Monday, March 18, 2013

Jeannie


 One of my clients was (told she was) overdue and becoming increasingly nervous about the fact. Unless a baby is conceived by artificial or in vitro fertilization, or the couple chart basal body temperatures and see ovulation occur, it is almost impossible to predict the exact date of conception and then calculate the due date. We are actually changing the term at this time from Due Date to Guess Date. In the past, doctors have induced babies rather routinely that were still not showing any intention of being born into their 41st week. They were worried about things that might happen when babies are truly overdue and their placentas are no longer working at 100% speed, but babies who ‘cook’ until 42 weeks are more often than not perfectly healthy and do very well. Babies are mature and viable, as we say, after 37 weeks, though they do better if they arrive closer to their 40th week. So, without knowing a true due date, babies have been induced far too early, due to miscalculations, and sometimes it becomes apparent that they are even premature, and not at all overdue. The medical community is taking a new look at induction at this time, with good reason.
          Jeannie called me the day after she reached her 40 week Guess Date. She had been to the doctor that morning who had insisted that they go ahead with an induction the next day and possibly a scheduled C-section as her doctor sited that the baby “appears rather large”. She had two other children before but the doctor was worried about a host of ‘risk factors’ surrounding post-dates babies. Jeannie’s first baby had been born by C-section, though baby #2 was a successful VBAC or TOLAC (Vaginal Birth After Cesarean or Trial Of Labor After Cesarean) at only 28 weeks. The next baby, a beautiful little girl was born in 2010 but was earlier than that and did not survive.
          So I got her call later that morning. Jeannie was crying and understandably upset. She told me all that the OB had laid out for them the next morning and said she came home and told her husband and asked him what they should do. Lonnie’s answer was, “Call Stephanie, she’ll know what to do.” So she was on the phone waiting for some advice and support.
            It is important here to explain that as a doula I do not make decisions for anyone. I don’t tell them which is the best of all the options they are offered, but I will help them explore the possibilities and give them as much information as I have or call someone else if I don’t know. Even as a retired midwife and lactation consultant, I won’t tell a family what to do. So I added a few possibilities to the OB’s list: they could have sex, for one. Yes, it has worked and the premise is that the male hormones assist with ‘turning on’ labor, or that orgasm simulates contractions and that the uterus follows suit. Some women have tried the notorious castor oil cocktail, which works by stimulating the bowel which in turn, if irritated enough, triggers a response by the uterus, and thus labor. Some practices are not advocating this method. Check with your practitioner first, please, before trying it. Riding a bike or taking a drive on a long dirt road has worked on occasion, too. “Stripping the membranes” is when a midwife or doctor separates the cervix from the bag of water by sweeping a finger around the baby’s head just inside the cervix which also tips off the hormones that labor should soon follow. This can only be done if the cervix is dilated 1 – 2 cm. already. An Amish lady friend of mine told me once when I was ‘overdue’ that you get in your buggy and go visit a friend and that will start labor, rather than sitting at home hoping. (I guess lifting 3 or 4 other little kids up into the buggy, riding along back roads and then lifting the kiddies back out at the friend’s house with all the snacks and coats and all, and hauling myself up and down on the buckboard would have worked for me!) I told Jeannie I knew of another couple who just thanked the doctor and didn’t show up for the decisive next appointment, but instead waited for labor to start on its own, which it did – I’ve never know a baby not to come out – and showed up at a smaller, local hospital once they were well into labor, but I’d advise against the last option if you don’t want to have some very ticked-off staff on your hands.
            Then I said to Jeannie, “You should also take some quiet time and connect with your baby. Tell her it seems to be time, and you don’t need a C-section or any drugs, for that matter, so maybe you two can work out some kind of a deal.” She agreed and thanked me and promised to call the next day. 
            The phone rang at midnight, later that same night. She was delighted! They had spent a quiet day at home together, took a nap, and then went to a barbeque at a friend’s house. Just as they finished eating WHAM! the rushes started, all on their own. She was euphoric, but told me they were going to head right to the hospital because she didn’t think there was time to go home and pick up her baby bag first. When I got to the hospital she was just getting checked by the nurse. 6 cm. already! We gave high fives all around, very pleased with ourselves. It was less than 12 hours short of the O.R. (operating room) according to their doctor.
            Then Jeannie told me one of the strangest stories I have ever heard. While they were home settling down for a nap, she had been talking to the baby as she fell asleep and connecting like I had suggested on the phone. Then she had a dream, describing it as “totally real” and in the dream she was talking to her baby, whom they were planning on calling Camilla. The baby was telling them, “Well, actually, I’m not coming out unless you agree to name me Veronica. No way!” So, in Jeannie’s words she said, “I said, 'OK, anything you want.' You got it!” and the dream ended. They told their other kids about it and all agreed that Veronica it would be though they had never given that name a thought. Then Veronica’s older sister said, “It should be Veronica Jordan. I am sure.” Jeannie and Lonnie looked at each other and said that their kids seemed to know more about this than they did as parents, so Veronica Jordan it would be.
            About half an hour after the nurse checked her, Jeannie said she was feeling a bit ‘pushy’. The nurse checked again and she was 10 cm. The nurse ran out, crashing into another nurse coming in and both raced to get the room set up with a warmer and instrument tray and all the paraphernalia that they bring in now. I helped her focus on breathing and getting into a comfortable squat on the bed while Dad picked up all the coats, the birth ball, and clothes strewn around us. In the rush, someone asked if the doctor had been called. She hadn’t, till just then. Jeannie and I just grinned at each other. Another doctor was on the floor who quickly gowned up and stood at the end of the bed, hands ready to catch. As the little head crowned Jeannie’s doctor rushed into the room, the other doctor stepping aside so she could catch the rest of Veronica Jordan as she slid out. It was all and more than we could have wished for.
            An interesting aside is that another baby girl was born to a family down the block from Veronica’s house about the same time as she was. They named her Camilla, not knowing at all that Jeannie had also picked out that name earlier.               
With permission from Veronica’s family.

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