Let's do some math. 12 laboring mamas. 2 available beds. That's craziness right there. I don't need to tell you that the ward was PACKED yesterday. Everywhere I looked, there were pregnant women - some composed, sitting and patiently waiting, others bent over, moaning and clutching at whatever would hold their weight. It was overwhelming and I didn't know where to begin or whom to choose first!
I decided to offer my services to a young mama who was lying on a gurney in the back hallway. As she was making the most noise, I thought this would be the most helpful. If anything, to help calm her and make the environment more relaxing for the 11 other ladies hanging around. She was soaked in amniotic fluid and writhing around on the little plastic mattress. She was in labor with her fourth child who was overdue by almost two weeks.
We were both relieved when she was finally given a bed and a midwife checked her progress. She was 8 cm! She had gone through most of her labor alone in that dirty, dimly-lit stretch of forgotten hallway. Poor woman!
She was by far, the loudest mama I have ever worked with. She screamed at the top of her lungs with each contraction. Not a high-pitched girly scream but one of those deep, she-man, start-with-a-growl, crazy lady screams. At one point during her labor, she was standing with her arms around my neck. A contraction came on strong and fast and she took in a deep breath for, what I was sure was going to be another banshee cry so I braced myself for the impending hearing loss but it never came! I congratulated myself on a small victory for it was all I could do to keep her in the good graces of the ward staff. She was scolded multiple times for making too much noise and somehow, I felt personally responsible for her receiving the correction! I know that's ridiculous but I felt that I should be doing more to calm her and help her focus.
Well along came 10 cm and the urge to push but a check by a nursing student showed a little lip of skin that was preventing the baby from descending properly through the birth canal. Now they were saying she wasn't fully dilated! As if this poor mama hadn't already had a hard day, she was told to, "Rest for an hour and then you can push." Um, what?! She was in agony as each contraction brought the overwhelming urge to do what was the natural next step. I'm aware that the muscles will contract and "push" by themselves without any work from the mama but this woman was told not to help - not to bear down. Oh boy.
I was so proud of her as she shifted positions and rolled from side to side to try and maintain control. A couple of times, she got up to squat but was sternly told that she needed to get back in bed, lie down and rest. Ugh. So frustrating for both of us. I thought the squatting would be helpful in moving that lip out of the way and that it would be a pain relieving posture. Each time she was told to relax or a contraction came, she looked into my eyes with the most pleading, pathetic expression. If it had been me, I would have threatened to punch that student if he used the words "rest" or "relax" again!
After the longest hour, she was allowed to help in what her body was already doing and she delivered a big baby girl within a few minutes of resuming her pushing.
This entire situation perplexed me so when I got home, I looked up what I could find on the little bit of skin that thwarted this mama's labor. Here's what I found and I am so excited because it describes my situation exactly! I hope this info is helpful for you too. Although, you probably already knew what was going on... Apparently, that bit of skin is referred to as the "anterior cervical lip" and is very common. The author of the article below talks about the physiology of this particular point in labor which offers great insight into why the anterior cervical lip even happens.
http://midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/
There you have it. I wish I had just a little more authority in the ward. (famous last words) If I did, I would have gone ahead and told that mama to let her body dictate what happened next. I would have let her push and praised her desire to squat. And I would have let her she-man holler all she wanted. Hey, if it helps...
No comments:
Post a Comment