Sunday, May 19, 2013

24 Hour Postpartum Visit

After a home birth the midwife will come visit at 24-48 hours to check on everyone. Even though the boys were already in bed when she came, they know and love Ms. M and were peeking through the bedroom door when she arrived. I gave them a nod and they were in like lightning, grabbing her stethoscope, which they called a telescope. Isaac went and got his own medical kit to be like Ms. M.

By the way, have you heard a 3 year old say "stethoscope" before? You need to. Immediately.
Jared told us he was going to check Katie with the "telestethoscope" and listen to her heart beat :)
 Isaac got out his "telescope" and then used the real one to check Katie as well.
 M is in the background filling in paperwork about our stats.
 And now she gets a turn ;)
 Checking her all over...

 M is so amazing that she was able to get Katie to poop AND burp during her visit! AND she changed the diaper. Rock on!
She checked me as well- my bp was good and I'm recovering very well. I had a small tear straight along where they gave me an episiotomy with Jared's birth. It's very superficial and does not require stitching (hooray!!!!) but I do have to stay away from our stairs for a few days to let it heal.

At the end of the appointment I asked M for some more details about the birth of Katie and her cord. Basically, this is what she said:

Mom and Baby BOTH contribute to the labor. If there is a slow labor pattern, it can be because the baby is not in a good position, or there is some kind of issue, like a cord. The body allows longer breaks between contractions to allow for the baby to progress down slowly and safely. M monitored the baby's heartbeat and my blood pressure often through the night. There was never a concern as we both stayed consistent and within normal limits. As a result, it was best to let me progress naturally, even though I wanted to have my water broken much sooner. She broke my water at 9 am. At 9:22 her head came out and M immediately checked for the cord. It was there and it was so tight that she was not able to get her finger between the cord and her neck. She told me to push again and I did, but Katie did not move forward. At that point, she told me to turn onto all fours and she started draining the tub. She had to drain the tub because the water level was right at that point where Katie could get air and we had to make sure she was either under water the entire time or out of water the entire time. (This is why I never intended to birth in my tub in the first place- we knew it was too shallow.) When I got onto all fours my pelvis was able to open much more. My legs were too close together the way I was lying on my back. When I got onto all fours I pushed and her body came out and went back in again. This was a good sign- often the baby will go out and then back in some and then out some more. You want movement to be happening. I pushed right away again and most of her body came out. It took one more push for the rest of her to come out. As she came out, M was able to slide the cord down her body. There are different ways to release a wrapped cord. Instead of pulling it over her head, she pushed it down and curled Katie's body down between my legs so I could take her in my arms. She was limp when I took her and M was telling the assistant to get the oxygen before I was even sitting with Katie in my arms. However, before the assistant was even down the stairs she was crying, moving and pinking up. (The midwives always bring oxygen to the births. It was set up downstairs since we were planning to birth downstairs. But that's part of the beauty of homebirth- you can be wherever your body wants to be. :) Also, this is why there are always 2 midwives- one is to assist the Mom, and the other is to assist the midwife). M and I rubbed Katie's back, put a warm wet towel around her and talked to her. She actually started moving and making sounds very quickly- I never had a chance to even tell her to breathe. She had an 8 on the Apgar for her first score and a 10 for her second score. The pushing stage was 6 minutes long.

I asked M what would have happened had I been in the actual pool downstairs. She said the same thing, except there would not have been a need to drain the water. She would have unwrapped the cord the same way she did and simply kept Katie under water during it. Had she not been able to pull the cord around her body, she would have cut it. When midwives come to a birth they come prepared with tools, including tools needed to cut a cord if necessary. Thankfully, the cord was able to be left in tact so we could leave it to continue pumping after she was born. The cord is the baby's lifeline and it provides oxygen and nutrients while the baby makes the transition to extra uterine life. M also pointed out that there was a lot of jelly around the cord, which was great! It protects the blood vessels within the cord which means Katie was able to receive everything she needed.  As M said, we do not need to be afraid of cords, our bodies are beautifully designed! 

The cord is something people always ask about- it's something we asked about during our research into home birth. The best possible thing to do was to allow Katie to labor down slowly and I'm so grateful we were home and in an environment where we could do that and we were not rushed to have a baby by a certain hour. M was so calm and did a great job at helping me wait through the labor. She was quick, professional and again, calm, when the cord was there. I never once had any fears...well, except when I started fearing that Katie was never coming out ;)

I can honestly say I love my midwife. She grew to become a part of our family and she was there to make sure I had the safest birth possible :)



1 comment:

Pam Hamilton said...

Thanks for explaining all of this.
Pam