Well, October started with a massive two births on the same day. Both women were 42 + weeks and this fact prompted my last blog. How we deal with over dates and what are the risks in reality. Anyway, both ladies managed to get themselves in to labour, with a bit of acupuncture and both delivered on the same day. I was called by the first, late the night before and she laboured beautifully through the night. During her labour I received a call from my other client who was beginning her labour. It was very early days for her so I encouraged her to rest. She called me again later the same night but just to say things were much the same. I let my colleague know and focused on our lady in proper labour. She delivered at 5am on the next day and as we finished up with her, we received a call that our next lady was contracting every 3-4 min and they were strong. We were an hour away but got there in time and she delivered at 14:30 that afternoon.
Both labours were lovely and the women truly embraced the goddess within and although my colleague and I were exhausted in the end, it was just wonderful. Our faith in birth and our clients proved itself one after the other. Both babies were a good size, one 4kg and the other 4,5kg and neither mother needed suturing! This was a good thing as I was really too tired to do it.
That same night my other colleagues were also called out and in all our team delivered 5 babies within that 24 hours! The birthing gods were working hard in Barcelona. Two days later I was called to attend a birth of a client who had tested streptococaus B positive at 36 weeks and again at 38 weeks. She was very nervous and subsequently had our doctor also attend her birth. She had requested possible IV antibiotics in labour at home and although I dearly wanted to support her I felt this was not something I was happy to give her. Our doctor decided she would honor this wish and everything was put in place for her to have the medication.
As a British Midwife, this was very unusual for me and I was very much out of my comfort zone. But my team at Marenostrum is amazing and I was well supported to support her ‘parto en casa’ or home birth but with the extra security she wanted of antibiotics at home. In the end she did not need them, she had two treatments of acupuncture and 30 min after I arrived at her house she pushed a baby out!. It was my first solo delivery of my career, because the doctor could not get there fast enough. Baby came a bit shocked and needed a few inflation breaths to get going and mummy had a brisk loss immediately after birth, but my midwifery head was firmly on and I was able to answer the two little hiccups. One the doctor arrived, all were checked over and baby was given a couple more inflation breaths to help clear its lungs then all was well.
In all honesty, after the fact I was a bit shaken, but really proud of myself, I felt like a real midwife and able to address the situation appropriately and well.
The following week another client broke waters but had no contractions for 48 hours, to top it off she also had meconium in her waters 12 hours after they had first gone. This was a very frightening situation for me, as I had not experienced this before and of course my first instinct was to send her to hospital. I conferred with my team and our doctors and with our client. We set out a plan of monitoring and and natural induction including acupuncture, a long walk and good old castor oil. All of these things were put into place and through out baby was well, but I was struggling deeply.
Everything I had learned had told me that meconium with out contractions was just dangerous. I could not understand why this was happening and each time I listened in to baby I was so afraid of what I might find.But each step of the way we talked everything through with our client and I was greatly supported in my support for here. In the end after all we could do, I told her she needed to go into the hospital, because after 48 hours she had not had one contraction and we had done all we could do naturally.
It was very difficult for her to take, but she went to hospital and after 5 hours of oxitocin she delivered a healthy baby girl! No pathology no infection nothing. I have no idea why this baby who was not post dates, had mec or why this very healthy mother who appeared in every way prepared to birth, did not labour on her own. We have discussed this over and over again, but somethings are as they are.
All of these experiences have left me deeply grateful for the combined wisdom and knowledge of the team I am privileged to work with and a stronger midwife and normal birth advocate. Of course not one of these birth was ‘normal’ but I am learning to question my understanding of this word and my place with it as a midwife.
http://www.nice.org.uk/nicemedia/pdf/IPCNICEguidance.pdf
http://midwifethinking.com/2010/10/09/the-curse-of-meconium-stained-liquor/
The Barcelona Midwife 