My MIL gave me about 8 copies of MIDARS (Midwives Information and Resource Service) Midwifery Digest from when she was involved in voluntary midwifery and childcare work back in the early nineties (She was a midwife in the seventies and early eighties).
There is a section in the publication entitled "What would you do?" in which midwives are given a hypothetical situation and they then provide explanations as to what choices they would make in that situation. Sometimes these situations are in a clinical setting and sometimes in the home of a birthing woman. I find these articles very informative and decided to try doing the same sort of thing here on MDC. Most women having a baby want to know what could go wrong and then what their midwife could do. It brings them a sense of comfort and ease.
I don’t want to cause any rifts, just a place where midwives can shed some light and ease a little anxiety in expectant mothers. For me, I feel at a loss as to what to say when someone says, "But what if X happens?" I trust that my midwife will know what to, but I feel it would clear some myths people believe about home births if I could give them solutions to potential problems.
So... here is your first hypothetical: SLOWED DOWN LABOR
You have been Jayne’s midwife since she came to you at 16 weeks gestation. She is 23 and married. This is her first pregnancy. So far the pregnancy has progressed without any complications and she and her husband are looking forward to having a homebirth.
She is now in active labor and so far things have progressed smoothly. She has been having regular contractions and seems to be coping well with the pain; you believe that everything is going well.
Then, without warning, Jayne’s contractions become irregular and eventually stop. You check the baby's heart rate and discover there is no sign of distress.
After an hour there are still no contractions and the baby is still fine, what do you do?
You were probably only asking midwives, right? I'm not one, but here is what I would do (or what I would want a MW to do for me):
I would wait. I would ask the woman if she is fearful or anxious, as these emotions can impede labor, and if she was I would talk with her. I would tell her that although there will be pain, it will go away right after the birth and will cause no damage to her body.
If she is not nervous, I would just look at this as yet another (normal) variation of labor. Maybe we could do something not baby-related - listen to some music, have a snack, go for a walk, look at some books.
I would also remind myself that no labor went on forever, and that all babies eventually come out. I would not see this situation as an emergency, and I would continue to monitor the baby with a stethoscope and reassure the mother. I would say a silent prayer of thanks that this baby will be born at home and not in the hospital where the mother could be on her way to being given drugs or cut open for no reason.
i just wanted to say that i am very excited about this idea of what would you do. this household suggests a few things:
1)have her makeout with her husband (nipple stimulation). give them some privacy of course.
2)go for a walk
3)music and dancing (just a little, just have a little fun)
Have her take a nap and see if labor kicks on and wakes her up.
As long as the baby is O.K. and the membranes intact, what is the rush?
Depending on her level of energy and the baby's tolerance of the labor thus far I would give her the option of doing some things to try to get labor going again (Start-up, nipple stim, etc.) or getting some sleep and seeing if it starts up again. I am a big fan of resting if you can rather than messing with labor and ending up with an exhausted mom.
I agree with resting, and to it I would add hydration. With a liter of fluids (IV or orally) and some good sleep, I have seen many a stalled labor start up again.
yep, a nice warm bath/shower, some herbs or alcohol and sleep. typically, she'll be woken up with strong, active labor contx again.
i would also leave the house. a watched pot...
I would perhaps look at the baby's positioning~
if there is no hurry ie past dates
rest, maybe a half glass of wine.
I would not try to rush it if her body doesnt need to,
midwife asst/apprentice here
I have never heard of giving the woman alcohol before... how would this help?
I'd say, "Lucky you! You did lots of great work, and now you're getting a break. Take a long, warm bath and a nap. I'll be sleeping in the spare bedroom."
Excellent discussion topic.
Actually, this situation happened to me with the birth of my son three years ago. I had jumped right into the jacuzzi tub at 4 cms with contractions about 5 minutes apart. They slowed, then stopped completely. No distress to my baby.
I was encouraged to walk and then eat and drink something. Rest, if I felt it and "talk" to the baby. After a walk around the block, my contractions started right back up again.
These are things I would tell Jayne.