Midwife Mondays 23: Water Birth, Back in Theatre and a Couple of Really Squidgey Babies!

So I know this post is a few hours late – I try to get these out first thing on a Monday morning but I’ll be entirely honest with you, I hadn’t even started writing it at that point today…it has been such a busy week. I know I have said this a few weeks recently but this week really was a bit mad.

Today is my day off and it’s taken me until nearly 1pm to be able to focus my brain enough to sit down and write this post…definitely feeling a little bit run down today (I may have a BUCKET of tea by my laptop and Harry Potter and the Half-Blood Prince on in the background….perfect chill time set up really!)

Ok, so here goes – I’ll try not to waffle on, because I’ve got a lot to share with you guys this week (as always, the order of events has been changed for confidentiality reasons)

Skills Lab
We had another skills day in uni this week. This one was a bit of a general recap of the stage of labour, in a practical way – admission to hospital, first stage of labour, pushing and labour positions for that, delivery of the placenta, inspection of the placenta and estimating blood loss – I wouldn’t say we learnt any specific skill for the first time, but it was a good overview of everything ahead of the next 5 weeks of placement working on the Midwife Led Birth Centre. Plus, it’s always funny to deliver a baby from a mannequin, with the use of copious amounts of fry-lite as a lubricant!!

A Super Speedy Water Birth
On shift this week we had a lady come in with her mum and husband for assessment in suspected labour. We brought her in and did the admission assessment – monitoring her contractions, checking her obs, listening in to her baby etc and we decided that she was advanced enough in her labour to keep her in the hospital and start labour care. She was coping quite well with her contractions, and had requested to get into the pool, so I ran it, and helped her in. This was her first baby, and generally, though not always (as I soon discovered!), with a first baby labour takes a while longer than if you’ve had one already.
This lady, however, broke all of the generalisations, as she sat in the pool, only half an hour after arrival, and called “I want to push!” – we had barely got her settled in the pool, and hadn’t expected things to happen so quickly so we popped a mirror in the water to see what was going on, and there was the top of her baby’s head! Within 3 pushes she had delivered her beautiful little girl into the water, and I pushed her through her mother’s legs so she could bring her straight up onto her chest. It had been less than 40 minutes from her arrival in the hospital to her baby’s arrival in the pool – amazing! She was so thrilled that it had happened so quickly – and her timing had been perfect! If she had stayed at home much longer, she may well have been one of those stories we all hear about where the woman delivers in the back of the car!

Pre-op Appointment and Elective Ceasarean
One of the ladies on my student caseload had opted for an elective caesarean with this pregnancy, having had an emergency caesarean with her first. This week, she turned 39 weeks and so it was time for them to bring her little baby into the world!
Early in the week she had a pre-op appointment – the procedure and anaesthetic is talked through, then we had a check of her baby, and handed over the consent forms for her to sign before the surgery.
On the day of the surgery, I met the couple in the hospital at 7am, got them settled in a side room, and we awaited the arrival of the anaesthetist and then the consultant, each of whom talked them through it all again and checked all was ok. She was second on the list of elective caesareans that day so we waited around until about 9.30 and then headed across to theatre. There the team placed her cannula, took her and her partner into theatre and performed the spinal anaesthetic.
Within 20 minutes, her gorgeous little boy had been placed onto a blanket in my arms, checked over and then put straight onto her chest, having a proper little cuddle while they finished the surgery and sutured her up. All had gone completely to plan and it was so lovely to see this wonderful couple, who I have got to know quite well through their pregnancy, with their gorgeous new baby!
Caesarean sections have their place, and I definitely wouldn’t say they are for everyone, but for this particular lady, she knew what she wanted, and she got it – she’d had a scary experience with her first and she wanted to avoid that with her second, and as far as I could tell, by having this elective section, she had managed to do just that.
I popped back into the hospital the next day to see her and she was already up and about, and really happy about it – and I got a proper baby cuddle too! 🙂

Home birth
I was at the hospital the other day, and it was so so quiet. Unbelievably so. So when a call came it to send the community midwife on the late shift to a home birth, and there was a slight confusion as to whether there was going to be a second midwife present, I offered to go with her. We hopped in the car and about 20 minutes later we arrived at the house, about 4 minutes after the baby’s delivery! There was already a community midwife there, who had been there to catch the baby, but it was way past the end of her shift so we relieved her and stayed to deliver the placenta and monitor mum and baby for a few hours.
I do think home births are really special – this woman had 4 children already and only her first was born in a hospital. Within a few hours of birth, we had left her and her husband to it with their new baby – happy and well and snuggled up on the sofa. She seemed so relaxed and safe having delivered at home – obviously, it isn’t for everyone, but for her it seemed to be the perfect fit!

My 8th ‘Catch’ – A Baby Girl
Women are amazing. I came on shift the other day and started working with a really lovely couple expecting their first baby. I spent the whole day with them, with her contracting really well, and her baby still really happy, it was just a case of waiting really. The room had a really calm feeling to it the whole time, with a GREAT playlist going (I definitely should have asked them what the playlist was – I want it in my flat!) and talk kept to a real minimum to help her keep her focus, it was a really lovely “vibe” the whole day.
Finally, after 52 hours of painful contractions, and over 8 hours in established labour, she managed to deliver a gorgeous little girl – she did get a little stuck on her way out, but we managed to release her shoulders and all was fine. When it came to weighing the baby, it became quite obvious why she had spent nearly two hours actively pushing, and why her baby had struggled to fit on her way out – she weighed nearly 4.3 kilos – 9lbs 7oz!
She was a proper little squidge with the most gorgeous baby chub! I went to see them the following day and the baby was wearing a babygro that was sized 3-6 months! I’m still amazed that the mum managed a normal delivery – she did so so well – and she did it all with only gas and air (and even that she used REALLY sparingly!) Very impressive indeed!

Another Caseload Baby
This week, another of the ladies on my caseload was having her labour induced so I headed up to see her while they started off that process. Her body reacted really well to the induction, so they didn’t need to do anything more than the vaginal pessary, which is the “first step” of induction. Within an hour she was contracting regularly, and a matter of hours later she was moved from the induction bay to the delivery unit as she was in “established labour”. By this point, however, it was the end of my shift (as I’d been dotting between her and my shift on the birth centre all day) so I had to head home to get s are hours sleep. I gave the midwife in charge of her care my mobile number and headed home, knowing that she would call when I needed to head back.
I woke up the next morning to my alarm, not to my phone ringing, and immediately thought of her. Had she delivered and I hadn’t been called? Was she still contracting as strongly as she had been when I left? If so, she must have been in so much pain for so long!
As I dragged myself out of bed to head into the hospital however, I received a call saying they were taking her to theatre – the baby was getting a bit fed up and so they were opting for a caesarean section. I rushed to the car, and got there just in time to head into theatre and settle her gorgeous little boy on her chest.
He was another baby covered in the most gorgeous baby chub – her baby was even bigger than the not-so-little girl I had delivered this week – a proper little “chunky monkey” (her words, not mine!)
It was so lovely to see her so relieved to have him in her arms – it’s a real honour to see that moment, when a couple see and hold their baby for the first time. Really special.
Unfortunately, her gorgeous little boy needed a dose of antibiotics and some glucose so he was taken up to NICU for monitoring and medication – I went with him, and his daddy, for a bit of moral support and I’ve been told he is doing really well now – thank goodness. I’m gonna try to pop in and see them tomorrow when I’m in the hospital too – see how they are all getting on. 🙂

As you can tell, it’s been a pretty full on week, and there have been some tricky moments, but it’s been amazing to be so hands on and active on the placement – yes, I am really enjoying having today to rest and recuperate, but I’ll be ready to be back at it tomorrow – I honestly have the best job in the world!

Image by Ignacio Campo

To read last week’s “Midwife Mondays” post, click here