Thursday, September 29, 2016

Time To Cut the Cord

A little over two years ago, I attended a pretty scary shoulder dystocia birth.  Everything worked out fine, but those first couple minutes were very nerve-wracking!  So when my client told me she was expecting again, I knew shoulder dystocia would be a big concern this time around.  

After several weeks of having contractions, my client was admitted to the hospital late Tuesday evening, dilated to 5-6 cm.  They called me around 11:40 and I arrived shortly after midnight.  Contractions were coming regularly, and mom was sitting on the birth ball and swaying,  After about an hour, mom climbed into bed to rest... and totally fell asleep!  By 3:00 am, contractions had pretty much stopped and mom was given the choice to sleep or have her water broken.  

Mom decided to continue sleeping and have her water broken in the morning.  So I went home to grab a few hours of sleep, too.  

At 9:30 am, her midwife broke her water.  She was 7 cm, but still not in active labor!  To encourage her contractions to pick up, we went walking outside in the courtyard.

The fall leaves were gorgeous, even though it was about 80 degrees outside!  Mom leaned over during her contractions and swayed her hips while I provided counter pressure.

The midwife came back around noon to discuss what would happen if this baby also had shoulder dystocia.  She recommended a drastic position change.  This information is great to have beforehand, as I have had clients with shoulder dystocia be very confused and alarmed when a team of nurses is suddenly forcing them into a different position.  

By 12:20 contractions were strong, and at 12:40 mom said "I must be in transition because I don't think I can do this!"  But she was doing it and doing it extremely well!  She was so focused and calm, back on the birth ball and listening to music.  Several minutes later I could tell we were close, so I ran out to find the midwife.  At 12:50 mom was 9 1/2 cm and starting to feel the urge to push!

Mom pushed in a modified hands and knees position on the bed.  Once the head was out, our fears were confirmed and it appeared that shoulder dystocia was preventing her baby from fully being delivered.  Quickly, everyone helped mom flip over onto her back.  The shoulders started coming, but something else was holding this baby in.  He was all wrapped up in the cord.  So wrapped up that the midwife clamped and cut the cord right then and there!

In 13 years of attending births, I have NEVER seen the cord cut before the baby is delivered.  But once it was cut, this little cutie slipped into the world at 1:17 pm, Wednesday, September 28th, 2016.

Tipping the scale at 8 pounds 13 ounces, he was a little shell shocked, but not near as bad as his brother had been.  The nurse took care of him while the midwife continued to care for the mom.

We all agreed it wasn't as scary as the last time, but I'm sure it still had dad's heart racing.  Here he is watching his little boy figure out his new environment.

It's hard to not hold your baby right away, but it didn't take too long to reunite these two.  Even though this baby was struggling at first, he perked up quickly and was perfectly latched about an hour after birth.  

Welcome to the world, Weston!

Monday, September 26, 2016

Laughing and Crowning Usually Don't Go Together...

When I woke up Sunday morning, I saw a text from my client from 6:00 am saying she was having contractions every 20 minutes or so.  Being a first time mom, I figured she would stay there for a day or so.  But by 1:30 pm her contractions were 5 minutes apart, and by 3:30 she was wanting some support.

I arrived at 4:30 and found mom at her computer.  In between contractions she sent instructions to the teacher who is going to cover for her during her maternity leave.  I could tell her contractions were getting intense, but she was popping right out of them and very conversational.  I couldn't tell if she was really in active labor yet or not, so I suggested hitting the pavement.

It was a gorgeous Sunday for a walk!  Mom was cranking out the contractions, and some people driving by yelled "get a room!" as she labored on the sidewalk.  So funny! (And I was loving her cut polka dots and denim shirt!)

By 6:30 is was clear that mom was in active labor, and we went to the birth center at 7:30 pm.  Mom was very instinctual and very quiet.  She changed positions frequently, and really just followed what her body wanted to do.  I was really impressed.  So impressed that I couldn't tell if she was progressing or not because her demeanor never changed!

At 12:45 am the midwife decided to check and see how far along mom was, and discovered that she was 10 centimeters!  Her bag of waters was bulging, and it seemed like the end was close.  But an hour later, the urge to push still hadn't come, so my client decided to have her water broken to try and bring on the urge to push.

Most people think that once a woman is fully dilated that she will start pushing out her baby.  And sometimes it works that way, but other times it requires patience as the baby's head molds and descends into the birth canal.  This process of "breathing the baby down" can take anywhere from several minutes to many hours.

The urge to push was nowhere to be seen.  So we did a lot of position changing, hip moving, stair climbing, vocalizing, hip squeezing, tub sitting, and waiting.  I was blown away by the strength and endurance of my client.  She never complained, never appeared to be frustrated or concerned, never asked how much longer it would take.  She just kept breathing through her contractions and trying everything I suggested.  

Finally around 5:00 am mom began to have the urge to push.  And once it came, mom knew exactly what to do.  Her baby's head began to crown in the tub, and unlike most mothers who wince in pain as their skin is stretched and burned, my client started LAUGHING!  In 13 years, I've never seen a woman respond to crowning with a laugh.  She appeared to be overcome with joy and excitement, and it was such an amazing thing to witness.  

At 6:18 am, Monday, September 26th, Silas slipped into the world.
Weighing 7 pounds 15 ounces

The cord was short and wrapped around him, so he had a bit of a time figuring out how to breath right at first.  The midwives knew exactly what to do, and within a minute or two, he was breathing and back in mom's arms.  Phew!

The room was very dark, so the pictures don't do any justice to how cute this little boy is!  His face is just perfection, and he was so happy to snuggle in with his mama!

Wednesday, August 17, 2016

Birth Unhindered

Every birth is so different.  Some need assistance all along the way- some need help here and there- and others occur safely without any help or interference.  No birth is "better" than the other.  Like life, birth is somewhat unpredictable.  And just as all lives are sacred and beautiful, all births are, too.

This morning I was able to witness the most hands-off birth I've ever seen, and it definitely brought tears to my eyes.  I received a call at 8:00 am, and I could instantly tell from the sound of my client's voice that she was well into her labor.  My lazy, summer morning turned into a mad dash to get to the birth in time.  

We all arrived at the birth center around 9:00.  Mom was breathing through her contractions, listening to her playlists (which were awesome!), and spent some time leaning over the bed.  I offered encouragement, massage and counter-pressure.  

Like most women, this mama found her solace in the tub.  

She wanted to experience birth the way women used to- before birth was industrialized; so she invited several of her closest female friends to attend.  

All of these women also attended my Music Birth class, and they brought their A games.  They provided hand and neck massage, and they also brought with them a sense of peace for the laboring mom.  I could visibly see mom's relaxation and focus improve once her support circle arrived.

The urge to push came quickly and mom informed us that she felt like the baby's head was coming out!  Without any assistance from the midwife, this mama delivered her baby all by herself.  And it was breathtaking!

Born Wednesday August, 17th, 2016
10:02 am
9 pounds 2 ounces

Water birth is so peaceful.  This baby doesn't even know it has been born yet.  

Looking to see what gender the baby is.  This is mom's "It's a boy!" face.  :)

I love seeing dad's reactions!

This baby was surrounded with love and adoration.  

Big hands for a newborn!

Here's big sister getting to check out her little brother.  What a cute face!

An amazing birth for a wonderful family.  Congratulations!

Sunday, June 26, 2016


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:
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


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!