Plan A?

'See you later mum!" says my eldest son as he presses a quick kiss on my cheek. I watch him as he walks out of the schoolyard, chatting briefly with the parents left behind. At that moment, I feel my phone vibrate in my pocket. 'Just come to the address below,' my colleague apps. 'First child five centimetres,' I read in the next message. Right after this, she sends the address where I need to go. 'I have to get going,' I say with a smile, say goodbye to the parents and head to the address given.

Stepping inside the expectant parents' house 15 minutes later, I find the birthing party upstairs in the baby's room. There is a set-up birthing bath, there is quiet music, the birthing stool is ready and the water is kept warm by the maternity nurse.

'I broke the membranes half an hour ago and she has five centimetres,' says my colleague. 'She is doing very well,' she says with a friendly nod to the barer.

After a brief handover, my colleague leaves and I stay behind with the expectant parents. I know these parents and know about their birth plan. She would like to give birth to her first child at home and preferably in the bath. The contractions follow each other at a brisk pace. She sighs them away neatly and I can see she is having a hard time. She has been awake all night and is visibly hard at work.

Suddenly she turns on her hands and knees in the bath, grabs my hands and looks at me dejectedly. 'I don't want any more,' she says wearily. 'Maybe we should go to the hospital after all,' she says after sighing away a contraction. 'What are we going to do there then?' I ask her teasingly.

'Maybe pain relief or something,' she says with doubt in her voice. I look at her husband, who shrugs doubtfully. I grab her hands as the next contraction comes and help her sigh this one away.

This lady has practised sport at a high level for several years. People in elite sports have a driven mindset. They can mentally push themselves to the limit and are trained to perform. I feel by everything that I can still bring that out in this lady.

After the contraction, I seek eye contact with her. 'You had a plan, didn't you?' I ask her. She nods. 'So what is your plan?' I ask her. 'Give birth in the bath at home' she says with a sigh. 'You can still do that' I encourage her. 'I know you are tired and worked hard through the night. Your waters have just broken and you are having very powerful contractions now, but the baby and you are doing very well together. Now let's give this one more hour. Just to see if we can implement your plan A. Should nothing or little happen after an hour, I'm going to take care of everything you want'.

She looks at me longingly and I hope I have gained her trust in this short time I have been there. Behind her, I see her husband sticking two thumbs up in the air. He is already convinced.

We sighed the contractions away together, alternating the bath for the shower, the bed, the stool and hands and knees within the hour. There is no shortage of posture changes. After a good hour, she asks if I want to examine how much dilation she has. I examine her and note nine centimetres of dilation! 'How well you did that woman,' I shout enthusiastically. She smiles and I see she has hope back in her gaze. 'Do you still want to go back into the bath?' I ask her. She shakes her head as another contraction arrives.

Moments later, she feels the urge to push. It takes her a while to find the right position. This ends up being next to her bed on her hands and knees on the floor. There she presses fully and I soon notice that she still has plenty of the strength to push through. I smile when I see her. She has set up a delivery bath and a large 2-person bed is fully protected with mats and towels. The birthing stool is also nearby and in the corner is another yoga ball. All possible postures can be adopted but she opts for hands and knees on the floor....

Then, after less than an hour, a shining baby girl is born and they embrace. Overjoyed, I see two people become parents of a daughter at that moment. In her tears of happiness, she looks at me. 'Still plan A huh,' she says through her daughter's crying. I give her a wink as I say: 'You won't lose your fighting spirit any time soon, you know. And you had a well-rested midwife at your bedside to remind you of that.'

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De Eerste Stap Midwifery Practice
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