The caped crusader

After I mentioned the toddler going for an unexpected dunking last week, so many stories about weird things falling in the pool at homebirths have come back to me from midwives around NZ.

Most of them involve animals, mainly cats! Although one midwife turned around to find a horse in the kitchen once. Yes a HORSE! She had to entice him outside with bread. Now thats not your every day event and certainly not in a midwife’s job description. I also don’t recommend anyone buying a Norwegian Forest cat, apparently once in the pool they won’t get out - they just swim round and round till a baby arrives. Slightly off putting I would imagine! The midwife said he’s in all the birth photos 🤣. Then another cat popped the blow up birth pool, now that’s a LOT of water through your lounge at a very inopportune time. Keep them coming ladies, I love a good laugh.

I had my own pool incident at home this week. The winds have been up lately and they roar inland from the west coast to us. I was almost asleep about 11.30 the other night and there was this weird bang against the bedroom window. A bit like a resounding SLAP! Dressing gown and slippers on, a closer inspection revealed I hadn’t locked the lid on the blow up spa pool. It was now nowhere to be seen. Shit. I contemplated pretending I hadn’t noticed when hubby got home in the morning, but then I thought of the power bill. Five minutes later I found it by phone light in the neighbours paddock. Lugged it home like a cape billowing behind me - along with a whole lot of sheep shit on my white dressing gown. It would have made a good picture!

Anyway, the hospital is of course a very different setting to home for a woman to have her baby. I’ve been “up the hill” as we say, twice this week running inductions. I do my best to make it the woman’s own space and not make that damn bed in the centre of the room the focal point. Props are lugged in such as birthing stools and Swiss balls. I’m not sure if sometimes I look homeless with all my bags or like a yoga teacher? Oh humour me, let’s go with hot yoga teacher 🤣.

I also always make sure I have music and aromatherapy going. This makes a sometimes very loooooong day way more pleasurable, it also serves another purpose. The hospital is the place of work for the doctors and other medical staff, they own it, they are there every day and it’s their norm. They have a job to do and do it well. But if they push open the door in a hurry and get slammed by a foreign smell and soft music playing (except for that death metal I had once - that was BAD) they tend to slow down and not flick on all the lights. It just gives them a moment to be reminded that this is now someone else’s space they are coming into.

So the other day when I was there with a repeat client we were expecting a long day for her induction. We got there early as that place just eats up time before you can even get started. Her last baby had been born prematurely and very fast. This baby was considered large and she had polyhydramnios, which means way more waters around baby than normal. The main concern when a woman has excess fluid is that when her water breaks the cord may rush out into the vagina first. This is called a cord prolapse, and it’s an obstetric emergency big time. The baby then can impact on that cord and cut off its own blood supply.

As I was breaking her waters that was in the back of my mind. It’s rare, but it’s a thing, enough to make me nervous anyway. But all good, no cord, just a small flood to deal with!

So now we needed to await contractions. Hopefully they would start on their own now that baby could sit lower in the pelvis and put better pressure on the cervix from the inside. This was a very good time for lunch! While the mum and dad were sent off to do the long walk to the cafeteria my midwifery partner (who was just finishing a meeting) and I arranged to meet at the nice cafe over the road. Living the good life here I thought...

First she forgets her wallet, then they bought me the wrong meal three times! They were very apologetic, but still it meant I had four minutes to eat before having to race back to meet my client. So I was running a tad late. Just as we arrived at the main lifts I heard my name being called and I turned to see hubby roaring towards us with my client in a wheel chair - looking a tad uncomfortable. I swear he had the front wheels off the ground!

“Shit, are we having a baby?” I said, like an idiot. Now don’t get me wrong, I know we were there to have a baby, but not within thirty minutes! Now if this had been my midwifery partners client I would have then gone with her to their room to make sure baby wasn’t about to fall out and give her a hand. But no, my partner just goes “yep, looks like it” with a big smile and walks off down the corridor in the other direction. She even did a little back handed wave. So laughing at her escaping, we high tail it down the long corridors back to our room. An orderly had found them the wheelchair when they saw her double over outside the cafe. Top bloke!

Turns out we did have a little time to get ready and I even got to turn the music on. This baby was much bigger than her first, so she took a while longer to push out. But mum did it like a rockstar, beautiful slow crowning of the head while in a position that makes the most room in the pelvis for baby to come through (think getting ready to run a 100m sprint). Once baby has their head out (usually) they are looking down, then their head turns to the side (restitution it’s called) and the shoulders follow, the top shoulder slides under the pubic bone and the baby slips out with the next contraction. Seamless.

That’s how it’s supposed to happen anyway. But not if that top shoulder gets stuck. Then it’s a whole other ball game. When baby didn’t come I reached in to try to unstick her myself.

When that didn’t work I asked grandma to push the big red button for help.

Next move is to roll mum over, boy she moved fast - what a rockstar. Then dad helped me do a trick with the legs called McRoberts, this is where you pull the legs out straight, then bend them back up so it’s like a lying down squat. Sometimes this releases the shoulder. Or pushing on the shoulder from the abdomen might work. But no cigar for either moves I’m afraid. So it’s enter the vagina again and try to release baby’s arm - turns out it was behind the baby’s back instead of in the front - so baby can’t squeeze it’s shoulders together to get out.

I was in the middle of trying to sweep this arm around when the troops arrived. All 12 of them! It was shift change, I had so many experts in that room it was wonderful. Even more wonderful to be able to hand over and calm the poor mum. That’s got to be a traumatic experience, I had to raise my voice to get her to look at me and focus so I could talk her through it. This is when it’s wonderful knowing your client, you can break through the panic and fear so much faster than the hospital staff could have. Besides they were pretty busy. The obstetrician continued with my sweeping manoeuvre and the rest of baby was born four minutes after the head. They drill into you when you are learning that you have seven minutes from head to body before baby’s is likely to suffer badly. So one eye is always thinking about the clock in this situation. Baby was a good colour, but not attempting to breathe despite the stimulation with a towel. But never fear the baby doctors had come with the emergency bell too and they undertook the resus.

Within fifteen minutes baby was returned to mum, her bleeding was controlled and I was left alone in the room with the family again. Wow did that just happen?

My calming music could suddenly be heard in the background. It had been drowned out by the emergency bell, it certainly hadn’t made anyone slow down and think as they entered the room - and thank god for that!

And thank you to my hospital colleague’s. I like to hide away in my room and do my own thing and just get on with my work, but I love that you all come running when you are needed!

Hopefully I don’t see you again for a while 👌.

Also hoping for a full nights sleep. I don’t seem to be bouncing back like I used to. I don’t even have the excuse of being markedly older! I just seem to be tired for longer after a night up. Three babies this week and I’m a bit shattered. This evening a clients waters have broken, but no labour yet, hopefully she rings me at dawn and we have both had some rest first. If not, I’m sure it will all work out, it’ll just be a bit of a blur!

I’ll let you know x