Born September 1st, 2012
Sam and I first met when she was about 20 weeks pregnant and we clicked almost instantly. The next time that we got together, I got to meet Kelly, who later that same day would become her husband. I've never had the chance to see someone both on the day they got married and the day they welcomed a baby into the world, so I felt quite honored. We met quite a few times over the following weeks, getting to know each other and making plans for Eva's birth. During our first meeting, Sam told me that although she was due at the end of August, she was sure she was having a September baby - so no one was all that surprised when her due date came and went without any sign of a baby.
Sam called me around 3:30pm on Friday, August 31st to let me know she thought her water had broken about 25 minutes earlier. She said it was clear and that she was leaking a bit with each little contraction. At a prenatal appointment earlier in the day, she was already 2-3cm dilated and 50% effaced. She sounded reasonably calm, though every word buzzed with excitement and anticipation. She promised to keep in touch and I began to gather my things, drinking most of a pot of coffee and waiting by the phone. She called back a little after 6:15pm to let me know that they were heading to the hospital and asked me to meet them there.
I arrived at triage shortly after they did at around 7:00pm. She was already having contractions every 4 minutes, during which she would close her eyes and roll her ankles and toes around. The nurse in triage was pretty terrible. She was already talking about Pitocin and IVs, not having mobility, and just being incredibly negative and pushy. This nurse checked her at 7:15pm and she was between 4-5cm dilated and 90% effaced. Sam's contractions were starting to take a little more focus and she would rhythmically rub my hands, commenting on their unusual softness, making us both smile. The nurse wanted her to be wheeled over to L&D but Sam insisted on walking, making it into a room at 8:30pm. This is when we met the amazing nurse that would care for her until after Eva's birth and Sam commented that she was glad she had the “biatch from triage” because it made her even more grateful for Amy, her new nurse. Amy got her on the monitors and put in a saline-lock in place of an IV.
She checked Sam at 8:55 and found her at a good 5cm dilated, completely effaced,with the baby at -2 station, still fairly high in Sam's pelvis. Dr. Merkell was the doctor who would attend the delivery, and although Sam had never met her we were optimistic that she'd agree to follow Sam's birth preferences. Amy got the doctor to agree to intermittent fetal monitoring which meant that Sam would spent about 30 minutes on the monitor and 30 minutes off. During her time on the monitor, she had to lay in the bed which really restricted her movement but we made sure she didn't go through a single contraction without hands on her. This is when everyone started learning what was going to be helpful throughout Sam's labor. She wanted Kel to rub her hands or her feet during contractions and when her hands weren't occupied, she wanted to be rubbing something, frequently my belly, arm, or hand. When she was free from the monitors, she walked back and forth across the room, coming back to the bed to lean over the ball during contractions. She would use this time off the monitor to use the bathroom as well, although being on the toilet made her contractions more intense. While she was leaning over the ball, either Kelly or I would press firmly on her back or hips until the contraction let up. She was getting really good at sensing them coming on, finding a rhythm with her body as each contraction built, peaked, and let down. She managed to eat a few cherry popsicles, which according to her had a lot of depth to their taste and might have been the best she'd ever eaten. Her family visited frequently during this time and her mom took video of her both in between and during contractions to show off her strength to family members waiting in the lobby. It was also around this time, during one of her breaks from the monitor that I french-braided her hair in an attempt to keep it out of her face during the hard work to come.
Sam was checked again at 11:05pm and we were told she was 6½cm dilated and the baby had moved down quite a bit with her head well applied to Sam's cervix. The fetal monitor was starting to show the expected signs of head compression as the baby continued pressing down on her journey out. While Sam was on the monitor and stuck in the bed, her contractions would slow down, giving her about 5-6 minutes in between to rest and regain her strength. Once she got back up, her contractions would pick back up and she would fall back into her ritual of pacing across the room and then leaning over the ball on the bed during contractions. While she was leaning over the ball, we would push the heating pad into the small of her back, apply counter-pressure, and massage away on her upper and lower back. From a light touch up and down her arm to massaging her feet, I tried to continually be touching her, even between contractions. When she was checked at 1:15am she was 7cm dilated and her contractions were really starting to pick up in intensity. They were still about 3 minutes apart when she was in the bed on the monitor and about 2 minutes apart when she was up and swaying through the pain.
Around 2:30am, the baby's heart rate was falling a little at the end of each contraction and although it quickly returned to normal, this meant that Sam would need to be on the monitor constantly from here on out. We spoke with the nurse and she agreed that it would be okay for Sam to get out of bed as long as we could keep the baby on the monitor. Sam stood beside the bed, swaying and moving her hips around in between contractions and assuming her favorite position of leaning over the ball during contractions. She was starting to need to make some low moaning noises around this time and moved back to the bed at 4:15am for just long enough to get checked. She was starting to feel a lot more pressure and was really glad to hear that she was about 8-9cm dilated, with it being a little bit thicker at the top. She was incredibly thankful to get up after this check and fell right back into her routine. At 4:30am, Sam started really needing to moan during her contractions. Since this was the first time Amy had heard her from the nurses station, she came in pretty quickly and recommended getting back into the bed for another check.
At 4:35am, the nurse checked Sam and found that she was completely dilated. During Sam's next contraction, the nurse told Sam to try and push and while she did, she pushed the small remaining lip of Sam's cervix over Eva's little head. Sam pushed two more times before Amy said she needed to go get the doctor. Dr. Merkell came in and instructed Sam to push while she set up everything she needed. Sam's mom and I switched places at one point so that she could help encourage Sam from the head of the bed while I waited for Eva's arrival with a camera in hand. Sam was making great progress and was just as awesome pushing as she'd been throughout the entire labor. By 4:50am, we could all tell that Eva had a little bit of dark hair and at 4:55am, Eva Francis was finally earth-side.
She was immediately placed on Sam's chest as she was cleaned up. They managed to get a few extra minutes still connected and then Kelly was instructed to cut the cord. Eva didn't quite pink up as quickly as they would have liked so she went over to the warmer to get dried off and stimulated a little more. Kel went over with the baby while I stayed with Sam at the bed. She had a small 1st degree tear that needed to be repaired and she even developed a little mantra to make it through this part of the delivery as well. While the doctor attempted to numb things up as much as possible, Sam just repeated rhythmically, “a stick and a burn” over and over. There were lots of facial grimacing and attempts to distract her but it was over pretty quickly.
The nurse weighed Eva and she was 7lb 9.6oz and was 20.3 inches long. She was returned to Sam's chest and we quickly started trying to get her latched on. Eva still sounded really gurgly and after she spit up a bunch of amniotic fluid during the initial breastfeeding attempt, the nursery nurse suggested that she be suctioned a little to get any remaining fluid out of her lungs. After she was suctioned, she was much more interested in breastfeeding and first latched on at 5:40am. She had a great latch and took to breastfeeding like a pro. I left the hospital around 5:30am to come home and get some rest, returning later that afternoon to check in on the new family. Sam did such an amazing job during her entire labor that it was no surprise to me that she took to motherhood just as well. We had a great little moment during our afternoon visit where we both expressed how well we felt we got along and we made the mutual decision that we just had to be friends from here on out. It's pretty rare that I feel such a great connection with a client of mine and I look forward to seeing our relationship grow and change!
**Posted with permission**
