Archive for the ‘Birth Stories’ Category

Whitney and Ben had an unplanned cesarean with their first daughter, and decided they wanted to try for a VBAC this time. We met at a Doula Info Session over the summer when they were just beginning to think about this birth. They took a Planning your VBAC class and a Labor Skills class, and we talked and prepared. Their doctor was supportive to try for a vaginal birth until 41 weeks. At her last checkup she was only 2cm dilated and very thick at 20% effaced.

 

Whitney thought her water broke around noon on 1/26 but nothing much was happening. Overnight on 1/26 and 1/27 Whitney had increasing contractions which kept her up most of the night, but by morning they had “pooped out”. They did a morning walk, but contractions were still nowhere near the intensity or frequency they had been overnight. We decided to have a meeting to discuss options/expectations.

 

I met at their house around 9:45am and we talked about the “what if’s” — if indeed her water had been broken now for 20 hours, and she was not in labor, it was likely they would end up with another cesarean later today. I know that was not what they had hoped for, but they understood the reasoning, and were mentally prepared. We did a few “spinning babies” techniques to help the baby engage into the pelvis better (just in case that was the problem with the start/stop labor) and then Whitney called in to the Dr’s office.

 

They alerted me that he was out for the day and were headed to L & D around noon. Apparently the contractions had started picking up. In triage, the nurse checked her and she was 3.5cm and 100% effaced! BUT- her water wasn’t broken. Wow- that’s what all those overnight contractions had done! Since she was having contractions every 5-6 minutes, they decided to keep her and check again in an hour.

 

At 1:45pm Whitney texted me again and said she was now 4.5cm and they were admitting her! She was in labor! They were moving to a labor room, told me to “take my time” but I went ahead and packed up and headed over. I arrived there at 2:30pm and was glad I did. Whitney was on her hands and knees on the bed, working hard through the contractions! It was a distinct change from when I saw them just a few hours before. Ben was calm but happy to see me.

 

I helped Whitney remember to use her vocalization (dying cow) sounds and that helped her get focused again. Ben was doing the double hip squeeze which helped a lot. She had a lot of hip and back pain.

 

The doctor who was on call came in around 3pm. He took Ben aside and said he understood that they were hoping to VBAC and reviewed what he thought an “ideal” VBAC candidate was, and we’d have to see how today went. We were having a hard time keeping the baby on the monitor with Whitney in the hands and knees position, so he was worried about the baby. Overall, he didn’t seem overly supportive or pleased, but luckily, we had a super supportive nurse who reminded Whitney and Ben of their rights and the safety of VBAC.

 

Whitney continued to work hard, we took a bathroom break, where she started to wonder about pain meds. Because the epidural had significantly slowed her labor last time, she hoped to do without, or at least get one very late. I suggested some IV meds in the meantime to see if that would buy some time. Our nurse could see Whitney was progressing quickly and suggested an exam before the meds- at 3:45pm Whitney was already 6cm! Things were moving well. She received the dose of Fentanyl at 4pm and was able to relax more. The contractions were still strong but the intensity was less.

 

We helped Whitney with ice packs, hip pressure and counter pressure, but within 30 minutes she was feeling overwhelmed and asked for an epidural. We hoped that with her moving so quickly now it would not have a negative effect on her labor.

 

Our nurse got fluids started and we continued to help Whitney manage the contractions. Around 4:45pm she started to gently “bear down” with the contractions and reported she was feeling some rectal pressure. Hooray! That was great news. We assured her she could still get an epidural. At 4:59pm her water broke, (for real) and we wondered if she would progress to complete soon! The nurse did another exam and found her to be 9cm! The doctor walked into the room very soon after the exam and was genuinely surprised to hear such good news!

 

Anesthesia walked in the room at 5:07pm and by 5:20pm he was done. It was literally the fastest epidural in the west! It took a few minutes but in a short time, Whitney was feeling some good relief! By 6pm her foley catheter was in, peanut ball in place, and she welcomed the chance to rest. I encouraged Ben to take a quick break and get some food.

 

When he returned, we talked about how crazy this day had been- physically and emotionally, from this morning thinking her water was broken and planning for a repeat cesarean, to full blown labor and now 9cm dilated! We wondered which of the “spinning babies techniques” did the trick- or had it been a combo? We’d never know.

 

At 6:30pm the nurse did another exam and reported a “tiny” bit of anterior lip left- 9 ½ cm/100/+1. The baby had come down a lot! She recommended let Whitney rest more and let the baby move down. We tried switching Whitney to her left side, but the baby would have nothing to do with it, so back to her right, where she remained happy as a clam.

 

I encouraged rest again, since I knew Whitney would need energy for pushing. Our new nurse came on at 7:20pm and checked Whitney at 7:45pm- officially complete and ready to start pushing! We started at 8pm and within an hour we could see lots of hair! It was exhausting work but with the nurse’s help and Ben’s and my encouragement, Whitney kept going. At 9:40pm the baby was nearly crowning so the doctor was called in. After 15-20 minutes we saw that Whitney wasn’t making much more progress, and he suggested a small episiotomy to release the tissue and help the baby come more quickly. It worked! Jocelyn Morgan arrived at 10pm on the nose and was immediately placed onto Whitney’s belly, where they could welcome their daughter with love. I reminded the doctor they hoped for a delay in the cord clamping, which he honored. Jocelyn had a lot of fluid in her lungs, but after a few moments, she was crying vigorously and worked it out on her own. Whitney was thrilled it was over and so happy she got her VBAC!

 

I’ve been attending so many amazing VBAC births lately! Here is a “flashback” from 2011, posted by request from the mama who is so proud and excited to share her story with other families:

Your mom had experienced a cesarean birth for medical reasons with big brother Ryvers, but she was eager to experience a natural childbirth for you this time around. She sought out a physician who would support her wishes for a VBAC (Vaginal Birth After Cesarean), and decided a doula would help support her and your dad through the process. (That’s me) They took Prepared Childbirth classes, did their homework, and prepared themselves as the big day approached. We discovered only a few weeks before your due date that Dr. McIntyre was scheduled for hip surgery the week before you were due… we hoped that you’d wait, as it was very important to Shawna that Dr. McIntyre be there… she had been experiencing “warm up” labor all week.

On Monday morning, 8/29/11, around 7:30am, I got a text from Shawna, letting me know she had been contracting all night since about 11:30pm. She had been nauseous, as her system cleaned itself out in preparation for labor. Her contractions were about 7 minutes apart and lasted 45 seconds. They were sending Ryvers off to school and she’d keep in touch. She said they were “yucky”.

I spoke w/ Jeremy around 8:30am and he said the contractions were now about 4 minutes apart/one minute long, and much stronger, and Dr. M had recommended they come in for a check. I had a feeling this was “it” so went ahead and headed down to St Davids Medical Center to await their call. In his office, Dr. M checked Shawna, and found her to already be 3-­4 cm dilated, and 100 % effaced… what a great start! They decided to head on over to labor and delivery and get settled.

9:45am Arrival at the hospital. We had a “shuffle” of nurses initially, it had been a busy night (we even had to wait for our room to get cleaned!) but finally were settled, with Amee supporting us. Shawna’s nausea was behind her, thank goodness. We got her on the monitors – you looked great! Her contractions were 2-­3 minutes apart, and getting stronger and stronger. She was using her breathing and relaxation to get through them. Jeremy and I provided some back massage/pressure to help as well. Shawna rated the pain at a “6” at that time. Amee asked “Can you go to 10?” and she said YES!

Because Shawna had some scar tissue on her cervix, we knew it might not open in a “textbook” format… so I reminded her to just focus on her labor and trust her body knew what to do. She asked me “how long will it be like this­­ contractions so close together?” I told her most likely
until it was time to push­­ and reminded her to not focus on what was ahead, to say present in the here and now. She settled in, doing a beautiful job of managing the contractions. Amee was very patient, allowing Shawna to sign forms and answer questions between the contractions.

By 10:45am, Amee got Shawna’s IV set up and the first dose of antibiotics in place. Shawna reported the contractions “felt different”­­ stronger, lower. I suspected her body had kicked into gear and officially put her into active labor. Jeremy was by her side, softly talking, sharing a laugh.

At 11:15am, we took a walk to the restroom. Shawna was more serious… obviously working hard. “These suck”. Her contractions were 2-­3 minutes apart and 1-­2 minutes long. Her body wasn’t kidding around.

Dr. McIntyre came in around 11:45am, (cane in tow, only a week post op!) and wanted to check on her progress. Shawna was now 5 cm, 100% and 0 station… very encouraging. It was geat to hear all those contractions were doing their job! “Shelley, I am so glad you are here!”

Jeremy checked in with the grandmas, giving them updates. They talked about Ryvers and how surprised he’ll be­­ he was sent off to school this morning, not knowing what was happening! Shawna liked sitting on the ball, leaning over the bed. I massaged her lower back with some lavender and peppermint oil. She continued to use slow breathing and relaxation to manage her contractions.

After a while, Shawna was ready for a change. Standing up was too much work, and made her feel sick, so we tried the rocking chair. That felt good. She dozed a little between the contractions, she was beginning to feel more pressure­ that was a good sign of you moving down. Lots of encouragement, Shawna was doing great.

Jeremy sat in front, rubbing her legs. I encouraged him to line up some lunch for himself, since the grandmas were on their way in anyway. Shawna’s back hurt still, so we wrapped up the rebozo around her hips and let Jeremy pull on them during the contractions. She said it felt really good. Jeremy said “And you look good too!” I told Jeremy he was going to get a good upper body workout today and Shawna thought her workout was going to be better!

Around 12:45pm, the labor intensified. Shawna was beginning to vocalize, softly moaning through the contractions. I assured her she was doing perfect. “As long as I get these breaks, I can do this.” Outside, the unit was busy­­ lots of noise and activity. Inside our room, it was peaceful, with dim lighting. Jeremy offered some music but Shawna was good with the quiet. Amee was checking in on us a little here and there, otherwise has pretty much left us to “do our thing”. Shawna was glad for the quiet, she closed her eyes to rest between contractions­­ it had been a long night and she was beginning to feel the exhaustion. I encouraged her to rest and conserve her energy.

As the contractions progressed, Shawna reported feeling more and more pressure­­- all good signs you were finding your way out. Jeremy commented, “You look so peaceful and relaxed”. Around 1pm, Katie took over for Amee as she needed to tend to another patient. Dr. McIntyre came back around 1:15pm and wanted to do another exam. He reported she was “about the same”­­, but the baby’s head was low, and everything looked good! After the exam, Shawna decided to stay in bed a while, hoping to get some rest. Although the breaks were short, she was managing to doze in

At 1:30, Jeremy’s mom arrived, with lunch, and lots of good energy. Jeremy took a quick break to eat some Chik Fil­A, but was back within minutes back by Shawn’s side. Shawna moved to a sitting position again, as the contractions were really strong in bed. She liked sitting on the stool, while Jeremy massaged and pushed on her back. We tried the instant heat packs , but they never seemed to get very hot. I suggested a shower for her back pain, which Shawna liked. Katie asked that we wait just a bit, to get the second dose of penicillian in, then she was free to take a shower. We tried an ice pack instead, which helped for a bit.

Around 2:50pm, Shawna felt something dribble out of her, and thought maybe her water had broken. We took a restroom break to change clothes and pad­­ there wasn’t a lot of discharge, so we weren’t sure… either way, she was doing amazing. Jeremy’s mom had stepped out, patiently waiting just outside our room, keeping family updated.

Shawna began to worry about what was ahead of her­­ I told her she was doing beautiful, and to just keep doing what she was doing. There was no way to know how long we had ahead of us-­­ it was useless to try to “forecast” things. Just stay in the moment and keep trucking along. Jeremy provided lots of love and support, never doubting her. Shawna was beginning to feel more and more low pressure, and began to ask questions about what it would feel like to go through transition. I admitted it was hard, but usually fast. With that self doubt creeping up, I knew Shawna was moving into late active labor, when most of us wonder “if we can do it”.

Timing couldn’t have been more perfect when Shawna’s mom arrived at 3:30pm­­ she had just flown in, and headed straight here. Shawna’s first comment was “You did this three times?” and her mom laughed and said yes… and it was well worth it. I reminded her there was a prize at the end of all this­­ she said “I think I forgot I was having a baby­­ it’s all I can think about just getting through the pain”. Her mom provided lots of love, support, and good mama energy… just what she needed.

4:00pm. “Shelley, they hurt worse”… luckily, the antibiotics were finally done and Shawna was released to take a shower. Dr. M had said the baby was looking great, so he allowed for intermittent monitoring. While Shawna enjoyed the relaxing effects of the shower, I hung out in the bathroom in case she needed anything. Jeremy took a break, chatting with the grandmas, re-living their birth memories, taking Lamaze classes, forgetting how much it hurt after the baby came! They all agreed, the shower was the best place for Shawna now­­ “At home she uses all the hot water herself”. The grandmas brought a loving and experienced presence to the process, reminding Shawna how many women have done this before her, and how many will do so in the future.

Shawna left the shower and said while it helped her relax between the contractions, they were getting even stronger, something she thought wasn’t even possible… she seriously doubted how much longer she could tolerate things. Dr. M showed up around 5pm to do another check, and said she was a good 6cm now and thought that her water had indeed broke. While Shawna was happy to hear the progress, she was feeling overwhelmed with the labor, and exhausted. We talked about options other than an epidural, and she decided she wanted a little something “just to take the edge off”.

Katie administered a dose of Stadol, an analgesic, around 5:15pm. Dr. M agreed this was probably a good call, as it would allow her to sleep a little between contractions, and help her “care a little less they were there”. I joked around it was like drinking a whole pitcher of margaritas by yourself in 5 minutes. He said that sounded like the voice of experience (with a sly smile).

The Stadol took effect quickly. Shawna was able to really rest between contractions while I massaged her feet and lower legs with lavender oil, to promote relaxation, and used some acupressure points to keep the contractions coming. (Sometimes medicine causes labor to slow down) Jeremy rested by her side, gently rubbing and massaging her back as she continued to breathe through the contractions. “They still hurt, just not as bad”.

The contractions slowed to about every 3-­4 minutes (previously they had been every 1.5 to 2 minutes!) which was a welcome break. Shawna was able to get a good rest in between, even saying she was actually falling asleep! “I’m enjoying my margarita!”

Around 6pm, Uncle Zach popped in…. everyone else was happy to see him, but Shawna was feeling less than social. Jeremy took a well deserved break to chat with his brother. At 6:30pm, Dr. M wanted to check on things again­­ he said Shawna was already 7 cm, still making good progress! Your head was still about 0 station, but we weren’t worried. I knew things were moving along just fine. The Stadol was beginning to wear off, losing effectiveness. Shawna was working a little harder to get through the contractions, but was still doing beautiful. I encouraged her to continue to rest as much as she could… things could move fast from here.

6:45pm I recommended to the grandmas if they wanted dinner, they might want to head to the cafeteria sooner rather than later… Jeremy declined needing food. He was not wanting to leave Shawna for even a moment. She wondered…”How much longer Shelley”­­ I replied, that’s a good question!

Around 7pm, Shawna reported the first “inkling” of rectal pressure­­ the first sign you were really moving down and things were getting close. I assured her that was a great sign! Jeremy joked he was ready now to go grab some food! We continued to rub her back and encourage her. With each contraction, it seemed that pressure got more and more intense. Finally around 7:30pm I called Katie in to let her know. Dr. M came in to check–­­She was indeed fully dilated and ready to push!

Katie said she needed just a few minutes to arrange for another nurse to care for her other patient, and asked us to “hold off” pushing for a short while. I encouraged Shawna to blow through the contractions, and to relieve that pressure with “little grunts”… but her body was ready and there was no holding it back. Shawna let me know she couldn’t stop pushing… I could see her perineum was bulging with her pushes, which meant you were right behind it! I called Katie again and said we couldn’t wait!

Katie hurried back in and ok’d us to go for it. The grandmas returned from dinner but I asked them to wait outside for a while, knowing Shawna had wanted her privacy during pushing. It was 7:45pm when we “officially” started pushing. Shawna knew she wanted to be upright­­ she had done her homework and knew squatting would make the most room, and shorten pushing time and effort, so we asked for a squat bar. In the meantime, I encouraged her to grab me on one side and Jeremy on the other and we’d support her in a squat until the bar got there. Shawna’s pushing efforts were evident almost immediately as we could now see the top of your head!

The squat bar never made it­­ -Shawna pushed so well we were calling Dr. M in within 15 minutes. The staff got everything ready for delivery as Dr. M got gowned up… Katie removed the end of the bed but allowed Shawna to remain in that upright squat by using the foot rests instead. Dr. M gently encouraged Shawna to continue pushing, and she did so with amazing effort. Suddenly Shawna said “tell my mom and your mom they can come in”. Jeremy stopped­­ “You want them to come in?” And she said yes. Katie went and grabbed them and invited them in. I got them settled quickly over to the side, out of the way of the staff. They were shocked and delighted to be there!

With gently guidance on the part of Dr. M, and amazing control and strength, Shawna pushed you into the world at 8:13pm. As Dr. M held you up, I said “What have you got?” and Shawna said “It’s a boy!” You were placed immediately onto your mother’s belly where she welcomed you with loving arms! She was so glad to be done!

Dr. M waited for the cord to stop pulsing, and then offered for Jeremy to cut the cord. Everyone waited with anticipation­­ you were a surprise and your name was still unreleased… finally Shawna said “You say it, you picked it out”. And Jeremy announced who you were­­ “Welcome, Bryce Cooper.”

I don’t know if I have seen texting grandmas react so fast… your name was published instantly! I helped Shawna get more comfortable (she was still practically hanging off the bed!) so she could just relax and enjoy you. Even Jeremy was a little teary eyed, welcoming his little boy. Shawna was exhausted, and exhilirated at the same time… She had done it!

My OB strongly recommended induction at 41 weeks due to a small risk increase because I’m officially of advanced maternal age (anyone 35 and up). I struggled with the decision but ended up agreeing to it and we scheduled for Friday, Sept. 12. 
 
On Thursday at 4pm I was already 3.5cm dilated, and the doc inserted a balloon to increase dilation to 4-5 overnight. The balloon caused painful cramping and contracting — like the worst period cramps ever — but with two glasses if wine (blessed by the doc) and Tylenol, I was able to deal and get a little sleep. 
 
The next morning we woke up at 4:30am to eat (last opp for solid food) and head out to the hospital for my 5:30am appt. My doc came in at 7:30 to remove the balloon and check me — I was 6.5-7cm and she said she’d never seen a cervix so ready! 
 
I was nervous about how pitocin would feel and they finally got me hooked up to the IV and had it started at 9:30am. They begin with a very low dose so I wasn’t feeling many contractions for the first couple hours. The most annoying thing was being attached to all if these wires and being monitored continuously. I had freedom to move technically but felt very tied down and uncomfortable. 
 
One cool thing about the continuous monitoring was being able to watch the monitor as the contractions got stronger. They increased in intensity but not to anything I couldn’t handle on my own through breathing through them. At around 1:30pm, my OB came back to break my water to get the labor really going. That felt like a warm flood! They were happy that the fluid was clear with no meconium – showing the baby wasn’t in distress. 
 
My doula, Shelley, was in the room at that point and thank goodness, because as soon as my water broke, I was in full active and painful labor. I threw up twice because of the intensity, and she and Adam were there to put a cold compress on my neck, give me a peppermint oil washcloth to smell, etc. I was having contractions every minute and a half, and that continued for the rest if the labor. 
 
As my body took over, they were able to turn down, and eventually turn off the pitocin, which allowed them to remove me from continuous monitoring. This was a huge boost to my mood because continuous monitoring absolutely sucks. They kept having to move the monitors and hold them into place to track the babies heart-rate, and it was very distracting and annoying while I had to have it. From then on, they would just check the baby’s heart rate every 1/2 hour or so through a contraction or two. 
 
I managed the pain through sitting on a birthing ball with Adam or Shelley pressing hard on my hips and sacrum (I had a lot of back labor), standing up and leaning over the bed, and then sitting in a “throne” position on the bed with a heating pad against my lower back. Throughout each contraction I would moan in a low register or flap my lips to try to stay relaxed. In between contractions I would try to let go as fully as possible to conserve energy. 
 
At around 5pm, the contractions felt closer together, and stronger. I was having a more difficult time managing the pain and started to feel a little panicky. Shelley suggested that I get in the shower. I got undressed (I had been wearing a sports bra and skirt), and sat on the birthing ball in the shower while Adam sat just outside and sprayed hot water on my lower back during contractions, and on the rest of my body to keep me warm when I collapsed in between. After about an hour of this, I decided to move to my knees in the shower, hugging the birthing ball while Adam continued to spray me. 
 
Soon after, my body started to move rhythmically forward and back and I began to arch my back. I started to make sounds that Adam now describes as a “wounded animal” and started to push a little. Shelley coached me through this for a while and when it became clear to her that it was really time to push, everyone scrambled to get me out of the bathroom and onto the bed for delivery. 
 
I got on my knees and hugged the birthing ball for a while, and then moved to elbows and knees — like a child’s pose but with my butt in the air. The OB took over coaching at that point, instructing me on how to push to get the baby out. I was no longer focused on pain, just a need to push, but I had a lot of fear about if/how I was going to be able to do this, and exhilaration at knowing that I would soon be meeting my baby! 
 
The physical and mental effort of pushing took every ounce of inner and physical strength I had, but within 15 minutes of pushing, I was able to give birth to my sweet Bess Maple! 
 
The doctor passed her to me through my legs so I was gazing down at her, with Adam holding me and crying with joy. I didn’t cry but just stared at her, trying to take it all in. I couldn’t believe this person, my daughter, had been living and growing inside me, and now she was here! The nurses dried her off while we were in this position and Adam cut the cord. They then helped me turn over to lay on the bed and placed Bess on my chest.
 
At this point they turned the pitocin back on to help me finish delivering the placenta. The OB and nurses also kept pressing on my stomach to push out all the blood, and the OB stitched me up (I had 2nd degree tearing). I’m not going to lie — all of that was no fun but I tried as best I could to focus my attention on the little one I was holding in my arms. Later, I breastfed her for the first time and they took her after an hour or so for newborn procedures on the other side of the room, before quickly bringing her back to me. Overall, it was one of the best, proudest, and most beautiful days of my life!
 
She was 7lbs 10 oz and 20.5 in long at birth, and we had decided months ago to name her Bess, after Adam’s grandmother. We knew we wanted to come up with an “M” name for her middle name, to honor my Nagymama, but didn’t decide on calling her Bess Maple until it was time to check out from the hospital, and her birth certificate was due to be turned in.
 

Stephanie had contacted me early in her pregnancy (which was a surprise!) looking for a doula to support she and Bryan during their birth. She hoped for a natural labor and delivery. I recommended childbirth classes with Chan McDermott, which would help them both feel more prepared and confident, and she communicated to her physician, Dr. Breen her wishes. She also saw Susan Steffes, an obstetrical physical therapist, who helped release her tight ligaments to help her have a easier birth.

As her due date approached, Stephanie was closely monitored to make sure she and the baby were looking good– and they were! Dr. Breen was very patient to let her go past her due date and wait for labor to begin on it’s own. Early Sunday morning 3/2/14 they had a “scare” of some bright red blood, so spent a few hours at the hospital just to make sure all was fine. They were released later in the morning, all looking good.

Her real contractions began that night. She and Bryan worked through a whole night of irregular but strong contractions. We talked in the morning, while it still seemed like early labor, they were going in for their regular appointment with Dr. Breen, so I told them to keep me posted… Bryan called me at 9:30am to inform me Stephanie was already 5 cm dilated, 100% effaced, and -1 station! Although Stephanie reported “leakage” overnight, the test for amniotic fluid came back negative. They were headed into Seton. I was close by, so headed straight over!

It took a while to get Stephanie admitted (several attempts for an IV before calling anesthesia) but finally we were able to settle into just laboring. Stephanie liked standing, leaning over the bed the best. She was using her breathing and relaxation to cope. Bryan was super calm and steady, making a few phone calls and texts to let everyone important know what was happening!

By 11am, contractions had picked up and were a steady 2-5 minutes apart. Dr. Breen was at his office so asked if it was ok to have one of the residents check her– Stephanie declined. She was fine with just plugging away, trusting that was needing to happen was happening. Our nurse Allison was wonderfully supportive– we discovered she actually works also at a local birth center, and was completely comfortable and supportive of natural birth. What luck!

After more discussion, it was agreed that Stephanie probably did have a high leak, and her water actually was broken. As the late morning progressed, Bryan and I noticed she seemed to be working harder, although Stephanie reported they felt “the same”. Dr. Breen came in at 1pm and suggested an exam. He happily reported she was now 6-7 cm! He recommended breaking the forebag of water, to help the labor progress. Stephanie decided that was ok– we hoped it would help put her into transition and bring us a baby quickly!

Stephanie spent a while on the toilet– a great place to help bring a baby down. She asked for her “gentle baby” aromatherapy which helped her get into her “zone”. She was doing an amazing job of managing her contractions…I suggested to Bryan that he run out to get a bite to eat, knowing things would get busier later. He didn’t argue a bit.

Since Stephanie was so tired, I recommended we try a side lying position for a while, to encourage rest, and perhaps to help the baby rotate. I put a hot pack on her front, where she was feeling most of her contractions. We had a few really big contractions there, signaling we were moving into the next phase.

By 2:30pm she was acting “transition-y”… closer, more intense contractions. They were taking more of her effort now to get through them. She liked massages, and both Bryan and I being close by. Her back was hurting more now– I hoped that was a good sign the baby was moving down. Stephanie continued to work with her labor, vocalizing more, clearly working hard.

Since the baby’s baseline had increased, the nurse recommended fluids– we were drinking regularly, but with a long labor it’s easy to get dehydrated. Stephanie agreed. She continued to plug away, one at a time. Around 4pm, Stephanie had the first “inkling” of pressure– a good sign the baby had moved down. As that built up, she was sure she had to poop, so I recommended she labor on the toilet a while, that way, if she did need to poop, she could! (But I was pretty sure it was a baby coming instead.)

She spent some time on the toilet, then was back to the bed. Hands and knees felt good. She said something felt “different”… more continuous rectal pressure. Yay! By 6pm she was very gently feeling a little pushy at the peak of the contractions– Allison and I hoped it was a sign we were getting close to pushing!

Dr. Breen came in around 6:30pm to do an exam. Stephanie was 8-9 cm and the baby had come down nicely. (+1 station) I asked him about positioning and he said the baby was “ROT” which meant she was on Stephanie’s right side, transverse. Most babies need to be LOA to fit through the pelvis well– we had tried moving her all day, so I wondered if she was going to rotate ROA instead to come down… perhaps she was doing this her “own way” as Frank Sinatra so claimed. Dr. Breen was very pleased with her progress and was in no way worried that we needed to intervene in any way. Sadly tho, he was leaving (having been on call for 24 hours already) so Dr. K was taking over. We said goodbye and hoped we’d be pushing soon!

Knowing the baby still had some rotating to do (which way I did not know…) I suggested some hanging squats and some lunges, to create space. I threw a sheet over the doorway and showed Stephanie how to hang from it in a squat. Thank goodness she was so physically fit! She was game for anything. We also tried the hip squeeze while she did hands and knees, hoping to release the sacrum to allow the baby to move however she pleased. Our new nurse Rachel was easy going and supportive!

By 8pm, Stephanie hit the “wall”– contractions feeling overwhelming, almost unbearable, wondering if she could do this. Bryan and I offered words of encouragement… she had already come so far. She knew she “had to do it”… so determined. The baby was so low, the pressure was intense. She was talking to the baby, her body to open up. Rachel suggested an exam, maybe she was complete and ready to push? Rachel stated she was 9+ cm, the baby was really low, was not sure of positioning, but recommended lying on her left, as there was a little more cervix on that side. This position would help the cervix move out of the way.

Rachel reported back to Dr. K our progress. Dr. K came in, concerned that Stephanie was slowing down in progress, and worried she would become exhausted. She recommended considering getting an epidural to help her relax, and some pitocin to strengthen the contractions. (They had spaced some). Stephanie politely thanked her for her suggestions and said she’d think about it.

Within minutes, Stephanie reported that something felt different– less sharp pain, more pressure, and some burning. Rachel and I were delighted to hear this! We hoped it meant the baby was coming down and we were getting ready for the next phase– pushing.

At 8:40pm Rachel called in a doctor to do an exam. One of the residents (Dr. M) said she was still about 9cm/90/0 station. (stingy exam) She also assessed the baby’s size (was the baby too big to fit?) and recommended some pitocin. Stephanie’s contractions had spaced somewhat, perhaps her body was tiring out? She also offered the idea of an epidural to allow Stephanie to get some rest. Stephanie was up for the idea of some stronger/closer contractions, but asked me “can they force me to get an epidural?” and I said no way, it was totally up to her how she managed her pain.

So although Stephanie was drop dead exhausted (so was Bryan) she opted for some pitocin without an epidural– let’s see what happened. It was 10pm. Those contractions definitely got stronger and closer– she was giving it all she had to get through them. It took both me and Bryan coaching and encouraging her to keep it together, she was doing amazing!

By 11pm, Stephanie was feeling defeated– like she was doing all this work for nothing. Dr. M came in again to check her– she was “almost complete”– just had a slight lip of cervix left, which she felt she could push back. So I explained to Stephanie what she was going to do– hold back the cervix while Stephanie had a contraction. It would be pretty intense and uncomfortable, but it would get us to the next step– pushing. Once Dr. M got the cervix out of the way, she said the baby was at +1 station, and still ROT– it was time to start pushing. It was 11:30pm.

We tried to encourage Stephanie to push gently at first, to keep the cervix out of the way and help bring the baby down more. We gave her some apple juice to give her some energy to work. It had been an incredibly long day and she was pretty wiped out. Keeping Susan’s recommendations in mind, we tried a variety of pushing positions, first on her side, a few on her back, then the other side.

At 12:30 (after an hour of pushing) the doctor came in to check. She said the baby was still about +1 station and had not rotated yet. She assessed Stephanie’s pushes and did say they were very powerful. At that point she encouraged us to keep going.

By 1am something changed– we saw some progress! Perhaps the baby was finally rotating! I asked Stephanie if she had enough energy to try some hands and knees pushing– we needed all the room to get that baby down. It was more work, and exhausting for Stephanie, but she was game. As I saw Bryan fading, I sent him to bed for a power nap– it would be a while still before we had a baby, and I knew he needed to have some rest.

Rachel continued to monitor our progress, offer encouragement. She said the thought the baby was direct OP, which meant she was rotating– the long way around. By 2:15am, I saw the first peek of the baby’s head without anyone holding Stephanie’s tissues out of the way. That was really encouraging! I told her she was going to finish this! That baby was coming! Dr. A came in at 2:40am to check– she said the baby was slightly acynclitic but had definitely moved down. We switched back and forth between side lying and hands and knees to give Stephanie a chance to rest. It sure seemed like the baby was finally making her way.

At 3am (Bryan was back up now after a good 1.5 hour nap) Dr. K came back in. Her take on things was that it had been plenty of time for this baby to come– if she was coming, she felt it would have already happened. She gave Stephanie an ultimatum of 30 more minutes– if the baby hadn’t made some significant progress in that time, she was going to recommend a cesarean.

So we put the pedal to the metal. I knew Stephanie was completely wiped out but said we needed to do something different if we were going to get a baby here. I helped her get into a squat with me on one side, Bryan on the other. It was hard work, but she did it. Rachel watched her progress and was really encouraging– she felt like this was really working. In between contractions, we let Stephanie lean back and rest. She was beginning to think maybe a cesarean was going to happen… but remained determined to give it her all.

Dr. K and the residents returned at 3:30am. They seemed to bring a cloud of doom and gloom into the room. They said “Ok, let’s see what kind of progress you have made”. One exam and she said the “same”… then the next push, the baby’s head seemed to really come down. Everyone in the room was cheering! They said “Keep going, she’s coming down”. “If you keep going like that, you’ll be able to have this baby, even if we have to help”… right when we thought all was lost, we had one final hope!

Stephanie continued to push, and we saw great progress. I think that baby had finally turned and was now officially coming down. It still took another hour– another offer of a vacuum (which Stephanie declined) and an offer of an episiotomy (which Stephanie also declined) but Stephanie pushed out that baby girl all on her own, after 5 hours of pushing, with no tears… Danielle was officially here at 4:32am.

At the moment she was born, we saw large amount of meconium, which made us change gears a bit. The cord was cut quickly, and Danielle was taken to the warmer for suctioning and assessment. They called a NICU nurse in to help. I encouraged Bryan to go be with her and to talk with her– she would be fine but needed the reassuring voice of her daddy to help.

Meanwhile I stayed with Stephanie and praised her for a job well done! She had done it!! Over a day of work, but she had the natural birth she had hoped. She had been incredibly strong and determined.

Once they had given Danielle a little attention, a decision was made that she needed to be taken to the NICU for further support and assessment. She was brought to Stephanie for a quick moment, skin to skin, so her mommy could kiss and love on her…then she and Bryan headed to the NICU.

Welcome, Baby Girl Danielle, we are so glad you are finally here!

Kaytie and Christian were planning for a natural birth, as Kaytie’s mother and sisters had done. They knew they’d want the additional support from a doula, so I joined their team. They took classes, planned and prepared and we waited for labor!

Kaytie’s contractions had been getting more frequent all week and by Saturday night they got close to 3 minutes apart, but were still mild. Around 1am, her water broke (the great flood…) and she let me know. Contractions were consistent but still manageable, so I encouraged her to rest and we’d see when things picked up.

By 6am they headed into the birth center. Roz checked her and said she was only 1-2 cm dilated, but 100% thin, so they headed back home to continue to labor. Kaytie was exhausted from being up all night, so they tried to get her comfortable so she could rest between the contractions. Her mom Sheila and sister Becca were there for support. They sent Christian to bed for a nap.

Sheila contacted me about 10:30am and said they were doing fine but things were getting more serious- maybe it was time for me to think about coming… in an hour or so. I agreed. I packed up my gear and headed over, arriving about 11:30am. Kaytie was resting on her side in the biggest bean bag I had ever seen. Christian had just woke up and felt much better. Mom and sister were hanging out with Kaytie in the living room, offering comfort, company, and nourishment.

Kaytie’s contractions were still about 3-4 minutes apart, but she seemed to be in a “holding” pattern– I was concerned that if it took a while for labor to get to the next level, it was going to really wear her out. We discussed the possibility of a very tight pelvic floor and I asked her if she was “game” for trying a side lying release to see if that would open things up and move us into the next level of labor. She was… with Becca’s and Christian’s help, we did a pelvic floor release on both sides. Afterwards, Kaytie wanted to get up and move around… and things started ramping up.

The contractions started coming more frequently and Katyie was working much harder to get through them. She liked standing, leaning, swaying through them– she had a little nausea but the peppermint oil helped. She moved around a bit until she got tired again and decided to try the bean bag again for rest. It was about 1:15pm. Becca was playing DJ, keeing the tunes going, helping create a peaceful and joyful environment for Kaytie to labor in. Sheila and Christian grabbed some lunch while Kaytie worked on a popsicle and some fruit.

It was a busy birth day– two other mamas were in labor at the birth center, and I had another client whose water had broken around 4am– it was raining babies! Kaytie was doing beautifully, using visualization (her special place at the ranch in the river) and listened to the Mormon Tabernacle Choir, perfect music to bring this baby into the world.

By 1:45pm, there was a big change in the intensity of the labor. Kaytie was working much harder, vocalizing, needing to sway and move. Her back was really hurting now– I told them it was probably time to think about going. Christian called the birth center and let them know we were on our way. Becca and Sheila took my car so I could stay with Kaytie during the car ride– those tough contractions are no fun in the car. Christian remained calm and supportive, even holding the bowl while she threw up in his car. (I bet he was really glad we grabbed it)

We arrived at the birth center at 2:40pm– the contractions were 2-3 minutes apart and very strong. The midwife Jennifer checked her and said she was already 5cm dilated, 100% and the baby was low at +1 station- wow! They had already put water into the tub and Kaytie was eager to get in!

Instantly she had some relief, the tub took the intensity of the contractions away… she was able to relax. Christian got music set up and offered to put her hypnobirthing CD in for her. Kaytie continued to use her breathing and relaxation to manage the contractions, with support from her mom, and Christian– who stayed by her side virtually the entire time.

At 3;30pm things took another leap in intensity. She was so tired– the exhaustion was really kicking in. There was so much love and support from her team– a new midwife named Scottie came in, since there were 3 moms in labor now. Becca worked on keeping the music going to help Kaytie stay relaxed and focused. We encouraged her to move around and change positions– her back was really hurting and I wanted to make sure the baby had a chance to rotate around.

By 4pm, Kaytie was feeling discouraged– she was so tired and the contractions felt overwhelming. It sure looked like classic transition– “I can’t do it”. Scottie was so encouraging. Kaytie kept saying she was just wanting to push! (She didn’t need to- she just wanted to be there already) She was starting to feel more pressure, which we reminded her was great news, the baby was moving down! She wondered- would she know when it was time to push? I assured her it would feel very different, and her body would just do it- she didn’t have to think about it. Sheila led her through a beautiful visualization and helped her relax and get re-focused.

Around 5pm, something changed– Kaytie reported “something feels different”. Kaytie calmed down, the uncertainty gone, replaced by acceptance. The contractions seemed to have lost their intensity– I suspected we were near complete and her body was “resting”… in preparation for stage 2! By 5:20pm Kaytie starting “catching” her breath with the peak of the contractions- pushy? Yes, by 5:30pm it was definite pushing. Scottie encouraged her to follow her body and push with her urges. She wasn’t worried about checking her.

At 6:30 pm Kaytie was worried something was wrong and wanted Scottie to check her. Things hurt and she wanted to make sure it was ok to push. Scottie did an exam and said she had only a “tiny lip” of cervix left– it was ok to push gently with her urges. The baby was nice and low and would push that lip out of the way.

We let Kaytie gently push– slowly increasing in intensity over time. A little after 7pm, Scottie encouraged Kaytie to feel– she could feel the baby’s head in her body! Kaytie was amazed and encouraged, things were going just fine. She had been pushing in the tub for a while, so Scottie encouraged her to get out a while to help the baby round the pubic bone. We got her to bed and had her pushing on her back awhile– we also tried squatting, and finally at 8:15pm, the birth stool. That really worked for Kaytie, Scottie said she was really getting that baby around the bone. By 8:45pm we could see the baby’s head even in between pushes– he was really close. Scottie said it would be time to move back to the bed soon for delivery!

Slowly, gently, Kaytie nudged that baby down more and more. By 9pm the baby’s head was nearly out– “As close as he can be without actually being here!” Kaytie was so strong and had amazing control. She pushed his head out– and said how good it felt! “I could stay like this all day!” I told her it would feel even better when his whole body came out. Scottie encouraged her to give it one more push and reach down and get her baby boy. At 9:11pm, Noah was born- Kaytie reached down and pulled him to her chest where she and Christian welcomed him with love and joy! The room was filled with midwives, assistants, and family– so much support. Even the staff said ‘That was a beautiful birth”…

Scottie waited til the cord stopped pulsing and then let Christian cut it. Kaytie held Noah for a while, delivered the placenta, then was ready for a break, so Christian took off his shirt and rested in bed beside Kaytie, holding his little boy skin to skin. Things settled down, the midwives got Kaytie cleaned up and comfortable. Sheila and Becca quietly slipped out and so did I– so they could enjoy these first few moments together as a family in peace. We asked “who is this little person” and Christian said “We think we want to call him Noah”… which seemed appropriate- It all started with a great flood…

Dina contacted me late in her pregnancy, wanting additional support during her 3rd labor and birth. She had gotten epidurals with her first two deliveries. This time she really wanted to experience a natural birth and knew the help of a doula would help both her and Brad get through it. We met only twice– the interview, and a quick “refresher” class to get them ready. It was a good thing we got those done quickly!

Only 2 days later, on Wed August 21, Dina called me around 4:30pm, to let me know her water had broken, and she was only having mild contractions, so notified the OB but stayed at home to wait for labor. Both Sabine and Beckett were so excited, they knew they’d be meeting their baby brother or sister soon!

Dina let me know over the course of the evening that contractions were picking up and by 9pm, they were every 5 minutes and getting strong. Her birth with Beckett was only a couple hours, so they decided to go ahead and go in, just to be on the safe side.

I arrived soon after around 10pm– Dina got checked at 10:15pm and was already 5cm, 100% effaced, and the baby was -1 station– a great start. Dr. Miller said “It’s a good thing you came in, the next 5cm may go fast”. The contractions were regular every 3-4 minutes, Dina was definitely having to “stop, relax, and breathe”. She was beginning to feel that “poopy” pressure– she didn’t like it. I broke the news to her it was only going to get worse as the baby came down, and she gave me a little stinky eye. 🙂

We got her admitted, IV in place (after a few tries) and a delivery table ready. Brad and I helped Dina stay comfortable and calm, she was beautifully working through each contraction. She liked standing and leaning best, it felt good to be out of bed and mobile.

Around midnight, the contractions got even closer and took a big leap in intensity. Dina began vocalizing during the contractions, we switched her to hands and knees in the bed and used a hot pack to help her aching back. The double hip squeeze also helped greatly. Brad was always close by to offer a kiss, gentle touch, or encouraging words. We kept Dina hydrated and encouraged her to rest in between contractions. I knew it wouldn’t be long now…

At 12:15am Dina began to feel the first “inkling” of pushing. I notified the nurse who called Dr. Miller in– she did an exam and said she was 9.5 cm already and the baby was low at +1 station! She encouraged very gentle pushes or grunting– not full blown pushing, to encourage the baby to
gently come down and to protect Dina’s tissue, which had been damaged in previous births. I helped Dina focus her energy on blowing through the contractions as much as possible– gently grunting when she felt she needed to. It was hard and intense, but Dina was doing great.

At 1am Dina’s urges became much more intense- she was still trying to resist pushing 100%. The baby was very gently coming down, easily stretching and molding. As the baby’s head moved down, Dina got scared of those sensations and we had to work to calm her down again– and to put her energy into bearing down… only she could end this. Dr. Miller encouraged her to really push by 1:30am– the baby’s head was right there. With careful guidance and control, Dina gently pushed the baby into the world at 1:38am on Thursday 8/22/13– and Brad announced… “It’s a boy!”.

I helped Dina roll over and we passed her baby to her! She was so delighted and thrilled, she started kissing and welcoming the baby immediately. August Hugo was here! She couldn’t believe it was over and she had done it! Dr. Miller helped her deliver the placenta and checked– she only had a tiny tear! Within minutes, Hugo was ready to nurse so we got her comfortable sitting up and helped him to the breast for the first time. He welcomed breakfast with vigor! Dina was exhilarated- she had done it!

Stacy had a planned cesarean birth with big brother Ethan (Breech presentation) and was determined to have a VBAC this time around. She described herself as stubborn, I saw incredible determination to the “10th” degree. She did her homework, planned, prepared, found a supportive OB group, and hired a doula. That’s me, and this is her birth story from my perspective.

Stacy called me first on Wednesday, May 22, around 9:30 pm to let me know things were happening- she had been having consistent contractions since about 4:30pm, but they were still mild and she could talk through them. By 11:30pm they were getting stronger and she anticipated wanting help. I jumped in the shower and waited, hearing from her again at 12:30am, saying “please come”.

I arrived at their house at 1am, finding Stacy propped up on a dining room chair in hands and knees. Contractions were coming frequently at 2-4 minute intervals. Daniel was working on getting Ethan to bed– it had been a rough night. I helped Stacy work through the contractions, she was relaxed and vocalizing through them. The double hip squeeze helped greatly!

Daniel “appeared” at 1:30am– Ethan was finally settled. It was Dad’s birthday today, and he had been kidding that this baby would appear on his day! By 2am, Stacy felt like things were pretty intense, so placed a call to OBGYN North and talked to midwife Siobhan, who said head on in.

We arrived at North Austin Medical Center around 2:45am and were taken directly to Room 1. Siobhan did an exam and said Stacy’s cervix was still “closed” but it was about 80% thinned, and the baby was -2 station. There was a lot of show, so Siobhan was fairly sure it was labor. We went ahead and got admitted while Stacy continued to manage the contractions with position, relaxation, and lots of vocalizing.

By 3:45 we were “fully” admitted, and it was time to get the first round of antibiotics going. Daniel looked exhausted, so I encouraged him to get a few winks– I could support Stacy for a while so he could rest, and be ready for the “big stuff”.

Siobhan confirmed the baby’s head was down via ultrasound, just to be safe, then let us labor. From 5-7am, everyone dozed in between contractions, which remained 3-5 minutes apart. Our new nurse came in at 7:30am for another dose of antibiotics (3rd one!)

Siobhan came in at 8am and wanted to do an exam to make sure all this work was getting us somewhere. She reported that Stacy was now a good 2cm, very soft, and the baby’s head was in better alignment. She was very pleased! (Stacy was not!) A whole night of work and only 2cm?

I sent Daniel out for breakfast and Siobhan allowed for a light snack for Stacy, so I made her some peanut butter crackers and juice. Within the hour the contractions spaced to 7-8 minutes apart– they were still strong but there was enough time in between them for napping. I reminded Stacy we still had a long way to go (if I had only known) and encouraged her to rest. I went to my car to nap myself.

When I returned at 11:30am, the room was quiet and everyone was dozing. Stacy was listening to her hypnobabies CD, which helped her relax.  Siobhan returned at noon, soon followed by Dr. Schmitz. At that point the contractions had spaced to 10-15 minutes apart, and Stacy was no longer in “active labor”. They recommended she go home and come back when things got busy again. At first, Stacy thought we were crazy! She couldn’t imagine going home still pregnant. But the more we talked about it, and discussed the alternatives, she agreed, home was the best place for her for now.

She ordered lunch and I packed up. She was given an Ambien prescription to help her rest, with strict orders to get some sleep. I headed out and went to sleep myself!

The contractions never went away– they remained spaced for the remainder of the day until around 9pm they started getting consistent again. Over the course of the evening they got close, then spaced again… she was in the tub a good part of the night as that helped with the pain of the contractions, however she really never got any “real” sleep. They texted me off and on, trying to decide when to head in again, not wanting to go unless it was “real” labor.

By 5am, Stacy was exhausted, frustrated, and was considering interventions- she couldn’t go on like this anymore, so they headed in. At 5:30am she was 4cm, 80% effaced, and the baby was lower at -1 station! It was good progress, and they asked me to come.

I arrived around 7am, to find Stacy on the ball, with contractions 5-6 minutes apart but long and strong. The double hip squeeze still felt the best. She was offered narcotics or an epidural and still wanted to avoid those if possible. We felt encouraged that she was finally making some headway! We talked about letting things proceed on their own vs augmenting labor and she decided she was “tired of waiting and resting”… it was time to get busy having a baby! The midwife Lisa took over for Dr. Schmitz at 8am and was super encouraging. The only sad part of the morning was they decided no more pudding, now that Stacy was in active labor (bummer).

We continued to labor, with Lisa our nurse, and her trainee Kristin. They were very encouraging and supportive of natural birth. I suggested some gentle nipple stimulation to trigger contractions. Stacy was “noticing” the baby felt lower now- all good signs.

Daniel took advantage of my presence to catch another nap– he was exhausted too. Stacy was so tired she was falling asleep between the contractions. Those endorphins finally kicked in! After a while she needed to move, so we tried “childs pose” on the bed to try to help her rest, but that didn’t feel good. We stood a while, leaning over the ball on the bed, and the contractions picked up! Stacy was using even more vocalizing and movement to cope.

Midwife Lisa could see lots of good signs of progress, so was not pushy for an exam. She wanted to let Stacy do her thing. We got into the shower- Stacy loved that! Daniel stayed with her, we tried to give them some space. The contractions were 5-7 minutes apart, but 1.5-2 minutes long- an unusual pattern to say the least, but we hoped effective at getting that cervix open!

Another round of antibiotics brought her out of the shower at 11:30am. Her back was hurting more so we put some heat on it. She was feeling a little chatty, refreshed from the shower, telling stories about Ethan. After a bit, those endorphins (and exhaustion) kicked in and she laid her head down to rest. I sent Daniel off for yet another meal and took over with the hip squeeze and heating pad.

Stacy tried another shower– that felt great! She stayed in there a while, and if she hadn’t started to fall asleep on the ball, would have stayed in there forever. She realized she needed to rest. We got her in bed, upright, sleeping in between contractions. Lisa suggested some music to help the mood– Stacy found it did help her relax.

Nurse Lisa left at 3pm and Amber took over. I did a foot massage, in hopes to trigger closer and stronger contractions. Stacy was doing fine but it seemed like she was in a “holding pattern”– I knew things needed to get harder to get her to complete.

By 3:30pm, she finally agreed to lay all the way down into a side lying position to fully rest. She was worried the contractions would feel horrible, but she did fine! She was able to effectively nap in between them for a while.

By 5pm, the contractions did slow again to 8-10 minutes apart and Stacy’s frustration appeared again. We wondered if her cervix had changed, and how much. Exhaustion was becoming a problem in the long run– how much farther did she have to go? I encouraged her to think about several “What if” scenarios to process where to go from here. What if she was still 4-5 cm dilated? (Dirty look) What if she was 9cm? What about 7cm? She realized getting that information was important at this point – although she had not wanted an exam earlier she realized it was critical now, in helping us decide where to go from here. Midwife Lisa agreed. Her 5:30pm exam was still 4cm, 100% effaced, and the baby was very low at 0 station. While it was progress, it was not a lot for 12 hours of work.

Stacy needed to shed a few tears of disappointment and frustration. We talked about options- she needed real rest (more than a narcotic drug could offer) and we needed progress. She decided an epidural for rest, and to have her water broken to hopefully augment the labor and help with progress. Lisa thought it was a perfect plan.

We got things ready– it took a while to get fluids in, and call anesthesia in, but we finally had an epidural in place by 7:40pm. It was time to rest! By 8pm, she felt like she could close her eyes and get some real sleep. I headed home for re-inforcements, a shower, and dinner… and told her I’d be back but would let them sleep. I’d be “in house” but wanted them to have privacy and quiet.

I returned at 10pm and let them know I was there, but to let me know if they needed me. Daniel texted me at 1:30am saying the last exam was the same, and contractions were 5-7 minutes apart. The baby was a little unhappy, so they were not going to proceed with pitocin. By 2:15am I received another text that Stacy was feeling pressure and wanted me there. By the time I got into their room, Lisa had already checked her and she was 8cm!! The head was coming down nicely! That’s what all that pressure was about! It was great news!

We turned Stacy over and helped her get comfortable again. The baby had one big scary deceleration at 2:45am, but oxygen and a position change resolved it just fine. After that we watched him carefully, not sure what had caused that. From 3-5:30am, it was fairly quiet and both Daniel and Stacy got some rest, while I dozed and kept the room quiet.

Amber came in at 5:45am and did an exam– Stacy was complete, but the baby was still too high to start pushing, so she said we’d just continue to “labor down” a while longer. It would most likely be the day shift who would help us with pushing. That was fine with Stacy- more rest sounded good!

We dozed more– by 7:30am our new nurse Jackie (a traveling nurse midwife from Minnesota) came in, checked Stacy and said it was pushing time! She was full of energy and Stacy needed a moment to “catch up” to her. Jackie was a VBAC mom herself, so knew how important this was to Stacy, so suggested gentle pushing so as not to stress the baby. She recognized his reserves were low and we wanted to proceed cautiously.

By 8am, we started with side pushing, gently– lots of encouragement from Jackie. Dr. Schiemenz came in (our 4th care provider!) soon after and praised her efforts– the baby was almost +3 already! We continued gentle pushing, rotating Stacy from right side to left side periodically. That baby needed time to mold and rotate– we made progress, but it was slow and gentle. Any time he acted up, we just paused and took a break. After a while, Stacy started to feel the urge to push, despite the epidural, and was having a harder time not pushing hard– she was following her body’s signals now!

Over time, the baby’s head slowly came down, we saw the first sign at 10:15am, and by 10:45 he was almost crowning! Dr. Schiemenz was super patient, offering gentle encouragement and very slight massage to encourage Stacy’s tissues to stretch. At exactly 11am on Saturday, May 25th, 60 hours after regular contractions had first started, Xavier James was born. He was placed directly onto Stacy’s belly, where she and Daniel were thrilled (and almost shocked) to finally meet him! Stacy cried with relief and joy, she had done it! Despite odds, exhaustion, and everything, she had her VBAC!

Stephanie had experienced a relatively fast and furious labor with big brother Cash. We anticipated another with Baby #2… here is her birth story from my perspective. (If you want to compare her story to mine, see her blog post!)

http://runningwithlumpy.blogspot.com/2013/01/the-full-truth-macs-birth-story.html

 

On Monday, 12/17/12, Stephanie texted me around 2am just to give me a “heads up” she was having contractions every 6-7 minutes, but they were not strong and she was going to rest. By 4:15am she texted again, saying she was getting “warm and shaky” with them– I recommended she call Nurture OB to check in, it was probably time to think about heading into the hospital. Soon after she let me know she had just talked w/ Andrea Campaigne and they were headed in as soon as Grandma got there.

 

I met them at North Austin Medical Center at 5am. They were in triage, Stephanie standing over the chair, breathing calmly through her contractions. Matt was gently rubbing her back. She said they were not awful, and she felt like she was handling them ok. She was a little worried they had come in “too early” and I assured her she looked very “labory” to me.

 

The nurse did an exam, and announced Stephanie was already 7cm dilated and 100% effaced! We were definitely not heading home. We took a long walk to room 16 and got settled. Stephanie kept remarking how much calmer this felt than last time. She really liked standing leaning over something best, and the nurses completely worked around her preferences.

 

We listened to the baby for a while… all looked good. The nurse set up Stephanie’s IV and drew her lab work. Matt was doing some quick texting to notify folks they were busy getting a baby here and would not be showing up to work today! We kept the room dim and quiet. Stephanie was doing really well– beginning to vocalize a bit to work through the contractions.

 

By 6:50am, Andrea suggested breaking Stephanie’s water if she was ready to “get this thing going”. Her contractions were strong- but probably not the transition kind yet, and still a little spaced apart. We talked about the pros/cons- how it might change labor and Stephanie decided to “go for it”. When Andrea did the exam, she said “You’re 9cm”. Stephanie was delighted to hear it- almost chatty! “Are you lying to me?” Andrea assured her no lies– she was almost there already!

 

Stephanie decided to stay in bed and rest– she was moaning softly with the contractions, almost sleeping. She started getting a little more pressure within 10 minutes and Andrea got her “baby catching gear” on… anticipating a potentially quick delivery. Stephanie kept saying “this one is so different”… we kept the room quiet/dim and were patient, waiting for her to feel like pushing.

 

By 7:35am, Andrea suggested that we do a little pushing to see if we could go ahead and move things along– Stephanie didn’t feel a strong urge but cooperated. We tried for about 20 minutes when Andrea checked again- there was still a slight lip of cervix left. She suggested getting up and laboring down a bit more and waiting for a stronger urge to push.

 

I tried to get Stephanie to sit on the toilet, but that didn’t feel good (that’s my trick to get babies down) so we labored in the bathroom, leaning over the sink, for about 30 minutes. She was feeling a little deflated- “Why did we go from pushing back to laboring?” I told her it was probably because the baby needed a little more time and space to get into the right position. We did some lunges in the bathroom, trying to make space. Soon she started getting a little “grunty” with the contractions, so I asked her to move back to the bed, just in case things moved fast. (We still anticipated a potentially quick birth!)

 

 

We got Stephanie comfortable leaning over the bed, and within minutes, she was clearly grunting through the contractions– her body instinctively pushing. We asked her to get back in bed for a delivery- she asked- “Are you sure it’s time?” I told her she was already pushing– we just needed to add to it and the baby would be here.

 

Stephanie didn’t like the idea of hands and knees, so we got in a traditional position for pushing. Stephanie requested assistance and guidance- it was hard to really hold her breath and push hard, she naturally liked to release the air as she was pushing… which would have worked ok if the baby was coming down fast. But at this point, Andrea and I suspected this baby was in a funky position and was giving mama trouble. Stephanie started doubting- was this baby every going to come? She just wanted to be DONE! She even asked Andrea to just get the baby out– and we all reassured her she was doing just fine.

 

After about 30 minutes of pushing, Andrea confirmed what we had suspected- the baby was facing up, not down. That’s why it was so much work pushing. Stephanie was definitely moving the baby down though, so we kept encouraging her. It was really hard work– “What happened to two pushes and the baby is out?”

 

Stephanie worked hard another 20 or so minutes– she was making great progress and the room started getting filled with lots of excitement. Andrea was encouraging “yes, yes, yes!” and finally we called in a baby nurse for delivery. All of us had been saying “She” and “Her” most of the labor– we kept thinking we would be welcoming Georgia. Well, as the baby came out, Andrea announced, “This is NOT a Georgia”… it was a boy! It was 9:31am on 12/17/12. And that boy came out completely OP- face up. Little George Cormac was here!

 

Mac was placed onto mom’s chest skin to skin where she welcomed him with joy! Matt was right there– saying hello to his second son! Cash had a little brother! Stephanie was so relieved it was all over and her little man was finally here. Welcome to the world, Mac!

Shelley’s note: This story is a great example of how inaccurate ultrasound can be in estimating weight, and despite recommendations to deliver via c-section, this mama had a wonderful and uncomplicated vaginal delivery at 40 weeks.

Lisa and Jason were first time parents with lots of first time questions. They knew they’d need all the information and support to help them through their pregnancy and birth. So they hired me- their doula. This is the story of their baby’s birth from my perspective.

Her pregnancy was healthy and uncomplicated. At 36 weeks she had a routine ultrasound which determined the baby to already be nearly 8 ½ lbs. Her doctor “warned” her that she was likely to have a big baby, and suggested considering planning a cesarean instead of risking a vaginal birth with complications. Lisa did her research and decided since she was no tiny person (5 feet 11 inches) she trusted her body would do what it needed to do when the time came.

The day following her due date, she started noticing contractions around 9:30am. They were mild at first, but gradually grew stronger. She contacted me at 12:00pm letting me know “We are getting some action over here”. Contractions were 5-6 minutes apart and she was easily breathing through them. They wondered if they should keep their 1:30 doctor appt that day and I said yes. It would be a good check in, and they could feel assured the baby was doing fine. She wondered if her doctor would recommend going to the hospital, so I said to pack the bags just in case. It was likely they’d be coming home, but better prepared than sorry.

At 2:20pm, Lisa texted me that she was 2 cm dilated and 90% effaced! That was huge progress since last week when she was “nothing”. So we knew things were moving along. They were doing a non-stress test and they would check in later. She was a little worried– ultrasound had measured the baby at 10 lbs 13 ounces, but her doctor said she could go ahead and “try” for a vaginal birth.

By 3:30pm, Jason called, and said things were starting to pick up. They were going to walk around a bit, get a snack, and plan to head into the hospital soon. I asked if I should join them- I heard Lisa working through a contraction, and said “Never mind, there’s my answer”. I gathered my things and headed out the door within 30 minutes.

I arrived at Seton at 4:40pm. Lisa was in bed, on monitors, looking a lot less cheerful than when I last saw her! Both her mom and Jason were by her side. She said Dr. B had checked her at 4pm and broke her water- she was still about 2cm, but the contractions were way more intense now. There was also meconium in the water, which would change our plans at the birth. I asked her if she wanted to try another position and she said yes. So we got her more comfortable on a birth ball. She was truly working- breathing and trying to stay relaxed. Jason and I offered back massages and encouraging words. She was doing great. The contractions were now 2-3 minutes apart, and felt really strong.

Lisa’s best friend came in to offer love and encouragement. Lisa was working so hard, she could barely acknowledge her presence. She and the rest of the family would be in the waiting room.

After about an hour of this, I asked Lisa if she needed to use the restroom. “I don’t know”! I suggested emptying her bladder might help, and a position change was always good. We helped her to the toilet. The contractions seemed to space a bit, but they became even more powerful. Lisa said “I don’t know how much more I can do”. I assured her she was doing great, and it was likely things were moving along well– she would not be 2cm still. “How much longer?” She did have options, if she thought she wanted an epidural it might be wise to get an exam just to see where we were. She agreed.

At 6pm our nurse called Dr. B in to do the exam- he said she was a good 4 to 5cm, 100% effaced and the baby had moved to -1 station. That was amazing progress in only 2 hours! Lisa was feeling pretty overwhelmed, and knew she still had some work to do, so opted for an epidural. Our nurse was right on it. Dr. J from anesthesia was in within minutes and easily placed the epidural. Jason and I were able to provide support and stay by Lisa’s side. As the epidural took effect, each contraction felt a little less intense. Within 30 minutes, Lisa wasn’t feeling them at all!

We got her settled laying down, and she couldn’t say enough good things about that epidural. She became an endorsement! She was so relieved to have the pain taken away. She could smile again! Dr. B said “Now you can enjoy this labor. It’s still going to be a big baby”. Our nurse got the urinary catheter in place– that’s when we discovered the poor positioning of the large room mirror. Luckily, I had my handy dandy scarf to help cover up things Lisa did not want to see.

Lisa felt ready for visitors, so Jason went to get the family. Lisa’s mom and dad, and brother and sister in law came in to offer love and comfort. They were curious how the epidural was working, and all the machines and monitors. Everyone was so excited to meet this baby! Lisa asked how her first “baby” was doing– their trusty hound was safe and sound and well cared for. Lisa got a little emotional just thinking about him.

Friends came in later, and Lisa greeted them with “Epidurals are amazing”. They were glad to see her pain had been taken away, and said they’d be in the waiting area. “We’re here”.

By 7:30pm, things settled down. Two new nurses took over and I encouraged Lisa to take a pause and rest. Her pain was gone, but she was still in labor. It was important to stay connected to her baby and body. Jason sat close by, stroking her arms and legs while I stroked her hair, helping her relax. I warned her- there would be little sleep after this baby came!

I gently rocked Lisa’s pelvis back and forth- it felt good and it would help the baby find his way. Around 7:45pm we turned Lisa to her other side- to keep the epidural even. Lisa was lucky- the only unpleasant side effect she had from the epidural was the shivers. All else looked great.

By 8pm, Dr. B came in again to check on Lisa’s progress. He gleefully stated she was 9cm now! Holy Cow- that was amazing. No wonder she was hurting so bad before- another 4 cm in only 2 hrs! She was really rocking and rolling now. He reminded her she still had work ahead of her- getting to 10cm was only the first part. He still was worried about a big baby. “But you’re tall”. He liked tall women. They get babies out well.

We continued with the pelvic rocking while Jason updated the “fans” in the waiting area. They started making bets about when this little guy would come and his weight. In the back of everyone’s mind was that ultrasound– how big would this baby be?

I gave Lisa a pep talk. There was no reason to be worrying about his size. Either he would fit or he wouldn’t. And if he didn’t– we knew what to do. She could have closure even if she ended up needing a c-section, knowing she had “tried”. We waited and rested some more.

Dr. B came back at 8:40pm and said “Let’s check you again. I bet you’re complete”. Sure enough, she was. He said “Let’s start pushing!”. Lisa and Jason looked shocked- how could they have come so far in such a short time? Only 4 ½ hours ago she was only 2 cm? It was crazy to think about.

It took the nurses a few minutes to get things ready for pushing and delivery, so we let Lisa rest while I gave the fans an update again. I Lisa’s mom asked what I thought- if the baby was too big and I told her “She’s gonna push this baby out”.

When I got back I gave Lisa my quick pep talk on pushing- positioning, strategies, and getting down to business. Pushing with an epidural is different– we’d be relying on the nurses to help us know when she was having a contraction and would need their guidance on how. At 9pm, Lisa started pushing and it seemed she got the hang of it pretty quick. “I’m pooping”. The nurses and I assured her that was a good sign that she was actually pushing correctly– it was ok. Poop happens.

Lisa kept pushing, and we began to see glimpses of the baby’s head within just a few minutes! The nurse said “This isn’t going to take long”. Lisa asked- “What’s happening down there?” I said “You’re moving your baby down!” and she gave me a look of almost horror and disbelief. We got a mirror so she could see- and she was amazed!!! At 9:20pm the baby’s head was almost crowning and the nurse said “STOP!” It was time to call Dr. B back in.

The whole “baby SWAT team” entered the room– with meconium present in the water, we had to have a team ready to care for the baby in case he needed help. Lisa gave it one more good push and the head was out. Another push and the rest of his body followed at 9:26pm — no complications or difficulties whatsoever. He was indeed a large baby– but I doubted he was an 11 pounder.

The baby let us know he was ok immediately with his vigorous cries. They cut the cord and took him to a warmer where the pediatric nurse looked him over. They didn’t even have to do anything. He was fine. They did a quick weigh– he was a mere 9 pounds even!

The baby was brought back to Lisa and placed on her chest skin to skin– she was so happy to hold him! She started crying, so happy it was all over and her baby was finally in her arms. Jason was close by, admiring his son– I took pictures so they could focus on enjoying the moment. All the craziness and intensity of the day finally faded. Their “Ten lb 13 oz” baby was finally here!!

Teresa had an uncomplicated vaginal delivery with first child Joe (which I had attended), but had ended up with a cesarean with second Issac- who was a full 2 pounds bigger. Most involved thought “he was just too big for her”. She consulted with her doctor who advised her to attempt a Vaginal Birth After Cesarean this time, being a safer option for both her and the baby. Teresa knew she’d need extra help and support, so hired me to be her doula again.

 

Her due date came and went- and Teresa began to get a little worried about approaching the Thanksgiving holidays, and going too far past her due date. We knew she was already 3 cm dilated, so hoped labor would start soon!

 

Monday night the 19th she noticed some light contractions, but went to bed. They were mild and not enough to keep her awake. Around 1:30 or 2am she awoke with contractions close- 2-4 minutes apart, and much stronger. She called me at 2:30am and said they were headed in. I reminded her to call and let Dr. Mingea know and I’d meet them there.

 

I arrived at St Davids Medical Center around 3:30am. Our nurse, Shelly had gotten Teresa settled in bed, and on monitors. Teresa was still smiling between the contractions, but when they came, she was having to work through them. I encouraged her to relax and breathe. Shelly did an exam at 3:40am and said she was already 6cm, 100% effaced, and the baby was -2 station. That was a great start! Contractions were 2-3 minutes apart. Teresa indicated she did want an epidural. Shelly said as soon as they could get her admitted and fluids in her they could do that.

 

In the meantime, Shelly notified Dr. Mileur, who was on call for Dr. Mingea. We started consent forms, and drew blood work and set up an IV. Shelly notified us that the hospital required an internal monitor for VBAC patients, indicating Dr. Mileur was on her way to break her water and insert that.

 

At 4am, Dr. Mileur came in, broke Teresa’s water and inserted the scalp electrode. She also checked her cervix, and called her 7cm– wow, things were progressing! Now that her water was broke we knew things had the potential to move fast, so Shelly made sure fluids were going in quickly, and called the lab to get her results as soon as possible. In the meantime, I helped Teresa stay calm and focused on getting through the now more intense contractions.

 

Teresa had had an epidural with both of her previous labors, and had issues with her blood pressure dropping each time. This was a concern again. We re-iterated we needed to get a whole bag of IV fluids in her before getting an epidural on board to try to prevent that. We got forms signed, and waited. Teresa began to ask “how much longer” and both of us reassured her it was coming. She needed to continue to do what she was doing– she was managing her contractions beautifully.

 

Anesthesia came in around 4:20am and the epidural was in place by 4:35am. We helped get Teresa comfortable laying down and waited for the medication to take effect. Teresa said the contractions were beginning to feel less intense already. Travis had been watching all this from the corner!

 

By 4:45am Shelly insisted on getting a catheter in place– Teresa had a lot of fluids and they needed to keep her bladder empty. While she did that, she also checked her cervix– 8-9 cm now and the baby was lower at 0 station. We couldn’t believe things were moving along so well! It looked like we’d have a baby before the night shift was even over!

 

 

 

Once things settled down, I dimmed the lights and encouraged Teresa to rest. She was not completely comfortable from the epidural yet, still having to breathe through the contractions. We tried rolling her to her side to see if that would help. She had been battling nausea off and on- could have been part of labor, also a common side effect from the epidural. Peppermint oil seemed to help. Her blood pressure was lower, but not low enough to be worried, and the baby looked great. Both Shelly and I assured her things looked fine, but she still felt crummy. We helped her with cool washcloths, and gently fanning her as she got hot flashes.

 

Travis headed out to grab a coffee. He had been a quiet observer during all this! We asked about names– they had a few in the works, but nothing confirmed. Waiting to see what the baby looked like!

 

By a little after 5am, Teresa was still having “too much pain” so we pressed her bolus button and rolled her over again. It was possible getting an epidural so late in labor that it would not have time to take effect completely– I encouraged her to close her eyes and rest, at least in between the contractions. Her being worried about her blood pressure and the epidural wasn’t helping things!

 

By 5:25am, Teresa stated she had “constant pain” and wanted to be checked. Shelly said she was completely dilated now, and the baby was even lower at +1 station. She felt it would be a good idea to wait til the baby moved down even farther, so suggested “laboring down” for a while. Baby looked good- and it gave Teresa a chance to rest.

 

Teresa’s blood pressure continued to drop slightly but the baby was never affected. We tried to keep her comfortable with peppermint, cool washcloths, and fanning. She felt very uncomfortable and a little scared. Shelly even stayed with us to reassure her that all was well. I helped her visualize welcoming the baby, or a safe wonderful place in her head– trying to help her get her mind off the epidural side effects.  Her pain levels seemed to diminish and she rested finally.

 

Travis hung out in the rocking chair. I encouraged him to take a quick nap too- he was too wired at this point to sleep, enjoying his hospital coffee which was “not as bad as he thought it would be”!

 

By 6am Shelly checked again– The baby had shown signs on the monitor that she was getting some head compression, a good sign. She had moved down nicely and we could start pushing! She notified Dr. Mileur.

 

At 6:10am we took our first “test push”. Within a couple pushes we could see quite a bit of the baby’s head! Shelly called Dr. Mileur in, who arrived at 6:20am. “Show her what you’ve got!”. Teresa got the hang of pushing quickly– she was really moving that baby down. Things were looking great! Staff quickly got ready for delivery– Lots of cheering and encouragement as Teresa brought that baby right on down. Helen Grace was born at 6:44am on Tuesday, November 20, 2012, after only 30 minutes of good pushing! She was placed immediately onto Teresa’s chest skin to skin, where she settled down. We covered her with warm blankets and let mother welcome her daughter. Travis was close by– we were so happy to have her here already!

 

We all started making bets on her weight– she looked like a good size baby. Would she be as big as her brother? She had 8/9 Apgar scores– she looked perfect. Dr. Mileur reported that Teresa had some tears that would require some stitching, so we just hung out skin to skin for a while. Teresa enjoyed snuggling with her new baby girl– announcing her name officially. The nursery nurse came in and offered to weigh her– we were all curious. She was 8 lbs 14 oz– exactly the same size as Issac who was born by cesarean!! Teresa had done an amazing job of bringing Helen into the world with love, joy and gentleness. Congratulations on a successful and beautiful birth!

 

How does a doula really make a difference?
Results from different studies have all suggested that having a doula reduces the overall cesarean rate by 50%, Pitocin use by 40% and requests for epidurals by 60%. The use of a doula also showed a major reduction in the length of labor due to fewer stress hormones being produced in the laboring woman’s body.

The Doula Book © 2002; Klaus, Marshall, Klaus and Kennell.