agree. It’s crazy that it all depends on some number-cruncher in a distant city.’
‘Don’t start me on that. That way is madness, girl.’ Karissa had obviously been there. ‘We’re just dots on the big picture.’ She shrugged and yawned. ‘But I’ve been up all night and what I vote for at the moment is going home to bed. Good luck and happy birthing.’
She pulled the drug keys from her pocket with a wry smile and handed them over. ‘I’m so glad I didn’t accidentally go home with the keys and have to come back.’ She yawned again. ‘Bye.’
ALONE and in charge of a labour, Georgia thought wryly. It had been a while.
She had a quick look through the two inpatient records to check there were no medications due and why the women had chosen to have Caesarean births. Both had had babies in the breech position and their doctor had suggested they not attempt vaginal deliveries.
She reminded herself to ask Max what his stance on that question was.
She picked up Mel’s chart and quickly scanned her previous labour and antenatal history, before tucking the chart under her arm and heading back to the labouring woman.
‘Hi, guys. How are you going in here?’
Tim looked a little more stressed and Mel’s smile had slipped. ‘It’s getting tough now,’ Mel said through clenched teeth, and the next contraction cut off her sentence as she began to rock and moan with the force of the pains.
When the contraction had eased, Georgia quickly checked Mel’s blood pressure, temperature and pulse, and then listened to the baby’s heart rate through the next contraction. All observations were normal and she documented the progress in the nurse’s notes.
When she’d finished she crossed to the cupboard where the large blue exercise ball was kept. Georgia rolled it across the floor to show Mel and Tim. ‘Would you like to try sitting on the ball in the shower for a change, Mel?’
‘I might fall off.’ Mel gave it a quick glance and shook her head. ‘The ball wasn’t here last time.’
Georgia rolled it around in front of herself and sat down on it to show Mel. She tried to move it with her hands while sitting on it and the ball didn’t budge. ‘It sticks to the floor and won’t roll away when you are on it, Mel. Balls are very safe.’
Mel frowned and then nodded that she understood.
Georgia went on. ‘Your legs must be tired. Sitting here will straighten your back and encourage the contractions to work straight down with gravity and onto the cervical opening to make the contractions achieve as much as they can, just like the position you are in now.’
Georgia studied Mel’s strained face and her instincts told her Mel would get some relief sitting for a while. ‘The position you’re in now has been great but you may benefit from a change of position, even if for a few minutes. It’s getting tough.’
‘Too right it’s getting tough.’ Mel glared at her husband and Georgia restrained her smile. When a woman began to express irritation towards her partner, it often meant good progress in labour.
‘You could take the ball into the shower and while you sit you could direct the heat of the water onto the area giving the most pain. You can sway from side to side too—all those things will give good relief from the pain.’
Tim grinned. ‘What a salesperson. Do you have shares in the company that sells birth balls?’
‘Absolutely. Have a go, Tim, and tell Mel if it feels safe.’
Tim lowered himself gingerly onto the ball and never looked in danger of rolling away. ‘I see what you mean about it sticking to the floor. If you don’t want the ball, Mel, I might sit here to rub your back. Mine feels better already.’
That was too much for Mel. ‘Get off. My turn.’
She sat, sighed into it as her back straightened, and smiled. ‘Ok. Let’s try the shower with this thing, then.’
Georgia wished that Max had been here to see that. Pain relief wasn’t always something you had to prescribe. She went ahead and turned on the water to warm and placed the ball in the corner of the shower room.
Two rails on the wall gave Mel safe purchase as she lowered herself onto the ball and when the handheld shower was directed onto her lower abdomen where the contractions hurt most, she sighed blissfully. ‘Oh, my. That is good.’
The next pain began and she pushed the nozzle close to her stomach, streaming the hot water across her abdomen. Georgia could see she’d gained relief from the change.
Georgia pulled the shower chair up behind Mel and gestured to Tim. ‘If you sit behind her like this you won’t get too wet and can rub her back firmly with your massager when she gets pain. Your back will get a rest, too.’
Tim settled himself and soon they were back into a rhythm.
Georgia could see they were getting close to the end of the first stage of labour and she quietly went back into the main room to ensure what she needed was ready. She toyed with the idea of phoning Max but held off until she had everything ready because sometimes the arrival of the doctor put pressure on the woman.
The baby resuscitation trolley was in the corner and she checked the oxygen and suction were both functioning, even though she didn’t expect to need either.
A green-draped trolley held a kidney dish, clamps, scissors and some sponges, and she turned back the bed for Mel and her baby to lie on afterwards.
A tray rested on the bench in case Mel bled too much after the birth. It contained the IV line and infusion and drugs they might need. She glanced around and couldn’t think of anything else she should prepare.
She went back into the bathroom. ‘So where do you want to have your baby, Mel?’
‘Don’t I have to have it on the bed?’
‘Not if you don’t want to.’ It amazed Georgia when women did not realise they had choices in birth position. ‘You can use the birth stool or stand up or kneel down. It doesn’t matter. Whichever you find the most comfortable.’
Mel glanced at Tim. ‘How about I use the stool for the pushing and maybe move to the bed if I want to at the last minute? I remember last time and it would be good if I could just lie back with our baby after the birth.’
She looked at Tim again and remembered some-thing. ‘And I don’t want the needle afterwards because I want Tim to cut the cord when it stops pulsating.’
Georgia nodded. ‘That’s fine. If your placenta doesn’t come on its own after half an hour or you bleed heavily, you might need the needle, though.’
Mel checked with Tim and he nodded. ‘That sounds OK,’ he said to Mel encouragingly.
‘Fine,’ Mel said.
Georgia handed her a bottle of water and a straw to sip with. ‘I’ll
