LABOUR DAY WEEKEND
How long is too long?
Anna began labour at 3a.m. on Fri. She was excited and relieved. They had lost a baby last year so thrilled to arrive at the due date and all looking very well. I arrived around 10a.m. to find Anna not really in established labour, the contractions were not regular but she was needing to focus. By 3p.m. she wanted to go to the hospital, where she could have baby checked and be reassured. She refused a vaginal examination.
The next few hours were spent in the bath, where labour seemed to intensify and become a little more regular, the midwife suggested a vaginal examination. Again she refused. A few minutes later and 2 doctors arrived, insisting on an examination as she did not look like she was in labour (great news for Anna at this stage – they have such a way with words!)
She was 1 cm. dilated at 9p.m. and they suggested she go home. They did not feel safe doing this so I reassured them, turned out the lights and suggested they both get a good night’s sleep as by now the contractions were very mild, and very irregular.
Sat. morning 9a.m. and back in the shower and bath. Contractions irregular but strong. Throughout the day she laboured, changing positions, drinking, encouragement from me and her partner. There were many vaginal examinations throughout the day. Sat. morning she was 2-3cms. By mid afternoon she was 3cms. Baby was posterior, wedged in a very awkward position and her cervix was swelling. Syntocinon drip had been commenced to increase contractions and hopefully dilation. We discussed options. She was exhausted. She was unable to have an epidural due to previous back surgery. Gas was not effective. She wanted a spinal anaesthetic and a caesarean. The Registrar doctor stated that there was no indication for a caesarean section to be done as the baby’s heart rate was good. This is indeed an extraordinary statement. There is much evidence to suggest that the CTG monitor does not give the most accurate picture. It certainly does not monitor how baby is feeling or how Mum is feeling. Syntocinon is rugged! Making the uterus contract artificially and causing pain. She continued with the Gas and we negotiated a plan that if there is no progress in 2hrs then look at ‘other’ options.
This seemed cruel. She was in so much pain due to baby’s position, swollen cervix and the syntocinon. Her partner and I provided the best support in a difficult situation. Anna was warrior-like, in the middle of the world’s longest marathon. The exhaustion was awful. Baby’s heart rate was good!
At about 8p.m. she was 5-6cms. And still the doctor wanted to continue. We had more discussions and more negotiating and an hour later he decided that there was a valid reason for moving to the caesarean option due to slow progress! Really??
Now I am usually in the position of negotiating the opposite on behalf of women. All those cases where ‘someone’ in the medical profession wants to rush to the caesarean option, for reasons that have nothing to do with the health of a Mum and baby!
This was different. It was distressing to see Anna’s level of exhaustion, and no baby, after 42hrs of bashing her head against a brick wall, is O.K.!
She had a caesarean section after 44hrs of labour, with a spinal anaesthetic. Her beautiful daughter was born – finally. Her condition at birth was ‘stunned’. With a deep ridge around her forehead, where she had been stuck, and large amount of congestion on the crown, she was certainly going to have a substantial headache.
This outcome was predictable many hours before it happened. There was no benefit to anyone of ‘struggling’ on, no matter what.
Are hospitals now so paranoid about being sued that they have reversed their point of intervention?
In over 35 years of being in this business I have never had to negotiate (we were begging) for a caesarean. Anna and her baby will need a lot of time to recover. I am thrilled they have a happy, healthy baby. Her strength, determination and belief was unwavering. Birthing women never cease to amaze and inspire.