Needing to change to a hospital birth late in pregnancy, my client was able to change to Dr. Wonderful who works at one of the two Baby-Friendly hospitals in our city. His promise to help her have a marvelous natural birth in the hospital wasn't bullshit; his words are Truth.
This first picture, however, demonstrates what occurred when mom was admitted to the hospital. The baby's baseline fetal heart tones were about 100, albeit somewhat reactive. FHTs during the pregnancy were 140's-150's, so 100's were somewhat disconcerting. Dr. Wonderful was called in.
This photo shows mom's sister laying on hands and giving loving energy. Mom is talking to the baby, letting her know she is safe and all is well... dad, as we can see, is concerned, but hanging in there. Mom has oxygen on her and technology all around.
The (wonderful, amazing) nurse (we had) did a vaginal exam and found mom to be 3 cm. The nurse and I began preparing mom for a cesarean - physically and emotionally. I explained the cesarean procedure, the epidural... and the nurse said the anesthesiologist would do a spinal because the spinal would be faster... and I explained things to dad, tried to get his garb for him to put on, but we were busy getting consents signed and all. Waiting for the doctor seemed endless. Fetal heart tones were dipping into the 90's and not getting any higher than 110 with accelerations. I kept calm, but was clear and sharp with the information.
My dear doctor was on the phone at the nurse's station when I went out to go ask his ETA and our nurse said, "Do you want to talk to him?" and I emphatically said, "YES!" before the other nurse hung up and said he was on his way in.
Dr. Wonderful floated into the room like a silk scarf on perfumed air, filled with more confidence and hope than I carried - more like a midwife than I was at that moment.
He did a vaginal exam and immediately, the baby's heart rate jumped to 148! She loved his touch on her head. Oh, and how I did, too. Mom had also progressed to 6 cm. in the last 30 minutes. Amazing!
Tears fell from my eyes as I watched the baby's heart rate settle back down into the low 100's (90's/100's) and the doctor suggested taking a whiff of oxygen every few minutes when she felt like it instead of keeping it on all the time like she had been. He also told her she didn't have to lie on her left side... to move wherever she wanted to - oh, how she wanted to be on her hands and knees! He said the baby was just low, having a vagal response and there was no need for a cesarean at all.
And me, thinking he needed a scalpel. How precipitous I would have been as a surgeon! Thank the goddess it wasn't me making that decision.
The entire labor, my client was extremely vocal, so much so that at one point, the people next door banged on the wall, presumedly to make her be quiet. She, so high in her Laborland (her word), made passing notice, "What's that?" - not, "Oh, am I too loud?" I was so friggin' amused, I joined her howls, getting even louder than her for a few contractions lest she be worried at all about the sounds (she wasn't). No nurse came in to tell her/us to be quiet - that she was scaring the other women or that she was using all her energy in the wrong way or anything. She just howled her baby on down. Yummy!
And so mom moves onto her hands and knees... squats at times, rocks at times... even once jumped up onto her haunches from hands and knees!
I love, Love, LOVE this photo. It speaks of the beauty a hospital birth can actually attain when given a chance with the right doctors, nurses and hospital. And supportive midwife as doula.
Because we thought she would need a cesarean, we had mom take off her gorgeous Hawaiian dress and mom was then naked. The great nurse handed mom a hospital gown once mom knew she was going to stay laboring in that room and she promptly took the gown, put it in front of her and puked all over it. I thought I was going to pee in my pants from laughing so hard. No one ever offered her another gown.
Dr. Wonderful and Nurse Fantastic are seen below with mom as she feels her baby's head as it descends into her vagina. The doctor is on her left side, on the bed; the nurse, kneeling on the floor. Most of the time, I was where the nurse was, but occassionally moved to take photos. Notice that mom's belts have been removed... this is easily many, many minutes before the birth. We/I held the monitor to her belly instead of her having to contend with the strap at the end. I held the monitor on her belly for most of labor so she was able to move around, too. I much prefer hand cramps to a mom's immobilization.
Mom had a couple of exams. The nurse asked to do an exam when mom had an urge to push, but I discouraged it, so she went away. When mom thought she was pushing, I asked her to feel for herself and she felt for the head and it was, indeed there. I couldn't see (my head was down under her, lying on the bed), so Dr. Wonderful just rested his hand on her perineum for one second and said, "Yup, baby's right there," and removed his hand.
I was inches away from mom's perineum as the baby was coming towards the earth and this was the last photo right before Dr. Wonderful put his hands in the way and covered the head as the baby was being born. (I'm going to have to speak to him about that!) This series of minute forward motion head shots is so incredible because I can see the capillaries stretching/breaking in mom's vulva as the head descends. Who knew all that happened!
Dad wasn't sure about catching, was going to help me catch when we were having a homebirth, but wasn't so sure about it at the hospital. Once there, though, I'd talked him into helping the doc and even had him practice washing his hands with the fancy foot soap and water thingie at the sink. Once the doctor was there, though, he was more nervous, but as things got closer, I put my midwife voice on and said, "You will only birth this child ONE TIME, so I HIGHLY suggest..." and that was as far as I needed to go before he jumped up and washed his hands and got ready to help the doc catch his baby.
The picture below is the beautiful photo of dad (who does NOT have gloves on, thank goodness!) assisting Dr. Wonderful with his newborn daughter.
In 24 years and 8 months of assisting women in birth in the hospital, I have never seen a woman birth on hands and knees. I've never seen an OB or a CNM allow a woman to birth in the hands and knees position. I have never seen an OB do a vaginal exam on a woman in any position except on her back until this birth when this doctor did a vaginal exam with mom on her hands and knees. I actually wondered if he could even find her vagina with her on her hands and knees! He didn't have any problems at all. Shocking. I think I've seen a CNM do a vaginal exam on a woman in an "alternative" position maybe 20 times in all these years, so even that is a sad commentary. I tell women I can find their vagina or fetal heart tones if they are hanging from chandeliers! How did I get so good at it? PRACTICE!
Nothing needs to be said about a mother's love. This picture is my desktop right now. I think this is one of the best pictures I have ever done showing a mother and child. I get shivers just looking at it! The shadows are perfect, the lights... the IV... all of it... her daughter isn't even 3 minutes old in this picture.
I end the series with a tender surprise photo I took of Dr. Wonderful with my client. He embraced her, then she him. He with tears in his eyes and both of them whispering thanks to each other.
So, it just seemed so important to demonstrate how it CAN be. It might not be for anyone else in the world but this one mom - or the moms who get this one amazing doctor - but if this one man can exist, then there is hope in hospital birth. It doesn't mean hospital birth replaces homebirth at all. My client needed to birth in the hospital for a very serious reason and she was so amazingly gracious about moving to the hospital to deliver there. So, if some women do have to deliver in the hospital... isn't it a good thing to have hope?