Our Actions As Nurses Are Powerful.
Adrienne.
Her name was Adrienne. This was her second pregnancy. Her first child was born vaginally, 15 years ago. I was assigned to her and after a short report, I went in to meet her. Report consisted of her obstetric and medical history. One thing stood out. She was a recovering drug addict that had been clean for two years.
Adrienne was up on her bed, in an all fours position, in active labor, swearing and moving her body frantically. On the couch in the her labor room, were her 2 sisters and her niece, all there to offer their support.
I had been told that she wanted a water birth and did not want any medications for birth. Adrienne had been told wrongly, that she could not get into the tub until it was time to birth. I quickly, reread the hospital policy and checked with my charge RN regarding her request to get into the tub to aid in reducing her discomfort. Adrienne could do what we call “hydrotherapy,” NOW, no waiting for this little one to emerge. I told Adrienne through a calm voice that I was filling the tub and that she could have the labor and birth of her choice.
Once in the tub, her voice calmed, her body was fluid in motion and the room took on a different, powerful yet peaceful ambience. I turned the lights down and Adrienne was what I refer to as, “one with herself.” Oh, mind you, she still swore like a sailor with the contractions, but once it was over, she collapsed into the warmth and security of the warm water and gained strength for the next powerful tightening of her uterus.
I had checked her cervix just prior to her getting into the water. She was 2cm dilated and her baby was still high (meaning not in her pelvis). While waiting for her tub to fill, we did some yoga and stretching standing beside her bed. I gave her family warm blankets and asked for them to be silent as this is what the patient had requested. About 60 minutes into her hydrotherapy, using an air filled glove for a pillow and rocking her hips while elevated by the water, she started making the sounds of wanting to push. I did an exam while she lay back in the water. She was now 8.5cm and 0 station (engaged). I called her provider to no avail. I called my charge nurse and told her I couldn’t get a hold of her provider. I informed Adrienne that her baby was coming and that she would have to get out of the tub, until her doctor arrived. I was able to safely assist her in the delivery of her newborn, but it needed to be in the bed per hospital policy. Just as she was getting out, I heard from her provider that they were on their way. They? Yes, there were a number of physicians that wanted to attend the delivery due to never having seen a water birth. The patient had ok’d this prior, so I did not question the physician. I did stop them at the door and talked to them briefly about what to expect. Adrienne’s personal physician made her way to the side of the tub while the other 5 doctors stayed in the far corner. I called for my second nurse as we do for our deliveries, and she brought her orientee with her. That now made 13 people in the birth room! No one was speaking, no one was making a sound other than the patient and her physician guiding her. It was a beautiful and serene birthing room.
Adrienne delivered her daughter in a way in which she was empowered and in control. She was surrounded by her family and their love. She had the respect of her medical team. All was well, but the best part and what I will always remember was the next part…
Once born, Adrienne stated that she would allow only one person to hold her daughter. I asked who that would be. Outside, there was a fierce storm, and that person had been delayed due to the rain. A few minutes later, a kid walked in. He was tall and beautiful and when Adrienne saw him, tears started streaming down her face. He then looked at her as if to say, “Mom, you did it!” She said through her tears, “here is your sister, you only had to wait 15 years to get one. Son, she is gunna love you!” He came to the bedside and stroked her forehead. I asked if he would like to hold her. Placing her in a warm blanket, she was handed to her big brother. The expression on his face was so incredibly loving…I had to turn my face, so he wouldn’t see me crying.
Several weeks later, I saw Adrienne’s physician in the hallway at work. She thanked me for assisting with Adrienne’s birth. She had just seen Adrienne in the office for her followup visit. She reported that Adrienne was happy and healthy. She was so proud of herself having used no narcotics to get through her labor. I very much believe that it was the water; it’s calming affect and it’s buoyancy, and the ability for her to make her choices known and respected during her delivery that had given her power to fight her addiction.