Fear vs. Faith

Since birth is unpredictable, there will always be some amount of fear concerning it.  But lately I have really noticed how so few care providers actually have faith in birth.  This lack of faith makes parents feel more fearful; and often, more willing to accept interventions that are offered to them without true medical need.  It's a cycle that desperately needs to stop.  

My latest client was expecting her third child.  She had been induced for medical reasons with both of her previous births, and was thrilled when this pregnancy had no medical issues.  For once, she was going to be able to go into labor all on her own!  

However, several weeks before her due date, her care provider kept finding things to fear.  The baby wasn't descended in the pelvis yet, or the heart rate was a few beats too low.  She talked often of the size of the baby, and worried it would be too large to be delivered vaginally (even though this mom had already vaginally delivered a baby barely under TEN pounds!).  The topic of cesarean came up at every appointment during the last 4 weeks of this woman's pregnancy.  

Where was the faith in this woman's ability to give birth?

She had already proven that she could, TWICE!  

Yesterday she was getting serious pressure to induce.  She and I spoke on the phone about the pros and cons.  This is a hard place for a doula, since we can't let our opinions sway the way we talk to our clients about their own agency.  But personally, I didn't see any true need to induce.  However, many couples agree to inductions because they feel that once the provider has mentioned it, that it is something they have to do.  Thankfully, this couple decided to go home and think about it.  And wouldn't you know, she went into labor that night!  

I received a text at 5:40 am, saying that contractions had just gotten intense.  Mom and dad arrive shortly before 6:00, and I got there shortly before 6:30.  I could hear mom vocalizing as I was walking into the maternity center, and I could tell she was about to have a baby within minutes!  

A fast labor is mainly a blessing, but can feel like a curse while you are experiencing it.  There are literally NO breaks.  Moms feel very overwhelmed, and often hyperventilate because it is so hard to find time to breath.  I quickly started helping mom find her focus, and use her breath purposely.  

Before the first official push, mom expressed her fear that the baby was too big.  Hmm... I wonder why she worried that.  Oh wait, it's because her provider planted that seed of fear weeks ago....

But there was nothing to fear, as her son was quickly born after just a few pushes!  

He came out a little blue, and a little lethargic; but had pinked up within a few minutes.  

No Name Baby Boy :)

Born February 5th, 2014

6: 47 am

9 pounds 5 ounces

Dad was able to hold baby while mom recovered.  

I could hear him talking and humming, and it was beyond sweet!  

Congratulations to a wonderful family, who truly had nothing to fear.  :)

I met my most recent client walking into church several weeks ago.  I asked her when she was due... One question led to another, and before we knew it, we were skipping Sunday School to talk birth.  I think we both felt an instant connection, and I was so excited when she asked me to be her doula!

During "Sunday School", this mom told me all about her first birth.  She was induced due to low amniotic fluid.  After contracting for over 24 hours, she only dilated 3cm, and had a cesarean.  Needless to say, it wasn't a great experience.  Her desire was to have a VBAC with her second child.  

Avoiding induction is key for a successful birth, especially a VBAC.  So I was thrilled when I woke up Thursday morning to a text saying she was in early labor.  She had an OB appointment at 1 pm, and was dilated 2 cm.  She arrived at the hospital at 6 pm, and was 3 cm.  Her contractions were very close together, and appeared to be quite strong, but they wouldn't admit her until she was 4 cm.

She labored quite a while in triage, and spent about an hour in the tub.  During this time I looked down and noticed her mucous plug was sitting right there... on my pants!  There's a first time for everything.  :)  

At 10 pm she was finally admitted, and was 5 cm by 11:15 pm.  

The contractions never eased up.  They were constant, which makes labor so much harder to cope with.  She was amazing!  By 1:00 am, mom was ready for sleep though, and received an epidural.  

Her OB came in around 8:00 am, and she was only dilated to 6 cm!  Not exactly what you would expect from a woman having contractions every 3 minutes for about 15 hours.  He broke her water, in the hopes it would help push her over this hump.  

But it didn't.

As the day went by, it was clear to see that no more dilation was going to take place.  Her baby was floating too high, and never engaged in the pelvis.  This prevented the pressure needed to push against the cervix and cause change.  A birth like this can be discouraging.  It is hard when you do everything right, and still don't get the birth you want.  But this mom doesn't have any "what ifs", like she did with her first birth.  She knows there was nothing else she could do, and that brings about a true peace of mind.

 

Baby Girl Remy

Born Friday, January 31st, 2014

5:38 pm

8 pounds 11 ounces

Squeezing In One Last Birth for 2013

I received a text at 5:20 am yesterday morning, saying my client's water had broken.  We kept in touch throughout the day, but her contractions never picked up.  We both went to bed surprised that she was still pregnant.  But at 4:00 am this morning, it was clear that she would be meeting her baby boy in the very near future.  I arrived at their home about 4:45, and found mom and dad working together and coping well.  

Mom was very instinctual, and spent her contractions leaning over and breathing deeply.  After an hour we were ready to head to the birth center.  

Dad helping mom into her slippers, getting ready to leave!

Mom was looking forward to laboring in the tub.  At 6:30 am, she was dilated to an 8, and decided to finish out her labor in the water.  

She continued to breath deeply until the urge to push was too strong.  

And at 7:13 am, 12/31/13, this cutie pie slipped into the world (and into the tub).  

Look at that perfect face!

By 7:40, this little guy was already nursing like a champ.

What a WONDERFUL way to finish off 2013.  I know this family is excited to ring in the new year with 3 sons tonight!

There's a Fine Line....

It's hard to know when your reaction goes from a true reaction, to an over reaction.  As a doula, it's not my place, or my specialty, to make that call.  However, at the birth I attended tonight, I couldn't help but feel that there was much over reacting going on!  

My latest couple is a military family that recently landed in Boise.  This was their 3rd pregnancy, and the first time she went into labor on her own.  I received a text at 9:25pm saying that she might be in labor, to a text at 9:42 saying "meet us at the hospital"!  I knew she would progress quickly, so I wasn't surprised at all that she was 8 cm when she arrived.  

When the nurse first listened to the heart rate, it was in the 80s and 90s, which is not optimal.  But it is fairly common during the pushing phase of labor.  And by 10:40 mom was complete and ready to push.  The urge to push wasn't there, baby was facing the wrong way in the pelvis, and he wasn't really moving when mom did push.  Because of the low heart rate, the on call doctor suggested a spinal and forcep delivery!  Excuse me?  How did we go from a perfectly progressing birth to an extremely high risk situation?  I could see that the over reaction of this physician caused extreme stress for my clients.  Dad became light headed, and mom appeared panicky.  

It's a tough call, and certainly no one wants to make the wrong call when it comes to getting a baby here safely.  But with so many other things to try in between 'nothing' and 'tons of interventions', doesn't it make sense to change positions, and see if that helps?  Anyways, chosen doctor arrived, and after several minutes we were able to get mom into a new position.  And even though mom didn't like it, the baby did.  He started to descend through the pelivs, and his heart rate improved.  Chosen doctor suggested we all take a deep breath and assess.  Thank goodness she arrived when she did, because anesthesia was about to give a spinal without consent...  

Annoyance aside, everything turned out beautifully.  Was it hard?  Yes.  But was it too hard?  No.  With birth, we need to have a little more faith.  (Or alot more if you are the on call dr....)  It is really hard for a mom to have faith in her ability to birth when the medical staff over reacts.  Because despite how hard it was, this little guy slipped into the world at 23:23 (11:23 pm for you non military timers) with apgars of 8 and 9.  He sure proved them wrong!

Edmund's first kiss.  :)

Showing his sisters (who both weighed under 7 pounds at birth) who's boss, 

weighing in at almost 8 lbs and one ounce.  

This couple was a great team.  It was a bit of a crazy night... But with 3 kids, who are all very close in age, crazy nights will pretty much be the norm for these parents!

Halloween Baby?

My most recent client sure has the gift of patience!  After going well past her due date, they set an induction date for Halloween.  But during her appointment on Tuesday, the 29th, they decided that an induction was needed that very day.  So at 12:45 pm, cervidil was administered to soften the cervix and get contractions going.

Contractions began around 3:00 pm, but mom could handle them just fine, and didn't even call me to her until midnight.  I arrived shortly before 1:00 am on Wednesday morning.  At 3:00 am, mom was checked and was only 2 cm dilated, even though her contractions were very intense and close together.

It could only mean one thing:  a posterior baby.

From 10 years experience, there are two things that can make a birth very difficult.  Getting induced, and having a posterior baby.  Having both is just plain awful.  But mom was a champ, and spent the next 12 hours trying everything I suggested.  She walked the halls, squatted, used the birth ball, got in the jacuzzi, the works!

At 8:30 am, she was only dilated to a 3, so she went ahead and had her doctor break her water in the hopes of stirring up her hormones.  She also used her breastpump to stimulate hormones.  I'm not kidding when I say we tried everything.

Dad was a great support.  He guided her breathing, and always knew just what to say.  I just love seeing a couple work so well together!

Around noon mom was exhausted.  She had now been in labor for 24 hours and was beyond needing a break.  She opted for an epidural.  Such a hard decision!  But it proved to be the right decision when she was still only dilated to 4 cm at 4:45 pm.  Her cervix just wasn't changing fast enough, so pitocin was administered to hopefully the strengthen the contractions.

Mom and dad were both able to nap quite a bit during the afternoon and early evening.  With all the needed interventions, I was starting to stress that pretty soon we would be talking cesarean.  But then, at 8:30, much to our pleasant surprise, mom was complete!  

Mom was an awesome pusher!  She had great control.  But as with alot of first time moms, pushing was slow going.  We all wondered if this would still end up being an Halloween baby.  

But at 10:58 pm, little Finley slid into the world.  

Covered in meconium and with a VERY impressive conehead.  :)

Since there was so much meconium, Finley was taken over the nurse's station to be suctioned before being placed on her mother's chest.  Here she is holding her daddy's hand.

They were so happy to be close again.

First family picture!

Look at those long arms!  

 

What falling in love looks like...

And even though she came TWO full weeks AFTER her due date, she only tipped the scale at 7 pounds and almost one ounce.  Some babes just need more time.  

I was so happy with how this birth ended!  Not a single stitch needed.  That alone kind of makes up for everything else this mama had to go through.  :)

Home Birth

I was so excited when this couple hired me to be their doula at their home birth!  I hardly ever attend a birth outside of the hospital.  But when I get to, it is always a wonderful and peaceful experience.  I had a feeling this mom would go quickly, too, since her first birth went well.  

I received a text at 3:20 am saying that her water had broken.  I got myself up early so I could be ready to leave any time.  Well this mom is a tough cookie, and made it almost 12 hours before calling me in for support!  I arrived shortly before 4 pm, and mom was clearly making her way into transition.  She labored in front of her bedroom window (It was a beautiful fall day, and the fresh air was perfect!), and leaned over during her contractions.  

Around 4:20 the intensity was even stronger, and mom said she was starting to feel the urge to push.  I was VERY relieved when the midwives arrived several minutes later!  Mom continued to labor until about 5 pm, when we moved her to the bed and she began pushing.  I sat behind her on the bed and wrapped my arms underneath hers to support a deep squat.  

And at 5:12, this little cutie slipped into the world.  

Caught by daddy and placed on mom's chest.

Both parents were pleasantly surprised at how quickly things went.  Big sister was busy at Grandma's house making a birthday cake, and they were excited to have a family birthday party tonight.  

Such a cute little guy!  

Cervix of Steel

A week ago, my client was told by her OB that she had a cervix of steel.  Sitting at 40 weeks, her cervix was still totally shut, long, and hard.  You know, just the opposite of what you want it to be.  So she spent the week trying to get things softened, and was able to get herself to a whopping 1 cm.  

Ug.

So the decision was made to induce labor at 41 weeks.  Mom and dad arrived at the hospital at 7 am Thursday morning, and mom was given cytotec.  She had been having small contractions the previous evening, and thought that there might be progress already.  

Nope, still 1 cm. 

Mom and dad spent the day at the hospital, trying to get things moving while cytotec was administered twice, and the contractions kept coming enough that mom wasn't even given pitocin.  But at 4:30 pm, mom was still only 1 cm.  Her spirits were still good though.

Around 6:00 pm, there was a noticeable change in mom's contractions, and I was called and asked to join them around 7:30.  When I arrived, mom was laboring in the tub.  She was doing great!  I could tell that things were really intensifying, and I figured early labor was well behind us.

But at 9:45, mom was checked and was now only dilated to a 2.  The nurse cheerfully pointed out that mom was TWICE AS FAR as she had been last time, but still, the news was very discouraging.  We then spent time walking the halls and squatting, and mom was a 3 at 11:15.  

Around midnight mom became exhausted, and asked for the epidural.  It kicked in quickly, and we were all able to sleep off and on for about 5 hours.  At 1:40 she was dilated to 4, and her water was broken at 2:30.  I thought for sure we would wake up and find out that mom was complete, but at 6:30 am, she was only 5 cm.  Still, she was progressing!  

Mom was then given some pitocin to try and get her the rest of the way, but dilation still came slowly.  The contractions began to become intense enough that the epidural was only dulling them.  At 9:20 mom was dilated to 6 cm, and was given an intra-uterine pressure catheter to determine the strength of her contractions.  The decision was made to up the pitocin, and hope that things picked up.

I stepped out for lunch at 11:30, and when I returned at noon, mom was bright eyed.  She was now dilated to an 8 1/2!  Now we're getting somewhere!  We figured we were just moments away from pushing.  This far in the game, dilation should happen very quickly.  But 2 hours later, there was no change, and mom's cervix was starting to swell.

Because of the prolonged labor pattern, it was getting safe to assume that baby boy was not in a good position, and may never engage in the pelvis enough to be born vaginally.  Mom was given two options:  1: Go ahead and have a cesarean.  2: Keep waiting it out and see if she ever dilated fully.

This is an extremely hard decision to make.  But ultimately, mom and dad both felt that there was a reason her body wasn't dilating anymore, and they opted for the cesarean.  

During the birth, I was able to chat with all four grandparents in the waiting room.  It was fun to answer their questions, and it gave us something to do while we all anxiously waited to see the new baby!

Welcome Carter!

Born Friday, Sept. 27th, 2013

8 pounds, 11 oz

2:56 pm

I was so impressed by how these parents handled this hard situation, and didn't let it ruin their day.  They are so in love with each other, and so excited to start this new step in life together.  They worked together as a team the entire time, and it was such a privilege to be their doula.

A cervix of steel, and a heart of gold.  

Congratulations!