My home birth story written by my midwife-XP

I am friends on Facebook with my midwife (well for my birth she was still a midwifery student but she is now a midwife with my practice now) and she said she came across her journal entry of my homebirth the other day and asked me if I'd like to read it!  This is so special for me to have, so I'd thought I'd share it with you ladies.  The only difference that I see is that my labor records say I was 7-8 cms at 10 am (and they told me I was 8 cms on the day of).  Other than that, this is pretty much as I remember it.  Enjoy (it is a little long though).  Oh, and I am positive that without their expertise in position changes, I would have been a c-section had I been medicated and/or in the hospital!  I am most grateful for them!

Hey Melissa,

Here is my journal entry from your birth!  I hope you enjoy it.  I?m still so glad I had the chance to be there with you, Martin, Erin and Kelly.  Your birth was certainly a memorable one!  Since then, I have had the chance to do sterile water papules with some success, and have thought of encouraging women who were low on energy to try some meatballs! 

Hope you are well, and if/when you are ready for the next one, I hope to see you! 

Take Care,

Katie

Melissa?s Story - March 31, 2008

 I got to Melissa?s house just before Erin on Monday morning. Melissa said that her water broke this morning around 5am (clear) and she has been having regular contractions since.  This was her first baby, and pregnant through IVF.  She also works as an RN in High Risk Antepartum.  I had never met her prenatally, but she graciously agreed to let me attend her birth.  So when we got there, Melissa was rocking and rolling in labor.  She looked like she was progressing well and I was thinking that we were going to have a nice, quick primip birth?. Especially when she asked to be checked at about 10am and her cervix was already 7cm/100/-1 with a bulging forebag.. But of course, I spoke too soon. Melissa continued to contract well for the next few hours, but didn?t seem to be making any progress.  We tried the tub, we tried the shower, we tried the stairs, we tried lunges, we tried hands/knees, we tried pelvic lifts (where someone?me?stands behind the client and she leans all her weight into you while you place your hands under her belly and lift during a contraction.).  Nothing seemed to be working.

 I hadn?t checked her cervix in awhile, but I was trying to avoid it for fear of discouraging her.  She was asking for an epidural and feeling very hopeless, when Erin suggested that we try sterile water papules.  She was having what seemed like a lot of back pain, and we thought that if she could have some relief from her back, she may be in a better place.  Since I  had only seen them done on the video, I let Erin do them.  And boy, did it look painful!  Melissa was begging for her to stop after the first one.  Fortunately Erin was very quick with it.  Melissa did actually get some relief from her back pain for about an hour and a half.  During which time we made her move around like crazy on the stairs and in the shower to try to shift this baby.  I wasn?t totally sure of this baby?s position because I didn?t get a good feel for suture lines with my exam since there was a bulging forebag over the head.  Finally, after a few more hours of trying to get this baby to show us some signs that Melissa was ready, she asked to be checked again.  It was now 4pm and had been 6 hours of fairly regular contractions.  I was hopeful that she would at least have made some progress.  When I checked her, she was basically just anterior lip and 0 station. The baby didn?t have much molding at all on its head and was in an LOA position.  I had her push a few times, and the lip would slide back.  We tried this for awhile until finally the head came down enough to keep the lip back.  When Melissa pushed, we could see the forebag.  She pushed and pushed for about an hour in every possible position, and wasn?t making much progress (her back pain was back).  I went ahead and ruptured her forebag and she pushed for another hour with slow, but steady progress.  She still had a lot of work to do though and was clearly getting very tired.  She had slept some the night before but not well and was just getting to the point that the pushing was not effective any more.  So we decided to let her rest for an hour or so.  Which surprisingly, she did. She stopped pushing and slept in a semi reclining position in her husband Martin?s arms.  She would wake up for contractions but fall right back to sleep.  Her contractions had spaced out a bit (q 5-7 minutes) which was giving her the rest she needed.  Throughout the day, she had not been eating or drinking much, so while she was resting, Erin and I made a plan to have her eat when she woke up before we started pushing again.  After about an hour of rest, we could hear that Melissa was bearing down with her contractions again.  Melissa came downstairs after we told her to get something to eat?and I kid you not? ate like 10 huge meatballs, a scoop of potato salad, and drank a glass of Pepsi.  She would bear down with her contractions, but would then continue eating.  I was convinced we were going to see the meatballs again.  But when she was done eating, she went back upstairs and sat on the toilet for awhile while pushing.  Her contractions picked back up to every 3-4 minutes (amazing what a little food energy will do!).  After about 45 minutes or so on the toilet, she came back into the bedroom and the baby?s head was on her perineum.  She had such good control with pushing, that I pretty much left her perineum untouched.  I haven?t done this much, but her bottom was so swollen anyway that I didn?t think anything I could do would help at this point. (The birth assistant, Kelly, had given her some Arnica, a homeopathic medication for swelling, but it didn?t seem to help this time).  Martin was also videotaping the baby coming out and I was trying to keep my hands clear so they could get a good shot. As the head was crowning, Melissa started screaming ?get your hands out of there!  Stop touching me!?  Which of course I was nowhere near her bottom? she was just feeling the baby?s head.  (I?m really glad it was all on tape to prove I wasn?t touching her! J) 

Melissa had a tiny little 6lb 12oz baby boy with a very well approximated 2^nd degree laceration.  I probably would have thrown a few stitches in it, but Melissa didn?t want to be repaired.  Erin and I talked about it for a long time as to whether she needed any stitches.  Erin said she has been talking with a number of CPM?s lately who never ever stitch.  She said that they have all said their perineum?s look fine by 6 weeks as long as they don?t tailor sit and move around a lot in the first few days post partum.  Also, Melissa was EXTREMELY swollen.  Even if we had stitched, it would have looked very different by day 2 or 3 anyway once the swelling came down, and the stitches would have most likely been very loose?..so we left her bottom alone.

In all, Melissa?s birth was not unusual for a primip with regard to length, since she was in active labor for about 12 hours and really only actively pushed for about 3 hours.  However, I do feel like she kind of got a raw deal in that she was in transition for about 6 hours.   We were trying to speculate during that time as to why Melissa was having so much back pain, and thought that maybe the baby had a hand up near its face posteriorly.  That wasn?t evident at delivery, but who knows?maybe all our position changes and stair walking moved the baby enough to help it through correctly.  Personally, I think it was the meatballs that got that baby out! J