Pushing for a Natural Childbirth #douladiaries By Rachel Schwartzman, ND

A women’s pregnancy can be smooth sailing and towards the end issues arise. This client of mine began to develop itchy skin in her 36th week. Her midwife referred her for tests, and the results came back with elevated liver enzymes and a diagnosis of cholestasis. Cholestasis occurs in pregnancy, in the third trimester and disappears after the baby is born.

Since this couple was close to full term, they decided to wait until 37 weeks to begin the induction process. She spent the next few days supporting her body for labour; she walked, ate spicy foods, and took an herbal tincture.

The night before she was 37 weeks the midwife administered a prostaglandin gel to soften her cervix. She contracted throughout the night and met her midwife at the hospital in the morning. Her cervix had softened to 2-3 cm. She was given an IV and oxytocin was started.

This strong mama-to-be was hopeful to labour without pain medication. She had a great support team; husband, midwife, birth doula and her mom. She kept saying “we will see how it goes.” And that’s what we did. She sat on a birthing ball as I squeezed her hips and her mother held her hands. Cool compresses were placed on the back of her neck. Her husband fed her ice chips. She took deep breaths with each surge, allowing her cervix to open as she relaxed her pelvis. Things were intense. “I can’t do this anymore!” she shouted. The midwife checked her, and she was 8 cm. Transition.
The hardest and shortest part of labour. “I want an epidural.” The anesthesiologist was called. Just as he arrived she screamed “I need to push! I need to push!” The door opened and in came the Anesthesiologist She looked at he and I, looked at the door and said “I’m ok.” Just like that she started pushing her baby.

It is expected that a labour that begins with an induction will at some point have an epidural administered. Labour is hard. It’s even tougher for first time moms that are induced. Oxytocin brings on strong contractions but it does so more intensely than a women’s natural oxytocin production. I would say a small percentage of induced women will deliver their baby without an epidural. This lady progressed so quickly and just when she needed help she was able to push her baby into her arms. Lucky lady.

Rachel Schwartzman is a naturopathic doctor in the St. Clair West neighbourhood. She is the co-owner of West End Naturopathic Doulas, a naturopathic collective that supports pregnant women and partners with the birth of their babies. WESTENDDOULAS.COM

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