Bournefree
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Hi Ladies,
Well I have just picked up my notes from my daughters birth in Nov 2009, and they are really interesting to read. It does go pretty much as I remembered and along with my birthday diary I made - but with a few differences.. that I either didn’t remember, or hadn’t noticed; such as how often my pulse, temperature, and babies HR were measured - I thought this only happened about 2 or 3 times, but from my notes, it was loads more. At the end it was every 3 min.
I also had my stage timings wrong, I thought it took at total of just under 2 hours for my placenta to be delivered and in fact it was just over an hour.
So I don’t know how beneficial or interesting this is to you ladies, but I thought I would type out my labour and birth notes for you to look through if you wanted to know the types of things they put. Feel feel to comment.
03.00 Called out to home. Contracting 3-5 mins apart. Very short in length. Irregular last 10-20 sec. Pad in situ as possible spontaneous rupture of membranes (SROM). Nicola felt some trickling. Nicola sitting on ball fairly comfortable.
03.10 Nicola well. Pulse 88, BP 130/76. On palpation, fundus = term. Long lie. Cephalic presentation. 2/5 palpable. Fetal heart heard 130-140bpm.
03.40 Plan - Due to possible SROM discussed speculum examination. If no evidence then vaginal assessment.
Pad seen - mucusy show, no liquor evident.
On speculum - vagina no abnormality detected (NAD), Mucus show, no liquor.
Vaginal examination performed:
Cervix central, soft 60% effaced, 1-2cms dilated, well applied to presenting part.
P.part Cephalic, position not defined, membranes felt.
Fetal heart heard (FHH) 130-140bpm. No defects noted.
03.50 Plan - To await regular contractions. Advised ¾:10 min lasting 1 min long.
Nicola to phone RE: decrease in fetal movement, SROM, bleeding
Advised paracetamol and to get some rest.
Bloods taken for group and save and full blood count, as no bloods taken since transfer from Bournemouth.
14.25 Called to home. Nicola planning homebirth. Contractions 3:10min but irregular in length, strength + duration. Pulse 72bpm BP 110/60. Fundus = term long lie cephalic 2/5 palpable. FH 136-150bpm good variability no decelerations heard.
Recently been out to toilet and passed urine. Blood stained mucus on pad. No SROM. Nicola would like to be examined to asses progress in labour.
14.40 Out to toilet and passed urine. Consent obtained for vaginal examination. Cervix slightly posterior fully effaced, soft and thin. 3-4 cms dilated. Membranes bulging (She didn’t tell me about my membranes bulging), and left intact. PP ceph. No fontonelles felt. FH 128-140bpm following VE. Findings explained to Nicola and Gareth. Pleased with progress. Nicola has not eaten at all today, advised to try and eat a sandwich.
Plan - Continue upright positions, Analgesia as required - has water pool to use, and TENS. Reassess as indicated.
15.00 Contractions continue 3:10 more intense since examination. Nicola upright and mobile making sandwich.
15.15 Coping very well with contractions, planning to have a warm bath and then to put TENS machine on. FH 132-144bpm, no decelerations heard.
Nicola feeling she is coping well and is reassured she has made progress from earlier this am. Not requiring analgesia and feels she is happy for me to leave for a while. She will ring coordinator when needs midwife to return.
17.15 Returned to Nicola and Gareth. SROM at 16.50. Clear liquor draining + blood mucusy show. Contractions have continued and are now more intense.
Nicola has had a bath which helped and pool is now filling ready for use.
17.20 FH140-150bpm good Var heard, no decelerations, P88, temp 36.1. Contracting ¾:10 strong.
Nicola coping well but beginning to feel a little distressed. Reassurance given pool almost ready.
17.30 Nicola into pool. Pool temp 37oC, Entonox also given as requested and with instruction in use.
FH 124-135bpm. 1st stage commenced.
Birth plans discussed. Hoping for pool birth and physiological 3rd stage. Gareth to cut cord if needed. Baby skin to skin and intending to BF.
17.50 Nicola aware of some pressure type sensations involuntary pushing not visible as yet and is able to breath through contractions with good support from Gareth. Community coordinator contacted for 2nd midwife to attend.
18.00 FH 132-144bpm contracting 4:10 coping very well. Use of Entonox
18.20 JH now in attendance. Nicola coping well in pool. FH142-154bpm
18.45 Nicola reporting increasing rectal pressure and giving occasional involuntary push, nil visible as yet. Encouraged to continue breathing Entonox
19.00 Some anal dilatation noted. Nicola reporting stronger urges to push and increased involuntary pushes seen. FH 138-148bpm
19.10 FHH 124bpm. Nicola beginning to push involuntary with each contraction. Coping well.
19.15 Examination - vortex felt at the introitus. Nicola reassured. Continues to push with each contraction
19.18 FH130-140bpm. On hands and knees in pool too difficult to visualise. Nicola continuing to push with each contraction
19.30 FH 134bpm contractions 3:10 but more expulsive. 2nd stage commenced. Nicola coping very well
1935 KG now in attendance to take over care, awaiting 2nd night midwife.
19.45 FH138-148bpm. Nicola giving good expulsive efforts and she can feel baby moving. Unable to see due to maternal position and not able to change position at the moment. Encouragement given to continue to go with natural instincts. Contractions 3:10
19.55 FH 140-150bpm good var, no decelerations heard
20.00 Pool topped up with hot water to Nicola’s comfort level, Thermometer not very accurate.
20.10 Mirror held underwater and vertex visible, using torch to visualise. Nicola encouraged to actively push.
20.12 FH144-156bpm
20.15 FH144bpm Vortex advancing well with good maternal effort
20.18 FH 138bpm
20.23 FH140bpm vertex advancing well
20.32 Head out, quickly followed by body. Nicola reached down and lifted baby to surface. Nicola wanted physiological 3rd stage. Care now given by AH and KG. Spontaneous vaginal delivery of female infant born in good condition. APGAR 8 @1min, 9 @5mins, 9 @10mins. No delay to first breath.
20.55 Nicola has cramp in leg. cord clamped, 3 vessels, cut by Gareth, out of pool. Condition after delivery - T 36.5oC, P60bpm, BP 120/70. Stage 1 = 4.50, stage 2 = 1.17.
21.05 Nicola sitting on toilet, giving some pushes and coughs. Separation blood seen, cord lengthening.
21.30 no sign, syntometrine given with content.
21.50 placenta and membranes delivered. Complete. 150ml blood loss. Stage 3 = 1.08
21.56 MRBU contacted as not happy to suture.
23.10 JM arrives for suture. Type II (2nd degree) damage, Local anaesthetic administered, sutured with 2.0 and 4.0 Viry Rapide.
Well I have just picked up my notes from my daughters birth in Nov 2009, and they are really interesting to read. It does go pretty much as I remembered and along with my birthday diary I made - but with a few differences.. that I either didn’t remember, or hadn’t noticed; such as how often my pulse, temperature, and babies HR were measured - I thought this only happened about 2 or 3 times, but from my notes, it was loads more. At the end it was every 3 min.
I also had my stage timings wrong, I thought it took at total of just under 2 hours for my placenta to be delivered and in fact it was just over an hour.
So I don’t know how beneficial or interesting this is to you ladies, but I thought I would type out my labour and birth notes for you to look through if you wanted to know the types of things they put. Feel feel to comment.
03.00 Called out to home. Contracting 3-5 mins apart. Very short in length. Irregular last 10-20 sec. Pad in situ as possible spontaneous rupture of membranes (SROM). Nicola felt some trickling. Nicola sitting on ball fairly comfortable.
03.10 Nicola well. Pulse 88, BP 130/76. On palpation, fundus = term. Long lie. Cephalic presentation. 2/5 palpable. Fetal heart heard 130-140bpm.
03.40 Plan - Due to possible SROM discussed speculum examination. If no evidence then vaginal assessment.
Pad seen - mucusy show, no liquor evident.
On speculum - vagina no abnormality detected (NAD), Mucus show, no liquor.
Vaginal examination performed:
Cervix central, soft 60% effaced, 1-2cms dilated, well applied to presenting part.
P.part Cephalic, position not defined, membranes felt.
Fetal heart heard (FHH) 130-140bpm. No defects noted.
03.50 Plan - To await regular contractions. Advised ¾:10 min lasting 1 min long.
Nicola to phone RE: decrease in fetal movement, SROM, bleeding
Advised paracetamol and to get some rest.
Bloods taken for group and save and full blood count, as no bloods taken since transfer from Bournemouth.
14.25 Called to home. Nicola planning homebirth. Contractions 3:10min but irregular in length, strength + duration. Pulse 72bpm BP 110/60. Fundus = term long lie cephalic 2/5 palpable. FH 136-150bpm good variability no decelerations heard.
Recently been out to toilet and passed urine. Blood stained mucus on pad. No SROM. Nicola would like to be examined to asses progress in labour.
14.40 Out to toilet and passed urine. Consent obtained for vaginal examination. Cervix slightly posterior fully effaced, soft and thin. 3-4 cms dilated. Membranes bulging (She didn’t tell me about my membranes bulging), and left intact. PP ceph. No fontonelles felt. FH 128-140bpm following VE. Findings explained to Nicola and Gareth. Pleased with progress. Nicola has not eaten at all today, advised to try and eat a sandwich.
Plan - Continue upright positions, Analgesia as required - has water pool to use, and TENS. Reassess as indicated.
15.00 Contractions continue 3:10 more intense since examination. Nicola upright and mobile making sandwich.
15.15 Coping very well with contractions, planning to have a warm bath and then to put TENS machine on. FH 132-144bpm, no decelerations heard.
Nicola feeling she is coping well and is reassured she has made progress from earlier this am. Not requiring analgesia and feels she is happy for me to leave for a while. She will ring coordinator when needs midwife to return.
17.15 Returned to Nicola and Gareth. SROM at 16.50. Clear liquor draining + blood mucusy show. Contractions have continued and are now more intense.
Nicola has had a bath which helped and pool is now filling ready for use.
17.20 FH140-150bpm good Var heard, no decelerations, P88, temp 36.1. Contracting ¾:10 strong.
Nicola coping well but beginning to feel a little distressed. Reassurance given pool almost ready.
17.30 Nicola into pool. Pool temp 37oC, Entonox also given as requested and with instruction in use.
FH 124-135bpm. 1st stage commenced.
Birth plans discussed. Hoping for pool birth and physiological 3rd stage. Gareth to cut cord if needed. Baby skin to skin and intending to BF.
17.50 Nicola aware of some pressure type sensations involuntary pushing not visible as yet and is able to breath through contractions with good support from Gareth. Community coordinator contacted for 2nd midwife to attend.
18.00 FH 132-144bpm contracting 4:10 coping very well. Use of Entonox
18.20 JH now in attendance. Nicola coping well in pool. FH142-154bpm
18.45 Nicola reporting increasing rectal pressure and giving occasional involuntary push, nil visible as yet. Encouraged to continue breathing Entonox
19.00 Some anal dilatation noted. Nicola reporting stronger urges to push and increased involuntary pushes seen. FH 138-148bpm
19.10 FHH 124bpm. Nicola beginning to push involuntary with each contraction. Coping well.
19.15 Examination - vortex felt at the introitus. Nicola reassured. Continues to push with each contraction
19.18 FH130-140bpm. On hands and knees in pool too difficult to visualise. Nicola continuing to push with each contraction
19.30 FH 134bpm contractions 3:10 but more expulsive. 2nd stage commenced. Nicola coping very well
1935 KG now in attendance to take over care, awaiting 2nd night midwife.
19.45 FH138-148bpm. Nicola giving good expulsive efforts and she can feel baby moving. Unable to see due to maternal position and not able to change position at the moment. Encouragement given to continue to go with natural instincts. Contractions 3:10
19.55 FH 140-150bpm good var, no decelerations heard
20.00 Pool topped up with hot water to Nicola’s comfort level, Thermometer not very accurate.
20.10 Mirror held underwater and vertex visible, using torch to visualise. Nicola encouraged to actively push.
20.12 FH144-156bpm
20.15 FH144bpm Vortex advancing well with good maternal effort
20.18 FH 138bpm
20.23 FH140bpm vertex advancing well
20.32 Head out, quickly followed by body. Nicola reached down and lifted baby to surface. Nicola wanted physiological 3rd stage. Care now given by AH and KG. Spontaneous vaginal delivery of female infant born in good condition. APGAR 8 @1min, 9 @5mins, 9 @10mins. No delay to first breath.
20.55 Nicola has cramp in leg. cord clamped, 3 vessels, cut by Gareth, out of pool. Condition after delivery - T 36.5oC, P60bpm, BP 120/70. Stage 1 = 4.50, stage 2 = 1.17.
21.05 Nicola sitting on toilet, giving some pushes and coughs. Separation blood seen, cord lengthening.
21.30 no sign, syntometrine given with content.
21.50 placenta and membranes delivered. Complete. 150ml blood loss. Stage 3 = 1.08
21.56 MRBU contacted as not happy to suture.
23.10 JM arrives for suture. Type II (2nd degree) damage, Local anaesthetic administered, sutured with 2.0 and 4.0 Viry Rapide.
Or am I being too impatient? 
xx
