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


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. :)