Saturday, October 31, 2009

A Birth Story


Charito: on-call doula, over fifty, extremely knowledgeable, a little bossy, my best mentor at the clinic.

Olga: doula, around forty, very kind, only comes into the clinic a couple times a week.

Cecilia: mother, thirty-six, strong and warm.

Dr. Alarcón: head doctor and director of the clinic, around fifty, jovial.

When I arrived, I found Charito and others in the cafeteria just finishing up lunch. They immediately hurried me along with them upstairs, as a woman was in advanced labor with her third baby. Generally, but not always, labors get shorter with each baby, so they were getting prepared for a fast birth.

Cecilia was laboring hard on a birth ball when Charito, Olga, and I entered. Her husband was smiling with great crinkles by his eyes, supporting her through contractions by rubbing her lower back and holding her hands.

It was not long before she started needing to push and Charito encouraged her to go ahead and do that. The resident came in to ask some questions between contractions, until it was clear the Cecilia was pushing on each one. We left the room so she could change into a gown. I learned that she had been laboring since 6am this morning.

At the Clinica La Primavera, one of the doulas´ favorite things to give the dad[1] to do is to write down the start, end time, and intensity of each of his partner’s contractions on a clipboard. For some dads, this is great because it gives them a place and a job in the birth room where otherwise they would be feeling left out and useless. However, in some cases it gets in the way of their ability to be as supportive and present to their partner as they would like or feel the need to be. I cringed a little when Olga scolded Cecilia’s husband for not doing this job when he was being a great birth-partner.

Cecilia stopped to pee on the way from her room to the massage room. Once we got there though, we only stayed for two contractions. The resident did an internal exam[2] to find that the baby’s head was well on its way, and suggested we move to the tub room.

In the tub, Cecilia changed positions three times. She started in a vertical squat holding onto the cloth hanging from the ceiling, moved to partially sitting with her back against the tub wall with her knees bent, and finally gave birth to her third baby (second girl) on her hands and knees. Approximately fifteen minutes later, Dr. Alarcón helped deliver the placenta under water.

The move from the tub to the room was much smoother than others I have seen, though there was a moment right after Cecilia got out of the tub when she began shivering hard. We covered her in extra blankets and Charito told her to breathe slowly through her nose. Cecilia soon relaxed, and was gently rolled to her room, with her husband at her side with their new baby in his arms.

[1] Some women do not come with a significant other and are often accompanied by other family members. In these cases, I’ve observed that usually a male relative is given this job as his only job, or it is not done consistently, filled out by the doula, the mother/mother-in-law, or sister (who are also providing labor support).

[2] One of the things I like about this clinic is their commitment to keeping births as un-invasive as they know how. This includes no or only one internal exam, no IVs, and well-spaced relaxed baby heart monitoring.

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