flashback to May 2009..fabulous natural birth

I met Christina in her house in mid-March. She and her fiance, Drew, were expecting their first baby together and Drew had an 8-year old from a previous marriage. I immediately sensed the love between them and could tell they were very supportive of one another. Throughout the two prenatal visits, we discussed their hopes for the upcoming birth. They had taken the natural childbirth class and were very much hoping for a drug-free delivery. Christina warned me that her family members had a history of rapid labors and her main fear was delivering too quickly- while en route to the hospital. I assured her that this was unlikely, especially given that this was her first baby.

The day before her due date, Christina called me...squeezing out words between contractions. Her membranes had ruptured, contractions were becoming regular and she was on her way to the hospital. Soon I had gathered my doula bag together and was on my way to meet up for the main event.

I found Christina laying on the bed in the triage area, Drew beside her on a chair. The midwife had checked her about a half hour prior and she was 1-2cm. She looked up with sweat dripping down her brow and told me that she was exhausted and in pain. I quickly got to work getting her out of bed so that she could labor upright and encourage the baby down. The nurse came in and warned us that they were having an extremely busy day in Labor and Delivery and that no real labor rooms would be available anytime soon. So, we made the most of our tiny space in the triage area. Christina labored standing, leaning onto the counter and rocking back and forth. She sat on a birthing ball and rocked side to side as she held onto the foot of the bed. She sat in the bed, laid in the bed, and breathed like a champion. She was doing an excellent job, very focused, and determined. The one setback to the focus was the vomiting that occurred for about a half hour. I assured her that this was a good sign- vomiting often signals that you are rounding a corner in labor and that great progress is occurring. She handled it and moved on and although she was tired, she did not request pain medication once.

About three hours into the labor, we were still in triage, going through our routine when a medical resident walked in. She introduced herself and explained that all of the midwives were assisting deliveries at the moment and that she would take care of Christina until the midwives were available. Christina's body tensed and although she did not verbalize her anxiety, it was clear that she was upset at the thought of not being attended by a midwife for her birthing. When the doctor left the room, Christina went back to her steady breaths and position changes. We barely had anyone coming into the room to check on us throughout the 5 hours we spent in the triage area. The nurse had 5 other patients she was caring for and knew that Christina was doing well so we were pretty much left alone...which was great.

Between hours 4 and 5 Christina began to feel pressure. I called in the nurse who called in the doctor who checked Christina's cervix- 9.5cm! Christina had not been joking about the fast labors in her family. Going from 1cm to almost 10cm in 4 hours with your first baby is so quick. The nurse began to realize that she'd better move us to a labor room quickly or Christina was going to push this baby out in triage. Luckily they found a room and 15 minutes later we were being run down the hallway.

Almost immediately upon entering the labor room, the Anesthesiologist stepped in and nearly scared Christina to death. He was explaining the procedure for an epidural to Christina (even though she was still adamantly against getting an epidural) and mentioned the words "in the event of a c-section". Christina shot up out of bed and said "WHAT? I need a c-section?" Luckily I was right next to her and assured her that she did NOT need a c-section and that she was doing a fantastic job and would deliver her baby naturally very soon. I think the doctor got the hint at that point that no pain meds would be needed and he left the room.

A midwife then stepped in and began gowning up for the delivery (she had just finished catching another baby and was available to take over for the medical resident, just in time). She checked Christina again and noticed that there was still a lip of cervix. Christina went through 30 minutes of agonizing rocking on her hands and knees to get rid of that lip of cervix while resisting the urge to push. She did an amazing job.

Finally she was given the go-ahead to push. Each time she pushed she made great progress and in less than an hour the baby's head was poking out. Unfortunately the baby was having decels on the monitor (his heart rate was dropping) so an attending OB/GYN came in to assess the scene and see if she would need to intervene. The midwife told Christina she had to push with everything she had so that they would not have to use a vacuum or forceps. That next push, baby Joshua entered the world. A beautiful 8lb baby with a full head of black curls. Within the hour he was breastfeeding and the room was transformed from a stressful labor scene to a serene mother-baby bonding session. As I left the labor room, Christina said to me "thank you so much, Kat. you're going to make an amazing midwife." I welled up as I thought about Joshua's beautiful birth and the many many births to come in my midwifery career.

Midwives Midwives Everywhere!

Today was a day full of wonderful midwives. After class today we were invited to a reception to welcome Holly Powell Kennedy, CNM, PhD to the Yale School of Nursing Faculty. Holly is one of the lead researchers in the world on normal birth and is just beginning here at Yale. She is the first Helen Varney endowed professor at YSN and it seems like she has wonderful things in store for us, including starting a birth center at Yale New Haven Hospital!

It was wonderful to be at her reception, surrounded by midwives and future midwives. Immediately following, the students were invited to a midwifery potluck hosted by the second years. There were about 45 student midwives there and it was both exciting and inspirational to meet everyone and see what brought each person into this career path.

I feel very lucky to be in this place surrounded by people who inspire me and make me feel at home in my chosen life path.

Becoming a Midwife, the beginning

After a whirlwind summer that went by far too fast, I find myself here, at Yale University studying to be a Nurse-Midwife. The first two weeks of my program have come and gone in a blur. A blur of activity, of meeting new people and of learning new things at an unnatural rate.

The people are wonderful, the fellow aspiring midwives are fun and kind and engaging and everyone has an interesting story to tell. We are all dying to do birth-related activities but the first year we will barely talk about catching babies. The first year we will learn to be nurses. Next week I will begin working on the adult cardiac unit at a local hospital. It will be quite the transition from working with laboring mothers. However, it is all part of the process of getting to where I want to go.

At some point, perhaps today, perhaps another day when I have less work to do, I must post my last few doula birth stories. They were wonderful and deserve to be told before I forget the details.

As my new adventure in nursing school begins, I must remember to take it all in and not get bogged down by the workload. I can easily become tense when I think too far into the future...I need to let things come as they will.