Posts tagged preterm birth
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 Paxton Lynn 11/4/20
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This little boy was so eager to see the results of the presidential election, he came over a month early! Of course, we all know the outcome had not been resolved that night but he was here nonetheless! And here is how it all happened. Stacy and Matt were repeat clients of mine, but this pregnancy was definitely not a repeat of the first. Not a bit of it was the same! This baby and the pregnancy all occurred over the course of the COVID-19 pandemic so that affected things. And this time around, Stacy had some alarming preterm contractions on October 24. She was only 34w3d along so buying more time for her baby boy to cook was ideal. Thankfully, iv fluids helped to settle things down enough to go home, and a steroid shot for good measure would help ensure his lungs were ready when he was. And Stacy was already dilated 3 cm so there was also that! Needless to say, the remaining weeks of the pregnancy brought an elevated level of vigilance and worry.

So when Stacy noticed some bleeding 10 days later she did not hesitate to call her midwife. They were instructed to go to the hospital and get checked out, and soon after she arrived Stacy felt the familiar roll of contractions. They were mild, but they were there. Stacy was 4 cm dilated and 80% effaced and her midwife told her that she would not be going home. She might be monitored until delivery unless she was in labor and would birth that night. Believe it or not, that still remained to be seen. Stacy wasn’t even sure herself, whether she was in labor. But within a couple of hours that changed. Just before 1:00 am, Matt sent me a text that they were pretty sure the baby was coming later that day. Stacy also happened to be 6 cm and 100% effaced so it was definitely labor! I arrived 20 minutes later. Thank goodness I live close.

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Stacy felt a lot of worry and anxiety in this labor. Her preterm labor contractions and bleeding, and now facing the reality of a late preterm birth had her struggling to feel calm and safe. She felt a nap and the opportunity to regroup would be instrumental in her mental and emotional readiness to welcome her son. She requested an epidural and the wheels were rapidly set in motion to make it happen. Stacy’s epidural was in place by 1:25am. Naptime! Or so she thought. Her son’s heart rate dipped from the strong contractions and his rapid descent, so everyone watched him closely, while also readying the delivery cart. We knew Stacy would be meeting her son very soon, even if she didn’t realize it. And 40 minutes after the epidural was placed and before the pump was set up, Stacy was fully dilated and feeling a lot or pressure! It was time!

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Stacy felt a lot of worry and anxiety in this labor. Her preterm labor contractions and bleeding, and now facing the reality of a late preterm birth had her struggling to feel calm and safe. She felt a nap and the opportunity to regroup would be instrumental in her mental and emotional readiness to welcome her son. She requested an epidural and the wheels were rapidly set in motion to make it happen. Stacy’s epidural was in place by 1:25am. Naptime! Or so she thought. Her son’s heart rate dipped from the strong contractions and his rapid descent, so everyone watched him closely, while also readying the delivery cart. We knew Stacy would be meeting her son very soon, even if she didn’t realize it. And 40 minutes after the epidural was placed and before the pump was set up, Stacy was fully dilated and feeling a lot or pressure! It was time!

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The relief that washed over Stacy and Matt was intense as they took in their perfect and healthy son who had them worried sick just a couple of weeks before. He latched in his perfect time at 3:00 am, and finally Stacy was the image of peace and serenity that she had evaded her. This baby’s birth was a master class on the importance of letting go and greeting your birth journey with open hands and an open mind and heart. She was patient, trusting, courageous, discerning, and accepting of the path her baby chose for himself. Their sweet loving relief was clear to me as I saw Matt’s lovestruck grin looking into his son’s squinty eyes, and in the way Stacy cradled her son confidently when just a couple of hours earlier she cradled her belly in anxiousness and fear. Paxton was born in his perfect time and it was beautiful. 

Proud big sister

Proud big sister