Hannah's Induction Part 2

Here is the link to part 1.

Extra Fun Birth – I had attended Hannah’s Sister’s Birth a few months before and a lot of the same people were there, so it was like a reunion of sorts.  I was so glad that I was able to attend Hannah’s birth!

Being in Town – It was pretty amazing that I ended up being at this birth.  Hannah knew I was going to be out of town for a week during her guess month, but she wanted only me and no back up.  So I let her hire me, with us both knowing full well I may not be there.  It apparently was meant to be that I was there, because baby stayed in until after I was home.   I had tried this 2 other times and the moms had baby’s while I was away.  I felt bad even though they KNEW.  For one I wish I had insisted she have someone else and actually had back up lined up that she could have called.  (She was a VBAC hopeful and ended up with a repeat cesarean)  This is one of my dilemmas of being a doula, what do I do with moms who want to hire me while I am out of town for part of their guess month?

Low Fluid – luckily Hannah, Doug and I had met the day before her NST and I had talked to them about low fluid, to ask the exact amount if they were told it was low.  So they knew that 3 really WAS low.  It was a necessary induction.

Life as a Doula – A stressful part of the birth for me.  We were supposed to sign loan docs that day for our refinance.    When Doug called we still hadn’t heard from the loan doc people, so I was a bit stressed as we were supposed to sign that day or we would lose our great rate.  This was hanging over my head until Rob texted me around 6 saying it would be ok as long as we signed the next day, but I was worried, what if she was still birthing the next day?  1^st time mom, being induced, that can take 24-48 hours.   I just put it out of my mind.  I had prayed on the way over that it would all work out and just tried to put it in the Lord’s hands.   It all worked out just fine.  But this is just an example of the craziness in the life of a doula.

I love the Change of Plan Script!  I love all of the Hypnobabies tools, but this particular script is perfect for situations like this.

Lots of People at the birth – It was great that Hannah had so much support there, but also knowing that birth is not a spectator event, sometimes it is better to have people clear out of the room so mom can really relax and let go!  Sometimes as the doula or main birth partner, you have to help make this happen.

When all the ladies came back from their walk after getting a snack that night, I asked if they had a plan?  Were they all going to hang out there until she had the baby?  It would have been ok I think, except I was feeling bad for Nana.  There were not really enough seats for everyone and I just had no idea how long Hannah’s birth was going to last.  Things might really not get started until the next morning!  They didn’t have a plan.  So I suggested they get a hotel room nearby and we could call with any changes.  They were open to that.  So I went to ask Hannah what she wanted.  She was fine with them going to a hotel.

I felt like the birth was AMAZING for a hospital induction until we got to about 9cm.

Here is where I got a little frustrated, here was this great birth, un-medicated mom with pitocin doing SO well.  Now is where the whole hospital/fear base came to interfere.

Peeing – I wanted to get Hannah up and to the potty one more time before she started pushing.  The nurse was nervous about this and said she didn’t really need to.  She would bring a bed pan and she could pee right there on the bed, she didn’t want her pushing the baby out in the toilet.   I really was pushing for Hannah to get up, but after the nurse said that, Hannah didn’t want to get out of bed.   (I later found out this was the first un-medicated birth this nurse had seen in 10 years of nursing, so maybe she did think the baby was going to pop out of a first time mom at 9cm if she sat on the toilet.)

Pushing – I told the nurse she wanted to push in an upright position because laying down really hurt her back.  Hannah was on her knees on the bed at this point.  I asked if she could push like this.  The nurse said that if the OB was ok with it and the baby looked fine then it should be ok.

Pushing scare tactics – When the OB got there he said she could push in any position she wanted, but he couldn’t protect her perineum in that position.  But it was up to her, but she might tear that way, more moms tear in that position.  UGGGGHHHH…. let’s scare mom into doing what we want her to do.  Hannah of course then wanted to be in the “right” position despite the fact it caused discomfort in her back.

Pushing power of our words – Hannah started pushing around 1:20.  The nurse had her in a pretty good position in the bed, but when she was ready to call OB in, she got the stirrups out and took the bottom of the bed off and got mom into the “proper pushing position”.  She also said something along the lines of “This is a pretty big baby and so we need to have you in this position.” Also “This baby is posterior, so we are going to have to work harder to get her through your pelvis”   She said comments like this a few times.  I think this is a great example of how nurses are not aware of the negative power of their words.  When she was pushing with the nurse, the nurse was doing some perineal support and massage and this had reassured Hannah.

The OB came in and sat on his stool between her legs up in stirrups, closed his eyes and kept taking cat naps between pushes.  When she started to push she asked for perineal support.  The OB looked confused.  I wanted to yell at him!  “DUDE, you said she couldn’t push in the other position, so you could support her while pushing and now you sit there SLEEPING!”  He told the nurse to do it.

So she was pushing and the nurse kind of made me mad because she would say, ‘If you push hard then the baby can come out next push.”    So then Hannah was frustrated and worried because the baby wasn’t coming out.  She thought that she wasn’t pushing well enough because the baby wasn’t coming out.  I reassured her that it took time, that she was doing great.

Also while she was pushing she wanted to be sitting up more and the OB made a comment “Gravity doesn’t really help in situations like this, your uterus is much more powerful than gravity.”  I explained she wanted to be more upright because her back was uncomfortable in that position.

At one point Hannah said, “Never mind.  I just want a cesarean.  What if the baby is too big?”  I reassured her she was doing fine.  The baby was good, she was good, her baby was the perfect size for her!  She could do it!    Lots of positive affirmations!  I think it helped her let go of the fear, which the nurse had planted in her mind.

Sticky Shoulders – ???  Well, it seemed weird to me that before the babies head even came out the OB moved her into the position and told her she had to go into this position to do the whole push on her stomach to get the baby out.   She had been pushing for less than an hour and was making progress.  Then when the baby’s head crowned, they didn’t let her rest, they yelled at her to push the head out.  So she did.  Then she didn’t even have another chance to rest, when they dropped the bed, called sticky shoulders and started all their stuff.

The baby was out within 20 – 30 seconds before the other nurses stormed the room.  I can’t help but wonder if we had taken a break when the baby’s head crowned.  Waited for the next pressure wave to push the head out if we could have avoided that.  What about pushing on hands and knees like she had wanted to?

Can you really tell you may have a possible shoulder distocia before baby crowns?

Overall Feelings –  Except for being made to push in a position she didn’t find comfortable and the scary last few seconds (which caused her to get a 3^rd degree tear, which took 40 minutes to repair) she had an incredible birth.   I can’t help but wonder if she had been able to push on her hands and knees like she wanted if that would have actually helped the baby just slide out easily and help prevent the tearing.

She overcame great odds, hospital, pitocin, posterior baby and did it un-medicated and was calm and did amazing!  I just wish she could have pushed in a different position.  I also wished I had MADE her get up to pee.  Being upright and walking to the toilet, sitting on it for a few minutes could only have helped.  That nurse totally undermined that.  I am sorry but that baby wouldn’t have fallen out in the toilet!  And if she did, that would have been nicer than what did happen.

Peeing Again – After I left the nurse wanted her to pee before she went to the postpartum room and Hannah couldn’t.  Her sister suggested she get in the shower (remember, Hannah is a shower peer) and the nurse said NO and did a CATHETER!  Seriously, you won’t let mom hop in the shower so she can pee?  Having a wonderful natural birth and she has to get a catheter, instead of going into the shower? Ugghh.

Breastfeeding – When her sister went back to visit the next day and the NURSE was feeding the baby a bottle of formula.  That pissed her off and she made her stop and said if the baby isn’t latching on, let’s get a pump for mom and finger feed the baby.  Baby actually wouldn’t latch on for 3 days.  I suggested a chiropractic adjustment might really help, with all the pulling they did on the baby.  So they arranged that and she latched on easily after that.