Thursday, March 19, 2009

A Cold Front and A Challenging Week


A major cold front came through the Houston area last week and brought many babies with it. Five women in my practice had their babies. All of them had some kind of problem or challenge that gave me a few more gray hairs. However, they and all their babies are doing fine.
The first one to deliver was one of the sweetest women I've ever met having her third baby. She had developed a condition called cholestasis- a liver dysfunction. It was a month before her due date, but she had been admitted to the hospital the day before and induced. We had spent a lot of time in the early part of the week consulting with a GI specialist and then finding an Ob/Gyn to take over her care. The encounter we had with the GI doctor had been very unpleasant. Dr. J at NW Memorial had taken over her care and he took good care of her. She had a vaginal birth and went home the next day. Unfortunately, the baby had to stay in the hospital, but is doing well.
My next client was having her first baby and was a few days overdue. She went into labor after a few starts and stops. I really believe the cold front is what did the trick to get her into labor. She had a relatively quick labor and a normal size baby, but a severe tear. I knew when I saw it, that I could not repair it at the Birth Center. I called Dr. M and made arrangements for him to meet us at the ER of the closest hospital to the Birth Center. He met us there a few hours after the birth. He did a great job. I have to say that he is something of a saint to help me the way he does when I have problems. Good natured and so competent. I can never say enough good words about him. Things are going well with her now.
That same morning, one of my other clients not due until April 2nd called to tell me her water broke (three weeks early). A definite casualty of the cold front. No labor at all. So we waited. I won't go into all we did to get her labor going, but just let me say we did everything (and worried). We had given up and decided to go to the hospital when the sun came up. I laid down for a little while and woke up and she was in labor and three hours later we had a baby!!! Joy to the world. When her baby was born, it did not breathe right away. I had to resuscitate it and we called 911. By the time they got there when she was 12 minutes old, she was fine- pink and breathing normally in her mama's arms. Just a few minutes of high drama.
My next client actually had her baby before the one I just wrote about. She had two due dates and I think because of the cold front, went with the first one. Went into labor and everything went well until she started pushing. It seemed like she was having a much more difficult time pushing than she did with her first baby. She only had to push for about 30 minutes with the first baby, but this one took an hour and a half. We knew this one was bigger, but she had to really work to push this baby out. She tried many different positions and we helped her every way we could think of. Finally the baby came out- face up! No wonder it had been such a challenge. And on top of that, he weighed 10 pounds. Thank goodness she was so young and strong and able to do it.
The next challenge came the next day, and was relatively minor. My client who I had been expecting for quite awhile went into labor. She was 11 days overdue. Had a wonderful, normal labor at her home. Everything went well. She was in a birth tub at her home, and pushing strongly. Her water had not broke and I was wondering if the baby would be born in the bag. Suddenly, her water broke and bright green meconium fanned out into the clear water of the tub. The baby was born about two minutes later. We suctioned him well to get all the meconium out. He was fine and had APGARS of 9 and 10. All well.
On top of all these interesting experiences, we were having a big family reunion for my husband's family at our home this past weekend ( the first one in 25 years). About 70 people showed up. I got to come home and see everyone for a few hours on Saturday afternoon. Thank goodness my three sweet sisters-in-laws and husband did all the cooking and cleaning and organizing. Since the weather was so cool, we all stayed inside (we had planned to be outside).
Another week in the life of a midwife. Jackie