This is the birth story of a 32 week baby. She is currently back in the hospital due to RSV and pneumonia. Your good vibes and prayers are appreciated by her family.
I was planning to go on call in March, or maybe the end of February. S was a second time mom, and her first son had been born about a month before his “due date”. This time, she was “due” the end of March.
Her pregnancy wasn’t exactly easy. She suffered with pancreatitis, which causes intense pain. She fell down the stairs, holding her son in her arms. One thing after another after another.
I started getting an inkling that birth might occur earlier than expected when S texted me to ask about Braxton Hicks contractions the middle of January. I encouraged her to call her midwife if they seemed consistent at all, but assured her that BH contractions are normal during your third trimester. A few days later, she told me she’d dilated to a 1 at her last exam, and that her midwife had done a fetal fibronectin (fFN) test to see if her body was preparing for labor, which might help them determine a course of action.
On January 21, S started having contractions that were more painful. She was advised to rest, take a warm bath, and go to labor and delivery if they didn’t abate. After a couple hours at the hospital, she was sent back home.
A week later, she was admitted to the hospital to be put on magnesium to help slow or hopefully stop her labor, and steroid injections to help baby B’s lungs mature, just in case labor didn’t stop. She was planning to return home soon, but her water broke.
Now, normally when a woman’s water breaks, she either goes into labor or gets her labor induced fairly quickly afterward. In the case of a premature rupture, however, the nurses and midwives involved in S’s care just worked to slow labor and to decrease the odds of infection. That meant that rather than regular cervical checks, none were performed for several hours as S labored. She was put on IV antibiotics and monitored continuously.
S texted me around 7 pm, to let me know that she would like for me to join her. I immediately left from the party I was at, rushed home to nurse my baby and wait for the sitter, and was at the hospital to join her by 8 o’clock. When I arrived, S was talking with a NICU nurse, but was otherwise alone in her room while Smallville played on the TV in the background.
My first knee-jerk reaction was anger. Why was she being asked to remember all the information the nurse was giving her– by herself– both during and between contractions? Could the hospital not wait until her husband returned? I bit my lip and introduced myself, and then I settled on the couch to allow the nurse time to finish what she needed to tell S.
I unloaded my things and took stock of the room. It definitely looked lived in, but was not too cluttered. I straightened a few things from my seat, but tried to stay out of the way. S looked uncomfortable. She was sitting mostly upright in her bed, the monitors stretched around her belly were just visible under her gown, and occasionally I noticed a grimace that told me that she was definitely contracting. She managed the contractions well– in fact, I’m not sure the NICU nurse noticed them at all.
Shortly after the nurse left her, S’s husband, K, arrived with her mom. S asked about their son, and K asked about the NICU nurse. Her mom asked how close the contractions were. By my watch, they were about 6-7 minutes apart, but the monitors were only picking up that they were 8-10 minutes apart.
They settled into conversation, and I asked if S could use a foot rub. I like to establish casual touch early on in labor, to make it easier to transition to a more intimate touch such as a hip press or sacrum press. I also like to establish where the laboring mother’s support is most comfortable. S’s feet and legs were hugely swollen, a side effect of the magnesium drip. Even her face was swollen, but it wasn’t immediately noticeable.
I carefully massaged her feet, helping to work some of the extra fluid out, trying to help her be a bit more comfortable. Baby’s heartbeat galloped along as S and K distracted themselves with more Clark Kent and Lois Lane. K seemed to bring S’s tension levels down, and he was able to make her laugh, despite the circumstances of her labor.
When I finished her foot rub, I asked what she would prefer. I have tools for slowing labor down as well as helping it move along. They can’t compare to the hospital’s array of tools (such as magnesium), but even a few extra hours in the womb can help a premature baby. S had a strong feeling that baby was coming that night, and wanted to try to get labor going, at least to the point where she could check her progress. Because of her broken water, the nurses had been instructed not to perform any vaginal exams, and I think she really wanted to confirm to them with numbers what she had been saying all along. Labor was moving along, baby was coming, and she wasn’t crazy.
I helped her to stand, showed K how to slow dance with her, talked to her about how swaying could help baby descend, and sat to watch for a bit. I was perplexed. I had never experienced a labor this far from “textbook” before. Even the incredibly long labors I’ve attended have had contractions consistently every 4 minutes or so. S handled her contractions like a champ, so I really couldn’t even tell from her reactions if the intensity was changing.
There are times when a doula arrives in early labor and steps out until active labor begins. One reason is to help the laboring mom feel less pressure. The saying goes that “a watched pot never boils”, and a “watched mom” in early labor might stress enough that her body slows her contractions down. I had this in mind when I asked if S and K would like some time alone or if they would like me to stay.
S looked at me like I was crazy. She said that I could go if I wanted to but that baby was going to come sometime that night. I assured her that I wasn’t going anywhere if she didn’t want me to and settled in for what I thought might be a very long labor.
The next time S’s nurse came in to check her, S pleaded for a cervical check. The nurse hesitated, but did the exam after asking S about her pain. We were all blown away by the news that she was 7 cm dilated!
Part 2 of Baby B’s story is now available!
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