Wednesday, June 10, 2020

Zero to Hero

 My latest client had her first baby a little over 3 months early.  So I missed that birth!  When she told me she was expecting again, neither of us knew what to expect this time around.  As her pregnancy progressed, her cervix looked great and there were no warning signs of another premature birth.  We moved forward with plans of having a full term, natural, music birth, delivery.

But this pregnancy had other plans!  Gestational hypertension had her in and out of the hospital for the last several weeks.  Yesterday it was decided that it was time to get off the roller coaster, and have the baby.  Even though she was over 4 weeks away from her due date, her cervix was already 3 cm dilated and 80% effaced.  A great place to start for an induction!

Pitocin was started shortly after 4:00 pm, but the baby didn't love that.  So the water was broken at 5:30 and the pitocin was turned off.  Mom was contracting, but not really feeling any pain.  Contractions were anywhere from 2 to 6 minutes apart.  By 7:00 pm things were getting intense and I was asked to join them.

I arrived shortly before 8:00 pm.  Thankfully they were delivering at the only hospital in the area that is allowing doulas! Covid-19 sure has made things difficult for doula support.  When I arrived, mom was laying in the bed and breathing deeply through her contractions.  Her husband was holding her hand and encouraging her through each breath.  At 8:30 pm, she was 5 cm dilated, but baby was still high in the pelvis at -2 station.  I suggested getting out of bed for a while to encourage the baby to drop into the pelvis.

Mom said that it was more comfortable out of bed.  I got the music going and started rubbing moms back during each contraction.  She continued with her deep breathing. 

We worked with two great nurses, one who even braided my client's hair.  :)

The other nurse made me chuckle when she said she thought this birth might go from "zero to hero".  She was right!

After standing for about an hour, mom was tired, so we switched to the birth ball. Mom was starving, so she snacked a little bit.  She started to really moan during her contractions, and an exam at 9:45 pm showed that mom was now 8 cm dilated, 100% effaced, and baby had moved to -1 station.  

As all moms do at this point, mom really began to doubt herself.  She told me to tell her it was too late for an epidural.  :)  I could tell things were progressing very quickly.  The urge to push was building with each contraction, and before we knew it mom was complete and baby was +2 station!  The nurses called the OB and told her to not to stop at stop signs, ha!  We changed moms position and had her pant through each contraction.  This gave mom a few minutes to find her focal point again after the intensity of going from active labor to pushing in about 20 minutes!

The OB arrived and it was go time!  Mom said "This really better be it and not just a poop!"  We assured her this was the real deal!

And at 10:14, this beautiful girl slipped into the world.

Even though she was more than 4 weeks away from her due date, this sweet baby cried and pinked up right away.  

After the chaos and stress of having their first baby at 25 1/2 weeks, and being hospitalized for the last few weeks with this pregnancy, I was thrilled that this mama was able to have such a perfect birth.  Just a few hours of hard labor, an un-medicated delivery, and an hour to breastfeed right after the baby was born.  It couldn't have gone better, and this mama really deserved such a wonderful experience!

We all guessed this babe would weigh less than 5 pounds, but she was just a little over 5!

This proud papa is a nurse at the hospital we were at, and was able to take his daughter to the NICU for some premie monitoring for the night.  Thankfully, she did great and was back with her mom before morning!

Welcome Audrey!
Born Tuesday, June 9th, 2020 at 10:14 pm
(35 weeks and 5 days)
Weighing 5 pounds, 2 ounces
And the prettiest lips in town!

Sunday, February 9, 2020

Double Water

 Hanging out at 41.5 weeks, my latest client decided to have her membranes swept on Saturday morning.  She was 3 cm, and the midwife could stretch her to almost 5 cm after the sweep.  We kept in touch over text all day, but there wasn't much to report.  At 7:30 pm she was having contractions every 45-60 minutes, and by 9:00 pm they were every 25 minutes.  We didn't know what to expect, so we both decided to try to get to bed early and see where the night took us.  :) 

She called me at 12:30 am to say contractions were coming every 4-7 minutes, and that she was feeling a lot of pressure in her hips.  It was go time!  I arrived at their home shortly after 1:00 am.  Mom was smiley and chatty.  She had to breathe through each contraction, but was conversational in between.  After just a handful of contractions we all headed to the birth center. 

We arrived at the birth center at 1:40, and contractions were coming every 3 minutes.  Each contraction was noticeably more intense, and mom's demeanor became more serious with each one.   I got the relaxing music going, and dad and I took turns providing counter pressure on mom's hips. 

At 2:20 mom was ready for a rest.  By 2:30 she had the shakes, and at 2:45 an exam showed she was 8 cm and 90% effaced.  By 3:00 am, mom was vocalizing and starting to show the signs of getting the urge to push.  She continued to labor in bed until 3:50.  At that time we decided to get up and see if a change in position would get things rolling more.  The midwife did another exam and mom was complete.  After just a few contractions upright, mom decided it was time for the tub!

Mom said she could feel her baby getting lower, but the urge to push wasn't taking over yet.  The midwife offered to break her water to intensify the urge, but mom decided to keep things going how they were.  At 4:30 I suggest a new position of side lunging, in the hopes that it would increase the urge push.  I don't know if that's what did the trick or not, but one contraction in that position and mom was full on pushing her baby out!

At 4:38 not only did this sweet little boy slip into the world, his amniotic sac remained in tact.  So he was born in the water... in his amniotic water!  A double water birth, and the only en caul water birth I've ever seen.   

It was a good position to push in, but took some serious coordination to get the baby into mom's arms after.  

Welcome Arthur!
Born Sunday, February 9th, 2020
Weighing 8 pounds 14 ounces

He was so calm and so alert, and so cute and squishy!

It was wonderful to support this mom during such a great birth experience, in a fraction of the time of her first birth several years ago.  This birth was shorter, but short births come with few breaks and lots of intensity!  She was amazing during both of them!

Tuesday, November 26, 2019

Where Have You Been All My Life?

 I got an unexpected surprise when my client texted me at 11:30 pm on Sunday night saying her water had broken!  Sitting at 37 weeks, I never thought I would be attending a birth this week!  I encouraged her to try to sleep (ha!).  In the morning, contractions were still pretty mild and far apart.  Around 11:00 they decided to head to the hospital and make sure everything was ok.

Contractions still weren't picking up, so around 3:00 pm, mom was given cytotec to try to get things rolling.  And it worked!  Dad texted me at 4:2o to head over, and I arrived at 5:00 pm.  Mom was leaning over the bed and moaning through each contraction.  I couldn't believe how intense things already were!

Around 5:20 I helped mom to the bathroom and she got the urge to push!  Several minutes later the nurse confirmed that she was complete and it was ok to really go for it.  By 5:45 we were in full pushing mode.

Dilation occurred quickly, but pushing proved to be more of a challenge.  We pushed in every position we could think of, and it didn't seem like we were making any progress.  Mom not only had to find endless amounts of energy, she also had to deal with a lot of anxiety and self-doubt.  I would tell her she was doing a great job, and she would respond with "I am?"

Then she would find times of inner strength and say things like "I'm ok" and "I can do this."  Her affirmation going into this birth was "All the strength I need is within me."  And that proved to be very true!  This mom was tough, and she pushed for hours!

We tried so many different positions, and upright positions helped her the most with focusing her energy to her baby.  But they are also very tiring and her legs were very tired and crampy. One charlie horse left mom in agony!  But she was a total champion and pushed in at least 10 different positions.

During a time of strong discouragement, dad told her she was doing a great job.  She honestly asked "How do you know?"  Then her sassy personality came through and she yelled "you don't know!" to him.  It was pretty hilarious.  I assured her that I knew she could do it!  In between contractions she would also say "this is so dumb!" 

By 9:30 we needed more help.  The doctor came in and turned on the lights to get her adrenaline going and the nurse administered a low dose of pitocin to make the contractions stronger and longer.  We also changed the music from relaxing to energetic.  Mom turned on Rihanna, and this doula had a very hard time not dancing.  :)  The lyrics "where have you been all my life?" played loudly and I thought about all the years of infertility this couple had gone through, and how they were so close to finally meeting the baby they had been dreaming of.  

And at 10:14 pm, this sweet little girl was finally born!
This couple did not know the gender of their baby, and mom instantly turned to her husband and said "you're screwed!".  Ha!
(And PS, I super love this photo!)

Emotions were strong and it was an amazing experience to see all the hours of pushing, and years of waiting and dreaming come to this moment.

Dad was hesitant to hold his baby, saying he wasn't ready or capable.  He was, of course, wrong!  He immediately settled into fatherhood!

Baby latched on quickly, and I snuck out of the room in complete wonderment that my Dec. 14th client delivered in November!

Wednesday, September 11, 2019

Forward and Backward

 Two and a half years ago I had the privilege of supporting this sweet family during the birth of their first child.  It was a long and difficult birth, and I was excited for her to experience the benefits of a second, shorter birth.  On Monday my client was 3 cm and about 60% effaced, and decided to have her membranes swept at her weekly appointment.  By Tuesday morning she was having contractions, but nothing very consistent or intense.  We kept in touch throughout the day, and contractions seemed to come and go.  As soon as it seemed like things were moving forward, they would take a step back again.

But at 7:00 pm she felt it was time to head down to the birth center and see where she was at.

I arrived at 7:30 and mom was being assessed by the midwife.  We were all thrilled to find that mom was already 7 cm at 7:45.  We chatted a bit, but things began to intensify quickly.  

By 8:30 pm mom was ready to get in the tub.  The water was really hot, but she enjoyed the relief.  She had some nerves and turned on some uplifting, Christian music.  I still remember them introducing me to the music of Lauren Daigle at their last birth!  The lyrics "with heart and with soul, I will always love you" filled the room.

As the evening progressed, labor continued to intensify and back off.  We filled the down time with pleasant conversation and our mutual love of all things Disney.  Mom moved her body and rolled her hips, and did many positions to encourage an open pelvis.  I provided counter pressure to help with back pain.

By 10:00 pm mom was vocalizing through her contractions and they were closer together.  But progress still didn't seem to be coming.  I reviewed some of the strategies we did during her previous birth, and we did some lunging and position changes in case this birth was going to be a little longer like the last one.

At 11:04 pm mom said she was starting to get the urge to push!  The midwife did an exam and felt that the bag of water was probably causing that feeling, and not the baby.  At 11:20 my client chose to have her water broken to try and speed things along.  The opposite happened.  Contractions spaced out and the urge to push was gone.  At this point mom was 9.5 cm with just a little bit of a cervical lip.  The midwife tried to push it out of the way, but it was too uncomfortable.  

At 11:40 baby started having some heart decels, so we got mom out of the tub and found some different positions to make baby happier.  

At 12:10 we moved mom to the birth stool to try to encourage descent and bring about the urge to push.  At 1:00 am, we got mom on the bed in hands and knees position, and I did some rebozo sifting.  Her husband leaned in close and said "Thank you for working so hard."

The midwife felt the baby to be a little crooked in the pelvis, so mom did several contractions on each side.  All the moving/rotating did the trick, and suddenly at 1:40 am, the urge to push became very strong and progress came very quickly.  The baby was at plus 2 station, and this time the midwife was able to push away that darn cervical lip that insisted on being present during both labors.  

The head came out smoothly and timely, but the body didn't follow.  One of the shoulders was stuck under mom's pubic bone.  Mom quickly moved from laying on her back, to hands and knees, then back to her back, then back to hands and knees.  I am not certain, but I believe she flipped positions a total of 6 times.  It was intense.  It was stressful.  The midwives worked quickly.

Finally the baby was born.  (I think at 1:56-1:57, I'm not certain.)  She was pretty shell shocked and required some assistance from the midwives.  They encouraged mom and dad to talk to their baby.  Mom looked me in the eyes and asked me if her baby was ok.  And to be honest, I really didn't know if she was or not.  All I could say was "the midwives are taking really good care of her".  

Finally, at 1:59, baby girl let out her first cry, and I think we all breathed an enormous sigh of relief as our eyes filled with tears.

She was quickly placed into her mother's arms.

Welcome Juniper!
Born Wednesday, Sept. 11th, 2019
Weighing 8 pounds 9 ounces

Mom and dad were hoping to not have a Sept. 11th baby, but then the midwife pointed out that her birthday is the same forward and backward.
I guess that won't be possible again for another hundred years or so! 

It wasn't the second birth I was hoping for, for this sweet mama who really had to work hard to get her first daughter here.  We did shave off about 12 hours, but this birth was definitely more difficult than we anticipated.  But this mama was so strong.  And those baby cheeks are so sweet!

Tuesday, August 20, 2019

41 Weeks and 6 Days!

Hanging out at 41 weeks, my latest client reluctantly agreed to an induction on Friday evening.  After processing a change in birth plan and coming up with a new plan, she arrived at the hospital to discover that it was too full that evening, and her induction was put off until Monday morning!  

But her baby had different plans.  Her water broke around 10:30 am Sunday morning.  Along with it was meconium, so off to the hospital they went.  When she arrived she was 1 cm dilated and about 70% effaced.  Baby was high and contractions were mild.  Around 2:30 that afternoon, some pitocin was administered to try to get things moving.  But bay didn't love the pitocin and labor wasn't progressing.  So at 2:00 am on Monday, they decided to just turn off the pitocin and try to get some sleep.  (An almost impossible task at the hospital!)

I heard from my client at 6:00 am Monday.  They were about to start the pitocin again and she was worried about coping with pain due to her exhaustion.  My back up doula met her at 8:00 am as I had a morning conflict.  She texted me at 10:00 saying my client was now 4 cm and 90% effaced, and that she was thinking about getting an epidural soon.  I felt bad for missing all the action!  By 11:00 mom was comfortable with an epidural.  I raced to the hospital as fast as I could.  When I got there shortly before noon I was shocked to find out that my client was now 9 cm!  I had missed almost everything!

Mom was in good spirits when I arrived.  We chatted for a while and worked on positioning to help baby descend.  Then mom tried to nap again.  She had a great playlist going with tons of Josh Groban, my fave!

At 2:00 mom was checked and was complete!  We reviewed pushing techniques for breathing and positioning.  And by 3:15 mom was pushing!

Pushing is really exciting at the beginning, but that excitement can quickly wear off when moms discover how difficult it can be and how long it can last.  This mom had the best epidural ever though.  She had so much control over her legs and was able to utilize a ton of different positions.  We did hands and knees, side lying, squatting, semi-reclined, you name it. 

At 5:30 mom was exhausted and her tissues were really starting to swell, and progress was minimal.  So we decided to rest for a while.  She pushed her epidural button and went back to deep breathing.  Mom was also starting to show signs of infection.  Her skin was very warm and she started having uterine pain, so antibiotics were ordered. (Once the water breaks, women are at an increased risk of infection.)

Mom was also hungry and she daydreamed about eating a cheeseburger and chocolate milkshake once her baby was born.

Shortly after 6:00 pm we started pushing again.  This mom was determined and we tried everything.  All the positions and this time we added tug-of-war with a sheet to help her really focus her energy down.  She was so freaking strong.  This yoga master was amazing, yet the baby was still hardly moving.

There were several residents supporting the birth, and I really enjoyed working with them!  They were so easy to talk to and asked me a lot of questions about positions and my take on things.  It was such an awesome collaboration, I wish every birth room could be like that!  There was one point it looked like mom would deliver on her hands and knees and the resident doctor was asking me to tell him about my experiences with that position!  He had never seen a birth that way, but was so open to learning about it and supporting it.  So awesome.

At 7:00 grandma arrived and brought with her encouragement and love.

At 7:30 a new OB came in to evaluate and felt that the baby was still too high to try a forcep or vacuum assist, and felt that a cesarean was the best option at this point.  This news can be so disappointing after hours/days of laboring and pushing, but sometimes it is the only way.  Mom said she was too tired to feel emotional about it.  Dad wasn't.  After his wife was wheeled in the OR, the emotions were strong.  His father in law offered him a religious blessing and blessed him to feel Christ's love, peace, to be strong for his wife, and to feel the love from his heavenly and earthly parents.  A feeling of peace entered the room.

Shortly thereafter though the nurse came into the room crying.  She was so sad to tell the dad that he would not be allowed into the birth.  Mom was not responding well enough to the anesthesia and would have to be put under for the cesarean.  It was a new disappointment to deal with and emotions quickly returned.  

Finally at 9:00 pm, sweet Mae was born.

During the cesarean, the doctors discovered a uterine abnormality that they believe swelled during the labor and prevented the vaginal birth.  It's nice to have answers, but it's even nicer to finally hold your baby!  I'm sure this mama is exhausted with sore muscles all over.  She worked so hard!

Welcome Mae!
Born Monday August 19th, 2019
9:00 pm
Weighing 6 pounds 6 ounces
13 days past her due date
And look at all that hair!