Welcome Tres!

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!

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Baby Born

L and MA. What a ride, what a journey.

L, the day I ‘met’ you online, I coveted becoming your doula. You were full of passion, a desire for a healing birth, and an aura of strength and wisdom that I did not often see in my mommas.

You had previously had a cesarean with Tri-boy, and were convinced that your body could do it itself. You were heart-set on a healing birth to reclaim your body’s ability and power. You were preparing for a natural birth. I wanted to support you in making it possible. So, I prayed I would be chosen.

When I initially met with you both, I was worried that I would be considered ‘too young’, as often I have been told. I was relieved, when, instead you gave me a call and told me that you would love for me to be your doula.

From that point on, I had the privilege of working with you on your birth plan (you had it in the bag), creating a positive birth story to complete your bad birth dreams, and simply prepare for the birth of your little one.

I was sure that you were going to be in labor on September 22nd. When that day came and went, I was astounded. You had been ‘labor ready’ for a long time by this point. You had a few bouts of start and stop labor, which urged me to recommend that you try the knee to chest position as often as possible. On September 23rd, you had quite a bit of loose stool and cramping. The following day, you had no action; and the next day, still no action.

I was encouraged and believed your baby had turned from a posterior position into an optimal positioning because she was giving you signs of labor and then a rest, a time to regain energy and prepare for birth. This was confirmed when, around 2am on September 26th, you called to let me know that you had been timing contractions and believed them to be the real thing as they were around 10 minutes apart.

I got up and put my doula bag and ball in the car and got myself ready for a nice long labor night. Shortly after your initial phone call, I received a second call from MA that he was up and thought it time I head on over. I met you at your home around 3am. You were on your hands and knees and working with your body by swaying your hips from side to side during contractions, only to sit back on your haunches between them.

Tri-boy was already gone to your grandmothers and MA was brewing coffee. You let me know that you were timing the contractions around 7 minutes apart. You also let me know that you were experiencing quite a bit of back and butt pressure, so I encouraged you to use the birthing ball to support your upper body weight. After watching you through a few contractions, I noted that your contractions were down to around 2-3 minutes apart.

Putting counter-pressure on your sacrum, I encouraged you with verbal affirmations while MA gauged your progress on how soon he wanted us to leave for the hospital.
A little after 4 am, MA and you decided that it was time to move to the hospital. I agreed with your contractions being about 2 minutes apart and your pressure moving lower. We arrived at the hospital around 4:30 and you signed the necessary paperwork while on all fours, leaning over the birthing ball, and vocalizing through contractions. After you were signed in, they checked you in the OR and you were found to be 7cm dilated. With the fetal monitors strapped on, leaning over the birthing ball, on the bed, you worked through your contractions while vocalizing. MA rubbed your back and I continued pressure on your buttocks while sneaking in a few pictures in-between.

You were settled into your room a little after 5am and you soon began to feel slightly pushy. Throughout it all, MA provided verbal encouragement, relieved my hands temporarily from my vigil on your posterior, and provided sips of water and back rubs.

You remained in the all-fours position and were found to be 10cm with only a little lip of cervix left. We alternated knees in a modified asymmetrical positioning to get the lip gone. It only took 2 contractions and soon you were grunty-pushing your baby down. Your body was truly designed for birth as your pushes moved her down so efficiently. Watching you throughout your labor was beautiful. You were so in tune with your body’s cues, doing exactly what it urged you to do, moment by moment.

Doctor Reynolds arrived in time to see baby’s head appearing. She encouraged you to turn around as her fetal heart tones were decreasing and to increase your urges to push her out more efficiently. On turning around into a classic position, you began really bearing down with each contraction, and her head quickly came to crowning. As her heart rate was remaining quite low even between contractions, she recommended an episiotomy. With the very next contraction, her head was born.

Before the next wave came, she began to grimace and cry, and her shoulders slipped free of your body. She had thick meconium at birth, so they whisked your wee one away to the warmers, but she returned to MA’s arms and then yours, in just a few moments.

L – Your body was strong, beautiful, and efficient – working together as a team, your body and your baby brought her into the world. You were right you “could do this” – you had your healing birth and what a beautiful birth it was!

Baby Born – Born September 26, 2007, at 6:22am
7lbs 14oz, 20 inches long

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C’s Birth

What a journey, what a ride.

Let’s start a few months prior. When I first met you, B, and you found out what I do for a living, your first words were ‘You’re crazy’. As time wore on, though, and your belly began to blossom and grow, your interest began to pique.

Bee, your mom, began taking my classes and had access to a multitude of resources which she began to share with you. Still, you were ‘interested, but not sure’. Around 5 and ½ weeks before your due date, you were handed a copy of The Business of Being Born. A few days later, we sat and talked, and the papers were signed – I was going to be allowed to witness the birth of your baby!

On March 19^th, I blogged this:

“I will be attending my friend’s birth in mid/late April (though I *think* she will be around 1.5 weeks early)”

The Saturday and Sunday after that, you attended a Weekend of Relaxation hosted at your friend’s house. We talked about the sounds, attitudes, emotions, and actions of birth. Jo was a constant support and encouragement, trying out every relaxation technique and vocalization right along with you. It was great to see his active participation and involvement. I knew that he was going to be a great birth companion.

On Friday, April 11^th and Saturday, April 12^th, I could not get the two of you out of my mind. So, on Saturday, late in the afternoon, I called to see how you were doing. I saw you on Sunday at church and your baby had dropped considerably. You mentioned that you were having a lot of Braxton hicks contractions and you seemed rather breathless. I had a feeling it would be that day.

Sure enough, around 5 that evening B called to let me know she was pretty sure this was it, your contractions were coming consistently and demanding your attention. You were laboring at 1.5 weeks before your EDD. I let you know that Calvin was gone but that, if you thought you needed me then, I could call him and have him come home. You assured me you were ok and agreed to update each other as the evening went on.

We talked a few more times, then, at 8pm, as Calvin pulled in the drive, you called to let me know you thought it would be a good idea for me to come over. I arrived around 8:30 to find you walking with your hand on your lower back, with a look of ‘ah, this is it’ on your face. Jo was nearby working on his i-pod and sitting at the computer. Son was tiredly but excitedly walking back and forth from his room to you.

After he went down to bed, things seemed to pick up and soon we were able to time them about 3-5 minutes apart. B, you continued to pack your bag and, between contractions, you did your hair and makeup for last minute pregnancy photos. Around this time, Bee showed up, we began baking cookies for the nurses, and Jo took a few pictures of you.

Soon, you found your most comfortable position to be on all fours, draped over the ball. Sometimes you would alternate to kneeling beside the bed and placing your head and arms on the bed. As soon as your bag was packed, you got much more serious and laid down on the bed for a short time while Jo packed the car and we talked about when to move to the hospital.

That time came sooner than I expected. Your contractions soon picked up to about 3-5 minutes apart and they were demanding your full attention. As soon as you began making noises, Jo began to show concern and, after talking about how spousal anxiety can affect labor negatively just as much as arriving at the hospital too early, we decided to pack up the bags and move to the hospital.

On arrival, the receptionist had you fill out your paperwork while Jo parked the car. You were still quite on top of the contractions and you only really needed to get serious with contractions.

In triage, they found your contractions about the same as when we left the house, and your work was over half done!

Whereas earlier, rubbing your back and applying counterpressure felt good, at this point, you did not want your lower back touched and so Jo and I moved into more verbal encouragement.

Settling into the hospital room, we turned down the lights and Jo really began to merge into his role as protector and partner. He spoke lovingly to you between contractions and gave you undivided attention during them. A simple touch was all you wanted at this point, a hand resting on yours or your hair being swept back between contractions.

You were definitely in heavy labor. You favored lying on your side, and I knew you were nearing transition as your face became flushed and you were no longer sweet B.

Your progress picked up and soon we both knew you had, indeed entered transition. You began saying you didn’t want to do it anymore and you were ‘mad’ and ‘pissed’. We found out later you were mad at your mom for ‘getting you into this’ and she had never done it herself.

Jo drew near to your side at this time and soon you were feeling like you ‘wanted to poop’. Jo grinned from ear to ear as he looked up at me, knowing you were starting to push. Soon, you were actively pushing on your side, then you turned into the classic position when your doctor arrived.

B, you were such a good pusher, bringing your baby down quickly and easily. Without coaching or counting, your body and baby worked together seamlessly, and soon she was crowning. There was not even a hesitation as you slowly brought out her eyes, then her nose, and mouth. Once her chin passed, though, she stopped moving.

Your doctor was patient and unhurried, though, and waited to see if you would be able to move her down without help. After around 8 minutes of baby not moving with each contraction (which were still coming a close 2 minutes apart and now heart tones began showing worrisome variables), she and I began to piston your legs with each push in hopes of opening your pelvis to allow enough room for your baby to rotate herself. When that didn’t work, she asked the nurses to apply suprapubic pressure. When that was not helping, she asked them to apply fundal pressure while also offering suprapubic pressure. This whole while, she did not attempt to manipulate your babe, in hopes of reducing risk.

After it was obvious she was not moving and had a good case of shoulder dystocia, she let you know that things had to get heavy at this point. She never frightened you, but let you know this was important. You pushed harder than I had ever seen a woman push, bringing yourself to a nose bleed (wow, superwoman). At the same time, the nurses gave fundal and SP pressure, and your doctor attempted and internal rotation by hooking her shoulder to turn it.

At that time, Jo was so concerned with you that I gently reminded him I would take care of you bleed and help you focus, his job was to love on you and watch his babe be born.

The pop was almost audible. Her top shoulder moved free and the rest of her quickly slid along. She was feisty from the beginning and an audible sigh of relief came from every person!

You did splendidly! Your body worked beautifully in tune with your baby and your choice in birth teams made for a wonderful assistance to a surprising ending! C was born!

The two of you did a marvelous job all-together! Let alone, as a crash course. What a beautiful quilt of love and trust that you both wove together to give your baby the best start possible and share in one of the most joyous events of a lifetime – the birth of your child! I was honored to attend the two of you!

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