21 January, 2009

unconventional hospital births, part one

before reading this, please scroll down and read the previous post which sets the scene.

Luisa is a 25 year old mother of 2. I attended her second child´s birth earlier this morning. She was admitted to the hospital around 9:30 am yesterday, unusual because her cervix was only dilated 3 cm. She spent the day laboring in the maternidad room, and around midnight came to the dilatation room. Her cervix had not changed much and her baby was very high in her pelvis. She mostly labored upright, tuning into her body and changing positions at will. The busy staff left her alone while I took turns providing labor support to her and several other women. Luisa experienced a lot of low back pain and appreciated my counterpressure to her sacrum.

At 1:40 am she was assessed and found to be dilated to 9 cm. But the baby was still very high. The Obstetra (University-trained medical model quasi-midwife) decided to break her bag of waters and see if that would bring the baby's head down. If not, a cesarean section was threatened.

Luisa began to push a little at the peak of her contractions. This is really common as women open up the last 2 centimeters or so. The Obstetra and all her intern students were attending women in the delivery room, so I was alone with Luisa and Andrea. Luisa clearly felt uncomfortable sitting in the enlarging puddle of amniotic fluid, so she edged to the side of the bed and I dropped the wet linens on the floor beneath her legs. I placed a dry sheet behind her in case she decided to get back up there.

Her contractions became quite intense and she grabbed me and held on with each surge. Several times she cried out "Ayudame!" (Help me!).

At 2:25 or thereabouts, she stood up, clasped me with both hands, squatted down low and emitted a primal, guttural roar. I heard a sploosh! and assumed more amniotic fluid was emanating from her yoni. I looked down.

I saw 2 greyish-purple legs kicking around.

"OH MY GOD!" I yelled, scooping the baby off the floor and placing him onto the dry sheet on the bed. He was slightly blue but had excellent muscle tone, cry, and respiratory effort. Babies are really resilient.

Luisa stood next to the bed, still coming back from her labor journey, very much in an altered state. Blood trickled down her legs, mingling with the amniotic fluid and terminal meconium at her feet. Meanwhile her earthside baby was gently transitioning and pinking up thanks to his still-intact umbilical cord.

By this point the Obstetra and several interns had run into the room, assessed the situation, and gathered their tools. They immediately set to work cutting and clamping the umbilical cord, because that's their modus operandi. Baby boy was whisked away to nursery for evaluation. (He is totally fine.) Luisa reclined on the bed, where she received a routine shot of pitocin in her hip, and her placental delivery was actively facilitated. She did visit the delivery room after all this morning, for a second degree laceration repair. Probably she tore through the episiotomy site from her first baby. (Insert your own opinion about episiotomies and perineal integrity here.) All the while, the Obstetra chided her and tried to feed her a huge guilt sandwich for pushing out her baby onto the floor without telling anyone.

Lady, it's over. Birth happens. Let it go.

Luisa was a woman birthing in her power. What a privilege to witness.


Sam said...

Holding back tears.

katie said...


I'm so grateful you're blogging about this so we can share a bit of the journey with you. Incredible.