She was almost one week past her due date, that magical date arrived at by adding 40 weeks to the last menstrual period, when she awoke to a feeling of her bag of waters leaking. Still feeling her baby move and not noticing any unusual color to the leaking, she waited for labor to start and called her Nurse-Midwife to discuss how long to wait at home before going to the hospital. Having had an uneventful pregnancy course, we decided to give a few hours and see if nature would take it's course.
A few hours later the contractions were only about 20 minutes apart, so it was time to head to the hospital to get labor picked up, first by walking around, then with the addition of low dose Pitocin through an IV drip. Walking, rocking back and forth, and sitting on the birthing ball passed the time of early labor moving into the active stage of labor.
Her husband was very attentive and encouraging as labor contractions began to come closer together. Lite kisses on her forehead gave her that sense of being cared for and feeling his strength and safety. The Nurse-Midwife offered suggestions for position changes and later a little rest in the bed. The RN and student nurse offered their support with breathing and relaxation too, bringing an additional freshness into the room.
Soft classical music had been selected by the patient and brought from home to create a more home like environment for labor....and we waited...now nearly 4 centimeters dilated and 90% effaced, the contractions became stronger and harder to deal with. With mom becoming tired from being up most of the night before, a decision was made to have an epidural for pain relief.
Most of the time epidurals provide fairly quick pain relief to the laboring mother, but this time relief would not come. Breathing and relaxation techniques were called into play as we encouraged and supported our patient and requested the epidural to be placed a second time an hour later.
As pain relief came the mother-to-be continued to dilate to 10 centimeters and labor down. The second stage of labor (from 10 centimeters to delivery of the baby) often takes an hour or two or a little longer in a first time mother and is usually well tolerated by the fetus. This little fellow, however gave interesting signs of slowing his heart rate in response to contractions when on mother's right side or in a mid sitting up position.
Having passed meconium earlier in the evening, an amnioinfusion had been started to thin the meconium and help protect the baby from trying to swallow the fluid after birth. Mother was encouraged in gentle bearing down efforts or mild pushing as we watched baby's response to the final leg of his journey. As baby continued to show signs of mild stress with labor it was decided to be in the best interest of mother and baby to stop the Pitocin, rest mom, and request the physician to come and assist the birth with a vacuum.
A little while later and two pulls, a vigorous baby boy entered the world, wide eyed and very unhappy about being removed from his safe place for the past 9 months.
Yes, I witnessed a miracle of a team effort in the birth of a baby boy on Mother's Day, May 9, 2010 with proud grandparents in Korea and Romania, all celebrating a new life on the same day in different countries. Welcome to the world, little man. You are so loved!
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