Hospital

Homebirth

Time

Dilation

Oskar Aaron (times in PM)
40+1 days, 25 March 2004

Dilation

Noah Baruch (times in AM)
40+4 days, 30 June 2006

2.30

?

Labouring at home, everything tolerable, enjoying the power of the contractions, burning lavender, lit candles, listening to music, saying affirmations.

?

Labouring at home, everything tolerable, enjoying the power of the contractions, burning lavender, lit candles, listening to music, saying affirmations.

4.30

?

Decide it is time to go to hospital, contractions still tolerable, just want to have enough time between them to kiss older sons goodbye.

4.55

7cm

Book in to hospital
Notes: “FHR 142
Temp 36.9
BP 140/85 P-76
Abdo palp – cephalic, 4/5 palp, ROP?
–C x 7cm dilated pp-3
Bulging forewaters
C+G in progress”

5.30

?

Notes here have lots of language: ‘TOS’ ‘head still high’

Ob writes: “Plan – Continuous monitor, repeat VE 3/29 if not pushing, Req a myself if not progressing in 1st half hour of pushing; watch for any PV blood loss and also FHR pattern”

?

Decide it is time to phone Sally, my IMW, contractions starting to feel close together and I desire her moral support and care.  We run the spa bath and I hop in.

6.00

?

Got into spa bath in labour ward

6.30

?

“Contracting 4:10
FHR 137
Commenced using gas”
(note, this is after Ob came into bathroom and declared that we should prepare ourselves for the fact that I would most likely need another c/sec)

?

From Sallys notes:
“Sally arrived at home, Rebecca in spa.  Moaning through contractions”

I had declined VEs as I didn’t want performance anxiety

Sally held my hand through a couple of contractions and told me my noises were beautiful.

6.50

?

?

“Contractions 2-4/60 lasting 70-80 secs
FHR 140 reactive”

7.15

?

“Comfortable using Gas, contracting 4:10, CTG satisfactory”

?

“Out of birth pool – sitting on toilet”

7.25

?

SROM
I start having hallucinations with the gas at this point.

?

FHR 140 reactive

7.30

?

Midwife changeover occurred at this time.  The Midwife who had upset me after a negative antenatal visit took over.

7.36

?

?

“Rebecca feels that the baby’s head is coming lower.  Some grunting at peak of contractions”

7.45

?

Out of bath

?

7.47

?

?

FHR 128 reactive

8.00

7-8cm

VE

8.08

?

?

“Mucous”

8.15

?

?

FHR 140 reactive

8.20

?

Midwife notes about past hour:
“Taken over care of Rebecca at 19.30 hrs.  In spa using Gas at that time.  Contracting 3-4(?) strongly.  Distressed. SROM at 19.25hrs,clear in the bath at that time.  Out of bath at 19.45hrs. VE at 2000 hrs cervix 7-8cms pp-1 copious pink liquor. 
Dr B notified of same.  CTG reactive + variable baseline 130-140 b/m at that time.  At time of report variable decelerations with contractions, Rebecca pushing with contractions and advised to breathe or pant through them.  Using gas.  Baseline 125-135 b/m”

8.29

?

“pushing through contractions”
FHR 120-130 reactive

8.40

?

FHR 130-140 reactive

8.50

Fully but with lip

“VE.  Soft anterior lip – easy to push behind babes head and felt descent of head.”
FHR 130-140 reactive

8.55

8-9cm

Midwife notes: “Still pushing with contractions, copious pink liquor and bowels opened.  VE to assess: cervix 8-9cm thick anteriorly to the right side of cervix pp -1.  Posterior fontanelle felt at 1 o’clock.  Papation anterior LOA.  Currently variable and reactive trace with variable decelerations.  Baseline FHR 130-140 b/m.  Show present on pad.  Contracting 4:10 strongly.  Maternal observations within normal limits as charted.”

I was screaming at the midwife to help me know what to do.  She seemed more concerned with catching ‘liquor’ and faeces on that pad, and reporting to her ‘superiors’.

9.05

ROM – clear

9.08

FHR 140 reactive

9.15

FHR 130-140 reactive

9.23

“moving between standing and squatting”

9.30

9cm

VE

9.39

“anal pouting”
FHR 130-140 reactive

9.40

Midwife notes: “Dr R M phoned and asked to R/V Rebecca.  On VE at 21.30 hrs, cervix 9cm with 8cm thick lip still.  Caput present and station -1 to spines.  Unable to determine position ? fontanelle felt at 6 o’clock.  Contracting 4:10 strong.  Copious amounts of clear liquor present and small amount of blood-stained show.  Rebecca needing encouragement not to push.  Await Dr R M R/V

10.00

8-9cm

Dr R M’s notes: “O/E vitals stable, Distressed at pains, Biggish babe!, cephalic 2/5 palpable; V/E Cervical rim around, os 8-9cms Vx at -1, Moulding + caput + ? OA, Clear liquors; CTG satisfactory trace, contractions 4 in10.
Pushing since last 1 hrs, not much progressed over last 3hrs.  D/W Dr K. Prep for emergency cs.  Consent taken.  Paeds Reg informed, Anesthetic informed.”

Btw, I don’t remember giving ‘consent’, I only remember feeling coerced.  I don’t remember signing anything.

Fully, but with lip

“VE – thick, soft anterior lip, no further descent of head.
-lay on left side, breathing through contractions, PLAN: no pushing, reassess in 1 hrs.”

10.26

FHR 130-140 reactive

10.50

FHR 130-140 reactive

10.55

Fully!

“VE – fully dilated.”

11.12

FHR 130-140 reactive

11.18

“perineal buldging”

11.23

“head”

11.25

“babe born”

Noah emerged naturally from my body.

Weight:  4.3kg
Head Circ: 36 cm
Apgars: 7 at 1min, 10 at 5 mins

11.28

“Breathed lustily”

11.30

Oskar extracted from my body.

Ob comments to me during surgery: “Judging from the size of him, he would have never fit through your pelvis”.

Ob’s notes: “Post LSCS. 9cms and not progressing.  Caput 3+, Moulding 2+, OA position.  Stil (sp?) 4/5 palpable abdominally (sp?) PDx CPD
In theatre findings confirmed.
LSCS some bleeding from a?g?h? (sp?) – seared (sp?) Single layer closure, HS (sp?) on Saturday”

I had 800 mls blood loss.

Weight: 4.23 kg
Head Circ: 34 cms
Apgars: 9 at 1 min, 9 at 5 mins

Had a few kisses on Oskars beautiful mouth as Andrew held him close to my face.  Was told I couldn’t have him in recovery.  Andrew went with Oskar to nursery.

11.47

“Blood loss small”

11.50

“Babe suckling
Perineum – grazes

1. R – towards clitoris

R - posterior”

12.25

Cold, sick alone and pining for my baby in recovery.  No one could tell me how he was, no one was picking up the phone in maternity, when the recovery nurse tried several times to find out for me.

“Placenta born”

Josh and Oskar had come up to meet Noah before I delivered the placenta, but I cant remember what time that was.  I was given a cup of tea and some jam toast.

1.00

Andrew holds Noah whilst I shower for about 20 mins

1.30

Wheeled to Maternity ward

My brother comes to visit to meet his new nephew, whilst we are tucked up comfy in bed.

2.30

Nurses notes: “Returned to ward on trolley with wardsmen & recovery staff at 0130 after an emergency lower segment caesarean section for CPD.  S/B Dr M for review of IV fluids.  Currently running 1L Hartmanns + 40 units of Synto (line A)& commenced 1L Hartmanns (Line B) over 3/24 ms (sp?) for adequate hydration.  Tolerating clear fluids IDC patent and draining dark brown stained urine.
Pain relief as charted.
PV loss small rubra.  P+ washed on return to ward. Abdominal wound intact.  Nil ooze.  Observations T38degrees, BP 138/70, P72, R20.  Warm blankets removed.
Baby brought to mum for breastfeed.  Sucked well & mum now settled.
1/24 Resp/sedation score continues as ordered.”

Nurses were confused that I wanted to keep Oskar with me.  They commented “Shall we take him back to the nursery now” after he fell asleep at the boob.  I told them he wasn’t going anywhere!!

Enjoying beautiful babymoon, drifting in and out of sleep with my babe in my arms and at my breast.

Sally goes home so she can jet off to her homebirth conference :-D

The next day

0615

Woken up continuously to be analysed, I get nauseous and have flashbacks of hallucinations for 24 hours, and cannot go into a deep sleep, as flashbacks wake me up with a start.  I vomit and am in a lot of pain.

Enjoying beautiful babymoon, drifting in and out of sleep with my babe in my arms and at my breast.

2.25

Still very sick.  Still unable to sleep due to flashbacks.  Family disturbed by the state I am in.

Obs notes: “C/s for CPD”

Go over to my brother and SILs for a bit of lunch and to show off new bubs….I feel as high as a kite!

I feel like I can take on the world!