Monday, November 23, 2015

Welcoming a New Baby to the Team

Time for another birth story of a new teammate. Apparently, I should add accompanying teammates during their births to my job description :) It is one of my biggest blessings and privileges to help teammates during their births. Once again it wasn't what we had expected but in the end we had a healthy mom and baby.

(I should mention that I won't be calling these teammates by their names or telling you where they live in Indonesia so some of the sentences might seem a bit awkward)

One of our new families is in language study is in one of the bigger cities in Indonesia in preparation for serving. They have three kids (including twin boys) already and shortly after they arrived they became pregnant with baby number #4. This momma has always delivered before her due date and this time around she had a couple of dates. The one given by the doctor and the one she knew was right a week later. Just to be on the safe side though I headed out a few days before the due date given by the doctor. Once again though we got to wait. Wait right past the doctor's due and then her due date till she was a week overdue. Since she had never been overdue before it was a surprise to us all and we were strongly debating the pros and cons of inducing labor. Being a midwife and they a family who prefers the more natural route we weren't fans of the idea but also realized it might be time. An ultrasound though showed the fluid level was good and he wasn't too big or too small. Still there was a lot of pressure from the doctor to induce so we agreed for the following morning hoping things would happen in the meantime on their own. 

And things did start slowly and surely overnight. We made the decision to go the hospital on the earlier side of things this time, especially since traffic in their city can be quite a nightmare and their hospital was across the city. Once we got to the hospital she was only a bit more dilated than the night before at the doctor's office and the doctor recommended induction but it was obvious to us that things were getting started slowly but surely on their own, so we declined. A few hours later she was in active labor hanging out on a labor ball we had brought much to the Indonesian staff surprise as they had only seen those in Facebook and YouTube videos. It was way more comfortable than their bed though! 

At her next check she was 8 cm and headed into transition with some spontaneous pushes at the peak of the contractions. The Indonesian midwife who so far had been really supportive of our plans and working well with us (minus her contraction monitoring method which involved poking her fingers into my teammates stomach during a contraction) though wasn't ready to call the doctor. After another 30 minutes in a bed and an increasing urge to push we more strongly suggested it was time to call the doctor but the midwife checked her and she was still 8 cm so wasn't willing to make the call yet. 

That was kind of the end of my patience so I encouraged my teammate to switch to a hands and knees position in the bed. I let her know it was ok to push with contractions and she could have the baby in that position if she wanted too. Apparently that position though really worried the Indonesian midwife and nurse in the room and they were making all sorts of worried looks and talking amongst themselves. My focus was on my teammate though and within a contraction or two she started pushing in earnest which really worried the Indonesian staff and they were quick to order her to turn around in the bed and stop pushing. At this point though baby was coming and despite the Indonesian midwifes attempt to push the baby back in my teammate pushed hard and fast and he came flying out. While he cried right away he did take some help getting going and was quite blue for awhile as I think those final contractions and ejection into the word were quite a shock to him too. The doctor did make it in time for the placenta though which was good as there was some increased bleeding which required several medications to help get it stopped. 

All in all at the end we had a healthy mom and baby even though in retrospect there are some things I would have done differently. For example, I should have thrown out my doula hat earlier and put on my midwife hat and been a bit more willing to offend as I think we would have had a better birth. She would have done fabulous delivering in the upright position I think instead of having to change positions etc which made things feel panicked at the end and not well handled. Overall I was impressed at the amount of equipment and how prepared the hospital was but found it odd that they thought measuring fetal heart tones every couple of hours (or more!) was acceptable. And despite my teammate having a postpartum hemorrhage her blood pressure wasn't measure once either during labor or in the early postpartum period until we had been transferred to the postpartum floor. I was also quite concerned to see the Indonesian midwife so hesitant to call the doctor even though birth was obviously not far away. There are not many women I know who have had babies before and when laboring without pain medication can manage to not push when ordered. 

Here are a few pictures of some time with them. 

The happy moments after birth - well ok the baby was less happy

Our birthing team minus Grandma who was taking the picture

Home from the hospital with big sister and brothers