Sorry I haven't been around much lately but things have been so busy! Let me see if I can do an update for you before I head off to the hospital for rounds.
I have had a lot of really beautiful natural childbirth lately. It's been great! I had a lady come in, who I was supposed to meet in the office that week, in labor. This was her third baby and she had had epidurals with the first two. She really wanted to have NCB this time. And she did it! She came in and was 5cms. We tried her in the tub but she didn't like that, which always surprises me because more women then not love the tub, but to each her own! So then she tried the birth ball, didn't really care for that. She really just wanted to lay in the bed on her side. And that made me think of the talk by Michel Odent. He spoke about women who are in active labor should be allowed to rest and that most of them would do that if left alone. He also believes that this is NOT detrimental to the woman's labor. Interesting because we tend to keep em moving more in this country. I'm really proud of myself because I am developing my ability further to just watch and not be a participant in birth unless needed by the woman. It's her show, not mine....after all! I can really tell that I am evolving as a midwife and loving it! Anyway, she progressed to complete and began to push. The bag of waters popped as it was crowning :) And the baby was right behind. She was very controlled and focused. It was beautiful to watch her. She had a great doula (who later posted the whole birth story in detail on a forum in our area - someone saw it and sent it to me, I was spoken of very highly and was so flattered!). Mama was so ecstatic afterwards!
I had another lady the next night, a 17-year-old patient of mine. She ruptured prior to labor starting. We gave her some time to get going but she really wasn't doing anything (no one had checked her but you could tell based on what she was saying and how she looked). Eventually, maybe after 12 hours had passed and she was tired, I decided to give her a little pitocin (with her consent of course) and give her uterus a kick . We only used the pitocin for about three hours, by then she was 5cms, and I shut it off. I wanted to be able to get her in the tub and off the monitor. Most women will continue their labor once established, if the pit is shut off! She moved along at a nice pace and did a wonderful job. Once she started getting restless, I knew she was transitioning but was still worried in the back of my head that she would still only be 5! Just paranoia and yes, some distrust in the labor process (I'm working on this and getting better at it all the time!). She started asking for an epidural so I asked to check her before she made that decision. I told her that if she found out she was close, that might give her that little extra oomph to keep going. She was 9cms! And this was only a couple hours after cutting the pit off :) So forget the epidural. She progressed to 10/100/+2 very rapidly and began to push in earnest. Fifteen minutes later she pushed out a beautiful baby girl! I was so proud of her!
I had one recently who had only a dose of Stadol during her labor. She whined and screamed her way through it. She didn't want to push and wanted me to 'pull' the baby out. The nurse was looking at me like "what do we do to make her push?" The baby looked fine and I told the nurse that eventually she would get tired of fighting it and push the baby out. It was a little miserable listening to her scream and whine. I also felt bad in a way because I couldn't do anything that seemed to help.
Another patient of mine, who had her first child naturally at 36 weeks, came to see me in the office for a labor check. She had been 1-2cms when I saw her the day before for her regular visit. And she was also past 38 weeks, which was weird for her. She was 4/100/-1 and intact bag. But she didn't look particularly uncomfy. I asked her if she wanted to go back home for awhile but she really wanted to go to the hospital now. She just knew that this was really it. So off she went. And she did her thing and delivered 2-3 hours later! Another beautiful, focused birther! And I am always so happy to catch when it's someone I have been seeing in the office throughout the pregnancy. It just becomes extra special...