Wednesday, November 23, 2016

Chicken Nugget

After weeks of nonstop contractions, multiple trips to the hospital to stop them, and the joys of having a very low baby, it was finally time to have a baby!  My client was checked at 10:00 am this morning and was 4 cm.  The midwife swept her membranes and told her to come back in a couple hours, so she and her husband took a drive around town.

We all gathered at the birth center at noon, and mom was now 6 cm!  She decided to have the midwife break her water at 12:10.  Baby was already at plus 2 station (had actually been there for a few weeks!) and she was 90% effaced.  We chatted for a few minutes, but it didn't take long for the contractions to become intense.  We turned on Simon and Garfunkel, and worked on breathing and focusing. 

We decorated the room with some birth affirmations cards.  They were so pretty and inspiring!

At 1:15 mom got in the tub and said "Woah, it really does help!"  She also kept asking if she was in transition.  :)  She was.  

Dad offered support by rubbing mom's back.  This was her third child, but his first, and he was very excited/anxious/nervous, as most dads are the first time around!

Around 1:50 mom started to feel the urge to push.  She said she couldn't do it, which always means she is about to do it!

She was very controlled and instinctual.  She might not believe me, but she was!

At 2:o1, this little "nugget" (as they referred to him during her pregnancy) slipped into the world.  Covered in vernix with the cutest cone head ever.  Dad helped catch, and baby started crying right away.

I love this photo!  Mom's face says it all.

Dad got some skin-to-skin bonding time while mom delivered the placenta.  

Robert Cash
Born Wednesday, November 23rd, 2016
7 pounds 8 ounces
19 inches long

By 2:45, baby was nursing and everyone was tucked in bed.  

A beautiful, fast, and powerful birth!  His big brothers can't wait to meet him and celebrate Thanksgiving as a complete family. :)

Wednesday, November 2, 2016

A Perfectly Appointed Hour

While preparing for her upcoming birth, my latest client told me that she believed God had a perfectly appointed hour for her birth.  I just loved that!  And her faith in the process really helped her stay calm and positive as her due date came and went.  At 41 1/2 weeks, this mama was eager to hold her baby, but still relaxed and trusted in this process, which often requires much strength and patience.

Yesterday at her midwife appointment, she was 3 cm and 80% effaced, so they decided to try and kick start labor with the help of a foley catheter.  By early evening she was having mild contractions, but they were far apart and not causing too much discomfort.  By 11:00 pm they were starting to get intense, and around 12:20 her water broke.  I arrived shortly after and found my client laboring beautifully with the support of her husband and mom.  

 Her contractions were more intense than I expected them to be for a first time mom just a few hours into her labor, and by 2:00 am we were all driving down to the birth center.

Mom found some relief in the tub, but still had some hip pain.  She was so instinctual and naturally tried different positions.  I offered counter pressure and cool cloths. She was on the verge of having the urge to push, but it wasn't quite there yet.  At 2:45 am mom stated, "We're going to be here forever!".  It really made me chuckle since we had just arrived.  She went on to say hilarious things as the night went on.  :)

At 3:15, the midwife listened to the baby's heart beat and said "Baby is happy!".  My client responded with "Well his mama isn't."  :) Over the next hour she also said "Why doesn't he have a small head?!" and "I want it out!"

After a couple hours of almost pushing, the midwife decided to do an exam to see what was going on, and discovered that mom had a cervical lip that the baby was struggling to move past.  For the next couple hours, that darn lip would disappear and reappear frequently.   (It's amazing how strong one small section of cervix can be!)

But this mom was stronger than her cervix, and was willing to try anything to help her baby descend.  We tried several positions in the bed, and I love the picture above, where mom is using dad's foot as a modified stirrup.  They were such a great team the entire time!

We moved into the Birth Suite and tried dangling in the hanging rebozo.  Very physically demanding, but definitely helped baby descend.  By 5:00 am mom was tired and hungry!  We returned to the bed for a new position and some apple slices and honey sticks to help her regain some energy.  At 5:15 she was able to feel her baby's head, and that was very encouraging!  But by 6:20, fatigue and discouragement were right around the corner.  She asked her husband to pray for her and to pray for the birth to finish quickly.  She continued to reach down and feel her baby's head.  It was a slow delivery, but it was encouraging to feel more and more of the baby's head with each contraction.

Their prayer was answered at 6:58 am, Wednesday, November 2nd, 2016.

They didn't know if they were having a boy or a girl, and dad was able to announce that it was a girl!  They were pretty surprised!

Welcome Baby Blythe!
7 pounds, 8.5 ounces
21 inches

Checking out the placenta.  :)  
(My 4 year old son is sitting on my lap as I type this, and he is begging to see a placenta in real life, lol!) 

This duo was exhausted, and spent some time just resting and bonding while the midwives took care of everything else.  There was a small amount of retained placenta which caused some bleeding for mom, but she was able to focus mainly on her baby.  She kept commenting on how smooth her baby's skin was and how good she smelled.  These moments of bonding are so important because they literally imprint the mother to the baby and the baby to the mother.  A little over an hour after birth, they enjoyed their first nursing session.

Such a strong woman, devoted husband, and loving family!   Congratulations!

Wednesday, October 26, 2016

Giving It Her All

For the first time in over a year, I got a call from a client in labor BEFORE her due date!  And it was even a day that her doctor was on call.  (These two things rarely happen, especially simultaneously.) It was 1:00 in the morning on Monday the 24th.  My client's water had broken about an hour or two before she called, and her contractions were about 10 minutes apart.  I encouraged her to try to sleep in between and to call me when things picked up.

At 4:00 am contractions were intense and between 4 and 5 minutes apart, so we met at the hospital about 30 minutes later.  Mom was 4 cm, and I could tell she was well in the throws of active labor. We spent several hours utilizing many comfort measures: music, massage, pelvic tilts, the birth ball, and even the ice roller.  The ice roller (a plastic rolling pin filled with ice water) was the trick, and gave mom some much needed pain relief and helped her cool down.  Labor is hard work, and most women become pretty warm.  During one contraction, mom asked "How does anyone do this without a doula?!"  :)

Mom was checked again at 6:30 and was 6 cm.  Very quick progress for a first time mom. Contractions were coming every 3 minutes and were very intense.  Mom was also exhausted from laboring all night, so she opted for an epidural to get some much needed rest and relief.  Her iv was driving her crazy, and she actually ripped it out!  Thankfully, the second iv felt much better, and mom had her epidural by 7:30 am.

Granny stopped by around 10:30 to give a hug and some encouragement.  And by 12:00, mom was dilated to a 9.  Baby was starting to engage in the pelvis and was in a great position for birth.  It seemed like the perfect scenario!  Mom was checked again at 2:00 and was about 9 1/2 cm, meaning that just a small portion of the cervix still needed to dilate.

Even though mom had an epidural, we were proactive about helping her labor progress while she rested.  Mom continued to utilize music and position changing in between naps.  Bad news came at 5:30 pm, when mom was checked again and found that her cervix had gone down to 8 cm.  Very discouraging, to say the least.  The doctor put in an IUPC (Intrauterine pressure catheter) to assess how strong the contractions were.  Turns out, they weren't very strong anymore, so mom was given some pitocin to help strengthen the contractions and finish dilation.  And it worked!

By 8:50 pm, mom was complete and baby was at +1 station, meaning it was starting to enter the birth canal.  The urge to push took a while to come, which is common.  But by 10:00 pm, mom was feeling the urge to push and was vocalizing and pushing during each contraction.  Dad fed mom ice chips in between each contraction.  Baby was making progress, but it was slow progress.  Mom was tired and getting discouraged with the lack of progress, but she kept digging deep inside herself the find the strength required of her.

By 1:00 am, there still wasn't much progress, despite hours of pushing.  The doctor asked mom if she would like her to try using the vacuum, to help encourage the descent through the birth canal.  The idea sounded great.  Anything to get things moving along!  After two contractions, it was clear to see that even with the help of the vacuum, this baby was just not moving down the birth canal, and it was decided that a cesarean would be the best option at this point.

Very discouraging and disappointing to hear after laboring and working so hard for over 24 hours. Most women do not want a cesarean, but there are women who will need them, and no amount of preparation can change that.  But there is peace that comes when you know you really tried everything.

At 2:00 am on Tuesday, October 25th, 2016, Baby Jack was finally born; weighing 7 pounds and 13 ounces.  A full head of hair and totally adorable.

His mom sure gave it her all.  But even when birth is hard, discouraging, and even disappointing, the prize at the end sure makes it worth it!

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!