Sunday, June 26, 2016

Theodorable

I started getting texts from my client around 3:00 pm on Saturday, alerting me that contractions had started.  We kept in touch throughout the day, and she had a textbook labor pattern.  Over the next ten hours, contractions progressed from 15 minutes apart to 5 minutes apart.  I received a call around 1:00 am from mom, telling me that she had been having an active labor pattern (contractions coming every 5 minutes and lasting for 60 seconds) for two hours and that they were heading to the hospital!


We met in triage around 1:45 am.  Mom was coping well and in very good spirits.  I'm not sure what was going on in triage, but we were in there for hours with very little communication from the medical staff.  At 2:30 a nurse finally came in to check mom.

She was 1 cm dilated.

No one wants to hear this after laboring all day!  But mom wasn't discouraged, and she just kept breathing through her contractions.  Her baby began moving like crazy.  We were all laughing as we could hear it through the monitor.  And all of the sudden:
POP!
Mom's water broke at 2:43 am and it was on.  The intensity of her contractions picked up instantly.


We weren't moved to our labor room until 4:00 am, and after an hour of iv attempts, mom was able to get into the tub at 5:00 am.  I was really excited to listen to this mom's labor music with her.  She gave me her music a couple months ago so I could familiarize myself with it, and I actually used it as my roadtrip music when I was on my book tour last month.  When the song "One Moment in Time" came on, I couldn't help but think how important this moment was to this family.  


Things were intensifying steadily, and mom sought out more comfort.  She hoped to find it in nitrous, but the mask made her feel claustrophobic, so she tried some iv pain medications, which helped her relax and find her focus.  Around 6:30 am she started saying she felt pushy.  It was hard to believe since she was just 1 cm dilated a handful of hours ago.  I continued to help her breath slowly and stay focuses, but by 7:30 she was starting to grunt.

Could it be?  Could she really be feeling the urge to push already?!  A cervical exam showed that baby was nice and low, and mom was 9 cm dilated!  She had a small anterior lip on her cervix, and as soon as that was gone, she would be pushing.  The lip was a little stubborn and didn't disappear until 8:20.  Mom was a champ, changed positions often, and grunted and blew through her intense contractions.


Once the cervical lip was gone. mom was able to focus all of her strength on pushing.  And less than an hour later, this little man slipped into the world!


Since there was light meconium, the doctor suctioned him out a bit before handing him over to mom.  In circumstances like this I usually see an immediate cutting of the umbilical cord and hand off to the nurses.  I love that the doctor not only remained calm, but kept baby close to mom, and allowed this couple to proceed with delayed cord clamping.  


Mom pulling baby up to her chest just seconds after delivery.


This is about 2 seconds later  I love how her facial expressions go from total disbelief to utter joy.



Dad was such a sweetheart.  Overcome with emotion as he held his son for the first time!


Camera didn't catch the weight, but this cutie came in at 7 pounds 11 ounces.
Welcome Theodore!
Born Sunday, Jun 26th, 2016
9:09 am


Monday, May 30, 2016

Prodromal Predicament

On the morning of Saturday the 28th, I awoke to an early morning text saying my client had been awake since about 2:00 am with contractions.  We kept in touch during the day over text, and I decided to swing by their home later that afternoon.  Mom was coping well, but wasn't in active labor yet.  I gave her a bit of a pep talk, a little advice, and went home assuming I would see them later that evening.

The hours kept ticking by, but early labor never turned into active labor.  She was definitely experiencing a prodromal (or abnormally long) early labor.  No fun.  Early Sunday morning (3 am-ish) mom was exhausted and decided to head to the hospital to see if things were progressing.

She was dilated 1 cm.  60% effaced.  (Exactly what she was earlier in the week.)
So disappointing after over 24 hours of contractions! 
She accepted a sleep aid and headed home to try and rest.  But rest didn't come easy.  Her contractions were coming regularly (so there wasn't much time to rest in between), but they were only lasting about 20 seconds.  Not long enough to make cervical change, unfortunately.

Mom tried to rest and stay nourished as Sunday progressed.  And then around 8:40 pm, her water broke with a big gush, and it was on!  Contractions lengthened and settled into a nice, regular pattern.  We met at the hospital less than hour later.


Upon arrival, mom was checked and was now 4 cm and 90% effaced!  Goodbye prodromal labor, hello active labor!  Contractions were coming strongly and frequently, and to make matters worse, it took SIX attempts to get mom's iv in place.  


Mom was pretty sure she would like an epidural, but wanted to put it off as long as possible.  She tried the nitrous, but didn't like it.  So around midnight she received her epidural, and was now dilated to 5 cm.  Sleep didn't come as easy as she hoped, but she did have a few moments of rest here and there.  Not as much as we had hoped, though.


In the morning, grandma stopped by to offer love and encouragement.  :)
At 7:00 am, mom was checked and was 9 cm with her baby fully engaged in the pelvis.  Awesome news!  But mom wasn't feeling well.  The expected anxiety that most women experience shortly before pushing was present, as well as some nausea and exhaustion.  Dad was a great support.  I know I say it all the time, but it's such a joy to witness a man love and support a woman during her labor.  

Around 8:45 mom began experiencing some intense hip pain.  We tried everything to relieve it, but it became clear that there would be no relief until baby was out.  Baby was nice and low, and even though the urge to push wasn't quite there, mom began pushing around 10:00 am to see if things would progress.

After a couple hours of pushing, with little to no progress, the midwife offered mom a break.  She wasn't able to sleep, but just a few minutes of resting did the trick.  After some position changes and a whole lot of effort, baby girl Sloane slipped into the world at 1:38 pm.



I couldn't love this photo more!  I hadn't seen mom smile in hours, maybe days!  But the moment that baby was born, mom was beaming.  Could she be more beautiful?!  Showered with kisses and tears of joy from dad, it was a breathtaking moment.





Sloane loves her mommy so much!  She snuggled right in and hardly cried at all.  She was so content and alert.  She spent alot of time looking at her daddy, too.


Such a pretty baby.  


It took a while for Sloane to become interested in nursing, but once she did, she latched on beautifully.  It's such an exciting moment for a family to experience that first nursing session.  After days of feeling like this birth would never happen, this sweet couple now has their baby in their arms!

Wednesday, May 11, 2016

Do-Over

My latest client wanted a do over.  After being induced with her first baby and suffering from a severe spinal headache (from her epidural), she wanted to experience a birth that wouldn't prevent her from being able to care for her newborn.  So this time around she opted for a home birth.  

At 41 1/2 weeks, it felt like labor would never begin!  After trying several things to get things started, and discovering she was dilated to 5 cm already, she decided to have her water broken at 5 pm yesterday.  Contractions began immediately, and I was called over within minutes.  


I found dad offering words of encouragement and counter pressure.  He was an awesome doula the entire time!  Mom labored instinctively.  Her labor progressed quickly, which can feel overwhelming, but she did great!  Emotions and contractions tend to grow in intensity together.




Her firstborn came in to offer some kisses, and I could see how much it meant to mom.  It helped her relax, and  once she had connected with her toddler she was able to surrender more to her labor.  It was a beautiful thing to witness.


Mom also had her puppies standing guard, and jumping into her arms to offer love and support.  They spent the rest of the birth on my lap!  Dogs always love the doula, lol!

Mom could tell things were getting close, and pushing only lasted a handful of minutes.
At 7:23 pm, Clementine slipped into her father's hands.


A perfect do-over!  
Congratulations to this sweet family!


Thursday, April 21, 2016

Down, Baby Down


Who wouldn't want to grow up in this backyard?!  I loved meeting my clients in their home last night, and supporting their labor in the beautiful, Boise evening!  I kept thinking about how next year when the blossoms are out, they will be teaching their little one to walk, and lifting him up to touch the soft petals on their gorgeous tree.  



This mom was one of those amazing women who could focus through a super- intense contraction, then go back to smiling and chatting the second it was over.  We really enjoyed the evening, chatting and contracting.  :)



(How cute is this dress?)


I couldn't resist snapping this shot of her cute dog protecting her during her contractions.  


Around 9 pm, we decided it was time to head to the birth center.  Contractions were much more intense and lasting at least a minute.  After being examined by the midwife, we got the good news that mom was about 6 cm, 100% effaced, and baby was engaged in the pelvis.  Great progress for a first time mom!



Shortly after 10 pm, mom got in the tub and it made her so giddy!  It was a very welcome relief.  


Pressure started to build around 11:30 pm, and I couldn't believe how quickly things were progressing.  It seemed like she was right on the brink of pushing her baby out.  But she stayed at the brink for hours, never quite getting a strong enough urge to push.  

She coached herself through her contractions, and talked to her baby.  She encouraged her baby to "come down", and told herself "pain is ok, I can do this".  She was doing everything right.  

We listened to SO much great music!  It really helped mom stay focused and positive, and I always love hearing the playlists my clients come up with.  Such a fun, unique way to get to know them.  

The midwife checked mom again around 2:20 and discovered that mom had a cervical lip that was making pushing difficult.  They jointly decided to break the water and see if that would finish things off.  Mom started noticing that she was "getting close", and pushing contractions were coming now.  But by 4:15, mom was tired and discouraged to still be pushing, and dad was stressed, too. (So hard to see the woman you love enduring so much!) 

Mom was pushing her hardest, but baby was posterior and was having a difficult time descending through the birth canal.  The midwife suggested new positions every few contractions.  Mom kept saying that was all she had to give, but then she would give more.  Always rising to the occasion.  Heart tones were low and it was time to get this baby out.  With a lot of effort on mom's part and some intervention from the midwife, this baby finally arrived!


Welcome Sullivan!
Born Thursday, April 21st, 2016
4:51 am
8 pounds, 6 ounces


It's amazing how resilient babies are.  
I think it is easy to forget how strong women and their infants are, but they truly are made to do this!


So much joy.
So much relief.



Despite how stressful the final moments of pushing were, baby boy cried and pinked up instantly.  It was like he wasn't under any stress at all!  He initiated breastfeeding and mom went right back to being her perky self.  Amazing. 


What a night.  What strength.  What endurance.  What love.

Wednesday, March 2, 2016

Gaskin Maneuver

I received a text from my client at 9:00 this morning, telling me her contractions were 10 minutes apart.  She also said she had a 10:30 appointment with the midwife, and would touch base with me afterwards.  So I went about my morning, assuming I would hear from her around 11:00.

An hour later I got a text from the midwife.  
All it said was "She's 8 cm"

I immediately called my husband, who is not only the most supportive person alive (how can you not be if you're married to a doula?!), but also works very close to home.  I yelled "Meet me at home in 5 minutes!"  I flew out the driveway the second he got home, knowing I could easily miss this birth since it was baby #6 for this awesome mama!

I arrived to find mom in the tub, holding hands with her sweet husband.  The room was so quiet and peaceful.  I could tell she was just about to start pushing.  The urge was there, but it was mild.  


I thought for sure that baby would just slide right out.  But after about 20 minutes, the urge to push was still weak.  Mom struggled to find energy, and asked her husband to pray for her.  I turned on some music to help her focus and gain energy.


I just loved how this couple held hands the entire time I was there.  And how can you not be impressed when a woman can still fit into her wedding ring at 9 months pregnant?!


After alot of pushing in the tub, the midwife suggested we try something different.  Mom climbed into the bed and began pushing in a hands and knees position.  It helped, but it wasn't enough.  What was enough was the Gaskin Maneuver, where mom brings one leg in front.  It still took alot of effort, but this mom was able to do it!


At 11:40 am, March 2nd 2016, 
Thiago was delivered into his mother's arms.




I love seeing moms filled with so much love for their babies.  
Her face says it all in these photos!



This little cutie nursed right away.  
And with 5 older siblings wanting to hold him, mom might only get him when he's hungry!

Leap Day, Baby!

I was woken up Sunday morning at 3:00 with a call from my clients.  I hopped out and bed and headed to their home, where I found mom relaxing in her bean bag, being protected by her dog.  How cute is that?!  But after a couple of hours, her contractions all but disappeared, so I sent everyone back  to bed.  :)


Sunday passed by, and I met my clients at the birth center around 5:30 pm for a non-stress test.  Mom's contractions were still irregular, with a couple hours on, then an hour or so off.  Unfortunately, it's pretty typical for a first time mom to have an early labor like this.

After the non-stress test, it was determined that mom should transfer to the hospital so baby could be monitored more.  Definitely not what a mom planning an out of hospital birth wants to hear.  But moms always do what's best for their children.  Since contractions were still somewhat mild, I went home to get some rest before things became more intense.

I was called back shortly after 2:00 am and found mom relaxing in the tub.  (Sorry, no pics!)  She was so focused and was laboring beautifully.  She was 7 cm, and I thought we might have a baby by breakfast!

I was wrong.


After hours of laboring in the tub, walking the halls, and swaying on the birth ball, mom was still 7 cm at 7:30 am.  Very discouraging news!  The nurse started talking pitocin, which mom really wanted to avoid.  But after a another hour, it was clear to see that pitocin was needed, so mom agreed.  



Mom's parents arrived Sunday morning, and offered some much needed family support.  


After enduring almost an entire day of pitocin-contractions, mom asked for an epidural.  It provided much needed relief and rest.  But by 7:30 pm, labor had not progressed any further, and it was clear to see that this baby was just not going to be born vaginally.  Mom was given some time to emotionally prepare for her cesarean.  She certainly did not want a cesarean, but enough was enough, and it was time to meet this baby!  


Only dads are invited into the operating room, but he was able to poke his head out and show everyone his son.

Check out that amazing conehead.  He sure tried to fit through the pelvis, but he was just too big!


So awesome to have all 4 grandparents there.  
They waited patiently in the hall and were so excited to sneak a peak of their newest grandson!


Asa Joseph
Born Feb. 29th, 2016
8:24 pm
10 1/2 pounds!



FINALLY getting to hold her baby!



I am seriously obsessed with his mouth and cheeks!



It is hard to express how amazing this mom was.  She literally labored for days.  She was so strong and so patient.  It was wonderful to see the hospital staff treat her with respect, and allow her to labor for a long time, and try everything before resorting to a cesarean.  This removes "what-ifs" from the birthing experience, so moms and dads can go home with a sense of peace.