Birth Story of Caleb

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Caleb The Birth Story of Caleb C and I go back a bit.  I was a student during her first pregnancy and delivery and was privileged to be part of many appointments and her birth experience.  She birthed her first baby by cesarean.  When she found out she was expecting baby number 2, she asked me to be her midwife for home VBAC. C had a perfect pregnancy.  Everything progressed beautifully.  C text me early the morning of September 7 to tell me she woke up to contractions at 2am.  They were still distant, every ten minutes, but she felt like this was the real deal.  Funny enough, I had another mom text me that she was contracting every five minutes and I was just leaving to check on her.  M, a dear midwife friend, lived just a couple minutes from C and went into check on her.  C was 1/50/-2.  Baby was still posterior, but contractions were there and regular. I kept in touch with C by phone throughout the day.  Contractions would get a little closer, then space again.  She called her doula over later that afternoon.  M went back over and checked on her at 11pm, and found her to be 3/50/-2.  C was going to get some rest. C text me at 300am the morning of September 8 stating contractions were every 2-3 minutes.  An hour later, she asked me to come.  I arrived to her house a little after 5 and watched her as calm as can be do her labor dance.  Mom and baby’s vitals were perfect.  K made mama and birth team a delicious breakfast.  It was wonderful, calm, peaceful.  At 900am, C requested a cervical check.  She was 4/50/-2.  Contractions had spaced to about every 5-7 minutes apart.  C was tired.  I talked to her about sleeping.  I left and went to my inlaws who were close by and gave C space to rest. I arrived back at 3:30pm.  Contractions were still spacey.  Mom and baby’s vitals were perfect.  It was obvious to me by abdominal palpation that baby was not yet engaged.  I discussed with C about trying the Walcher’s Maneuver (check out spinning babies to get a description) to encourage baby to engage.  I put her in Walcher’s for three contractions.  Of course, when you are waiting on a contraction, it never comes.  Then she walked around her house, rocking her hips.  And then moved to the birth ball.  She continued changing positions to encourage her sweet baby to engage, drop, and get in a better position. Contractions were staying about every 7 minutes.  Around 5:30pm, I discussed with C about trying a pelvic release on both sides to see if it might help.  Contractions stayed spaced out.  Around 7pm, did a cervical check and found no change.  I discussed with C the importance of resting.  We agreed I would go home and sleep.  C would sleep.  She would call when contractions were 3-5 minutes apart, lasting a minute long.  M agreed to be on call and check in on C for the night. September 9 came.  I check in on C in the morning and she was doing well.  By lunch time the contractions were coming close.  C asked me to come around 2pm.  Contractions were every 4 minutes, lasting 90 seconds.  Cervical check found her to be 5/50/-2. C alternated positions often.  Curb walking, lunging, hands and knees, birth ball…. C had to concentrate with the surges, sometimes letting out a light moaning.  I had a heart to heart with C’s doula and convinced her to call someone in to give her a little break.  She was a breastfeeding mama and going on little sleep.  I knew we were still in for the long haul and C would need her doula more when things moved closer to her birthing time. At 7:00pm, C was 6/70/-2.  These harder contractions were making good change. F, the acupuncturist, arrived soon after to moxibustion to encourage this stubborn baby to rotate out of the posterior position.  Contractions were definitely stronger.  C was moaning with each surge.  She felt baby move some during the treatment.  A check around 10pm found no cervical change. C tried to rest.  Tried to move.  Tried sitting in bath tub.  We moved into the early hours of September 10.  C asked me what should we do a little after 2am.  We discussed our options.  Breaking water, transporting.  I was very concerned about breaking C’s water at home.  It was quite clear by palpation that C had an abundant amount of amniotic fluid, along with the high position was a disaster waiting to happen.  After talking and crying, C and K decided a little after 3am that they wanted to transfer to Ben Taub to continue her labor journey with the help of amniotomy in the hospital and epidural to help C rest. We left her home at 4 am for Ben Taub, arriving there at 5am.  Her doula met us there.  C was 7/70/-2 upon check in.  After a couple hours in triage, she got moved into her room.  She got an epidural.  The head obstetrician came and did an ultrasound to get an amniotic fluid index since she too felt that there was a large amount of fluid.  24cm is what she estimated.  Several residents came in and out.  No one wanted to attempt to rupture her membranes.  One bold resident talked to C about the risks and said she could attempt to rupture her membranes very gentle with the tip of an internal monitor.  It would make a small pin point versus the big whole we get with a hook.  C agreed.  As soon as the gentle prick was made, her entire bag ruptured.  C’s bed was soaked.  It took three providers to keep baby in a steady position.  Baby dropped to a 0 station after rupture. After a couple hours, no change was made.  C decided to get the IUPC device and start pitocin to strengthen the contractions to see if her cervix would change. C continued to labor on, no cervical change.  Around 3pm, the head obstetrician came in to try to manual rotate baby.  C’s cervix was super stretchy, but baby’s head continued to get caught on the sacrum.  The OB worked and worked, but could not get the baby to rotate.  The OB told C that she could continue to labor, there was nothing wrong, but that she felt like her sacrum was too prominent and wasn’t allowing baby to rotate and didn’t think a vaginal birth would happen.  Tears flowed down C’s face.  She talked it out.  She decided to go in for the repeat cesarean.  She was happy with her labor experience and felt that this was far different than her first and that she had a fair shot at a vaginal birth.  I reminded C that it was okay to mourn her birth, but be happy to have her baby. Baby Caleb was born at 4:21 pm by cesarean section on Tuesday, September 10, 2013.  He was 7.6#, 20” long.  He breastfed like a champ, and did not have a tongue tie, which was a concern for C.  He looked exactly like his big brother! C was so strong.  So peaceful.  Completely calm and serene through her labor journey.  K was an amazing partner.  I loved how supportive her family was with beautiful affirmations and words of encouragement on her facebook group for her labor.  I will forever be in awe of how beautiful and strong C was through her labor journey.

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