Uh...we've got a baby in the toilet!
Well not quite, but almost. Let me start at the beginning....
Friday began slowly with handover being rather muddled as morning staff were being run off their feet with three women labouring at the same time, and quite a number of postnatal mum's to care for. Being one midwife down, it took a while for the midwife in charge to decide how to divide up the rooms and make sure all bases were covered. After much debate about midwife, women ratios the shift began.
Sarah* was happy to have a student with her so when the morning staff left we went to be with Lauren* who'd been in labour since the morning, this was her first baby, and we'd been told she was 9 cm dilated.
The room was dim, Lauren propped up on the bed with lots of pillows, her partner Dan* sitting beside her, quietly holding her hand. She was using the gas and as each contraction came she'd take two or three deep breaths on the mouth piece and work with her breath for the rest, holding the mouth piece between her teeth and blowing out through the nozzle but sucking in fresh air. She was so rhythmical... I think the constant sound of blowing out on the nozzle and hearing the valve was a focusing point for her.
Sarah and I spoke little, there was no need as Lauren was in her own space, very controlled, working with her body. Dan hardly spoke a word, he was just there, a good presence. Sarah and I simply felt contractions every now and again, offered Lauren water, kept the facewasher on her head cold, checked the baby's heart rate and sat or squatted beside the bed focused on Lauren's face.
As time goes on in my midwifery training I find, when sitting for any length of time watching labouring women, that I adapt their breathing pattern, a softer version, but at the same rate - strange.
When we'd been with her a short while Lauren mentioned she felt pressure and wanted to push, Sarah encouraged her to breathe through to give the cervix time to fully dilate until she really couldn't breathe through anymore and began pushing involuntarily. So Lauren did, she breathed like I've seen no one breathe before. Occasionally at the height of contractions I could hear her voice change to sound like a push, but only for an instant and then she'd be right back to sucking in her air and breathing out on the nozzle. Sheeuuch, phwuooh, sheeuuch, phwuooh, sheeuuch, phwuooh.
After about ninety minutes of watching her breathe and hearing the slight catch in her breath become stronger, Sarah suggested to Lauren that emptying her bladder would be good so the baby would have room to really come down well. As soon as Lauren sat down on the toilet, she began to push strongly. Being a first time Mum, Sarah and I expected that things would take a while to really get happening... were we ever wrong!
There was a knock on the door, Lauren's Mum was on the phone. Amazing how mothers often suddenly want to contact their daughters when their girls are birthing! It happens a lot. Dan ducked out to let her know that Lauren had just started pushing. As he went Sarah decided to get the torch and have a look to see what was going on with Lauren's perineum as it had been quite swollen last time we'd checked. Sarah clicked the torch on then off suddenly saying, "Laura, get Dan! We've got 5 cm of head on view!" I dashed out the door, and hurried Dan back in the room.
Lauren stood up and waddled a few meters to the bed as I pulled on some gloves. As she sat, a perfect head emerged gently and we waited a good three minutes for the next contraction to birth the body (it felt like a very long time to me). I had my hands gently near the baby's head but not on and with the next push expected baby to slide out easily. Nothing happened as Lauren began pushing so Sarah and I had to firmly try help bub's anterior shoulder slip down and out. The baby came without too much fuss and we placed the little girl up on mum's chest. She breathed well and within minutes was nuzzling mum's breast and soon sucking away like a little machine.
Dan and Lauren simply sat in awe of their little girl, while Sarah and I breathed a sigh of relief that the baby hadn't been born in the toilet bowl, and then marveled at how Lauren had been breathing her baby down and out. Just awesome!