Stand and Deliver? There’s No Stopping Her

I recently read a post from another blog about the study cited in The Cochrane Library discussing patient mobility & upright positions in early labor. The summary talks of the authors’ conclusions that there’s evidence supporting walking and or upright positions in early labor which can reduce the total length of labor without being associated with any increase in medical interventions or untoward affects on mom or baby.

Thus I was immediately taken back to 1977, long before any such studies. This woman certainly didn’t read them! She wasn’t my patient…. my patient was in the bed next to her.  (No single labor rooms back in 1977.)

When she arrived on the unit, she was already entering active labor. Her contractions where about 2-4 mins apart lasting a good 60 seconds and she was WILDLY out of control. This was her first baby, and at 4 to 5 cm dilated, she was thrashing all over the bed refusing any measures of support, IV or pain medicine offered to her by her nurse. She was probably offered “Twilight Sleep” consisting of Scopolamine and some narcotic–which we used a lot and many mom’s had hallucination or delirious type side effects.

It is important to note here that this woman was 5 ft 11.5 in tall and probably weighed a good 225lbs.  I remember this because she seemed huge and I thought she was at least 6 feet tall and looked at her chart. Her nurse was only 4 ft 11.5. The doctor on duty that evening was of Asian decent, very petite and about 5 ft, 1 or 2 in.

Back to the poor mom in labor. I couldn’t help much because I was assisting my own patient and a few labor checks that were hanging around. No other labor coach or father of the baby around in those days… It wasn’t long before this run-away train of labor progressed to point where mom was fully dilated and had the urge to push. Many women of this body stature have quick, sometimes fierce labors…..I have no study, just my observation.
Here’s what happened:
Mom: “I have to get up out this bed”
Nurse: “We have to start pushing now, I need you to take some deep breaths and when that next contraction starts, you can push with it.”
Mom: “Mmmh Hymmm I have to get up out this bed!!! Do you hear me???”
Nurse: “I hear you, we can’t let you get up right now, the baby will be coming soon… Let’s try to focus on pushing”
Mom: “I AM TELLING YOU….. I HAVE TO GET UP OUT THIS BED!!!! YOU NEED TO HELP ME!”
Nurse: “I am trying to help you”
Mom: “I’m gettin up”
Nurse: “Please try to relax”…blah blah blah

There was no stopping her. This woman stood up, ON THE BED, placed her hands on the ceiling, spread her legs and began to push—loudly !
There wasn’t anything to do except accommodate her. The nurse grabbed the “precip-tray” we use for emergency deliveries and called the doctor in. They put the large metal side rail down and these two tiny birth attendants were actually the perfect size to get in under her large frame and assist the delivery of the baby. It was an awesome sight!
I wonder if she ever reads about the research now and thinks back at how she was ahead of her time..she knew what her body needed to give birth.