Sherrie and Chris were typical first time parents– excited and nervous to welcome their new baby girl. Chris’ sister had strongly recommended they hire a doula to help them through the journey, so that’s where I came into play. We met several times before Sherrie’s due date, making plans, learning, planning, and preparing for the big day.

It was Thursday night, 6/2/11 around 6:15pm, when things first started. Sherrie texted me to let me know her water had broken. She had notified Dr. S, who said it was ok to stay at home until contractions were 5 minutes apart, or by 8am, if contractions didn’t get that close. I advised Sherrie to get some rest, since she was only having mild contractions every 10 minutes when we spoke at 8:30pm. She was so excited!

Friday morning I received another text at 7am stating nothing had changed much, and Sherrie and Chris were heading into the hospital to get labor going. I told them I’d meet them there.

I arrived at 8:30am, running into Chris as he headed out to the car. Sherrie was settled into a room, and was on monitors in bed when I arrived. She had experienced some stronger contractions overnight but they had died down this morning. Lisa, a midwife, was on call for Dr. S, so she came into the room to introduce herself, and to see if it was ok with Sherrie to use Pitocin to augment her labor. Sherrie was ready to get things rolling, so gave permission.

Lisa did an exam to see where we were starting… at 8:55am, Sherrie was already 2-3 cm dilated, 70% effaced, and the baby was -3 station. It was a huge improvement from Tuesday’s exam, when she was still closed! All those overnight contractions had done their job. It was a great start.

Our nurse, got the IV set up and began a very slow Pitocin drip. By 10am, Sherrie was feeling the contractions a little stronger, still nothing “difficult”– they were 5-7 minutes apart, so she was just resting. Chris’ parents were on their way, bringing all the “forgotten” supplies, including her Boppy!

By 11:30am, the contractions were 3-4 minutes apart, and getting more challenging. Sherrie was beginning to have to “relax and breathe” to get through them. She reported they were still very manageable and she was doing great! The Dads decided to step out to get a bite to eat– a good distraction.

At noon we set Sherrie up on the ball, leaning over the bed. It felt good to get out of bed for a while and have her back massaged. The French Open was a good distraction, with family chatting. The Pitocin was up to 10ml, and Sherrie had a good contraction pattern going, so they decided to hold there.

Around 12:30pm, the contractions started getting more intense, and Chris’ Mom decided it was time to “give us some space”. They headed to the waiting room. Sherrie announced “This isn’t fun any more”. Chris laughed– but it was clear she was now working hard. It became apparent why we use the word “labor” to bring babies here. She liked standing, leaning over the bed, using her breathing and relaxation to get her through the tough contractions.

At 1pm, after a restroom break, Sherrie declared “What’s the game plan?” Chris again laughed– “I think we are still on to have a baby!” Sherrie was beginning to feel exhausted, from a nearly sleepless night, and the contractions were clearly “no fun”. She was ready for a new position, as she needed to rest. We tried the rocking chair with her feet propped up and a neck support pillow– good. She was able to rest well between the contractions. “I know you told me not to forecast, but how much longer do you think I’ll be doing this?”… I reminded her to stay in the moment, one contraction at a time. There’s no way anyone can know how long it takes to get a baby here.

Something changed, because Sherrie stopped worrying, and really dozed between contractions. The contractions even spaced out a bit, giving her a little more break between them. We had soft music in the background, the lights dim, helping her be able to really relax. Her endorphins kicked in, making her feel sleepy and lightheaded– I assured her that was ok, and good! Those endorphins help those contractions feel more manageable. “Just keep doing what you’re doing”.

By 2pm, Sherrie was ready for a change again. I suggested hands and knees over the bed to relieve some back pressure. We were able to get her all propped up and comfortable. Lisa popped in for a quick check– everything was looking good! She was pleased to see Sherrie in active labor.

Chris stayed by Sherrie’s side, encouraging her as she worked through the contractions. She inquired about possibly taking some pain meds just to “take the edge off”. I told her they were absolutely available whenever she was ready. All we had to do was notify the nurse. Sherrie didn’t bring it up again for a while– she continued to work through the contractions, resting in between. By 2:30pm, she decided she needed a little help, and asked to speak to the nurse about a narcotic. She suggested a vaginal exam, just to make sure we weren’t really far along– you never know! She reported Sherrie was now 3-4 cm, still 70% and the baby was coming down. Sherrie was disappointed– “That’s all?” I reminded her it was normal to have slower progress in the beginning. “Don’t worry about the numbers”.

At 2:45pm, the nurse administered a dose of Stadol to help take the intensity away… We got Sherrie comfortable resting in bed. Chris went out to update his parents. Dad was away, checking on the house and big “canine” brother at home. I chatted w/ Mom for a while– she was praying. “Doesn’t she want to take the epidural?” I reminded her that Sherrie knew it was available to her at any time, and that her original wish was to go as long as she could without it. She was doing great and we needed to trust she’d do what she needed to get through this labor.

By 4pm, Sherrie had slept well between the contractions, but awoke, needing to use the restroom again. The contractions were feeling strong again… she need a lot of help and Chris was right there. She had a big surge of her own oxytocin and had 6 contractions in a row, with hardly any breaks! They were now 1-2 minutes apart, lasting 60 or more seconds. She was overwhelmed. We talked about having the nurse turn down the Pitocin, since it seemed obvious her own body had kicked into high gear. Sherrie was ready to “throw in the towel” so I called the nurse in to talk about an epidural.

By 4:40pm, Sherrie officially made the decision to get an epidural. The nurse started IV fluids and arranged for it’s administration. Anesthesia came and talked to Sherrie briefly, then began the procedure. It took a few minutes, and Sherrie was scared. Chris sat right in front of her and held her hand, talking her through it. She did great, and by 5:15pm, the epidural was in place. It took a while for the medicine to take effect, so Sherrie had to continue to use her breathing to get through the contractions. Chris put her relaxation music on again in the background which really helped. By 5:25pm, Sherrie was still fairly uncomfortable, so the anesthesiologist gave her another dose. By 5:35pm, she was hardly feeling them. She welcomed the break!

Our nurse finished getting things settled, got a urinary catheter in place, and we got Sherrie comfortable. I encouraged her to get some sleep-we still had a ways to go, and she would need her energy for pushing! I encouraged Chris to get a nap too, but he was way too wound up– I couldn’t convince him to close his eyes! He grabbed a Diet Coke and went out to visit with his parents, who were still diligently waiting in the waiting room.

Once Sherrie’s pain was taken away, she was suddenly aware of my needs– “Don’t you need a break, do you need to get some food?” I laughed, reassuring her I was taking care of myself, and not to worry one bit about me. She needed to focus all her engery on just getting this baby out.

Lisa came in at 6:30pm and did another exam– Sherrie was 7cm, thin and stretchy, and -2 station! Well, no wonder she had been hurting so much– she had really made great change since the last exam at 2:30pm. Lisa encouraged us to keep swtiching Sherrie from left to right, helping the baby continue to move down. Everything looked great. I encouraged Sherrie to keep resting! We hoped it would not be long now…

I took a break and went to visit with Chris’ parents in the waiting room. I gave them the good news, things were moving along!

I returned at 7:30pm, with Sherrie resting, Chris working on his John Grisham book. Andre Boccelli sang in the background. Our night nurse helped get Sherrie’s bed linens freshened up. We talked about what pushing would be like… would this little girl come today or on her due date, tomorrow? I said I thought there was a good chance it would be today, but only she knew…Lisa the midwife had predicted it would be in the “wee hours” of the morning– I hoped she was wrong!

At 8:45pm, Sherrie began to feel the contractions again… they were uncomfortable enough I had her press her “bolus” button, which gave her a little more medicine. Sherrie was a little shaky and there were mild decelerations in the baby’s heart rate with the contractions— all a good sign that she was getting close.

We continued to flip Sherrie back and forth to keep the medicine even, and to help the baby move down. The was getting more and more uncomfortable with the contractions, so I encouraged her to keep pressing her button. Chris livened things up with some reggae music! Sherrie was feeling good enough to allow Chris to take a picture, and to check her messages… she wondered who Chris had updated, friends and family would be wondering what was up!

At 9:30pm, Sherrie got a bad case of the shakes again– very common for late labor. I rubbed her arms and back, and helped her do her slow breathing, which helped. I assured her this was all ok and normal and a good sign labor was progressing! I hoped she was close to being fully dilated.

At 10pm, Lisa came in to do an exam– she was excited to report Sherrie was 9cm, 100% thinned, baby was in the perfect position and now 0 station! That was amazing progress! We were so excited and reassured things were getting close. We were finally on the home stretch! Lisa really liked the reggae music and did a little jig on her way out. Hopefully we’d be pushing a baby out soon.

At 11pm, it was finally time to talk names– Chris and Sherrie had both liked Isabela but after finding out it was the number one girl name for 2010, they decided against it. This baby’s name was “unreleased” still–

Sherrie was getting a little nervous about what was to come– pushing and delivery was sounding scary. I sat with her, describing how things would work, and reassured her that she’s come this far, surely she can finish this job. We would be right by her side, helping her along the way.

It was late– it was looking like it was going to be a while before we’d meet a baby. Chris decided he needed to send his Dad home one more time to check on the dog… it had been a long day for everyone. Sherrie was getting another little nap, which was great. She still had work to do! At this point, it was looking like she’d be born on her due date, 6/4/11 after all!

At midnight, I helped Sherrie roll over again, keeping her moving helped keep the epidural even. There was lots of shivering– more signs she was getting ready to deliver. She popped up, said she’s going to win the bet guessing the right date! We teased her– had she made it a long day today purposefully just to win the bet?

It had been a couple of hours since the last exam. Sherrie was not feeling any pressure or different sensations, but I was sure she was complete. I told her they were probably letting her “labor down” knowing the baby needed to get lower before they would have her start pushing. We were just waiting at this point for her to get the “feeling” like a baby was right there.

At 12:30am, we officially got our 3rd night nurse! I asked about when they would do the next exam, it had been nearly 3 hours since she was 9cm. She said the midwives usually do their own exams, but she’d check in with Lisa to see what she wanted her to do. She agreed, it had been plenty of time. I was worried about Sherrie losing her momentum, she had slept a bit, but wasn’t really resting well anymore due to the extreme shakes… if she was ready to push I wanted to get her going.

The nurse returned and did an exam at 1:15am, finding Sherrie completely dilated and the baby had desscended to +1 or +2 station– we were ready to push! She would check in with Lisa and let her know. Lisa came in, had just dozed off, so wanted to grab a cup of coffee and would be back. We started pushing without her, excited to get things going! Sherrie started on her side, and was making great progress. We moved her to her other side for a while, then to her back… it seemed that the baby was slowly but gently making her way down. As time went by, we saw more and more of her head, a lot of black hair! Chris stayed by her side, coaching and urging her on, to push more and more. Chris put on some good 80’s music for energy and inspiration, and we wondered which song would the baby be born to?

Finally, around 3am, we could see that head wasn’t sliding back at all… and I knew delivery was imminent. They had already brought in a team for support, and were completely ready. Sherrie pushed one more time, and at 3:05am, Naomi Christine entered the world. First her head came out, then her arm, it looked like she was waving at us! Then the rest of her emerged, and she was placed directly onto Sherrie’s belly where she welcomed her! Chris was right there too, amazed that his daughter was finally here!

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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.