I.am.exhausted.

Posted by D

I'm trying to figure out whether my exhaustion is a result of something with my health, or just my general state of circumstances at the moment. Several nights of disrupted sleep from a few births and also a 3 year old who is waking up at 3 Am and insisting that he wants to go play with his friend outside, does nothing to improve my sense of well-being.

It was an interesting week of births. Only 4...although I guess to some that sounds comical. Only? Four births with 3 different midwives. It both exhilarates me and exhausts me just thinking about it. I came away from all four births with lessons learned.

The first birth was so gratifying. The midwife (DC- we'll call her), worked with my precepting midwife for about 5 years. She is a CPM, who only does births for her conservative Christian church group. Unfortunately, because I am not affiliated with this group the couple was very put off that DC was going to bring me along. After an hour and half conversation, they relented. I volunteered to wear a long skirt (to my ankles) and a long sleeve shirt as well. This put them somewhat at ease.

The mom started labor and was contracting about 3 minutes apart when we arrived. She was extremely resistant to any vaginal exams and I was thrilled that the midwife did not push the issue. This was baby number 4 and her largest to date had been 7 lbs. This baby was predicted to be 10+ lbs. While they labored we reviewed steps for shoulder dystocia and discussed other dynamics that were happening throughout the day.

At one point, I was with the mom in the bathroom and she said, "I am so happy that you are here. You have such a wonderful midwife personality. This is exactly the birth that we were hoping for." I was shocked, after knowing their feelings on me coming previously. The labor progressed much slower than we anticipated, but eventually with a lot of work, the mom was complete. She pushed for two hours and the baby still had not come any lower than a -2/-3 station. We transported. While I waited with the children, the midwife and the couple rushed to the hospital because by now the mom was exhausted and beside herself with discomfort.


About an hour later I got to the hospital and expected to find them either prepping for a c/s or with an epidural and pitocin. Ha. Imagine my surprise when I walked in to find mom with a beautiful 9 lb 11 oz baby girl!! The CPM, unlicensed in Pennsylvania (no licensing here), was told to catch the baby, that came less than 5 minutes after they arrived at the hospital!

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baby of the week was a lovely primip birth. The couple was young and so excited. They labored most of the night and into the morning. The mom worked so hard! She pushed for less than two hours and gave birth to a beautiful little boy, squatting beside the bed. My precepting midwife takes every Monday off, so the backup midwife caught this baby.

We do prenatals on Tuesday and Thursday. They are long days with 6-8 hours of appts sometimes. This Tuesday one of the mothers was coming whom we had all been worried about. Her husband had been in a motorcycle accident two weeks earlier and was in a coma, not expected to recover. They were both about 30 years old, expecting baby #4. When she came she told us how he was doing, how she was doing and indicated that she was ready for the baby to come. Given the circumstances and also the fact that my midwife was going on vacation in a few days, she discussed the options for induction later that night. She chose to do the induction. We got called to her home hours later, where she labored quietly with her sister and a new doula. When the midwife checked her she was 7 cm, they decided to break her water. While I went downstairs to get something, she went from 7 cm to the birth of her baby in 13 minutes!! What a woman! It was a beautiful birth and she was so thankful that she and her husband had discussed names before his accident. Baby Elliott came in the most peaceful way, while his father lay in a hospital bed 30 minutes away fighting for his life. I went to bed that night beside my husband, thankful for the many blessings in my life.

The last birth of last week, was a VBAC mom, with 9 children. She was less than 5 ft tall and the last baby (the c-section) and was about 91/2 lbs. The midwife wanted her to try a castor oil induction (with homeopathics), so that this baby wouldn't be so big and also because she (the mw) was going out of town. This mom also had a baby who almost died at the breast while nursing immediately postpartum and so the midwife and mom had a long relationship and they didn't want any other midwife to do the birth. I got a call about 1 AM that the mom was contracting and to leave quickly, as she births quickly. As I was ready to leave, I got another call to go directly to the hospital. The mother was bleeding too heavily. I arrived at the hospital about a half hour later, just as they were wheeling her into an emergency c-section. We waited for a few minutes with her husband and then got a call that the baby was born...huh? Baby born? It had only been about 5 minutes since they had taken her back. C-sections are quick, but not that quick. We went back to the OR to find a happy mom, happy baby, and a flurry of activity and surprise from the nurses and doctor. Just as the anesthesiologist was getting ready to give the mom general anesthesia, the doctor decided to check the mom's cervix one more time. Surprise!! She was complete and the baby "right there." He broke her water and voila! A baby was born in 2-3 pushes. It was decided that the blood was likely from a partial abruption, and the estimated blood loss about 1600 ccs total. They cleaned the pair up and sent them back to postpartum room. The couple decided against the tubal ligation that was offered with the cesarean section.

It's almost a week later, with no births. I am much more rested and have enjoyed the break and being able to spend some uninterrupted time with my family. My midwife is on vacation so I am doing the prenatals for the week by myself. I'm having a great time and looking forward to what the next birth has to bring!