Birth defying the odds - Stories and Text Pastebin

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Birth defying the odds By fishy9890 on 17th August 2021 12:40:41 AM

BIRTH: DEFYING THE ODDS – Veritascara
Thank you to all my fabulous L&D friends for their encouragement on this series! Here’s story number two. What does a vaginal delivery look like to a labor and delivery nurse? This is one from a few years ago, but the extraordinary situation has always stuck with me.
No trigger warnings for this story, but if the relationship described herein bothers you, please simply ignore it and take the beautiful birth for what it is, or skip this read. I am not trying to make a political statement, simply telling a true story.
——————————————————————————-
“Your patient’s a forty-seven-year-old prime? You might as well just cut her now.”
“She’s doing really well, though, and she is starting to get uncomfortable now,” I answer my co-worker, skirting her pessimism as best as I can. I know I sound defensive, but at this moment it’s really all I can do. I hate ending up in the OR after laboring a patient for hours and hours. I’m not ready to let my mind wander there.
A dinging sounds from the computer in the corner, and my gaze refocuses on the bank of computer monitors mounted high on the wall on the other side of the desk, a dozen different fetal heart tracings playing across them. A quick glance reveals that my patient’s baby has run away again, and I propel myself out of my chair towards her room. It’s the middle of the night now, and my patient is still slogging her way through a long, hard induction. A week past her due date, we’ve been throwing medications at her for well over twenty-four hours to try to convince her body to go into labor, and while she’s finally starting to feel the effects of it, her cervix sure isn’t going anywhere fast.
Opening the door, I move silently into the dimly lit room. My nose is hit with the strong aroma of lavender oil, and I offer up a silent thanks that I don’t have to deal with the headache-triggering fumes of peppermint tonight. My patient sits on a large exercise ball at the side of the bed, quietly, rhythmically breathing in and out as another contraction fades. She is slender and graceful, her long, mostly brown hair draped across her left shoulder, interspersed with just a few strands of gray. A few lines grace the corners of her eyes and mouth, but were I not privy to the details of her chart, I would easily think her ten years younger. In front of her kneels the doula, massaging her feet with care. Perched awkwardly on the edge of the bed and clutching her right hand sits her partner. Her gaze steadily fixed on her partner’s face, she runs her other hand through her cropped salt-and-pepper hair and draws her lips into a tight, thin line; she radiates anxiety and concern, looking every bit the fifty or so years to her credit.
Every time I step in the room I briefly feel a little bit daunted by the knowledge that either of these women could easily be my mother—could be a grandmother to my own infant daughter. But here I am, her nurse, and I know my job, and know it well. I move quietly to squat down at my patient’s side, smiling up at her gently as she opens her eyes to acknowledge my presence.
“I just need to adjust your baby’s monitor again,” I tell her. Keeping a continuous heart rate tracing while a mom is on the ball is not easy, but intermittent monitoring isn’t an option with the medications, so I do what I must and reach under her gown on my baby-hunting expedition. In just a few moments, the steady beating of the baby’s heart is audible again on the monitor, and I pull a second band over the round monitor piece on her belly to try to brace it at the awkward angle it needs, just in time for another contraction.
“Take a deep cleansing breath,” the doula instructs, “and then breathe slow. In through your nose, out through your mouth.” And the patient follows her instructions as best as she can, but I can see that she’s starting to struggle. She has been doing this a long time now, and pitocin is not kind. I guiltily look at her irregular contraction pattern on the computer screen. I’m going to have to turn the pitocin up again, I think. I always feel cruel increasing the rate when someone is going natural and hurting.
As her breathing slows again, she looks up at me, “I don’t think I can keep doing this.”
“You’re doing an amazing job getting through these contractions,” I encourage her, and the doula nods and smiles her assent.
“Do you think … do you think I could get checked again?” she asks. I can hear the hesitation in her voice, and I know she’s scared that maybe this won’t give her the boost of encouragement she’s looking for.
“That sounds like a good idea. It’s been a few hours. I’ll go find your midwife, so she can check you,” I reply. She gives me a small smile, which I return as I rise and step out of the room to go page the midwife, pushing my thoughts of increasing the pitocin aside for now.
I return a few minutes later following behind the midwife, a sunny presence in the middle of the night with her short, sandy blonde hair, freckles, and wide smile. She stands near the patient, watching how she copes through a couple contractions, before helping her get up off the ball and move to the bed for the exam. “You’re doing awesome,” she effuses, pulling the sterile glove I’ve handed to her on her hand. “Ok, lots of pressure now,” she warns the mom as she finds her cervix. I watch her cheerful face become a blank mask and know that what news she has won’t be what the patient is hoping to hear.
“Well, your cervix has changed a little. You are two centimeters now, and a little thinner, as well,” the midwife states, trying to maintain a tone of calm optimism in her voice. My own heart falls at her words, and turning my face away towards the computer to chart, I purse my lips and take a deep breath that is not quite a sigh.
“Two? Two centimeters?” my patient replies. Her voice is a mixture of anguish and confusion, and she grasps the hand of her partner tighter for comfort as her eyes threaten to leak fresh tears. At this moment, hope feels very far away. Hope that she can last. Hope that the pain will end soon. Hope that her body will make it to a vaginal delivery. “What do we do now?” She asks the midwife quietly.
“You’ve had the pitocin going for several hours now, and we’re turning it up as we are able to try to get your contractions stronger and more regular. The one other thing I can do at this point is to break your water. Sometimes that helps the baby’s head to come down and put more direct pressure on the cervix, which can help your labor progress better. I don’t usually like to do it this early, but there aren’t a lot of other options right now. It does increase the risk for infection, so after that I would check your cervix only when we absolutely need to,” the midwife offers.
“Ok, let’s do it,” she agrees, and her partner nods her head as well. “But …” and here she hesitates, torn briefly between her dreams and tormenting reality, “but I don’t think I can keep doing this without anything. Could I get some medicine to help? I don’t want the epidural, just something to make it easier.”
“Being induced is really, really hard, and you’re doing an amazing job,” the midwife, still sitting on the end of the bed, assures her. “But you can have something in the IV, if you would like. It’ll help you to relax a little bit and take off the edge off the pain, although it won’t take it all away.” And turning to me, she says, “I’ll order some fentanyl.”
I nod and hold out the long, and now very familiar, yellow plastic hook to her, so she can rupture the bag. I put on some gloves and grab a clean towel and chux to replace the ones the patient sits upon, which have been quickly soaked with clear amniotic fluid. That done, I run out to the med room and pull out the medication, returning as quickly as I can to the room to give the laboring mom the dose and telling her more about it as I do so, “The fentanyl will probably make you feel dizzy and drowsy, like you’ve just had a couple of drinks, so you shouldn’t try to get up for a little while. Like the midwife said, it won’t take the pain completely away, but it should help you get through it a little bit. This medication is short-acting, though, so it wears off quickly, usually in about an hour, and I can get you more then, if you want it.”
She acknowledges this and smiles, a tired, but genuine smile, “Thank you.”
She closes her eyes and yields herself to the medication. And for a few contractions, I watch her cycle between breathing methodically and melting into the bed in drugged exhaustion. Her partner and doula remain close to her side providing support, and for the moment I feel extraneous. “I’ll be back to see how you’re doing in about fifteen minutes,” I tell the group, softly.
“Thank you,” her partner replies, looking up at me, gratefulness written on her face.
I return to the room a few minutes later, and instantly, I can feel the shift in the atmosphere. My patient is breathing hard through her contractions, moaning as they reach their peak, even though the medication should still be in full effect. The once-irregular contractions are suddenly coming every two minutes, so I move to turn down the pitocin by a couple milliunits. Breaking her water has clearly done its job. Her own body is taking over in a big way.
Instead of returning to the desk, I linger in the room, crouching by her side, whispering soft encouragements, watching in quiet fascination as she surrenders to the sudden gale-force power of her labor. She is a palm tree bending before a hurricane, holding on with all her might in hopes that she won’t break. She is a kid who was just running through sprinklers, now suddenly facing a fire hose.
Contraction after contraction passes, each more powerful than the last. Her moans continue to increase in volume, becoming low and guttural. As another contraction washes over her, she restlessly curls around her abdomen, grabbing at anything in her reach. She shivers uncontrollably.
I read her movements and sounds. I know what I’m seeing, but it’s hard to believe them. “Are you cold or just shaky?” I ask.
“Not cold. I just … can’t … stop it,” she replies.
“Don’t try to fight it. The shaking’s normal. Are you feeling any pressure down in your bottom or feeling any need to push? Kind of like you have to go to the bathroom?” I question her, hurriedly.
“Yes,” she gasps out. She doesn’t have any spare energy to focus on speech right now. Another contraction takes over and she moans low and deep, tightening the muscles of her abdomen into an involuntary push. It’s been barely an hour since the midwife ruptured her membranes, but the signs of transition are unmistakable. She needs to be checked again, and my instincts tell me that I shouldn’t wait for the midwife to get here to do it. It’s ok. At least the one on tonight isn’t vagina possessive, like some of the others are. She won’t be upset, I rationalize. If she were a doc patient, I wouldn’t hesitate even a moment.
“If you’re feeling like you need to push, I really need to check your cervix now. You might be going really fast,” I tell the mom, snatching a sterile glove out of the drawer while the doula helps her get into position.
“Okay, cold gel and lots of pressure now,” I warn her, as I insert two fingers. They don’t get far, running into the baby’s head almost immediately. I move them in further, sweeping all around the baby’s head, and feel nothing, no cervix at all. Holy crap, she’s already complete, my mind spins.
“You’re ten centimeters!” I announce, a smile I just can’t help beaming across my face. Both the patient and her partner gape at me in astonishment, and the doula cheers. And I fly into action, calling the desk to send the midwife in, turning on the radiant warmer to get the blankets warm for the baby, and pulling the delivery table out of the closet to set it. I am everywhere at once.
The midwife strides in, her own face a mixture of surprise and delight. “Wow, you’re complete! I guess it’s time to start pushing.”
It doesn’t take long. A few contractions of pushing later, and I call for a baby nurse. A couple more after that, and the midwife is lifting a beautiful baby boy into my patient’s waiting arms, where he lets out a strong, lusty cry. The baby nurse swiftly dries him off, and I help the new mom pull the hospital gown off her shoulders, while her partner cuts the umbilical cord with shaky hands. The other nurse moves the tiny boy up to his mother’s chest, laying him against her skin and covering him with fresh, warm blankets.
The patient looks to her right at her partner, and they share a brief laugh. Matching looks of relief and joy adorn their faces. Matching tears shine in their eyes. After all that wait, for it to suddenly go so fast, so perfect … it’s overwhelming. And in this miniscule moment, they are lost in their own world. Nothing else exists beyond the three of them—mom, mom, and baby.
I keep moving around the room—fetching the midwife the sutures and lidocaine she needs to repair a small tear, starting the postpartum pitocin when it’s called for after the placenta delivers, charting the delivery record every spare second I get. But all the while, I’m still basking in the joy that floats all around me. There’s an intangible euphoria, a strange kind of high you get after a birth like this. It’s soothing, it’s happy, and there’s no crash afterwards. (Well, if you don’t count getting a crash c-section later, that is.) It’s living, inhalable beauty.
And all of this is why I do what I do. These are the shifts at work I live for.

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BIRTH: DEFYING THE ODDS – Veritascara

Thank you to all my fabulous L&D friends for their encouragement on this series! Here’s story number two. What does a vaginal delivery look like to a labor and delivery nurse? This is one from a few years ago, but the extraordinary situation has always stuck with me.
No trigger warnings for this story, but if the relationship described herein bothers you, please simply ignore it and take the beautiful birth for what it is, or skip this read. I am not trying to make a political statement, simply telling a true story.
——————————————————————————-
“Your patient’s a forty-seven-year-old prime? You might as well just cut her now.”
“She’s doing really well, though, and she is starting to get uncomfortable now,” I answer my co-worker, skirting her pessimism as best as I can. I know I sound defensive, but at this moment it’s really all I can do. I hate ending up in the OR after laboring a patient for hours and hours. I’m not ready to let my mind wander there.
A dinging sounds from the computer in the corner, and my gaze refocuses on the bank of computer monitors mounted high on the wall on the other side of the desk, a dozen different fetal heart tracings playing across them. A quick glance reveals that my patient’s baby has run away again, and I propel myself out of my chair towards her room.  It’s the middle of the night now, and my patient is still slogging her way through a long, hard induction. A week past her due date, we’ve been throwing medications at her for well over twenty-four hours to try to convince her body to go into labor, and while she’s finally starting to feel the effects of it, her cervix sure isn’t going anywhere fast.
Opening the door, I move silently into the dimly lit room. My nose is hit with the strong aroma of lavender oil, and I offer up a silent thanks that I don’t have to deal with the headache-triggering fumes of peppermint tonight. My patient sits on a large exercise ball at the side of the bed, quietly, rhythmically breathing in and out as another contraction fades. She is slender and graceful, her long, mostly brown hair draped across her left shoulder, interspersed with just a few strands of gray. A few lines grace the corners of her eyes and mouth, but were I not privy to the details of her chart, I would easily think her ten years younger. In front of her kneels the doula, massaging her feet with care. Perched awkwardly on the edge of the bed and clutching her right hand sits her partner. Her gaze steadily fixed on her partner’s face, she runs her other hand through her cropped salt-and-pepper hair and draws her lips into a tight, thin line; she radiates anxiety and concern, looking every bit the fifty or so years to her credit.
Every time I step in the room I briefly feel a little bit daunted by the knowledge that either of these women could easily be my mother—could be a grandmother to my own infant daughter. But here I am, her nurse, and I know my job, and know it well. I move quietly to squat down at my patient’s side, smiling up at her gently as she opens her eyes to acknowledge my presence.
“I just need to adjust your baby’s monitor again,” I tell her. Keeping a continuous heart rate tracing while a mom is on the ball is not easy, but intermittent monitoring isn’t an option with the medications, so I do what I must and reach under her gown on my baby-hunting expedition. In just a few moments, the steady beating of the baby’s heart is audible again on the monitor, and I pull a second band over the round monitor piece on her belly to try to brace it at the awkward angle it needs, just in time for another contraction.
“Take a deep cleansing breath,” the doula instructs, “and then breathe slow. In through your nose, out through your mouth.” And the patient follows her instructions as best as she can, but I can see that she’s starting to struggle. She has been doing this a long time now, and pitocin is not kind. I guiltily look at her irregular contraction pattern on the computer screen. I’m going to have to turn the pitocin up again, I think. I always feel cruel increasing the rate when someone is going natural and hurting.
As her breathing slows again, she looks up at me, “I don’t think I can keep doing this.”
“You’re doing an amazing job getting through these contractions,” I encourage her, and the doula nods and smiles her assent.
“Do you think … do you think I could get checked again?” she asks. I can hear the hesitation in her voice, and I know she’s scared that maybe this won’t give her the boost of encouragement she’s looking for.
“That sounds like a good idea. It’s been a few hours. I’ll go find your midwife, so she can check you,” I reply. She gives me a small smile, which I return as I rise and step out of the room to go page the midwife, pushing my thoughts of increasing the pitocin aside for now.
I return a few minutes later following behind the midwife, a sunny presence in the middle of the night with her short, sandy blonde hair, freckles, and wide smile. She stands near the patient, watching how she copes through a couple contractions, before helping her get up off the ball and move to the bed for the exam. “You’re doing awesome,” she effuses, pulling the sterile glove I’ve handed to her on her hand. “Ok, lots of pressure now,” she warns the mom as she finds her cervix. I watch her cheerful face become a blank mask and know that what news she has won’t be what the patient is hoping to hear.
“Well, your cervix has changed a little. You are two centimeters now, and a little thinner, as well,” the midwife states, trying to maintain a tone of calm optimism in her voice. My own heart falls at her words, and turning my face away towards the computer to chart, I purse my lips and take a deep breath that is not quite a sigh.
“Two? Two centimeters?” my patient replies. Her voice is a mixture of anguish and confusion, and she grasps the hand of her partner tighter for comfort as her eyes threaten to leak fresh tears. At this moment, hope feels very far away. Hope that she can last. Hope that the pain will end soon. Hope that her body will make it to a vaginal delivery. “What do we do now?” She asks the midwife quietly.
“You’ve had the pitocin going for several hours now, and we’re turning it up as we are able to try to get your contractions stronger and more regular. The one other thing I can do at this point is to break your water. Sometimes that helps the baby’s head to come down and put more direct pressure on the cervix, which can help your labor progress better. I don’t usually like to do it this early, but there aren’t a lot of other options right now. It does increase the risk for infection, so after that I would check your cervix only when we absolutely need to,” the midwife offers.
“Ok, let’s do it,” she agrees, and her partner nods her head as well. “But …” and here she hesitates, torn briefly between her dreams and tormenting reality, “but I don’t think I can keep doing this without anything. Could I get some medicine to help? I don’t want the epidural, just something to make it easier.”
“Being induced is really, really hard, and you’re doing an amazing job,” the midwife, still sitting on the end of the bed, assures her. “But you can have something in the IV, if you would like. It’ll help you to relax a little bit and take off the edge off the pain, although it won’t take it all away.” And turning to me, she says, “I’ll order some fentanyl.”
I nod and hold out the long, and now very familiar, yellow plastic hook to her, so she can rupture the bag. I put on some gloves and grab a clean towel and chux to replace the ones the patient sits upon, which have been quickly soaked with clear amniotic fluid. That done, I run out to the med room and pull out the medication, returning as quickly as I can to the room to give the laboring mom the dose and telling her more about it as I do so, “The fentanyl will probably make you feel dizzy and drowsy, like you’ve just had a couple of drinks, so you shouldn’t try to get up for a little while. Like the midwife said, it won’t take the pain completely away, but it should help you get through it a little bit. This medication is short-acting, though, so it wears off quickly, usually in about an hour, and I can get you more then, if you want it.”
She acknowledges this and smiles, a tired, but genuine smile, “Thank you.”
She closes her eyes and yields herself to the medication. And for a few contractions, I watch her cycle between breathing methodically and melting into the bed in drugged exhaustion. Her partner and doula remain close to her side providing support, and for the moment I feel extraneous. “I’ll be back to see how you’re doing in about fifteen minutes,” I tell the group, softly.
“Thank you,” her partner replies, looking up at me, gratefulness written on her face.
I return to the room a few minutes later, and instantly, I can feel the shift in the atmosphere. My patient is breathing hard through her contractions, moaning as they reach their peak, even though the medication should still be in full effect. The once-irregular contractions are suddenly coming every two minutes, so I move to turn down the pitocin by a couple milliunits. Breaking her water has clearly done its job. Her own body is taking over in a big way.
Instead of returning to the desk, I linger in the room, crouching by her side, whispering soft encouragements, watching in quiet fascination as she surrenders to the sudden gale-force power of her labor. She is a palm tree bending before a hurricane, holding on with all her might in hopes that she won’t break. She is a kid who was just running through sprinklers, now suddenly facing a fire hose.
Contraction after contraction passes, each more powerful than the last. Her moans continue to increase in volume, becoming low and guttural. As another contraction washes over her, she restlessly curls around her abdomen, grabbing at anything in her reach. She shivers uncontrollably.
I read her movements and sounds. I know what I’m seeing, but it’s hard to believe them. “Are you cold or just shaky?” I ask.
“Not cold. I just … can’t … stop it,” she replies.
“Don’t try to fight it. The shaking’s normal. Are you feeling any pressure down in your bottom or feeling any need to push? Kind of like you have to go to the bathroom?” I question her, hurriedly.
“Yes,” she gasps out. She doesn’t have any spare energy to focus on speech right now. Another contraction takes over and she moans low and deep, tightening the muscles of her abdomen into an involuntary push. It’s been barely an hour since the midwife ruptured her membranes, but the signs of transition are unmistakable. She needs to be checked again, and my instincts tell me that I shouldn’t wait for the midwife to get here to do it. It’s ok. At least the one on tonight isn’t vagina possessive, like some of the others are. She won’t be upset, I rationalize. If she were a doc patient, I wouldn’t hesitate even a moment.
“If you’re feeling like you need to push, I really need to check your cervix now. You might be going really fast,” I tell the mom, snatching a sterile glove out of the drawer while the doula helps her get into position.
“Okay, cold gel and lots of pressure now,” I warn her, as I insert two fingers. They don’t get far, running into the baby’s head almost immediately. I move them in further, sweeping all around the baby’s head, and feel nothing, no cervix at all. Holy crap, she’s already complete, my mind spins.
“You’re ten centimeters!” I announce, a smile I just can’t help beaming across my face. Both the patient and her partner gape at me in astonishment, and the doula cheers. And I fly into action, calling the desk to send the midwife in, turning on the radiant warmer to get the blankets warm for the baby, and pulling the delivery table out of the closet to set it. I am everywhere at once.
The midwife strides in, her own face a mixture of surprise and delight. “Wow, you’re complete! I guess it’s time to start pushing.”
It doesn’t take long. A few contractions of pushing later, and I call for a baby nurse. A couple more after that, and the midwife is lifting a beautiful baby boy into my patient’s waiting arms, where he lets out a strong, lusty cry. The baby nurse swiftly dries him off, and I help the new mom pull the hospital gown off her shoulders, while her partner cuts the umbilical cord with shaky hands. The other nurse moves the tiny boy up to his mother’s chest, laying him against her skin and covering him with fresh, warm blankets.
The patient looks to her right at her partner, and they share a brief laugh. Matching looks of relief and joy adorn their faces. Matching tears shine in their eyes. After all that wait, for it to suddenly go so fast, so perfect … it’s overwhelming. And in this miniscule moment, they are lost in their own world. Nothing else exists beyond the three of them—mom, mom, and baby.
I keep moving around the room—fetching the midwife the sutures and lidocaine she needs to repair a small tear, starting the postpartum pitocin when it’s called for after the placenta delivers, charting the delivery record every spare second I get. But all the while, I’m still basking in the joy that floats all around me. There’s an intangible euphoria, a strange kind of high you get after a birth like this. It’s soothing, it’s happy, and there’s no crash afterwards. (Well, if you don’t count getting a crash c-section later, that is.) It’s living, inhalable beauty.
And all of this is why I do what I do. These are the shifts at work I live for.