2.2.b Labour and Birth

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Timeline

04:00  Thursday morning in July.  Mee’s bag of waters breaks and the baby continues to move normally. Mee is 39 weeks gestational age.

07:00 Mee begins to experience contractions that started gently and slowly. 

13:00 Mee’s contractions have established a pattern and are long, strong and close together. Mee is needing to focus strongly on her breathing during each contraction. Alang calls the Midwife Serena to come check on Mee in their home. 

13:30 Serena arrives to their home and assesses Mee. Her vital signs are normal. Serena listens to the fetal heart rate and finds it to be normal. Mee’s contractions are lasting one minute long, occurring every 3 minutes. Mee’s cervix is soft and shortened. Serena finds it to be opened to 7 cm. Mee is in active labour. Mee and Serena agree it is a good idea to go to the hospital at this time.  Alang drives Mee to the hospital and Serena agrees to meet them there. 

At the hospital, Serena arrives before Mee and Alang. She is greeted by Karen, the nurse, who she will be working with for Mee’s birth. Serena briefs by giving her a handover Karen to provide her the necessary information related to Mee.

When Mee arrives Karen introduces herself and notices that Mee’s forehead is sweaty and her face is red. She takes her temperature and discovers that Mee has a temperature of 38.2 Celsius. Karen considers the possible causes of an elevated maternal temperature in the intrapartum period:

  • physical activity with labouring
  • infection
  • dehydration
  • overheated room/environment

Karen notifies Serena about the fever using an SBAR. Together, Mee, Alang, Serena, and Karen have a discussion about the pros and cons of IV hydration to resolve the fever. Mee is concerned because invasive procedures into the circulatory system are not sanctioned in her Hmong tradition.

Just as Karen and Serena are discussing management of the fever and their next steps, Mee begins moaning and expressing the need to push. Serena and Karen quickly become occupied with preparing for a possibly imminent birth as Mee begins to spontaneously push very actively with each contraction. Within 20 minutes of active pushing, Mee births a 3080 gram vigorous male infant. Mee experiences a small first degree tear. She and Alang are overjoyed. The baby is crying and placed skin-to-skin on Mee’s breast.