March 4, 2022
12:05am Caitlin called and said that she thought maybe her water broke because she made a puddle after she stood up from the toilet. I explained how to dry off with a pad and that she will continue to pass fluid if it's her water but it could be just the baby moving her bladder. She called the midwife about the pain and they offered to have her come in for therapeutic rest with either a shot of morphine or something to help her sleep but Caitlin is afraid that it will affect the baby which I assured her it won't.
She’ll call me with her decision.
4am
Phone call: They went to the hospital to see if they could give her something to sleep. Midwife came in and told her she could check her cervix or not and gave her risk and benefits. Caitlin asked me and I asked her if it would change her mind about either fentanyl or epidural and she said maybe. She thought it might be better to get the fentanyl before an exam and I think that's a good idea too since it will give her an hour or so to maybe rest. Midwife did a quick ultrasound to make sure baby is head down and they are. She also mentioned that it's likely that baby is face up so she will bring in a peanut ball so Caitlin can sleep in side lying position almost on her stomach. Elliot needs to leave for a little bit and so they asked me to come up so I'll be getting dressed and heading that way soon.
I hear her throat close with breathing. I encourage her to keep her throat open.
5am: I arrive at the hospital. Elliot just left. She's in 325, left side lying, I bring pillows to put between her knees. Cooks & sacral release since she's reporting rectal pressure. Baby is likely OP. Jessica is her nurse. No checks yet.
Went off monitor - nurse replaces. Next contraction shows bigger.
6am CTX 7+ apart but lasting 1-1.5. FHR 140-160 (girl?) Encourage the "h" with ha-aa-aa on out breath.
Up to urinate heavy.
Pain moved to front suddenly. Warm pack.
She maybe wants tub.
Jessica came in. Caitlin wants more fentanyl.
7:16am, new nurse Olivia, new Midwife, Heather Jorgensen.
Plan: sleep, tub, food, epidural, big sleep, baby!
Castor oil rub on hips & sacrum, passive pelvic tilt. Cold legs feels about 4-5 cms.
She asks about epidural. Will need IV, catheter.
7:45am
7 cm 90% - She's crying with happiness
9:10am Elliot returns to find us in the tub room.
Tub is huge, candles, she's so relaxed.
5 contractions .. Old IV hurts
11am - Heather checks in. She offers to check her, break her forebag
Caitlin says maybe in an hour
11:30am new IV
Side lying to rest for an hour with d5 drip
Elliot at her side
Back hurts
Hands knees Elliot shakes apples
Knees hurt so we go to left side lying
I work on Spleen 6 to either lengthen or bring contractions closer.
Castor oil feet
12:36pm mini walk down the hall while Olivia is at lunch
1pm broke water
8/100/-1 anterior soft
Caitlin says she feels so much pressure
1:47pm up to restroom, I change her linens, she puts on mesh panties
off monitor
Caitlin is irked that on the data board they spelled their names wrong, urgh!
I tell Caitlin she is a Unicorn. This is the most oddball labor pattern. She’s a real question mark!!!
2:15pm Elliot goes to eat
I get busy with the rebozo
Olivia says, “you know the things that make you want to poop? Do them!” I adore her!
Caitlin gets up and does some belly lifts,she begins to pour on the floor!
She goes back to the toilet (dilation station)
She and I took a walk around the unit. I purposely walk a tiny bit faster than she does so she’ll meet my gait. We met Elliot at the entry. He’d just enjoyed a pulled pork sandwich.
3:48pm - After some deliberation, Caitlin finally decides to accept some pitocin. Let’s pee first.
She cried that she didn't want epidural, and we talked about it, risks vs. benefits.
4pm She gets a dose of 100 fentanyl to try to rest a little.
5:10pm - Oh my goodness, this woman is 9 cms, -1
5:34pm She returns to the tub. She wants to wash her hair. The pain is so much. She’s way too advanced and yet seems so far away.
She stands up and does some belly circles
6:30pm = 9.5 0 station
After some soul searching and deliberation, she finally agrees to an epidural and she's in love
Shift change - Jessie who was here last night came in again
8:30pm - Same. Just a little cervix on the right but too much to reduce.
We get her into the flying cowgirl position on her right side
10:15pm - Oh holy night! She’s finally complete +1!!!
The new midwife, Patricia, recognizes Elliot from Seaside. They have a quick chat about band and the old days.
They begin to instruct Caitlin how to push, including the way to use open glottis pushing.
She asks for a mirror. The birth team counts to ten for each push.
11:16pm - we begin to see labial separation, indicating that the baby’s head is in the birth canal now.
Caitlin is shocked that's already been an hour. Time in pushing and time in labor loses it’s meaning.
March 5, 2022
12:21am - Caitlin feels like she needs to pee.
1:45am - Dr. Pennekis came in and helped her get the baby to fit her under the pubic bone.
2:05am - Finally the head is clearly visible with pushing.
2:10am - her temp is 100.5. (37.9 not 38) so no diagnosis of chorioamnionitis. The midwife says that some would treat it now, but she is within the realm of normal.
Baby slides back after pushing, Dr. P offered a vacuum assist, which scares Elliot and so they declined, then once he left, Caitlin second guessed the decision and asked if we should have accepted. We assure her that she is doing this. For goodness sakes, Jessie is almost ready to call the baby nurse.
Time of birth - 2:40am
2:57am - Placenta arrives and I notice that it is heart shaped.
Caitlin gets stitches while Dad & daughter are skin to skin on the sofa.
550 Estimated blood loss
All repairs are done by 4am.
We work on getting this baby girl latched on to the breast and she does amazingly well. She’s a hungry little lady.
I know that the time left until they go to postpartum is very short and they have not had private time to just be the three of them. I let them know that I can come this week or early next week to help at home and process this amazing, but exhausting experience. left at 4:30am, just shy of two hours postpartum.
Caitlin and Elliot, when we met all those months ago, I could tell that you were both so very excited about meeting your little surprise baby. You both put in so much work to prepare for this birth, learning all about pregnancy, labor, birth and postpartum. You did all the Spinning Babies classes and exercises and were so ready to put in all into practice. Elliot made a perfect doula and your midwifery team worked so well with you to get your baby daughter earthside.
I hope you realize your strengths and that you did an extraordinary work in keeping yourselves focused during a very, very long prodromal labor, through to a very unusual labor pattern throughout the rest of your experience. Your new little girl is very lucky to have such a devoted mommy and daddy to take her on wonderful adventures in life.
I am very lucky to have been by your side through your portal into parenthood. Always remember: YOU DID THIS! You can do ANYTHING!
Much love,
~ Brenda
