Birthing Balls and that process called labor.

The power of the human mind never ceases to amaze me! Education, good nutrition, daily exercise, personal goals and birthing wish lists all play a role in preparing a woman for her starring role in the labor and delivery process. When not confronted with regular contractions, during a prenatal visit, I take the opportunity to ask my patients what their plan is for relief of the discomforts of labor. Usually when I hear "I'm planning to go natural, but I'm open to an epidural", the epidural is moved up the list of options for pain relief quite quickly once regular active labor ensues.

Over the past few months and years I've been privileged to assist first time moms and experienced moms walk their road map of labor. I always find that the natural, un-medicated mom has first made the choice in her mind that her body is capable of giving birth without medication or epidural, and she will work with her body as it changes to welcome the new life within her. Moms can accomplish this feat when they feel safe and are surrounded by people they know, love and trust. Intermittant fetal monitoring, when the strip is reassuring, encourages their mobility by way of walking, rocking in a rocking chair, taking warm showers, having warm compresses to their back and using a birthing ball.

It is so gratifying to see that look of relief and control as a mom gets out of bed and sits on a birthing ball, which simulates boyancy, allows them to rock sideways or back and forth, and is a good position to help the fetus keep his or her back to the front of mom's abdomen and assist descent throught the birth canal.

One mom coped with an induced labor using the above measures and not looking very uncomfortable until reaching 7 cm dilation. Never asking for pain medication or epidural, her husband and I encouraged her, refreshed warm compresses to her back and supported her natural childbirth goals until she felt that bearing down urge to push. Returning to bed for pushing and directed by her body how to do that, within an hour a healthy, pink, vigorously crying baby was born.

Yes, the mind is a powerful tool...and labor is kind, always giving a rest between contractions.

Sometimes the position of the baby or its size comparing to the size of mom's pelvis doesn't allow a vaginal birth, and epidurals and C-sections have their place...ah, but the mind is a powerful thing, and birth is a miracle!

Judy's story

Judy was just 23 years old and looking forward to the birth of her first child when during the first part of the 8th month of her pregnancy she began to feel badly. Not sure if it was anything to be worried about, she noticed her feet and ankles swelled so badly she could barely get her shoes on to go out to see a movie about D-day on the campus of Andrews University in October 1966. The following day she and her husband put the baby bed together and began to get the nursery ready for their Christmas arrival, still a surprise in the days before routine ultrasound. Later in the evening nausea and epigastric pain set in and was unrelenting. Denying contractions or vaginal bleeding the couple laid down and tried to rest, but to no avail.

Around 6 a.m. her physician was called about the uncomfortable night and her headaches and confusion, and stated he would come over to see her after he had showered and was on his way to the office.

By 8 a.m. the physician arrived, checked her blood pressure, stated it was high and that she needed to rest as she hadn't slept all night, and gave her a shot of penicillin. Why, I have no idea. Jello was made and put in the refrigerator for later on, and her loving husband chose to stay home from work with her, as things just didn't seem right.

Around 10a.m. Judy had her first seizure and at that point was taken to a hospital nearby. During her admission and throughout the day her husband and sister would be asked, "Has she had epilepsy before?" The answer would be returned, "She's never had epilepsy, but she is 8 months pregnant." Not knowing how the pregnancy, high blood pressure and seizures related, the family would restate that Judy was not epileptic, and when was the doctor coming?

After a nursing shift change, visits from the emergency room physician to the bedside to attempt to assist the seizing patient and cessation of fetal heart rate of the baby, a "specialist" finally came into the room around 8p.m. A quick examination of the patient, her blood pressure, and fundal eye check and he promptly said "she has eclampsia and the remedy is to deliver the baby." As the physician left the room to try to arrange for a cesarean section, Judy stopped breathing...

A code was called, CPR was carried out and the patient placed on a ventilator with cardiac compressions. After lots of prayers, long distance visits from family members, and attempts of medical care that were initiated way too late, the young mother and her unborn baby (later to be found to be a little girl) passed away.

I believe every mother-to-be must be taught the difference between common discomforts of pregnancy and warning signs of complications that threaten their life. High blood pressure in pregnancy always needs to be promptly evaluated and treated. Some swelling of the feet and legs in the later half of pregnancy may be completely normal, but marked swelling above the waist and especially in the face are signs of complications. Bad headaches that cannot be relieved by rest and/or Tylenol need to be evaluated that day.

Judy has been the driving force behind my decision to become a Certified Nurse-Midwife. She was my older sister, loved by the family and missed by all. I expect to see her again in heaven and get to meet her infant there.

Loved by the Family

Loved by the Family... I was privileged on Mother's Day weekend to attend and be an active participant in the labor and birth of a precious baby girl. Her mom, a veteran homemaker, home schooler and very capable in all of her tasks, had walked this road before, yet each pregnancy brings with it the anxiety at the end of how will it go for me, and how will I know?

As mom came to the hospital she was lovingly flanked by two of her daughters and her husband, who were very attentive to her needs. You could see and feel God's love in the room as mom was helped with drinks of water and walked down the hall to help get this labor going. A medical need had brought her in and her readiness to complete the tasks of labor and delivery in a safe manner and environment kept her there. After reviewing the options of how to pick up her labor pattern it was decided to have her walk for 40 minutes,release the bag of waters around the baby, monitor the baby's heart rate for reassurance and have her walk again for about 40 minutes. When you are already 4-5 centimeters it doesn't take a lot of intervention to coach labor to continue. Slowly but surely the contractions increased from 4-6 minutes to 4-5, occasionally causing mom to stop her walk, rest and catch her breath again. For about three hours her cervix remained the same dilation, but effaced (or thinned) a little. We talked again about how to get her over this hump of staying at 5 cm in spite of the walking, rupture of membranes and rocking in the rocking chair. It was agreed that we would start Pitocin at 1 milliunit and see if this would get her past the hump and on to her delivery.

Contractions began to slowly shorten in interval to 2-3 minutes apart. Mom was assisted to change her position, rock in the chair or stand and rest her arms and chest on a birthing ball for relaxation. Two sweet daughters kept at work stroking mom's hands, rubbing her arms and dad massaged mom's back. Talk about loving family support...as mom would occasionally frown and ask if her contraction had peaked yet I would see an empathetic tear roll down one of her daughter's cheeks. We kept encouraging mom at what a great job she was doing, conserving her energy and staying just ahead of the contractions that would culminate in the birth soon. At one point the the comment was made, "I'm think I'm going to need an epidural."

"You're doing fine", I countered. "Let me check you after this next contraction." Contractions were getting stronger now and the Pitocin had been reduced to 1/2 milliunit. Upon the exam she was found to have only a small lip of cervix now and the pitocin was turned the rest of the way off. Pitocin had only been necessary for one hour.

The knowledge that birth is eminent brings a second wind to a laboring woman that will enable her to work with her body when that urge to push comes and complete her work. The request for an epidural was forgotten as the room was prepared to receive the new baby. A very supportive RN, a student of nursing, medical tech and other personnel to support the needs of the new baby entered the room. Closest to mom still were her husband and two daughters.

Approximately 17 minutes later a beautiful feisty baby girl entered this world, reaching her little left hand out with her head, ready to grasp life and all its surprises and challenges. She was placed in the arms of her mother and appropriately let us all know how upset she was at being pushed out of her home for the past 9 months. Apgars of 9 and 9 at one and five minutes attested to the good start this little girl got that evening.

How blessed this little one is to be the 7th child to join a family who love and care for each other and greeted her as if she were the only child they had. Welcome, sweet baby girl!

Welcome to my blog

Welcome! For the past 15 years I have dedicated my life to improving the life and health of women through my profession as a Certified Nurse-Midwife. After completing my studies at Emory University in Atlanta, Georgia, my midwifery journey began in the central Florida region with an OB/GYN practice consisting of 2 physicians and 4 certified nurse-midwives. I was then led to the northwestern Kentucky region to head up a hospital-owned midwifery practice of 4 certified nurse-midwives providing prenatal care and deliveries to women served by four community health centers. Currently, I now practice in the Chattanooga area of southeastern Tennessee with a team of 3 physicians and 1 other certified nurse-midwife. Throughout my career, I have enjoyed serving women with various gynecological and health needs, watching many trust their bodies to nourish a pregnancy and give birth in a hospital setting, either with very little intervention or with epidural anesthesia.

I look forward to sharing my experience and knowledge with you. My desire is that this blog becomes a source of information on women's health issues through an interactive dialogue exchange with my readers. That's where you come in. Please feel free to ask questions, comment, or give suggestions on future topics that are of interest to you. Thank you for following my blog outlining my own stories of midwifery moments.