Saturday, May 25, 2013

Birth Timeline (midwives' notes)

To see the story of Norah's birth written from MY point of view, click here.

>>>>>   Start at the BOTTOM of this post and work your way up - that way it will flow chronologically. :)


Maternal Immediate Postpartum for 40 weeks

TimeBPTempPulseFundusEst. BleedingInits
MONDAY, 13 MAY 2013
10:20:11Comments:
After Norah was born, Dana again refused the HIV screen.
AC
THURSDAY, 09 MAY 2013
13:45:00Discharge Note
Dana, Norah and family are resting quietly. Dana's bleeding is minimal, vss, NAD. Norah is pink w/ vss. NAD. nuzzling, attempting to nurse. PP care of both discussed at length with Kim. Plan to talk again this evening. PPV at Dana's home 48-72hrs, unless otherwise indicated.
AC
13:45:00Departure from Dana Cluff 's Home: Anna Catron, Primary Provider
13:35:00Input/Output:
Input: finishing coconut water
Output: voiding
Comments: bleeding min
AC
13:30:003 F<U; Firm
13:15:00Comments:
Discharge instructions discussed and understood with Dana, John and Kim
AC
13:00:00Departure from Dana Cluff 's Home: Kristy Hammack, Assistant
12:40:00Comments:
Showed family the placenta and then proceeded to help Norah nurse w/o much success.  Attempted side lying on both sides as well as sitting up.  Norah slept easily in Dana's Father's arms as Dana's brother/family said hello.  
AC
12:29:55113/6596
KH
12:15:00121/81
AC
12:15:00Input: Bagel sandwich, coconut water
Mother's Position: Left Side Lying
Comments:
In bed with baby Norah. Eating, drinking, attempting to nurse.
KH
12:10:44Input/Output:
Output: Void
Comments: Up to toilet walking well with no apparent difficulty or dizziness.
KH
12:00:00128/82102Firm
KH
Vital Signs: Minimal bleeding 
11:53:51134/83102Firm
AC
Vital Signs: Minimal bleeding 
11:45:00125/84102
AC
Vital Signs: Minimal bleeding 
11:35:00Comments:
Total EBL 450cc.
AC
11:32:57125/9092Firm
KH
Vital Signs: Bleeding minimal 
11:24:00Medications and Therapies:
Medications:
10units Pitocin (IM)
Lot #293662
Expires 09 Aug 2013
Left thigh
Comments:
NDC42.23-116-25
KH
11:22:00Cord Cut/Clamped - 16 minutes after birth
KH
11:20:18Placenta Presentation at Delivery: Schultz 
KH
11:10:20Medications and Therapies:
Medications:
10units Pitocin (IM)
Lot #293662
Expires 09 Aug 2013
Right thigh
Comments:
NDC42023-116-25
KH
11:08:01Initial Maternal Assessment
Alert/Oriented: Yes
Active Management Initiated: Yes
Bleeding: Stable
Comments/Treatments: Talking to and bonding with baby.
KH
11:05:31Birth: NSVD baby girl with nuchal hand and tight shoulders. Spontaneous cough, followed by strong cry with stimulation.
Mother's Position: Squatting, Not in water
Fetal Presentation: Compound Cephalic
Position of Presenting Part: Anterior 
KH

Newborn Immediate Postpartum for 40 weeks

TimeHRRRTempColorVoidStoolInits
THURSDAY, 09 MAY 2013
13:45:00Discharge Note
Dana, Norah and family are resting quietly. Dana's bleeding is minimal, vss, NAD. Norah is pink w/ vss. NAD. nuzzling, attempting to nurse. PP care of both discussed at length with Kim. Plan to talk again this evening. PPV at Dana's home 48-72hrs, unless otherwise indicated.
AC
13:45:00Departure from Dana Cluff 's Home: Anna Catron, Primary Provider
13:00:00Departure from Dana Cluff 's Home: Kristy Hammack, Assistant
12:32:08Newborn Physical Performed - 1 hour after birth Go to physical


Weight: 3997g / 8lbs13oz

Length: 52.7cm / 20.75in

Head Circumference: 34.29cm / 13.5in

Chest Circumference: 35.56cm / 14in
12:03:0312060PinkYes - copious
AC
11:54:27Yes
AC
Vital Signs: Percussion by AC 
11:48:58Comments:
Attempting to nurse.
KH
11:33:4515068Pink
KH
Vital Signs: Clearing 
11:29:33Yes
KH
11:25:0015064
KH
11:22:00Cord Cut/Clamped - 16 minutes after birth
KH
11:18:32Yes
KH
11:13:2220065Pink w/ Blue Extremities
KH
Vital Signs: Grunting; no flaring or retracting. 
11:10:31Apgar Score - 5 minutes: 9
Heart rate: 2 - Over 100 
Respiratory effort: 2 - Strong Cry 
Reflex stimuli: 2 - Cough/Sneeze 
Muscle Tone: 2 - Well Flexed 
Color: 1 - Body Pink/Ext.Blue 
AC
11:07:16Initial Newborn Assessment
Term Gestation:Yes
Breathing or Crying:Yes
Good Muscle Tone:Yes
Meconium:No
Color Pink or Lavender?:Yes
Cord:Full
Comments/Treatments:Skin to skin with mother.
KH
11:06:31Apgar Score - 1 minute: 8
Heart rate: 2 - Over 100 
Respiratory effort: 1 - Weak Cry 
Reflex stimuli: 2 - Cough/Sneeze 
Muscle Tone: 2 - Well Flexed 
Color: 1 - Body Pink/Ext.Blue 
AC
11:05:31Birth: NSVD baby girl with nuchal hand and tight shoulders. Spontaneous cough, followed by strong cry with stimulation.
Mother's Position: Squatting, Not in water
Fetal Presentation: Compound Cephalic
Position of Presenting Part: Anterior 
KH

Labor Flow Sheet for 40 weeks

VITAL SIGNSCONTRACTIONSPROGRESS
TimeFHRBPTempPulseFreqDurStrgDilEffStatInits
THURSDAY, 09 MAY 2013
11:20:18Placenta Presentation at Delivery: Schultz 
KH
11:05:31Birth: NSVD baby girl with nuchal hand and tight shoulders. Spontaneous cough, followed by strong cry with stimulation.
Mother's Position: Squatting, Not in water
Fetal Presentation: Compound Cephalic
Position of Presenting Part: Anterior 
KH
11:04:15Head: Loose nuchal cord, reduced by AC
Nuchal Cord: Yes
KH
11:02:57Crown
KH
11:00:15FHR: 
Comments: FHT audible 
KH
10:54:12Head Visible: Calmly breathing her down
KH
10:51:58120 - 130
AC
10:48:55Mother's Position: Squatting, Not in water
Comments: Out of tub to supported squat in living room. Pressure.
KH
10:45:02
Input: Water 
KH
10:40:11130 - 140
KH
10:38:00
Output: BM 
KH
10:30:41120 - 130
KH
10:29:48Rupture of Membranes: Spontaneous: Clear
Confirmed by: Midwife's Observation
KH
10:29:00130 - 130
KH
10:22:00Mother's Position: Squatting
Comments: Pressure increasing
KH
10:12:00118 - 124
KH
FHR: 
Measured: After Contractions
Coping: Yes
Comfort Comments:
Focused and breathing through contractions. Dana mentions "So much pressure." Listening to hypnobirthing CD.
Mother's Position: Semi Reclining, In water 
10:10:00
Input: 2 spoonfuls of honey 
KH
10:05:00Arrival at Dana Cluff 's Home: Kristy Hammack, Assistant
9:50:00120 - 120
AC
9:35:00120 - 120123/768610.0100%0
AC
Coping: Yes
Progress:
Active Labor: Yes
Mother's Position: Semi Reclining, In water 
9:30:00Arrival at Dana Cluff 's Home: Anna Catron, Primary Provider

Initial Labor Notes from Anna:

"Dana texted @ 230 saying she felt pressure.  Spoke with Dana at 0739 she was still smiling.  Spoke with Dad @ 0839 and decided towards Dana's home.  Arrived @ 0939.  Dana is in the tub breathing well."  


 THE BEGINNING! My text message exchange with Anna, our midwife:

May 9, 2013, 2:39AM
From Dana: "Keeping you updated: So I was awakened with LOTS of pressure. It is very rhythmic and has been happening for about an hour. I'm not convinced if it's the real thing or not... But I'm definitely feeling surges! We will do our best to keep you up to speed."

3:08AM
From Anna: "Cool beans! Get some rest!"

3:32AM
From Anna: "Remember to super hydrate and maybe a warm bath."

7:05AM
From Dana: "Ok, I was able to nap and a shower felt nice. They are still very much here... Things are definitely happening this morning!"

From Anna: "Keep trying to subdue them. You don't want to start tired."

...and things happened quickly after that! 


All our love, at

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