03/16/2018
This is trust in birth! ❤️
I posted this story on my personal FB page a few days ago and it generated a lot of interest, so I am reposting it here so y’all can see it as well. I have also included a glossary of the medical terms that I use just in case that’s helpful for anyone. The story is short, but the glossary is long. Sorry! 😬
*** Birth story told with permission ***
Today I attended a beautiful TWIN VBAC with these two awesome nurses! The mother was sweet and courageous. Baby #1 was born easily and without fanfare, but baby #2 decided to make it interesting! The second baby naturally came down head first, but there was a prolonged bradycardia for several minutes, compound presentation with fetal hand, head in military attitude, and -4 station. The four of us (that includes mom) stayed calm, communicated clearly, moved swiftly and decisively, executed a series of coordinated maneuvers, and we got that baby out safely! Apgars 8/9 for both of these little cuties! Mom and dad are over the moon! 👶🏻👶🏻
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Glossary of Terms:
== Bradycardia - A slow fetal heart rate. A normal fetal heart rate is from 110 to 160 beats per minute. Anything less than 110 is considered slow. If this goes on for more than 2 minutes, it is considered prolonged. It indicates reduced oxygen delivery to the fetus at that moment. Bradycardia is extremely common and normal in labor. But if it goes on for too long, that could potentially prove harmful to the baby. This is why when the baby’s heart rate goes down, the doctor’s heart rate goes up!! 😆
== Presentation – The part of the baby that is coming out first. Usually this is the baby’s head, but in a minority of cases can be other parts (the butt, the feet, a shoulder, the umbilical cord, etc).
== Compound presentation – When more than one part is coming out at the same time. In this case the head was coming first, which is normal, but there was also a hand/arm up alongside the side of the head. This makes it harder for the baby to come out. It’s easier if it’s only the head coming through the birth canal and no other body parts.
== Military Attitude – an old term that refers to the angle that the baby holds its head and neck. Normally the baby’s chin is tucked down into the chest, so that the head’s smallest diameter is what is exiting through the birth canal. Military attitude means the head is lifted up (picture a soldier standing at attention with his nose lifted slightly into the air). This means that a larger diameter is passing through the birth canal, and it makes it harder for the baby to pass through.
== Station – This refers to how high or low the baby is within the mother’s birth canal. It is in reference to a pointy bone that you can feel in the mother’s midpelvis, known as the ischial spine. If the baby is above that point, it is called minus (-) station. When the baby is even with that point, it is zero station. When the baby moves past that point and is closer to the vaginal opening, that is called plus (+) station. So as the baby descends through the birth canal it goes from -4 to -3 to -2 to -1 to 0 to +1 to +2 to +3 etc.
== Apgar Score – This is a score assigned to a newborn to characterize its status in the first few minutes of life. Either 0, 1, or 2 points are given for color, heart rate, muscle tone, respiratory effort, and response to stimulation. A score is typically given at 1 minute of life and again at 5 minutes. The score can therefore vary from 0 to 10. A score of 7 or higher is considered normal. In practice, you almost never see a 10 given.
