Natural birth with epidural

Sarah K., a doula colleague from Be'er Sheva, called me yesterday to ask if I am available to meet a client of hers at Shaarei Tzedek hospital. Sarah usually works at the hospital in Be'er Sheva but this client decided to give birth in Jerusalem, a 1.5 hour drive away.
Her client, a sweet lady, was already on her way to the hospital with ruptured membranes but no contractions. It was her 4th birth; her 1st ended in a cesarean and births #2 and #3 were both vacuum extractions. This time she wanted a normal, natural birth with a doula, preferably without epidural.

Sarah asked me to meet her client at the hospital, and to give her some reflexology to stimulate contractions. They already told her at the hospital that they would give her until the morning, and then they would induce her with pitocin if labor still hadn't started. Pitocin is extra risky for women with a previous cesarean, because it increases the risk of uterine scar rupture. There are many hospitals that won't even consider giving pit to a woman like that, but prefer to give her a repeat cesarean right away.

I went to the hospital, and gave her a nice foot rub. I also stimulated some well known shiatsu pressure points. It didn't seem to influence her right away, even though she told me that her contractions were starting to get stronger a bit. She got worried that if her labor would suddenly pick up, Sarah would still need 1.5 hours to get to her. I assured her that if need be, she could always call me and I would be there within 20 minutes.

Sarah called me again at 5 am. She was already on her way to Jerusalem, but it would take her at least another hour. Her lady had called her and her contractions were really coming on strong now. On top of that, there was suddenly meconium in the amniotic fluid. The midwives at the hospital told her that she couldn't walk around anymore because of that, and because of the fact that the head was still very high and there was a risk of cord prolapse. So the lady started to panic, because she couldn't manage labor while lying down.

When I arrived, she had just gotten her epidural. She explained to me that the contractions were manageable while she was able to walk around, but she just couldn't do it while being stuck in bed. So she had asked for pain relief.
It took a while for the epidural to settle in, and even then it did not take away all the pain. I gave her reflexology on her hands and when Sarah arrived, she started doing reflexology on her feet simultaneously.

Since the contractions started to slow down, a common side effect with epidurals, Sarah and I suggested that she turn around on all fours. She still had full control over her legs, which was a huge advantage. One of the big disadvantages of an epidural is usually that it numbs you completely from the waist down so you aren't able to move around anymore and help your labor progress. In this case, she had the best of both worlds.
And in no-time she was fully dilated and ready to push.
It took her about an hour, and then a beautiful baby girl was born without the help of a vacuum pump. This was truly a natural birth with epidural!


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