Baby Koming Chantia

The night of my last shift we decided to transfer the first time mom with ruptured membranes as there had been no change with natural induction methods. The 3rd time mom with ruptured membranes, Nyoman, had only had a high leak so we weren't as concerned. Nothing was happening with her labor post castor oil and acupuncture, but they decided to spend the night because they lived far away.

So around 11:30 pm I snuggled into bed in the midwife room between Lisa ( my friend, the homeopath, who was sticking out my 24 hour shift with me), and Liman ( our 23 year old nurse). Shortly after I was awakened by the husband of Nyoman with a report of sakit secale ( much pain). Contractions had begun and she was feeling a little pushy. She wasn't quite ready to push ( 5 cm) but she was definitely in active labor so I set up for the birth and stayed with her for the next couple of hours. After awhile I woke Lisa and when she was completely dilated I woke the Indonesian Midwife Ibu Ketut and Liman. They came in and we sat with her as she pushed. I was coaching, Lisa was holding presence, and Ibu Ketut and Liman had fallen back asleep in their chairs : ). She pushed  for what seemed like awhile for a multip, maybe around 40 minutes. While she was pushing I assessed the size of the baby ( big) and decided to prepare Lisa as an assist in the case of a shoulder dystocia ( when the head comes out but the shoulder is held up behind the mom's pubic bone and the midwife has to do certain maneuvers to assist the delivery of the shoulders). Soon the head was coming and Ibu Ketut had awoken to assist with flexing the baby's head to prevent tearing ( did I mention there is almost no such thing as a 2 handed catch at Bumi Sehat- a whole other discussion to have sometime).

It was a slow emergence of the head and then a cord around the neck, which unwrapped over the head easily. And then nothing. No real restitution ( natural turning of the head), and a slight turtling (the head draws slightly back in ). Now I had been at one shoulder dystocia when I first arrived but Robin had been managing it. I had seen the Indonesian midwife try to do fundal pressure (pushing down on the top of the uterus) there and I remembered talking to Robin about it and her saying that Indonesian training of shoulder dystocia was just plain bad. And what happened at that moment was Ibu Ketut began pulling on the baby's head. Oh god this wasn't going to get us a baby I thought and commanded the mom to get on her hands and knees. I tried to flex the shoulders but it didn't really work and then I went to extract the posterior shoulder which helps bring the body. I managed to get the baby's hand from her hip and bend it up to her waist but could not retrieve the arm. We shouted for Liman to call Ibu Robin ( just as we would call 911 in the states) and then flipped the mom on her back to try McRobert's position with traction. Lisa tells me I was narrating the entire time- talking to the baby and explaining to Lisa what was happening but I don't remember my words only that I was keeping my hands working and calling on ALL of the gods and angels. At 6 minutes post delivery of the head Robin came running into the room ( thank god she lives 3 minutes from the clinic). We turned the mom back on her hands and knees and while Robin went for the posterior arm I did suprapubic pressure and told Lisa to get her homeopathic remedies and Liman to get the oxygen ready for the baby. At 9 minutes the baby came and Robin began mouth to mouth resuscitation. I was relieved to hear a strong heartbeat with the stethoscope and quickly the baby started breathing on her own. 

I was so grateful this baby was alive and so grateful that Robin had come when she did. I took over with baby giving her blow-by oxygen, reiki, and craniosacral therapy and Robin began to repair mom's 3rd degree tear. Lisa was steadily administering homeopathic remedies to baby, mom, and dad and it began to feel stable in the room. The baby's left arm was somewhat limp and there was no palmar grasp in the hand but it didn't feel like anything was broken so we were thinking maybe there was a brachial plexus injury. I stayed with the baby for about an hour and began to actually feel the baby's hand begin to grasp which gave me hope and utter belief in the body's ability to heal. The mom was ready for her baby and we laid them next to each other with the baby swaddled so as to protect her little arm. 

We let the family be for a little, regrouped in the midwife room, and then went back to assist the baby in nursing. The babe was not interested and I wasn't surprised but Robin kept at it and the babe gave a few sucks here and there. Pretty soon the baby was nursing full on- it felt like a miracle! I went into the midwife room and felt myself beginning to cry - starting to release some of my own feelings now that everyone was stable. Robin walked in and saw me tearing and began tearing herself. She could tell that I was feeling like I had failed because I had not been able to get the baby out. She looked at me and said, "Do you know what they ( the parents ) just asked me? They just asked me what your name was so that they could name their baby after you- her name is Koming Chantia" And then she looked me fiercely and said, " You would have gotten that baby out." And I knew it was true. And I was still grateful she had come.

And then we sat and had tea and rescue remedy and Robin told stories of the other shoulder dystocias she  had had that had been longer, scarier, etc... and how everything had turned out fine. I gave thanks for this guerrilla midwife who knows how to be the calm in the eye of the storm, who honors birth, and who tells a fine story at just the right moment.

My shift was over by this time and Jenny, the acupuncturist midwife was coming on and I knew they would be in good hands. I called Esther, the "Body Talk" energy worker/naturopath to come and do some trauma release with the family and I packed my bags reveling in the miracle of this baby's life.

The  family stayed at the clinic for a couple of days postpartum and the reports from the midwives who gave them care were that the baby was an excellent nurser, had several Body Talk sessions, and that the only complaint from the mom was about her postpartum pain.

I will close this last post with the Gayatri Mantra, a sacred Hindu chant that is sung to every baby during the pushing stage, as soon as the head is seen. I find it incredibly beautiful, calming and centering and want to share the words and translation with you. Blessings, Chantia

OM BHUR BHUVAH SVAH

TAT

SAVITUR VARENYAM

BHARGO DEVASYA DHIMAHI

DHIYO YONAH

PRACHODAYAT

.........

English Translation

Throughout all of existence

"That" essential nature

illuminating existence is the

Adorable One.

May all beings perceive with subtle intellect

the magnificent brilliance of enlightened awareness.