. At one point mom said that those two things were an amazing help through the pain. I chuckled and said those two tricks only cost me $400 to learn! One contraction after another, one head squeeze and one hip squeeze with each contraction. Nothing else gave her the comfort she needed. When it was all over Dad said if he had to do one more head squeeze he was afraid he would pop his wife’s head off.  I realized through all those hours I would need a good message afterwards for me!

We started getting close. Mom was starting to feel pushy.  This time the two doctors came in and determined she was within a centimeter of delivering. The room got broken down to deliver while Mom started pushing.  At one point I asked the nurse if she could feel the baby’s head when it crowned and she informed me that she would have to ask permission of the doctor, really?  Lesson learned, I will never ask again permission for a mom to feel her own babies head coming out of the birth canal.  I have found that just as a mom thinks labor will never end, touching her baby’s head gives her the strength to push through. Sure enough mom was energized.

Dad who had said he would never watch the actual birth looked down and his face was priceless.  He kept saying, honey, this is AMAZING, look that is our baby! That was the coolest part for me. A dad got to experience the actual birth and was forever changed.  The actual birth only took a couple of pushes after the head crowned.  Out came out a perfect baby boy!  He weighed a little over 8 pounds.  Docs had been in favor of immediate skin to skin so that is what happened. Baby “C’ was looking at mama right away.  He did the breast crawl which is amazing. A baby at birth can actually crawl up his mamas’ belly and find her breast. Not only can the baby find the breast but can latch on without looking and without any help. It is an amazing thing to witness.

While Dad and Mama were bonding with their precious son I got to witness another wonder. Both docs were great.  There was a problem with the placenta. It would not deliver on its’ own. It had become bonded to the uterine wall and had to be pulled off the wall piece by piece. I had asked permission to watch and learn. I had shared that I was training to be a midwife and this would be a wonderful opportunity for me. The doctor explained how this happened in the first place and then shared what had to be done. After the placenta was taken out it was time to stitch.  Now my only other experience with stitching was with Baby “A” and that occurred on a bed with a flashlight. I have to admit it was simpler and quicker on a high bed with something sturdy underneath Mom. The doctor explained what muscled were being sutured and how it was done.

Too bad the nurse wasn’t as kind. She had made it clear with little jabs here and there she did not appreciate my methods. I was not prepared though for her stinging grade afterwards. I thanked her for the experience to work with her and wished her a good night.  I learned so much.  In spite of the poor review from her I was on cloud nine. I had helped a Mom and Dad birth the way they wanted.  Their thanks was enough for me. 

About an hour later the grandparents came in along with some close friends. I was just so overwhelmed with the events that I asked everyone to join me in prayer over the new baby. We all gathered around the bed and prayed over Baby “C’.  It was a fitting end to a wonderful day.  By this point it was after 1 am and little did I know that eight hours later I would be delivering a baby all on my own!  I went home with a song on my lips and prayer in my heart.

In Christ Alone,
Jill
 



Be the kind of woman that when your feet hit the ground each morning Satan says, "Oh crud, she's up".

Tuesday, December 18, 2012

Gratituesday

As the precious children are being buried in Connecticut, I have to ask myself, what can I be thankful for today?  The mother's hearts that are forever changed. The daddy's that will never ever get to play ball with their child again. Or the grandparents who will die with a broken heart for all that was lost.  How do we find anything to be grateful for today?

I would suggest a pause, a moment to just be.  There are no words that will explain such evil. A pause to just be.
"Be still and know that I am GOD"

For today, that is enough.



Be the kind of woman that when your feet hit the ground each morning Satan says, "Oh crud, she's up".

Wednesday, December 12, 2012

The Key









Last time we talked about Moses’ unique perspective when it came to leading God’s people for over forty years.  Remember when Joshua and Caleb had come back from spying out the land? They were ready to take possession of what God had promised them. However, those two stood alone with Moses. Because of the people’s lack of trust in their Redeemer, they were told they would never enter the promised land and would die in the wilderness.
Did you know that was around 600,000 people?  Now that is over a half a million people.  In order for all the them to die in the 40 years of wandering there had to be one funeral every 20 minutes each and every day around the clock, 24/7!  It had to be a constant reminder having one funeral every twenty minutes, can you imagine?
After all that death and destruction Moses stands on the top of the mountain and says this…
 Lord, you have been our dwelling place in all generations. 2  Before the mountains were brought forth, or ever you had formed the earth and the world, from everlasting to everlasting you are God. 3 You return man to dust and say, “Return, O children of man!”
Psalms 90:1-3 (ESV)
Moses starts with the most important thing for all to remember. God, it is you and you alone who are our dwelling place.  There is no where else to go my friend.  He is our dwelling place if we let Him in.  So many times God is not our dwelling place.  We keep our feet, our hearts, our eyes, ears and mouths planted in this world.
Moses understood the key to life.  This world is NOT our home. Why we do we live as if this is it? Why do we scratch and claw our way through life when our dwelling place is in the LORD and not the earth?
Imagine what would change in our life if we not only understood that foundation but lived it? How would we spend our time? How would we be raising our children? Would we stay firmly planted in his WORD everyday single day.  Only a prayer away from the heart of God?
In the past few years in particular I have paid very close attention to this subject.  With my husband losing his ability to work and to minister to others I have been reminded once again that we strive for a heavenly home and not this tent.
Our Heavenly Dwelling
1 For we know that if the tent that is our earthly home is destroyed, we have a building from God, a house not made with hands, eternal in the heavens. 2 For in this tent we groan, longing to put on our heavenly dwelling, 3 if indeed by putting it on we may not be found naked. 4 For while we are still in this tent, we groan, being burdened—not that we would be unclothed, but that we would be further clothed, so that what is mortal may be swallowed up by life. 5 He who has prepared us for this very thing is God, who has given us the Spirit as a guarantee.
2 Cor 5:1-5 (ESV)
Are you and I “groaning” for this earthly tent or are we “groaning” for our eternal home? One not made with hands, a gift from God our Father?  Think about it, won’t you?
In Christ Alone.
Jill
  

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