StorkStories.....

May 2

Medical Science vs Natural Childbirth

I sat here to write the story of our first planned VBAC and realized as I scanned my other posts that I had to tell just a little more history to help explain the attitudes of the times.

During the mid 70’s early 80’s… our country was changing in many ways. In the medical world, Obstetrical medicine was becoming more specialized with the development of many subspecialties including “Perinatology” and “Neonatology”. Perinatology by definition is the study of the unborn fetus and recently born infant during the first several weeks of life. It was the changing concern of obstetricians from a sole focus on the mother’s health to one which is balanced between the mother’s health and the unborn or newborn. ACOG started to offer a specialty certification exam for perinatology in 1974, and in 1977, the Society of Perinatal Obstetricians (now called the Society for Maternal-Fetal Medicine) was formed. The term used to describe a Perinatologist today is a Maternal-Fetal Medicine Specialist. This specialty is the management of high-risk pregnancies and the assessment and treatment of the fetus. Neonatology (established 1975 by the AAP) is the study of a highly specialized care of the newly born infant especially the ill or premature newborn infant usually hospital based in NICU’s.

Young women were becoming more and more interested in a natural approach to childbirth. People all over the country were driving maternity services to offer the availability of birth options for these moms. The ICEA [International Childbirth Education Association] came to our town in the late 70’s and a local chapter was born. “Freedom of choice based on knowledge of alternatives” in childbirth was a motto on their pamphlet information. There were some individuals in the community going for the new certification of childbirth educators. They were educating some new mom’s about birth options…… that we, the staff hadn’t learned about let alone developed as an option for our patients. Many on the staff scorned this movement. It seemed to me that these changes were all happening at the same time. We were learning about advances in observing and monitoring the well-being of both the laboring mother and her unborn fetus, preventing complications etc…. arising from the research studies done from the emerging sub-specialties. We had one fetal monitor and purchased another. As soon as the specialists found that continuous fetal monitoring was advantageous to picking up potential problems in advance, to possibly avoid or prepare for complications, there was a natural childbirth revolt against the constant recumbent positioning that EFM (electronic fetal monitoring) seemed to require. There were more examples as with IV fluids or access and other routine procedures. The nurses didn’t understand. They were just trying to do what science and our doctors were telling them…[though not always willingly as some were afraid of the newer technology.] To them, this group pushing a natural childbirth movement was the same population that had just wanted to be given drugs, put to sleep and “wake me when it’s over” crowd.

I realize that although these advances in science and the movement of young people seeking natural childbirth options seemed to happen so close to the same time in my world, it probably didn’t happen this way for all of the country. Here, I really think it probably greatly contributed to the attitudes of nurses and doctors I worked with at the time. Those professionals who just couldn’t relinquish control. They were learning more about the science of birth, of monitoring and couldn’t quite allow or see how the “natural” component could fit in. Those individuals often were guilty of the abuse of professional power, the use of misinformation and the blindness and arrogance to maintain control of the birth process… taking it away from the mother. Those professionals who should have known better. They did not know of the rights of childbearing Women, or of general patient rights for that matter. Unfortunately– there are some who still have these control issues.

That’s another story….

Apr 16

12 Comments

Stand and Deliver? There’s No Stopping Her

I recently read a post from another blog about the study cited in The Cochrane Library discussing patient mobility & upright positions in early labor. The summary talks of the authors’ conclusions that there’s evidence supporting walking and or upright positions in early labor which can reduce the total length of labor without being associated with any increase in medical interventions or untoward affects on mom or baby.

Thus I was immediately taken back to 1977, long before any such studies. This woman certainly didn’t read them! She wasn’t my patient…. my patient was in the bed next to her. (No single labor rooms back in 1977.)

When she arrived on the unit, she was already entering active labor. Her contractions where about 2-4 mins apart lasting a good 60 seconds and she was WILDLY out of control. This was her first baby, and at 4 to 5 cm dilated, she was thrashing all over the bed refusing any measures of support, IV or pain medicine offered to her by her nurse. She was probably offered “Twilight Sleep” consisting of Scopolamine and some narcotic–which we used a lot and many mom’s had hallucination or delirious type side effects.

It is important to note here that this woman was 5 ft 11.5 in tall and probably weighed a good 225lbs. I remember this because she seemed huge and I thought she was at least 6 feet tall and looked at her chart. Her nurse was only 4 ft 11.5. The doctor on duty that evening was of Asian decent, very petite and about 5 ft, 1 or 2 in.

Back to the poor mom in labor. I couldn’t help much because I was assisting my own patient and a few labor checks that were hanging around. No other labor coach or father of the baby around in those days… It wasn’t long before this run-away train of labor progressed to point where mom was fully dilated and had the urge to push. Many women of this body stature have quick, sometimes fierce labors…..I have no study, just my observation.
Here’s what happened:
Mom: “I have to get up out this bed”
Nurse: “We have to start pushing now, I need you to take some deep breaths and when that next contraction starts, you can push with it.”
Mom: “Mmmh Hymmm I have to get up out this bed!!! Do you hear me???”
Nurse: “I hear you, we can’t let you get up right now, the baby will be coming soon… Let’s try to focus on pushing”
Mom: “I AM TELLING YOU….. I HAVE TO GET UP OUT THIS BED!!!! YOU NEED TO HELP ME!”
Nurse: “I am trying to help you”
Mom: “I’m gettin up”
Nurse: “Please try to relax”…blah blah blah

There was no stopping her. This woman stood up, ON THE BED, placed her hands on the ceiling, spread her legs and began to push—loudly !
There wasn’t anything to do except accommodate her. The nurse grabbed the “precip-tray” we use for emergency deliveries and called the doctor in. They put the large metal side rail down and these two tiny birth attendants were actually the perfect size to get in under her large frame and assist the delivery of the baby. It was an awesome sight!
I wonder if she ever reads about the research now and thinks back at how she was ahead of her time..she knew what her body needed to give birth.

Apr 15

8 Comments

Once a Cesarean—ALWAYS a Cesarean

Thought process, attitudes and practice surrounding Cesarean Section Births of the mid 1970's from my memory.

Apr 7

2 Comments

Tuesday Twins

A Few 70’s Twins Tales

It was Autumn 1975 when she arrived on the unit in labor. She stood close to 6 feet tall and was very very pregnant. She knew she was having twins. Twins were usually diagnosed after a mom grew larger than dates and by finding two fetal heartbeats. I had never seen someone that big! I was amazed she could even walk. She was taken to a labor room for the standard prep and SS enema (3H..High-Hot and a Hell of a lot). They did an abdominal girth: 60 inches…. that’s 5 full feet! We did not have any U/S to check fetal position. We relied on our exam and assessments. If the first twin was head down (vertex), that was all that mattered for the moment. Labor progressed and when she was close to crowning, she awkwardly and with a great deal of difficulty, maneuvered over to the stretcher and then once again, across the hall, moved onto the delivery table. She was asking for anesthesia. They provided that with some nitrous oxide or something by mask. The first baby was born spontaneously. A boy!! a BIG BOY! He weighed 9 LBS 6 oz! Wheeh! The doctor checked the 2nd baby’s position and it was vertex and moving down. I think they used some low outlet forceps and within 3 minutes, the 2nd baby was born. A girl!! An even BIGGER GIRL! She weighed 10 LBS 7 oz! Both were strong, vigorous and pink.
The placentas were delivered and Pitocin IV given (a Pit Drip we called it). She had no complications I can remember. These babies were just the biggest twins I had ever seen or ever did see so far…;-)
How about you? I have a poll on this page…please answer! I’m interested in your twin stories.

The young wife of a prominent local attorney arrived with her mother-in-law to be admitted to the labor room for delivery of her second child in the late 1970’s. She was about a month early, 35 – 36 wks. Her husband was away at a conference. Her belly was pretty big for her small frame. The doctors were all quite concerned about the size of the baby and how it would fit through the birth canal. They decided to send her to X-Ray for Pelvimetry. They would take films and measure the internal size of the bony pelvic inlet, spines and outlet, the compare those with biparietal diameter of her baby’s head. The film showed TWO baby’s heads, not one! Surprise! I’ll never forget the phone call the dad’s sweet refined little mother had to make to her son. She maintained her composure…”Thurston dear, we are at the hospital. Elizabeth is in labor, dear……..yes dear, I am quite aware that she isn’t due yet….Thurston dear, there’s more….. You are having twins darling……..Are you alright dear?? Yes..they are all fine…. we’ll call you back soon. See if you can come home, dear.” Elizabeth and Thurston (names changed for this story) became the proud parents of identical twin girls by vaginal delivery later that morning.

One of our OB staff nurses, Sue, had a sister having her third baby. She had 2 boys at home and everyone was hoping for a girl. Nobody ever knew the baby’s sex before the birth back then, unless you had an amniocentesis for medical reasons. Even then, many moms did NOT want to know and it was written on the chart that way. The mom’s labor progressed very quickly and soon she was in the delivery room, her sister Sue at her side. I was designated to wait outside the DR and let all the anxious staff know if it was a girl..
I couldn’t wait after I heard the baby crying. I peeked in- there was a little 5 pounder squirming on the Kreiselman! It was a boy! The doctor was saying “Check the belly—check the belly, I think there is another one!” Sue was huddled over her sister trying to help calm her while reaching back to hold oxygen oven the baby’s face. I came in to help. Quickly after that, another baby was born! Again, a squirming 4 or 5 lb baby boy! Surprise twins! Everyone was quite shocked! Sue was then holding the one oxygen mask over both babies together while hugging her sister. The boys turned out to be identical and quite handsome young men as they grew up.

Apr 2

4 Comments

An Amazing 1970’s Hypnobirth

Circa 1975– I had the privilege of caring for and witnessing a birth so incredible and controlled that in retrospect, I feel this must have been a hypnobirth. My understanding of a hypnobirth is a focused concentration of the mother where she can be in a total state of physical relaxation yet be truly focused and totally aware, in complete control. I’m sure there is more to it but I am no expert.

The mother arrived first; labor had started at home while dad was at work. She was in early labor trying hard to do some breathing techniques. I thought this was another of the new “natural” childbirths. I was coaching her as best I knew how. When the father arrived, the tone immediately changed. Mom had been struggling to maintain control with breathing. The connection between them was instantly apparent. She relaxed quickly upon his arrival, his touch, his presence and they then slipped into their own world. She became very relaxed. He made it clear to me, nicely, not to interrupt them unless I needed to check on or examine mom or baby. He sat close to her in his own state of relaxation very silent, head bowed. When she would begin a contraction, she lightly touched his finger. He then began an energetic animated and quite interesting fast paced storytelling on which she concentrated during the entire contraction.

The contraction ended, the story stopped and dad was once again silent, relaxed, head bowed…waiting. Mom was very relaxed sometimes dozing until another contraction. She lightly signaled him again, and quickly his story picked up right where he left off with the same energy. This went on for about an hour and a half.

She seemed to be progressing in active labor quickly for a first baby. She sailed right thru transition and went on to push. I honestly don’t remember how long she needed to push but she pushed well with his coaching. He didn’t tell the story during pushing but had her completely relaxed in between pushing. She delivered a beautiful baby boy about 7lbs without any complications or any episiotomy! An AWESOME event!

I asked them about this process they had developed for their birth. She told me she was always mesmerized by his stories that they had decided that would be a good “focal point” for her concentration thru contractions. He told me he didn’t even give her a hint of the story he had planned until he began the tale in the labor room.

I think about them from time to time. I wonder if he writes children’s books or something.

I also wish I could have heard the end of that really good story…..

Apr 2

1 Comment

Childbirth Evolves “You say you want a revolution”

The young pregnant women in the 70’s began to realize they wanted and deserved a better form of childbirth than what was available to them at their local hospitals. They wanted a more natural approach. The Lamaze techniques which started in France in the 50’s (from observations of the Russians) came to the US in the 60’s and made it into the mainstream of “flower children”. Although it wasn’t unheard of, that movement didn’t quite reach our neck of the woods in full force until the 70’s. Many medical staff were solidly unwavering in their principles and still wished to control the entire event.

The fathers were wanting.. and some rightfully so… demanding to be involved and included. The connection that was often witnessed between the couple was no short of amazing to me. I was young, very interested and eager to learn about this “natural childbirth”, so I often let the couples do what they wanted or had prepared and I offered help and support when I could.

Mar 28

13 Comments

The Vintage 1970’s Maternity Ward

Just my own personal impression of how it was when I started in this business..to set the stage for some future stories in the 70's and later as the world changed.

Mar 24

1 Comment

My First Birth Event

BIRTH STORIES !!!

I can’t possibly start to tell these stories without a tidbit of the first birth I ever attended! This birth did indeed implant a desire for me partake in the miracle of birth over and over again!

The year is circa 1963. Living in our old 1811 saltbox farmhouse, all 5 of us ( my brother, sisters and I) are gathered in the large upstairs bathroom which was probably a bedroom at one time prior to indoor plumbing! Near the radiator on a bed of old towels, our beloved dog Dreena was giving birth to a litter of puppies! How excited I was at the age of 9! I was always an outspoken little girl… a “hoyden” my father so fondly called me. I had to try to be involved in the entire event. The first two puppies were born and Dreena was affectionately licking them. I was immediately sold on the whole thing.

A little while later, the third puppy was expelled with the amniotic sac intact…….Not waiting to see what happened next—I ran to my father to report!

“Daddy!”

“There are 3 puppies now and this last one came out in a plastic bag!!”