Tuesday, November 07, 2006

The tip of the iceberg

A nurse asked me the other day, “Do you just meet your clients at the hospital? Do you meet with them at all during the pregnancy?”

Kat’s pregnancy and birth sprang to mind instantly. A nurse herself, she knew the superstition about nurses’ labours - “you get everything that you don’t want.” So, she knew she’d have to work hard to set up the best environment for birthing her baby without much “fuss.” So, referred by a friend, she hired me one October when she was three months pregnant. She had a lovely family doctor who specialized in maternity care, and trusted Kat’s ability to give birth. Then she signed up for prenatal classes, prenatal yoga and fitness programs. Everything was in place.

After our initial interview over tea, we phoned regularly, and I made two long visits to her home, talking with her and her husband about their personal philosophy, their challenges over the years, and their hopes for the birth. I answered all their questions from, “How will he be able to finish his thesis with a baby in the house?” to “Why does everyone say I must have an epidural?”

Throughout the pregnancy there were challenges to discuss...not big enough to call her doctor, but enough that Kat needed my support. For example, early in her pregnancy, she went to an independent lab for an ultrasound. She had been shuffled in and out within 5 minutes. “Next!” She was back in the car before she knew it...in tears. We talked on the phone after that, for at least an hour. After our talk, she decided she would only go for testing at her own hospital, where there was a greater chance of continuity and consistency of care. She was glad that she could use me as her sounding board.

In our many phone calls, we talked about her fears... “What if it’s so fast that you don’t make it to our house?” and her thoughts on her own ability to deal with pain...”I’m a bit of a wuss.” We talked about her hopes and dreams, her expectations of motherhood, and her concerns about her husband making it through the labour if it was long ("He'll need to sleep!") She called whenever she had a cold, when her friends gave birth ("Why isn't it me?"), when the baby was moving too much or too little, when she needed help sleeping, whenever anything needed to be discussed.

I worked to help her see the big picture, to help her to let go of expectations, to help her listen to her body. As an oncology nurse, she found it was a struggle to let go of fears, but, with encouragement and her own strength and wisdom, she met the challenge.

In late March, another phone call: “Did I tell you that I want to avoid the baby being suctioned, to have everyone quiet at the birth, to avoid medications, to get lots of encouragement??? The last minute worries had surfaced, the fear of not having her wishes honoured was voiced. We had talked for 12 hours by this point, over the course of the pregnancy...and it was really starting to spill out now.

Then came the due date. Another phone call. Then came another two weeks. Daily phone calls to me. More doctor visits. Testing at the hospital. Our contact increased as the days passed. When she finally went into labour, she was comfortable with her “team,” and we had discussed almost every possible scenario in advance. Kat had decided that, in order to labour with minimal intervention, she would have to stay home as long as possible.

Two days later (all the time in labour)...

...we had baked, walked, made soup, taken photos, and watched two nights of playoff hockey. Her husband was finally asleep in the bedroom, and I was at my limit and ready to fall onto the futon beside me.

Kat was still pacing the living room. To say she was frustrated was an understatement. Her contractions had never quite “kicked into gear.” We had been in touch with the doctor and hospital at regular intervals, and had been told to stay home until things escalated. What was it going to take?

Finally, I said that we would have to go to the hospital for further support if nothing had changed within the hour. I suggested that she try one last bath, (and a firm talk with the baby!) while swishing her hips from side to side to loosen her body. I closed my eyes...

“Quick! Jacquie! My water broke!” The words tumbled into my dream. It was an hour later. Kat was standing beside me, dripping... I tried to wake up. The next contraction came, and it was STRONG! Finally! I worked hard to wake up her husband, and we drove Kat to the hospital.

The baby was born!

Someone at the hospital said, “Well, that was easy for you guys! You just popped into the hospital and the baby was born!” We all yawned, then laughed.

So, to answer the nurse’s question, “No, I don’t just meet the couple at the hospital. We usually work together for many months during the pregnancy, and many hours in labour before you see us. It might look easy...but...”

It’s just the tip of the iceberg.


doulicia said...

Excellent example! And a great story to boot. Thanks for it.

Anonymous said...

great blog!

:) true entry!


Samantha Grice said...

Hi Jacquie Munro, My name is Samantha Gric e and i'm a writer in the Arts section of the National Post. I'm writing a story about the increase in doulas in the delivery room and I was hoping to speak with y ou. My email adress is sgrice@nationalpost.com. Would you be interested in speaking with me? And if so, are you available today or tomorow? Many thanks