Science and Sensibility’s Healthy Birth Blog Carnival #2: Walk, move around, and change positions throughout labor
This month’s Healthy Birth Blog Carnival is “Walk, move around, and change positions throughout labor.” This is a repost from a story I wrote back in March however, I feel like it is a really great example of how important movement and position changes are to a successful labor and birth, especially a vaginal birth after cesarean (VBAC)! This story has been a popular posts with my readers in the past and I hope by participating in this blog carnival it reaches and helps empower more and more expecting women out there!! In reposting this story I have highlighted all the times where Alyssa used upright positions and movement to cope with pain, help her uterus contract more efficiently, help her baby find the best position in her birth canal, use gravity to her advantage, and be an active participant in her labor! And there is no doubt in my mind that all of these things helped her have a safe, positive and empowering VBAC experience!
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Last week I had the honor to be a part of one of the most beautiful VBAC(Vaginal Birth After Cesarean) hospital births I have ever witnessed. I would like to share that couple’s story with you today as both a feel-good tale of personal triumph and a story of inspiration for all those moms planning a VBAC out there that might stumble upon my blog. Since this is a blog about “a nurse’s view from the inside” this story is probably much different than any other birth story you might have read from the mother or father’s point of view. But then again, maybe that isn’t so bad! Enjoy!
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It was ten to 11 o’clock am as I walked through the lobby doors of the hospital I work at, rushing towards the elevator so I could punch in on time. As the elevator doors started to close, a hand shoved through the crack, forcing the doors back open. “Please make room!”said the woman, a phlebotomist who works in the hospital, in a shaky voice, “Woman in labor here!!”Following behind was a very pregnant woman, huffing and puffing as she waddled into the elevator, followed by what looked like her husband and her mother. “Don’t touch any buttons!”said the phlebotomist, “We’re going right up to labor & delivery!” Since that was where I was headed too, I smiled at the husband and said, “Don’t worry, you’re here now and she won’t have the baby in your car! I work up on L&D so I’ll show you were to register.” Something told me that if this woman was truly in labor then she would be assigned to me since I was just starting my shift. But she had to “pass” triage first, so after helping the family to the registration desk, I hurried into the locker room to change into my scrubs.
Fifteen minutes later the triage nurse came to the main desk, “I’ve got a term mom, 40 weeks 5 days, who’s five centimeters,” she said, “We’re gonna need to put her in a room…. And she’s a VBAC with a ‘birth plan’.” “I’ll take her!,” I said excitingly, knowing that I have my bestdays when I can assist a woman through labor, as opposed to getting stuck on the OR team or in the high risk ward running magnesium. (Not that those women don’t need a lot of TLC too, it’s just that I like labor the most!) Birth plans, natural unmedicated labor, and getting my patients out of bed…those are my specialties!
I quickly set up the room across the hall as the resident finished the patient’s history and physical in the triage room. Then I quietly knocked on the triage room door and let myself in. The patient, Alyssa*, was standing by the bed, rocking her hips back and forth, as the continuous monitors strapped to her abdomen traced the baby’s heart rate and her contraction pattern. It looked like she was contracting every 3 minutes, and the baby’s heart rate was beautiful and reassuring. Her husband, Jared, was leaning nervously against the wall and her mom, Deb, was sitting quietly in the corner. I could really tell that Alyssa was lost in “Laborland” and I wanted to make the transition to her room as seamless as possible as to not break her rhythm and concentration too much. I quietly introduced myself and with the help of Jared and Deb, moved all of their belongings across the hall as Alyssa waddled behind.
I could tell that Alyssa was coping well with the contractions while standing but a quick glance at her prenatal summary revealed that she was Group B Strep positive and would need IV antibiotics (our hospital’s policy and the midwife’s order) and hence, and IV. Now I feel that I am pretty skilled at starting IVs, but I have not yet mastered starting an IV with the patient standing and swaying! So in the two minutes between the contractions, I explained to the Alyssa what I needed to do before the admission process was complete: get 5 more minutes of continuous monitoring on the baby (to equal the “20 minute strip” my hospital’s policy requires before we can switch to intermittent auscultation), take a set of vital signs, draw three tubes of blood, start an IV, and ask a few more questions. “Give me 8 minutes sitting on the bed,” I said, “and I can have everything but the interview done. The rest of the admission can be done with you standing up.” “Okay,” she said, “I can do eight minutes.” Eight minutes later the IV was in, antibiotic running, labs drawn and sent, vital signs done, monitors were removed, and the patient was helped out of bed (Phew!! That was close!! J). And it wasn’t a moment too soon because Alyssa was having a lot of back labor and sitting in bed was just making it worse!
Then there was a knock at the door. Here’s how the subsequent conversation went down…
Me: “Who is it?”
Med Student: “It’s just the medical student,” (said as he walked right into the room)
(I hadn’t yet gotten a chance to ask Alyssa if she was okay with medical students so I just kind of looked over at her and Jared and tried to judge their reaction.)
Med Student: “Hi I’m Michael. I have to ask you a few questions.”
(Have? How about “Is it okay if I ask you a few questions? Sheesh!!)
Med Student: “Are you being induced today?” (asked as he stared down at his paper)
Alyssa: “INDUCED! DOES IT LOOK LIKE I AM BEING INDUCED!”
Med Student:“Okaaaaay. Umm, any problems with this pregnancy?”
Jared: “Do you really need to ask these questions right now? The resident already asked her that stuff.”
Med Student:“Umm yeaaaah, I do. There is a lot of repetition but we have to ask again.”
Deb: “Doesn’t her prenatal summary tell you all of that?
Med Student: “Ummmmm….”
Me: “With all do respect, Michael. But I think they are trying to tell you that they do not want any medical students. Or anymore residents for that matter. Okay? So I think we are done here.”
Med Student:“Ummm, what am I supposed to tell the resident?”
Me: “Tell her I said that the next induction that comes in is all yours.”
As the med student left, Jared, Deb, and Alyssa all looked at me simultaneously and said “THANK YOU!” “I don’t think he was getting the hint,” said Jared. “Yeah,” I said, “I figured he needed it spelled out.” In hind sight, I think this was one of the moments that really helped me to bond with this family because after all, I understand how difficult it must be for families to come into the hospital and have to work with a nurse that they have even never met during one of the most intimate experiences of their lives!
I spent the next fifteen minutes finishing up the patient’s admission assessment as quickly as I could. I told Alyssa that if she was having a contraction to just ignore me, and asked Jared to help answer any questions he knew the answers to. (Unfortunately, our hospital’s pre-registration does not include performing an admission assessment and hence, it has to be done on arrival to the hospital. Usually, if a patient comes in for false/early labor a time or two, it gets done then but Alyssa had not been to the hospital her whole pregnancy, which is great, but it meant that I did have to bother her with some silly questions during labor. Kind of a bummer, but with the help of Jared, it went pretty smoothly.) It was during the admission interview that I found out some of the details of Alyssa’s pregnancy and prior cesarean section. Alyssa had an unremarkable health history and a normal, healthy, uncomplicated pregnancy. She was a G2P1, but since her first baby was born by cesarean section, she technically was considered to be a “primip” (healthcare slang a woman who is about to deliver her first baby) regarding a vaginal delivery.
Jared told me that when their son was born two years ago, Alyssa was persuaded into an induction at 39 weeks for “LGA” (a.k.a. large for gestational age, which by the way is NOT recognized as an appropriate indication for induction of labor by ACOG), was first given a few doses of misoprostol to “ripen” the cervix, followed by pitocin to stimulate contractions and continuous external fetal monitoring to monitor those contractions, then given a couple doses of Stadol and eventually an epidural for the pain, followed by artificial rupture of membranes to place a fetal scalp electrode after the epidural dropped Alyssa’s blood pressure and caused a prolonged fetal heart rate (FHR) deceleration, then an intrauterine pressure catheter to assess if the pitocin induced contractions were “adequate”, and eventually a cesarean section after 1 hour of pushing in a back-lying position for “failure to descent & cephalopelvic disproportion (CPD).” Thirty minutes later baby Kevin was born at approximately 2:00am, weighing in at 7lbs, 5 oz.
In my opinion, Alyssa was a victim of the “cascade of interventions.” Many maternity interventions, including elective induction, pain medication, artificial rupture of membranes, epidural anesthesia, back-lying positions for labor or for birth, etc. have unintended effects. Often these effects are new problems that are “solved” with further intervention causing a domino effect that ends up creating yet more problems. This chain of events has been called the “cascade of intervention” and unfortunately often leads to vacuum extraction/ forceps delivery, episiotomies or 3rd or 4thdegree tears, and even cesarean section. Many of these women are often also then mislabeled with diagnoses like “CPD,” “failure to progress,” “failure to descent,” and at the end of it all, the obstetricians turn around and say, “Thank God we were in a hospital; look at all the technology we needed! So when will your repeat cesarean be??”
This time, however, things were different. After the birth of their son, Alyssa and Jared started to research more about labor and birth, VBAC, and natural birth. They interviewed and chose a doctor (Dr. Z) that was supportive of natural birth and VBACs, with the statistics to prove it! And here they were now, at my hospital, ready and rearing to go! Alyssa said that for the past few days she had been having contractions “on and off” but that they really started to get going at 8:00 am. When the resident had checked her on admission, her water spontaneously broke during the vaginal exam at 11:15am. It was now 11:45am and Dr. Z’s midwife entered the room. Although it had only been 30 minutes since her last vaginal exam, the midwife decided she would check Alyssa again since she seemed pretty active. And boy was she ever! The midwife’s exam showed that Alyssa had progressed to 7-8 centimeters! “I don’t think I can do this anymore,” Alyssa softly whimpered to the midwife. We all reassured her that she was doing so well and that things were getting more intense for a reason and to stick with it!!
The midwife then offered to help Alyssa into the shower to help alleviate her back pain. Alyssa seemed skeptical at first but we assured her that if it wasn’t helping, that we could get her right back out. So Alyssa agreed and the midwife and I, along with Jared, helped the patient into the shower. What happened for the next hour was one of the most beautiful displays of love, perseverance, hard work, and dedication I have ever witnessed. Alyssa turned her back to us and rested her hands on the grab bar on the shower and her head on the shower wall. Her cadence was this: Between contractions she would sway side to side, as if she was slow dancing. During contractions she would squat up and down, up and down, moaning in a low tone as she carried out her ritual. She just moved with the rhythm of her labor, listening so instinctively to what her baby and her body were telling her to do.Jared used the hand held shower head to spray Alyssa gently with a stream of warm water up and down her body, concentrating mostly on her lower back. I quietly entered the bathroom a few times that hour to check the baby’s heart rate with the portable doptone, trying hard not to disturb Alyssa’s concentration. Mostly, however, the midwife, her mother, and I stayed outside the bathroom door as to give Alyssa & Jared the privacy they needed to facilitate the progress of her labor.
At 12:35pm Alyssa told me that she was starting to feel a strong urge to push. The midwife entered the room and as Alyssa knelt in a hands and knees position in the tub, the midwife checked her cervix. To everyone’s surprise Alyssa only had an anterior lip of cervix left to go (this means she was about 9 ½ centimeters dilated)! After the next contraction, Jared and I helped Alyssa out of the shower to the toilet where we both used warm towels to dry her off. Then Alyssa walked over to the bed, “Can I kneel on my hands and knees?” she asked. “Sure!” we all said in unison, as we helped her up onto the bed. “I feel like I have to push!” Alyssa said convincingly and when the midwife checked her cervix, the anterior lip was gone…Alyssa was fully dilated at 12:45pm, only 1 hour and 55 minutes after arriving at the hospital! “You can start to push anytime,” said the midwife.
One of the best things about being a part of this experience was the fact that it was one of the only times that I have been present at a delivery where that a birth attendant has allowed the mother to use spontaneous or mother-directed pushing, as opposed to directed pushing. I knew that Alyssa was interested in using a variety of pushing positions for the second stage of labor from her birth plan and for the next hour and a half the midwife, Jared, Deb, and I helped Alyssa get into a variety of positions including right/left side lying, squatting, hands and knees, and kneeling.
(Side Note: I would like to digress for a moment to point out how important it is to be physically fit during your pregnancy whether you are planning for a natural birth or not. Many a woman I take care of blindly fills out a “birth plan” they find online where they can click on the boxes for options that sound “good” to them, without actually researching or thinking over what they are writing down. For example, they say that they want to try squatting during labor and birth, but couldn’t even do a squat at the gym pre-pregnancy. Although it is definitely true that a woman can sum up and realize an incredible amount of strength during labor and birth related to not only hormones but also sheer will power, it should also be known that labor is HARD WORK and pushing out a baby is HARD WORK which both require a great deal of physical strength and stamina. This is yet another reason why it is so important to follow a modified exercise plan and eat a healthy well balanced diet rich in protein and omega-3 fatty acids before, during, and even after your pregnancy.) Let’s continue with Alyssa’s story…
What was so amazing was that although there were plenty of times during the labor and pushing phase that Alyssa would doubt her ability to go on (“I can’t do this anymore!” “The baby isn’t moving?” “Is the baby moving?” “I am so tired!”), she never gave up on herself. Each time she made a comment like that, we all took it as a request for more support. And every time we gave her more encouragement, cheers, and reminders of her progress and goals, (“Keep going!”, “You are doing so well!”, “We can see so much more of the baby’s head!”, “She has lots of hair!”, “Just a few pushes more”, “You are so strong, you are going to do this!”, “You can do this!”), she found the ability to keep going! Towards the end of the pushing stage Alyssa was (understandably) exhausted and was pushing in a modified lithotomy position while Jared and I supported both of her legs. Then all of a sudden Alyssa popped up and said (and I quote)…
“I need GRAVITY! I need to be UP!” as she sat upright into a full squat and
PUSHED her baby’s head out with one gigantic ROAR!
“Whoa, whoa!” the midwife and I said almost simultaneously, “Easy, easy, baby pushes.” “Blow like you are blowing out birthday candles,” I said. The midwife checked for a cord around the neck (which there was none) and cleared the baby’s mouth and nose. And with only a few more “baby pushes” Addison Joy was born at 2:27pm!
The room erupted into cheers of excitement and tears of happiness! I put the baby skin to skin on mom as I dried her off with warm blankets and cleared her mouth and nose with the bulb suction. A quick palpation of the baby’s cord revealed that her heart rate was nice and strong and she was pinking right up! Jared and Alyssa kept hugging and kissing each other and talking to their new baby girl, “Hi Addison! Hi baby girl! I am so glad to finally meet you!” The midwife waited until the cord stopped pulsating before she cut it (per mom and dad’s birth plan) and then checked Alyssa for any tears. Except for some swelling, she only had a small tear on her right labia that didn’t even require any stitches!! We kept mom and baby skin to skin for a full hour after birth and baby Addison nursed almost the whole time. When she was an hour old, I weighed her to satisfy mom’s curiosity and to everyone’s surprise the baby weighed 9 lbs 3 ozs!!!
So much for “cephalopelvic disproportion” huh!!
And it was as I handed baby Addison back to Alyssa that she looked up at me and said softly, “I needed to know my body could do it. I knew my body could do it! I really needed this. Thank you.” So as you can imagine, I started to well up. I have never felt so honored to be a part of something so special. What a privilege to have a job where I witness the miracle of birth and the miracle of motherhood every week!
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So let’s recap shall we. Alyssa, after having a cesarean section for her 7 lb 5oz son two years earlier for “CPD” and “failure to descent”, pushed out a 9lb 3oz baby after a 6 hour and 27 minute labor, including 1 hour and 42 minute of mother-directed pushing, without any pain medications or an epidural, monitored by intermittent auscultation, needing not a single stitch to her perineum! Her tools included good and relevant labor & birth preparation, appropriate and helpful family support, sheer strength, determination, and will power. The midwife’s arsenal included extensive knowledge of and experience with natural birth and labor support, a doptone, a trust in birth, and a belief in Alyssa’s ability to do it! No medications, no vacuums, no scalpels, no scissors, and no doubt!
Boy how I love my job sometimes 🙂
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*As always, names and any identifying information have been changed to protect privacy.
For more information on VBAC please visit: International Cesarean Awareness Network and Childbirth Connection
For more information on how you can move and groove through your labor check out:
Nursing Birth 
Beautiful, BEAUTIFUL hospital birth story!!! I am a doula who has attended several hospital births lately that have left me frustrated and hesitant to attend more births. This story made me well up too…thank you so much for sharing!
That brought tears to my eyes! I’m sure she’s still on a birth high from that one.
beautiful story!!!
Beautiful. Thank you for sharing that.
What a wonderful and inspiring story! Thank you so much for sharing it.
Aboslutely beautiful! Brings back memories for me.
Um, will you please clone yourself already?? The maternity wards of the world need you! You rock so hard. I especially love the dispatch of the medical student. Do they all act as though the mothers are just, like, doing a demo for their educational purposes? Holograms, perhaps? I mean, I know they need to work with live human beings, but when they message is clearly “No thank you,” sheesh!
And it must be so aggravating to have to answer the same questions over and over. I mean, it drives ME nuts when I’m on the phone with some company and I type in my account number, SSN and PIN and whatever else they’re asking for – and then when I get a live human being, I have to give the same info all over again. So . . . what did I do it for the first time? And I’M not a woman in labor, for crying out loud.
Anyway, most importantly, that mama is an inspiration. YAY ALYSSA! Congratulations to all.
Dou-la-la, Oh man I wish I could clone myself! That would make my life easier in so many ways!! Haha! You are so sweet! And I agree, medical students sometimes just don’t get it. When I was a nursing student it was drilled into our heads that we needed to obtain permission to do ANYTHING with patient from the patient himself. We were not “entitled” to anything. Some of these med students man have such a sense of entitlement! Not all but some. It’s really annoying!
Thank you for re-posting this story. It is so difficult these days to have a VBAC within the hospital system and I am always happy to see stories like this. Sometimes ICAN is accused of pushing home-birth & bashing hospital birth when we are honest about the difficulties of birthing within the medical system. Stories like this are a great resource for women who do plan a hospital VBAC — you didn’t ignore the possible pitfalls and you showed how hard Alyssa worked (both before and during her labor) to make things different the second time. Hospital VBAC is sadly rare, and often difficult to do but *not* impossible. With good caregivers (like Alyssa had), good preparation and a clear understanding of the system, it can happen. Keep the stories coming!
Gretchen Humphries
Advocacy Director, ICAN
Gretchen, I am so glad you liked the story! I am also so honored that you even read my blog! As I said before, I refer people to ICAN ALL the time, at work, on the street, via the blog, etc. You write, “We are honest about the difficulties of birthing within the medical system.” It is so true! That is one of the missions of this blog…to be honest with women about the difficulties of birthing within our screwed up medical system. With Alyssa, not only did she do her homework, find a truly supportive birth attendant, and work really really hard during her labor, but (and I don’t mean this in a bragging way but in a serious way) she really lucked out with getting me as her nurse because (unfortunately) there are SOOO many nurses that would have flat out refused to do intermittent auscultation b/c she was a VBAC, discouraged her from getting in the shower because of her IV, snarked at her birth plan, etc etc. It is sad but true. I work with a few nurses that are right on board with natural childbirth like me but there are many nurses I work with that are, for example, going on 20 years + working at the same hospital in the same L&D ward who are set in their ways etc. Her birth could have gone a lot differently for sure. And you are right, Hospital VBAC is sadly rare and often difficult, even though it is not impossible.
Thank you for your words of support! I just had the pleasure and honor of being a part of another amazing hospital VBAC just the other day that I will write about soon! Stay tuned!!
Loved this story! Thanks!
I know I read this story back in March, but I re-read every word, and it brought tears to my eyes all over again!! Thank you for telling these stories – how wonderfully inspiring!
A beautiful story! I wish I had had that kind of support in the hospital. Your an amazing nurse!
Jessica took the words right out of my mouth! Such a great story – even the second time around. 🙂
Brought me to tears. What a beautiful birth. Having strong labor support helped tremendously, I’m sure. When we get to that point where we feel like we can’t go on…just having someone in our corner encouraging us is so helpful.
I agree with the comment above: it would be pretty darn cool if you could clone yourself! Are you in MA?! I’ll go to your hospital next time! 🙂 I read this story when you first posted it, but I had to read it again. Thank you for sharing. Very encouraging for those of us who had chaotic labors full of unnecessary interventions.
I LOVED this story when I first read it and still love it now! I wish all nurses were as supportive for Natural Childbirth moms as you are.
I think YOU deserve a medal! Can you come over to my Moms Deserve Medals site? I have a give away ending on Friday and want you to enter! Great nurses deserve medals too!
http://www.momsdeservemedals.com/
enjoybirth, YOU are adorable and very very sweet! I will definitely check out your site!!
[…] Posted on October 25, 2009 by Kathy This one is a bit different, in that it’s told by the L&D nurse, instead of the mom, but it is wonderful, just the same. […]
A fabulous birth and birth story! Every couple deserves such support during labour, and it is a shame that so many don’t get it. You are a wonderful nurse and human being!
I’m so happy you just “happened” to be meet Alyssa in the elevator, and that everything came together so beautifully so that she could have the birth she knew she could/should have!! Fabulous. Beautiful.
Me too! Thanks for commenting!
[…] Two phenomenal posts show how important movement is in VBAC labors. Kristin at Birthing Beautiful Ideas writes about how she “moved and grooved” to a healthy VBAC, and the labor and birth nurse at NursingBirth offers another powerful story of how movement and great labor support helped a mother achieve a healthy and triumphant VBAC in the hospital. […]
I want you for my nurse when I’m in labor trying to VBAC!
Is it safe to try a vBAC less than 2 years after surgery? How soon could you plan this? Is 15 months safe?
That is truly a great story. 😉
You mentioned not seeing many “mom directed pushing” cases…and I have a funny story with that.
I attended a birth just this week for a mom having her 2nd baby. With her first she’d gone from 5 to birth in about 1.5 hours. So when she was found to be about 8 cms at about 12:10, I reminded the nurse & resident of this, cautioning them that she probably would “go fast.” The nurse seemed to discount what I was saying, commented “well every birth is different you know.”
At about 12:20 they were not in the room, and the mom was on the toilet and her water broke. When the resident was back in the room a couple of minutes later, I told her about the SROM. I heard her tell the nurse this a couple of minutes after, and the nurse got all in a tizzy, getting the birth cart and all. But then again, we were still being left alone in the room.
So around 12:30 the mom was pushing with a contraction, so I hit the nurse call button–I don’t usually jump to call the nurse with the first pushing contraction, but given the history here…
So the nurse comes in, and wants the mom on the bed–not unexpected. The resident and attending OB come in, and the baby nurse. They are all standing at one end of the room looking at the mom–who was kneeling on the bed at the other end of the room–while they hubby and I worked with her. It was clear to me that she was pushing, so I wondered why everyone was keeping their distance.
After a couple of ctx the OB says (hand folded across his chest–he was irritated with the nurses about another situation) “you aren’t pushing, are you? ’cause you shouldn’t do that since we don’t know if you are 10 cm. You could hurt yourself.” And he remains standing there.
I try to get the mom turned around so the OB would be able to see better, but I only got a 90 degree turn. She’s still pushing, complaining that it hurts, it burns. She was not really loud or out of control though.
Then she gets a lot more “intense,” and I start trying to pull up her gown, thinking we will see the baby crowning…and just as I do that she exclaims “F*&%, there is the head!” And sure enough, the ENTIRE head was between her legs.
The OB comes rushing across the room saying “you were pushing?!?!?!????”
HELLO. I guess if she wasn’t in lithiotomy with people yelling a 10 count at her, she couldn’t really have been pushing. 😉
Baby was born at 12:45.
Knitted in the Womb, that is an awesome story!! Thanks for sharing!! I’ve heard one or two OBs and nurses say “ARE YOU PUSHING? STOP PUSHING!!” but not because the patient wasnt fully, but because they weren’t “ready”. Hahaha!
I have been reading this blog off and on after a very traumatic birth of my fourth child, who died 3 days later. Knitted in the Womb’s story gives me chills becuase I went from trusting my OB entirely, never doubting, for 3 prior pregnancies/deliveries and then the 4th delivery was a clusterf__k. I now know better than to trust a doctor just because he has a phd behind his name. But it cost me a child. I have heard so many stories about the things doctors do. The fact that birth is a major major procedure where so many things can go wrong for both teh baby and the mother seems like it gets overlooked by people who are supposed to know what they are doing….but don’t. I can never listen to another birth story and wonder how close the mother or baby were to dying. Because these aren’t routine procedures. Every pregnancy and EVERY birth is different. And the fact that there are idiots out there running the show and call themselves doctors is haunting.
What a wonderful story! I love reading these blogs of nurses who are pro natural birth. We’ve moved since the totally natural birth of my daughter and have found our new city seems to be very against a natural birth (signing waivers that you do not practice Bradley method, etc)
Being in charge of my birth was the most amazing experience and it saddens me that not every woman is given that opportunity.
Lovely story but sad in a way.
Admittedly I work in Australia and am a midwife so it is very different to what I have read of birth in the US. We don’t have labour nurses. All normal births in public hospitals are done by midwives who do all the labour care as well. The number of hospitals that do true continuity of carer is smaller and I am fortunate to be in one of those.
To me it was a very interventionist birth though totally different to what I believe is the norm.
I get the opportunity to know my women through antenatal care where we discuss what the want, to be their birth support and midwife in labour, to empower women to self educate and decline treatment and to be able to support their decisions as long as it is well documented.
I don’t believe there was a necessity to do so many vaginal exams, it breaks the rhythm too much.
Sounds like the previous CS was because of Failure to Be Patient or Care Provider Distress.
Smart mum to look for better care and amazing that she was able to get a nurse and midwife to support her properly.
I just wanted to thank you for posting this story. I keep reading this as I prepare for my VBAC and it is very inspiring.
your hospital and your labouring moms are privileged to have you for a nurse. I have been a maternity nurse for 35 years and now practice as a lactation consultant. Over the span of my career I have seen us move further and further away from respecting womens bodies and their ability to birth their babies.
Everyone talks about “evidence based practice”, then proceeds to ignore the research!
Midwifery care is on the upswing here which gives women options for successful natural births and VBACS. I assist our local midwives at home deliveries, which is amazing. But it saddens me that women can’t have the option of this kind of birth in hospital – or at least it is rare.
Your birth story account is beautiful. It brought back memories of being present at my daughters VBAC miwife assisted birth of my grandson. Witnessing the miracle of birth over and over during our careers really is awesome!
nancy smith
BC Canada
This is a wonderful (and wonderfully written) story.
But, I would have believed it if you said it was all a made up fantasy. Its sad how rare it seems that this kind of kindness and attentiveness is in the L&D nursing community.
You are a true inspiration and a blessing to all birthing moms you encounter. Please continue to bring this humanity into the hospital birthing experience.
I will be sure to read your blog from start to finish. Hopefully you will continue to write and share your thoughts and experiences.
Thank you.
I have been reading your blog off and on since I found it when I was 3 months pregnant with my daughter (8 months old now). I want to say I love your blog! I also was curious to find out how you feel about directed pushing vs. spontaneous pushing, and about waiting for the magic 10cm. When I had my daughter, I was doing alright coping with the contractions until I started feeling the urge to push. I told the nurse, and she called the OB, who did a cervical check and told me not to push yet because I was only 8cm. I have to say the time from when he told me not to push until the time he finally told me I could push was the worst part of my labor by far! I felt like I was fighting against my own body to hold in something that needed to come out. It made every contraction into a horrible struggle to not push, and despite my best efforts, I know my body was pushing anyway! I also lost my concentration on relaxing and breathing because I was trying so hard not to push, and I started hyperventilating. I know that transition is naturally harder than earlier labor, but I feel like trying to fight against what my body was telling me to do made it 100 times worse. Then when I did get the green light to push, the OB tried to get me to push on his count of ten while holding my breathe, and I completely ignored him. I pushed my baby out with short small pushes while groaning through every contraction. The OB and nurse kept telling me to hold my breath and stop groaning, but I only half registered what they said, and just did what felt right to me. I did pause when he told me to right before crowning so that I wouldn’t tear, but other than that I ignored everything they tried to tell me about pushing.
Since then I have read some articles by various midwives that say it’s not actually always a bad thing to begin gentle pushing before 10 centimeters, and it makes me wonder if my birth experience could have been more calm and peaceful if I had kept my mouth shut and just done what my body was telling me to do.
Anyway, sorry for rambling! I was just wondering what your thoughts are on that from a medical perspective.
This is such a beautiful story. I’m glad you shared. I too had a truly wonderful L&D nurse who believed in me and in my husband’s ability to support me and gave us all the help she could within the hospital policies to help us achieve a wonderful natural birth! Thank you for the job you do. Be encouraged that there are so many moms out there who are blessed to have you help them. Kelly
AWESOME! Nurses make ALL the difference to laboring women! Horray for everyone involved!