alas, another vaginal birth (4)
With two C-sections in a row, I was beginning to wonder if I’d ever see another vaginal birth.
I arrived to shadow the midwife at 9AM yesterday. The midwife had just warned me of a slow morning , when at 9:30AM the office phone rang. The midwife said, “Ok, I’ll be right up”. I put down my writing and followed her upstairs to the maternity unit.
Michelle laid flat on the bed, her mother and partner on either side of her head, holding her hands. Her mamaw (granny), and sister sat in the corner. Michelle’s golden hair framed her quiet face, a sign the epidural was working well.
The midwife checked the mama’s cervix. Fully dilated and the baby was already well on her way down.
There was a rush to roll the new born incubator/monitor and the delivery tools into the room. The midwife put on her sterile blue gown, locking it with a bow tied on the side. She asked Michelle if she’d mind sitting up, and tilted the head of the bed up 45 degrees. The mama bent her knees up and placed her feet flat on the bed about a foot from her butt.
Epidurals take away the pain of the contractions, not the pressure of the baby. This makes it more difficult for laboring women to accurately indentify their contractions
The midwife stood at the left side of the bed, just below the woman’s waist. She placed her un-gloved left hand on the mama’s lower abdomen, detecting contractions through hardening of the uterus.
Initially the midwife guided the mother to push with contractions. Mama bore down, naturally – a series of short pushes, followed by a break.
As the baby girl’s head became visible at the vaginal lips, everyone’s encouragement increased. The room filled with excitement. The mama’s mom wanted her to push continuously, harder and longer. The assisting nurse told her to push with contractions and pulled her leg up.
The midwife encouraged her to push when she felt like it (as long as she kept barring down). The evidence says that no pushing style is more effective than others. Therefore, as long as the mother is moving the baby down, the style is good.
Michelle pushed with all her might, breathing deeply. Her eyes stayed shut and face scrunched to her nose with each forceful motion.
The vagina and perineum slowly expanded, opening until the widest diameter of the baby’s head crossed the threshold and the head popped right out. A little hand wiggled under the baby’s chin. The midwife told the Michelle to hold off for a moment. Michelle opened her eyes. The midwife reached in and checked for elbow placement. Then asked the mom to resume. Michelle closed her eyes. With one swell push, out came the baby’s pink, squirmy body.
It wasn’t much more than 30 minutes and the baby was delivered. Dad cut the chord. Michelle held the baby at her chest. Ten minutes later, while the baby got cleaned up, when the uterus was ready, mom pushed out the placenta.
Soon as the nurses had Michelle cleaned up, the room was filled with eager family and friends waiting to catch a glimpse of mother and baby.
Before the midwife and I left to return to the clinic downstairs, we stopped by Michelle’s room. The midwife wanted to check her vaginal swelling.
The dad (who during the birth had curiously glanced in my direction a few times) called me over, “Have you seen her yet?”. The 6lb 4oz baby was bundled up in his arms. Her eyes where locked on his big ole round face. He looked down at her, glowing, then over at me and said, “meet Vanessa”.
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