Confused about labor pregression, your input please

Jackie7183 · 08-23-2006, 12:33 PM

OK ladies I am way confused, I have never had this happen as of yet. I felt great yesterday, but now I am feeling discouraged. So here is some back story.

Yesterday my client called me after her OB appointment, she is 39 weeks and she was 5cm, 80% effaced. She was at 1cm on Friday night, so 4 cm in 3 days. She didnt even know she was at 5, and has had contractions every night for about 30 min and yesterday was the first day she started having contractions during the day. She could not even feel most of her contractions(apparently she has a very high pain tollerence (lucky her)). So knowing that once a mom gets to 6, things tend to progress quickly, I went to her house last night at about 8pm to do her belly cast before things got to uncomfortable. I was also thinking that I would stick around for her nightly contractions to see how things went.

So we were hanging out, playing cards, and her contractions start getting uncomfortable for her. We stopped playing cards and started breathing, streching on the ball and all that. So she starts getting nauseas, I get her some peppermint oil (I swear that stuff works wonders!), contractions are now about every 2 to 4 min apart and a little more than a minute long, not on a great schedule, but steady. She is very uncomfortable, cant sit still, and she starts getting really hot. So from my experience and everything I learned, I am thinking active labor or transition. So I suggest we go to the hospital. We pack up, I drive in a seperate car.

We get to the hospital and the moment I see her, I can see things have changed. She is more lighthearted than she was at home and not having as many contractions. So I am hoping that once she lies down and gets checked she can relax a bit and things will start again. So they get her on a monitor and contractions are the same frequency, not a set pattern, but steady. They check her, and she is at.....3! 3?!? WTF? What happened to 5?

I feel stupid for having her come in, and I dont get why she would have tightened back up?

I know there is a certain element of not being as comfortable in the hospital, but this change has me baffled

So a few qq's, first please just help and explain this to me, what you think may have been happening, and also how do you keep your clients from digressing once they get in the hospital??

TIA Ladies

jesscardona · 08-23-2006, 12:42 PM

well, I dont about what happened there.. but I don't see about feeling dumb b/c you told her to go to the hosp. I told my first mom to go to the hosp. when she was right at 3cm and she was having contr. every 3min. and they left her..

joandchris18 · 08-23-2006, 12:46 PM

I have heard of that happening. I think Ina May actually talks about that in her book. What happened? Did she go back home, stay, and where is she now?

heathenmamaof5 · 08-23-2006, 12:52 PM

Jackie, sometimes there are emotional issues that need to be dealt with for a mom to make progress. It sounds to me like she's more comfy laboring at home. I've had this happen to a few clients of mine. They get to the hosp and it is scary for them. They have all these random thoughts. Their going to strap me down to monitor the baby and the contractions, will they let me up? What about all those interventions that lead to a c-section? Will we be safe? Mu suggestion is just to listen. You might ask her, "what needs to be done before the baby gets here?" She may have a whole shopping list of things.

I had one mom that was laboring quite well and was a stretchy 4 before we got to hosp. The nurse comes in and bands mom and dad and says, "don't worry, we've only ever had one baby kidnapped from our hosp." Not one contraction after that and she didn't birth for close to three weeks later.

That's my

syncreo · 08-23-2006, 12:56 PM

Hi,
Yes, women's cervix can close back up if they are stressed or something else happens. What may have more likely happened was that she had 2 different care providers assessing the dilation of her cervix and often times they come up with different interpretations. Perhaps she wasn't quite 5cms after all or maybe she was and the person who examined her at the hospital judged it as a 3.

Cheers,
Shawna

Jackie7183 · 08-23-2006, 01:35 PM

Quote:

Originally Posted by heathenmamaof5

The nurse comes in and bands mom and dad and says, "don't worry, we've only ever had one baby kidnapped from our hosp." Not one contraction after that and she didn't birth for close to three weeks later.

That's my

Jill, OMG, I can understand why that mom would be timid. I dont think there are issues otherwise but I will definitely ask that qq later today.

Jo, She is back home. She just called said she had a few bad ones during the night that woke her up, and she is resting now. I told her that one thing we will have to work on next time we head to the hospital is keeping her relaxed. I think me going in a seperate car was a barrier last night. I think when we go again, I will have her drive with me.

~Tranquility~Doula · 08-23-2006, 01:50 PM

Quote:

Originally Posted by syncreo

Hi,
Yes, women's cervix can close back up if they are stressed or something else happens. What may have more likely happened was that she had 2 different care providers assessing the dilation of her cervix and often times they come up with different interpretations. Perhaps she wasn't quite 5cms after all or maybe she was and the person who examined her at the hospital judged it as a 3.

Cheers,
Shawna

This was my first thought as well.

MindOverLaborDoulas · 08-23-2006, 01:50 PM

oh boy Jackie.. you need to read the other post first!!

fearlessbirth · 08-23-2006, 02:13 PM

Quote:

Originally Posted by MindOverLaborDoulas

oh boy Jackie.. you need to read the other post first!!

I was just thinking that! LOL I had this slow motion NOOOOOOOOOOOOOOO in my head.

Jackie7183 · 08-23-2006, 02:49 PM

HOLY CROW! I didnt even think about that. I think my brain is so invloved with her, I totally didnt think about the liability.

I think it is important to be with her calming her, but I would hate to drive with them to the hospital and be stuck there. ARG!

Thank goodness I have you ladies here to keep me in line, hahaha.

teachinmamaof4 · 08-23-2006, 02:57 PM

What about being on your cell phone with her?

I know I know...it's not safe to drive and be on the phone.

MsDoula · 08-23-2006, 05:49 PM

A cervix can't sustain 5 cms dilation if there aren't adequate contractions. If her contractions stop or slow for any reason then her cervix is likely to go back to about 3 cms or so until her contractions are back to a point that will sustain and even push her past 5.

Kim Trower · 08-23-2006, 06:29 PM

Reverse dilation is possible...ina may calls it the sphincter law. When you are stressed all sphincters are on lock down. LOL! Another way to avoid this is don't be the one to tell mom to go to the hosp. Really give her the power...I have never met a mom who did not know when to go if she really trusted herself...it helps if the doula really trusts the process as well. Especially if it's a first time mom...you usually have plenty of time..yes there are a few that go against the norm..but for the most part you have lots of time. Most of my clients arrive at the hospital between 7-9 cm and deliver within 2 hours of arriving and this is based on leaving the decision up to them when to go.

AmandaB · 08-23-2006, 06:46 PM

It is interesting about the "sphincter law", I have hear about cxts slowing down but not the cervix actually closing up!

I am also very curious about the dilation thing ... with all our "technology" how can checking dilation still be so subjective? I have very tiny fingers (short and stubby), and I look at Greg's (dh) and they are huge in comparisson. So if the two of us checked a woman (ok no need to go there, ladies!

), we could get to totally different readings. I suggested to a colleague that they should create a measuring tool ... something like a meat thermomether. She said "Ewww, maybe not something so pointy!!"

~Tranquility~Doula · 08-23-2006, 10:14 PM

Quote:

Originally Posted by MsDoula

A cervix can't sustain 5 cms dilation if there aren't adequate contractions. If her contractions stop or slow for any reason then her cervix is likely to go back to about 3 cms or so until her contractions are back to a point that will sustain and even push her past 5.

That's interesting. I had a client that was 5cm for 2 weeks.