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21/12/10
(Note – 41+2 today, and exactly 1 week on from the date Alice thought it would be!)
06:50 Get a call from A to say she’s having “hard, painful ctx” but not sure of regularity or length. She’s been up most of the night with Benjamin, who’s been quite sad, and she’s also been having diarrhoea. She had a bloody show last night and has been losing browny pink mucous overnight.
07:30 Arrive to find A very perky and fairly cheerful. The boys are up and quite vocal… Ctx coming 2 – 8 mins apart, short, but, says A, “the real deal!” I suggest she calls the midwives to let them know things are happening. She calls the hospital and talks to a mw who is a bit patronising until A tells her it’s her 5th baby – her tone changes completely! Says mw will call her back.
07:35 Mw calls back, and, to our delight, it’s Mandy! She’s on an early shift, but is fairly sure A will deliver in that time. She has a few things to do, then will make her way here.
08:10 All is calm and quiet in here – the rest of the house is less so, and we can hear nappy changing and eczema cream application going on downstairs under protest! I have changed the sheets, so that baby Samuel can be born onto the same meconium-stained sheet that Benjamin was born on….
08:15 Mandy arrives. A ctx roughly 3:10 probably lasting 30-50 secs (although not easy to work out as she makes no noise or change of breathing). M does routine obs which are all fine. She palpates & listens to baby Samuel, who sounds very happy. He hasn’t moved this morning, so it’s reassuring to hear his healthy heartbeat.
08:40 M has asked for the Christmas tree to be moved off the stairs in case we need to transfer in an emergency. The boys are a bit manic, so Neil resorts to Smarties on the sofa while he moves the tree, saying rather shamefacedly to me, “Bribery & corruption…” but I answer, “That’s what Smarties are for.” The tree goes onto the school table, while the boys munch on Smarties & stare wide-eyed. N moves the tree with great ease and I am very impressed.
08:45 M looks through the birth plan and is happy with everything except 3rd stage, which she would much rather do with syntometrine “as it’s your 5th baby” and because of the further bleeding risk of the succenturiate lobe. A thinks it over and agrees.
09:05 M has asked if she can stay in the room. A has declined a VE, so M wants to observe how she’s progressing. A is happy with this, so M sits on a chair at the end of the bed, silently, and does paperwork. I sit on the floor, next to the bed, and knit. A is still contracting silently, but it looks as though they are getting longer and stronger.
09:30 I go in search of towels, and Arthur helps me find some in the airing cupboard. He says it’s ok to use the one they usually use for a bath, “because we had a bath yesterday”. He asks if the baby’s coming yet and I tell him not to expect the baby until after lunch, or maybe not even until teatime. I don’t think it will be that long, but it’s better to say that so he’s not asking every 5 minutes!
We discover that the radiator in A’s room isn’t on, and the dial is turned to the snowflake sign, which is appropriate for the snowy weather…. I crank it up to full. Next it’s a search for the thermometer – Neil looks in all the usual places downstairs, and we eventually find it upstairs in A’s drawer. A is feeling a bit anxious (good sign…) and quite nauseous (another good sign…) so I give her a peppermint flannel. Ctx much longer and more intense now – slight changes in A’s breathing. FH good after ctx.
09:45 A has zoned out a lot more now, and taken off her glasses. She’s lying on her right side, eyes closed most of the time. She says she’s feeling “searing pain quite low, and moving round to the buttocks”. M is trying to work out when to call the 2nd mw. From observation of last time, I’d say there’s at least another couple of hours to go. All is fairly quiet downstairs and the boys are listening to a story tape. So far, the Christmas tree is still standing and unmolested….
10:10 N comes in to say that Benjamin has gone to sleep, which is good news. The others are watching Postman Pat. M is checking equipment etc. outside the room, and apart from periodically asking in a whisper if she can listen in or do an ob, she’s being marvellously silent. I’m still sitting by the bed, still knitting. My sense is that A needs a lot less reassurance than she did last time, so I’m staying quiet, although I do move the “Fear not” scripture from the wall behind A to the side of the chest of drawers so she can see it. A’s breathing changes with most ctx, and she’s doing gentle blowing now. FH still excellent. I ask A if she’s feeling safe and she says she’s feeling a lot more secure now she’s not feeling so nauseous (good old peppermint – works every time!) No idea what the weather is like outside as the curtains are closed, but snow is forecast for about midday. How lovely to have a baby boy born on a snowy day so close to Jesus’ birthday!
10:50 A says the last 3 ctx have been stronger, and she feels that her buttocks “are moving apart by themselves” so M thinks it’s a good idea to call Becky, the 2nd mw. It will probably take her a little while to sort out her car and get here in the snow. M prepares the syntometrine. The atmosphere in the room is very peaceful and calm – it’s so lovely not to have to keep shushing the mws or get them out of the way!
M looks at A’s rear end through a ctx. There’s no visible purple line that I can see, but A can feel “the bottom thing” during ctx! [note from me: the purple line Heather is talking about is something that is visible above the buttocks with full dilation or close to full dilation. It's an observation sign that my midwife uses (at Heather's suggestion with Benjamin's birth) because I refuse internal examinations, to see if I'm getting near to the 2nd stage yet.]
11:00 A blows into her hand for the first time (good sign) and needs to wiggle her toes to get through ctx.
11:10 Mw Becky arrives, and starts chatting quite loudly, but M takes her out of the room to update her, telling her that A prefers no chat in the room. A is lying on her left side now, so I have moved onto the bed where she can see me, and I’m not in the way.
11:25 A is starting to feel the chest/throat constriction, and puts her hand over her eyes. She’s feeling lots of pressure which is still sore after the ctx have gone. B is in the room with M now, and they communicate in the quietest of whispers. M whispers to B, “She doesn’t look like she’s in labour, does she?” No, but we know different if the past 4 births are anything to go by! Samuel is moving + + which is rather uncomfortable for A. I go to give N an update and say I wouldn’t be surprised if it was in the next hour or so.
11:40 A has been quite flushed (normal for her in labour) and M suggests we exchange the duvet for a sheet. Suddenly A says, “I’m so hot!” so I wipe her face with the flannel and she says, “Oh, that’s so nice!” M says, “they’ve definitely slowed down since B arrived.” Immediately, A has a big ctx, hiding behind her hand and making some little noises (this is new). Baby Samuel is supremely happy on the Sonicaid with the odd acceleration but no decels. A reluctantly gets up to go to the loo and rushes (as far as that’s possible….) to lie down again! While she’s out of the room, M comments that it’s helpful to have seen A in labour before, otherwise she would have thought not much was happening and might have gone away to do some visits. I say, “I wouldn’t have let you!” I can tell from what M & B are saying to each other that they are noticing ctx have slowed. They’re not seeming anxious, just commenting, but I’m sure this is just “rest & be thankful”/transition type stuff. I’m never sure why mws get so windy about this – it’s classic labour behaviour.
11:55 Another big ctx, A blows into her hand, more noises – all good! I say, “did that one feel different?” A says, “Yes.” I ask, “How different?” and she says, “That horrible end bit!” then adds, “You’re going to write that down now, aren’t you?!”
12:00 Another big one, and A needs to hold my hand. More noises of the “Ow!” and “Ooh!” sort…. A says, “I really don’t like this bit – how much longer now?” I answer, “We never answer that question…” The next one is much more in her bottom.
12:25 A says, “I don’t think I want to do any more.” We hear Benjamin crying downstairs and asking for the Hoover. A is needing to hold my hand for every ctx. She’s feeling pressure with every ctx, and beginning to bear down. Says she can feel “fanning out”. She needs reminding to blow into her hand. M can now see prgress from the outside (anal dilation and purple line). B goes to tell N that “progress is progressing!” I really need the loo but don’t want to leave A now….
12:50 Manage to get a quick wee between ctx! A’s hip is sore so she turns back to the right side and I move back onto the floor. The ctx are very sore in A’s back so M does massage while I hold hands. A says, “I really can’t do this.” (Note – this is such classic transition – wonderful to watch it happening!)
13:05 Change of position to semi-reclining. Back is still sore so I put my hand underneath and push hard into the sore bit. M massages A’s thigh as she’s got cramp as well. A says again, “I don’t like this bit. I don’t want to do it.”
13:15 First involuntary push with ctx. Says again, “I don’t want to do it.” I tell her she needs to lose control to birth the baby.
13:32 Head visible. M gives good directions to minimise tearing “Little push, blow, little push, blow”. A says, “I don’t want to” so I tell her to say, “I want to see the baby” which she repeats. I say, “Do you want to feel the head?” A says, “No!” then “Yes!”
13:40 Waters break and are, thank God, clear and the head is born. A says, “What’s happening?” I say, “Head out” and A cries, “Oh, take him out, take him out!”
13:41 Baby Samuel is born! The cord is round his neck and body, and he cries lustily while M untangles it, then Samuel goes straight onto his Mummy’s chest. I go and call N, who hasn’t heard a thing! He comes to the bottom of the stairs and says, “Yes?” and I say “He’s here” quietly so we don’t get a stampede! N comes running up.
13:42 Syntometrine given.
13:47 Placenta born. M takes it to the bathroom to check it over and there’s no succenturiate lobe! A miracle??
14:10 Samuel has been crying lustily on and off and is still on A’s skin. M has looked at A’s perineum and discovered a 2nd degree tear which needs suturing. She suggests doing it now – A isn’t great with suturing and doesn’t want to be holding Samuel while it’s done, so M suggests B takes Samuel & chacks him over (sigh) A looks at me & I mouth, “Not before the first feed..” so A declines. M says, “Well, put him on the boob then.” Samuel, knowing what’s expected of him, latches on and feeds like the pro he is.
Later….
B checks Samuel and comes back with the news that he’s a whopping 3.4kg/9lb 9oz! He’s 59cm long and has a 38cm head circumference. He’s their biggest boy to date!
I hold him (lucky me!) while M does the suturing (after quite a long search for the right bulb to go in the new lamp bought expressly for the purpose!) Samuel is still hungry and sucks on my finger the whole time. I keep A talking throughout the suturing and it’s not nearly so bad as last time. Samuel goes back to A and latches on again. M gets herself ready to go then remembers she needs to do baby obs. She discovers his breathing is a bit fast (80bpm rather than 60 or less) and makes noises about possibly needing a doc to look at him…. We both think, “Oh no!” and can’t bear the thought of having to transfer in. M does his temp and discovers he’s a bit cold, so we wrap him up (still skin to skin) and M waits 20 minutes to do obs again. I go downstairs and order Marmite on toast for A, then I stay down and read Frog & Toad, and The Cat in the Hat to the big brothers.
16:15 I come back upstairs to check what’s what and find M in her coat, ready to go, baby’s temp & breathing are fine and all is well – hooray! The boys come up to say hello t the new baby brother.
Another fantastic, instinctive and triumphant birth! Again, a privilege to witness – I look forward to many more…..
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