Welcome Keziah-May!

On the 14th of November I woke up at bout 5am. I knew I had to head into the RBWH (Royal Brisbane & Woman’s Hospital In Australia) from my cousins house at some point that day for clinic. Rang the hospital, they said to come in at about 1pm. We jumped on the train and headed in. I’d had a bit of an achy stomach and back since the night before, but didn’t think anything of it as I had SPD and baby had dropped.

We got into see the doctor at 1:30pm, he checked my blood pressure, it was all over the place. He didn’t seem overly bothered though. I told him I’d been having some cramping and he told me that it was probably just Braxton Hicks and not to worry too much about it. We left the clinic and headed home; the train ride is about half an hour. Me being a smart ass turned to Michael and told him how funny it would be if I went into labour once we were back on the other side of town.

I’ve learnt that I jinx myself all the time…

We got into Woodridge (where we were staying) and i had the overwhelming need to go to the toilet, I honestly thought I had to have a bowel movement. Well nothing was budging on that toilet, so I gave up on that idea and just assumed I had constipation (which I did). Went back out to Michael and told him that the cramps were getting worse and that I was pretty sure I was in labour. This was about 2:30pm. We rang the midwives at the hospital and they told us only to come in if the contractions were 2-3minutes apart or if I couldn’t talk through them. So that was alright, we started counting contractions. They were already 2minutes apart but they felt like an eternity apart! I didn’t want it to be false labour again so we decided to walk the 2km to the shopping centre. Rang the family on the way, figured this would be it. Got about half way and was only just able to finish the conversation on the phone with my sister. Finally got to the supermarket and Michael got me a cup of water from Donut King (of all the places to get water). I’m sitting there looking absolutely hilarious, puffing and panting and I think I was going red in the face.

We rang my cousin and she came to pick me up from work, we had to stop back at her place (where we were staying) to pack my hospital bag and get to the hospital. She was terrified my waters were going to break in the 20 mins it took to drive to the hospital. They didn’t though.

We got there about 3:30 and they put me in an assessment room whilst they found a birthing suite. After about 10 minutes of being very tired and emotionally drained (complications about bub had arisen a week prior) I started crying and asked Michael to see if they could get me an epidural. they said yes, and whilst I was on my way to birthing suite (walking no less) they went to find an anaesthetist. I got to the birthing suite and got into something a bit more comfy. They set me up with some wireless baby heart rate monitors and got me in the shower. It was amazing! However the monitors glitched so I ended up back on the bed. I was 3cm when I got to the hospital. I went 4hrs of established labour without pain relief, just moaning and breathing.

At sometime between 8pm and 10pm I got started on the gas and air. Brilliant stuff. Vomited everywhere but it felt good. At about 1am I had the urge to push (they were thinking of breaking my waters as i was 5cm dilated), so I pushed and broke my waters, I started apologizing thinking I’d done the wrong thing.

After that they gave me a shot of morphine in the leg. Ouchies! That was about 1:15am.

Then after watching ponies running around the room (oh yes gas and air is good stuff), I needed to push again (I’d gone from 5cm to 10cm the moment my waters broke). So I started pushing. another midwife came in and pushed my leg into my hip (I was labouring on my side with a back2back baby) and told me to push. I just wanted to sleep.

She started to crown and I’d sleep in-between the 3 pushes (it felt like sleep but it was barely a minute lol!) The midwife that hurt my leg told me to put my hand down and help my daughter into the world (my normal midwife was brilliant, this other lady was an old bat) and I screamed at her, in no uncertain terms ‘NO!’.

3 minutes after starting to push Keziah-May Danielle was born screaming her lungs out (which was good because there had been meconium in the waters), we didn’t get delayed cord cutting like we wanted, because of the meconium, but Michael cut the cord and they cleaned her up and checked her over and brought her back to be.

First attempt at breastfeeding went miserably. Michael dressed her whilst I went to the toilet. Came back out cuddled her for a bit more then she had to be taken to the special care nursery. Had a shower, went down for a smoke (after that I needed one!) and went back up to the SCN and gave breastfeeding another go.

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Welcome Eason

Lani and Toby, when I met you, you were excited and anxious, happy and cautious. We spoke about your dreams and desires for this, the birth of your first baby.

On February 2nd, Lani, you called me in the early a.m. to let me know that you believed your water had broken. After discussing things, it sounded like it had, indeed, broken. I encouraged you to eat something and call a short time later if no contractions were felt. Shortly afterward, you called to let me know that you were not feeling any contractions but that you were seeing a lot of pink discharge. I reminded you to watch your temperature, stay hydrated, try walking, stairs, foot massage, and nipple stimulation.

You began using the breast pump and stayed active. Around noon, you attempted to take a nap but couldn’t from the excitement. We began talking about your options, including the pros and cons of staying home vs going to the hospital. You decided to stay home and keep working on getting things established on your own.

Around 6:30, you let me know that you and Toby would be heading into the hospital sometime later that evening and that you would call me when you knew more about how you were going to proceed. Around 10:30, you called to let me know that you were having contractions every 15 minutes but were not feeling them and the plan was to start pitocin sometime that night to try to get things moving.

At 4 am, I received the call that you were ready for me. Your contractions were coming quickly (every 3 minutes) and strong. They were completely in your back and you wanted my help. I packed up and headed over immediately, arriving around 5am.

When I arrived, you were standing beside the bed, moving gracefully and peacefully through the timeless movements of the labor dance. Toby, you had your hands always at the ready to support and your voice, to encourage. Beautiful! We talked about your discomfort and where it was at. With the last exam, your cervix was still high and posterior and around 3cm.

We began with lunges, as I had strong reason to believe, from your description, that your baby was posterior as well. After a few lunges, we worked on a pelvic floor release, and then you moved right back up again – ready to get things moving toward birth.

Toby and you moved in such beautiful synchrony, alternating from quiet words of encouragement, prayer, and touch to dancing, hanging, and sitting on the birthing ball, and walking.

After around an hour of moving through this cycle, I asked your nurse’s permission and unhooked your monitor for a walk around the halls. During this, I encouraged you to open your hips and sway, and during contractions, to move your hips in a figure 8 or squat. Once back to the room, they checked your progress and you had moved up to 4cm and baby was nice and low, with babies head starting to turn into the right position.

We opted for hands and knees next, and I sifted you through some contractions, which seemed to help with the back pressure, but it wasn’t long before you were up and moving again with me providing counterpressure to your sacrum and lower back. Your sister, who had come to be with you through your labor, began breathing prayers over your birthing space, quoting Psalms, while Toby loved you through every contraction, praying over you and speaking life over your labor and body.

Throughout all of this, Toby leaned in close to you and you both prayed that your labor and birthing time would bring glory and be a testimony to God’s grace and goodness. It was breathtaking.

Throughout labor, you had attempted to eat, but couldn’t. Coupled with no sleep and hypoglycemia, you were getting to the point of pure exhaustion. We talked about options to try to get you some rest, but the contractions were coming strong and close. We talked about the pros and cons of getting an epidural and how your risks could best be minimized if you opted for the epidural.

If baby was low enough, and had turned well, you were ready for the epidural. You didn’t want one before then, and wisely so, in order to let baby get into the best position possible and to make sure that there were no regrets with your choice.

At your request, you were checked and found to be a good strong 5cm, baby was +1 station and was in a good position. 20 minutes later, your epidural was in place. You soon realized, though, that the epidural that was supposed to allow you some much needed rest was not going to allow for it. You had a window of pain over your right hip. By 11:45 am, we were alternating you from left to right, working on massaging the hip joints, and opening your pelvis through different positions, including the throne.

The anesthesiologist was called back into the room and, around 12:30, he gave a slight pull on the epidural catheter in hopes to straighten it and give better complete coverage. Directly afterward, though, you mentioned lots of pressure down below, different from what you had felt previous.

You asked to be checked again and were complete, 10 cm! At this point, I encouraged you, if you didn’t feel a strong urge to push, to take advantage of the time, since baby was looking strong, and try to rest. You attempted to rest but, after 30 minutes, you felt a good amount of pressure and were able to start bearing down with the contractions.

After a few trial pushes, you really began to get the rhythm, really moving into a groove that you could feel and work with. With Toby alternating on one side with your sister, I held your other leg and you began moving your baby out and into the world.

Soon, you came to that place where you had to decide if the pressure in your womb, or the pressure at your perineum was greater. Slowly and evenly pressing through, you brought your babe to crowning. Slowly, he spiraled out of your womb and into your arms.

Immediately, you and Toby both began speaking blessings and words of welcome over your new son. At 3:09, after 1 1/2 hours pushing, Eason arrived with gusto!

You were a beautiful team, wholly and completely one, working as a unit, from the moment your womb spilled it’s water until the moment your son was placed, slippery and beautifully new into your arms, you were ‘family’.

Congratulations family H! You are blessed!

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Carol & Shawn

During the week of March 20^th, your NST showed that you had three mild contractions in the 20 minutes you were on the TOCO. That would equal contractions around 7 minutes apart. You were still pain-free, simply uncomfortable.

March 26^th, we were to meet for a refresher course. I called to find out how you were doing and if our plans were still on. You and your family decided to head out and try to get the lower backache and cramping to turn into labor. At this point, I definitely would consider you, from your symptoms, in early, unestablished, 1^st stage labor.

On March 28^th, I called to see how things were going and if Sunday’s outing helped at all. You were still pregnant, achy, and feeling lots of lower abdominal cramping and backache. No Babes. We met for a refresher and so that I could meet your mom that evening. Throughout class, Carol, you were practicing effleurage on your own abdomen, repositioning every once in awhile, and stopping to ‘ugh’ yourself through a discomfort. This kept up throughout the next two days with intermittent spells of consistent contractions… only to have them taper off again after awhile.

March 29^th, you had an appointment with Brenda Daniels. At your previous appointment, you had discussed induction, as you were nearing the 42 week mark, in the event you were not in labor by March 29^th. On that Wednesday, Brenda checked and found you to be 2cm dilated. You both agreed to induction on Friday, March 31^st if you had not established labor on your own. The mode of induction was requested by Brenda as Cytotec as a cervical ripener, following by Pitocin. We all prayed you would dilate and begin labor on your own.

The following day, Thursday, March 30^th, you went in for a routine NST. During the ultrasound scan, they found little water around Babes and over-reacted, sending us all into a panic. After getting a second opinion and consulting with Brenda, you continued with your plan for induction the following evening. That night, I received a phone call at 6:30 that you were having consistent contractions and cramping every 8 minutes. We were all excited! Babes was coming!

On the day of Friday, March 31^st, we were all praying solidly that you’re labor would progress to the point that you would not need induction; or, at the very least, that you would not need a cervical ripener. At 8:45, 15 minutes before your scheduled induction Time, you called to let me know that you were headed to Your hospital as your contractions had reached every 4 minutes. You were in solid active 1^st stage labor.

When I arrived, they were just preparing your 20 minute strip and you notified me that your contractions had slowed to every 6-8 minutes in the car ride over. They did a vaginal exam and found you to be 3cm dilated. Not much dilation progress, but you were 70% effaced and were handling contractions like a pro.

After your strip was done, we walked the halls and did some labor dancing. Shawn was an excellent coach, giving you solid support while also moving with your body’s need to open and move the baby down. Your movements were amazing, swaying to accommodate baby and keeping gravity in your favor. Breathing with each contraction, you welcomed the surges and worked with your body beautifully; a strong and confident woman. I offered back support and counter-pressure, administering acupressure to your spine only when your contractions were putsy.

After a check in from Brenda, and a few contractions on the toilet, you decided on a bath. During your bath, your contractions seemed much more manageable, but also spaced out to 7-8 minutes apart. You stayed there for a good 25 minutes before deciding on having some crackers and getting out. At this point, we noticed that your labor was well established while walking, but, slowed down considerably and seemed less manageable while laying or sitting. Unfortunately, this meant for a tedious and active labor for you, who had already been working on labor on some level for the last 6 days. Toward 3am, you began to favor the all-fours position and pelvic rocks. At one point, you even took a short nap on the floor so as to be able to get into the all-fours position again as soon as the next contraction waved over you.

Roughly 3:30am, Brenda checked your progress, and we were all surprised to hear that you had only progressed to 4cm and were still at 70% effacement. With all of your previous work, not only this night, but others, we knew that Pitocin was the only option to get your labor well established. Exhaustion was sneaking up on you. So, until the Pitocin was administered, we attempted to allow you rest while waiting for the medicine to be ordered. Again, while lying down, your contractions spaced out and you were allowed 30 minutes rest. It was at this point that I began to think that it was not your labor that was stalling out, as it could not be a natural alignment plateau that was keeping you from dilating. This is when I began to think that there may be cord issues with Babes – you were mirroring my own first labor in too many ways.

Pitocin was an excellent decision in this case, as it forces your body to have stronger and more consistent contractions – no matter the position. In this manner, even if cord issues were preventing Babes from descending further, the Pitocin would establish stronger contractions to push him down at an accelerated rate. Around 4am, they were able to establish a good line for your IV, after botching the first attempt. At this point, your confidence began to wane – and Shawn and I could see the correlation between past experiences with IVs and the fear that you were associating with this one. Fear inhibits labor, as well as inhibits relaxation. For this reason, you began having more intense contractions that seemed less manageable and more difficult, even though the Pitocin had not begun to affect your body.

We knew it would not be long now as you began exhibiting symptoms of transition at this point. I continued to give you counter-pressure while Shawn gave verbal encouragement. At this point, you did not want rubbing or touching of almost any kind, snapped frequently at Shawn and ordered me to “don’t make my contractions harder with acupressure”. Your favorable position at this Time was bending over and standing… though the IV line and TOCO belts inhibited your movement. You began doubting your abilities and requested an epidural. Shawn was an excellent coach, working through your fears with you and reminding you of your goal. Brenda encouraged you to make it through one contraction at a Time. I reminded you of how far you had come and all that you had accomplished to this point. You were a wonderful laborer and we could see the signals of transition in your body language as well as your emotional state.

After choosing an epidural, Brenda contacted the anesthesiologist, but they were in a cesarean at the Time and would not be available for 45 minutes or more. You began vomiting and shaking, another symptom of transition… you were giving up and giving into your labor. At 4:15, to give you some rest until the epidural could be run, Kelly, your wonderful accommodating nurse fed Stadol into your IV. Immediately, you feel asleep and only woke to work through contractions. Even though were loopy from the meds, you handled each contraction amazingly well – breathing slowly and deeply and relaxing the tension from your body.

At around 4:45 or 5, they were able to give you the epidural. They checked you immediately after and found that you were 7cm! You had gotten through transition on your own, and now the Pitocin would give you the last few centimeters needed! You were getting the rest you needed from such a long labor, and you would soon be 10cm! It was not going to be long and you would have Babes… or so we all thought. Brenda broke your water at this point as well and found meconium in the water. Soon, we noticed that, the epidural combined with the supine position that it necessitated you be in, was giving Babes mild bradycardia. We moved you onto one side and he evened out considerably.

At 6:30, you began to feel pushy with lots of pressure in your rectal area. Shawn encouraged you by reminding you that this was the Ferguson reflex and that you should be close to full dilation. We tracked down Brenda and you were found to be 9cm and completely effaced.

At 7, the urge began to be overwhelming, even with the epidural, and Brenda was summoned once again. She found you to be 10cm and it was Time to begin the pushing stage. Your pushing was hard to establish as your sensations had been inhibited, but you soon got the knack and you became a world-class pusher! Pushing began in earnest around 7:30. Shawn coached your left side while your mom coached your right side. You began in the near-full recline, but soon moved into the 45-degree angle (or classic) position. You pushing seemed very efficient, until +2 to +3 station, when Babes did not want to move down anymore. His heart rate, at this point, began to fluctuate even more, lowering during each contraction to around 56; at some points even lower.

Under Brenda’s direction, we moved you over to all fours on the bed to try to help him descend further. We continued to flip you from all fours over to pushing position, and back. This went on for awhile with no progress. You tried a variety of pushing positions as well. In order, they were: supine, classic, side-lying, upright, and, finally, modified squat. At this point, Dr. VanVelkema was paged to assist with a vacuum extraction. She applied the vacuum to Babes’s scalp and, in essence, held him down after the contractions ebbed – to keep him from moving back up. It took 2 contractions for his head to emerge. At this point we found the culprit for your erratic contractions, ineffective dilation, and difficult 2^nd stage – the cord was looped like a sash across Babes’s neck and across his abdomen.

After looping the cord off, Carol, you gave one more push and he slip free. Babes was born! You only had a 1^st degree tear, and Babes was healthy as can be! He hesitated on crying and was quite comfortable lying on mommy’s abdomen. You delayed clamping or cutting the cord for 5 minutes – until it was decided he needed a little jostling to get him active and breathing independently. As soon as he was cut free from your body, he began crying heartily.

Beautifully done, he was born at 9:35am, 7lbs 10ozs, and 20 inches long! You were an amazing couple to work with. Shawn, your coaching was top rate. You supported her like a professional – moving with her movements, providing solid support when she leaned against you, verbally encouraging her and recognizing/anticipating her symptoms and emotional needs without question. Carol, your relaxation was amazing. You moved with your body and listened to it’s cues beautifully. Your relaxation was complete and your breathing was deep and consistent. Vocalizing, you kept it open and low – you both were model laborers!

Congratulations on your beautiful baby boy!

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