Friday, February 09, 2007

Day one...water water everywhere

Well, the first day of "Hell Week" seemed to be relatively unhell- acious. I worked my regular clinic shift, which would usually be my one and only for the week. This week it will be my first out of 5 days of prenatal clinic.

It was a very rainy day. I got to see a lot of babies here for post partum visits. Many practitioners only do one post partum visit with their clients at six weeks, but we do five visits. We do a 24 hour home visit, and at the center, we see the mom and baby at 3 days, 10 days, 3 weeks, and 6 weeks after the birth of the baby. The director of the center, Shari, has found and other research has shown that moms and babies do a lot better with excessive attention than none for a month and a half. We have excellent results with breastfeeding. Well over 95% of our moms are breastfeeding exclusively at 6 weeks postpartum. We also catch other issues quickly and provide lots of support.

We had one baby which looked a little jaundiced today. Even though he had gained weight well, and was passing plenty of poopy diapers, his yellow eyes and skin were enough of a concern that we ordered a bilirubin test. Most babies who have jaundice badly enough to require treatment also have feeding, weight and / or defecation problems. Well, it is a good thing we decided to test the levels of the pigment, because the results did come back high. The mom and dad are worried, but we need to take another reading in the morning. Hopefully with lots and lots of nursing, the baby will pass enough of the pigment in through his stool. We will be doing another blood draw first thing in the morning to see if the numbers are dropping.

Just when we were done mopping and filing, we got a call from a mom who is planning a homebirth. (Let's call her Homebirth Mom) Her waters apparently had broken. Maribel is a midwife assistant and was on duty with me. We went to go check the mom.

Her house is beautiful. Her husband is a designer and had cool art everywhere. Other than the Chihuahua who seemed to be very angry at us for being there, the rest of the family, her mom and husband, were happy to see us and extremely sweet. This is Homebirth Mom's first birth. Most of our births are at the birth center, but we do about one homebirth a month.

Her cervix had thinned out a good amount, but she was only dilated 1 1/2 centimeters. First time moms tend to focus on that dilation number, but they generally need to thin out first. Her contractions had started, but were only coming every 10 minutes or so, and she was talking through them easily. After calling in a quick report to Shari, we told her to get some rest if possible.

Having broken waters puts her on a time clock where infection risk starts to climb. Luckily, most women don't have their waters break before regular contractions start, but Homebirth Mom is not as lucky. Her mom was wonderful and sweet, but was unfortunately filling her head with stories of her own four hour labor that may be hard for her daughter to live up to. That is a very short labor for a first time mom! We are hoping she will be calling us back soon, and I should get some rest.

I feel guilty because I was so excited about the visit to Homebirth Mom, I forgot to call to say goodnight to my husband Coach Stu and baby Z. S is staying with his real dad for the week. I did call 5 times from the car on the way here and once after dinner, so I think they know I miss them....

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