First official day =)

So my last post was on the Sunday before I officially started. I got a call the next day, Monday, and there was a mom in labor. Judi wanted to know if I would like to observe the birth. Of course! It was still a bit early but I headed over to the center to be there when the mom arrived. While waiting I started the scavenger hunt around the center and got very familiar with where all the supplies and equipment are stored. A few hours later and still no momma, so Judi called to see how she was doing. Her contractions were becoming irregular again and waning so they were probably not going to be coming in. I was disappointed but grateful to get to know the center a bit more and went home.

The next morning at 5:30am I got the call from Judi. L had come in around 4am and she was around 6cm with fairly regular contractions every 5-7 minutes. I jumped in the car and drove over the bridge into the city with the early morning traffic. By the time I got there L's contractions had slowed a bit, and she was being well supported by her husband and doula. I ate some breakfast and got introduced to them. Sweet couple, mom in her early 40's, first baby, its a boy "Paulo". At this point I was just helping with taking vitals and timing the contractions occasionally.

The next 12 hours seemed to fly by with taking vitals and trying to help her swing Paulo into a better position. The silly monkey had his back on one side and his head turned the other way. To help do that we had her changing positions and walking, trying to keep her contractions going, but it was hard because of his funky position, his head wasn't applying the even amount of pressure on the cervix to synchronize the contractions.

At 7pm after having a bit of yogurt with honey for energy L vomited and her water broke at the same time. Even though most people think vomiting is a bad thing... in labor it can actually help a lot. Her waters were clear and perfect. Throughout the whole day Paulo's heart rate was fantastic. The little guy wasn't even phased =) Now that her water was broken we needed to monitor her temperature to see if she was at risk for an infection. So far so good =)

After her water broke she became a bit dehydrated so Judi suggested an IV and they accepted gratefully. After an hour or so of the IV she was feeling much better and had much more energy. She was rocking and swaying with the contractions. Around 10pm Judi decided to check her again to see if she'd made any progress. If she hadn't we were going to talk about transporting because the contractions she had kept coming and going and weren't strong enough to help turn Paulo. If she got a bit of Pitocin at the hospital it would help, and before she was too tired for the pushing stage.

When Judi checked her she was still 7-8cm, but very stretchy. So Judi decided to hangout for a contraction and see if the head came down when L pushed. It did. So through a few contractions Judi helped move the cervix out of the way for the head to come down. And down he came. We moved L to a birthing stool to let gravity help and with each contraction and push he came closer and closer. Soon we could see his little head full of dark hair molding perfectly to fit. As he started to crown she panted through the contractions and his head came out perfectly. He had turned the right way!

With the next couple contractions his whole body came out and we helped lift him to L's lap. He was pretty flaccid (floppy) and didn't start to cry after being stimulated with rubbing, talking and some suctioning. Judi listened to his heart and it was pretty slow, so she clamped him and brought him to the resuscitation table. I was right there ready with the oxygen on and a warm blanket to help dry him and stimulate him more. After a few seconds he started to pink up, I listened to his heart and it was back up to a good range. But he still wasn't crying or making strong efforts to breath. Judi asked me to call 911 and ask for a neonatal resuscitation team.

I flew to the other side of the room and called. Somehow I remembered the address even though I'd only been here twice before. While on the phone I could see Paulo moving around and starting to make a little noise. Once I confirmed everything I went to the front of the building to wait for them. They arrived about 8 minutes later (longest 8 minutes of my life) and I let them in. When I went back to the room Paulo was breathing on his own but still wasn't crying. So the decided to transport him just to be cautious. So Paulo and dad went to the hospital and mom stayed with us to make sure she was doing ok.

During the commotion of resuscitate and calling and waiting L had delivered her placenta with the help of the other student midwife and her doula and was doing great. Before we could let her leave we had to make sure she wouldn't hemorrhage, was able to go to the bathroom, get something to eat and rest for a bit. We got her in bed and I made her some scrambled eggs. While feeding her the eggs and some yogurt we talked about what happened and how Paulo looked to me, and that I was certain that he was going to be fine. As the EMS was leaving with him we heard him cry.

After about an hour and a half, with a good nap, food and being able to walk around without feeling dizzy... I drove L to the hospital. We had her sit and she was finally able to hold Paulo and cuddle him skin-to-skin. They had done some blood tests and found that his hematocrit was higher than normal, meaning his blood was thicker than they liked. The talked to the parents about doing a procedure to help dilute his blood, by extracting some from his umbilical vein and adding saline through and IV. The risk of a high hematocrit is having his blood clot and potentially give him a stroke. The benefits of the procedure definitely out weighed the cons so they agreed to go forward with it.

I offered to stay at the hospital and wait with them till after the procedure and Paulo was all settled with his mom again. The father still needed a ride back to the center to pick up their things that were left behind in the rush and to get their car. So around 9am everything was finished, Paulo was back to cuddling with his mom and resting so it was time for me to head out. I as so grateful to be able to support them. I was able to help assess L's bleeding while at the hospital to make sure she was still doing fine and make sure she stayed hydrated.

Even though I had been awake for more than 27 hours, I was high on adrenaline from the whole evening and so satisfied and happy that they were all doing great and finally together again. I learned a ton and was so grateful that I was able to help so much during the birth and afterward. Judi does have another midwife on staff, but the decision to start pushing happened so quickly that even if she had called her, she wouldn't have made it there on time. And I'm super glad that I came early on monday and got to know my way around the center. Knowing where everything was helped a ton and I was able to preemtively prepare things. I was fast and efficient. It felt great =)

I got home around 10am, took a shower, ate and then crashed into bed =) *sigh* It was a good start to my new apprenticeship =)