Birth is Unpredictable
Life is unpredictable. The weather forecast can be wrong. Mothers and midwives can be surprised. Actually, we often are. J had had the luck that many women wish for: smooth, quick, unmedicated births. The first time she gave birth, she pushed twice and her baby slid out. The second and third were similar. She is a healthy thoughtful woman and please forgive us for expecting the same the fourth time around. Her first three babies were born on the early side, at about 37 to 38 weeks and were about 7 pounds. Her fourth baby wanted more time to grow. A couple of days prior to her due date J called saying she “thought” she was in labor. She was hesitant but her husband wasn’t. He had watched J before. The baby was on his way. Upon arrival at the birth center, I was unsurprised when a vaginal exam showed her to be almost fully dilated. The heart rate was heard on the lower right and the head was low and well applied to the cervix. I thought that the baby was in right occiput anterior position and that the baby would probably be born in a few minutes.
Who knows those pesky right-sided babies? Yes, they are unreliable. I wonder what it feels like for a baby to be inside a mother? Somewhere, deep in my unconscious brain matter I know that I remember, but for the life of me I can’t figure out why babies find the left side a better exit route than the right. Those on the right often, given the opportunity will slither to the posterior. Then if you’re lucky they’ll find their way comfortably to the left. If you’re unlucky they’ll roll around in the back whatever you do and give us all a hard time. It’ll be hard for us all, but mostly for the unlucky mom.
So back to J. She got into the bathtub. That’s what most women want to do when the going gets heavy. This may have been her undoing (or her baby’s) or maybe not. Within a couple of minutes she was pushing. And pushing. And pushing. She liked pushing standing. She pushed on the toilet. She pushed on the birth stool. She got into knee chest position, into lunge position. We used the rebozo as she knelt. We put her into back-arching upside down on her back (seen it work before!). J gave it her all, powering into her pushes and bursting blood vessels in her eyes. After an hour and a half we still could not see any baby at all and the sinking feeling that this might not happen flitted through my mind. No, no, J is strong and focused. This baby and Mamma will do it.
And then millimeter by millimeter the baby began to come down more. It was going to happen. After two and a half hours of pushing, with J’s husband sitting on the bed, supporting her into a squat, she bore down and gently eased her baby out. He emerged face-up looking his mom in the eyes. He had a huge cone on the right side of his head showing that he was not only in a posterior position but also ascynclitic. (He also had a nuchal cord, not tight, probably not contributory) Ascynclitic means that he didn’t have the direct back part of his head descending first but rather was kind of cockeyed with his head which means that there is a larger diameter of head presenting. Anyway, apart from a temporarily interesting head shape, baby C was beautiful and perfect. He weighed 2 pounds more than her other babies, nine and a half pounds.
Why did this happen? Well, Kristy, who was assisting me that day suggested that it might have been the anterior placenta. Yes it might have been. But most babies with anterior placentas find the efficient way out. So it must remain a mystery why C chose to exit J’s body this way. That is his story which will be buried in his unconscious brain matter.
J was swollen and sore but happy and felt that she had learnt much. So had I.