A Natural Birthing Experience…

Posted on: January 4, 2009

Dec 17th, 2008: One more of my moms went into labor! This mom was extremely active, well-informed and conscientious about her exercise program. Her due date was on the 14th of December, but as mom and baby were healthy we decided to wait for labor to start on its own. In the meantime, mom practiced her exercises twice a day, walked and climbed stairs 2-3 times a day, all in an effort to get labor to start on its own! She also tried some pressure points and nipple stimulation in an effort to get labor started.

Finally, on Dec 17th she had her scheduled appointment with the OB. CTG was equivocal, so she was asked to get admitted for observation, since she was already past he due date. Mom and dad called me, and since I was already at the hospital in labor support with another mom, I told them to come in, and that we could talk after they had been in observation for a couple of hours. As luck would have it, by the time mom came in to the hospital, labor had started by itself! I met mom and dad, soon after their admission, and found mom breathing through mild contractions. I told her to continue walking, changing positions frequently, and that I would be back if they needed me for anything. CTG monitoring revealed that all was well with baby, and mom and dad labored through this initial phase of labor on their own in their room. Mom had a light lunch and some rest. When I checked in on her at around 2pm, I found her to be in a chair straddling position, breathing through her contractions. She was still fairly early in labor, with contractions 7-10 minutes apart, and contractions lasting for 30 -45 seconds. By this time, I had been at the hospital for almost 2 days, so I asked mom if she was okay with laboring on her own for a while, until she got into more active labor. She was fine with this, so I headed home for a bit.

At 4:30 pm, the first and only internal exam was done, and it was found that mom was 60% effaced and 2-3 cms dilated. Good News! Labor started to progress into the active phase at around 7:30 pm and mom was managing her contractions well with breathing, and still continued with change of positions frequently, and the pelvic tilts whenever she could. Dad was very supportive with keeping mom well hydrated. At 9 pm mom started going into the transition phase. She wanted to lie down on her back for a few minutes, and we let her do that, but a minute or so later, she was up again, trying to find a position for comfort. Pains were quite intense at this time, and I found that mom was starting to panic. I suggested that she try the birthing ball, and that is how we labored for the next 45 minutes or so. I turned off the lights, and with only a small night light on, mom labored through this most intense phase, rocking on the ball, breathing, occasionally moaning, and resting in between the contractions. When she withdrew into herself, I knew that she would enter the pushing stage soon. Massage seemed to help her a lot, so I continuously massaged her back (rubdown relaxation massage) while she was in transition. At around 10:45 pm, mom said she would like to use the bathroom. She was on the toilet seat for a while, and she looked very comfortable, so I asked her if she wanted to remain seated there for a while, and she said, very calmly “I feel like pushing”. Since we had not done any internal exams after the initial one, I wanted to be sure that she was well dilated before she pushed. Internal exam showed that she was 100% effaced and 10 cms dilated, and baby was at +1 station. She was indeed ready to push! By this time the body’s natural catecholamine surge had ensured that mom was alert and awake and ready to push. Just as I thought we could go back to the restroom to try mom’s comfort position for pushing, her bag of waters started to trickle. Mom said she would like to try pushing, and so we tried the C-position on the bed, and within the first two pushes, the bag of waters burst completely. Mom kept pushing with her contractions, and her natural urges. However, her perineum was extremely tight, and so we had to do an episiotomy with mom’s consent. Breast feeding was started soon after the pediatric check up and mom and baby bonded skin-to-skin for the next hour. Mom was walking within 2 hours. What an empowering birth for mom, and after the previous 2 C-sections, I felt tremendously invigorated as well. This is how birth is meant to be!

Lessons learnt: A informed mother with a strong desire for natural childbirth can and usually does make it happen. Of course, the labor support that she gets and the hospital and her OB are equally important catalysts in helping her achieve the birthing experience she desires and deserves!

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