And so it goes.

My term Mom from yesterday slept the night and we started some medication to augment her labor this morning at 4a.m. My 7:30a.m. repeat cesarean delivery went great and we got a beautiful baby boy who is a pound larger than her last one and all is very very good. My lady from last night got into an active pattern about 8a.m. this morning and we labor danced and walked and rocked and sat on the toilet and laid in the bed and sat on the ball and switched positions and ultimately ended up with a beautiful unmedicated birth at about noon. This one a girl 8 pounds and change. It was a happy day so far. There was an induction going on which was set up by the MD that I am in practice with. She wanted pain medication. We got her an intrathecal and in hind sight I think an epidural might have been a better choice because it would not have worn off, but I didn't really believe that she was going to be in labor that much longer. After the intrathecal, I ruptured membranes. She got to complete and pushed for an hour after which she said she wasn't going to do this any more. I tried encouraging her, but was unable to change her mind. Her family was upset, but I explained to them that I can't get the baby out vaginally without the BirthMom's help. She didn't want to help, I can not make her do the work. I contacted my MD and we took her for cesarean delivery in the OR. I was sad, because I really believe that if she would have worked with us, she would have delivered vaginally. However, I cannot make her do something that she has decided that she is not going to do. Ultimately, we got a good baby 8 pounds and change. Then I went to the office (mind you it is after 6p.m.) and did an ultrasound scan on a Mom for whom the nurse couldn't find fetal heart tones. I found the baby easy and made some cute pictures for her. While I was scanning her, the nurses left the office and went home. I found this a bit frustrating. I still have charting at the hospital to do and so cleaned my exam room, shut off the ultrasound machine and headed back to the hospital to do my paperwork. My back is tired. My feet hurt. I'm tired and hungry (no breakfast, no lunch, no dinner - yet). I still love what I do.
Tomorrow I talk to students from the nursing program at the local college and then I have office hours. I'm hoping for sleep tonight.