3 cm to anterior lip in 30 min. on a first-timer? (LONG post) - Mothering Forums

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#1 of 36 Old 01-09-2008, 12:01 AM - Thread Starter
 
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I've had some time to process this and I'd love some input.

Recently (within the past couple months), I spent the evening on the phone on and off with a woman in early labor, trying to help her decide when to come in to the birth center. She had had a prenatal appointment earlier that day and was a tight 2cm, 50% and minus 2. G1P0, in her early 30s. At first when she called that evening, her contractions were mild, and coming "every 45 minutes." (NOT every four to five.) She waited a while, called again, we chatted again, and she waited a couple more hours. Her husband called back and said that her water had just broken, and things were picking up, so I had them come in.

When she arrived, she was clammy and acting desperate. Her eyes had a wild look. I tried to get her to pee, but she had a monster contraction trying to sit on the toilet and was unable to pee. I was thinking I would check her and she would be at least 8cm. I managed to get her on the exam table to do a quick vaginal, and let me tell you, SHE WAS 3 CM. A tight 3 cm.

I do not always feel 100% confident of my vaginal exams. I almost never actually give the mom a number, because I'm afraid she'll have another exam by another midwife, and she'll be told a smaller number and be disheartened. So I try to say something vague but encouraging, like, "Oh, you're making progress!" or "Well, it seems like everything is going well." Then the midwife will check her and give an actual number and record it in the chart. But in this particular case, it was so totally completely not mistakable that she was 3 cm, that I had no reservation whatsoever recording it in the chart, calling the midwife and telling her, and making decisions based on my exam. I was also reasonably confident that the baby had moved waaaaay down to at least plus one if not plus two. (remember that earlier in the day the baby was at minus 2 according to the chart.) I could feel hair, no bag. I did not feel a suture line, but at 3cm I never really can.

So I tell her that we have got to get her calmed down, so she's going to get in the bath and relax. I tell her husband, privately, to please not call all the family yet, because it was going to be hours and hours, and they could get a good night's sleep and come in the morning in time for the birth. And a watched pot never boils, she's already all worked up, etc. etc. He informed me that there would be hell to pay if the relatives missed the birth. (Not in a threatening way, but to let me know it was serious.) I told him I was confident that we would have plenty of time to summon them and the best idea was not to call them yet.

Meanwhile, we get her into a room, start the tub, and I try my best to do the required vitals and all that while she has pretty strong-seeming contractions and says, "I'm in a lot of pain" (in a creepily calm voice) over and over again. I'm in wonder at how she can be in so much pain at 3 cm. I'm trying to make her comfortable and get the initial filled out. I have another student w/ me who is running around to get everything set up before the midwife comes over.

About 30-45 minutes after I checked her, the midwife comes over. The mom is in the tub, and loving the water. She feels much better in the water. The midwife checks her... AND INFORMS ME SHE HAS AN ANTERIOR LIP.

You can imagine that my chin hit the floor. Then I checked her at that point, there was no mistaking it, she was almost fully dilated.

After the birth when we had a minute, the midwife told me that when she first checked her, she thought she was at 4, but then she realized that it was the fontanelle she was feeling.

I wanted to accept that, but I just cannot accept that I was feeling a fontanelle. What I felt (and yes, I have second-guessed myself a million times now) was a dead-on 3cm dilated cervix with a head very well applied. And when I went in and she had the lip, there was no obvious 3cm or 4cm fontanelle that my fingers ran into; it felt very, very different in there.

But IME, anyone who is dilating uncommonly quickly has a lot of bloody show, and she had very, very little.

The rest of the story was great... nice water birth, family arrived right after the birth, no one was upset about that, and the family was very pleased with the whole experience. The mom even told me a few days later that "it was so wonderful, and it was all because of you." And I wanted to ask her, "How is that possible, seeing as I was totally wrong about everything I told you?" But of course I just kept my mouth shut. I'm THRILLED that she has processed everything as such a positive experience, but I feel like I messed up so bad!

At this point I could really use any insight as far as what you all think probably happened, what is possible etc. In my head I haven't ruled out an insanely fast dilation, nor have I totally ruled out that what I felt was really a fontanelle. I wish more than anything I could go back in time and do that first exam again, with the other midwife standing there beside me to do one right after!

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#2 of 36 Old 01-09-2008, 12:57 AM
 
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"At this point I could really use any insight as far as what you all think probably happened, what is possible etc. In my head I haven't ruled out an insanely fast dilation, nor have I totally ruled out that what I felt was really a fontanelle. I wish more than anything I could go back in time and do that first exam again, with the other midwife standing there beside me to do one right after!"

Hmmm....hard to tell.....
Let me tell you a story....I know another midwife who took a client to the hospital because she had been "complete and pushing for 4 hours". The midwife was fairly new, but had been an OB RN for years and had done plenty of cervical checks. When the client was checked at the hospital she was completely effaced, cervical dimple, vertex 0/+1 station. The woman was not dilated at all !!!! What the midwife had felt was the vaginal wall being mushed down by the head. This story reminded me of something I had happen in midwifery school...the exact scenerio. I had told my instructor that my lady was complete - but she wasn't. Luckily, I hadn't had her push. Taught me a big lesson....I check VERY carefully for the cervical rim.
Could have been rapid dilation. Could have been a fontanel. I don't suppose you wlll ever know. Cervical exams are like magic sometimes. Two different examiners can get something very different. After many years of doing births I am convinced that they can go forwards, backwards and sideways !!!
But one thing for sure.....we can't go back in time....YET.
Keep moving forward and learning.
Carla
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#3 of 36 Old 01-09-2008, 12:57 AM
 
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To me this screams "CASTOR OIL" (in excess)! Do you think that's a possibility that she would do that and not tell you?

Don't second guess yourself. You know that it's not usual, but you also know it happens. You're just having a hard time believing that it happened to you.

The first vaginal exam I ever did I was sure that the cervix was only a tight 1 cm. Actually, she was about 4 and I had stuck my finger in the baby's anus (you can imagine how that revelation played out).

The second mom seemed to be in active labor when I checked her and found her to be completely dilated with no remaining cervix and a taught bag over the baby's head. She was 3 cm with with 100% effacement.

Third exam mom was acting as if she was in transition, again I found her cervix to be completely gone. Her cervix was so posterior I never even reached it.

Ok, so I'm 0 for 3. Luckily the clients knew it was a teaching opportunity so it didn't matter that I got it wrong because my preceptor also checked. However, she also misjudged the breech and the total effacement at first too.

Fourth exam the client felt pushy and I found her to be a 8 cm/90% so the midwife told her try not to push yet. A few minutes later the baby slid out. At first I was embarrassed because I was wrong. But... for someone with any experience at all it's hard to misjudge that you feel a small rim of cervix almost but not quite encircling the baby's head with identifiable sutures. Obviously he hadn't been in the birth canal long enough to have wrinkly molding. I am 100% certain she dilated 2 cm and involuntarily pushed the baby out in under 10 minutes.

Because of my first 3 experiences I know to do more thorough exams to be sure what I am assessing is cervix. I tell the clients "I am good at this, but I take my time because I'm good at this". Sometimes I'm not sure what I'm feeling. I'm honest and I say, I'm not completely sure what it is. And I explain to them why, and I bend toward them and use my hands to make a little circle around my occiput and tell them what I should feel, and how what I am feeling is different. I also assure them that nothing I'm feeling concerns me (unless it does which I will tell them too). If they don't ask I usually don't say anything at all.

I never give mom a definite number for her dilation either. I say "You're about 5-6" and show them with my fingers about how far apart I can spread them. I kind of wiggle them a little to demonstrate the measurement is give or take a little bit so they understand that it's not an exact science. I tell them "it's not like I stuck a ruler in there". As has been vehemently hashed out in another thread, dilation isn't the most predictable way to determine someone's labor status. If I check them again I usually just say "you've made a lot of progress!" before I tell them a number (if I even do). Or I might have to say "there's not much change in dilation but the baby's moved down/the cervix has come to the front/it's more stretchy..."

So the moral of my excessively long post is that I think you have the right amount of clinical judgment tempered the right amount of humility. It's ok to tell the clients the well-kept secret that measuring dilation is not an exact science. It's ok to say "I'm a little confused because what I'm feeling doesn't match the feelings you're having". And the next time you have an experience like this, afterward it's ok to say "Wow, that was weird. I'm positive you were only 3 cm when you came in here but you surprised us all and shot that baby right out!"
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#4 of 36 Old 01-09-2008, 01:59 AM
 
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I'd guess that she was 3 and progressed that quickly. My personal record for a primip was a lady who was a tight 5 cms (and I'm absolutely postive of that) and pushed her baby out straight OP 11 minutes later with 1 good push - so, it happens!

A favorite client of mine a couple years ago had a similar situation. She came to the hospital in early, early labor - about 2 cms dilated, but contracting regularly with bloody show. She was laughing and enjoying a party like atmosphere with her family. She sent her dh to run errands, and I asked her if she'd mind if I ran home for a bit to get some supper. She assured me she felt like she had hours to go, and to feel free. (this was her second baby) Within a couple of minutes of arriving home (I live 8 minutes away) the labor nurse called. She was a fairly new nurse, and she was puzzled over what to do with my client. She said the client had been happily bouncing on the birth ball when her water broke. Within a few seconds, she was crying and asking for pain meds and "out of control." The nurse checked her and found her to still be 2-3 cms. Knowing this client had really wanted to avoid pain meds, I suggested to the nurse that she offer her the tub, and the nurse rather doubtfully said she'd try, but that the client was really yelling and carrying on and she didn't know if she'd be able to convince her.

After I hung up, I thought this whole situation didn't add up - so I got in the car immediately and took off for the hospital. When I arrived 8 minutes later, I found my client sitting on the toilet waiting for the tub to fill. She was rocking back and forth and moaning loudly, and didn't even look up when I came in the bathroom. Suddenly, she jumped up from the toilet, grabbed her husband with both hands, sank down a bit and pushed. I was so startled I said "what are you doing!" and she said "what the hell does it look like!" The labor nurse ran in the other room and brought me gloves, which I managed to get on just in time for my client's baby girl to splash out, showering me in amniotic fluid as I sat on the floor beneath her. It was 12 minutes from when the nurse had checked her and found her 2-3 cms, and only about 35 minutes from when I'd checked her and she'd been 2 cms. The client said "what happened? I thought I was 3 cms? Did I dilate all the way to 10?" and looking at the lovely chubby baby girl in my hands I said "I'm going to have to say yes, since this doesn't look like a 3 centimeter baby!"

In the years since I first started, I find that I've become pretty adept at figuring out where women are in labor. I'm not too hot at guessing dilation by looking at someone, but I can usually be pretty accurate about whether the baby is coming soon or what based just on how a woman is acting. The fact that my client was acting like someone about to birth a baby was much more accurate than the fact that her cervix was 3 cms dilated! I'm guessing it was the same for your client.
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#5 of 36 Old 01-09-2008, 02:20 AM
 
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I wouldn't second guess yourself. I had a doula client who went from 2cm to fully dilated in about 15 minutes. It isn't the most common labor pattern, but it really does happen.

Erika, mama to three beautiful kids (plus one gestating), and wife to one fantastic man.

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#6 of 36 Old 01-09-2008, 02:31 AM - Thread Starter
 
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Originally Posted by nashvillemidwife View Post
To me this screams "CASTOR OIL" (in excess)! Do you think that's a possibility that she would do that and not tell you?
Dude.

She did take castor oil.

She was advised by the midwife (I don't know why, she was only one day past her due date; maybe she was eager?) to take 2 oz in a cup of orange juice, but she told me she only took 2 tablespoons, and she took it straight. That was quite a bit earlier in the day, after her prenatal, but hours before she started calling me.

I am SO fascinated by your stories ladies! Really. Although I'll never know for sure what happened, at least I know that there's a possibility I was right on, and really experienced something out of the ordinary. And I think the next time someone is acting like one thing but the exam seems to reveal another, I'll be more thorough with the exam, even if the situation seems obvious at first.

I did pretty much say that to them, that I was sure she was 3, and her progress was a huge shock to all of us. I also told her that's why she was in so much pain, because her body decided to get it over with so quickly, she experienced hours worth of labor in a few minutes. At the time that I was telling them this, I was conflicted; was I saying this because I really felt it was true, or was I trying to cover up that "the student" had messed up on the exam? My preceptor was sure I had messed up... and usually I can admit when I'm wrong... but I was just SO SURE of what I felt! And now, I feel it is possible that I was right about the 3.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#7 of 36 Old 01-09-2008, 02:59 AM
 
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Here's my best birth story ever.

When I was a senior apprentice my senior midwife called on her way to a labor check and said that from what she heard on the phone I might want to make my way over. Before I got to the highway she called back and said "never mind, she's only 2 cm". So I stopped and got some french fries. About 20 minutes later she called back: "you need to get over here, apparently she took some castor oil". She was only 38 or 39 weeks. She didn't discuss it with us. We would advised her against it, but at least we would have told her the proper dosage. Apparently she got anxious that her baby might get to big and downed an entire bottle.

We had just finished another birth and when I got there 30 minutes later the midwife was in the other room frantically trying to get some stuff organized. The mom was leaning over the tub with all sorts of carrying on. She grabbed hold of my waist and wouldn't let go. The dad was a paramedic so he showed up pulling on gloves saying "Ok, I'm ready. What do I do?" Mom says rub her back. Dad's about to rub a hole in her back with those latex gloves so he asks if there's any kind of lotion. She still won't let go of me. I'm just trying to turn around and see if there's some KY or something with my reach. She reaches up trying to pin down my arms because she's afraid I'm going to leave her. She says she needs to throw up but won't let go of me long enough to grab a bowl so she throws up on my bare feet. She says "the baby's coming" and dad looks and says "yes, the baby's coming". I yelled for the midwife and she ran in the room trying to pull on gloves and I just reached out and grabbed one out of her hand as I climbed into the tub in my long dress, one glove half pulled on and holding a wash cloth in the other. The head came out and nothing else, no big deal, but I told her she needed to change position (she was still leaning forward over the side of the tub). I reached down to put my hand on the baby's head to make sure she didn't beam him on the side of the tub, and she grabbed my top and pulled me down with her. I hit my head on the tile back splash and got a concussion.

What really struck me about that birth was how amazingly calm everything instantly became as soon as the baby was born. Everyone got quiet and I quietly asked for a stethoscope and poked my hand in just to listen to the baby. No one said anything else except cooed over the baby. Of course, my experience of this moment was probably affected by my concussion.
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#8 of 36 Old 01-09-2008, 09:02 AM
 
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It happens......my very first catch as a student was something like that.
Mom is in the tub, asks to be checked, so I check her and she's a very thick 4 cms. My preceptor goes to the kitchen to make herself some breakfast, I get busy setting up, and mom says, very calm, "Okay, the baby's coming" I turn around and her baby literally shot out and took a swim. I scooped him out and that was that. The baby looked just as surprised as we did.

Another time, a mom was laboring on H&K's, said she felt positive she was ready to push and asked to be checked. I checked her and she was barely 5cm, and wouldn't you know the baby's head came right behind my fingers and was born. I slid the baby between her knees so she could see him. She kept looking over her shoulders at us saying, "well, where is he, then?" Took mom a few moments to realize the baby had been born, she said later she didn't see him right away and thought we were lying about him being out.



My dear friend and repeat client tends to do the same, go from 4 to complete in 60 seconds. (Not really, but it seems that way). With her last baby, she came in early because she and I both know how fast she goes. She was barely 2cm, but contracting regularly every 7-8 with broken waters, but not enough so she had to breathe or stop talking through them. Her mom brought dinner for all of us, so we set down to a big plate of garlicky shrimp and pasta. The other midwife realized we had run out of trash bags, so she ran to her house, literally 3 minutes away. She was gone for a total of 10 minutes, (She never even got out of her car, she had her DH bring them out to her) but she missed the birth, anyway. Mom, who was sitting on the couch with her plate of pasta, calmly put her plate down, stared off into space for a moment with her hand on her belly (I thought she had to burp!), stood up, dropped her pants, turned around to H&K's with her head on the back of the couch, and said, "Herrrrrrrrre he coooooooooooomes!" No time for gloves or chux or even a towel. The baby flew out, kind of froze in a moro reflex, with his arms up in the air and a look on his face like, "WTF just happened here!?!?!?!" while her DH (who is 6'4 and a good 280 pounds) fainted and hit the floor and her 15 y/o step daughter furiously snapped pictures with the lens cover still on the camera.
Her mom's garlicky shrimp pasta became quite the hot item amongst the pregnant ladies in her neighborhood!

Don't question it, just feel the love for the butter births!
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#9 of 36 Old 01-09-2008, 01:40 PM
 
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Those are some seriously wild stories! Thanks for sharing. I can't wait to start! (I'd rather not get a concussion though. Wow!)
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#10 of 36 Old 01-09-2008, 03:54 PM
 
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OMG! This thread is soooo cool. I'm just : reading these stories.



Looks like you got to experience one of these quickies momileigh!
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#11 of 36 Old 01-09-2008, 05:04 PM
 
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I had a quickie birth like that. I was never checked, so I don't know how fast I progressed, but I know that from first real contraction to baby out was 45 minutes, and I neve rhad any bloody show or anything. I had lots my mucus plug a few days before, and had a series of braxton hicks earlier int he day, but nothing to indicate that I was progressing that quickly! In fact, i was in denial about my quick progress until we pulled over on the side of the road, and my dh took a look, and told me he could see the head.

Violin teaching, doula-ing Mom to Abby, (8) Ashlynn, (6) : and Max (11/13/08) Diagnosed with Metopic Craniosynostosis. First surgery 5/1/09, Second surgery March 2010.
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#12 of 36 Old 01-09-2008, 05:28 PM - Thread Starter
 
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These stories are insane!!!

I need me some wild birth stories...

(Well, now that I think of it, I have a couple... maybe not *quite* that wild, though!)

OK I take it back. I just realized what I asked for.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#13 of 36 Old 01-09-2008, 08:49 PM
 
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These stories are insane!!!

I need me some wild birth stories...

(Well, now that I think of it, I have a couple... maybe not *quite* that wild, though!)

OK I take it back. I just realized what I asked for.

Oooo, be careful of what you ask the Universe to send you!

Butter, butter, butter, butter, butter, butter, butter...............
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#14 of 36 Old 01-09-2008, 08:49 PM - Thread Starter
 
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I already took it back!!

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#15 of 36 Old 01-09-2008, 10:16 PM
 
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my own second baby was born in 1 hr- total- no castor oil no herbs- just boom

the cases where I have felt a cervix at typically 2 cm that open to 8 usually are gals with adhesions if they have had a procedure - laser, cryo but normally you can feel tightness

another time when I had a primip melt down - I was covering for another mw who was on vacation 38 weeks -- an unusual detail that she had an ovarian tumor-- semi-solid mass followed by one of the specialists in town- didn't enlarge or change shape in pregnancy, I am not remembering all the details seems that we had some hormone level labs as well( i wonder if it had a effect) wanted to be checked to r/o rom- no fluid except a tsp in underwear- probably urine -- 2 to complete in about 2 hrs- the first hr with very short spaced out contractions ( she called during this time), next 45 minutes- 5 min apart lasting 90 seconds- 15 min pushing stage--- was there because of the suspected ROM-- she covered her head with a towel nearly the whole time-
--------------------------------------------------



your description "she was clammy and acting desperate. Her eyes had a wild look" sounds like too much castor oil--
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#16 of 36 Old 01-09-2008, 10:46 PM
 
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I've had some time to process this and I'd love some input.
I wanted to accept that, but I just cannot accept that I was feeling a fontanelle. What I felt (and yes, I have second-guessed myself a million times now) was a dead-on 3cm dilated cervix with a head very well applied. And when I went in and she had the lip, there was no obvious 3cm or 4cm fontanelle that my fingers ran into; it felt very, very different in there.
Have you encountered a lady being 3 cm and 100& effaced? It feels just like that! That happened to me on a G2P0 and I couldn't figure it out. The senior mw checked and had me check again, cuz I wasn't sure what I was feeling.(and she said you dont' find them very often!) The lady was having good ctx, and we admitted her(it was a birth center) and sure enough, she went from 3 cm to baby in about 45 min.... so, yes it can happen!

Quote:
But IME, anyone who is dilating uncommonly quickly has a lot of bloody show, and she had very, very little.
I wonder if she got rid of most of it the previous week to two weeks?

Quote:
The rest of the story was great... nice water birth, family arrived right after the birth, no one was upset about that, and the family was very pleased with the whole experience. The mom even told me a few days later that "it was so wonderful, and it was all because of you." And I wanted to ask her, "How is that possible, seeing as I was totally wrong about everything I told you?" But of course I just kept my mouth shut. I'm THRILLED that she has processed everything as such a positive experience, but I feel like I messed up so bad!
I don't think you messed up, I bet that effacement was what you were feeling! It is round and a fontanelle isn't round, is it? this feels like a thin strong rubber band, and if the baby's head wasnt behind it, you could put your finger thru it!
Quote:
At this point I could really use any insight as far as what you all think probably happened, what is possible etc. In my head I haven't ruled out an insanely fast dilation, nor have I totally ruled out that what I felt was really a fontanelle. I wish more than anything I could go back in time and do that first exam again, with the other midwife standing there beside me to do one right after!
It does help to have someone standing by, but you don't always have that opportunity. But i am glad things were happy with the family! I think that what you have gone thru is just one of the secrets of midwifery... just a thought....
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#17 of 36 Old 01-09-2008, 11:04 PM
 
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Not a birth professional, but you could have written my birth story! I went from a 4 to a squirming warm baby in my arms in less than 25 minutes. The nurse who admitted me came in the next day and talked to me about the experience and said almost the same things you did. She said was still trying to figure out how I went so quickly, especially when I wasn't having any measurable contractions when I was under observation prior to be admitted and that it was one of the fastest progressions she had seen.

According to the notes, she checked me at 00:26 and noted that I was a 4 and that they were admitting me. I remember walking about 25 yards down a hallway to the birthing suite and having one BIG , ginourmous, monster contraction. By the time I got to the suite they were filling up the birthing tub and I kept telling them, "I think I have to go to the bathroom. I think I have to go to the bathroom" in what the nurse and midwife said was an very strange but calm voice. My SIL and doula helped me to the toilet and it felt like I had to have a BM and so I pushed a couple of times but nothing happened. I got in the birthing tub and the midwife immediately checked me and said, "It's time to have this baby!" At 00:51 out popped my wee baby, bag of waters intact and ready to join the world.

So yes, fast first babies can happen. Just not that common I guess. And no, no castor oil or other tricks to get the baby to come. It was a hypnobirth though--I would have honestly just gone home but my SIL and my doula (also my hypno instructor) said that even though the machines weren't picking up contractions, I was acting like a woman in labor and should stay. All I knew was that it was late and I wanted to go home and sleep in my own comfy cozy bed, please.

Dissertating wife of Mr. Amazing Man, mother to Boo Bear ( ) Captain Knuckle (13), and The Professor (5). Expecting Penelope Rose 5/10/2010 via planned c/s.
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#18 of 36 Old 01-09-2008, 11:20 PM
 
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I want that kind of labor! (I say that now...)

CNM mama.

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#19 of 36 Old 01-10-2008, 12:45 AM
 
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the cases where I have felt a cervix at typically 2 cm that open to 8 usually are gals with adhesions if they have had a procedure - laser, cryo but normally you can feel tightness
Not a birth professional either, but that is a very interesting thought! I had a LEEP procedure done about 4 years prior to DD's birth (first child). I'm not sure how fast I dilated, but the whole labour was under 4.5 hours, with 10 minutes of pushing. Nobody was expecting that!

I wonder how common this is?
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#20 of 36 Old 01-10-2008, 02:00 AM
 
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I went from 4 cm to complete (lip but nothing to stop me from pushing) in about an hour. It had taken me 24 hours to get to 4.

Laura, CBE and mom to Maddiewaterbirth.jpg ( 06/03/04) & Graceuc.jpg (  09/10/06)
 
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#21 of 36 Old 01-10-2008, 03:43 AM
 
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I want that kind of labor! (I say that now...)
But you won't want it when they have to insert gortex mesh into your pelvic region to keep the girlie bits in place! (Be sure to scroll down to see the total mesh implant placement). Fast labors come with a high price I have decided.

Back to the regularly scheduled thread.

Dissertating wife of Mr. Amazing Man, mother to Boo Bear ( ) Captain Knuckle (13), and The Professor (5). Expecting Penelope Rose 5/10/2010 via planned c/s.
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#22 of 36 Old 01-10-2008, 04:00 AM
 
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These stories are insane!!!

I need me some wild birth stories...

(Well, now that I think of it, I have a couple... maybe not *quite* that wild, though!)

OK I take it back. I just realized what I asked for.
Hahah, I was going to say...

I have a few "exciting" birth stories but have never gotten a concussion. Oh my goodness Nashville. Did she realize what had happened to you after the baby was born?
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#23 of 36 Old 01-10-2008, 04:02 AM
 
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But IME, anyone who is dilating uncommonly quickly has a lot of bloody show, and she had very, very little.
Totally ignorant question, but in "Pushing for First-Time Moms" there's this bit:
"Are you continuing to see "show"? Red show is a sign that the cervix is still dilating. Once dilation is complete the "show of blood" usually ceases while the head molding takes place. Then you can get another gush of blood from vaginal wall tears at the point that the head distends the perineum."
So, since the head was well-seated, would it have been stopping the bloody show you would normally expect during quick dilation?
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#24 of 36 Old 01-10-2008, 03:48 PM
 
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THis is a wonderful thread! I am currently a student midwife and love reading all this.

My take on your story is that she was at 3cm but she was definitly acting like she was in transition.
Anyway, I have never felt a cervix besides my own so I have no experience there. Just guessing.

I have fast labors, in fact my last (#6) was just 1 hour long, born at home in my shower. I never knew what was coming! LOL
I went from 0 to baby is 1 hour, hit trasition about 40 minutes after first contraction. Did not push, called DH to come help me! (it was 2am) and just let my body do all the work. DH helped baby into the world.
Fast labors can be really awesome!
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#25 of 36 Old 01-10-2008, 09:55 PM
 
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But you won't want it when they have to insert gortex mesh into your pelvic region to keep the girlie bits in place! (Be sure to scroll down to see the total mesh implant placement). Fast labors come with a high price I have decided.

Back to the regularly scheduled thread.
My UC baby was born in less than 4 hours, start to finish. I don't have any pelvic floor issues.

Laura, CBE and mom to Maddiewaterbirth.jpg ( 06/03/04) & Graceuc.jpg (  09/10/06)
 
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#26 of 36 Old 01-10-2008, 10:32 PM
 
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Here's a little trick if you're not sure if it's cervix you are feeling. Try to run your finger a little bit UNDER the cervix and lift up a little. If you can go under and lift, your are pretty sure to be inside the cervix. if not....maybe not. And yes, in my early days I've been fooled before too and thought someone was complete when the cervix was 1 cm, 100% eff., and veeerry posterior.

Also, bloody show can vary widely from one mom to the next. I've seen mom's who never had a speck of bleeding during their entire labors and some who had so much show that it tricked down their legs throughout labor. So you can't base anything on just that.

But I'd vote that your first exam was correct and she dilated fast. My record was a mom with a 10 minute labor. It was her second baby- first labor had been over 24 hours with a 3 hour second stage. This one -three contractions. Start to finish. First contraction- water breaks. Second contraction- head out. Third contraction- baby out. Ta da!

Said she didn't even have any cramps or twinges AT ALL before that first contraction. Needless to say, I didn't make it. Neither did the ambulance they called, even though she lived 5 mins from the hospital.
So, it can happen!

Retired Ohio midwife. Mama to my boy E, born 7/05
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#27 of 36 Old 01-10-2008, 11:05 PM
 
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Here's a little trick if you're not sure if it's cervix you are feeling. Try to run your finger a little bit UNDER the cervix and lift up a little. If you can go under and lift, your are pretty sure to be inside the cervix. if not....maybe not. And yes, in my early days I've been fooled before too and thought someone was complete when the cervix was 1 cm, 100% eff., and veeerry posterior. !
I do something similar- move one finger across to the top of the front- if there is still cervix you will feel it is sort of tented and mom will say she can feel it- it if is bow/head it just moves smoothly around and past
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#28 of 36 Old 01-11-2008, 12:38 AM
 
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Not a BP - just wanted to say such a great thread, I'm loving these stories!

My 2nd birth was 75 minutes from "whatever I was walking around at" to pushing. about 8 contractions. You can bet I'm homebirthing #3...
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#29 of 36 Old 01-11-2008, 01:36 AM
 
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About checking the cervix - I do the same as above. I make sure I can get my finger under the rim of the cerivx and can feel it lift up.
I did a birth last week - 20 minutes from her first contraction waking her up to feeling pushy...waited for me to get there to push TWICE and the baby was out.
Makes all those 36 hour labor sitting births worth it....
Robinna - good for YOU. I did 7 homebirths for a women who was given a c-section for breech - and the baby was vertex at surgery..(they thought it might have changed on the way to the OR).

Carla
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#30 of 36 Old 01-11-2008, 03:02 AM
 
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I went from 4 to pushing in 2 ctx and then pushed twice... but that was my second baby.
Just yesterday I felt a cervix that was a snug 3cm and very posterior on a laboring Mom. She was holding her baby in 35 minutes!

I once talked a primip (intending to drive 2 hours to birth with us at our center) through her less than 1 hour labor while she waited for her husband to get home! He showed up in time to catch.
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