When A Home Birth Doesn’t Go As Planned – Part 2
Transport gone right
Thank you for joining me as we continue to look at transports. Today, I’d like to take a moment to look at a case when everything went well. I think it’s important to note that just because there may be need for a transport, doesn’t mean that everything is out the window! Remember, I’m not anti-hospital. I am glad they exist and that they are there to help us when they are needed. When the system works well, we can all benefit.
Let’s take a look at an example of when a transport was necessary.
First time mom laboring well at home but contractions are irregular. She’d had some prodromal labor the night before that stopped. We try various things to regulate contractions both in frequency and intensity, but she doesn’t seem to progress. The baby appears to be a little asynclitic (her head not flexed or tucked just the right way).
We take breaks, allow her to rest and pace herself and try various positioning exercises to help the baby get into a more favorable position. We discuss the balance necessary to not completely exhaust herself in labor because, while delivery is an end to pregnancy, it is only the beginning to the parenting journey.
Keeping in mind that first-time moms push on average around 2 hours, and the work that breastfeeding takes, we decide to transport before there is a medical problem. Our thought and approach is that she needs an epidural and Pitocin. She’s been at this for a while and could use the full relaxation of an epidural and the uterus could stand some harder, more consistent contractions.
After consulting with our physician we decide to head in to the hospital but must use the on-call physician because our consulting doctor is unavailable. The nurses are supportive and a couple recognize me and are familiar with some of my midwife associates. They help to get us settled and work with us toward the desired vaginal delivery my client desires.
While the doctor was cautious and made us aware of time frames and the progress he was looking for, the staff stood strong and united. He broke her water and began Pitocin and she was given an epidural. The nurses worked with us to help change the mother’s position regularly, since she was unable to do so on her own after the epidural.
The mother was able to rest, regroup and prepare for the next stages and reflect on the hard work she had accomplished. The father was encouraged and supported, which allowed him to also rest and regroup in order to best support his partner. She met each milestone and we diligently continued our cadence throughout until it was time for second stage and she was able to push with those contractions she had been working so hard to get on her side.
Each push brought more determination and resolve for what was and was about to be. And then, just like that, her daughter was born. She was overcome with relief, pride, joy, elation and never doubted herself or the decisions that took place and brought her to where she was in that moment.