Birthing the Baby
Warren
A Johnson
©2015
Ashley
Clark posted a take on writing based upon the painful experiences of the labor
process during the birth of her son. I am not experienced in that side of the
deal, but I’ve been around a few births. I have been exposed to the process by
which nurses and OB GYN staff determine the quality of health of the baby
during the process known as Electronic Fetal Monitoring (EFM). So, with the
idea churning around in my brain, I thought I’d birth it for you here. If you
are interested in learning more about the technical side of this and you have a
smart phone, find the app called EFM Guide. It will explain the terms and
physiology of what’s occurring at any given time on the fetal monitor.
The first thing to learn concerns
the process of EFM. No one has x-ray vision. No one can see your creation, your
story. It will only come to fruition if you let it out. However, with the
proper monitoring, one can tell the overall health of it. So, the first step is
to apply the belly band around the mother. This device connects to the fetal
monitor and shows patterns understood through observation. And, since birth is
as much about the mother’s health as it is the child’s, we will also connect
the mother to a heart monitor, We will watch her blood pressure, pulse rate and
breathing rate. By discerning the increase in stress of the mother, we’ll know
to look for like stress in the baby and whether or not the baby, like the
mother, can recuperate from periods of stress.
Although millions of people attempt
to birth books, the successful ones I see plug into a venue to expose their
efforts to people of greater knowledge and skill. This is the importance of
writers’ conferences. Get plugged in. Dare to put your efforts up for
observation. Let the pros discern your status. It’s for your own health and that
of your creation.
Since you are attached, so to speak,
we’ll look at a few of the terms and what they mean to the baby. Fetal heart
rate (FHR) refers to the predominant average rate displayed on the graph. The
issue is that a baby in the womb experiences many influences changing their
pulse rate. For instance, the baby may not like mom’s diet and the rate goes
up. Mom may bend over and apply pressure to the baby and the rate goes down. The
rate ranges from 90 to 200 beats per minute (bpm). What we’re looking for is
the average baseline rate, generally expected to be around 140, ranging from
130 to 150, during rest or normal times.
You experience any number of things
throughout your day. Some of you may even have an hour by hour calendar so you
know exactly when to write, when to do chores, when to go to the store, etc. If
you don’t write during the proposed time, your baby suffers. If the cat plops
on your computer key board, the baby suffers. If the older child falls off the
porch rail, everything goes haywire until the emergency is under control.
When the baby is excited, its heart
rate accelerates. If the increase is over twenty bpm, it shows on the graph as
an upward swing of the FHR. Accelerations are expected to decelerate as evenly
as they accelerate. What you see is activity measurable by rate and time. An
increase of fifteen bpm over a period of twenty seconds will show the peak at
ten seconds and a return to baseline FHR at twenty seconds.
One day you’ll zoom through pages
of text, moving right along on the plot and character development, and then
it’s back to the grind. But that’s good! Realizing writing comes in spurts
allows you to go with the flow and realize there will also be the work
associated with normal activity.
In the same vein, decelerations
occur. This time the monitor shows a depression of the FHR. It is always a sign
of stress. Whereas an acceleration can happen from fun things, like receiving
Brussel sprouts for lunch, decelerations occur from stressful things, like
contractions mentioned previously. Again, stress is a part of labor, but the
key is how well the baby recovers. We look at how low the FHR drops, how long
it takes to get to its lowest rate, and whether or not it recovers to baseline
FHR in the same time span. This pattern, equal time going into the depression
and equal time coming out of it, is normal for babies.
Most of you know writer’s block
will slow you down and you’ve overcome the illness. One way or the other you
have taken steps to recover, whether it’s writing something else (like a blog)
or brain-storming with cohorts. The issue is when your story is depressed you
don’t let it stay that way. You get on with it. That’s normal life to a writer,
so I’m told…
Accelerations and decelerations
generally occur in association with the mother’s health. If mom’s heart rate
goes up, chances are there will be a response from the baby and it will chart
accordingly. If mom’s blood pressure changes significantly due to an event, the
baby will be stressed, too. However, the OB folks also have terms like Early
and Late Accels and Decels. These events occur, generally, because of events
that are not obvious. These events are watched with a closer eye on the chart
to determine if they are a) regular, b) predictable (able to tie the pattern to
a cause and it repeats), c) whether or not they can be relieved.
Sometimes when we write, stuff
happens. Stuff outside of normal or the occasional emergency discussed earlier.
Most of you have had these experiences: bad health reports relating to
significant diseases, loss of a loved one, hard economic times. Each of these
will have an effect on your writing. That’s why Hemmingway always wrote in the
morning. He knew that he’d be drunk by early afternoon and that all writing
ceased at that time. I’m not advocating you plan that well for early
decelerations, but you get it.
The last thing I think is important
for you to know about this FHR monitoring is a major problem when the actual
birth is occurring and it’s known as Shoulder Dystocia. The term dystocia
simply means something abnormal. Many causes exist for this, but the inclusion
of the word shoulder gives us a clue. When the baby starts down the birth canal,
the preferred position is with the head preceding everything else. The baby
also rotates so the shoulders end up with one toward the belly and one toward
the spine. The baby faces either the left or the right side of the mother. This
is the best position, considering the shape of the pelvic bone girdle through
which the baby will pass. On the top of mom’s pelvic girdle lays the pelvic
arch bone.
The problem comes when the baby’s
shoulder closest to the mom’s belly catches, or hangs up on, the pelvic arch.
Here’s the mom in heated battle with contractions going on, breathing heavily
labored, she’s pushing to expel the baby and WHAM. The shoulder dystocia thing
happens. The external sign observed by the OB folks is the head “crowns” (the
top of the baby’s head is exposed through the vagina and is usually a sign of
imminent delivery), but then it gets sucked back up into the birth canal
(turtling—like a turtle pulling in its head). Holy smokes! Emergency! The
birthing staff starts doing many things at this point. The FHR monitor is
removed. The mother is placed in a number of positions to assist in relieving
the pressure and to assist the baby in acquiring a better position for delivery.
Someone will usually start by applying full body pressure on the pubic arch to
try to effect a change in the girdle shape. Often the mother’s position changes
to her hands and knees to alter the pressure points. All of these ensure the
baby comes out as quickly as possible at the right time.
What we know about writers is
unless they are tended by observant staff they will experience shoulder
dystocia of an incomplete or unpublishable work. I’ve experienced this. I wrote
my first novel about twenty years ago, but didn’t really have the interest in
continuing with the writers’ conference route. Life changes, work experience,
the economy and any number of other excuses kept me from pursuing the dream of
publication. Then one day someone offered to publish it for three hundred
dollars. What a pittance to pay for a book I could hold in my hand instead of
looking at the manuscript in a box in the closet. I jumped.
It was the wrong thing to do. Yes,
I have a book to hold. Yes, I had friends buy it. Yes, I gave many away and
some even said they liked it and want to read the next one. It was premature
and should have hung up on the way out! Now I know better. Now you do, too.
Don’t get anxious. I have since learned God has my best interest at heart and
He directs my path, if only I will follow him instead of getting in front of
him. Thanks to many, I know I’m on the right path to publication, but it’s
likely to be nine months from now.
