March 11, 2008 5:45pm
Joellen and Mark Armstrong were students in my childbirth class series at the Willamette Valley Medical Center. As it turned out, they were also good friends with several of my former Doula and Midwife-Assistant clients! That was a fun discovery. On the last night of class, Joellen asked me if I would be available to be a Doula for them, and if I'd consider bartering for payment. I was thrilled to serve them, and having Mark help me set up a website for my blooming Midwifery practice was a great trade!
Later that same week, Joellen felt she was having lots of contractions, and at an appointment with Dr. Barker she was assured that labor looked to be starting up soon. Unfortunately, it wasn't so. She was, in fact, having lots of contractions, but they didn't lead to labor right away. Joellen's uterus was doing its warm-up exercises, but wasn't in a hurry to shift to progressing labor. It was difficult to wait through the next two weeks, but Joellen and Mark found ways to pass the time.
Finally, on Monday March 10, Joellen started to feel noticeably stronger contractions at about 7 pm. She stayed around the house and felt things shift to become even stronger at 10:30 pm. She had a little applesauce to eat and laid down to rest for a bit. She even let Mark get some sleep as labor picked up momentum. At about 2:30am she decided to get Mark up and they made a trip to Winco to buy some food for Mark during labor. As they were leaving Winco they gave me a call at 3 am to say they thought they should head for the Birthing Center. I said I'd meet them there.
At WVMC, Joellen was settled into the exam room by Nurse Ellen, who checked Joellen's labor progress at 3: 15 am. She was 2-3 cm dilated, 80% effaced, and 0 station. Her cervix was stretchy, and Ellen was able to stretch it to a solid 3 cm. (I'm not sure what was up with the 0 station estimate, because later exams put her at-2 and -1 station.) Unfortunately, the exam made Joellen's cervix bleed more than usual, and Ellen became very concerned. She called Dr. Barker to come and take a look. Thankfully, Dr. Barker felt it was fine and pointed out that she had a friable cervix with a history of cervical bleeding during her pregnancy. Thus, admission procedures were completed and Joellen was moved to room 4, the only labor room without a soaking tub. As it turned out, she was moved to room 4 because of the concern about the bleeding, Ellen had felt that it was likely Joellen would be having a cesarean birth.
At 8 am, Dr. Barker arrived to check Joellen's progress and found that she was 3-4 cm dilated, and he was able to stretch her cervix to a solid 4 cm. Dr. Barker felt that this was slow progress, but still progress, and he suggested breaking her water to speed things up. Mark and Joellen talked and decided that they would like to go ahead with the rupture of membranes, which Dr. Barker performed at 8:20 am. LOTS of water! Mark and I helped Joellen onto the ball with a chux pad after about 10 minutes so that we could clean up the soaking wet bed. As we finished, Natasha Lawson, Joellen's Nurse-Midwife, arrived. She was a breath of fresh air and a great support to Mark and Joellen. She encouraged Mark and I to go eat breakfast while she stayed with Joellen, doing some back massage as Joellen sat on the ball. As it turned out, it was Natasha's birthday, too.
At about 11 am, Joellen asked to be checked so that she could decide about having an epidural. She was very clear in her request. Natasha found that she was 6 cm dilated and -2 station and Joellen decided that she wanted an epidural for pain relief The process of calling the anesthesiologist was initiated, and Joellen tried to settle into the bed to handle very strong contractions that she no longer had motivation to cope with. It was a very difficult time in her labor for both Joellen and Mark. Dr. Richardson, the anesthesiologist, arrived at 11:40
At 3:30 pm, Joellen was 9cm dilated, but no further descent of the baby's head. Natasha said that she was beginning to worry about the length of the transition part of labor. Although baby had been doing very well, she felt that the baby's heartrate was beginning to show signs of a tired baby. We helped Joellen in to a squatting position at the foot of the bed, with th
At 5:15 pm, Joellen left the labor room while Mark and I dressed in scrubs, mask and hat. We joined her soon, and baby Asher was born at 5:45 pm. Mark was able to watch his arrival, and headed for the baby warmer to welcome his newborn son. Mark and Asher came back to visit with Joellen for about 10 minutes before they left to return to the labor room for newborn procedures. I stayed with Joellen during the completion of her surgery, hopefully providing comfort and reassurance. Joellen was uncomfortable with the feeling of her body being manipulated, but seemed to handle the medications and everything else very well. Dr. Barker was finished with her skin staples at 6:05 pm and she headed for recovery at 6: 15 pm. I wasn't able to accompany her to recovery, so I went back to the labor room with Mark and Asher. Newborn Asher weighed in at 8 pounds, 14 ounces and 20 lh inches long. His slightly molded head was 15 inches in diameter. He had sweet, long feet and very boy-ish hands! Cute as can be! He had his first bath at 6:25 pm and headed to the postpartum room to meet his mama at about 6:40 pm.
Congratulations on the birth of your sweet son! I know that Joellen and Mark will be devoted, loving parents to this wonderful baby boy!!! Thank you for asking me to serve you. With love, Margy
Joellen and Mark Armstrong were students in my childbirth class series at the Willamette Valley Medical Center. As it turned out, they were also good friends with several of my former Doula and Midwife-Assistant clients! That was a fun discovery. On the last night of class, Joellen asked me if I would be available to be a Doula for them, and if I'd consider bartering for payment. I was thrilled to serve them, and having Mark help me set up a website for my blooming Midwifery practice was a great trade!Later that same week, Joellen felt she was having lots of contractions, and at an appointment with Dr. Barker she was assured that labor looked to be starting up soon. Unfortunately, it wasn't so. She was, in fact, having lots of contractions, but they didn't lead to labor right away. Joellen's uterus was doing its warm-up exercises, but wasn't in a hurry to shift to progressing labor. It was difficult to wait through the next two weeks, but Joellen and Mark found ways to pass the time.
Finally, on Monday March 10, Joellen started to feel noticeably stronger contractions at about 7 pm. She stayed around the house and felt things shift to become even stronger at 10:30 pm. She had a little applesauce to eat and laid down to rest for a bit. She even let Mark get some sleep as labor picked up momentum. At about 2:30am she decided to get Mark up and they made a trip to Winco to buy some food for Mark during labor. As they were leaving Winco they gave me a call at 3 am to say they thought they should head for the Birthing Center. I said I'd meet them there.At WVMC, Joellen was settled into the exam room by Nurse Ellen, who checked Joellen's labor progress at 3: 15 am. She was 2-3 cm dilated, 80% effaced, and 0 station. Her cervix was stretchy, and Ellen was able to stretch it to a solid 3 cm. (I'm not sure what was up with the 0 station estimate, because later exams put her at-2 and -1 station.) Unfortunately, the exam made Joellen's cervix bleed more than usual, and Ellen became very concerned. She called Dr. Barker to come and take a look. Thankfully, Dr. Barker felt it was fine and pointed out that she had a friable cervix with a history of cervical bleeding during her pregnancy. Thus, admission procedures were completed and Joellen was moved to room 4, the only labor room without a soaking tub. As it turned out, she was moved to room 4 because of the concern about the bleeding, Ellen had felt that it was likely Joellen would be having a cesarean birth.
At 4:30 am in room 4 we were introduced to our labor RN, JoAnn. Joellen found herself most comfortable sitting up on the edge of the bed for contractions. She also tried sitting in the rocking chair, but it wasn't as helpful. We turned down the lights and she tried walking a bit between contractions. By 6:15 am, the contractions had picked up again, becoming longer, stronger, and closer, and she was feeling more pain in back. Joellen was relaxing well during contractions, and used a variety of positions for comfort. She sat on the birth ball for quite a while, laid down to rest for a bit on the bed, and took a shower with the hand-held wand to help with her back pain. At 7 am we were introduced to Linda, our day-shift RN. Joellen decided to sit on the side of the bed again.
At 8 am, Dr. Barker arrived to check Joellen's progress and found that she was 3-4 cm dilated, and he was able to stretch her cervix to a solid 4 cm. Dr. Barker felt that this was slow progress, but still progress, and he suggested breaking her water to speed things up. Mark and Joellen talked and decided that they would like to go ahead with the rupture of membranes, which Dr. Barker performed at 8:20 am. LOTS of water! Mark and I helped Joellen onto the ball with a chux pad after about 10 minutes so that we could clean up the soaking wet bed. As we finished, Natasha Lawson, Joellen's Nurse-Midwife, arrived. She was a breath of fresh air and a great support to Mark and Joellen. She encouraged Mark and I to go eat breakfast while she stayed with Joellen, doing some back massage as Joellen sat on the ball. As it turned out, it was Natasha's birthday, too.
Mark and I were back in 15 minutes, and found Joellen handling stronger contractions with grace. By 10 am she was beginning to show signs of discouragement, and Natasha suggested that we move to one of the labor rooms with a soaking tub. I went down to fill the tub in room 2, while Mark and Natasha helped Joellen get ready to walk down the hall. Once settled in the water, Joellen had a lot of relief from the pain of contractions, but she also threw up and started to feel shaky-signs of more rapid cervical change. Her contractions were further apart, but very long when they came. At one point Joellen felt a little pushy, but the feeling passed. She made it through the contractions with long, open sounds, but it was obviously becoming a much stronger experience for her.
At about 11 am, Joellen asked to be checked so that she could decide about having an epidural. She was very clear in her request. Natasha found that she was 6 cm dilated and -2 station and Joellen decided that she wanted an epidural for pain relief The process of calling the anesthesiologist was initiated, and Joellen tried to settle into the bed to handle very strong contractions that she no longer had motivation to cope with. It was a very difficult time in her labor for both Joellen and Mark. Dr. Richardson, the anesthesiologist, arrived at 11:40
am and Joellen had pain relief by noon. In fact, she said that she felt the best she'd felt in 9 months!
At 12:30, Natasha checked her cervix and found that she was now 7-8 cm and the baby had made a little bit of progress to -1 station, which was still pretty high in the pelvis. The baby's head was in a favorable position (LOA to LOT) and was beginning to mold. So Joellen settled in to rest in a dark and quiet room
and let the labor progress on its own. Unfortunately, the popsicle she enjoyed was soon thrown up, but she handled it well. Natasha stepped out for a little while, and returned at 2:20pm to check Joellen's progress, 8 cm and -1 station with more molding and some caput (fluid under the scalp-common). Natasha suggested that Joellen try pushing to get the baby to come down because the cervix felt plenty stretchy to move out of the baby's path on descent. After a couple of trial pushes, Natasha said to wait a little longer before getting serious. So we sat and chatted, hanging out in the labor room.
At 3:30 pm, Joellen was 9cm dilated, but no further descent of the baby's head. Natasha said that she was beginning to worry about the length of the transition part of labor. Although baby had been doing very well, she felt that the baby's heartrate was beginning to show signs of a tired baby. We helped Joellen in to a squatting position at the foot of the bed, with th
e squatting bar, to start pushing. Natasha was certain that Joellen's pushing efforts and contractions were very effective-no need to add pitocin to increase the labor. Eventually, Joellen even got up onto the birthing stool to push. She seemed to be making a tiny bit of progress. But the baby's heartrate began to slow at the end of contractions at about 4:15pm. Natasha asked her to stop pushing and lie down on her left side in the bed so that the baby would get the best dose of oxygen from Joellen's bloodstream. At 4:45 pm, Dr. Barker checked Joellen, and found that there had been very little change in the baby's descent, so he recommended a cesarean birth. Mark and Joellen decided to go ahead with surgery.
At 5:15 pm, Joellen left the labor room while Mark and I dressed in scrubs, mask and hat. We joined her soon, and baby Asher was born at 5:45 pm. Mark was able to watch his arrival, and headed for the baby warmer to welcome his newborn son. Mark and Asher came back to visit with Joellen for about 10 minutes before they left to return to the labor room for newborn procedures. I stayed with Joellen during the completion of her surgery, hopefully providing comfort and reassurance. Joellen was uncomfortable with the feeling of her body being manipulated, but seemed to handle the medications and everything else very well. Dr. Barker was finished with her skin staples at 6:05 pm and she headed for recovery at 6: 15 pm. I wasn't able to accompany her to recovery, so I went back to the labor room with Mark and Asher. Newborn Asher weighed in at 8 pounds, 14 ounces and 20 lh inches long. His slightly molded head was 15 inches in diameter. He had sweet, long feet and very boy-ish hands! Cute as can be! He had his first bath at 6:25 pm and headed to the postpartum room to meet his mama at about 6:40 pm. Congratulations on the birth of your sweet son! I know that Joellen and Mark will be devoted, loving parents to this wonderful baby boy!!! Thank you for asking me to serve you. With love, Margy
