Feeds:
Posts
Comments

Archive for the ‘Obstetricians’ Category

Lani and Toby, when I met you, you were excited and anxious, happy and cautious. We spoke about your dreams and desires for this, the birth of your first baby.

On February 2nd, Lani, you called me in the early a.m. to let me know that you believed your water had broken. After discussing things, it sounded like it had, indeed, broken. I encouraged you to eat something and call a short time later if no contractions were felt. Shortly afterward, you called to let me know that you were not feeling any contractions but that you were seeing a lot of pink discharge. I reminded you to watch your temperature, stay hydrated, try walking, stairs, foot massage, and nipple stimulation.
You began using the breast pump and stayed active. Around noon, you attempted to take a nap but couldn’t from the excitement. We began talking about your options, including the pros and cons of staying home vs going to the hospital. You decided to stay home and keep working on getting things established on your own.
Around 6:30, you let me know that you and Toby would be heading into the hospital sometime later that evening and that you would call me when you knew more about how you were going to proceed. Around 10:30, you called to let me know that you were having contractions every 15 minutes but were not feeling them and the plan was to start pitocin sometime that night to try to get things moving.
At 4 am, I received the call that you were ready for me. Your contractions were coming quickly (every 3 minutes) and strong. They were completely in your back and you wanted my help. I packed up and headed over immediately, arriving around 5am.
When I arrived, you were standing beside the bed, moving gracefully and peacefully through the timeless movements of the labor dance. Toby, you had your hands always at the ready to support and your voice, to encourage. Beautiful! We talked about your discomfort and where it was at. With the last exam, your cervix was still high and posterior and around 3cm.
We began with lunges, as I had strong reason to believe, from your description, that your baby was posterior as well. After a few lunges, we worked on a pelvic floor release, and then you moved right back up again – ready to get things moving toward birth.
Toby and you moved in such beautiful synchrony, alternating from quiet words of encouragement, prayer, and touch to dancing, hanging, and sitting on the birthing ball, and walking.
After around an hour of moving through this cycle, I asked your nurse’s permission and unhooked your monitor for a walk around the halls. During this, I encouraged you to open your hips and sway, and during contractions, to move your hips in a figure 8 or squat. Once back to the room, they checked your progress and you had moved up to 4cm and baby was nice and low, with babies head starting to turn into the right position.
We opted for hands and knees next, and I sifted you through some contractions, which seemed to help with the back pressure, but it wasn’t long before you were up and moving again with me providing counterpressure to your sacrum and lower back. Your sister, who had come to be with you through your labor, began breathing prayers over your birthing space, quoting Psalms, while Toby loved you through every contraction, praying over you and speaking life over your labor and body.
Throughout all of this, Toby leaned in close to you and you both prayed that your labor and birthing time would bring glory and be a testimony to God’s grace and goodness. It was breathtaking.
Throughout labor, you had attempted to eat, but couldn’t. Coupled with no sleep and hypoglycemia, you were getting to the point of pure exhaustion. We talked about options to try to get you some rest, but the contractions were coming strong and close. We talked about the pros and cons of getting an epidural and how your risks could best be minimized if you opted for the epidural.
If baby was low enough, and had turned well, you were ready for the epidural. You didn’t want one before then, and wisely so, in order to let baby get into the best position possible and to make sure that there were no regrets with your choice.
At your request, you were checked and found to be a good strong 5cm, baby was +1 station and was in a good position. 20 minutes later, your epidural was in place. You soon realized, though, that the epidural that was supposed to allow you some much needed rest was not going to allow for it. You had a window of pain over your right hip. By 11:45 am, we were alternating you from left to right, working on massaging the hip joints, and opening your pelvis through different positions, including the throne.
The anesthesiologist was called back into the room and, around 12:30, he gave a slight pull on the epidural catheter in hopes to straighten it and give better complete coverage. Directly afterward, though, you mentioned lots of pressure down below, different from what you had felt previous.
You asked to be checked again and were complete, 10 cm! At this point, I encouraged you, if you didn’t feel a strong urge to push, to take advantage of the time, since baby was looking strong, and try to rest. You attempted to rest but, after 30 minutes, you felt a good amount of pressure and were able to start bearing down with the contractions.
After a few trial pushes, you really began to get the rhythm, really moving into a groove that you could feel and work with. With Toby alternating on one side with your sister, I held your other leg and you began moving your baby out and into the world.
Soon, you came to that place where you had to decide if the pressure in your womb, or the pressure at your perineum was greater. Slowly and evenly pressing through, you brought your babe to crowning. Slowly, he spiraled out of your womb and into your arms.
Immediately, you and Toby both began speaking blessings and words of welcome over your new son. At 3:09, after 1 1/2 hours pushing, Eason arrived with gusto!
You were a beautiful team, wholly and completely one, working as a unit, from the moment your womb spilled it’s water until the moment your son was placed, slippery and beautifully new into your arms, you were ‘family’.
Congratulations family H! You are blessed!

Read Full Post »

I was privileged to be called on for your birthing time, Melanie. For the birth of your 3rd child, you had decided to look into the help of a doula, and I was ecstatic. Each pregnancy, you had desired an unmediated birth but, every time, you had opted for an epidural. I promised I would help you to achieve your desires as best I could and would support your choices along the way, it was a match!

After working with you and your husband Matt, your two daughters decided that they wanted to be there to welcome their little brother into the world. So, 1 month before your estimated due date, we held a sibling class and worked our way through a birth video and Cary York’s coloring book, “When is The Baby Gonna Hatch“.
Then, we waited…
On January 11th, you called around 8pm to let me know that you believed your water had broke. We talked about what it felt/acted like, the smell and color, and I recommended that you put on a pad, lay down on a towel or plastic bed covering, and try to nap until contractions started.
By 9pm, your contractions had moved up to around 10 minutes apart, 30 seconds long, and strong. I encouraged you to have a bite to eat, still consider napping, and perhaps call your husband home (who worked 3rd shift).
At 10:30, you called to let me know that it was time for me to come over because you were timing them around 5 minutes apart and very difficult to work through alone. Though your mom was there, you wanted Matt and I there.
I got dressed, woke my 9 year old (who had been invited to be your daughter’s mini-doula) to get ready, and we headed out into a light snowfall.
I arrived at your home at 11:30 at night and you were working through some strong back contractions. With every contraction, you lifted your buttocks off the bed and breathed through them. Your face was flushed with each contraction and you described it as ‘low pressure’. I timed a few of them and noted that your contractions were coming every 3 minutes consistently.
You decided that you were ready to move to the hospital. I let you know that your emotional markers said ‘early active labor’, but your contractions were saying ‘active labor’. You were ready to go, so we packed up and made the 10 minutes drive to the hospital, your kids piled into my van with my daughter and all of our bags, my doula bag and their entertainment bags.
By 12:10, we were settled into the room and you were checked and found to be 80% effaced and 4 cm. As soon as you were able, you moved onto the birth ball and commenced to rock your way through a great many contractions which were consistently 3 minutes apart, and 30-45 seconds apart.
You became increasingly more tired and soon had a hard time focusing, feeling a nearly overwhelming urge to push with every contraction. You asked to be checked and found you had rocked your way to 5 cm in 1 hour.
At this point, I encouraged you to try getting into the tub to reduce the pushy feel and to try to give you some rest-time. The tub worked wonderfully to allow you to get from a semi-recline into a side position with every contraction. Matt massaged your hips, which were beginning to cramp, while I vocalized with you through the contractions. Your bloody show increased and I could tell you were making great progress.
At around 3am, baby began showing minor decels, but you had ‘aaahed’ your way to 7-8cm, 90% effacement, and +1 station.
Your urge to push was overwhelming, though, so we began trying different positions, from walking the halls to getting on the birthing ball, to all fours. You ended up spending most of your time on the birthing ball as it allowed you to stretch your hips without requiring you to stand (because of your exhaustion).
At the peak of every contraction, you arched your back and attempted to move away from the contraction. I tried to coax you to focus your energy forward and down, without pushing. It was your nurse, though, at this point, who was able to get you to focus all of your energy forward. As the urge was overwhelming, I sat between your feet at the base of the birthing ball and held your hands, met your eyes, and vocalized through each contraction. Your wonderfully supportive husband sat behind you on the bed, his thighs were your arm rests, and continuously traded out warm washcloths for cold ones.
Around 3:30, it was back into the tub for you as the warm water called out to your aching hips. We working on using the roll-over technique, in the tub, while Matt resumed massaging your hips. Your pushes were grunty at this point, so you asked to be checked again.
At 4pm, you were measured at 8cm, very swollen from uncontrollable pushes, and +1 station. We went for a walk through the halls at this point, and then you gravitated back to the tub. While in the tub, we talked about your options. With your cervix swelling from the overwhelming urge to push, we walked through a few scenarios: we could work extra diligently on finding a way to keep you from pushing without medication, or you could have a low-dose epidural.
You opted to get on top of the contractions.
Around that time, I went out and spoke to your nurse at the nurse’s station. She didn’t understand your desire for an unmedicated birth and, at one point, asked Katy and Amelie, your daughter’s caregivers, why she wouldn’t just take the epidural. I explained that you and I had already gone through the options, you understood the situation, and this was what you had chose, my number one job was to support your decision. Kindly, I was hoping she would understand that that was her job as well.
Returning to your dimly lit bathroom, I again sat beside you and watched as you moved through your birthing space with determination. Your tenacity and strength poured from you in waves that nearly brought tears to my eyes as you worked for the next 3 hours, with all of your emotional and physical fortitude, to climb on top of every contraction that wanted you to bear down with all of your might. The strain in your body was evident as you pushed your face closer to mine with every contraction, demanded my eye-contact, and we puffed our way through contractions that were coming strongly every 2 minutes and lasting 60 seconds or more.
Without any prompting, we fell into a rhythm: every contraction, you would move onto your side or into a frog-squat and would seek out my eyes. Then, we would deeply and deliberately breath through the climb of the contraction. When the peak came into site and your body curled around itself, trying to barrel baby down, we would ‘Lamaze’ puff our way through the increasing pressure, sometimes loosing the battle, most times triumphing! Matt scooped water over your rounded belly, massaged your hip, and whispered his encouragement and pride of your strength.
After every contraction, you would sag, exhausted, against the wall of the tub and close your eyes, sometimes overwhelmed to the point of tears.
At 5:45, you were measuring 8cm, less swollen, and baby was still sitting nice and low. You were showing signs of transition, saying that you didn’t think you could go on and wanted to be done. Baby was showing more decels, but was still strong and moving plenty. Back in the tub you went, and we moved through more of the same.
at 6:45, your doctor came in to talk with us. He asked what I was seeing, I told him how well you were working through the contractions, what the obstacles were, with an overwhelming urge and swollen cervix, the decels I was seeing, and the possibility of a malpositioned baby.
He did a vaginal exam and said you were a beautiful 9cm! He then confirmed the decels, but made sure to say that they were nothing to be worried about at this point and that, as long as baby was healthy, you could continue working through things they way that you had been. He also noted that baby was in “deep transverse arrest” (see here for a description), though, and that, when he got back from a surgery he was heading to, he wanted to talk with you about what this meant for your birth.
He left for his surgery and immediately you stated you were ready for your epidural. I knew that we had a small window to move baby, so I said that we would get it for you if you were absolutely certain, no regrets. The nurse called up the anesthesiologist, and I asked you to get on all fours. Unlike the other times, I didn’t help you, but made you rotate on your own.
When you moved onto all 4s, you had two strong contractions back to back and said that you had to have a bowel movement. You insisted that it was not just the pushiness, but something actually ‘there’. I smiled and encouraged you to squat beside the bed and go to the bathroom. I threw a bed pad on the floor and you squatted on it. Immediately, you were all out pushing.
At the exact same time, the nurse peeked into your room and asked what you were doing on the ground. I replied that you were having a baby (actually, I think I said you were pushing). She threw herself on the ground and peeked up between your squatted legs. There was babies head pushing on your perineum.
The smile on my face could not have been any larger – YOU had moved your baby!
She ran out to stop the doctor from getting into the elevator. While she was gone, you climbed onto the bed onto all fours again and kept pushing. Your doctor returned and you moved your babies head out and into his hands. Immediately, babies head pulled back toward your perineum. When you had a good 4 contractions without any further dissent, he told you to flip over onto your back. In a 140 degree recline, we began trying McRobert’s maneuver to move baby out. When that didn’t work, doctor quickly moved onto the Wood’s maneuver and, with an audible pop, Tres squeezed slowly out into the doctor’s waiting arms.
He had a slow start but, with the doctor working diligently to get a response out of him, and mama and daddy calling him home, Tres let out a lusty cry!
At 7:45am, Tres was born, weighing 9lbs 3 oz and measuring 19 inches long. Mama showed one of the strongest wills I have ever seen in the face of adversity. Melanie and Matt, thank you for the honor of attending this miracle! Your family of 5 is beautiful!

Read Full Post »

This is the story of a friend and fellow doula‘s birthing time. I was supposed to be at this birth, but alas, it was not to be. 🙂

A lady knows when it is time…………this is so true, especially Tuesday, September 23rd when my sweet little girl came into this world. Yes, this past Tuesday, I was blessed to have in my arms a beautiful baby girl, named Imari. Oh my gosh, (mommies are partial to their babes), this girl is a cutie. She has a light, caramel complexion, brown eyes, straight black hair, long fingers and toes. To me and her Daddy, she is absolutely perfect!

My due date was September 30th. I ran out of patience and was determined to have a September baby, (as a Doula I would encourage to just let nature take its course, without hurry or basically support whatever the mommy wished to do, I was not the Doula this time :0) ), and so I opted to ‘nudge’ mother nature and baby along.

I went into the Doc’s office Thursday the 18th and discussed my options for induction. I researched my info on the subject and took his thoughts into consideration. My husband and I left the office that day with the idea of going home and trying all the ‘natural’ self-induction methods we could, if those things didn’t work then we would go in to the Doc’s office on the following Monday and have my membranes stripped in the hopes I would go into labor that night, and if that didn’t work, then Tuesday morning we would go over to the hospital and begin an elective induction with Pitocin.

Well, it’s obvious which one we chose, (birth date was at the beginning of post), but I really think my little lady knew what time it was and she had jumped on board overnight, really over the past 3wks. (Let me back up a bit), Over the past 3wks, like one or two nights out of the week, I would awake to nice contractions that could be timed. These were nothing like toning contractions. They were 15, then 10-7, then the last week before the birth they were 3-5 minutes apart, but all times they would fade after 2-4 hours.

(Moving Ahead), okay, so Tuesday morning we get to the hospital around 6am. I was a little crampy, having some contractions, and a lot of nerves. I went through admission and signed my life away, finally at 7’ish I went to the bathroom to change into my lovely hospital gown, and SURPRISE, my water broke, just after I discovered my mucus plug in my undies, (this was an exciting find, I can finally tell with experience what a ‘mucus plug’ may look like!). So I hop on the bed, get hooked up to the monitors and all, my nurse checks me and I am 3cm, so then I excitedly call my Doula to let her know what was happening at that point. She informed me to call her whenever I thought I would need her, she would be ready and waiting for my call. About a quater to 8, I got my i.v. hooked up and the PIT was started at a level 3. A very light start, but I could automatically feel a difference in the contractions, nothing hurt, nothing was uncomfortable, just different. I was excited and began settling with the thought that my baby was coming to see me today! Well, at 9a, my nurse came in and said “why don’t you get up and move…….try the bathroom, you want to keep your bladder empty.”So I took my new friend, the i.v. pole, with me to the bathroom and sat there………..I pee’d………..and sat there………..then I had a REALLY different contraction, it caught my smile. Then I had another contraction with a gentle rocking of the pelvis and sway, and then I knew, I needed my Doula. I hollered for Rylan, my husband, to call the Doula, tell her this was it, labor has started. He called her at 9:09a. I finally got back to the bed, I was so in shock of the last contraction that I had, that the offer to go walk from my nurse, just seemed impossible…………I felt like laying down, and that’s what I did. My nurse checked me and I was at a ‘6-7’. I hugged the left side of my bed, stroking the side rail from top to bottom during the contractions and as the contraction peaked and began to come down, I would open my eyes and blow out the flowers on the wallpaper that bordered the room. The flowers matched the ‘coming down’ of the contraction to the T. I knew when I blew on the last pink flower in view that the contraction was over. My husband and my mother gently stroked me or rubbed my hand and back. They were such good support at this birth. My Doula was on her way, she had an hour travel time to reach the hospital. I never thought to call her anytime sooner than I did, ’cause it was agreeded to call her when I thought I would need her. And I did that……….but who knew how short and fast this labor was really going to be? Needless to say, she was in route and the Doctor was on stand-by at his office, literally across the street from the hospital. I suddenly felt the baby move down into my pelvis, I told the nurse anxiuosly, “she just dropped to station 0, she is coming.” The nurse checked me, and I was 8cm on one side of my cervix and almost complete on the other side, baby was at station 0 true enough. My nurse walked out the door and asked someone at the nurse’s station to call my doc. She came back over to me and asked me to turn onto my right side and manage a few contractions on that side. So, eventually they got me to turn over. I had 2 contractions on my right side and I screamed, “she is coming, help me, I’ve got to push……….”, and I pushed. My nurse kept a poker face the whole time, she was so wonderful. She asked me on the first contraction after me telling her I had to push, to breathe and not push, just breathe through the urge………well the next contraction came and I began pushing instead of breathing and my sweet nurse did not say anything about stopping, she just told me to breathe slowly because the baby was crowning. Two pushes and my baby was here, 10:16a.m. My nurse caught my baby, and I couldn’t have been anymore happier. Imari weighed 7lbs. 14oz. and measured 21 1/2″ long.
The doc walked in a good 10minutes later, basically to pat me on the back and deliver the placenta. I had no tears, so he didn’t get to practice his sewing 101 skills. My Doula got there at 10:40a.m., she was so worried about what I would say…….she didn’t make it and she had so wanted to be there, not just as a Doula,but as my friend. My excitement and contentment with how my labor went, (fast and relatively un-painful even with the Pitocin), that it was okay for those who didn’t make it. I achieved a goal of mine, an uncomplicated, med-free, (only med used was Pitocin), vaginal birth. It didn’t really matter that the doc didn’t make it, mainly b/c having worked in L & D and being a Doula, nurses are the ‘eyes’ and most of the time they are the ‘hands’ too. And as far as my Doula, we just couldn’t help the timing. She had been there for me during prenatal q & a’s. Her encouraging words and how I knew she would treat me during labor played in my mind. Just as was posted by someone on her blog, we got a lot of the labor out of the way before the actual day, so true!

Imari is truly my little princess! She lies here on my chest as I re-tell the amazing day she came into my life. I loved this lil’ bean from the moment the pregnancy test was positive………now look at her, OMG she is wonderful! We had a beautiful LABOR DAY, the blessings are amazing!

Read Full Post »

Older Posts »