Birth Week

My long anticipated initiation into helping with a home birth kicked off full force last week! I've been attending prenatal appointments and learning from the midwife for the past five months - and finally my first births to attend. We had two mamas (originally three, but one moved in September) due in November. Both their due dates came and went and still no babies. That is one really nice thing about home birth, no one is in a super hurry to get baby out. Of course the mama's were ready to meet their babies and tired of swollen ankles and labored breathing, but they were comfortable letting their babies cook just a little longer.

One mama had fairly consistent contractions for several weeks. Her baby was in a fairly odd position - face-up (occiput posterior) and off to the side. This meant the baby's head was making contact with the cervix, but not really settling in to get things going. After a waiting a week past her due date, the mama asked that we reposition the baby (try to get the baby to flip over) and break her water. And boy howdy was baby ready to come! Two hours later a sweet, ten-pound, baby girl made our hearts melt! Mama was amazing! Really working with her body. Walking or bouncing (on the birth ball) through contractions. And when it came time to push she picked a position that seemed natural to her for this birth. She chose the hands and knees position - which in hindsight was perfect for a baby of this size. Just three pushes later and baby made her debut. I was in awe. I learned lots from this birth - repositioning, setting up, I even got to do my first vaginal check (TMI - I know). I saw how the baby's heart tones move lower and lower in the mama's abdomen as the baby descends. I learned about meconium in the water and when to be worried (or not) about it. And I was once again, convinced and amazed at how well women's bodies can do this thing we call birth!

The next morning, I got an excited call from the midwife. Mama number two was having contractions every ten minutes. This mama was known to have precipitous (fast) labors and she was 2 1/2 hours from my house, so I kicked in high gear and got on the road. Fortunately this labor was a little slower than her last one, and I arrived about 2 hours before baby. This was another beautiful birth - but completely different than the one the night before. This mama too worked through her labor she moved around some, but then chose to relax on her bed with her family. Her husband rubbing her back and getting her a hot water bottle. We never even did a vaginal check, but instead just watched her for signs of transitioning. (Per her request). It's not hard to tell when a woman is getting close to having the baby as everything intensifies and it's often important that the mama's support team keep her focused. This mama did great and again just a few pushes and baby arrived. Another beautiful little girl - 6 lbs. 8 ounces. I learned a whole new set of skills with this birth - like how to manage a bleed afterwards and how to do the newborn exam. I also examined the placenta and tested the babies blood type. Amazing.

After a few hours of checking and watching mama's and babies we left these families in the comfort of their homes with selected friends/family to enjoy this sweet time. The mama's breastfed and bathed and grabbed a snack and settled in to get to know their new little ones. I'm not against hospital birth! But there sure are some nice things about home birth!

Finally, a dear friend of mine also a week and a half past her due date called Saturday morning asking for some laboring tips. She and her husband had hired a doula to be at their hospital birth, but having gone a week and a half past her due date and into the Thanksgiving holiday, her doula was out of town. This mama was cooking right along and really looking forward to a better labor than with her first baby. She was excited and fresh. We talked briefly, and I expected the baby to come before noon. At three that afternoon she called sounding tired and frustrated. She had dilated to an eight and stalled - she'd been there since nine that morning. After hours of painful contractions she got an epidural and agreed to having her water broken. That was at one. It was now 3 and her doctor told her she had an hour before he wanted to start pitocin (a labor augmenting drug) and then possibly consider a c-section if things didn't progress quickly. She asked the doctor for two hours since the baby's heart tones sounded great, and then she called me. She sounded dejected - like she had somehow failed. That was the furthest thing from the truth! We just needed to try some things to get this labor going again. I was able to give her a few techniques to try in bed (with an epidural). I started with the "roll-over" technique, which gets mom into five or six different positions either sitting or lying on her side for 15-20 minutes each. This allows baby to get into different positions and hopefully make better contact with the cervix and get things going again. I also suggested nipple stimulation. What??? I know, when I first heard about it I thought to myself, "there is no way I'll every recommend that to a mom, that is just too private." Guess what, it really works! Nipple stimulation causes oxytocin (a natural hormone that encourages labor - among other things) to get flowing. She agreed and went to work. Just before five she called back. She was a 9 1/2 (cm dilated) and wanted some techniques for pushing as they had discovered the baby was face-up (occiput posterior). Now the stalled labor made sense. Oh how I wish they could have tried to reposition the baby earlier in the day. But we discussed the best options for pushing with an OP baby. I know that the mama still had a cervical lip that they needed to get out of the way, so it was three hours later before she was allowed to push. And, with the first push the baby rotated into the face-down (occiput anterior) position and came soon after. I have a lot of questions for the mom about what happened in the hours I didn't hear from her, but I'll give her a couple of days to rest and recoup before I bombard her!

These were amazing experiences. What a blessing to be a part of watching a new soul enter the world. I'm amazed at how much I've learned this week, but also in the past 9 months. I remember helping my first doula clients back in May. They were so sweet to let me "practice" on them. I was able to help this mom more over the phone this week than I did for supporting the mom through 13 hours of labor last spring. And, I know I have SO much more to learn. I can imagine that I'll look back at this post in a few months or a year and shake my head at all I didn't know "back then". But we have to start somewhere - and I'm blessed to have people who are letting me be a part of their stories as I learn!

We have one more mama due before Christmas and then a little break until January. I'm looking forward to this birth as I'm sure I'll learn so much more!

Counting the Cost

Counting the Cost. This seems to be the theme for my life this year. Right now it's just an idea that I spend a lot of time pondering. But I want it to be more than an idea; I'm just not sure what that means just yet. Jesus was pretty specific about what He required of His disciples - read Luke 14:25-35 - you'll get the idea. Thing is, do we really know what He meant by "hate your mother, father, sister, brother, wife, children....", "take up your cross", or "lay down your life." I'm not ready for a theological debate, I just want to find what He intends for those words to mean to me. I certainly don't want to jump into an emotional decision to follow Christ - I want to wisely "count the cost" as He instructs.

I've been reading several stories of people living lives sold out to Christ. Does that mean that those of us living comfortable lives dedicated to our jobs and families aren't true disciples? That isn't for me to decide. But I know a little soul-searching, heart-to-heart time with God never hurts! I trust His guidance - it is always loving and gentle.

Here are a few links to get you thinking.
Kisses From Katie is a blog about a young woman living in Africa with her 14 adopted daughters and Amazima is the organization born out of her desire to help the children of Uganda.

David Platt, pastor of The Church at Brook Hills, taught a radical series on Luke 14 that is causing me to take a hard look at some of the hard words of Christ. I'm not through listening to all of the messages, but so far I'm feeling pretty energized! Dr. Platt has also written a book on the subject called "Radical"; I haven't read it, but I plan on it. It reminds me of another book I read earlier this year that started this whole "Counting the Cost" theme - called "Crazy Love" by Francis Chan.

Finally, I follow several midwife missionary blogs from around the world. One girl linked me to this great article that follows several inspirational stories of people helping people. I'm a sucker for inspirational stories!

By the way, are you wondering about missionary midwives? I know you are :) Here's a great link to a girl working in Sudan.