Friday, March 9, 2007

Birth in the night

I had a Mom who was 41 weeks gestation come for a visit in the office. We put her on the monitor because she was post dates and we had good dating. The baby's heartbeat was flat as flat could be. No variability. I got her scheduled that day at the hospital for induction. She (unbeknownst to me) went to lunch prior to showing up at the hospital for her induction. When she finally got into the hospital the nurse did all of the admit stuff prior to starting the IV and the antibiotics for the positive GBS status. When the IV finally got started it was more than 3 hours after I had sent the patient in to be induced. I wanted 2 doses of antibiotics prior to delivery, to protect the baby from the GBS, so this meant that we had a further delay. After the second dose of antibiotics had infused, I ruptured membranes and we anticipated a very rapid delivery. Didn't happen. Of course, now it is into darky night. I have worked at the office all day and I'm tired. It is my Friday and I want to be done and go home. The BirthMom wanted to turn off the pitocin and get into the jacuzzi. I had told her that we could do this, even before we started the pitocin. So we turned off the pitocin and let her get into the tub. She was very comfortable there for about half an hour. She informed me that the contractions were getting easier and further apart, so she got out of the tub and we restarted the pitocin. She did the labor dance, the labor moan, the labor on hands and knees and was really working well with her contractions to get the baby out. Then she wanted to get back into the tub or the shower. So - off goes the pitocin again and we assisted her up to the shower. She spent maybe 5 minutes in the shower and she stated that she needed to push. We helped her to the bed. She pushed and I could feel the head move down. With the next push, I could see the top of the head. She pushed beautifully and delivered a really cute little girl over an intact perineium. She did such a great job and they were so happy. Baby went to breast right away and nursed well. Of course by this time it was 3a.m. so I charted, dictated, and when home to my bed. It was a nice birth and a good time was had by all. When I left the big sisters, who had been present for the birth, were holding their new baby sister who really still wanted to be at the breast.

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