Monday, May 13, 2019

Graduation-Mother's Day-Birthday

 My latest client is a repeat client who had her first baby a little less than 2 years ago.  Her first birth was AMAZING, so I knew this birth would be great, too.  On Thursday she was checked at her appointment and was already 3 cm dilated and 90% effaced.  But she wanted her baby to stay inside for at least a few more days because she was graduating with her Bachelor of Arts Degree on Saturday!

She was able to march at graduation, but felt like she had pushed her body a little too far because the busy day brought on painful, but inconsistent contractions.  She texted me Sunday morning say she had a gut feeling that her baby would be born that night or the next day.  We kept in touch over text throughout the day.  By afternoon, she was having contractions every 10-20 minutes.  Nerves were starting to come as well, as mom remembered how difficult childbirth is!  Mom wondered if she should go in and be checked, even though her contraction pattern wasn't active yet.  

Around 6:30 pm, mom decided to head to the hospital and see if this was real labor or not.  She was checked at 7:00 pm and was 5 cm and 100% effaced, and baby was at a minus 1 station.  I arrived at 7:30 and found mom preparing to get into the tub.  She was definitely nervous and doubting her ability to do this again.  Normal emotions, but no fun.

Once in the tub, mom focused on her breathing and vocalizations.  I turned on relaxing music, and reminded her to blow her contractions away and fully relax in between.  After just a handful of relaxed contractions, mom began to tell us that she felt like something wasn't right, and that she would definitely be getting an epidural.  I encouraged her to have her cervix checked before making a decision like that.  She was talking like a woman in transition, and I wondered if her baby would be born too quickly to get an epidural anyway.  Two contractions later she started grunting and I ran in the hall to alert the nurse.

Within seconds, several nurses appeared with a wheelchair and we quickly got mom into her birthing room at 8:30 pm.  I could tell she was overwhelmed, and we had a quit chat about how it's OK to feel scared right before you give birth.  I reminded her that we were all there to help her.  At 8:40 the midwife confirmed that mom was 10 cm, baby was at plus 2 station, and it was time to have a baby.  The midwife broke her water and...

two minutes later, this little girl slipped into her daddy's hands.

It was all so fast, I think it actually took mom a few minutes to process that she had given birth! 

Baby girl nursed within 20 minutes of being born, and was so sweet holding onto her  mom's finger.

Welcome Ivy Grace!
Born Sunday, May 12th 2019
Mother's Day
10 days before her due date
Weighing 7 pounds 7 ounces

This little girl is so loved by both her parents.  She was delivered into her dad's hands, and then got to snuggle him skin to skin within the first hour of her life.

I love this photo.  It reminds me of one I took at their first birth when mom watched dad hold their baby for the first time.   So much love.

She may have doubted her ability to have a natural birth, but she totally proved herself wrong!  We are usually much stronger than we give ourselves credit for.  Within 36 hours, this amazing mama graduated college, celebrated Mother's Day, and rocked her natural birth!

Sunday, March 31, 2019

Face Presentation

 My latest client is a repeat client from Oct. 2017.  Her last baby came 9 days late, so we weren't expecting an early delivery this time around.  Once 41 weeks hit, talk of induction was abounding, but this mama did not want to induce.  She scheduled an induction for the very last day possible, and ended up giving birth the day before her time was up!

Her contractions began early Saturday morning, around 2:00 am.  But by sunrise they had stalled out quite a bit.  We kept in touch throughout the day.  She contracted sporadically and lost her mucus plug around 5:00 pm on Saturday.  But by bedtime things were pretty chill, so we both went to bed.  She woke up with contractions every 10-15 minutes at 3:30 am, and by 7:00, it was time to head to the hospital.

I arrived at 8:00 am and found mom laboring in bed with dad offering support and encouragement.  Mom was feeling "shaky and emotional", which is a pretty normal way to feel in labor!  She was 6 cm, and we assumed things would progress really fast like last time. (Last time we arrived at the hospital at 6 cm, and her baby was born 68 minutes later.)

 At 9:00 the OB arrived and mom was now 8 cm, 90% effaced and her baby was at zero station.  There was a bulging bag of water, too.  

We spent the next couple hours changing positions.  I rubbed mom's back during contractions while dad pretended not to have a headache.  (Poor guy suffers from chronic, cluster headaches.  I kept telling him he could take a break, but he wouldn't leave his wife's side.)  After a trip to use the restroom, mom literally crawled across the floor and back into the bed.  Not a glamorous way to get around, but a great way to change positions and encourage good positioning!

At 11:30 we were all a little surprised that things weren't progressing.  I kept wondering what would happen if the water broke.  In an attempt to see if gravity could help us break the water, mom got out of bed and did some leaning and lunging on the edge of the bed, and at 11:40 her water leaked.  It wasn't a gush, but there was definitely something.  But it didn't change anything.

At 12:30 the OB came back in and mom was 9 cm, but there was still a bulging bag of waters.  The OB offered to break the water to see if that would encourage the baby to descend more.  She broke the water and exclaimed that the baby "came down miles", ha!  

Things did intensify a bit, but I was surprised that the urge to push wasn't taking over yet.  Dad and I held each of mom's hands while she moaned almost continuously.  She was totally in the zone.

At 1:10 mom said she wanted to push, so she was checked again and was complete, and baby was almost at +2 station.  I could tell the urge to push was still a little off, but mom worked hard and figured it out! 

Several minutes later we were all surprised to see a little face presenting instead of the crown of the baby's head.  A face presentation is rare, and often requires a cesarean.  But with the skilled technique of the OB and mom's incredible strength, this baby girl was born at 1:36.

Weighing 8 pounds 6 ounces

I was so happy my client was able to have the natural birth she desired and was able to go into labor before she needed to be induced!  So often women feel like they will never go into labor, but they will.  :)  Even if it is 12 days late.

Tuesday, March 5, 2019

44 Hours

 My latest client started texting me Sunday morning saying she was having low back pain, and what felt like menstrual cramps.  We kept in touch throughout the day, and I made sure to get a Sunday nap because I assumed we would be up all night!  She went to the hospital at 7:00 pm, but was sent home with a sleeping pill because she was only dilated 1 cm.  At 3:30 am her husband called saying they had been admitted to the hospital at 4 cm/80% effaced.  

I arrived at 4:3o am and mom was still struggling with back pain.  So we did lots of position changes and I provided back massage during contractions.  At 6:15 an ultrasound confirmed that baby was posterior, so we continued working to get baby to rotate by moving often and utilizing hands and knees positioning.  At 6:40 her husband turned to me and said "I'm so glad you are here!".  :)

At 7:50 mom spent some time in the tub, but her contractions were so spaced out she decided to get out and move around more.  She arrived at the hospital with contractions coming every 4-5 minutes, but now they were every 6-9 minutes.  The nurse mentioned breaking the water or starting some pitocin, but my client wanted to keep working with her naturally progressing labor.  We also discussed the possibility of going home for a while if the cervix wasn't changing.

At 10:20 mom endured 3 cervical exams before the nurse with the longest fingers confirmed that mom was now at 6 cm.  To be honest, I was pretty surprised!  I didn't think we would be making progress with so few contractions.   So the option to go home was gone, but we still needed to speed up contractions.

Mom was motivated and energized.  She walked up and down several flights of stairs, stopping to lunge during her contractions.  Things started to pick up and mom said it was "a good pain".  

The entire day mom was all smiles.  She had originally planned on getting an epidural, but found that she could easily cope with her contractions, and that she preferred being able to move and work with her labor. 

At 2:30 pm her OB stopped by to check on things.  Mom was now 7 cm and 90% effaced.  She offered to break mom's water, but mom wanted to let things progress the way they were.  At 3:30 mom decided to get in bed and rest in between contractions, and they spaced out to 10 minutes apart!

Mom got out of bed at 4:15 pm and contractions picked up again.  Her own mother attended the labor and offered lots of physical and emotional support throughout.

We hit the hallway again to keep things moving and stopped in the family waiting room to talk to all the expectant grandparents.  Both sets of grandparents came from India for the birth.  I loved learning more about their culture and awesome family values.  I met them all about a week ago and answered many questions about birth in America and the support I would be giving their daughter.  It was such a fun night!

At 5:30 pm mom was now 8 cm, but progress was coming slowly and night was quickly approaching.  We were starting to worry about mom being able to maintain her energy throughout the night, so the decision was made to break the water, which would hopefully speed things up.  Losing the water put extra pressure on the baby and we worked with the nurse to find positions that worked well for both mom and baby. 

At 8:30 pm mom was still 8 cm.  Contractions were getting more painful and closer together, but it was clear that the birth was still hours away.  Mom opted for an epidural and a well deserved nap.  After sleeping for a few hours, mom was at 9 cm, so some pitocin was started to help mom get through the final dilation.  But baby didn't like the pitocin, so it wasn't on for long.  

At 3:30 mom was finally dilated to 10 cm and it was time to push.  I assumed that pushing would take several hours because everything had progressed slowly throughout the entire labor, and because she was a first time mom.  But I was wrong!  

Less than an hour later, this sweet little girl arrived!

She had so much thick, dark hair.  So adorable!

What a journey!  Approximately 44 hours from the first text to holding her baby!

Welcome sweet baby girl!
Born Tuesday, March 5th 2019 at 4:14 am
One day before her due date.
Weighing 6 pounds 2 ounces

Monday, February 18, 2019

23 Minutes

 I got home from my last birth at 5:45 am on Saturday.  At 8:38 I received a text from my next client saying she was having contractions.  Selfishly, I was soooo tired and relieved when she told me that afternoon that things had died down.  Sunday morning was the same thing.  Contractions every 10-15 minutes with nothing by late afternoon.  So when I heard from her again this morning saying that she was contracting again, I didn't really know what to think!  

She texted me this afternoon at 2:30 saying her contractions were every 7-10 minutes, and at 3:30 her husband called to say they were every 3 minutes!  So we all rushed to the birth center!

I arrived right at 4:00 and found mom laboring on the bathroom counter with her husband applying counter-pressure.  He left to take care of logistics and get her playlist going, so I took over with counter-pressure.  She did a couple contractions on the toilet and I could tell things were intensifying very quickly.  

Mom made it to the tub at 4:17 and Maroon Five set the mood.  She started vocalizing and grunting, and I knew she was close.  I reminded her to slow her breathing down in between contractions.

Dad hopped in to offer more support and it was go time!  I encouraged mom to focus her breath and vocalizations down to her baby.

And 23 minutes after I arrived, this little sweetie slipped into the world!  Check out her cute little baby bum, all covered in vernix!

Mom was thrilled and exclaimed "I did it!".  She then started singing to her baby.

Welcome Lexi!
Born Monday February 18th, 2019
Weighing 7 pounds 9 ounces

The room was filled with love songs.  Can't Help Falling in Love With You and At Last .  The perfect soundtrack for a mom who had to wait 10 days after her due date to finally go into labor!

Within 20 minutes the placenta was delivered and baby was nursing perfectly.  This mom earned her stripes with her first birth being long and difficult.  So the second time around, she really deserved a quick, day-time birth with no stitches!  It couldn't have gone better (or faster!) and I am so happy for them.

Saturday, February 16, 2019

That Was Epic

I spoke with my latest client on Thursday afternoon.  She told me she had just had her membranes stripped.  So at 41 weeks, I assumed it would be go time fairly quickly.  Wasn't I surprised to wake up to texts on Friday morning from my other client at 39 1/2 weeks!  She had been up most of the night with contractions coming every 5-10 minutes. 

I arrived at her home at 8:30 am and found mom resting in bed.  Shortly after I arrived she was a little restless, so we started mixing things up with the birth ball.

Her dog needed some love, too.  :)

She spent some time reading through birth affirmations and choosing the ones she would like to focus on as labor progressed.  She was doubting herself a bit, and  fatigue was creeping in, so she decided to try to rest again.  I ran home to grab some lunch because I thought mom was resting!  But she wasn't.  Shortly after I got home I received a text to meet them at the birth center.

We all arrived at the birth center shortly after noon, and the midwife confirmed that mom was in active labor and that her water was actually leaking.  The midwife did an internal exam, but my client didn't want to know where she was.  I could definitely tell that mom was well into active labor, and my main goal was to help her cope with the intensity of her contractions.  Mom liked upright positions and she would lean over during contractions.  I provided back massage and the hip squeeze during (I think) every contraction.  This mama was so quiet and in control!  It was actually hard to decipher when she was contracting!

Mom got in the tub at 2:45 pm.  She instantly liked the water, but she did struggle to find a position she liked.  She changed position often and focused on relaxing during her contractions. Contractions spaced out a bit, and she nodded off in between.

To stay energized, mom snacked on fresh oranges, grapefruit juice, sparkling water, and nuts.  She did a great job of making sure she was nourished.  At 4:15, mom's temperature was getting too high, so she got out of the tub and we set out to walk a bit.

In an effort to bring on more contractions and comfort, we walked around the birth center and tried a ton of different positions: leaning, lunging, squatting and sitting on the birth ball. 

At 5:20 mom was checked again and the midwife told us she was making progress.  Mom was tired though, so she stayed in bed to rest for a while.  Her husband offered great support and at 6:45 she told him he was the "best husband ever".  

Mom got back in the tub at 7:00 pm and by 8;00 she was telling us how discouraged she was feeling.  It did seem like she should be pushing soon.  She had been vocalizing through her contractions for hours, but the contractions were still about 5 minutes apart, and from my perspective, they didn't appear to be intensifying.  

Mom spent a lot of time  laboring on the toilet.  Many women like to labor there.  It opens up the pelvis and has the added bonus of the muscle memory of a place we relax our pelvic floor.  

At 9:00 pm mom told us she wanted to transfer to the hospital.  She was tired and discouraged.  I encouraged her to have her cervix checked again and find out where she was so she could make an informed decision.  She agreed that was a good idea, and she was 9 cm!  She was still feeling anxious and doubting her ability, but it was enough to make her want to continue with her plans for an out of hospital birth.

Along with her team of midwives, we set out on a joint mission of doing anything and everything we could think of to finish this labor safely and successfully.  We did a technique called side-lying release, used the rebozo, did lunges on the edge of the tub, and squatted.  

I need to preface this next part by telling you how incredibly strong this woman is.  As in, she's been on America Ninja Warrior.  She has the best biceps I've literally ever seen.  After talking to her about her athletic training throughout her pregnancy, I knew in my heart that she already had all the tools she needed to get through a natural birth.  She knows how to push herself physically and set goals, and keep going even when it's hard.  But I could always tell there was a small part of her that doubted that she would be tough enough for birth.  There always seemed to be a bit of anxiety.  

Mom battled her anxiety on and off throughout her entire labor.  But at 10:00 pm, her warrior came out.  We turned on her positive focus music (favorite music that always makes you feel good) and the look in her eye completely changed.  As the Beach Boys and Neil Diamond serenaded us, mom led herself through what could really be described as athletic conditioning.  She rotated herself through lunges, squats, walking and leaning.  Her anxiety was gone and all that was left was an intense focus that always leads to the finish line.  She became the warrior birther I always saw in her.

Though all these activities can be incredibly tiring during labor, sometimes they are absolutely necessary when it comes to getting stubborn babies through the birth canal.  And it was exactly what this labor needed.  By 11:50 pm mom was starting to feel the urge to push.

We had made it to pushing, but there was still a lot of work left to do.  Mom had to continue changing positions often and trying different pushing techniques.  Dad offered lots of encouragement and kept reminding mom how strong she was.  They were such a great team throughout the entire process.

Mom went back and forth between ending each contraction by saying the "F" word or just sayings "guys" in a tone to let us know that things were tough.  Mom snacked on honey to stay energized, but pushing went on for hours.

Finally, at 3:20 am, the baby's head was starting to crown and mom was able to reach down and feel her daughter for the first time.  Once that happened, mom pushed with a renewed strength and determination.  And at 3:29 am, it was all worth it.

I am swooning over their first family photo.  The look on mom's face and dad holding his daughter's hand for the first time is about as sweet as it gets. After greeting her daughter, mom took a deep breath, smiled and said: "That was epic!"

 Welcome Hazel!
Born Saturday, February 16th, 2019
Weighing 8 pounds 10 ounces

It was a long, tough birth.  But I have a feeling this little girl was worth the effort. :)

(And as a side note, the first time she was checked she was 6 cm.  Second time 8 cm, and third time 9 cm.)