A nurse who knits…

November 22, 2007

A non-epidural birth

Filed under: Nursing — yarnnut @ 1:55 am

For those of you who are looking to read a knitting post, this is not one of them.  I’ve done a bit of knitting but a lot of working.  And by working, I mean birthing babies.  I do have a preceptor who is guiding me and I need lots of guidance right now since I’ve only done nursing stuff with pregnant women these past two days.

Yesterday I had a Spanish speaking multip who was post date and coming in to get induced at 8 am.  She specifically stated that she did not want pain medication.  As nurses, my preceptor and I had to explain her options anyway just so she knew.  We did all of the usual tasks of getting her admitted to our unit, orienting her, starting her IV, starting her pitocin, and getting her labor “started”.  She was rating her pain as 2/10 most of the day and it was tolerable.  Her doctor came in around 8 am to check her out and she told us that the woman’s cervix was very high, dilated to 1 cm, and her bag of waters was intact.  To an L&D nurse, this means that we’re in for a long day.  Or so I thought….

We were increasing her pitocin all day long trying to get her contractions to come at regular intervals.  I pretty much stayed in the room and practiced my Spanish with her.  Her sister in law was in the room but not really participating.  She started feeling them more at around noon.  That’s when I started doing my doula maneuvers.  I used ice to distract her from her pain.  We repositioned countless times.  She used the bathroom A Lot to keep the baby moving down.  I put counterpressure on her back to relieve her back labor.  My preceptor said I was doing a great job supporting her during her labor.  Now, I haven’t told many nurses including my preceptor that I am a doula for UCSD.  I’ve been hearing some of the nurses saying bad things about doulas like they aren’t helpful to anyone and that they tell moms not to have c sections when they need one.  As a doula, we can help clarify things that we are able to and to encourage the parents to seek education.  But never, ever do we provide medical advice.  It’s not our place to do so.  We’re supposed to support the parents’ decision.  So, I’m holding my tongue for now until I am off orientation.  So around 1:45 in the afternoon, her doc comes in to check her.  My preceptor was helping down in another room because another baby was having some decelerations in the heart rate.   In case you were wondering, “decels” are not necessarily good and need intervention.  The doc tells me that my lady is 5 cm dilated, 100% effaced, and -2 station.  My patient from the day before had her water broken, was at the same station and around the same dilation and did not give birth for 6 hours.  That lady was also a multip.  So the water was broken at 1:46.  Right after the doc left, my patient started to lose it.  She told me that she couldn’t handle the pain and she started grabbing my hands and was getting quite hysterical.  Meanwhile, I’m trying to get the baby back on the monitor before I take a look at what happened in her nether regions.  I was trying to calm her down saying that we could get the anesthesiologist in if she wanted pain relief.  Luckily, my preceptor walked in and stuck her head down there and said, “We need to set up for stat delivery.”  At this point her water had been broken for about 3 minutes!  The poor patient was instructed to not push and I paged the doc as my preceptor tried to get the room set up.  The doc walks in around 1:55.  The baby was born at 1:57.  Jiminy cricket, that was fast.  What an adrenaline rush!  My first birth without pain meds.  I found that it is much faster than other births that I had seen and that transition is MUCH more apparent.  Which is probably why I didn’t recognize that birth was imminent so quickly after the rupture of membranes.

Now this birth did not follow the pattern for a normal birth so I was totally discombobulated.  I didn’t restart the pitocin at the right time.  I wasn’t firm enough with my lady in getting  her to push.  I think everything was such a blur that nothing I learned the day before popped into my head.  I ended up being baby nurse, which is the best job of all when the baby is ok.  I got to dry him, put him on mom’s belly, and do his assessment.  This baby was beautiful.  And I played a small part in bringing him into the world.  I thought my preceptor was going to be upset but she told me that I did great and that she was also out of sorts because of the speed of this delivery.  My second delivery as a nurse… I’d like to think that I helped this woman forgo the pain meds even though she was on pitocin which can make labor contractions unbearable.

As for knitting, the Charlotte’s Web is on it’s last few rows.  I just have to crochet an edging around it after that and put a fringe on.  I was scared that I wasn’t going to have enough of the 4th skein to finish the color sequence but I ended up having about 5 feet left over.  Yeah!!!  I will post pics probably before the weekend of an unblocked shawl.

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6 Comments »

  1. Love reading your baby stories!

    Comment by Cindy — November 22, 2007 @ 2:18 am | Reply

  2. You ROCKED IT!! Yeah for you.

    I can’t wait to see your CW!

    Comment by knittingnurse — November 22, 2007 @ 3:32 am | Reply

  3. Oh! You have reminded me of all the reason I always wanted to work in L&D. someday…

    congrats on such a great experience!!!

    Comment by Kristina — November 23, 2007 @ 12:09 am | Reply

  4. Great story! L&D is my 3rd choice after CCU and ED, but that story just reminded me that I should choose to work in a hospital with L&D, just in case the other two don’t work for me!

    Comment by missebaby — November 26, 2007 @ 5:57 am | Reply

  5. Wow! Great job! I wish you were around when I had to get induced. It took me 2 days.

    Comment by Karla — December 1, 2007 @ 2:05 am | Reply

  6. Great story. I wouldn’t wish induction on my worst enemy, but do realise the reason for this one.

    I am a retired RN, who had 3 prepared childbirths 29-24 years ago. All different, all doable.

    3rd child was a -3 presentation, 5cm at arrival to hospital at 5am. She was born at 9:45am. My shortest labor time at the hospital.

    Continued good luck as a L&D nurse. You sound like a dedicated one. Your patients are lucky.

    Comment by Marsha — December 2, 2007 @ 3:57 am | Reply


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