Wednesday, January 17, 2018

Are You in Labor?

 My latest client was surprised to find herself at 41 weeks since her first baby came right before her due date.  She opted to have her membranes stripped at her midwife appointment yesterday, and was surprised again to discover she was already dilated 4 cm and 50% effaced!  I checked in with her at bedtime, and not much was happening, so we both went to bed.  

She woke up around 4:00 am with some cramping, and by dawn she was in a consistent, early labor pattern.  We kept in touch over text all morning, and met at the birth center at 1:15 pm.  Mom asked to be checked, and she was 7-8 cm, and 80% effaced!  But the weird thing was, she wasn't acting like she was in labor!  Not even breathing heavily through her contractions.  Most of the time, I couldn't even tell if she was having a contraction or not!  But she kept reassuring us, saying she was having them, lol!


Mom was getting lots of snuggles from her firstborn, until grandma came to take over.  Snuggling is a great way to get those labor hormones going!


To help mom focus and get into her "labor brain", I had her read some birth affirmations, and pick a few that she wanted to focus on throughout her birth.

 Around 3:00 pm, mom started telling me how she had enjoyed reading my book, and we discussed some of the perspectives she appreciated while reading it.  Of course, it was fun to talk (especially about my book, ha!), but I kept wondering when things were going to get intense for this mama!  After another cervical check, the midwife recommended doing some lunges to help the baby get into a better position.  I rubbed her back during contractions, but for the most part, mom was acting like she wasn't in labor!


Mom was ready to get into the tub at 4:00.  She was still really chatty, and honestly, we were having a great afternoon talking.  But I could feel in my bones that change was on the horizon, so I suggested 15 minutes of silence to help mom get into the zone.  We made it to 4:20, when her husband starting snoring and we started giggling.  :)  

At 4:40 her sister-in-law arrived, and so did the intensity!
Mom kept saying things like "this is not pleasant", and "I am not enjoying this".
I offered encouragement, cool clothes, and fanning to help keep mom reassured and as comfortable as possible.

At 4:53 mom started feeling the urge to push.  She didn't push for long, but she had to push hard!


 And at 4:59 pm, her second daughter was born!



Welcome Lily!
Born Wednesday, January 17th, at 4:59 pm
Weighing in at 8 pounds, 9 ounces
8 days after her due date

Dad got to cut the cord and sneak in a few snuggles. 

 By 5:35, this sweet family was tucked into bed, and baby was nursing like a pro!






Tuesday, December 26, 2017

A Birthday of Her Own

It took 14 years of working as a doula to finally get called to a birth on Christmas day!  My client's water broke at 5:40 am Christmas morning, so much to my sons' excitement, I allowed them to wake up early and get our family festivities going!  Around 10:00 am my client checked in with me because they was meconium (baby's first bowel movement) in the water, so she went to the birth center for some monitoring.  Baby was doing great, so mom was sent home to rest and enjoy her day.  We kept in touch over text, and her contractions were mild and infrequent for the majority of the day, giving her a chance to catch a final nap.

She asked me to meet her at the birth center at 8:15 pm.  When she arrived she was feeling emotional, as many moms do once labor gets going.  She was also sad to be leaving her firstborn for the first time over night.  Her labor pattern was still somewhat sporadic, so I pulled out my affirmation cards so she could go over them and choose a few that stood out to her.  We hung them on the bed frame so she could refer back to them as needed.



At 9:15 contractions started coming more frequently and they were more intense.  Mom was resting in the bed in between contractions, and her husband provided back massage during.  At 9:30 the midwife offered to check her cervix and see where we were.  Mom was 5 cm, 50% effaced, and baby was a minus 2 station.  


Mom was definitely in labor, but we had a ways to go.  I suggested some positions to help baby descend and encourage more contractions. 
 

These two were such a great team!  Always fun to see a couple working together and sneaking in some laughs in between contractions.

By 11:00 pm things were much more intense, and at 11:45 she asked to get in the tub.  She began vocalizing and changing positions frequently and instinctively.  




At midnight mom was struggling and wanted some help with visualizations.  We discussed a few options, and to be honest, I don't know what she landed on, but she was able to find her focus and continue coping.  Her vocalizations became much louder around 12:30, and her husband hummed in between her contractions.

At 12:40 mom started telling us she was feeling nervous, which is totally understandable and common.  I reminded her to trust her body, because it had known what to do all day.  Mom was cold, (which isn't common!) so the midwife kept adding boiling water into the tub.  


At 12:50 mom began vomiting, which really adds to the fun of labor.  I always feel so bad when this happens!  At 1:10 mom was struggling to get back into the zone and found herself feeling really emotional again.  Her vocals were getting lower and stronger during her contractions, and I knew she would be pushing soon.  Then at 1:35 something really cool happened.  Mom started talking to her baby.  Saying things like "I got you, and it's going to be ok."  It was such a sweet thing to hear and witness.  Mom (finally) became really hot so I started fanning her off, and dad continued to give physical support in the tub.  

And suddenly her baby was born!  It was like her little chat with her baby magically made the baby appear!  




Welcome Eliza Florence!
Born Tuesday, December 26th, 2017
At 1:41 am, 3 days before her due date
We all thought we might have a Christmas baby, but this sweet girl deserved a day all her own!

Tuesday, December 19, 2017

Sunrise


Yesterday my client had her weekly appointment with her midwife.  I decided to join her since I figured they would start talking induction options now that she was almost 41 weeks.  The midwife suggested a non-stress test.  If only it hadn't been stressful!  Baby's heart rate was not cooperating, and within a couple hours, mom was sent to the hospital for further testing.  

Hoping for an out-of-hospital VBAC, this wasn't the path my client wanted.  But she kept her chin up, and remembered some inspiring words from her friend, reminding her of God's timing, comparing it to how the sunrise always comes when it's time. By early evening, mom was admitted to the hospital for an induction due to low amniotic fluid.

At 8 pm her midwife checked her cervix and she was dilated to 1 cm.  The midwife was able to insert a foley bulb to encourage the cervix to ripen and dilate through the night.  Mom was given a sleep aid, which didn't work, but at least the bulb did!  By 8 am, mom was dilated to 4 cm and pitocin was started shortly after.

Mom and I kept in touch over text all morning.  She spent time walking and watching tv.  I arrived shortly before 1:00 and mom was just about to get in the tub.


I turned on some relaxing music and helped mom breath through her contractions.  We experimented with a couple positions because it was difficult to trace the baby's heart rate.  The nurse was in and out constantly, but mom was able to stay focused and relaxed.  After an hour in the tub, it was too hard to tell if the monitor was picking up mom or baby's heart beat, so we got mom out of the tub to reassess.

At 2:10 the midwife arrived and checked mom's cervix, and she was complete!  Amazing progress!  Baby was at zero station, so we did a modified hands and knees position over the birth ball to encourage descent, and hopefully offer mom some comfort through massage.  


The midwife wondered if the low amniotic fluid was contributing to the heart rate issues, and wanted to give an amnio-infusion to try and give the baby a little more cushion.  To do so she needed to break the bag of water.  She did this at 2:35, and then found that there was meconium in the water.  The baby was starting to have more dramatic heart decels, so instead of breathing the baby down, it was time to start pushing!

Mom was a great pusher, and within 20 minutes, baby went from 0 station to +3.  Pushing is so much work, and I always encourage my clients to rest and relax in between contractions.  

Mom rotated from side to side often during pushing.  This helps baby rotate into a better position, and can also help when the heart rate is dropping.  

It's hard to watch the woman you love struggle through labor, and this dad was definitely emotional.  But he was a great support, holding mom's leg and cheering her on the entire time.

At 3:30, the baby's heart rate finally decided to cooperate, and we could even see the head during contractions.  Mom was starting to get frustrated with the slow progress, but she was making great progress!

Baby was so close, and at 3:52 mom pleaded "Just pull it out!"  Three minutes later, she had a baby!

They didn't know if they were having a boy or a girl, and mom was first to notice!  She only held him for a second before he was taken over to the NICU nurses.  He was pretty quiet, and we all waited anxiously for that first cry.



After a few minutes with the nurses, he was taken back to his mom for some much needed snuggling!


There were tears of joy and relief.


Welcome baby boy Declan
Born Tuesday, December 19th 2017
at 3:55 pm
6 days after his due date
Weighing 7 pounds and 9.9 ounces

Sunday, December 17, 2017

Long Warm-Up, Fast Ending


We finally had our first snow on Friday night, and I woke up Saturday morning to texts from 2 clients saying they had been up with contractions!  (Everyone thinks it's the full moon that puts women into labor, but it's totally storms!)  Thankfully, (for my sake) only one client went into labor.  We kept in touch over text all day Saturday.  Her contractions were coming about every 10 minutes and she seemed to be in a good, early labor pattern.  

I wasn't sure if I should go to bed on Saturday night or not, but when my client said she was going to get some sleep, I decided to do the same.  She called at 3:00 am saying she had woken up with around 1:00 am, taken a shower, and that the contractions were now coming every 3-5 minutes.  So I hopped out of bed and raced over.  As I was pulling into her neighborhood she called to say they had stopped!  I still went in to visit and see how things were going.  I really wanted to stay and watch her through a couple contractions, but no contractions came.  After about 30 minutes we all decided to go back to bed.  Since her last labor was a long, multi day event, she was starting to worry that this labor would be the same.  I tried to assure her that early labor stops and starts, and a long warm up usually leads to a fast active labor and birth.

On my way to church I checked in to see how things were going.  Contractions were now about 7 minutes apart.  At noon, mom and dad decided to head down to the birth center to be checked.  Things picked up on the drive.  Mom was checked upon arrival and was about 4 centimeters, but stretched to 6.  Baby was also really low and engaged.  Shortly after being checked, mom's water broke at 12:30 and things really picked up!

I raced to the birth center and arrived at 1:08.  I found mom in the tub with dad providing support.  She was vocalizing during contractions, but very calm and focused in between.  I didn't think we were as close as we were!


 The midwife was running downstairs to get some boiling water because we hadn't even had time to fill up the tub.  She was about 3 steps down when baby's head slipped out.  :)  


Welcome Emily Noelle!
Born Sunday, December 17th, at 1:20 pm
One day after her due date


She was all tangled up!
 



Baby girl was so calm and alert, and it was sweet to see her parents getting to know her.  I love her little hand reaching out to grab both of her parents'. 
 


By 1:54, she was nursing perfectly.  
It was definitely a slow and steady start, but the race to the finish line was short and sweet. :)
 

Saturday, October 28, 2017

Third Time's a Charm

Wanting a completely different experience than with her first 2 children (both born in the hospital), my latest client opted for a birth center this time around.  Being almost a week past her due date, we've been checking in with each other often the last few days. I checked in with her in the early afternoon yesterday, and the poor thing was sick in bed with the flu.  But as we texted throughout the day, I started to wonder if it was really the flu or if it was early labor.  By early evening I was getting more convinced.  Her contractions were coming about every 7 minutes and lasting about 40 seconds.  A great early labor pattern, but she did say they were already really uncomfortable and she was worried about how much worse they would get.

Since I live quite a distance from her home, we decided to meet at the birth center.  She arrived at 10:30 pm and said that her contractions had spaced out a little more during the drive, but that they were still painful.  We quickly headed upstairs to the birth suite to figure out where we were.  The midwife listened to the baby's heart rate, and was somewhat concerned because it was elevated.

Mom was checked at 11:05 pm and was 5 cm and 50% effaced.  Contractions were intense, but still short, and the baby's heart rate was still elevated.  Since mom hadn't been feeling well that day, she wasn't able to eat or drink much, so the midwife decided to do a bag of iv fluids.  If mom was dehydrated, that could be the reason the baby's heart rate was so high.  And if we couldn't get the heart rate lower, we'd have to transfer to the hospital.


After a few pokes, the iv was in place.  In situations like these I usually see the iv really speed things up, or really slow things down!  But by 12:30 am, mom's contractions were visibly more intense.  I put on relaxing music and helped mom remember to release her tension on the exhale.  As soon as her iv was out, she hopped in the tub, around 12:45 am.  Dad hopped in, too!


The tub brought relief and mom was in the zone.  She was tired and rested in between contractions.  She had been chatting up until this point, but once she was in the tub, she really started to tune out the world.  By 1:15 am her contractions were really close together, and by 1:35 she was needing to vocalize through each one.  I reminded her to keep her voice low and relaxed, and I knew she sounded like a woman who was about to have a baby!  


I even made it into a picture.  The sweet midwife on call snapped this on her phone.  :)

 

At 1:55 mom announced she was feeling a lot of pressure.  Dad turned on some music they had wanted to listen to and told his wife how proud he was of her.  He was beaming with anticipation, just like a child on Christmas Eve.  He kept saying how he couldn't wait to the hold the baby, and he provided counter pressure on mom's back during each contraction.


At 2:05 the urge to push was very strong.  Several minutes mom announced the head was out and dad was extremely thrilled to be holding the head in the water.  And at 2:10 am, their baby was born.


Welcome Becks!  Born Saturday, October 28th 2017 at 2:10 am.

(And at 2:15, they took their first family selfie.)


Dad had some much anticipated one-on-one time while mom got out of the tub. This might be the happiest dad I've ever seen!


By 2:50, mom and baby were both ready to start nursing, and by 3:15, he was latched perfectly.  There was a rousing Halloween party nextdoor, but I'm pretty sure we had an even better night!