Posts tagged Induction
The Birth of Ella Helene 12/6/21

Jordan and Mike became parents in a way they didn’t expect but rose into their roles as mom and dad with such confidence and courage, it was remarkable. They took my 7-week Birth Essentials class and learned about so many things—what to expect in pregnancy, labor, and birth, postpartum, and even all the interventions that could come into play. And about a month after the conclusion of our classes, they put what they learned to work.

Jordan got a call from her concerned midwife about her elevated blood pressure and lab results. A couple of days later she developed some upper back pain that brought her to the hospital for monitoring as her midwife recommended. And it soon became evident that Jordan would be giving birth much sooner than expected. In addition to preeclampsia, she had also developed HELLP syndrome. And in a few short hours, her care was transferred to Maternal Fetal Medicine, and she was transported to a completely different hospital to induce labor for her 34-week baby. Jordan and Mike rolled with it and embraced the many changes that took place from that point on.

Cervical ripening and administering steroids to her baby girl were job one. There was also discussion of an epidural at some point just in case there was a reason to move rapidly to a c-section. It was a mostly safe proposition to induce, but with her baby still so young, they wanted all their bases covered. It was going to be a lengthy process, so Jordan and Mike settled in.

The induction began with cervadil as well as magnesium for Jordan’s too high pressures. It was just another addition to her collection of interventions that she didn’t know she would need. She got dinner that evening for which she was so grateful. But we weren’t sure when she’d eat next. With inductions and first-time moms, it’s usually a long process, a statement Jordan and Mike heard over and over as they waited for labor.

In the middle of the night, around 3:00 am a balloon was placed in her cervix to manually dilate her to 4 cm, a much better starting place for induction. Jordan was dilated 1 cm which was a modest change from no dilation at admission. And in less than two hours she was having regular contractions that required her to breath and focus. 

Jordan had the epidural catheter placed ahead of time for insurance, while allowing her time to labor without it. She decided that night to have the epidural medicine added. She was having contractions steadily every 3 minutes and it would only get more intense.

By 8:30 the next morning, Jordan was dilated 2-3 cm. At 11:00 the began Pitocin, and just past 2:00 that afternoon, Jordan’s contractions were 3-6 minutes apart. Within the hour she was dilated 4 cm. They would wait another 4-6 hours before breaking her water if it didn’t break on its own first.

At 7:00 that night, they broke her water and inserted an IUPC to make certain her contractions were strong enough. Jordan’s cervix had not changed and remained at 4 cm, but the thinking was that her baby’s head would come down upon it and encourage dilation. The Pitocin was at the highest level, but Jordan’s contractions were coming steadily. And the IUPC confirmed they were strong enough. All she needed was time.

Jordan soon felt her contractions in a different way. She felt more pressure lower and in her back as well as rectal pressure. Her baby’s heart rate took a concerning dive, so the nurse did a check to see if maybe Jordan’s cervix had made big changes. Unfortunately, it hadn’t, and Jordan was still 4 cm. It was time to change positions, so her nurse and I helped to reposition her onto her hands and knees. She labored in that position for 30 minutes before returning to her side on the bed.

Then Jordan felt a contraction that was a lot more uncomfortable than the others bringing much more pressure with it. And on the monitor, we could see head compression and her nurse and I were hopeful for big cervical change. And that’s what happened because Jordan was COMPLETELY DILATED, and her baby’s head was at +2 station! In just 2 ½ hours, Jordan had dilated from 4 to 10 cm!

The room quickly filled with people There were extras there for the baby who would be born several weeks preterm. An isolette was wheeled in as well for Jordan’s baby was be destined for the NICU for a time. All the while, Jordan felt more and more pressure to push. I reminded her to blow out the birthday candles while the final members of the birth team got assembled. With her baby a premie, it was important they had the necessary support. And once everyone present and accounted for (but the baby), Jordan gave her first push. And it was an excellent one! We already saw her baby’s head and just one more push or two and her baby girl came into the world at 12:05 am on December 6, 2021! 

Baby Ella Helene cried out right away, sounding like a kitten. She got a good rub down from nurses as well as her auntie who was also a NICU nurse, and soon went to the warmer for additional breathing support. Mike followed his baby and stood watch by the warmer while Jordan beamed at her new baby girl. She was the epitome of joy and had full trust in her baby’s care providers. She too, was a NICU nurse, so she had more of an understanding than most.

Ella weighed 3 lb. 1 oz. and measured 11.4 in. long. She was little but so strong. She was placed in the incubator and took a stop bedside for a quick sendoff from mom. Jordan talked through her labor in that first hour or so. It was a whirlwind and took some time to get her head wrapped around what had transpired.

Jordan pumped milk and delivered it to the hospital for her baby in those first few weeks. She and Mike faithfully commuted to the hospital to visit and get updates and even snuggles. And day by day, Ella gained weight. And after just over 2 weeks, she was discharged home just in time for Christmas!

Jordan’s birth journey took a sharp left turn and had her off-roading for the entirety of her birth. And what an adventure it was! She had good support, had agency, and played an active role every step of the way, and in the end she and her baby were healthy and strong, and off to a great start. Birth is a mysterious thing with no guarantees really. So, when risks present themselves its more important than ever to trust your team and to trust yourself. Which is exactly what Jordan and Mike did. Congratulations again!

The Birth of Nova Wren 10/21/21

Alexa and Frank met their little lady, Nova Wren, on October 21, 2021. They were students in my 7-week childbirth class and learned a lot about labor and birth, and about the ways birth might deviate from the straight and narrow path. It was no surprise that their little lady was, well little. Nova was suspected small for gestational age. So as Alexa rounded out the final month of pregnancy, and after NSTs and ultrasounds kept a closer eye on baby and her growth was still below the curve, an induction was scheduled in her 40th week. Alexa was glad to delay the induction as long as possible since her initial hope was to have a birth without interventions. But she also wanted her baby to be born safe and healthy and was willing to compromise the ideals she had for her birth. 

Alexa had one last appointment the day before the induction. She was dilated 2 cm and her doctor did a membrane sweep hoping it would either start things or help to further ripen her cervix so they might break her water to induce. Alexa and Frank had a realistic expectation of the long duration of a typical induction, especially with a first baby, so when a room was ready, they went to the hospital and settled in for a long stay.

Her doctor came in and broke her water at 9:15 am. They started Pitocin within the hour. Alex felt her first contraction at 10:25 am and figured things might take a bit. But they surprisingly didn’t. Two hours later at 12:30 pm, Alexa was dilated to 5 cm and 100% effaced. Alexa got teary as it settled in that she was actually having a baby. Apparently, there wouldn’t be the long, gradual wait everyone had prepared her for.

She requested an epidural knowing things would continue to escalate. She felt pain in her lower abdomen even after it was placed so we tried to position her in ways to minimize it. It didn’t take long before she felt pressure in her bottom with contractions and we told her that would normal and to be expected. It was a good sign of continued progress too. We encouraged Frank to go grab something to eat since he wouldn’t have an opportunity later.

Alexa labored on her side with the peanut ball between her legs and in thirty minutes she was feeling so much pressure they did another exam. And we were all thrilled to learn that Alexa was fully dilated, and her baby was at +2 station! Frank had recently left so we texted and called Frank to tell him to come back up because it was baby time. He arrived a few minutes later a bit winded. Frank told us he threw $20 at the cashier and told her to keep it as he breezed on by, chicken tenders in hand.

The delivery table was getting set up at 1:35 pm and in ten minutes Alexa was pushing! Five minutes later they broke down the bed, and then at 2:00 they called in nursery for delivery. And Nova Wren was born at 2:02 pm! (And her placenta was born 6 minutes later, completing the birth in very efficient fashion!)

Frank and Alexa cried at the sight of their baby girl and were simply in awe of how everything transpired. The doctor was likewise shocked and leaned in to congratulate Alexa and comment on how perfect her baby was. And she didn’t look nearly as small as everyone expected. She wasn’t huge, but weighed in at a respectable 5 lb. 14 oz. And she was 19 in. long.

As you might guess, Nova was latched with little trouble by 3:00 pm. Despite her rapid entrance, she seemed to adjust to being born just fine, scoring Apgars of 8/9. She was healthy and strong, just a little petite. It was beautiful how this induction unfolded. Alexa rode the waves of her contractions and the tides of her birth with courage and confidence. She trusted her body and she also trusted her birth team. And she was in the middle of every decision made. She was empowered by the experience. What a great start to parenthood, don’t you think?