Toby and Dana eagerly awaited your arrival– they had done their homework and prepared for as natural birth as possible. On the morning of 7/18/12 Dana thought her water broke around 3am, so the day was spent trying to get Dana in labor, including an acupuncture visit to Melissa Light, anticipating a medical induction by 3pm if they were unsuccessful. Family drove in, expecting a baby soon! Finally they ended up in the doctor’s office and were told her water was NOT broken, and were sent home. Although both of them were disappointed, I reassured them this was good– they had wanted to labor at home anyway, and a medical induction would have been a whole different experience they were hoping to avoid.

Melissa’s magic kicked in later that day…Dana’s real labor began around 5pm with strong contractions– she tried to rest initially but the contractions proved to be too strong to sleep through. They were still sporadic at the time, so they waited. Toby called me around 9:30pm to inform me they were getting more consistent, roughly 3-5 minutes apart, and stronger, and they were ready for support.

I arrived at the their household around 10:15pm. Toby instantly apologized for this being a late night event, to which I laughed. “Most births happen at night, that’s just how it goes”. Dana was sitting upright in bed, quietly breathing through the contractions, which were getting even stronger and closer. Dana’s mom was there too– Cindy, offering comfort and love. Ocean waves played in the background, and Toby encouraged her to relax and let go with each contraction. It was obvious Dana was working hard. I felt her uterus and those contractions felt moderate to strong– it sure seemed like things were moving along!

We labored like that awhile. Dana used the restroom… getting around was getting harder. She liked standing leaning positions and sitting upright best. Those contractions were getting closer to 3-4 minutes apart by 11pm. After she used the restroom, they seemed like one after another, so I suggested we may want to consider heading into the hospital. The way she was acting, it was good strong active labor. Toby put a call into the doctor and we waited for a call back. Meanwhile we got the car packed up. By 11:40 the caravan was on the road to Seton Medical Center.

We arrived about midnight and got Dana up to Labor and Delivery. Cindy and I stayed with her while Toby moved the car. Analisa was our nurse and she got Dana on the monitors. Contractions were now every 3 minutes and strong. We began some of the paperwork– Dana didn’t like it! Scary! Due to the active labor pattern, Analisa wanted to do an exam sooner rather than later. Sadly, she reported Dana was still only about 1cm, 70% effaced. Dr. Hansen was on call for Dr. Bushart and really did not want to admit Dana, since it didn’t appear she was in active labor based on her cervix. We talked about the possibility of there being scar tissue on her cervix, which causes this type of labor– all the signs of labor progressing without cervical change. I said Dana was acting more like 5-6 cm, not 1cm, and to not give up. Her cervix would give in eventually. We decided to stay for a couple hours and see what happened. They would check her again then. Toby could not believe they would even consider sending her home. Analisa agreed– so we kept our fingers crossed the next exam would be good news.

Dana continued to work with her labor, mostly sitting upright in bed. I told her to “be 7cm in her head”, to welcome the surges as they came. At 1:30am, I walked to the visitor restroom and found the Fan Club all in the waiting room! I assured that all was good– baby looked wonderful and mom was hanging in there. Of course, we were disappointed she was only 1cm, but we were taking it one step at a time.

Dana was fighting nausea off and on. The peppermint oil helped. The contraction intensity was building and Dana was doing a great job of managing them. Toby had the ocean waves going again. The room was dimly lit and quiet. Dana continued to have good signs– mucous and bloody show. We felt encouraged!

At 2;45am, Analisa did another exam– she said she was now 2cm and 80% effaced. She could feel a “tight band” of tissue in the cervix and tried to work on it… it was very uncomfortable for Dana but we hoped it would help move things along. The good news was there was cervical change, so the hospital could officially admit her. Yeah! Surges were coming every 2-3 minutes, it was crazy to think we could have been sent home. Analisa began the admission process, which meant more forms and getting the saline lock set up.

By 3:30am, Dana was battling nausea again, and finally gave in. She felt better after that for awhile… She remained in her “throne” position. I suggested position changes, or alternatives, but she really was most comfortable like that. Exhaustion was beginning to set in, so we encouraged her to rest as much as possible.

At 4am, I stepped out again to use the restroom. More Fans were in the waiting area! I convinced them it would be awhile, and I strongly advised they consider getting some sleep. A baby wasn’t going to “fall out” anytime soon, so I turned out the lights and told them firmly to go to bed. No one argued with me!

Dana took another restroom break too and we saw more bloody show– great news. We tried standing leaning over the bed for a change in pace, but Dana was just too tired, so we ended up sitting in bed again. All of us were feeling the effects of a long night, so we all dozed between surges.

Around 5:15am, Dana wondered when her next exam would be. What if she was still 2cm? I encouraged her to keep an open mind– it was hard to know when her cervix would “give in”. Her uterus was doing all the right work, and she needed to trust her body. We discusses options– breaking her water, pain medications, and an epidural. All those options were available to her whenever she wanted.

Analisa did another exam at 6:15am and reported Dana was now 3cm and 100% effaced. So we were making progress, just very slowly. The cervix had begun to move more forward, which was also good news. She predicted once that band finally let go, it could be fast. We just didn’t know when that would happen.

I convinced Toby to take a break at 6:45am. He headed to get his sweatshirt from the car. Dana and I tried a sidelying position, to help her get more rest between the contractions, but it was just way too intense. We moved her back to the “throne” where she stayed. At 7:15am, Rachel took over for Analisa. We talked about getting some IV fluids to help– Dana had not been able to keep much down over the course of the night and it was likely she was dehydrated. She would probably feel better and her labor could become more productive if her body had what it needed. She agreed. At that point, she had been in labor about 14 hours. Rachel offered something for the nausea, but Dana declined. Dr. Cosantino was on call, and we again talked about options– Dana decided on a dose of an analgesic to help her relax and reduce the pain. She received that around 7:30am. It did help calm her, and helped her relax. It was a quiet, peaceful morning.

8:20 am Dr. Bushart stopped by. He was not on call for deliveries that day but would check in when he could. He did recommend considering having the water broken to “stir things up”… with a warning that those contractions would be even more intense after that was done. That was a little scary for Dana to think about– she was feeling pretty much maxed out at this point and could not think about doing even more. She started considering if an epidural would be the right choice for her at this point, even tho she had previously felt strongly about not getting one. She and Toby went back and forth, talking about the risks/side effects… I mentioned that sometimes when the benefits of an epidural begin to outweigh the risks/side effects, that’s when a mom needs to consider it. At this point, Dana had been in labor about 15 hours, and it wasn’t looking like we were close to having a baby. She used the restroom one last time and had a few tough surges. That was when she decided she was DONE and needed some rest and relief. So we called in an order for an epidural.

Anesthesia came at 9:20am – the epidural was easily placed by 9:35am and Dana began to feel it’s effects almost immediately. The contractions began to feel less and less painful and within about 20 minutes she could not feel them at all. I encouraged Toby to go get a bite to eat and to update the Fans. Of course they were all thrilled Dana had chosen to get some rest. She was feeling much better, and even a little chatty! I reminded her firmly that although she felt better, this was a critical time to sleep– we still had a long day ahead of us potentially and pushing was still work.

At 10:20 Dr. Cosantino arrived and offered to do an exam. He said she was still about 2-3 cm, very thin, and the baby was still a little high. He broke her water with a small needle so that there was just a gentle leaking, so that the baby could come down. At that point, all we could do was wait.

Dana, Toby and I dozed through the last morning. Rachel came in saying the baby was having some “telltale signs” of moving down and she wanted to check her– great news, Dana was 5-6 cm and the baby had come down to -1 station. We were all so relieved to hear there was good change! We helped clean Dana up (she had leaked a LOT of amniotic fluid!) and got her comfortable on her other side. Back to sleep.

Buzz popped in for another visit around 1:30pm. He offered encouragement that things were moving and assured her she had chosen the right thing by getting an epidural. Dana ready to head back to sleep. Toby put in an order for a smoothie for lunch while I quietly munched on my sandwich. Cindy delivered the smoothie and stayed for a quick visit– offering love and encouragement!

By 2:50pm Dr. Cosantino came in– he had noticed a few more decelerations on the baby and wanted to check and make sure they were due to head compression, not a problem. Sure enough, Dana was now 8cm and 0 station. She was making great progress now! There was light at the end of the tunnel– he’d wait for another couple hours for an exam, but felt very reassured things were moving along nicely.

We continued to rest off and on the rest of the afternoon. We went through probably 4 nurses over the day– finally getting Marty at 5pm, who promised she’d be “ours” til she left at 7pm. About then Dr. Cosantino arrived and said Dana was almost there– just a slight rim around the cervix and now +2 station! He wanted to give it a little more time and wait for Dana to feel more pressure, indicating it was time to push.

I recommended to Toby he probably should go grab some dinner. He placed an order and visited with the Fans. Cindy and Lillian came into offer love and support– they were so proud of her! There was finally laughter and joy– it had been such a long night/day. We new baby would be here tonight for sure. We hoped she would have the baby before shift change– they really liked Marty and were tired of the “revolving door” of nurses.

At 5:50pm, Dr. Cosantino came back to check again– helped push back that last part of the cervix and called her complete and +2. Time to start pushing! We did a little “pushing pep talk”– I explained that because she had an epidural, things would be different than we had planned. She was not feeling the urge to push, so she’d have to follow our lead on when. Her legs were pretty numb too, so we were limited in positions. Dana worked really hard, giving it all her might. The baby was making progress– just taking his time, like most of the day. We reassured Dana she was doing great, it was just going to take a while. The good news was, Analisa was back on and was our nurse at 7pm– although we were sad to say goodbye to Marty, at least we welcomed a familiar face.

Analisa and I started getting creative to help Dana’s pushes become more effective. The tug of war game worked great! It was exhausting, but each time she did it, we could see real movement. Even Dr. Cosantino was impressed with the strategy and held the sheet for a push! He seemed to enjoy getting into the game. It took some time, but by 8:30pm, the baby’s head was getting close and the staff prepared the room for delivery. The birthday party was called in– lights, camera, action!

Finally, after over 24 hours of labor and almost 3 hours of pushing, Harlan Cash was born at 8:54pm on 7/19/12… after a brief moment to let the cord pulse, his cord was clamped and he was placed onto Dana’s belly for skin to skin. Dana and Toby fell in love instantly! They were so glad he was here– it had been such a long day. Dana was so glad it was OVER! (Although I reminded her– it was actually just beginning.)

Toby and Dana just admired Harlan’s face while I captured those first moments on the camera. It was quiet, peaceful, dimly lit– just what they had wanted to welcome Harlan into the world. We knew the Fans were waiting outside, but after such a long haul, Toby and Dana deserved a few moments together, as a family, to just cherish the moment. Welcome Harlan Cash!

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Does a doula really make a difference?
Families report having a postpartum doula improved breastfeeding outcomes, increased their confidence as parents, helped them get better sleep, and improved their emotions, including reducing symptoms of depression and anxiety.