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

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.

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.)

A Difficult Induction

My latest client texted me Thursday afternoon letting me know that she was in the hospital being induced!  A combination of labs and high pressure made the induction necessary, even though she was just 37 1/2 weeks.  Her bishop score was about as low as it could be, so the OB prescribed cytotec to ripen the cervix.  Ripening can take a long time, especially with a first time mom with a closed cervix.  So I prepped them for a long road ahead, and was really surprised when they called me about 12 hours later to join them at the hospital!

During the night, contractions had started and her water had broken.  She also had the added bonus of vomiting profusely for a while.  I arrived at 3:30 am and found mom laboring in the tub.  She was vocalizing through her contractions.  She got out of the tub at 4:15 and we tried some different positions to help baby rotate.  Over the next few hours we tried many different positions and techniques for pain management and progress.  At 5:30 am she turned to me and said "it's getting more intense and I'm not loving it."  Totally cracked me up. 

At 6:30 am the nurse went over some options, explaining that the OB would be in soon and would want to check her and probably start pitocin.  At 7:20 the OB arrived and checked my client, and after all that she had been through, she wasn't even quite 1 cm dilated.  Her baby was high in the pelvis and her cervix was 50% effaced. 

We kept walking and leaning and breathing and massaging as the morning continued.  We listened to music, walked the halls, and used the rebozo.  The baby's heart rate was near impossible to find, and my poor client was constantly being poked and prodded as the nurse unsuccessfully searched for a good place to put the monitor on.  Pitocin was started and things were intensifying quickly.  At 10:00 a doctor was called in to do an ultrasound to help locate the heart, but even that was fruitless.  What finally did make the difference was an adhesive monitor. 

Mom was coping through her contractions beautifully and was starting to even have bloody show.  I was feeling so encouraged about her progress!  The heart rate was finally being monitored but mom's back pain continued to sky rocket.  We tried everything to get that baby to rotate! She opted for some nitrous, but it brought back her nausea, so that was a no-go. 

At 11:20 mom asked for her cervix to be checked again.  By this time the cervix had come forward and fully effaced, and baby had descended and engaged in the pelvis, but she was still only dilated 1 cm.  Very discouraging after almost 24 hours of hard work! Mom needed a break, and she got one.  By noon she had an epidural, and we all said "good night".

At 2:15 mom was 5 cm and baby had descended further into the pelvis!  I couldn't believe it!  Things were finally going smoothly.  But it didn't last long.  Shortly before 5:00 pm the baby started to have issues with his heart rate and mom's cervix began to swell.  The decision was made to deliver the baby via cesarean. 

Some tears were shed.  It's an emotional crossroad when a mom has to say goodbye to her birth plan in order to say hello to her baby.  Of course the main goal is to always get to the baby, but a woman's experience and goals are meaningful, too.  Inductions make those goals harder to reach, but sometimes factors beyond our control make inductions necessary. 

Pumpkin Pie

My latest client was so nice to wait until after Christmas to have her baby.  :)  (Although I would have been happy to support her any day!)  It took a couple membrane sweeps and castor oil "labor cocktails" but contractions finally picked up shortly after 4:00 pm.   

 I arrived at 5:40 and found mom laboring on her hands and knees while dad did the hip squeeze.  Mom was still chatty and smiley, but that didn't last long.  By 6:10, things were getting intense.  We added an ice pack to her back and did some rebozo shifting in between contractions.

We moved upstairs at 6:20 while her other kids prepared to go over to grandma's house.  This little cutie didn't want to leave her mom's side.

I attended this cutie's birth about 2 1/2 years ago.  Click here to see her birth story.

Once the girls were off with grandma, some emotions set in, which is really normal as transitions hits.  Dad was such an awesome supporter.  He always had the right thing to say, and he was working pretty hard carrying boiling water up the stairs to fill up the birth tub faster!

At 6:55, mom said she was starting to feel pressure during her contractions, and at 7:20 she said she thought it was going to be soon.  (Spoiler alert, she was right!)

We rushed mom to the tub, and dad hopped in too.  He kept squeezing her hips, and her two little dogs were very interested in what was happening.  :)

 Daisy Pumpkin Pie was born at 7:34 pm on Friday December 28th, 2018. 13 days after her due date. Weighing 9 pounds, 5 oz.

Her head was born in the water with mom on her hands and knees.  But her shoulders didn't like that, so mom stood and placed one leg up on the birth pool to open up her pelvis.  That provided just the space she needed.

The midwife asked my client if she had eaten dinner, and her response was she had eaten a piece of pumpkin pie that afternoon.  Thus, the nickname Pumpkin Pie was born.  And isn't this the cutest little sweater, all ready and laid out on the car-seat just for Pumpkin Pie to wear on her first outing?

Mom and baby were nursing in bed shortly after 8:00 pm.  Such a beautiful, home birth and so fun to support this family again.

A Quick Induction

 On Friday evening, my client went in to have a foley balloon inserted into her cervix.  This is a non-pharmaceutical method of starting labor by encouraging the cervix to ripen and dilate.  However, while her balloon was being inserted, her water broke!  So instead of going home to give the balloon some time to work, she spent the night in the hospital, trying to sleep.  Too bad sleep is a hard a hard thing to get in the hospital.  

Pitocin was started at 6:45 am, and we kept in touch over text throughout the morning.  By 10:00, things were starting to get uncomfortable for mom, so I made my way over.  

When I arrived mom was resting in the bed, feeling uncomfortable and anxious about the day.  I suggested walking and modified-squatting to help labor pick up and to encourage baby to descend, so we hit the halls at 11:20.  We spent the majority of her labor walking in between contractions, and leaning over and swaying during contractions.  Her husband and I took turns massaging her hips and back, and encouraging her all along the way.  

We made frequent stops in front of the room so the nurse could listen to the baby.  By 1:00 I could tell that we had crossed into hard active labor.  Contractions were lasting much longer and mom was having to cope through them more.  That being said, I had no idea how long it would take.  Inductions can literally take days, so I always prepare my clients for the long haul!

Grandma stopped by at 1:45 with food and encouragement.  Mom was too far into labor to eat at this point though, but dad go to eat!

Mom became tired at 2:00 and climbed into bed to rest.  We put a peanut ball between her legs and played relaxing music.  At 2:20 she said she had to push.  I was taken off guard!  She was coping way too well to be ready to push!  The nurse checked her and she  was 8 cm.  At 2:40 she was 10 cm and her baby was already at +2 station!

Mom started out pushing on her hands and knees, but her baby's heart rate indicated that it wasn't a good position for baby.

13 minutes later, this sweet chunk entered the world!

She pinked up so fast and had the most beautiful skin!  

She also had a very robust cry! 

This mama was so strong!  A medication-free induction is not an easy task!

Holding hands with mommy for the first time... so sweet!

Nursing by 3:40

Welcome Arya!

Born Saturday, October 6th, 2018 at 2:53 pm

8 days after her due date

9 pounds 5 ounces