Now with a date and time in mind, Andrea and I began to make plans. She would go to the hospital, get settled in, try to sleep and keep me posted. I received a text message at 1:46 AM on Friday, March 27. Andrea had checked-in and was waiting for her first dosage of Cytotec. The doctor had left directions to give her one tablet (50mg) every four hours. She was also a little disappointed because she didn't believe that her sister would be able to be at the birth. I told her everything would work out just fine and I encouraged her to sleep through the night and call me if anything changed.
I didn't get the next text message until 2:14 AM. "No surges yet, they haven't administered the med yet...was told we can bring a ball." The next message came around 7 AM and it resounded of disappointment. Andrea explained that she had only dilated 1/2 cm in 4 1/2 hours, and was taking her second dose of Cytotec. I called her right back and added my own interpretation: You are progressing! It was so difficult that this induction was such a slow process. She waited patiently, anticipating change, and saw very little. Her patience was an attribute that continued to shine throughout the day and into the night.
At 2:07 PM, Andrea called to let me know that there was talk about rupturing the membranes and starting Pitocin. I encouraged her to get up and walk. I was already on the way to the hospital, so I just increased my speed! When I arrived at Redlands Community, I checked in at Labor and Delivery and was greeted in the hallways by a "roaming" Andrea. We walked for about an hour and tried to distract ourselves from the interventions scheduled for the day. Andrea was very relaxed, focused and positive--three factors that would serve her well in the upcoming hours. The doctor ordered the pitocin at 3:30 PM and followed the procedure by rupturing the membranes at 3:35 PM. It was quite a bit for Andrea to deal with all at once. Instead of being able to adjust and allow her body to work through each stage, she had to cope with both events simultaneously. She did a splendid job. I dimmed the lights in her room, sat by the foot of her bed, and gave her a massage--focusing on each joint in her foot--while she listened to a relaxation script on my iPod. She once again went into a zone and found peace. Her dad was in the room, and added to the environment of calmness. He was a fixture of stability as he sat by the window, quietly in awe of his daughter's resolve. He had driven Andrea to the hospital and hadn't left her side.
Andrea's mom arrived after work, and she too slipped into the room almost undetected. I was very impressed that Andrea's family was able to surround her with love and support without interrupting the peace that Andrea was creating in the room. They were consciously helping Andrea by anticipating what she needed and silently providing it. Mom adjusted the temperature of the room, offered ice chips, secured a second blanket; Dad silenced the beeping machines, kept the cell phones quiet, gave Andrea space, and fed the family (including me)--all without being asked. The team worked together like a well-oiled machine. I was fortunate to meet all of them.
We continued relaxation techniques and utilized the birthing ball until around 5PM, when the surges forced Andrea to sit quietly and dig deep for comfort. She sat back in her bed listening to relaxation music. By 5:40 PM, Andrea was exhausted and feeling pressure to an extent that she wanted something to take the edge off. She was at 4 1/2 cm and at station -1 when the nurse brought Nubain and administered it through the IV. Andrea slept between contractions and was coping very well. All her work was paying off. She was yielding her body to release the baby into the birth canal. She tried to get comfortable as she worked through the next hour of strong surges. At 6:30PM, she asked for another dose of Nubain and was told that she would receive it at 6:45. The clock went passed the deadline and all feeling had returned. By 7:20 PM, when the anesthesiologist offered the epidural, she was ready for any relief she could get. She was dilated to 5, 90% effaced and at station 0. I assured her that the labor she had participated in had brought her daughter closer to her, and I would help her though any path she took.
Following the epidural, her pitocin was increased to 4 or 12ml/hour. The epidural allowed Andrea to relax, get her second wind and concentrate on the next phase of labor. Adding to her comfort was the arrival of her sister, brother-in-law and nieces. All the family respected the mood of the room and added another dimension of peace. Andrea's sister would be at the laboring mom's bedside through the delivery--a scenario we didn't think would be possible just a few hours before.
We all knew birth was imminent. At 8:45, Andrea's nurse announced that she was dilated to 9 and at station -1. The next exam came at 10:00 PM after Andrea explained the pressure she was feeling--her feelings were confirmed with a dilation of 10 and 100% effacement. We were preparing to push!
Andrea's nurse was a God-send. She allowed Andrea time to slowly encourage the baby to move down the birth canal. Andrea took a cleansing breath, inhaled, curled over and pushed for a count of 10. The sister and I provided counter-pressure and I helped Andrea curl up. She continued this for three consecutive breaths, and then took a short reprieve. Her strength, which she found from a place deep inside, served her well. She never faltered--never gave up. She performed like an Olympian. Each push revealed more of the little girl's hair. Her head slowly stretched the opening while the nurse massaged the perineum. By the fourth set of pushes Andrea asked for a mirror and she was introduced to the show her sister and I had been so captivated by. No longer was her daughter a bulge in her tummy, she was there, inches away, readying to enter this world. The bed-side nurse continued her ritual of message until the baby was a couple of pushes shy of delivery, then she requested the doctor. We attribute the success of the third stage to Andrea's strength and the nurse's compassion. The doctor still decided to give Andrea an episiotomy when he took his position at the foot of the bed. The pushing that had begun at 10:10 PM, climaxed with the birth of Andrea's daughter at 11:10 PM. The little angel weighed 7lbs. 3 oz. and was 20 inches long. She responded right away to her mommy's voice and began breastfeeding in her mommy's arms. The family once again surrounded Mom with love and affection--an environment that will nurture and develop Andrea's baby into a beautiful young lady--just like her mom.
What a privilege to share such an intimate moment with such a wonderful family. Once again I was amazed by the power, resolve, strength and determination that a woman was able to display bringing a life--her life--into this world.
Christy Jo Hendricks, Doula