Skeptic Nurses and doctors.

Why is it that whenever a woman dilates quickly, that nurses are so apt to disregard their pleas that they need to push or they need to be checked.

I've had two, no four incidences where the hospital staff thought my client was either lying or simply over reacting.

One occurred back in 2007 and I had a volunteer client. When we get to the hospital my client is doing really well and then around 2:30pm is checked and is found to be 5cms. A few minutes later the doctor comes in and they want to put a scalp monitor on her because they are having a hard time getting the baby's heartbeat. While the doctor is fiddling around with the package I sense my client pushing and ask her if she is and she says she can't help it. The doctor is still fiddling and I say that she is pushing and the nurse is convinced she is pushing on a full cervix. I try to tell her to breath through the contractions but she keeps insisting the baby is there and then that the baby is out. The doctor and nurse are completely ignoring her and then when the doctor lifts the sheet to insert the scalp monitor, there is the baby! Head out, ready to have the shoulders birthed. That was at 2:50pm. It was crazy but shows that women know their bodies and the medical community don't trust what the woman says about her experiences.

I bring this up because it happened again last night. My client whom I had just met as I was called in for back up was assessed in triage and found to be 1-2cms. They came to the hospital early but given that their drive was over an hour, mom felt like she needed to be there. I always say, if you feel like you need to be there, then you need to be there. They called and told me it was early but I felt like I should go, (I was already half way there) to meet them and get to know them a little. I met them in the hall, they were sent for a walk and had basically had taken 20minutes to walk up the hall and were on their way back down. Her contractions were intense and over a minute long. They were coming every two minutes. Her skin was goose pimpled with each contraction, that's how intense they were. She said she felt like she needed to push and I don't take that lightly anymore. Her husband and I got her back to the room they were using to store their stuff and I suggested going to the bathroom to see if perhaps it was a full bladder she was feeling. Trying to urinate was just far too intense and she said again she felt like pushing. I confirmed with her that she was feeling pressure in her bottom and she was clearly loosing her control. I told the dad to go out and get the nurse and tell them she is feeling pressure and needs to push. "That outta get a reaction out of them" I said. The nurse came in and tried to calm her through the contractions and the look on her face clearly said "I don't believe you, suck it up." My client was begging for pain medication and the nurse finally decided to check her and in the 40minutes since they had been checked she went from 1-2cms to 7-8cms and then 20minutes later was fully dilated and pushing her baby out. She pushed for about 20 minutes and her beautiful daughter was born.

These labours are called Precipitous Labors or Precipitous deliveries. They are births where the labour lasts less then 3hrs. Some information I've read says they occur between 2 and 5% of labours and are less likely to happen in first time labours. These labours are so rapid and it is so hard to manage the pain. The mothers are literally overcome by the contractions. Epidurals are useless in this case as even if one is able to be given in time the medication will not be able to cover the intensity and or catch up with her pain. One key thing will be to remain as calm as possible and not be over come by fear and tension. I know, easy to say, harder to do. But it is critical that you let your body do what it has to do and not stand in its way.

So as a doula it is my job to listen to the woman and trust in her body and trust in her own reading of her body. She knows better then anyone what is going on and if given the ability to labour in safety and a stress free environment her instincts will rarely be wrong.

Toronto East General Hospital

Wow, is all I can say for this hospital. It was amazing. The birth itself was great. Unmedicated, my client was in complete control and she was a rock star. I'm so proud of her. And to top it all off the hospital was amazing. Great jacuzzi tub that the nurse suggested to use. (Normally I get a weird look if we ask to use the tub.) One nurse brought out the birthing bar for my client to squat if she wanted to. (Normally they pretend like they can't find it.) The room was beautiful and very quiet. The doctors were all so nice and amazing. One actually complimented me as opposed to treating me like wallpaper, and they seemed pleased that my clients had a doula. I would give my eye teeth to do another birth there. Oh wait I am. I'm jazzed to have been hired by another client who is birthing there. Yeah me. Yeah them!

All I can say is Kudos to Toronto East General Hospital, to Dr. Maya Ganz and all the nurses there as well. And finally Kudos to my client and her strength and her control.